Christopher Fryer/News and Tribune via AP
Army veteran Matt Thomason, who suffered from PTSD after serving in Afghanistan, stands by the Global War on Terrorism memorial at Wilkerson Park in downtown Sellersburg, Indiana, June 2016.
When men and women leave the U.S. military, the road back to civilian life can be bumpy. Some have major readjustment challenges, which can leave some of them unemployed, homeless, or suicidal due to untreated medical conditions.
Over the past two decades, Congress has tried to make this transition smoother. The Department of Defense (DOD) is now required to offer job search counseling before soldiers leave the service. All former military personnel who served in combat in post-9/11 wars are guaranteed five years of free medical care from the Veterans Health Administration (VHA). In offices co-located on the military installation, congressionally chartered veterans service organizations (VSOs) help eligible veterans access these and other VA benefits.
Thousands of veterans would transition more smoothly from combat to civilian life if they were automatically enrolled for VHA medical care when they leave the DOD payroll, while remaining responsible for later proving their individual eligibility for continued VHA care, which is based on low income, a service-related medical problem, or other qualifying factors.
On July 28, Democrats on the House Committee on Veterans’ Affairs embraced this veteran-friendly approach by sending H.R. 4673, the Ensuring Veterans’ Smooth Transition Act, to the House floor. Introduced by committee chairman Mark Takano (D-CA), this bill authorizes automatic enrollment of new veterans by VA. Veterans who don’t want to enroll for VA care may easily opt out.
“This legislation is critical,” says Paul Sullivan, a Gulf War veteran and past deputy secretary of the California Department of Veterans Affairs. “If enacted, it would send a strong signal that VA is ready, willing, and able to help veterans quickly get the quality VA care they need for their military-related medical conditions. Under this bill, VA is actively encouraging new veterans to get that care sooner, when that care is more effective and less expensive.”
Thousands of veterans would transition more smoothly from combat to civilian life if they were automatically enrolled for VHA medical care.
Since Republicans invariably claim to be “pro-veteran” and have urged the VA to focus on the problem of veteran suicide, one would think that the Republican minority on Takano’s committee would have supported his long-overdue initiative.
Instead, during a recent markup session on the bill, the GOP legislators voted unanimously against automatic VA enrollment for new veterans. Congressman Michael Bost (R-IL), who favors outsourcing of veterans’ care to the private sector, tried to derail H.R. 4673 by proposing a commission to study VA eligibility rules.
Bost’s amendment reprises a similar effort by Congressman Phil Roe (R-TN), a former chair of the committee and proponent of VA privatization, before he left the House last year. Roe’s bill never made it out of committee because of lack of support from some VSOs, which correctly suspected that Roe’s ultimate goal was restricting eligibility for VA care, a policy that would be harmful to new veterans who need transitional assistance readjusting to civilian life. Providing VA care sooner is far more effective for a new veteran with even mild medical symptoms. The alternative sought by penny-pinching Republicans is for veterans to wait years before learning about and seeking care, at which time the care would be far more expensive for conditions, such as homelessness and suicidal ideation, that have grown more serious over time.
In reality, all Takano’s bill does is assure a smoother administrative transition. After automatic VA enrollment, veterans would still have to demonstrate—as they do now—that they have a service-related condition or sufficiently low income to pass VA means testing. And there would be no much-needed change in current rules that disqualify hundreds of thousands of veterans from care because of their “other than honorable” or “bad paper” discharges.
“Under this bill, the military would send VA the needed records so VA can quickly provide quality care,” Sullivan told the Prospect. “The bill appropriately shifts the burden from the veteran to the DOD and VA, which is just where it belongs.”
As confirmed by a 2018 report by the National Academies of Sciences, Engineering, and Medicine, many post-9/11 veterans don’t seek mental-health services because they’re not aware of their existence, are confused about their own eligibility, don’t know how to apply for such help, or don’t think they deserve it.
Kevin Miller, an Iraq combat veteran who has spent the last eight years working with homeless veterans, believes this legislation would be an asset for his peers. “I was really unusual because I enrolled in the VA right away,” Miller told the Prospect. “The folks at VA were surprised because that happened so rarely. Most of the combat vets I have worked with don’t have a clue about their benefits. Automatic enrollment would not only give them access to health care but a host of other VA programs.”
“The bill appropriately shifts the burden from the veteran to the DOD and VA, which is just where it belongs.”
H.R. 4673 would also help veterans overcome the lingering impacts of their military training and conditioning. That socialization often discourages some from getting help for problems that were acquired or exacerbated while on active duty. As one former Marine told the Prospect, “You just try to suck it up. The general attitude was, if you went to the medical, you were trying to get out of something, you were just faking it.” If the problem was an emotional one, like PTSD, alcohol abuse, or depression, he explained, “it seemed like it could ruin your career.” For this ex-Marine and others like him, simply being better informed about the availability of VA care would be an incentive to seek it.
When she was medically discharged from the service after a suicide attempt following a rape that the Air Force refused to prosecute, an Air Force veteran told the Prospect that enrolling in VA was the last thing on her mind. Still suicidal, she says she was lucky that her family encouraged her to go to VA for the services that helped her survive military sexual trauma. This bill could be very beneficial, she said, particularly if VA provided enough information—and even VA personnel—to help active-duty service members before they separate from the service.
As Takano told the Prospect, “Automatic VA enrollment is something policymakers and veterans service organizations have been trying to advance for years—with the EVEST Act, it will finally become a reality.”
