WASHINGTON — President Trump signed legislation Wednesday paving the way for a major overhaul of the Department of Veterans Affairs and expanded access for veterans to VA-funded care in the private sector.
The measure, which passed both chambers of Congress last month with overwhelming bipartisan support, delivers on a key campaign promise for Trump, who pledged to provide veterans with more non-VA health care choices.
"What a beautiful word that is — choice — and freedom to our amazing veterans," Trump said at the signing ceremony. "All during the campaign I'd go out and say, 'why can't they just go see a doctor instead of standing in line for weeks and weeks and weeks?' Now they can go see a doctor."
Working out the details of exactly how and when that will happen is now up to agency officials tasked with drawing up regulations under the law.
If confirmed, Trump’s pick to lead the VA, Robert Wilkie, would lead that effort. Criteria to be considered include wait times for VA appointments, quality of VA care and distance from a VA facility.
Known as the VA MISSION Act, the law directs the VA to combine a number of existing private-care programs, including the so-called Choice program, which was created in 2014 after veterans died waiting for appointments at the Phoenix VA.
Two veterans from Texas who traveled to Washington to be at the signing said the Choice program has been extremely helpful for them. Laura Vela, who served in the U.S. Army, and Air Force veteran Antonio Garcia said they previously had to drive nearly four hours each way to reach the nearest VA hospital in San Antonio.
"To me, it’s the perfect program," said Garcia, who had his knee replaced last year by a health care provider about a half mile from his home in Brownsville.
"I think it’s a step forward," said Vela, who saw a private provider at VA expense for gall bladder surgery. "It is strengthening our health care, and I think it will improve the healthcare and welfare of all of our veterans."
The law also creates a commission to recommend which VA facilities are worth repairing, where new ones should be built, and which ones should be closed and care provided in the private sector instead.
The measure includes some incentives to help the VA hire more health care providers. It allows the agency to provide scholarships to medical students in exchange for their pledging to work at VA. Currently some 33,000 positions are unfilled at the agency.
In addition, the law provides pre-9/11 veterans with benefits to help cover the cost of in-home care-givers. Such benefits previously were provided only to post-9/11 veterans.
The VA also will be allowed to set up pilot programs under the law to test how to deliver better care more efficiently, including with public-private partnerships.
"We're really encouraged about that," said Tony Tersigni, president of Ascension, the largest non-profit health system in the country.
In an interview before attending the signing at the White House, he dismissed concerns that such moves might mark the first step toward privatizing the VA.
"There's certain things that the VA has truly become world specialists in that it would be crazy for us to do away with or try to replicate it somewhere else," Tersigni said. "But there are things that we do extremely well, that we ought to bring to the advantage of a veteran."