Bill Overview
Title: To amend title 38, United States Code, to make certain improvements relating to the eligibility of veterans to receive reimbursement for emergency treatment furnished through the Veterans Community Care program, and for other purposes.
Description: This bill expands eligibility for Department of Veterans Affairs (VA) reimbursement of emergency treatment for veterans who are treated in a non-VA facility. Specifically, the bill waives the requirement that a veteran must have received VA care within the 24-month period preceding the furnishing of emergency treatment if the veteran receives such emergency treatment within the 60-day period following their enrollment in the VA health care system.
Sponsors: Rep. McMorris Rodgers, Cathy [R-WA-5]
Target Audience
Population: Veterans eligible for VA emergency treatment reimbursement
Estimated Size: 9000000
- The bill is specifically aimed at providing financial relief to veterans who receive emergency treatment at non-VA facilities.
- The target population includes veterans who are part of the VA healthcare system or those enrolling into it.
- Given that this bill intends to waive previous treatment requirements, it likely affects new enrollees or those who haven't accessed VA services in the past 24 months.
- Approximately 19 million veterans are currently in the United States, but not all of them are enrolled in VA healthcare.
- Around 9 million veterans are enrolled in the VA healthcare system, forming a broad estimation of those potentially affected.
Reasoning
- The policy affects veterans who need emergency care but haven't used VA facilities in the past 24 months, potentially reducing their emergency care costs.
- The target population is roughly 9 million veterans currently enrolled in VA healthcare.
- The impact is expected to be more pronounced for veterans who recently enrolled or have barriers accessing VA services, potentially affecting their wellbeing.
- Most veterans either receive care directly through the VA or have insurance coverage that doesn't require emergency reimbursement adjustments, so the impact distribution is skewed towards recent enrollees.
- The allocated budget will need to ensure coverage of emergency treatments within non-VA facilities under the constraints given.
Simulated Interviews
retired (San Diego, CA)
Age: 67 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 2.0 years
Commonness: 10/20
Statement of Opinion:
- This policy might help me if I need emergency care when I can't reach a VA facility.
- I don't usually plan to visit emergency rooms, but it's good to be covered just in case.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 7 | 6 |
| Year 10 | 6 | 6 |
| Year 20 | 6 | 6 |
paramedic (Phoenix, AZ)
Age: 34 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 5.0 years
Commonness: 5/20
Statement of Opinion:
- I think this is really good for veterans who might end up away from VA options.
- Emergency care is unpredictable, and this policy offers peace of mind.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 8 | 5 |
| Year 10 | 7 | 5 |
| Year 20 | 6 | 5 |
construction worker (Atlanta, GA)
Age: 45 | Gender: male
Wellbeing Before Policy: 4
Duration of Impact: 5.0 years
Commonness: 3/20
Statement of Opinion:
- I'm glad the VA is looking out for us beyond their centers, especially when emergencies happen.
- This makes me more confident about seeking care when I need it.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 4 |
| Year 2 | 7 | 4 |
| Year 3 | 7 | 4 |
| Year 5 | 7 | 4 |
| Year 10 | 6 | 4 |
| Year 20 | 5 | 4 |
self-employed (Boston, MA)
Age: 55 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 2.0 years
Commonness: 6/20
Statement of Opinion:
- I'm covered by my own insurance mostly, but this ensures even better coverage if I need it.
- It's a relief knowing any emergency care can be reimbursed, avoiding large bills.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 6 | 5 |
| Year 5 | 5 | 5 |
| Year 10 | 5 | 5 |
| Year 20 | 5 | 5 |
part-time student (Miami, FL)
Age: 29 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 4.0 years
Commonness: 4/20
Statement of Opinion:
- I'm often travelling between places, so it's great to have coverage for emergencies.
- This policy makes me feel more secure when I'm not near a VA facility.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 6 | 5 |
| Year 10 | 6 | 5 |
| Year 20 | 6 | 5 |
software engineer (New York, NY)
Age: 38 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 2.0 years
Commonness: 8/20
Statement of Opinion:
- This takes off some financial pressure regarding emergency visits.
- While I don't foresee much emergency care, it's good to have reassurance.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 6 | 6 |
| Year 5 | 6 | 6 |
| Year 10 | 6 | 6 |
| Year 20 | 6 | 6 |
teacher (Dallas, TX)
Age: 49 | Gender: female
Wellbeing Before Policy: 4
Duration of Impact: 4.0 years
Commonness: 7/20
Statement of Opinion:
- I've seen friends struggle with unexpected bills, so I appreciate this.
- This will definitely ease my mind about seeking emergency help when necessary.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 6 | 4 |
| Year 3 | 6 | 4 |
| Year 5 | 6 | 4 |
| Year 10 | 5 | 4 |
| Year 20 | 5 | 4 |
retired (Chicago, IL)
Age: 64 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 3.0 years
Commonness: 11/20
Statement of Opinion:
- I would feel more secure about my healthcare situation with this policy.
- I'm concerned about emergency visits, especially far from VA hospitals.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 6 | 5 |
| Year 5 | 5 | 5 |
| Year 10 | 5 | 5 |
| Year 20 | 5 | 5 |
sales associate (Charlotte, NC)
Age: 55 | Gender: female
Wellbeing Before Policy: 3
Duration of Impact: 6.0 years
Commonness: 4/20
Statement of Opinion:
- This coverage for emergency services is crucial for veterans like me on limited incomes.
- A good move to support emergency care access.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 3 |
| Year 2 | 6 | 3 |
| Year 3 | 6 | 3 |
| Year 5 | 6 | 3 |
| Year 10 | 5 | 3 |
| Year 20 | 4 | 3 |
retired military (Houston, TX)
Age: 72 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 3.0 years
Commonness: 5/20
Statement of Opinion:
- Feels like a safety net for unexpected health issues.
- Having access to non-VA emergency rooms is essential especially in urgent situations.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 6 | 6 |
| Year 10 | 6 | 6 |
| Year 20 | 6 | 6 |
Cost Estimates
Year 1: $1800000000 (Low: $1500000000, High: $2100000000)
Year 2: $1836000000 (Low: $1530000000, High: $2142000000)
Year 3: $1872720000 (Low: $1560600000, High: $2184840000)
Year 5: $1949495250 (Low: $1621350000, High: $2273437500)
Year 10: $2123652000 (Low: $1760100000, High: $2477580000)
Year 100: $3300000000 (Low: $2750000000, High: $3850000000)
Key Considerations
- Increased financial burden on the VA due to the expansion in reimbursable emergency care services.
- Potential for a higher uptake of emergency services by veterans who were previously ineligible.
- Managing budgetary constraints while accommodating a possible surge in claim volumes.