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1 1 (January 25, 2019)

handle is hein.crs/govydk0001 and id is 1 raw text is: Congressional Reerhevc S Updated January 25, 2019 Veterans Health Administration: Gender-Specific Health Care Services for Women Veterans Introduction Traditionally, the Veterans Health Administration (VHA) of the Department of Veterans Affairs (VA) had predominantly provided gender-specific health care services to male veterans. The U.S. Census Bureau began asking women about their military service in 1980 and found that women veterans accounted for less than 3% of the U.S. veteran population, according to a VA report (VA, Women Veterans Report, https://go.usa.gov/xPzNC). Congress, in response to this revelation, requested investigative reports from the Government Accountability Office on women veterans' access to VA benefits (https://go.usa.gov/xEBkM). Congress also passed a number of laws such as the Women Veterans Health Program Act of 1992, which is Title I of the Veterans Health Care Act of 1992 (P.L. 102-585, as amended) to specifically increase women veterans' access to gender- specific health care services through the VHA. The number of women veterans accessing VA care is increasing. In 2005, for example, a total of 237,952 women veterans had accessed VA care and that number has increased by 46.4% to 455,875 women veterans receiving VA care in 2015, according to the aforementioned VA report. It is likely that more women veterans will access VA care because the population is projected to increase by more than half from 9.4% of the U.S veteran population in 2015 to 16.3% of the U.S. veteran population by 2043. VHA Enrollment Requirements Note that the VHA enrollment requirements are the same for all veterans, whether women, men, transgender (whose gender identities are different from their sex assigned at birth), or intersex veterans (who are born with sexual and reproductive anatomies that are outside the definition of the male and female sex categories assigned at birth). The Veterans' Health Care Eligibility Reform Act of 1996 (P.L. 104-262) required the VA to establish an enrollment system that all veterans must meet in order to be eligible to receive VA health care services. Enrollment in the VA health care system is based primarily on veteran status (i.e., previous military service), service-connected disability, and income. Veterans can apply to enroll in VA health care by mail, telephone, and in person at a VA medical facility. Access to Gender-Specific Health Care Services The VHA operates more than 1,700 VA medical facilities where veterans can access gender-specific health care services. Veterans can also access these services from VA- contracted providers in their communities and from providers of the Department of Defense (DOD) at DOD medical facilities. (Note that veterans can access certain gender-specific services such as infertility treatments only from non-VA providers.) In addition, veterans can access gender-specific health care services through telehealth. Telehealth refers to a health care service that is provided via a technological method. The VHA provides women's gender-specific telehealth services such as gynecology and mental health through the VA Tele-Women's Health program. Gender-Specific Health Care Services All veterans access gender-specific health care services through the VA as specified in the VA medical benefits package. The VA medical benefits package refers to a suite of health care services that the VA covers and provides to eligible veterans, generally at no cost to the veterans under certain circumstances. In FY2017, the VA spent $453.9 million on gender-specific health care services for women veterans (VA, FY 2019 Funding and FY 2020 Advance Appropriations: Volume II Medical Programs and Information Technology Programs, p. VHA-169, https://go.usa.gov/xPhnV). Discussed below are some gender-specific health care services that women veterans can access though the VHA, unless otherwise noted. This discussion is not comprehensive. Primary Health Care Services Women veterans can access a range of gender-specific primary health care services such as contraceptives, breast and cervical screenings, and menopausal support services through the VHA, in a Women's Health Clinic and in a mixed gender primary care clinic by a designated women's health care provider. According to the VHA Directives 1341 and 1330.01(2), a transgender or intersex veteran can access the aforementioned primary health care services through the VHA, regardless of whether a change in sexual anatomy has transpired. Maternity Health Care Services The VHA currently provides and pays for a limited number of maternity and newborn health care services to eligible veterans and their family members. Women veterans can begin accessing VA maternity care as soon as their pregnancies are confirmed. The VHA is different from other integrated health care systems because VA medical facilities do not operate full-service birthing centers with medical units such as maternity wards, newborn nurseries, and neonatal intensive care units (NICUs). The VHA does not have the specialized health care providers or functioning birthing-related medical units in VA medical facilities to deliver babies on an ongoing basis. Women veterans deliver babies at non-VA medical facilities such as DOD medical facilities and community hospitals. The VA may perform, however, emergency childbirth deliveries. https://crsreports.congressge

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