Department of Veterans Affairs Secretary David J. Shulkin announced this week that his priorities for improving services to veterans include expanding their access to private-sector health care in part by asking Congress to remove two irksome cost controls.
Under the oft-criticized Choice program, enacted in 2014 in response to a wait-time scandal across the VA health system, veterans can seek private-sector care at VA expense only if they face wait times longer than 30 days for a VA appointment or they live more than 40 miles from a VA health care facility.
Congress set these restrictions to limit the exodus of patients to private-sector care during what was seen as temporary crisis. Without them, the Congressional Budget Office predicted, Choice users would burn through the $10 billion set aside for a three-year emergency program in less than a year.
The Trump administration now wants Choice extended and expanded, as do key congressional leaders, despite warnings from veteran service organizations that shifting too many patients and too much funding to private-sector care could begin a slide toward full privatization of VA health care.