The VA Mission Act, which Congress passed with bipartisan support before Memorial Day, was designed to overhaul the way veterans get private-sector care, close or consolidate underused facilities and provide new incentives to hire doctors, among other changes.
One of the central purposes of the law is to replace emergency legislation called the Choice Act, which was passed after a VA wait-time scandal sparked demand to change the department and give veterans more choice for their health care.
Congress pushed through the Choice Act in 2014, mandating that the VA implement it within 90 days, which set the program up for failure, said
Rep. Phil Roe
(R., Tenn.), the chairman of the House Committee on Veterans’ Affairs. Earlier this week, a Government Accountability Office report said the VA “cannot determine whether the Choice Program has helped to achieve the goal of alleviating veterans’ wait times for care.”
“We started this four years ago,” Mr. Roe said. “It’s one of the most sweeping pieces of legislation we’ve passed since I’ve been” in Congress, he said.
The new legislation, while welcomed by most lawmakers and veterans groups, comes at a time of turmoil for the department. The VA has cycled through three secretaries since 2014 and doesn’t have an official nominee to succeed
David Shulkin,
whom Mr. Trump fired in March.
“What this department needs is some long-term stability,” Mr. Roe said. He said he is tired of the turnover at the top of the VA, which makes it difficult to have policy continuity.
“This is my fourth secretary. It’s not unique to the Trump administration,” he said.
After Dr. Shulkin’s dismissal, Mr. Trump, a Republican, said he would nominate his personal physician,
Rear Adm. Ronny Jackson,
to take over the job. His nomination was derailed by misconduct allegations, which led to a Pentagon investigation.
Mr. Trump has said he intends to nominate Robert Wilkie, who was serving as acting secretary following Dr. Shulkin’s departure, though he had to step down to be legally nominated for the permanent post. The president hasn’t filed nomination paperwork, according to Senate officials.
Mr. Wilkie declined to answer questions about the matter. Acting Secretary Peter O’Rourke also declined to comment.
Some on Capitol Hill said guarantees made by VA administrators about how the law would be implemented come from people who could quit or be fired when a new secretary takes the helm.
“A lot of these promises being made by people currently filling positions are just hollow promises,” said a congressional aide familiar with the bill’s drafting. “The Senate has a real job ahead of it trying to get assurances from the nominee, moving forward, to define exactly what privatization is and what that is all going to look like.”
Other aides said the bill has protections baked in to make sure that the law is implemented as intended, no matter who is in charge of the department.
“This was a very collaborative effort with the VA, veterans service organizations as well as the White House,” said a staff member for
Sen. Johnny Isakson
(R., Ga.) the chairman of the Senate’s VA committee. “We are not concerned.”
At the signing ceremony, Mr. Trump was surrounded by Republican lawmakers. Only a few Democrats were in attendance, despite the measure’s bipartisan support. Two conspicuous absences were the top ranking Democrats from both the Senate and House veterans committees, Sen. Jon Tester of Montana and Rep. Tim Walz of Minnesota.
In a statement Wednesday criticizing the law, Mr. Walz said it doesn’t have clear funding, which could require the department to cut corners elsewhere and which will lead to a department “forced to cannibalize itself in order to pay for care in the private sector.”
Asked about Mr. Tester’s absence, a spokeswoman for the senator said he is “a work horse not a show horse.”
The White House didn’t respond to a request for comment on the absences.
Representatives of some major veterans organizations said they trust the established process of interaction with the VA as it makes new rules and puts laws into place.
Write to Ben Kesling at benjamin.kesling@wsj.com
Article source: https://www.wsj.com/articles/revamp-for-leaderless-va-aims-to-overhaul-how-veterans-get-private-care-1528286403