IAVA | September 28, 2017
Read: Veterans in the Health Care Debate
Debating Health Care
The veteran community is often looked upon as a measured voice of leadership in national discussions. When it comes to health care, it’s no different: the veteran community has a role in shaping the future.
For the past few years, our nation has been embattled in a debate on health care: what it should look like, what Americans want from their health care, how much it should cost, and what role the government should play. In recent months, the debate has reached a crescendo; it seems every month there is a new health care bill introduced that would rewrite the system and we are launched into a renewed conversation on the future of American health care.
It is a debate worth having: health care makes up over one sixth of the American economy, and changes to the system has implications for our economy, our jobs, our families, and of course, our health.
While veterans are always at the forefront of conversations about the Department of Veterans Affairs (VA) reform, it is important for the veteran community to participate in the larger health care conversation as well. In 2014, only 42% of all veterans were enrolled in VA health care, and less than 30% actually used those services. Over 70% of veterans use either private insurance or a combination of private and public insurance, meaning the majority of veterans are seeking at least some care outside the VA. IAVA members are split as well: in our most recent member survey, 25 percent of respondents used only VA health care and 32 percent use VA health care and supplemental insurance. Another 25 percent of IAVA respondents use outside insurance entirely.
On any discussion about health care, it is important for us as a community to keep in mind that most veterans seek care from the same doctors and clinicians as civilians, and many are insured by private insurance companies. So when changes are made to the private health care industry, it impacts our community.
The RAND Report
A recent RAND report explored the difficult relationship between veterans and the health care industry under the Affordable Care Act and how new legislation may impact veterans both inside and outside the VA system. The big takeaway is that the RAND report suggests veterans are more likely to be insured since the passage of the ACA due to Medicaid expansion and the public marketplaces. The results showed what the veteran community already knows: veterans’ health care choices are as diverse as the veteran population itself.
The RAND report makes one finding that should be key in the discussion of health care and the veteran space. If the ACA is repealed, it will likely increase the demand on the VA from veterans that either use other forms of health insurance or use the VA in conjunction with another form of health insurance. The report estimates that without the ACA, the VA may see an increase of 125,000 office visits, 1,500 inpatient surgeries, and 375,000 prescriptions. That means that the problems the VA already faces, such as staff shortages, accountability problems, and oversight issues, could potentially become worse. To be fair, the study can only estimate the impact of health care changes due to the data available, but even given this, the importance of the study is that it confirms what the community suspected: repeal could lead to further strain on VA.
The bottom line is that when we discuss health care, more often than not, the impact on the veteran space is left without a voice. But it shouldn’t be: veterans will be impacted under any health care legislation as much as every other American. Since many veterans don’t use the VA, changes to the health care system will likely mean they will seek care at VA if they are eligible, or if they choose not to go to VA, they will still be impacted by the implications for private insurance.
While the debate on the latest health care legislation may be over, we know that there is still a larger, ongoing national discussion about the future of American health care. IAVA will continue to make your voice heard on Capitol Hill on a range of issues, including health care and VA reform.
Find out more about our priorities this year by checking out our Policy Agenda. If you, or someone you know, needs help navigating the VA system, our RRRP veteran transition managers are ready to assist.