More than 600 New Hampshire veterans have used a temporary new program that lets them choose care from private doctors instead of traveling out of state to a VA hospital.
Now, with continued funding for the program uncertain, New Hampshire's two U.S. senators want to make Veterans Choice permanent for veterans here.
The Department of Veterans Affairs unveiled Veterans Choice last fall after Congress passed the Veterans Access, Choice and Accountability Act of 2014 (VACAA). That was in response to a scandal about wait times and fraud at some VA facilities in other states.
VACAA allows veterans in most states to seek care from non-VA providers if they live more than 40 miles from a VA facility, or have to wait more than 30 days for an appointment; the VA will reimburse providers for that care. The program is open to veterans who were enrolled in the VA as of Aug. 1 and to recently discharged combat veterans.
Shaheen, a Democrat, and Ayotte, a Republican, worked together to add a provision allowing veterans who live in a state without a full-service VA medical center - and live more than 20 miles from such a facility in a neighboring state - to qualify for the program.
In New Hampshire, that means veterans who live more than 20 miles from White River Junction, Vt.
Mary Morin, director of the state Office of Veterans Services, said her office gets calls from veterans who are confused about how the new program works.
One problem is that the information posted on the VA's Veterans Choice website does not include the special 20-mile provision for New Hampshire veterans. "It's not advertised at all," Morin said.
She advises veterans to call the number listed on the Veterans Choice Card they received in the mail - 866-606-8198 - if they have questions about how the program works.
Congress appropriated $10 billion to implement the program, which is meant to run for three years or until that funding runs out.
But Shaheen and Ayotte announced Friday that they had introduced legislation to extend the Choice program for veterans living in states without full-service hospitals. "For far too long, New Hampshire's veterans have been at an unfair disadvantage when it comes to accessing health care services," the two said in a joint news release.
The senators last week also sent a joint letter to President Obama expressing concern about a provision in the administration's 2016 budget that proposes shifting some funding from Veterans Choice to other VA programs.
Shaheen and Ayotte said they are "deeply troubled that the administration is proposing to cut funding from this program only months into its implementation."
"That is unacceptable and inconsistent with congressional intent," they wrote in a Feb. 4 letter.
Kristin Pressly-Mills, public affairs officer at the Manchester VA Medical Center, said veterans have to go through Healthnet, the third party administrator of the Choice program, to make sure they're eligible and arrange care from a non-VA provider. "For the veterans, that's a change in practice," she said.
She said 611 veterans have used the program so far.
But she stressed that those who wish to continue receiving care at a VA facility can do so. "For the people who say they don't want to change their VA doctors, they don't have to," she said. "They can continue to have that quality of care."
Michael Epright of Epsom said he's glad that veterans will be able to get medical care closer to home if they choose to. But he said, "My first choice is VA."
Epright, 56, joined the Army right out of high school; after 8 years of active duty, he went on to serve in the Army Reserve, Air Reserve and Air National Guard. He deployed to Afghanistan in 2010 with the 157th Air Refueling Wing.
Epright has chronic back pain and nerve damage from a 1981 fall from a tanker mover. He's gone to private physicians but prefers the care he's gotten in Manchester and White River Junction. "There's always someone there treating me in a human, respectful way," he said.
Many employees of the VA are military veterans themselves, he said. "It's a level of compassion that I don't see anywhere else."
Gary Wayman, department service officer for the American Legion, expects many vets may choose to continue to get care at the VA, especially at the new wing Manchester just opened.
The addition, which has 32 exam rooms, offers "a more patient-centered model," Pressly-Mills said, with mental health, primary care and nursing services available in one area.
Peter Burdett, vice chair of the State Veterans Advisory Committee, said those who want to access care outside the VA system need to be proactive. That means making sure a private doctor is willing to accept Medicare rates, calling the 866 VA help number and asking to have that doctor added to the approved list of providers, he said.
It's all about giving veterans more options, Burdett said. "There are reasons why it might work for some people and there are reasons why it might not work for others," he said.
Meanwhile, Epright said he hopes the nation's leaders continue to fund veterans' health care at appropriate levels. "It would be really nice as a veteran to think that even when all the wars are done, that we're not going to be forgotten."
Because, he said, "That's what America does. It's a great place, but the veterans get forgotten after they're not needed anymore ... It would be comforting to know that we were safe from that."