The VA and the ACA

Ken Kizer’s recent JAMA viewpoint is a quick way to get up to speed on what the Affordable Care Act could mean for the Veterans Health Administration and the population it serves. It may puzzle some that there should be a connection at all. Don’t all veterans get VA care and, therefore, the ACA doesn’t really apply to them? Um, no.

Approximately 37% [of veterans] are enrolled in the Department of Veterans Affairs (VA) health care system in accordance with a congressionally mandated eligibility system based on having a service-connected disability, low income and net worth, or other prescribed circumstances. More than 80% of VA enrollees older than 65 years are also covered by Medicare and about 25% of enrollees are beneficiaries of 2 or more non-VA federal health plans (eg, Medicare, Medicaid, TRICARE, or Indian Health Service). Another 56% of veterans have private health insurance or are covered by a non-VA federal health plan, while 7% have no health insurance.

Only a minority of veterans receive health care at the VA, and most VA patients also receive care in other settings, financed by other systems. I’ve made these very points before (as have many others) and then been amazed how quickly people forget them.


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