RAO Davao City

United States Military Retiree Activities Office Davao City, Philippines


Posted by Service Officer on August 29th, 2008

VA CATEGORY 8 CARE UPDATE 06: Congress is moving to reopen the VA health care system to many more thousands of Priority Group 8 veterans – those who aren’t poor, at least by government standards, and have no service-related ailments. Disabled American Veterans and some partner organizations support such a move but with two caveats, explained DAV representatives.

• First, accepting new “Priority 8” enrollees should be gradual to protect access to care for service-disabled veterans and all other current enrollees.

• Second, resumption of Group 8 enrollments, which were suspended in 2003, should not occur without reform of VA health care budgeting to ensure that VA health budgets, year after year, finally become “sufficient, timely and predictable,” said Joseph A. Violante, DAV’s legislative director.

Congress has refused to pass a law that would mandate full funding of VA health care based on number of enrollees. But Violante said DAV has joined with eight other veterans’ service organizations to back an alternative to mandatory funding that lawmakers are more likely to embrace. With the House having voted this month for a 10% rise in Priority 8 enrollments starting 1 OCT, and with Democratic senators also supporting for such a move, DAV and its partners believe VA budgeting reform has a new urgency to protect enrolled veterans’ access to care. The Veterans’ Health Care Budget Reform Act, to be introduced after lawmakers return from recess in September, has two parts.

• One would put VA health care under an “advance appropriation” schedule. If it were in effect already, Congress this year would be passing a VA health budget that would take effect in fiscal 2010, a year ahead of the current schedule. The goal, said Violante, is to end a crippling pattern by lawmakers of failing to pass VA health budgets before the fiscal year begins 1 OCT. These budget delays, which last two to three months, force VA medical facilities to operate under “continuing resolutions” which freeze spending at previous year levels until a new appropriations bill finally is passed and signed.

• Part two of the reform package would seek to keep funding levels for VA health care sufficient. Until very recently, VA health budgets were sharply under funded, Violante said. Yet Congress declines to support a mandatory full funding law, arguing that it limits congressional prerogatives. It also is an expansion of VA entitlements which triggers a “pay-go” budget rule. That rule requires that any new entitlement spending either be offset by an entitlement reduction or paid for with tax increases.

What DAV and fellow organizations in the Partnership for Veterans Health Care Budget Reform now propose is that VA be directed to use a new actuarial model it has developed which very accurately can project the per capita cost of providing health care to its enrolled patient population. The Partnership’s proposal would require the Government Accountability Office to verify annually the accuracy of these VA health cost projections so everyone knows the cost of continuing to provide current services to enrolled beneficiaries. If the administration then were to seek a budget that fell short of covering those projected costs, the White House would have to explain why both to Congress and to veterans, and the political heat could be severe. VA now won’t share what its actuarial model shows about proper funding of VA health care, said Peter Dickinson, a consultant to DAV and former professional staff member on the House Veterans Affairs Committee. “It’s sort of behind the curtain, inside the black box. Instead they put forward a number that may or may not be based on that but also reflects other [spending] priorities of the administration. Requiring an annual audit to force VA to reveal what health care spending must be to support full services to all VA patients would make it politically difficult to short these budgets in the future. If we can get a budget process that’s a year in advance and based on numbers we can look at, the cost of re-opening enrollment to Group 8’s veterans would be known and presumably fully funded. ” Dickinson said. If health budgeting isn’t reformed, and enrollment doors swing open, “we could be in danger of returning to the days of ‘03 and ’04 when more than 300,000 veterans waited six months or longer to get an appointment.” [Source: Stars & Stripes Tom Philpot article 23 Aug 08 ++]

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