Veterans care under Donald Trump may be a ‘public-private’ option

Donald Trump could propose restructuring the Department of Veterans Affairs to allow veterans to purchase private health insurance if they so choose, as the president-elect readies his plans on an issue that has attracted headlines for all the wrong reasons in recent years.

The Trump transition team says he is eyeing a “public-private option” for health care as Mr. Trump ponders his choices for secretary of Veterans Affairs, one of just a few top Cabinet positions he has yet to fill.

“The president-elect wants to make sure that veterans get the care and the quality [of] care that they deserve,” said incoming White House press secretary Sean Spicer.

Though many veterans like the VA care they get, the agency has suffered in recent years from reports of patients dying while awaiting care and mismanagement at local VA branches.

In response, Congress passed legislation in 2014 that, among other things, created the Veterans Choice Program, which allows certain veterans to opt for private care if they face particularly long wait times or live more than 40 miles from a VA facility.

That initiative was intended to be temporary, and Mr. Trump could choose to pursue a longer-term option.

Vermont Sen. Bernard Sanders, a 2016 Democratic presidential candidate, said he would oppose any attempt to fully privatize the agency, and that such a move would be an insult to veterans.

“When men and women put their lives on the line to defend us, the president must listen to them, not to the Koch brothers and their extreme right-wing, anti-government ideology,” said Mr. Sanders, a past chairman of the Senate Committee on Veterans’ Affairs, referring to the leaders of Koch Industries who have contributed millions of dollars to conservative causes.

But the president-elect isn’t proposing privatization per se, which would entail a wholesale selling off of a government function to a private industry, said Dan Caldwell with the group Concerned Veterans for America (CVA).

Mr. Caldwell said reforms will likely have to occur as millions of veterans of World War II and the conflicts in Korea and Vietnam die over the next 15 years or so and necessarily move off the VA rolls.

“We think this expanded choice, which the president-elect is proposing, should be part of that solution,” Mr. Caldwell said recently on CNN.

Even as lawmakers have almost universally acknowledged the department’s problems in recent years, complaints about long wait times, access to care and other ongoing issues with local VA facilities have persisted. A government-commissioned report released over the summer found that the design and implementation of the choice program is “flawed” and said the government needs to do a better job of developing an integrated system.

At least one veterans advocacy group is urging Mr. Trump to consider retaining current VA Secretary Robert McDonald, saying Mr. McDonald should be given more time to implement and oversee changes in the wake of the recent scandals.

“We feel compelled to continue the transformation that is currently underway at the department. McDonald deserves the opportunity to see it through,” said Joe Chenelly, executive director of the group American Veterans (AMVETS).

Mr. McDonald was confirmed by the Senate in July 2014 after former Secretary Eric K. Shinseki resigned in the wake of reports on the widespread mismanagement.

Mr. Spicer said one reason the decision for VA secretary is taking longer than that for other Cabinet-level posts is that Mr. Trump wants to get it right.

“He wants to make sure that the person that comes in [and leads] the VA fully appreciates the concerns and frustrations that veterans have, and that we have a world-class system to give them the care and services that they deserve,” Mr. Spicer said.

A few names that have been mentioned as possible picks include Pete Hegseth, a former CEO of CVA and current Fox News personality, and former Massachusetts Sen. Scott Brown, who served 35 years in the Army National Guard.