Is the Department of Veterans Affairs conspiring to strip veterans of needed health care options? According to a leaked internal report, yes.
This VA “Red Team” report was commissioned by the Veterans Health Administration to strategize how to steer more veterans into VA-run facilities instead of independent, or “community care” providers. It’s a nefarious move from a VHA worried about competition.
Community care, established via the VA MISSION Act, requires giving veterans the option to use their health benefits for care outside the VA when drive and wait times for care at VA facilities are too long. It’s a popular program that has been a gamechanger for millions.
But the VA has a budgetary interest in veterans choosing VA facilities.
Through documents like the Red Team report, the department is coming up with ways to ensure veterans’ choices are limited.
Despite editorialized reporting on its existence, the Red Team report itself was not widely circulated. Neither the House nor Senate VA Committees could get a copy despite multiple requests. Fortunately, Empower Oversight, a government accountability watchdog organization, released the full document. The report’s recommendations tell us why it’s been so under wraps and only seen by those friendly to gutting choice.
First, the report suggests using telehealth to cut off veterans’ access to community care. Right now, when the VA can’t offer veterans care that is nearby enough or soon enough, veterans can use community care instead.
The Red Team report suggests using shorter virtual appointment wait times to allow the VA to claim that it is “providing timely care” and to deny community care referrals. Telehealth is a useful innovation but shouldn’t be used to eliminate veterans’ choices.
Second, the report recommends the VA approve fewer community care appointments for veterans across several treatment areas to “mitigate” (read: cut) costs, including emergency care, mental health care, and oncology.
Apparently, timely, quality veterans’ care for ER visits, cancer screenings, and PTSD treatment are less important to the VA “Red Team” than prioritizing the VA.
Finally, the report suggests “repatriating” (read: choiceless transitioning) veterans undergoing treatment plans at community providers back to the VA system. If veterans like their community care, that’s just too bad. The VA only cares that they keep veterans in their own system.
VA Secretary Denis McDonough recently doubled down on efforts to limit community care access in a House VA Committee oversight hearing, bringing to fruition his earlier statement “my hunch is that we should change access standards” to make community care harder to get. (RELATED: BARR: Despite Robust VA Budgets, Many Vets Still Have Difficulty Obtaining Disability Assistance They’re Entitled To)
Are you concerned yet?
I’ve worked at the VA, in the White House, and in veterans’ health care policy for decades, so I know bureaucratic scheming when I see it. This report scares me, not only because of the secrecy and intention to skirt the MISSION Act, but because veterans are the ones paying the price.
The community care program is wildly popular. In April, Secretary McDonough testified that last year VA facilitated 47 million community care appointments, 5 million more than the in-person appointments the VA scheduled at its own facilities. Demand for community care has grown 15-20% per year. Nearly 40% of VA’s “total care workload” was delivered through community care last year.
A program doesn’t grow that much by accident. The Red Team report stated that long drive times, unavailable services, and long waits were the main reasons veterans turn to community care.
Veterans are voting with their feet, and the VA can’t stand it.
In the wise words of former VA Administrator General Omar Bradley, “we are dealing with veterans, not procedures; with their problems, not ours.” That sentiment should guide VA’s decisions.
Congress cannot stand for a VA that blatantly undermines the choices the MISSION Act provided veterans. House and Senate leaders must prioritize oversight and investigations into what VA is doing under the surface to promote itself at the expense of those it serves.
They should also prioritize swift passage of Sen. Jerry Moran’s Veterans’ HEALTH Act and Rep. Mariannette Miller-Meeks’ Veteran Care Improvement Act, which would write into law standards by which veterans can access community care so the VA is not able to skirt and rewrite regulations behind the scenes.
Veterans deserve nothing less.
Darin Selnick is a senior advisor for Concerned Veterans for America and an Air Force veteran. He served as veterans affairs adviser on President Donald Trump’s Domestic Policy Council and as a senior advisor to the VA secretary.
The views and opinions expressed in this commentary are those of the author and do not reflect the official position of the Daily Caller News Foundation.
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