With Private Care Push, Trump’s VA Bucks Lawmakers and Some Veterans Groups

When Congress passed a bill last year to transform the Department of Veterans Affairs, lawmakers said they were getting rid of arbitrary rules for when the government would pay for veterans to see private doctors.

Under the old program, veterans could go to the private sector if they would have to wait 30 days or travel 40 miles for care in the VA. Lawmakers and veterans groups, including conservatives, criticized those rules as arbitrary. The new law, known as the Mission Act, was supposed to let doctors and patients decide whether to use private sector based on individualized health needs.

On Wednesday, the Trump administration proposed new rules, known as access standards, to automatically make veterans eligible for private care. Instead of 30 days, it’s 20 days for primary care or 28 days for specialty care. Instead of 40 miles, it’s a 30-minute drive for primary care or a 60-minute drive for specialty care.

The announcement appeared to do little to settle the debate over whether the VA’s rules are arbitrary.

“Twenty days is just as arbitrary as 30 days,” Bob Wallace, the executive director of Veterans of Foreign Wars, one of the largest veterans service organizations, said in a statement.

What is clear about the new rules is that they are dramatically more permissive. The new drive-time standard alone will make 20 percent of veterans eligible for private primary care and 31 percent eligible for private specialty care, up from 8 percent for both kinds of care under the old program, according to a briefing document circulated on Capitol Hill.

“This is doubling down on the administrative rules such as drive times and wait times,” said David Shulkin, the former VA secretary who was fired last year by President Donald Trump, in part over disagreements about this bill. “I was in favor of a system that was clinically based, that put veterans’ needs first and allowed the right…

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