WASHINGTON — Several national veterans organizations are warning that Republican legislation to repeal Obamacare will strip health care from the military veterans who need it most, including those who are disabled or struggling with mental health issues.
In a letter sent to all 100 senators Tuesday, Paralyzed Veterans of America, one of the largest nonpartisan veterans' groups in the country, denounced the "opaque and closed process" of crafting the bill that has not allowed the group to weigh in on how it would impact "catastrophically disabled veterans."
"Congress can no longer fake listening to these men and women," Carl Blake, the group's associate executive editor, said in the letter.
Two other major organizations, Disabled American Veterans and AMVETS, also expressed alarm that the bill could limit veterans' access to health care. This comes as President Donald Trump, who backs the bill, has said he is following through on his campaign promise to protect veterans by taking high-profile steps to move toward reforming the Department of Veterans Affairs.
Many advocacy groups expressed frustration at the widely held misconception that all military veterans can seek Veterans Administration care.
"I can't tell you how many times someone with a puzzled look on their face has remarked 'Don't all veterans go to the VA?'" said Will Fischer, the head of government relations at VoteVets, a progressive veterans organization. "It should be crystal clear to people that this (bill) is absolutely a veterans issue."
Of the more than 21 million veterans in the U.S., only about 8 million receive health care from the VA. In fact, many aren't eligible due to minimum service requirements, discharge status and different disability ratings. In addition, millions of veterans in rural areas cannot access care at VA facilities.
Nearly one in 10 veterans — approximately 1.75 million — rely on Medicaid for health care coverage, according to an analysis of U.S. Census Bureau data by Families USA. The bill would cut Medicaid spending by $772 billion, leading to 15 million fewer enrollees nationwide, according to the Congressional Budget Office.
Under the Senate Republicans' bill, an estimated 44,900 veterans in Florida would lose Medicaid coverage by 2026, according to an analysis by the Center for American Progress, a liberal think tank. In Texas, 72,800 veterans could lose Medicaid coverage; in Georgia, 31,800 veterans; in North Carolina, 27,900 veterans; and in California, 25,900 veterans.
Advocates said the legislation would leave some of the most vulnerable veterans without options, including those requiring disability care or struggling with mental illness.
The effort to repeal and replace the Affordable Care Act "comes at a time when we are facing a mental health crisis in the veterans community. … This is not the time to play political games with veterans health care," said Emily Blair, the lead on veterans' issues for the National Alliance for Mental Issues.
Roughly 20 veterans commit suicide every day, according to data from the Department of Veterans Affairs.
The cuts to Medicaid in the Senate bill "will devastate and decimate the ability for these veterans and their family members to access the needed primary care, specialty care, including mental health care and substance use treatments, that are life-saving," Blair said. "These veterans are some of the most vulnerable in our society."
Even if Congress were to act to open up the VA's system to all veterans, it is unclear whether the VA would be able to handle even half of the veterans currently covered under Medicaid, Paralyzed Veterans of America told senators in Tuesday's letter.
"You may need to see a psychologist once a week and can't get to the VA once a week," said Andrea Callow, a Medicaid policy analyst at the consumer group Families USA. "For veterans with chronic conditions, traumatic brain injuries or post-traumatic stress disorder who need ongoing treatment, Medicaid is really a tremendous support, and for many the largest source of support."
Under the Affordable Care Act, Medicaid was expanded to those earning 138 percent of the federal poverty limit in states that chose to participate. The line had previously been drawn at 100 percent.
"Taking $772 million out of the Medicaid program means that essentially nobody is safe," Callow said. "Veterans, children, everyone will feel those cuts."
The cuts would save the government $321 billion over 10 years, according to the Congressional Budget Office. The White House expressed skepticism about the projections put out by the CBO on Monday that 22 million Americans would lose coverage, saying the office has a "history of inaccuracy, as demonstrated by its flawed report on coverage, premiums and predicted deficit arising out of Obamacare."
Military veterans as a group saw dramatic gains in health care coverage under President Barack Obama's health care law. The rate of uninsured veterans under age 65 fell by nearly 40 percent during the first two years of Obamacare's coverage provisions, including the Medicaid expansion, a study by the Urban Institute think tank found.
The number of veterans without health care coverage fell from 980,000 in 2013 to 552,000 in 2015. The families of veterans also gained from many provisions in the Affordable Care Act, according to the study. The rate of veterans' spouses without insurance fell from 9.2 percent to 5.5 percent, and the rate among children dropped from 4.5 percent to 2.9 percent.
"This bill isn't just unacceptable, it's downright shameful," Sen. Tammy Duckworth, an Illinois Democrat, said Tuesday while on a conference call panel with the Amputee Coalition and the American Orthotic & Prosthetic Association on Tuesday. The groups said that the new bill threatens proper care for 2 million Americans who are amputees, including military veterans.
Health care for people who have lost limbs and require special care and rehabilitation would only become "worse and more expensive" under the new bill, Duckworth warned.
"I will do everything I can to stop Trumpcare in its tracks," she said.
Fisher said his organizations will not allow Republicans to get away with not answering questions about the bill's consequences for veterans' care.
"These are people who may be in dire straits," he said. "If they decide that it's a good idea to rip health care from veterans by slashing Medicaid — we'll make it our mission to not allow them to go to church or a community event without their constituents pointing at them and saying, 'You are punishing veterans.'"