Veteran healthcare changes explained during budget hearing

Future VA funds focused on “foundational services”

Jonathan Kaupanger
March 22, 2018 - 9:35 am

Photo by Oliver Contreras


It doesn’t seem like VA Secretary David Shulkin has to worry about his job, if the Senate Committee on Veterans Affairs has any say in the matter. With only a few minor exceptions, Wednesday’s budget hearing went well for VA leadership, at least for now.

Ranking Member Jon Tester (D-MT) is very forceful with his concerns of privatization of VA’s healthcare. VA spends $370 million each month to pay for veteran healthcare outside of the VA system. Privatization could be at the core of Shulkin’s problems at the VA right now,

Read also: Is Shulkin fighting for his job? 

Shulkin did give more insight on how he sees private care functioning alongside the VA.  “I am implementing reforms,” he said, “that will prioritize our foundational services while redirecting to the private sector those services that they can do more effectively and efficiently.”  The foundational services are more service-connected, according to the Secretary.  They are primary care, including women’s health; urgent care; mental health care; geriatrics and extended care; rehabilitation; post deployment health care and war-related illness.

The Secretary said that even though this was a significant change to how VA provides care, veterans could continue to receive all services at VA facilities.  “VA will continue to ensure that the full array of statutory VA health care services are made available to all enrolled veterans,” said Shulkin.

If the mid-term elections change things, then Shulkin could expect more difficulty at these hearings. The Washington Post reports that while Shulkin may be taking VA towards private healthcare, he’s doing so slower than some would like, including the president.

The only other big concern was about consolidating VA’s checkbooks. VA finance is confusing at best. This hearing is for next fiscal year’s budget and also projecting into 2020.  VA has to do this so in the event of a government shutdown, like the two that have occured this fiscal year, veterans can still receive benefits and healthcare. 

The Choice Program – veterans getting care outside of the VA system – has added problems to the process.  It’s hard to predict how fast the program will grow, which is why Shulkin keeps returning to the committee to request more community care money.  VA wants to simplify things by consolidating the payment process. Lawmakers are worried this will limit their oversight on VA spending.  Jon Rychalski, VA’s new Assistant Secretary for Management and CFO, explained that the money would be in an account that is already under the committee’s oversight, so it should be easier for both sides.

In total, the requested budget for next year is 8.3 percent higher than this year’s budget. Modernizing VA’s IT systems is a much needed reason for the increase.  $1.2 billion is going into the new electronic health record system. Other older systems that are being upgraded include the Benefits Delivery Network and the Burial Operations Support Systems.  Another almost $400 million will be put into protecting veterans personal information.

In the middle of all the money requests, Shulkin had some good, cost-saving, news.  VA spends about $25 million every year on the upkeep of 430 unused or mostly unused buildings.  “VA is on track to meet the goal that I set in June 2017, to initiate disposal or reuse actions for all 430 buildings by June 2019.”  According to Shulkin, there are only 299 buildings left on that list.