WASHINGTON — Veterans who live as little as a 30-minute drive from a Veterans Affairs health care facility will instead be able to choose private care, the most significant change in rules released Wednesday as part of the Trump administration’s effort to fix years-old problems with the system.
Veterans who can prove they must drive for at least 30 minutes to a Department of Veterans Affairs facility will be allowed to seek primary care and mental health services outside the department’s system. Current law lets veterans use a private health care provider if they must travel 40 miles or more to a VA clinic. Measuring commuting time rather than distance will greatly open the private sector to veterans in rural and high-traffic urban areas.
Supporters say the new policy, which is likely to go into effect in June, will help veterans get faster and better care. But critics fear it will prompt the erosion of the largest integrated health care system in the country as billions of dollars are redirected to private care.
The goal of the new policy, officials say, is to provide veterans with easier, streamlined access to health care. “This is the most transformative piece of legislation since the GI Bill,’’ Robert L. Wilkie, the secretary of Veterans Affairs, said.
The move has been anticipated for months, after congressional lawmakers passed legislation last spring that empowered the administration to make substantial changes to veterans health care.
Current law lets veterans facing a wait of 30 days or more for an appointment at their closest VA facility seek private care, but under the new policy, that would be reduced to 20 days, and with the goal of 14, by 2020. Veterans will also be allowed access to walk-in clinics; however, those will require copays for treatment after a third visit. If seeking a specialist after the new policy takes effect, veterans must prove a drive of at least 60 minutes.
Taken together, the percentage of veterans eligible for what officials refer to as “community care’’ currently — roughly 8 percent of the 7 million treated annually — would rise to between 20 and 30 percent, according to department officials.
Lawmakers and veterans advocacy groups — which have been wary of large-scale moves into the private sector — were to be briefed about the program on Wednesday.
In recent years, Veterans Affairs hospitals have struggled to keep up with patient loads as service members returning from Iraq and Afghanistan — many with complex injuries and post-traumatic stress — hit the system at the same time that aging and increasingly ill veterans made more use of it.
A scandal in 2014 over hidden waiting lists at VA facilities sent lawmakers in search of solutions, with many Republicans favoring more use of the private sector and Democrats preferring to add doctors and medical centers to the existing system.
