About | HeinOnline Law Journal Library | HeinOnline Law Journal Library | HeinOnline
LOG IN
LOG IN

1 1 (December 16, 2016)

handle is hein.crs/goveara0001 and id is 1 raw text is: SCongressional Research Service Inforring the legislative debate since 1914 Introduction to Veterans Health Care December 16, 2016 The federal government's role in providing health care to the nation's veterans can be traced back to World War I. The veterans' health care system was first developed when Congress passed P.L. 65-326 in 1919 and authorized the Public Health Service to provide needed care to veterans injured or sick as a result of military service (today known as a service-connected disability)-a disability that is incurred or aggravated during active military, naval, or air service. In 1924, with the passage of the World War Veterans Act (P.L.68-242), veterans with no service- connected disability financially unable to pay for care were also given access to Department of Veterans Affairs (VA) health care, thus creating a safety net mission. Congress has enlarged the scope of VA's health care mission and has enacted legislation expanding benefits, new programs, and services. This In Focus briefly outlines the mission, eligibility and enrollment requirements, health care delivery system, and funding for veterans health care. Selected trends in enrollment and budget are provided as well. Mission of the VA Health Care System The VA provides health care and health-related services through the Veterans Health Administration (VHA). Its primary mission is to provide health care services to eligible veterans and some family members. The VHA is also statutorily required to conduct medical research, to train health care professionals, to serve as a contingency back up to the Department of Defense (DOD) medical system during a national security emergency, and to provide support to the National Disaster Medical System and the Department of Health and Human Services (HHS) as necessary (38 U.S.C. §§7301-7303; §8111A; §1785). Eligibility and Enrollment for Care Not all veterans are eligible to receive care, and not every veteran is automatically entitled to medical care from the VHA-the system is neither designed nor funded to care for all living veterans (The Journal of Law, Medicine & Ethics, Volume 36, Issue 4, p.680, Winter 2008). Eligibility for veterans health care has evolved over time, and laws governing eligibility have been amended by Congress many times. The last major eligibility amendments occurred in 1996 with passage of the Veterans' Health Care Eligibility Reform Act of 1996 (P.L. 104-262). This law established two eligibility categories and required the VHA to manage the provision of hospital care and medical services through an enrollment system based on a system of priorities. The first eligibility category is veterans with service- connected disabilities, Medal of Honor recipients, Purple Heart recipients, former prisoners of war, veterans exposed to toxic substances and environmental hazards such as Agent Orange, and veterans whose attributable income are equal to or below an established means test. The second eligibility category is veterans with no service-connected disabilities but who also have attributable incomes above an established means test. Once veterans are determined to be eligible for care in VHA, veterans are required to formally enroll in the VHA health care system in order to receive services and are placed in one of eight priority groups based on the first or second eligibility category. Once a veteran is enrolled, the veteran remains in the system and does not have to reapply for enrollment annually. Enrolled veterans do not pay any premiums, deductibles, or coinsurance for their care. Some veterans are required to pay co-payments. In contrast, major medical insurance plans typically have premiums, deductibles, and co-payments. Trends in Enrollment As required by the Veterans' Health Care Eligibility Reform Act of 1996, VHA began formally enrolling veterans for the first time in FY1999. As shown in Figure 1 just over 4.9 million veterans (19% of all veterans) were enrolled in the VHA in FY2000; by FY2016, that number was estimated to have increased 86%, to 9.1 million enrollees. This increase is due, in part, to factors such as enrollment of newer veterans from Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn (OEF/OIF/OND), a larger number of female veterans, and economic conditions, among other factors. Figure I. VHA Enrolled Veterans, FY2000 to FY20 16 MIMONS S.*** ` ° 9.7S illilon 7.5 _. .. +~_ .._ enrollees 5 - 4.9 million enrollees 2.5 2000 0 2000 2002 2004 2006 2605 2010 2032 2014 2016 Source: Chart prepared by CRS based on VA enrollee numbers in the Department of Veterans Affairs budget justifications Note: FY2000-FY2015 numbers are actual; the FY20 16 number is an estimate. In a given year, not all enrolled veterans receive their care from the VA-either because they do not need services or because they have other forms of health coverage such as Medicare, Medicaid, or private health insurance. Figure 2 shows the percentage of enrollees who are unique patients in a given year. Generally, around two-thirds of enrollees in a given year are VHA patients and receive some or all of their health services from VHA. nttps://crsreport

What Is HeinOnline?

HeinOnline is a subscription-based resource containing thousands of academic and legal journals from inception; complete coverage of government documents such as U.S. Statutes at Large, U.S. Code, Federal Register, Code of Federal Regulations, U.S. Reports, and much more. Documents are image-based, fully searchable PDFs with the authority of print combined with the accessibility of a user-friendly and powerful database. For more information, request a quote or trial for your organization below.



Short-term subscription options include 24 hours, 48 hours, or 1 week to HeinOnline.

Purchase Access

Contact us for annual subscription options:

Contact Us

Already a HeinOnline Subscriber?

Log In

profiles profiles most