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The Senate gave final passage on Wednesday to a multibillion-dollar revamp of the veterans health care system, consolidating seven Veterans Affairs Department health programs into one and making it far easier for veterans to take their benefits to private doctors for care. The legislation, which passed 92 to 5, also expands popular stipends to family caregivers of veterans who served during the Vietnam War era or after. And it establishes a nine-member commission to study the department’s current infrastructure to determine where its health system should expand and contract. (Fandos, 5/23)

The sweeping measure would allow veterans to see private doctors when they do not receive the treatment they expected, with the approval of a Department of Veterans Affairs health provider. Veterans could access private care when they have endured lengthy wait times or VA medical centers do not offer the services they need. The bill's approval comes despite concerns from some Democrats that the effort would prove costly and be used too broadly by veterans in search of top-notch care even when the VA is able to provide treatment deemed sufficient for their needs. (Yen, 5/24)

About one-third of veterans in the system now see outside doctors through a program called “Choice,” which Congress hastily approved as a temporary remedy in response to the scandal. But the program — designed to serve the overflow at VA facilities both of aging Vietnam-era veterans and younger service members returning from the wars in Iraq and Afghanistan — is fragmented and unwieldy. Doctors have complained of slow or nonexistent payments, and veterans say there’s insurmountable red tape. (Rein, 5/23)

Senate committee leaders sought to tamp down House Democrats’ concerns over the bill’s funding Tuesday evening by promising a solution to fix congressional spending caps that could limit the bill’s implementation. Appropriations Chairman Richard C. Shelby, R-Ala., and ranking member Patrick J. Leahy, D-Vt., said in a written colloquy they would offer an amendment to fix the caps when the fiscal 2019 Military Construction-VA appropriations bill comes to the floor later this summer. The program would run out of funds in May 2019 if nothing is done. “I will not stand in the way of the new policy created in the bill, as I do believe it creates a better Community Care program,” Leahy said, “but Chairman Shelby and I have a proposal that will help us fulfill our promise to our veterans by allowing for an adjustment to the caps to help us pay for this program.” (Clason, 5/23)

House VA Committee Chair Phil Roe (R-Tenn.) said as he is thinking about implementation of Choice he is turning his focus to the roll-out of the new electronic health record system which is slated to happen as the department has to consolidate and streamline the community care programs. The Senate's Wednesday vote meant that Congress met Trump's Memorial Day deadline to get the legislation finalized — which at one point seemed like a heavy lift as negotiations lapsed late last year when Sen. Jerry Moran (R-Kan.) voted against the Senate VA Committee's version of the bill and pushed his bill that incorporated designated access standards in statute that the VA would have to adhere to. (Luthi, 5/23)

The Senate easily cleared legislation on Wednesday overhauling medical care options for veterans, sending the bill to President Trump's desk. Senators voted 92-5 on the proposal, called the VA Mission Act, with only a simple majority needed to pass the bill. Sens. Bernie Sanders (I-Vt.), Brian Schatz (D-Hawaii), Jeff Merkley (D-Ore.), Mike Rounds (R-S.D.) and Bob Corker (R-Tenn.) voted against the legislation. (Carney, 5/23)