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U.S. Sen. Patty Murray visited Vancouver on Wednesday to meet with veterans affected by a 2018 change in how health care benefits are administered and billed.
At a roundtable conversation at Fort Vancouver National Site, the Democratic lawmaker heard from three local veterans who navigated the switch to the Veterans Affairs Community Care Program, part of 2018’s MISSION Act. Murray is a senior member of the Senate Committee on Veterans’ Affairs.
Murray said she has been hearing from U.S. Department of Veterans Affairs officials that the transition to the new system is going off without a hitch. But conversations with veterans around the state who rely on VA health care, Murray said, paint a different picture.
“They told us that they’ve rolled it out, that it’s working great, that they’ve notified all the veterans and all the providers, and everybody knows what they’re doing,” Murray said. “And that is not the case at all.”
From Choice to MISSION
From 2014 to 2018, certain health care services for veterans were covered under the Choice Act. The Choice Act allowed veterans to receive care from eligible non-VA health care entities or providers if they couldn’t get an appointment within 30 days, or if they lived more than 40 miles from a VA facility.
The Choice Act was temporary, tied to the lifespan of a $2 billion fund. Of that, $500 million went toward hiring more VA providers.
Last year, the MISSION Act, or the Maintaining Internal Systems and Strengthening Integrated Outside Networks Act, replaced Choice. It expands the criteria that would allow a veteran to seek non-VA primary care doctors and specialists, allowing more people to choose private health care providers.
Among the new criteria: Is your VA personal physician more than 30 minutes away by car? Is your specialist more than an hour away? Does your referring clinician agree that a non-VA doctor would be in your best interest?
The MISSION Act had bipartisan support in the House and the Senate, and President Donald Trump signed it into law in June 2018.
“The changes not only improve our ability to provide the health care veterans need, but also when and where they need it,” VA Secretary Robert Wilkie said in a written statement. “It will also put veterans at the center of their care and offer options.”
The MISSION Act is not without critics on Capitol Hill, who argue that overreliance on non-government health care for veterans further privatizes the VA, outsourcing care for which the federal government should be held responsible.
Struggles on the ground
The new law also is not without critics in Clark County. One local veteran told Murray on Wednesday that the MISSION Act’s rollout created a tangle of confusing red tape that prevented him from getting health care.
Nate Patterson, a Navy veteran who moved to Vancouver in 2013, said he has experienced two difficult transitions in his life — first when he attempted to adjust to civilian life, and again around the same time the VA switched from the Choice Act to the MISSION Act.
“In that transition, MISSION was starting to roll out, but nobody had any idea what you were supposed to do, who you were supposed to see, who had the answers or information to find health care,” Patterson said.
Unable to get answers from the VA, Patterson finally ended up getting the information directly from Murray’s office, he said.
“That’s not how it’s supposed to work,” Murray responded.
Patterson said he needed mental health services for a range of issues. It was hard enough getting the care he needed the first time around, he said, but going through the process of finding a provider all over again during the switch from Choice to MISSION added an extra layer of discouragement.
“It felt horribly awful to try and go through it again — without there being a proper out-boarding process for active duty transitioning to the civilian sector — doing it again, and kind of feeling alone in the process, was just rough.”
After moving to Seattle about the same time the MISSION Act was implemented, Patterson said he struggled to have his medical records transferred to a closer facility. But he ended up just driving back to Vancouver to see his specialist.
“Because Choice was already phased out but MISSION wasn’t really rolled in, I just drove two and a half hours both ways,” Patterson said.
It wasn’t sustainable, he added. He ended up dropping his VA health care.
“I just didn’t go. I managed personally until I could get privatized health care,” Patterson said.
The whole experience was isolating, he said. It left him feeling like “you’re the only one that feels that you matter.”
Another veteran at Wednesday’s roundtable, Tonya Wark of Veteran Services Partners in Careers, had mixed reviews of the new Community Care Program.
Urgent care services are better under MISSION, Wark said — but before, she added, they were nonexistent.
Wark said she recently tore a calf muscle and was able to get an appointment and crutches immediately, and she billed the VA without any issues.
Murray said most of the problems she’s heard so far from veterans focus on confusion surrounding MISSION’s initial rollout, and on problems with billing.
“I’m hearing a lot of what you’ve been through, which is: Who do you call? Who’s been trained at the VA to deal with it? It sounds like the VA down here’s doing fairly well,” Murray said. “(But) then people are getting the bills, and it goes into a black hole somewhere where they can’t figure out who’s supposed to do what with it.”
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