WASHINGTON — President Barack Obama on Thursday signed into law a $16.3 billion plan to overhaul the troubled nationwide health care system run by the Department of Veterans Affairs.
In a speech at Fort Belvoir, Va., Obama said the law is an important step toward reforming a dysfunctional agency that has outraged Americans, but cautioned that much more work is needed to fix chronically long wait times for veteran patients and systemic wrongdoing among staff.
“This will not and cannot be the end of our effort,” Obama said. “Implementing this bill will take time. It will take focus from all of us.”
GRAPHIC | Where the money goes
MAP | Where the new VA facilities will be
The massive reform package has been a rare instance of bipartisanship in Washington and won overwhelming support in both chambers of Congress in late July, just three months after delays in veteran health care exploded into a national scandal. It dramatically expands veteran access to private care, adds medical staff and facilities, and streamlines the firing of VA executives found to be incompetent or guilty of manipulating patient data.
“It’s a good deal,” Obama said. “This bill covers a lot of ground.”
The law will pay private health care providers $10 billion to treat vets who cannot get VA appointments within 30 days of requests or who live more than 40 miles from a VA health care facility.
Another $5 billion will go to hiring new VA doctors — including specialty care physicians — nurses, mental health professionals and other medical staff. The remaining $1.27 billion would primarily pay for 27 new medical centers in 18 states and Puerto Rico.
Obama received a loud round of applause when he mentioned a measure in the law aimed at cracking down on management misconduct.
The law allows new VA Secretary Robert McDonald to fire senior executives at will and those federal employees now have just seven days to appeal a termination and an administrative judge would be required to rule on the appeal within three weeks. In the past, the process typically took months.
Comprehensive reviews of the entire VA health care system including its antiquated electronic appointment system, a $360 million annual cap on employee bonuses, and more funding for sexual assault treatment programs are also tucked into the law.
The overhaul will ring up about $10 billion in new deficit spending during the coming decade but only attracted the scattered opposition of a handful of fiscal hawks in Congress. About $4.46 billion of the bill’s total $16.3 billion price tag will be covered by cuts from elsewhere in the existing VA budget.
Obama said the law follows on the heels of a renewed VA effort to fix its health care system, which serves about 200,000 patients a day and is the largest of its kind in the United States.
“We’ve already taken the first steps to changing the way VA does business,” he said.
Obama said the VA has reached out to hundreds of thousands of veterans who have been guaranteed lifetime health care after military service but been unable to get treatment.
The confirmation of McDonald last month was part of the effort to rebuild the VA’s leadership team, he said.
McDonald, a former Procter & Gamble CEO, attended the signing with Obama and was scheduled to make his first visit to a VA medical facility Friday when he meets with veterans and staff at a Phoenix hospital.
That facility became the epicenter of the department scandal in April when a doctor alleged secret patient waiting lists might have led to 40 deaths. On Saturday, the secretary was slated to visit the VA’s newest medical center in Las Vegas.
Earlier this week, McDonald called for town hall meetings at VA facilities across the country “to listen and learn directly from those who use our system,” according to a released statement.
VA Deputy Secretary Sloan Gibson, who headed the agency for two months following the resignation of Gen. Eric Shinseki, visited hospitals and clinics across the country and was continuing the visits this month.
During a Wednesday public appearance in Denver, Gibson repeated a claim that the VA can solve its problems and regain the trust of veterans within two years, The Associated Press reported.
That claim has been met with skepticism on Capitol Hill. The access crisis in the veteran health care system has been deep and persistent.
The VA has reported it was juggling 6 million appointments in mid-July and more than 636,000 of those patients had been waiting more than a month for care — an increase of about 45,000 in such delays from May when the country was first learning of the crisis, according to the most recent data published by the department.