Congress wants the VA to speed up veterans’ care by using private doctors and clinics, but department officials told lawmakers Wednesday their wait lists data is so bad they couldn’t even be sure who has been waiting long enough to be eligible.
Veterans Affairs has had a long-standing program to send patients to private providers if veterans needed specialized care or couldn’t be treated in a timely manner, but the VA has shied away from that in recent years.
Philip Matkovsky, assistant deputy under secretary for health for administration operations, said the VA had gotten so many complaints about overusing the program in the past that it scaled back — contributing to the long wait lists that have landed the department in trouble.
“Some years back we were receiving a good deal of criticism for use of non-VA care. Historically we have been criticized, so we overcorrected, maybe inappropriately, to use that less,” he told the House Committee on Veterans’ Affairs.
VA officials also admitted to Congress last month that they underused the option because they felt it was more important to keep care within the VA.
Rep. Jeff Miller, Florida Republican and chairman of the committee, said providing veterans health care — not making sure that health care comes from the VA — should be the department’s top priority.
“Providing our veterans with timely, accessible and high-quality care — regardless of whether or not such care is provided in a VA medical facility or through a private sector provider — should be VA’s ultimate goal,” he said. “After all, isn’t non-VA care preferable to no VA care at all?”
Both the House and Senate passed legislation last week that would let veterans seek care outside the VA if they experienced long wait times or lived more than 40 miles from a VA facility. The House voted on Wednesday to appoint conferees to iron out the differences between the two bills and send a final version to the president.
Rep. Michael H. Michaud, Maine Democrat and ranking member of the committee, said he thinks concerns about budget responsibility may have prevented the VA from sending patients to outside providers.
“Unless we in Congress are willing to write a blank check to VA, we also need to be conscious of cost-effectiveness,” he said.
In fiscal 2013 the VA spent $4.8 billion, or about 11.6 percent of its medical services budget, on non-VA care, according to a Government Accountability Office report.
The cost of harnessing private health care could eventually run to $50 billion a year, according to the Congressional Budget Office.
Despite that price tag, Congress will likely pass its legislation, said Rep. Tom Cole, a close ally of House Speaker John A. Boehner.
“I don’t know if it will be paid for or not. I think the votes will be there either way,” said Mr. Cole, Oklahoma Republican. “Obviously, if there is a way to pay for it that’s going to cause some angst and] you may lose a few votes, but at the end of the day, it is going to get done.”
Mr. Cole said that fewer House Republicans will balk at the hefty price tag on the VA bill than they did for the $50 billion emergency aid for communities hit by Superstorm Sandy. The Sandy aid, which mostly went to New York and New Jersey, was nearly derailed over objections to it not being paid for.
“Look, everybody’s got veterans in their district. Sandy didn’t hit every place in America,” said Mr. Cole. “We need to keep the promises we made. Whatever we have to do to pay for it, let’s do that. Whatever it is is less important than keeping our promises.”
• S.A. Miller contributed to this report.