Following the Department of Veterans Affairs scandals of 2014, a popular reform was enacted allowing veterans to bypass the VA for medical care in certain cases. A new law would continue the program — although it had to overcome some obstacles, including a failed House vote in July.
The law continues funding for the Veterans Choice Program, which ensures that veterans can have access to medical treatments and procedures which the VA itself does not provide. In other words, it guarantees veterans can see a private non-VA physician if medically necessary, at government expense.
The program was started in 2014, in the wake of the VA scandals where dozens of veterans died from lack of care and some of the deaths were covered up. This culminating in the resignation of VA Secretary Eric Shinsekiand a series of congressional reforms. One was the Veterans Access, Choice, and Accountability Act of 2014, which passed the Senate with only three dissenting votes and established the Veterans Choice Program.
What the bill does
The program had been set to expire in August, but President Trump signed an extension in April. This law, introduced by Sen. Dean Heller (R-NV) in the Senate as a bill labeled S. 114, provides $2.1 billion in funding for the extension.
President Trump’s proposed budget would increase the VA’s budget by 7 percent, one of the only agencies which would receive an increase rather than a cut. President Obama also significantly increased the VA’s budget and cut the patient backlog, though not eliminating it entirely.
What supporters say
A press release from lead Senate sponsor Heller mentioned several real-life examples of how the law could be used for constituents in his own home state of Nevada.
“Wendell, a Navy veteran from Lovelock, used the Choice Program to get a neck surgery to ensure he could still walk. John, an Air Force pilot from Battle Mountain, used the Choice Program to remove cancer above his neck,” Heller’s office wrote. “The Choice program allowed an Army veteran from Ely to access mental health services nearby as opposed to traveling over 200 miles to Salt Lake City, UT or forgoing the care entirely.
Votes, where it originally failed in the House
Despite passing the Senate on May 25 by unanimous consent, meaning there was no significant opposition and no record of individual votes was recorded, the bill initially failed in the House on June 24 in a vote that surprised many.
Why? Because House Republicans made changes that would pay for the Veterans Choice Program by diverting funds from elsewhere in the VA, a move that most Democrats and even a few Republicans opposed.
Democrats almost entirely opposed it 2–182, while four Republicans also opposed. The bill received 219–186 support overall, but at 54 percent, that fell short of the two-thirds required.
Four days later on July 28, with the controversial provisions now removed, the bill passed the House by a unanimous 414–0.
It was signed into law by President Trump as Public Law 115–46.
The summary below was written by the Congressional Research Service, which is a nonpartisan division of the Library of Congress, and was published on Aug 13, 2017.
VA Choice and Quality Employment Act of 2017
TITLE I--APPROPRIATION OF AMOUNTS FOR VETERANS CHOICE PROGRAM
(Sec. 101) This bill provides funding for the Veterans Choice Program.
TITLE II--PERSONNEL MATTERS
(Sec. 201) The annual determination of the Veterans Health Administration (VHA) staff shortages shall include shortages for a minimum of five clinical and five nonclinical occupations for each network. (Such determination currently includes the five occupations for which there are the largest Department of Veterans Affairs [VA]-wide shortages.)
(Sec. 202) The bill establishes in the VA an executive management fellowship program to provide Veterans Benefits Administration and VHA employees with training and experience in the private sector and private sector employees training and experience in the VA. Employees shall be selected in a manner that reflects veteran demographics and provides a preference for rural employees.
(Sec. 203) The VA shall conduct an annual performance plan for each political appointee that is similar to the plan conducted for VA career senior executive employees.
(Sec. 204) The VA may noncompetitively appoint a qualified former employee to any VA position within the competitive service that is one grade or equivalent higher than the person's most recent position.
(Sec. 205) The VA shall establish a promotional track system for employees who are technical experts to advance without being required to transition to management positions.
(Sec. 206) The VA shall prescribe regulations to allow for excepted service appointments of qualifying students and recent graduates leading to career employment.
(Sec. 207) The VA shall establish a program to encourage service members with a military health care specialty to seek postmilitary employment with the VHA.
(Sec. 208) The VA shall establish a single database that lists each vacant VA position that is: (1) critical, difficult to fill, or both; or (2) for a mental health professional. A qualified applicant for a position in the database who is not selected may elect to be considered by the VA for similar positions in the database.
(Sec. 209) The VA shall provide VHA human resources professionals with recruitment and retention training.
(Sec. 210) The VA shall develop and implement a plan to hire qualified directors for VA medical centers without a permanent director.
(Sec. 211) The VA shall develop a standardized exit survey for employees and executives who voluntarily separate from the VA.
(Sec. 212) Physician assistants are included in the list of VA health care personnel who must receive pay that is competitive with non-VA health care facilities.
(Sec. 213) The VA may appoint highly qualified candidates without regard to competitive service provisions if there is a severe shortage of highly qualified candidates.
(Sec. 214) The Government Accountability Office shall assess the VA's succession planning policies.
TITLE III--MAJOR MEDICAL FACILITY LEASES
(Sec. 301) The VA may carry out major medical facility leases in specified amounts at certain locations.
TITLE IV--OTHER MATTERS
(Sec. 401) The bill extends through FY2027: (1) the $90 monthly limit on a VA pension paid to veterans residing in nursing homes when their nursing costs are paid through title XIX (Medicaid) of the Social Security Act; (2) VA authority to collect certain fees at current levels for housing loans made, insured, or guaranteed by the VA; and (3) VA authority to obtain veterans' income verification information from the Social Security Administration or the Department of the Treasury.