The Trump administration and House Republicans suffered a stunning setback Monday night in the failure of a floor vote on a controversial bill to extend the VA's Choice program allowing veterans to choose private health care.
The vote on the House floor was 219-186 in favor, but the emergency funding bill still failed under the two-thirds majority vote required under the rules that brought the legislation to the floor.
The failure to pass the bill left the future of the Choice program in doubt. Funding for the program was expected to run out in mid-August and House Republicans had counted on moving the bill to the Senate for quick passage this week before going on August recess.
Earlier, Rep. Phil Roe, R-Tenn., chairman of the House Veterans Affairs Committee and the main sponsor of the bill, said "We know that veteran demand for care through Choice has never been higher and consequently the remaining money in the veterans Choice program will run out in mid-August, a few short weeks from now," he said.
- Struggle in Congress to Revive VA Choice Program Extension
- Trump Signs Bill to Extend Veterans Choice Program
- Background: The Veterans Choice Program
"We cannot allow that to happen," Roe said, but he did not immediately offer a plan to revive the measure in the House. Thousands of veterans reportedly have had referrals to private care held up as Congress debated an extension of Choice, and thousands more would lose eligibility for referrals without an extension and renewed funding for Choice.
The House began moving toward a vote Monday afternoon on the controversial Choice extension bill that was opposed by several veterans service organizations (VSOs).
In the floor debate, Roe sought to allay the concerns of the VSOs that the proposed legislation was a smokescreen for efforts to privatize VA health care.
"I fail to see the logic" of the VSOs in arguing against an extension of the program that allows veterans who live more than 40 miles from a VA facility or who have to wait more than 30 days for an appointment to become eligible for private or community care, Roe said.
"I think it's critical to get this done," he said of the extension of Choice through February to give Congress time to work on reforms demanded by the VSOs.
"We're very aligned on the goals here," said Rep. Tim Walz, D-Minn., the ranking member on HVAC, despite "opposition rarely seen from the VSOs" to the Eliminating the Sunset Date of the Choice Act legislation.
He urged House members to "get this thing passed and end this ridiculous argument on privatization versus non-privatization."
Walz said there would be ample time to debate the merits of Choice once the extension was passed, but he was having difficulty holding Democrats on HVAC in line.
Rep. Mark Takano, D-Calif., said "it's time for us to recognize that private care is not the panacea. The VA Choice program has failed to deliver on the promise of shorter wait times. I urge my colleagues to reject this legislation."
Brian Duffy, national commander of the Veterans of Foreign Wars, said at the opening of the VFW's national convention in New Orleans that the extension bill went against one of President Donald Trump's pledges to veterans.
Duffy said Trump promised the VFW last year that the "VA would remain a public system, because it is a public trust." He urged VFW members at the convention to call their representatives immediately and urge them to vote "No" on the extension.
Ahead of the vote, VA Secretary Dr. David Shulkin made an appeal for an extension and reform of the Choice program that would preserve the VA's role as the primary health care provider and avoid over-reliance on private and community care that would weaken the system.
He said "fears of privatization are simply unfounded. President Trump is dedicated to maintaining a strong VA, and we will not allow VA to be privatized on our watch," Shulkin said in an op-ed for USA Today.
"What we do want is a VA system that is even stronger and better than it is today. To achieve that goal, VA needs a strong and robust community care program," Shulkin said.
He added that "veterans deserve the best. If a VA facility isn't meeting the community standard for care, doesn't offer a specific service, or doesn't have an appointment available when it's needed, veterans should have access to care in their community."
Over the weekend, several VSOs in a joint statement said, "All of our organizations are committed to building a future veterans health care system that modernizes VA and integrates community care whenever needed so that enrolled veterans have seamless access to timely, quality care."
"However, if new funding is directed only or primarily to private sector 'Choice' care without any adequate investment to modernize VA, the viability of the entire system will soon be in danger," the statement said.
The document was endorsed by the VFW, AMVETS, Disabled American Veterans, Iraq and Afghanistan Veterans of America, Military Officers Association of America, Military Order of the Purple Heart, Vietnam Veterans of America and Wounded Warrior Project.
The $10 billion Choice program was enacted in 2014 to address the wait times scandals that emerged from the crisis at the Phoenix VA hospital. The program was due to sunset in fiscal 2018 but its popularity has exhausted the funding that was expected to run out in mid-August, according to the VA.
-- Richard Sisk can be reached at Richard.Sisk@Military.com.