House Republicans said Wednesday that the Department of Veterans Affairs may not be ready to handle the hundreds of thousands of veterans who may sign up for health benefits next year to meet the new individual mandate under President Obama's health care law.
VA officials told the Veterans' Affairs Committee they are preparing for a net of 66,000 veterans to seek benefits when the Affordable Care Act requires all Americans to have coverage in 2014.
That accounts for about 1 million eligible veterans who may come forward for the coverage, and those who could leave the system to take advantage of either tax credits on health insurance markets set up under Mr. Obama's law or Medicaid benefits in states that decide to expand the federal-state entitlement program, officials said.
"The individual is going to have to weigh the value of the tax credit against the services that they're getting," said Robert A. Petzel, an undersecretary who oversees health matters at the VA.
But Rep. Dan Benishek, Michigan Republican, said he sees a "real disaster in the making," because veterans are unlikely to relinquish their VA health benefits.
"If they have a choice between VA and Medicaid, they're going to go with the VA every time," Mr. Benishek said, fearing the department did not have an adequate contingency plan if many more veterans flooded the rolls than expected.
Mr. Petzel said the department has done a thorough analysis.
He said veterans consider many factors when deciding where to seek health care, and said more than 75 percent of veterans already use some type of health insurance outside of their VA benefits.
Mr. Petzel said the department asked for an additional $85 million in its 2014 budget, which he said would allow it to cover more people.
If a person enrolls in veterans' coverage, he or she would not be eligible for tax credits under the health care law, said Lisa Zarlenga, tax legislative counsel for the Treasury. However, the veteran's family members could separate themselves from VA coverage and seek insurance through the health exchanges.
Officials said they believe veterans who live in states that decline to expand their Medicaid enrollment will seek VA benefits in higher proportions than those in states that do expand the entitlement program. They are eyeing Texas and Florida as two populous states that may not extend the program to those making up to 138 percent of the federal poverty level.
All sides at Wednesday's committee hearing agreed that the situation will take time to sort out.
Rep. David P. Roe, Tennessee Republican, said he doubted the VA will do a very good job of explaining things to veterans, saying that he had just sat through two hours of testimony himself on Tuesday "and I don't think we fully understand what you're talking about."
Chairman Jeff Miller, Florida Republican, said the issue has received "distressingly little attention from the administration and the media to-date," and ranking Democrat Michael H. Michaud of Maine said "it is imperative that conflicting messages do not get out there and confuse our veterans even more."
"We're not going to know these things with absolutely certainty until we get to the point of actually implementing the law," Mr. Petzel said.
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