WASHINGTON – The U.S. House passed a major overhaul of veterans' health care on Wednesday night, as U.S. Rep. Tim Walz broke with most of his fellow lawmakers and major veterans' services organizations to oppose it.
The DFL congressman's opposition follows months of negotiations over how to salvage the Veterans Choice Program, which was designed to give veterans in greater Minnesota and many other rural areas easier access to private care when other VA facilities had long wait times or were too far away.
But veterans and health care administrators describe the program as a bureaucratic mess, and it's set to run out of money by the end of the month.
The VA Mission Act passed 347-70 with no Republicans voting against it. It provides $5 billion to fund the program for another year before implementing a $47 billion replacement.
But Walz, of southern Minnesota, sounded alarms about how the government would pay for the legislation in the long run — and how it would be carried out in a U.S. Department of Veterans Affairs with no permanent leadership and continuing controversy about privatizing more services for veterans.
"I see long-term problems caused by this, but I understand a short-term desire to get something done," Walz, the ranking Democrat on the House Veterans Affairs Committee, said in an interview hours before the vote. "And in this Congress, I think there's a fair debate to be made: Do we take something for the short term? I'm making an argument that the threat is too great."
As Walz prepares to leave Congress in pursuit of the Minnesota governorship, he's also acted as one of the top negotiators in Congress on improving the system for veterans to seek private health care faster and closer to their homes. Health care providers have been eager for Congress to act, saying that the program takes too long to reimburse them and that authorization errors are routine. And veterans' service organizations have also been demanding change, saying long wait times at participating providers defeat the purpose of the Veterans Choice Program.
"Opponents of this bill will tell you falsely that this is aimed at privatization of the VA health care system," U.S. Rep. Phil Roe, the Tennessee Republican who chairs the House Committee on Veterans Affairs, said on the House floor Wednesday, adding that there were provisions to attract personnel to work at the VA. "That preconception is based on nothing but fear."
Walz drew criticism from Joe Chenelly, executive director of the veterans' service organization AMVETS. Chenelly said on Twitter that he was "very disappointed that Tim Walz is choosing politics over veterans with his opposition. This bill isn't perfect, but it's the right bill at the right time."
The VA Mission Act would streamline the agency's myriad community-care efforts into one permanent program. It would expand benefits for caregivers of veterans injured before Sept. 11, 2001, and also create a board to review how to modernize and realign the large patchwork of VA facilities, closing some in underused areas and expanding them in areas with more need. The legislation preserves the current system of paying for private care for veterans who live at least a 40-mile drive away from the nearest VA facility or who can't schedule a doctor's appointment at one for 30 days, though former VA Secretary David Shulkin had proposed eliminating that standard last year.
The White House backs the bill, saying that it would transform the VA into a "modern, high-performing and integrated health care system that will ensure our veterans receive the best health care possible from the VA, whether delivered in the VA's own facilities or in the community." Veterans' service organizations such as the American Legion and VFW described the legislation as a "major step" toward reforming the system of veterans' health care. The Senate is expected to act soon.
Walz said he agrees with 90 percent of the bill, and he said Roe and other Republican lawmakers negotiated in good faith. But he criticized the bill for moving funding for the current Veterans Choice Program from a system of mandatory to discretionary spending in the budget, raising concerns that at some point lawmakers will be in a "hellish situation" of having to cut other critical programs in the VA to pay for the legislation when costs exceed spending caps. He's particularly worried that there's not a plan to pay for the bill's expansion of caregiver benefits.
"I think the chairman is being pragmatic in this regard, just saying, 'This is the best we can do at this point in time,' " Walz said. "I feel a responsibility, especially as an outgoing member, to say ... 'This is where we have to stop kicking the can down the road and get this right.' "
Walz said that if lawmakers run into funding problems next year, that could open the door for more expansive efforts to privatize the VA, a debate that's been growing under the Trump administration yet remains uncertain as the second-largest federal agency lacks permanent leadership. Trump fired Shulkin in March, and his nominee to replace him, Ronny Jackson, withdrew from consideration after allegations of professional misconduct.
Walz praised Acting VA Secretary Robert Wilkie. But he said that if someone else takes over who supports more privatization, "we're handing them the keys to the car on this. They are going to have the capacity using this new piece of legislation to do that."
Maya Rao • 202-662-7433
