Bill Overview
Title: Veterans Health Care Freedom Act
Description: This bill requires the Center for Innovation for Care and Payment within the Department of Veterans Affairs (VA) to implement a three-year pilot program to improve the ability of veterans who are enrolled in the VA health care system to access hospital care, medical services, and extended care services through the covered care system by providing such veterans with the ability to choose health care providers. Under the bill, the covered care system includes VA medical facilities, health care providers participating in the Veterans Community Care Program (VCCP), and eligible entities or providers that have entered into a Veterans Care Agreement. A veteran participating in the program may elect to receive care at any provider in the covered care system. The pilot program removes certain requirements (e.g., location of the veteran) to access care at VA and non-VA facilities. After four years, the bill eliminates the requirements for accessing care under the VCCP and Veterans Care Agreements and requires the VA to provide such care under the same conditions of the pilot program. Additionally, after four years, veterans may receive care at a VA medical facility regardless of whether the facility is in the same Veterans Integrated Service Network as the veteran.
Sponsors: Sen. Blackburn, Marsha [R-TN]
Target Audience
Population: Veterans enrolled in the VA health care system
Estimated Size: 9000000
- The bill is specifically aimed at veterans enrolled in the VA health care system, which includes millions of individuals who have served in the U.S. military.
- According to recent estimates, there are approximately 19 million veterans in the United States.
- Not all veterans are enrolled in the VA health care system, but a significant portion are, with enrollment numbers around 9 million.
- The bill impacts veterans by providing them with more options for accessing healthcare services through a pilot program, hence directly affecting their healthcare choices and access.
- The implementation of the policy could also impact healthcare providers who are part of the Veterans Community Care Program or those with Veterans Care Agreements.
Reasoning
- The Veterans Health Care Freedom Act primarily targets veterans enrolled in the VA health care system, which is a significant portion of the veteran population in the US, approximately 9 million individuals.
- The policy aims to improve healthcare access, providing veterans with more options by allowing them to choose healthcare providers beyond VA facilities, impacting their self-reported wellbeing.
- Budgetary constraints means the program must balance providing widespread benefits with the cost of extending network options, especially since not all veterans may be equally impacted.
- The policy might have varying levels of impact depending on factors like proximity to healthcare facilities and specific healthcare needs, resulting in differences in wellbeing scores across the veteran population.
- It's important to include perspectives of veterans who might be less impacted, such as those satisfied with current VA services or those residing near VA facilities.
Simulated Interviews
retired veteran (Texas)
Age: 44 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 20.0 years
Commonness: 10/20
Statement of Opinion:
- I think the policy will allow me access to more specialized care that is currently unavailable nearby.
- I'm worried about the possible delays in integrating new providers into the system.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 8 | 6 |
| Year 5 | 8 | 6 |
| Year 10 | 8 | 6 |
| Year 20 | 9 | 6 |
software developer (California)
Age: 31 | Gender: female
Wellbeing Before Policy: 8
Duration of Impact: 5.0 years
Commonness: 15/20
Statement of Opinion:
- The policy seems beneficial, but I am satisfied with current VA services.
- I might use it for specialized appointments. It’s a good backup.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 8 |
| Year 2 | 8 | 8 |
| Year 3 | 8 | 8 |
| Year 5 | 8 | 8 |
| Year 10 | 8 | 8 |
| Year 20 | 8 | 8 |
retired (Florida)
Age: 67 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 15.0 years
Commonness: 8/20
Statement of Opinion:
- Access to more healthcare facilities will greatly improve my life. I travel long distances now.
- I'm concerned about potential bureaucracy in the transition.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 8 | 5 |
| Year 20 | 8 | 5 |
student (New York)
Age: 29 | Gender: male
Wellbeing Before Policy: 9
Duration of Impact: 3.0 years
Commonness: 12/20
Statement of Opinion:
- I'm not directly affected as I hardly use VA health services now.
- Good to know options will be there if needed.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 9 | 9 |
| Year 2 | 9 | 9 |
| Year 3 | 9 | 9 |
| Year 5 | 9 | 9 |
| Year 10 | 9 | 9 |
| Year 20 | 9 | 9 |
nurse (Illinois)
Age: 52 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 20.0 years
Commonness: 7/20
Statement of Opinion:
- Having more choices for mental health professionals would be a huge benefit.
- I hope the cost won't be pushed onto us. VA care should remain affordable.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 8 | 6 |
| Year 3 | 8 | 6 |
| Year 5 | 9 | 6 |
| Year 10 | 9 | 6 |
| Year 20 | 9 | 6 |
mechanic (Ohio)
Age: 39 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 11/20
Statement of Opinion:
- This policy might diversify care options which could reduce wait times.
- Concerned about continuity of care with different providers.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 7 | 5 |
| Year 20 | 7 | 5 |
teacher (Virginia)
Age: 60 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 10.0 years
Commonness: 9/20
Statement of Opinion:
- Flexibility to choose facilities could improve my treatment experience.
- I am wary of disruptions during the policy transition period.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 8 | 7 |
| Year 3 | 8 | 7 |
| Year 5 | 8 | 7 |
| Year 10 | 8 | 7 |
| Year 20 | 8 | 7 |
construction worker (Georgia)
Age: 47 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 15.0 years
Commonness: 6/20
Statement of Opinion:
- Policy would be very beneficial because it allows me to access local clinics.
- Finally possible to avoid long trips for healthcare.
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 | 8 | 5 |
| Year 20 | 8 | 5 |
artist (Washington)
Age: 36 | Gender: other
Wellbeing Before Policy: 7
Duration of Impact: 10.0 years
Commonness: 5/20
Statement of Opinion:
- Easier access to diverse providers could aid in getting specialized care.
- Worried about the vetting process for new providers.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 7 |
| Year 2 | 8 | 7 |
| Year 3 | 8 | 7 |
| Year 5 | 9 | 7 |
| Year 10 | 9 | 7 |
| Year 20 | 9 | 7 |
lawyer (Massachusetts)
Age: 55 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 20.0 years
Commonness: 8/20
Statement of Opinion:
- Granting access to outside providers could cut down my wait time drastically.
- Concerned about coverage specifics and potential out-of-pocket costs.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 8 | 6 |
| Year 5 | 8 | 6 |
| Year 10 | 9 | 6 |
| Year 20 | 9 | 6 |
Cost Estimates
Year 1: $1500000000 (Low: $1200000000, High: $1700000000)
Year 2: $1550000000 (Low: $1250000000, High: $1750000000)
Year 3: $1600000000 (Low: $1300000000, High: $1800000000)
Year 5: $1800000000 (Low: $1500000000, High: $2000000000)
Year 10: $2000000000 (Low: $1700000000, High: $2200000000)
Year 100: $5000000000 (Low: $4500000000, High: $5500000000)
Key Considerations
- The policy will require effective coordination between VA and non-VA health providers to ensure smooth implementation.
- Monitoring and evaluation mechanisms should be in place to assess the outcomes of the pilot program effectively.
- Potential cost overruns due to higher than expected demand from veterans choosing non-VA facilities could challenge budget projections.
- Long-term reliance on non-VA services might necessitate additional collaboration and negotiation practices to manage costs.