Veterans Affairs Department expands coverage amid patient safety concerns

The Associated Press reports that the VA "opened the doors of its health care system Monday to about 266,000 nondisabled veterans with moderate incomes, some of whom have been shut out of those benefits. The veterans eligible are from a category known as "Priority 8." They have no illnesses or injuries attributed to their military service, and they earn more than the average wage in their communities."

The AP notes that such veterans were previously denied enrollment because of a cost-savings move in 2003, but the VA is expanding eligibility by raising income restrictions from about $29,000 to $32,000, which is adjusted for the cost of living. The effort represents part of President Barack Obama's campaign promise to bring all veterans into the VA's system. The AP notes that: "In 1996, Congress ordered the agency to open health care to nearly all veterans, but lawmakers also gave the VA secretary the authority to suspend enrollments" (Hefling, 6/15).

Stars and Stripes reports that the expansion should occur by October 2010 thanks to $543 million in new funding this fiscal year. The department will send out letters to nearly half a million veterans asking them to reapply to see if they qualify under the new rules and as many as 4,000 new veterans could be enrolled in the next few weeks. The paper notes: "As the economy has faltered, the department has seen a sizeable leap in the number of veterans outside the system asking for help. In the first six months of 2008, just under 30,000 veterans applied for hardship benefits from the department, a temporary enrollment into the health care system. So far in 2009, more than 69,000 have asked for the same help."

The paper also reports that the VA "will determine eligibility using an exhaustive list of income thresholds based on where veterans live" and "has also set up an online calculator on its Web site where individuals can check whether their salary falls above or below the cutoff for benefits. For higher priority veterans - those injured on duty, those living in poverty, former prisoners of war - free health care is virtually guaranteed, provided they received an honorable discharge. Recent combat veterans are also promised free health benefits, and are currently ranked by the Department as Priority 6, the same as World War II veterans. In all, department officials said about 7.7 million people are currently in the health care system. Priority 8s in the system face co-pays for doctor visits and prescriptions, but spend far less than they would on a private insurance plan" (Shane, 6/16).

As it expands coverage, the VA is also receiving attention for a report that found continued problems with colonoscopies at its medical centers in Tennessee, Georgia and Florida. The Associated Press reports: "Veterans Affairs officials will face fresh questions about patient safety at a House hearing Tuesday after an internal review found continued weaknesses with colonoscopies and other procedures at the agency's medical centers.The latest findings - that fewer than half of VA facilities selected for surprise inspections last month had proper training and guidelines in place - are contained in an inspector general's report to be released at the hearing. The findings, obtained in advance by The Associated Press, suggest that errors in colonoscopies and other minimally invasive procedures may be more widespread than initially believed. The report comes months after the agency learned that mistakes at three centers in Georgia, Florida and Tennessee may have exposed thousands of veterans to HIV and other diseases. Rep. Harry Mitchell, D-Ariz., who will chair the hearing, on Monday called the situation a "damaging blow to the trust veterans place in the VA." The AP reports that "earlier this year, the discovery of a mistake at a Murfreesboro, Tenn., facility led to a nationwide safety campaign at the VA's 153 medical centers, calling attention to potential infection risks from improperly operating and sterilizing the equipment" (Evans, 6/16).