The Veterans' Access to Care through Choice, Accountability, and Transparency Act of 2014 (; ), also known as the Veterans Choice Act, is a United States public law that is intended to address the ongoing Veterans Health Administration scandal of 2014. The law expanded the number of options veterans have for receiving care and granted the United States Secretary of Veterans Affairs more power to fire senior executives. The Veterans Health Administration scandal of 2014 began with the discovery that there was on-going systematic lying by the Veterans Health Administration about the wait times veterans experienced waiting to be seen by doctors. By June 5, 2014, Veterans Affairs internal investigations had identified a total of 35 veterans who had died while waiting for care in the Phoenix VHA system. Another audit determined that "more than 57,000 veterans waited at least 90 days to see a doctor, while another 63,000 over the last decade never received an initial appointment."
The bill was introduced into the United States House of Representatives during the 113th United States Congress under the name "Pay Our Guard and Reserve Act" as one of the October 2013 mini-continuing resolutions passed by the House during the United States federal government shutdown of 2013. President Obama signed it into law on August 7, 2014. The law includes access to healthcare at non-VA hospitals for rural veterans, as well as vast increases in staffing and facilities at existing VA medical centers.
Background
CNN reported on April 27, 2014 that at least 40 United States Armed Forces veterans died while waiting for care at the Phoenix, Arizona, Veterans Health Administration facilities. By June 5, 2014, Veterans Affairs internal investigations had identified a total of 35 veterans who had died while waiting for care in the Phoenix VHA system. An investigation of delays in treatment throughout the Veterans Health Administration system is being conducted by the Veterans Affairs Office of the Inspector General, and the House has passed legislation to fund a $1 million criminal investigation by the Justice Department. On May 16, 2014, the Veterans Health Administration's top health official, Dr. Robert Petzel, retired early at the request of Secretary of Veterans Affairs Eric Shinseki. On May 30, 2014, Secretary Shinseki, himself, resigned from office amid the fallout from the controversy. As of early June 2014, several other VA medical centers around the nation have been identified with the same problems as the Phoenix facility, and the investigations by the VA Inspector General, the Congress and others are widening.
Provisions of the bill
The bill costs nearly $2 billion. Approximately $500 million would be used for hiring more doctors and nurses to work for the VA. Veterans who live over 40 miles away from the nearest VA health clinic or who are unable to get an appointment in a reasonable time frame would be able to receive "choice cards" allowing them to seek treatment from a non-VA facility. This would be a pilot program lasting for two years. Veterans would be allowed to go to other providers that accept Medicare, the military's health program TRICARE, or at facilities run by the United States Department of Defense. The Secretary of Veterans Affairs would have increased power to fire senior executives. The executives could be removed immediately from the payroll and would only have a week to appeal being fired. Three weeks later, a merit board would make a final decision in that person's case. The bill would authorize the VA to build 26 new facilities. The bill would require public colleges and universities to grant veterans in-state tuition. The bill would improve the medical care that victims of military sexual assault receive. The Act shifts the cost of the medical treatment and care to the veteran's private insurance plan and the Veterans Administration now requires joining the Choice program as a condition of receiving medical care, although this change has not been published. Congressman Jeff Miller's House Committee report anticipated a $200,000,000 recovery from veterans' private health plans, but with only 84,386 appointments made through the first six months of 2015, shifting the cost to the private sector has not been successful.
Congressional Budget Office report
This summary is based largely on the summary provided by the Congressional Budget Office, as introduced in the Senate on June 10, 2014. This is a public domain source. Title III of S. 2450 was incorporated completely into H.R. 3230. This relationship was identified by the Congressional Research Service.