Messing with Medicaid could hurt veterans

With the fate of America’s health care system up in the air, it might be prudent to think about how changes to it might impact different sectors of the population. This is especially true of the Medicaid program, which in any given month provides coverage to nearly 75 million Americans of all stripes.

Among that population are children, the elderly, people with disabilities, workers, people in recovery and one group you may not have expected: veterans.

This is a big deal in a state with one of the highest percentages of veterans in the population. According to Ballotopedia, veterans make up slightly over 9 percent of our population. I can’t figure out how to do the math, but I’m pretty sure that most families in the state, including my own, have members who served in the military.

According to a new report by FamiliesUSA and VoteVets.org, 1.75 million veterans — around one in 10 — receive Medicaid coverage. This includes but isn’t limited to 340,000 who gained coverage due to Medicaid expansion under the Affordable Care Act and who may lose care if it is repealed.

Contrary to popular belief, not all veterans receive care from the VA. According to the Congressional Research Service, in 2014 only about 42 percent of the total veteran population was enrolled by the VA.

Eligibility for VA programs can depend on a number of factors, such as minimum service requirements and disability and discharge status.

In addition, not all eligible veterans can take advantage of VA services. For example, one-third of enrolled veterans didn’t use VA services in 2014. Transportation issues and distance from VA facilities can be a bar to access.

Finally, the VA isn’t set up to provide for the health care needs of veteran’s families.

By contrast, Medicaid provides care that can fill gaps not covered by other programs or complement the services they offer. In some cases, Medicaid is a supplement for VA or Medicare for veterans over age 65.

However, the report notes that about half of veterans covered by Medicaid were between 18-64 years of age and were ineligible for Medicare. Of these, 40 percent had no other form of coverage than Medicaid. In 2015, Medicaid provided coverage for 660,000 veteran’s spouses.

The number of veterans receiving health care has gone up since passage of the Affordable Care Act. In West Virginia, the total number of veterans covered by Medicaid was around 15,000, not counting family members in 2015. The number of veterans aged 18-64 enrolled in Medicaid increased by 45 percent here between 2013 and 2015.

Undoing the Affordable Care Act isn’t the only threat to veteran’s health care. Some in Congress have proposed structural changes to the traditional program, such as block granting, budget cutting and capping benefits.

As the report notes that veterans are at a higher risk than most other people for “unique and sometimes serious or complicated health care issues as a result of their service. These health conditions might include musculoskeletal conditions, traumatic brain injuries, and posttraumatic stress disorder.”

It concludes that “Congress should be taking steps to make it easier, not harder, for veterans to access the health care they need when they need it. Voting to end the Medicaid expansion or to cap or cut Medicaid is a vote against veterans and their families.”

(This ran as an op-ed in today's Gazette-Mail.)