Sens. Jeanne Shaheen, Kelly Ayotte tout VA reform package at event in Merrimack

Last modified: Saturday, August 02, 2014
Had the Veterans Affairs reform that passed this week been around earlier, Mike Lopez – who served in Vietnam – said he might not have needed to travel all the way to White River Junction, Vt., for an operation because the procedure wasn’t available at the Manchester VA Medical Center.

Bill Ryan, also a Vietnam veteran, hopes that he might be able to avoid 55-minute trip he usually takes between his Lyndeborough home and the Manchester facility. Now, Ryan said, he can go to a doctor’s office outside of the VA system and “could be there in 10 minutes.”

And Judy Bell, a U.S. Army veteran from Nashua, said she’s relieved to be able to seek care in an environment that’s less male-dominated and more sensitive to her needs as a survivor of military sexual trauma.

“Women veterans, or another veteran who has suffered, would feel more comfortable when they’re able to get health care in timely manner, in private manner and with dignity,” said Bell, who has previously spoken publicly about her experience.

These and other veterans who gathered at the Merrimack VFW Post 8461 yesterday morning said the Veterans Access, Choice, and Accountability Act – which passed overwhelmingly in both houses of Congress this week – eases a significant burden on veterans who have had to travel hours to access their nearest VA medical facility and gives them more of a say in their health care overall.

The law was born from an effort to respond to the widespread scheduling issues that plagued VA facilities in other states, but New Hampshire Sens. Kelly Ayotte and Jeanne Shaheen fought for a key provision that allows veterans who live in a state without a “full-service” VA medical facility to access care at private providers.

“We all know too well what this has meant for our veterans: long travel times, long wait times,” Shaheen told the crowd at the VFW. “We’ve heard too many stories, from veterans, of sitting on a bus to get the care they need.”

Under the new law, if a veteran lives in a state – like New Hampshire – whose VA medical facility doesn’t offer “hospital care,” “emergency medical services” and “surgical care rated by the Secretary as having a surgical complexity of standard,” they can seek out care at another provider to be covered by the VA. This also applies to veterans who live more than 20 miles from the nearest such facility in a neighboring state and those who live more than 40 miles from the closest VA medical facility or community-based outpatient clinic, according to the law.

For example, Shaheen said in an interview Thursday, if a veteran lives in Keene – where there is a VA outpatient clinic – he or she can still access care at another provider because the closest full-service VA medical facility would be more than 20 miles away.

As pointed out by PolitiFact New Hampshire last year, “there is no industry-wide definition of a ‘full-service’ hospital.” Shaheen, when asked about the designation, pointed to criteria in the legislation that outlines what the government considers to be equivalent to “full-service” care.

Shaheen and Ayotte said the law is especially critical in New Hampshire, where the Manchester facility doesn’t offer the full range of services found at other VA hospitals. Both said they’ve been hearing for years – in Shaheen’s case, since she was governor in the 1990s – from veterans who struggled to access the benefits they’re promised as part of their service because they lived hours away.

Ayotte said she’s also hopeful that New Hampshire can serve as a model for the rest of the nation on giving veterans more choice on where they can go for medical treatment.

“Veterans have not had what many of us have taken for granted: the ability to choose our own health care provider,” Ayotte said at yesterday’s event. “It’s about choice for our veterans, respect for our veterans to decide what is best for them.”

Even with the health care reforms and other accountability measures, the senators said the bill isn’t perfect. Ayotte and Shaheen each said, separately, that they wished the legislation included reductions in bonuses for the VA staff who were involved in the wait-list scandal that came to light earlier this year. And both said they’d continue to push for measures that would hold those officials accountable.

Details of the law’s implementation will require further work, the senators said. Several at the event, including Bell, raised questions about the new provision. Bell wondered whether veterans would still be burdened by having to travel to a VA facility to be screened for military sexual trauma before having their care covered at another provider. The senators said they would follow up with Bell to further address her concerns.

As Ayotte described it in an interview Thursday, getting the health care access provision in the bill was a matter of dividing and conquering: Shaheen made the rounds to explain its benefits to Democratic colleagues, and Ayotte did the same with fellow Republicans.

In the end, the senators agreed, the teamwork paid off.

That didn’t go unnoticed by Bob Desmond and other veterans. Desmond, who serves as the commander of the New Hampshire Korean War Veterans Administration, commended the New Hampshire senators for working across party lines on this issue – and he said leaders elsewhere should take note.

“The country is divided, but this shows it can be done. And it took two ladies from New Hampshire to do it,” said Desmond, who lives in Nashua. “What they did for us is just the beginning of what bipartisanship can do for the country.”

(Casey McDermott can be reached at 369-3306 or cmcdermott@cmonitor.com or on Twitter @caseymcdermott.)