Members of Congress are hoping to pass legislation in the next few weeks that would allow the Department of Veterans Affairs to boost funding for the Veterans Choice Program before funding is exhausted in August.
The Choice Program was created in 2014 legislation that responded to the VA waitlist scandal, which revealed thousands of veterans were unable to get timely healthcare appointments at the VA. The program gives veterans the option of finding care outside the VA system if the nearest VA clinic is too far away from where they live.
But about a year after it was created, the VA surprised Congress by saying it needed to take $3 billion from the Choice Program in order to close a budget shortfall and keep VA hospitals around the country operating. Congress agreed and quickly passed a bill letting the VA repurpose $3.348 billion from the Choice Program.
Observers say that two years later, that decision is contributing to a shortfall in the Choice Program that will make it shut down unless money is found. Under current law, the VA isn't authorized to put money back into the program without an act of Congress.
In June, VA Secretary David Shulkin outlined the problem in a Senate Veterans' Affairs Committee hearing, and suggested that Congress could give the VA authority to move existing money around in order to fund the program past August.
"[I]f there's no action at all by ... Congress, then the Choice Program will dry up by mid August," he said then. He suggested the shortfall is about $600 million.
But with just weeks to go, House and Senate aides indicated they aren't clear yet on exactly how to fix the problem. An aide on the Senate side said lawmakers are working on legislation, but didn't say what fix they are considering.
Representatives of the House Veterans' Affairs Committee didn't return a request for comment.
Veterans groups are watching closely to see how the problem gets repaired. Concerned Veterans for America said in a VA reform memo on Tuesday that the money for the Veterans Choice Program is expected to expire on Aug. 7.
Dan Caldwell, the group's policy director, told the Washington Examiner that there are several ways the problem could be fixed. That could include giving the VA the authority it's seeking or authorizing fiscal year 2018 funds early for the agency. But he said Shulkin's idea of giving the agency more flexibility is "most ideal for us."
Assuming this short-term problem can be fixed, Caldwell's group is already casting an eye toward ways to reform the Choice Program.
"While Congress must quickly move forward on a temporary fix for the VCP budget shortfall, the choice program must ultimately be overhauled, expanded, and permanently reformed," Caldwell wrote in his memo. "Accordingly, VA Secretary Shulkin has asked Congress to pass legislation creating a new VA choice and community care program for the VA by end of the current fiscal year."
The Choice Program was a major victory for veterans groups, although the VA implemented it reluctantly at first under former President Barack Obama, and some Democrats feared it was a step toward privatizing the agency.
Caldwell said that over the long haul, the program needs to be expanded so that veterans have increased healthcare options outside the VA. He also wants it to control costs and boost the transparency of costs and quality of VA care.
"Considering that many veterans are still waiting months for critical care and have no option to receive care in the community, it is critical that Congress produces legislation that not only streamlines existing contracted care programs, but which puts the veteran at the center at the VA by empowering them with more choice," he wrote.
The clock is ticking on these longer-term reforms as well, and there is no guarantee they will be made.
The Veterans Choice Program was created as a three-year, temporary solution. President Trump in April signed legislation allowing the program to continue past its planned Aug. 7 expiration and use available funds for as long as they last.
The VA under Trump seems to recognize the demand for maintaining some kind of choice program for veterans.
"The VCP is a critical program that increases access to care for Veterans by authorizing millions of appointments for Veterans in the community," the VA's own website says about the program.