This bill directs the VA to establish a pilot program offering eligible veterans health savings accounts to access primary care through non-VA direct primary care arrangements, while also requiring regular reports to Congress on the program's implementation and results.
Chip Roy
Representative
TX-21
The "Veterans Access to Direct Primary Care Act" directs the VA to establish a five-year pilot program offering eligible veterans health savings accounts to access primary care from non-VA providers through direct primary care arrangements. Participating veterans will receive annual deposits into their health savings accounts to cover primary care services, but will not be able to receive VA medical care covered by the direct primary care arrangement during their participation. The VA will monitor the program for fraud and report results to Congress. The program will be funded through existing Veterans Health Administration appropriations.
VA Pilot Program Lets Vets Use HSAs for Non-VA Primary Care: Five-Year Test Launches in 2025
The "Veterans Access to Direct Primary Care Act" sets up a five-year test run, starting one year after it's signed into law, that gives some veterans a new way to handle their primary care. Instead of going through the VA system, eligible vets can opt into a program that provides them with a health savings account (HSA) specifically for primary care services from providers outside the VA network.
Paying for Care Outside the System
This bill essentially lets participating veterans use pre-loaded health savings accounts (called "veteran health savings accounts" or VHSAs in the bill) to pay for things like regular check-ups, basic medical services, and even prescriptions, as long as it falls under "primary care." The amount put into each vet's account each year will be figured out by the VA, working with an actuary. The key here is that these vets cannot double-dip: if they're using this program to pay for primary care outside the VA, they can't also get those same services from the VA. (SEC. 2)
For example, imagine a veteran living in a rural area with limited VA facilities. If they're eligible and choose to participate, they could use their VHSA to pay for visits to a local doctor offering a "direct primary care service arrangement" – basically, a membership-style practice. This could mean quicker access to appointments and potentially a closer relationship with their doctor. But, that same vet couldn't then turn around and try to get a similar check-up at a VA clinic.
Funding and Fine Print
One big thing to note: the money for these HSAs is coming out of the existing Veterans Health Administration budget. (SEC. 2) That means no new taxes or anything, but it could mean resources are being shifted around within the VA. The bill also includes a requirement for the VA to keep a close eye on how the money is being spent, with measures to prevent fraud. (SEC. 2). They'll also report to the Committees on Veterans' Affairs of the Senate and the House of Representatives quarterly for the first two years on how the setup of the program is going, and after that, they will report annually on how the program is working.
Real-World Ripple Effects
This pilot program could be a game-changer for some, especially those who prefer private-sector care or live far from VA facilities. It gives them more control over their healthcare choices. However, there are a few things to keep an eye on. First, there's the question of whether pulling funds from the existing VA budget will impact services for other veterans. Second, there is always the potential for some bad actors to misuse the funds, for veterans to use the funds for non-primary care expenses, or for providers to take advantage by overcharging. Finally, how do we make sure veterans are getting good quality of care and that their primary care is well managed if they are receiving some of their care through the VA and some through private providers? The bill is designed as a five-year pilot, so presumably, these are the sorts of questions the VA will be looking to answer as the program rolls out.