Sens. Bernie Sanders (I-Vt.) and John McCain (R-Ariz.) on Thursday announced a deal on legislation to reform the Veterans Affairs Department’s troubled health system amid a scandal over long wait times for treatment.
The $2 billion compromise measure gives the VA secretary expanded powers to fire poorly performing individuals, would allow some veterans to seek outside health care and would hire more doctors.
{mosads}Sanders, the Senate Veterans’ Affairs Committee chairman, and McCain worked the last two days on how to merge their competing bills to tackle problems within the agency.
Announcing the deal on the Senate floor, Sanders said veterans’ care “should not be a political issue” and that Americans had been “appalled” by revelations that VA officials around the country manipulated patient wait times, leading to long delays in care.
The bill seeks to improve accountability at the VA by removing any fired senior executives immediately from the payroll. Dismissed employees would have one week to appeal the decision, with a VA merit board having three weeks to render a final decision.
It also incorporates a measure backed by McCain to issue veterans a “choice card” that would allow them to see a non-VA provider in some cases.
Veterans would be able to seek outside care if they cannot see an agency physician in a timely manner or if they live more than 40 miles from a VA facility. The distance exemption will last for a two-year trial basis.
The measure also authorizes the construction of 27 new VA facilities in 18 states and would tap $500 million in money already authorized for the VA toward hiring new doctors and nurses.
It would also allow in-state tuition for all veterans at public colleges and universities and improve medical care for military sexual assault victims. Surviving spouses of former servicemembers would also be eligible for more VA benefits.
McCain, speaking on the floor after Sanders, urged his colleagues to “pledge to seeing this thing all the way through.”
The Arizona senator told reporters earlier Thursday that he and Sanders had worked out all the differences between their two bills, but said further changes could be forthcoming.
“I want to have amendments,” McCain said.
It is also unclear when lawmakers will vote on the compromise bill.
McCain told reporters that they expected to have the language prepared by Monday night. He said that if approved, the compromise measure would be conferenced with the VA accountability bill the House passed last month.
Sanders said Senate Majority Leader Harry Reid (D-Nev.) wanted a vote “as quickly as possible.”
The compromise on VA reform comes following the resignation of Secretary Eric Shinseki after the agency’s inspector general confirmed charges that officials at a Phoenix clinic had lied about patient wait times. A White House-mandated audit also found fraudulent practices at a number of VA facilities around the country.
The IG report found veterans at a Phoenix hospital had waited an average of 115 days for an initial primary care appointment, while official data falsely claimed the wait was only 24 days.
The House last month overwhelmingly passed legislation that gave the VA secretary expanded powers to fire officials for poor performance, but that effort stalled in the Senate amid competing bills.
Sanders had prepared a bill that would grant the VA secretary new powers to fire senior executives and allow veterans to seek treatment at non-VA providers in some cases.
But Republican lawmakers rallied behind a similar measure from McCain, which included the House language, leading Sanders to postpone a hearing Wednesday on his bill in hopes of hashing out a compromise.
Some Democrats had expressed concerns over new firing powers, questioning if the measures weaken federal employee work protections.
On Thursday, McCain and Sanders said that neither side got everything they wanted in the bill.
“But right now we have a crisis on our hands and it is imperative that we deal with that crisis,” Sanders said.
McCain told reporters that the 40-mile requirement for veterans to be able to seek outside care was included to address Democratic concerns that the bill would “erode” the VA and lead to privatization of care.
He said the provision would sunset in two years, giving the Government Accountability Office time to assess how the measure worked.
Sanders said he convinced McCain to back hiring new doctors and nurses despite charges from GOP lawmakers that VA personnel only saw half the number of patients as private providers.
McCain conceded that in “some parts of the country” there was increased demand for healthcare providers.
Sen. Marco Rubio (R-Fla.) who pushed the House legislation in the upper chamber, welcomed the deal.
“I am pleased that real accountability measures are included in the legislation. Considering the deep debt of gratitude our nation owes our veterans, I’m optimistic that the Senate will soon join the U.S. House of Representatives and pass these important reforms,” he said in a statement.
Ten Senate Democrats, many facing tough reelection bids, had backed Rubio’s VA reform measure over Sanders’s proposal.
Sen. Richard Burr (R-S.C.), the ranking member on the Senate Veterans panel, also hailed the compromise. But Burr cautioned “that the issues at the VA are systemic and deeply rooted in the agency’s culture.”
This story was updated at 3:47 p.m.