Should All Eligible Veterans Be Automatically Enrolled in the VA’s Healthcare System? (H.R. 4673)

What is H.R. 4673?

(Updated March 10, 2022)

This bill — known as the Ensuring Veterans’ Smooth Transition (EVEST) Act — would direct the Dept. of Veterans Affairs (VA) to automatically enroll eligible veterans in the VA’s patient enrollment system by using the Dept. of Defense’s Defense Manpower Data Center (DMDC). All veterans enrolled under this would be provided with a notice within 60 days of their enrollment status and instructions for how veterans may opt out of such enrollment. Currently, veterans who are eligible for VA healthcare must proactively enroll with the VA using online, phone, or in-person services.

Argument in favor

Veterans may be unclear about their eligibility for VA healthcare when their military service comes to an end and neglect to enroll when they’re eligible. This bill would automatically enroll eligible veterans and give them a notice to inform them of their enrollment and give them an opportunity to opt out.

Argument opposed

While this bill is well-intended, it’s potential impacts on the VA’s healthcare system hasn’t been considered in enough depth yet to move ahead with it. The Democratic majority should hold a hearing on this bill where the VA and veterans’ service organizations can weigh in on its potential impact before the bill gets a vote.

Impact

Veterans eligible for VA healthcare; and the VA.

Cost of H.R. 4673

The CBO estimates that implementing this bill would cost $3.1 billion over the 2022-2026 period. Under current law, the Congressional Budget Office (CBO) uses a baseline expectation that most newly separated and eligible veterans will enroll in VA healthcare. It projects that an additional 58,000 veterans would be automatically enrolled in 2022, and that a similar number would be enrolled in subsequent years. After accounting for the voluntary disenrollment of some veterans, CBO estimates that about 250,000 of those who would be enrolled automatically would remain enrolled by 2026.

Additional Info

In-Depth: House Veterans’ Affairs Committee Chairman Mark Takano (D-CA) explained the rationale for this bill to automatically enroll eligible veterans in VA healthcare as it relates to an inspector general report that the Dept. of Defense failed to screen transitioning servicemembers for suicide risks as it’s required to:

“It’s VA’s job to care for veterans once they leave service, but given this report, I’m concerned that DoD is not setting VA up for success, especially when it comes to mental healthcare… Through my EVEST Act, we can address these issues head on by automatically enrolling all eligible veterans into VA healthcare services — the “warm handoff” that the IG identified as sadly lacking.”

Republican lawmakers opposed this bill in committee, citing a failure to hold a hearing on the bill in the current Congress; a lack of feedback about the potential impact from the VA and veterans service organizations; getting ahead of a forthcoming strategic plan that’s related to VA’s healthcare for veterans within one year of their separation from service; and a lack of recognition of disparities among veteran populations. Ranking Member Mike Bost (R-IL) added in the committee report:

“The Minority appreciates the intent of this bill, which is to support transitioning servicemembers by helping to connect them seamlessly with VA hospital care and medical services. Currently servicemembers are encouraged to enroll for VA healthcare and coached through the application process while attending mandatory Transition Assistance Program sessions prior to discharge or retirement. While in theory an automatic enrollment may appear less onerous, there are too many unknowns to proceed with this bill as written and without appropriate review.”

The House Veterans Affairs Committee advanced this bill on a party-line vote of 16-10.

Media:

• Sponsoring Rep. Mark Takano (D-CA) Press Release

• CBO Cost Estimate

• House Veterans Affairs Committee Section-by-Section