Across Four Fronts, Big Changes in the Works for Veterans

Across Four Fronts, Big Changes in the Works for Veterans
U.S. Air Force photo / Sean Kimmons

There were four notable news developments for military veterans in Washington, D.C., this past week, potentially impacting:

  • How the Department of Veteran Affairs will be led over the next few years
  • How the House will deepen it oversight role as the VA fields a new electronic health record system
  • Whether 90,000 “blue water” Navy and Marine Corps veterans of the Vietnam War gain eligibility for Agent Orange-related VA benefits, and
  • Whether millions more disabled veterans gain access to on-base stores.

Related: Wilkie Lays Out 5 VA Priorities During Confirmation Hearing

Here's a rundown:

VA Secretary Nominee
Robert L. Wilkie sailed through his June 27 confirmation hearing to be the next Secretary of Veterans Affairs, vowing to oppose privatization of the VA health care system but to implement provisions of the new VA Mission Act to consolidate and streamline VA community care so veterans' access to outside care, as needed, is prompt and private-sector doctors and hospital get paid on time.

The Senate Veterans' Affairs Committee lauded Wilkie's depth of professional experience in leadership posts at the defense and state departments for Republican administrations, as well as his personal knowledge of veteran issues from service in the Army and Air Force and from his father, a career Army artillery officer who suffered severe disabling combat wounds in Vietnam.

Sen. Jon Tester (Mont.), ranking Democrat, warned Wilkie that his predecessor, Dr. David Shulkin, complained that plans to reform VA care were undermined last year by political appointees at the VA and the White House who want to close more VA facilities and shift more health services to the private sector. Shulkin aligned with veterans service organizations to oppose those moves.

At the VA, Tester warned Wilkie, “sound policies and ideas are being increasingly marginalized at the expense of politics. We are seeing VA reform after reform implemented in a manner inconsistent with congressional intent. We are seeing political interest groups given a seat at the table instead of veterans service organizations.” Even the VA's press office, he cautioned, has begun to attack news outlets for “fake news,” echoing a favorite line of the president.

“Sooner or later you're going to come to a crossroad with these” appointees bent on privatization, Tester told the nominee. “My only advice to you is to take your cues from the veterans, the folks who are sitting in this audience, and do what you think is right even if political forces threaten your job.”

Wilkie said his priorities will be to “improve the culture” by emphasizing “world-class customer service” to veterans; improve access to care; transform VA information technology; reduce backlogs in compensation claims and payments; and transform business operations. The last priority includes standardizing policies and practices across all 21 Veterans Integrated Services Networks (VISNs) run by the Veterans Health Administration.

“Will you vigorously oppose, whether it is the Koch brothers and their various organizations [including Concerned Veterans for America] or the President of the United States, the effort to privatize the VA,” asked Sen. Bernie Sanders (I-Vermont).

“My commitment to you,” said Wilkie, “is that I will oppose efforts to privatize VA.”

Electronic Health Records
Rep. Phil Roe (R-Tenn.), chair of the House Veterans' Affairs Committee, announced that he and Rep. Tim Walz (Minn.), ranking Democrat, have decided to create a new five-member subcommittee to oversee the department's $15.8 billion investment over the next decade to modernize the VA's electronic health record system.

The VA decided last year to buy the same commercial electronic record system, developed by Cerner Corp., that DoD is adapting to replace its own legacy health record systems. Roe said the new Subcommittee on Technology Modernization will “focus intensively” on details of the “big bet” the VA has taken to replace the VA's aging VISTA system, which costs the VA $1 billion annually just to maintain.

“And we simply must make sure [the bet] succeeds,” Roe said.

VA expects to spend $5.8 billion over the next decade on staff and other resources to prepare for the new electronic health record system, and pay another $10 billion to Cerner for its software, training, and system customizations.
Roe called the nearly $16 billion total cost “a staggering number,” and blamed it in part on a “culture” inside VA of modifying VISTA year after year “to fit any process. … There is much to be said for local authority in health care, but it seems to have gotten out of control and made the [VA information technology] landscape ungovernable.”

Blue-Water Navy
The House passed 382-0 the Blue Water Navy Vietnam Veterans Act and forwarded the bill (H.R. 299) to the Senate, where it also is expected to be voted on favorably later this year.

Veterans who served aboard ships that patrolled within 12 nautical miles of Vietnam or Cambodia from Jan. 9, 1962, to May 7, 1975, would be eligible for VA health care and disability compensation if they suffer from ailments the VA presumes were caused by exposure to defoliants used during the war.

Compensation to veterans, or survivors, would be paid retroactively if claims were filed for one or more of the presumptive conditions on or after Sept. 25, 1985, and before Jan. 1, 2019, and if the claim was denied because it had failed to establish the disease was incurred or aggravated by the veteran's service.

The House modified the original bill to extend the presumption of herbicide exposure to veterans who served on or near the Korean DMZ from Sept. 1, 1967, to Aug. 31, 1971. Also, it would extend health care, vocational training/rehabilitation, and an allowance to children born with spina bifida, if at least one of their parents served in Thailand between Jan. 9, 1962, and May 7, 1975, and the VA determined at least one parent had been exposed to wartime herbicides.

As reported here last week, the bill would cover the cost of expanding Agent Orange-related compensation to blue-water veterans by raising fees under the VA home loan guaranty program. A group of veteran realtors intend to urge senators to modify the House-passed bill so the home loan fee increases don't hit any disabled veteran using VA benefits to buy a home, including those buying more expensive homes using a new jumbo loan feature offered under the bill.

Base Shopping for Disabled Veterans
A senior Defense official confirmed last week, in a Washington, D.C., meeting of brokers and manufacturers servicing the military resale system, that the department conditionally supports language in the House defense authorization bill to allow 4.3 million veterans with service-related disabilities to shop in military exchanges and commissaries.

Sales have plummeted at base grocery stores due to stiffer competition from commercial discounters and other challenges. Opening base stores, and other morale, welfare and recreational services, to all disabled veterans and Purple Heart recipients, is seen as a way to boost store profits, cut taxpayer support of commissaries, preserve discounted shopping on base, and recognize veterans.

Next week's column will take a closer look at this controversial initiative.

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