Congress last August gave the Department of Veteran Affairs 90 days to issue medical “Choice Cards” to 9.1 million veterans enrolled in VA care.
The tight deadline of Nov. 5 won’t be met, say representatives of major veteran organizations who attend periodic VA briefings on plans for rollout of the Choice Card.
The card will ensure veterans have access to private sector health care if they reside more than 40 miles from a VA clinic or hospital, or if they face unacceptable waits, usually longer than 30 days, to access VA healthcare.
The simple guarantee, centerpiece of the Veterans Access, Choice and Accountability Act of 2014, is not so simple to deliver, at least in 90 days.
“I have heard nothing to lead me to believe they will get any (cards) out by November fifth,” said Joseph Violante, legislative director for Disabled American Veterans. He doesn’t even think VA has picked a vendor yet to make the cards.
VA declined a request to interview the official in charge of the Choice Card rollout because key decisions are not yet final. A VA statement called the law “highly complex,” said officials are striving to implement it “as quickly and efficiently as possible,” and the “goal has always been to meet the timelines set forth in the Act.”
Vet advocates didn’t disagree. Violante said he thought from the start the 90-day deadline was impossible for VA to meet.
While the card program is to end in three years or when $10 billion has been spent on care, whichever occurs first, VA still must build or buy expertise to run it, write regulations to govern it and decide how to monitor providers and care they deliver. It also must ensure health records are returned to VA to be merged with VA records for continuity of care. VA also must educate vets on who can use the card, how they can use it and when.
Roughly 700,000 to 800,000 veterans, less than 10 percent of current enrollees, will be eligible to use the card immediately if they need care. About 300,000 of those qualify because they live far from VA care. VA intends to issue cards to these two groups as soon as it can.
Later, in phases, it will send cards to all other veterans enrolled in VA health care as of Aug. 1, 2014, and those who enroll later if they had active duty service in a theater of combat operations in the previous five years.
This mandate in the law to give the card to more than 8 million veterans who won’t be eligible to use it worries vet advocates. Some veterans or even doctors could be confused and give care VA won’t cover.
VA already knows who lives more than 40 miles from VA care. But the law allows VA to adjust the 30-day wait threshold, and it likely will, based on type of care needed. Waits longer than 30 days might be reasonable, for example, for hearing exams, and far shorter waits for cardiology care.
When vets get their cards, they will have a phone number to call to verify eligibility and begin use.
Tom Philpott can be contacted at Military Update, P.O. Box 231111, Centreville, Va. 20120-1111, or by e-mail at: