Amid the furor over the on-again, off-again drama of the North Korean summit and the prospect of a trade war with China, a bill aimed at helping fix health care for veterans was off the radar for most Americans when it passed the U.S. Senate on a 92-5 vote earlier this month. But you can bet many current and former service members were paying close attention. The bill aims to correct many of the flaws of the well-intentioned but poorly designed Veterans Choice Program, and its core provisions should go some distance toward better outcomes for Alaska veterans seeking care.
The Veterans Choice Program, enacted in 2014, was itself designed as a fix for a badly ailing Veterans Administration health care system. A series of national media reports documented months-long wait times for procedures that VA officials had conspired to conceal from the public; the scandal ultimately forced the resignation of then-VA Secretary Eric Shinseki. In an effort to reverse the waits for care, Congress passed Veterans Choice to help provide more options for former service members. Ironically, it was modeled partially on Alaska's VA system, which had instituted changes from the nationwide system that made it more responsive.
But although the program was designed with the intention of better, quicker care options for veterans, it had the opposite effect in many cases — particularly here in Alaska. Call centers that handled scheduling were based outside the state, where workers had little comprehension of Alaska's unique geography and the paucity of treatment options in rural communities.
In a state with tens of thousands of active-duty military and the nation's highest per-capita population of veterans, it is unacceptable to provide inadequate health care for current and former service members. Fortunately, the VA Mission Act of 2018 provides fixes for many of the problems afflicting Alaska's system.
Importantly, the act recognizes that when it comes to health care, our state faces dual challenges of limited treatment centers and far distances for many in rural communities. It authorizes payment at rates exceeding Medicare in "highly rural areas," including a specific Alaska fee schedule that amounts to recognition of the high cost of quality care here. And it expands options for those without a VA clinic nearby, as is the case for a great many Alaska veterans: It continues care partnerships between VA and the American Indian and Alaska Native health
care systems that allow veterans here, especially those in rural communities, to receive treatment and outpatient care far closer to home.
The bill will also seek to prevent a shameful outcome experienced by veterans because of inefficiency at the VA: In the past, bill collectors have come after individual former service members because it took the VA so long to process payments to health care providers. With a new 30-day limit on VA reimbursement, that should no longer be the case.
The members of Alaska's congressional delegation, and Sens. Dan Sullivan and Lisa Murkowski in particular, should be commended for their roles in making sure the bill does right by Alaska veterans. Through his role on the Armed Services Committee, Sen. Sullivan was able to make sure the bill didn't unintentionally hurt Alaska veterans while helping others, as was the case with the Veterans Choice Program. And Sen. Murkowski was instrumental in ensuring care partnerships with tribal health organizations were preserved, an essential aspect of rural health services for the state.
Ultimately, the proof of the VA Mission Act of 2018's benefits will be in its success or failure to enhance the quality and responsiveness of care for Alaska's veterans. Assessing that will take time. But the framework of the bill gives reason to be optimistic that our state and those who defend it will see improvements.