Vets Hopeful, Skeptical New Law Will Bring Choice Outside VA System

Jan 12, 2015

Veterans and their families listen to a presentation at the VA clinic in Conway.
Credit Jack Rodolico

Last April, the news broke that 40 veterans had died while waiting for medical care from a VA Hospital in Arizona. That provoked a national outcry at long wait times for sick vets.

Congress passed a $16.3 billion law to overhaul the Veterans Affairs Administration, and a crucial aspect of that law is now unfolding in New Hampshire. The idea is for the VA to pay for medical treatment outside the VA system.

At a recent town hall-style meeting at the VA clinic in Conway, Stan Solomon expressed the frustration many vets feel with accessing the VA system. For eight years he was a volunteer driver, bring vets from up north down to the VA hospital in Manchester.

"For things like diabetics having to have their toenails cut. The cost of driving them down there and back would be far greater than having the cost of a podiatrist up here," says Solomon.

"I thought that this perhaps might make the difference," Soloman adds, holding up his shiny, new Choice Card. Congress passed the Veteran’s Choice, Access and Accountability Act last year to get this card into Solomon’s hands. It’s like an insurance card that, in theory, will allow him to see a local doctor, who will then be reimbursed by the VA at Medicare rates.

But Stan already tried using the Choice Card to set up an appointment with a local dermatologist. And he got conflicting information from staff at the Manchester VA about whether he even qualifies for the program.

"For one person to tell me that I’m qualified and for another person to say well I have to wait to see if you’re qualified – well I don’t know what stage I’m at. Do I make another appointment with Manchester, or do I just wait?" Solomon asks VA staff.

The Choice Program is supposed to make things easier. New Hampshire is home to more than 117,000 veterans, and about one-quarter of them uses the VA system.

And under the new Choice Program, vets who live more than 20 miles from White River Junction – that’s the location of the closest full-service VA hospital – and who meet a couple other qualifications, are be able to see a doctor close to home, with VA paying the bill.

That is, if the doctor already accepts Medicare, and has agreed to participate in the Choice Program.

There’s already some confusion. The VA in Manchester is responsible for communicating with the state’s vets. But they don’t run the Choice program. It’s a private company that’s determining veterans’ eligibility and distributing the cards.

Veteran Bill Hounsell of North Conway is concerned about having so many parties communicating. Or miscommunicating. He says he recently went to a hospital, and they mixed up his VA billing.

"When you go into the hospital and tell them to bill the VA, they just don’t listen. So they bill Medicare. And then you assume that the VA’s going to take care of it. Time goes by, then you get collection letters," Hounsell says.

Gary VonGeorge, the Manchester VA’s business office manager, says VA is communicating with hospitals across the state to educate them about the new program.

He also emphasizes that vets need to be proactive. He says if the private company overseeing the Choice Program sends a veteran to doctor 70 miles away, that veteran should push back.

"This is your choice.…If they give you an appointment that you feel is unreasonable, tell them, No. You’re exercising your choice under the Choice Law. And you want a provider closer," says VonGeorge. 

Everyone at this meeting had glowing praise for staff at New Hampshire’s six VA facilities. And that makes sense. According the VA’s own data, approximately 95 percent of veterans in New Hampshire get appointments in less than 30 days.

It’s the bureaucracy above the local staff that has veterans like Stan Solomon skeptical.

"I’d like to be optimistic but I’m going to take a wait-and-see attitude. I would hope that it’s not just another political ploy of some sort. 'Thank you for your service' is a meaningless statement unless you follow it up with some action," Solomon says.

Choice Cards will be mailed out in the coming weeks. Then it will be a matter of vets doing their homework to find out where they can get service closer to home, if they choose to. The program is set to expire in three years, when the VA should have enough staff to avoid the kind of long delays that spurned Congress to pass the law in the first place.