The House of Representatives on Wednesday overwhelmingly passed legislation intended to end a crisis in Department of Veterans Affairs healthcare by getting hundreds of thousands of veterans off waiting lists and into doctor's offices.
The bill passed the Republican-controlled chamber by a vote of 420 to five, with seven abstentions. The Democratic-led Senate may vote on the measure as early as Thursday, with just two days left on the congressional calendar before the August recess.
The legislation was the product of a conference committee deal brokered over the weekend by Rep. Jeff Miller, R-Florida, and Sen. Bernie Sanders, I-Vermont, chairmen of the Senate and House veterans' affairs committees, respectively.
"My expectation is that the Senate will do the same thing as soon as tomorrow," Sanders said in a statement. "The veterans of this country are entitled to quality and timely health care. This legislation will take us a long way toward making good on that promise."
Miller on Wednesday told the House the legislation is "the first step to alleviating [veterans] pain and paving the way for the failing VA healthcare system" to be put right. He criticized the agency as a bureaucracy of corruption that permitted long delays in providing care for veterans.
"Thousands of veterans across the country have been left to wait, some for years, some in pain, and some in caskets draped in an American flag," Miller said. At the same time, he said, "poor performing" agency executives were manipulating data to conceal serious, even fatal, delays in treatment.
Investigators confirmed whistleblower allegations in May that dozens of veterans on a secret waiting list at the VA Medical Center in Phoenix died before getting to see a doctor. An investigation is continuing and some officials may face criminal charges.
Oversight officials also revealed that manipulation of patient appointment records was systemic across the agency. As the scandal unfolded, VA Secretary Eric Shinseki was criticized for failing to grasp the nature or scope of the problem, and he resigned in May.
The House's passage of the reform bill comes a day after the Senate's 97-0 vote confirming Robert McDonald, an Army veteran and former chief executive officer for consumer giant Procter & Gamble Co., to be the next Secretary of Veterans Affairs.
Miller said the bill will give McDonald more power to fire underperforming officials – a necessary responsibility in order to improve agency management. The tougher authority was demanded by lawmakers from both parties following revelations that officials at VA hospitals across the country manipulated data to conceal the fact they could not make timely appointments for veterans.
The bill includes about $17 billion in new funds and savings from existing programs.
Of the that figure, $5 billion would be used to hire additional doctors, nurses, mental health professionals and other medical staff, as well as to enter into leases at 27 major medical facilities in 18 states and Puerto Rico.
The lion's share of the funding, $10 billion, would go toward a "Veterans Choice Fund" to make it easier for veterans to seek treatment from non-VA and private healthcare providers.
For example, veterans living more than 40 miles from a VA facility will have the option of getting care at a qualified community-based hospital, or medical center receiving federal funding – including military bases or those of the Indian Health Service.
About $2 billion will go toward providing services to victims of military sexual assault, extending Post 9/11 GI Bill benefits to the spouses of fallen troops, and guaranteeing in-state tuition to veterans, surviving spouses and eligible dependents regardless of where they attend school or their home of record. It will also help extend a rural healthcare program that provides rehabilitation therapy, quality of life and community integration services to vets suffering from traumatic brain injury.
The legislation calls for the creation of a commission to look at VA's ability to provide long-term healthcare long term, and to determine what changes, if any, should be made in services.
In a shift from the way Congress has previously handled spending bills, the veterans' legislation funded mostly by new dollars, with no offsets as typically demanded by GOP lawmakers. Only the $5 billion going toward new healthcare hires is to be offset by cuts elsewhere in the budget.
In addition to Miller, other lawmakers on the House Veterans Affairs Committee, as well as House minority whip Rep. Steny Hoyer, D-Maryland, spoke in favor of the bill's passage.
Hoyer backed the bill despite his reservations about the provision making it easier to can senior executives and other managers. Existing Civil Service rules already allow for speedy removal of bad managers, he said, while still enabling employees to do their jobs without fear of arbitrary removal or political reprisals.
But Hoyer said he supported the legislation for the improvements it would bring to the agency.
Rep. Mike Coffman, R-Colorado, a Marine combat veteran of the Gulf War, said he was "proud that Republicans and Democrats put aside partisan differences to support warriors with choice, accountability and greater transparency."
Offering an option to seek care from non-VA or private facilities, he added, "will allow veterans to vote with their feet [by going outside VA for care] if they can't get an appointment in a reasonable amount of time at a VA facility."
Rep. Phil Roe, R-Tennessee, said called the so-called choice provision "the most important thing this bill does. "Only by forcing the VA to compete will w achieve the cultural change" needed at the VA, he said. "A corrosive culture has been allowed to exist in the VA bureaucracy for far too long ... and to the detriment of our veterans."
Rep. Corrine Brown, D-Florida, said it's critical that the legislation be fully implemented and that the VA gets all the resources it needs. "A lot of us talk the talk or walk the walk but don't really roll the roll," she said. "We have to make sure we just don't talk about providing service, but provide the service."
-- Bryant Jordan can be reached at firstname.lastname@example.org