Jacquelyn Martin/AP

Obama Accepts Most of Panel’s VA Health Reform Proposals, but Rejects Core Changes

Administration says its own plan to integrate with private sector is preferable.

President Obama has committed to more Veterans Affairs Department reforms, though he rejected several of the core principles of change that a congressionally-chartered commission proposed to better deliver private sector health options to VA care recipients.

Overall, Obama told congressional leadership he agreed with 15 of the Commission on Care’s 18 recommendations. He rejected a proposal to restructure the Veterans Health Administration governance, including the creation of an 11-member board of directors to set the agency’s long-term strategy. Obama said the Justice Department has told him the reform would violate the appointments clause of the Constitution.

“The proposal would undermine the authority of the secretary and the under secretary for health, weaken the integration of the VA health care system with the other services and programs provided by the VA and make it harder -- not easier -- for VA to implement transformative change,” Obama wrote in a letter to House and Senate leaders.

The Commission on Care, created by a 2014 VA reform law to provide suggestions for the health care component that houses 90 percent of VA’s employees, issued its recommendations in July. Even before the commission wrapped up its work, alternative proposals emerged in Congress, the veteran community, from representatives of the VA workforce and even within the panel itself. Only 12 of the 15 commissioners signed their name on the report, with the remaining members issuing a dissenting view the commission’s chairwoman declined to include in the final document.

The commission proposed a new VHA Care system, made up of government-owned, VA and Defense Department facilities, as well as “VHA-credentialed community providers.” Those partners would be “fully credentialed with appropriate education, training and experience, provide veteran access that meets VHA standards, demonstrate high-quality clinical and utilization outcomes, demonstrate military cultural competency, and have capability for interoperable data exchange,” the commission said.

Obama said the plan was similar to one he sent to Congress last year, but maintained his approach was preferable to the one laid out by the commission.

“Of particular note, I strongly support the commission's principle that creating a high-performing, integrated health care system that encompasses both VA and private care is critical to serving the needs of veterans,” Obama said.

He stressed, however, the importance of preserving the VA’s health care system and its “multidisciplinary” and “comprehensive” approach that provides veterans with not just mental and physical care, but also other benefits and other services. 

The commission’s plan, Obama said, would force “untenable resource tradeoffs that would limit the ability of VA to carry out other parts of its mission on behalf of veterans.”

The president said many of the other recommendations are already under way at VA, including through Secretary Bob McDonald’s MyVA initiative. Obama noted VA is already “enhancing clinical operations, establishing a more consistent policy for appealing clinical decisions, eliminating disparities in how health care is delivered to veterans from different backgrounds, modernizing IT systems and establishing new processes for leadership development and performance management,” as the commission proposed.

On the personnel side, the commission called for a new performance management system that could benchmark VHA leaders to the private sector and create performance measures that reward top performers with awards. The panel suggested Congress empower VA with more direct hiring authority and temporary rotations to allow more health experts to cycle through the department.

The final report included a proposal to shift all 300,000 VHA employees away from Title Five and onto Title 38 to provide the department with more flexibility in pay, benefits and recruiting. While the change would be designed to ease hiring and firing at the agency, the panel said the new system should maintain due process appeal rights and merit system principles. It suggested, however, removing the Office of Personnel Management’s oversight of the new system.

Overall, the president praised the work of the commission and said he “strongly” supported the vast majority of its suggestions.

“These recommendations underscore the fundamental challenges that face the VA health care system, and the reforms needed to provide America's veterans with the high quality health care they need and deserve -- both now and in the future,” Obama wrote.

He directed VA to “develop plans” to implement the recommendations he agreed with that are not already under way, and said he would work with McDonald to send Congress legislative proposals to enact the proposals that require new laws.

For his part, McDonald said VA “stands firmly behind” Obama’s assessment of the commission’s report. The secretary also noted the administration’s plan to reform access to private sector care “would provide veterans with the full spectrum of health care services and more choice without sacrificing VA’s foundational health services on which many Veterans depend.”

The House Veterans' Affairs Committee will hold a hearing on the commission’s report next week. 

X
This website uses cookies to enhance user experience and to analyze performance and traffic on our website. We also share information about your use of our site with our social media, advertising and analytics partners. Learn More / Do Not Sell My Personal Information
Accept Cookies
X
Cookie Preferences Cookie List

Do Not Sell My Personal Information

When you visit our website, we store cookies on your browser to collect information. The information collected might relate to you, your preferences or your device, and is mostly used to make the site work as you expect it to and to provide a more personalized web experience. However, you can choose not to allow certain types of cookies, which may impact your experience of the site and the services we are able to offer. Click on the different category headings to find out more and change our default settings according to your preference. You cannot opt-out of our First Party Strictly Necessary Cookies as they are deployed in order to ensure the proper functioning of our website (such as prompting the cookie banner and remembering your settings, to log into your account, to redirect you when you log out, etc.). For more information about the First and Third Party Cookies used please follow this link.

Allow All Cookies

Manage Consent Preferences

Strictly Necessary Cookies - Always Active

We do not allow you to opt-out of our certain cookies, as they are necessary to ensure the proper functioning of our website (such as prompting our cookie banner and remembering your privacy choices) and/or to monitor site performance. These cookies are not used in a way that constitutes a “sale” of your data under the CCPA. You can set your browser to block or alert you about these cookies, but some parts of the site will not work as intended if you do so. You can usually find these settings in the Options or Preferences menu of your browser. Visit www.allaboutcookies.org to learn more.

Sale of Personal Data, Targeting & Social Media Cookies

Under the California Consumer Privacy Act, you have the right to opt-out of the sale of your personal information to third parties. These cookies collect information for analytics and to personalize your experience with targeted ads. You may exercise your right to opt out of the sale of personal information by using this toggle switch. If you opt out we will not be able to offer you personalised ads and will not hand over your personal information to any third parties. Additionally, you may contact our legal department for further clarification about your rights as a California consumer by using this Exercise My Rights link

If you have enabled privacy controls on your browser (such as a plugin), we have to take that as a valid request to opt-out. Therefore we would not be able to track your activity through the web. This may affect our ability to personalize ads according to your preferences.

Targeting cookies may be set through our site by our advertising partners. They may be used by those companies to build a profile of your interests and show you relevant adverts on other sites. They do not store directly personal information, but are based on uniquely identifying your browser and internet device. If you do not allow these cookies, you will experience less targeted advertising.

Social media cookies are set by a range of social media services that we have added to the site to enable you to share our content with your friends and networks. They are capable of tracking your browser across other sites and building up a profile of your interests. This may impact the content and messages you see on other websites you visit. If you do not allow these cookies you may not be able to use or see these sharing tools.

If you want to opt out of all of our lead reports and lists, please submit a privacy request at our Do Not Sell page.

Save Settings
Cookie Preferences Cookie List

Cookie List

A cookie is a small piece of data (text file) that a website – when visited by a user – asks your browser to store on your device in order to remember information about you, such as your language preference or login information. Those cookies are set by us and called first-party cookies. We also use third-party cookies – which are cookies from a domain different than the domain of the website you are visiting – for our advertising and marketing efforts. More specifically, we use cookies and other tracking technologies for the following purposes:

Strictly Necessary Cookies

We do not allow you to opt-out of our certain cookies, as they are necessary to ensure the proper functioning of our website (such as prompting our cookie banner and remembering your privacy choices) and/or to monitor site performance. These cookies are not used in a way that constitutes a “sale” of your data under the CCPA. You can set your browser to block or alert you about these cookies, but some parts of the site will not work as intended if you do so. You can usually find these settings in the Options or Preferences menu of your browser. Visit www.allaboutcookies.org to learn more.

Functional Cookies

We do not allow you to opt-out of our certain cookies, as they are necessary to ensure the proper functioning of our website (such as prompting our cookie banner and remembering your privacy choices) and/or to monitor site performance. These cookies are not used in a way that constitutes a “sale” of your data under the CCPA. You can set your browser to block or alert you about these cookies, but some parts of the site will not work as intended if you do so. You can usually find these settings in the Options or Preferences menu of your browser. Visit www.allaboutcookies.org to learn more.

Performance Cookies

We do not allow you to opt-out of our certain cookies, as they are necessary to ensure the proper functioning of our website (such as prompting our cookie banner and remembering your privacy choices) and/or to monitor site performance. These cookies are not used in a way that constitutes a “sale” of your data under the CCPA. You can set your browser to block or alert you about these cookies, but some parts of the site will not work as intended if you do so. You can usually find these settings in the Options or Preferences menu of your browser. Visit www.allaboutcookies.org to learn more.

Sale of Personal Data

We also use cookies to personalize your experience on our websites, including by determining the most relevant content and advertisements to show you, and to monitor site traffic and performance, so that we may improve our websites and your experience. You may opt out of our use of such cookies (and the associated “sale” of your Personal Information) by using this toggle switch. You will still see some advertising, regardless of your selection. Because we do not track you across different devices, browsers and GEMG properties, your selection will take effect only on this browser, this device and this website.

Social Media Cookies

We also use cookies to personalize your experience on our websites, including by determining the most relevant content and advertisements to show you, and to monitor site traffic and performance, so that we may improve our websites and your experience. You may opt out of our use of such cookies (and the associated “sale” of your Personal Information) by using this toggle switch. You will still see some advertising, regardless of your selection. Because we do not track you across different devices, browsers and GEMG properties, your selection will take effect only on this browser, this device and this website.

Targeting Cookies

We also use cookies to personalize your experience on our websites, including by determining the most relevant content and advertisements to show you, and to monitor site traffic and performance, so that we may improve our websites and your experience. You may opt out of our use of such cookies (and the associated “sale” of your Personal Information) by using this toggle switch. You will still see some advertising, regardless of your selection. Because we do not track you across different devices, browsers and GEMG properties, your selection will take effect only on this browser, this device and this website.