Veterans, Families to Benefit From Affordable Care Act Implementation

money, stethoscope, and pillsVeterans currently enrolled in the Department of Veterans Affairs health care system will not experience any changes to their health care benefits as a result of the opening of the Affordable Care Act’s online marketplace on Oct. 1, 2013.

Health insurance under the VA meets the minimum essential coverage required by the new health care law so veterans do not need to take any additional steps to obtain health coverage. Benefits and out-of-pocket costs under the VA system will remain the same, and most veterans will continue receive free care and services, depending on their income level and service connection.

This includes veterans and family members enrolled in the veteran’s health care program, the Civilian Health and Medical program (CHAMPVA) and the Spina Bifida health care program.

For veterans not enrolled in VA health care, Paralyzed Veterans of America recommends they seek enrollment with the VA to satisfy the individual mandate requirement of the health care law. Uninsured veterans and their family members who do not qualify for VA health care benefits can obtain coverage through the health care exchanges.

The law will benefit many members of Paralyzed Veterans, particularly as they represent members of the community of people with disabilities who have long faced discrimination from the health insurance industry.

“For veterans and their family members who have not been able to get insurance coverage because of a preexisting condition or they could not afford it, at least now they will be able to get some nondiscriminatory health coverage,” said Susan Prokop, associate advocacy director for Paralyzed Veterans.

Paralyzed Veterans holds some concerns over the impact some provisions of the law could have on the quality of care for veterans. The potential for one million uninsured veterans potentially eligible for enrollment in the VA, which already is overburdened, could have serious financial, staffing and quality of care challenges for the VA. Estimates by the department that just 66,000 new veteran enrollees will come into the system as a result of the Affordable Care Act are likely understated, Prokop said.

“I would suggest that if a substantial number of new veterans came into the system today, the VA would struggle mightily, as it is already overburdened with demand,” Carl Blake, national legislative director at Paralyzed Veterans of America. “The VA usually gets excellent marks for quality of care but is dinged all the time for access because there are so many veterans trying to get into the VA.”

Implementation of the health care law also has not addressed the challenges posed for veterans enrolled in the VA or family members enrolled in the CHAMPVA or Spina Bifida program who live in rural areas and choose to use private insurance for basic primary care needs. Because of their VA enrollment, these individuals will not be eligible for premium tax credits offered through plans in the health exchanges.

Congress also needs to enact legislation to change the eligibility age for dependent children enrolled in CHAMPVA to age 26 to align this benefit with other health care programs. Currently, the only qualified dependents who are not covered under a parent’s health insurance policy are those of 100 percent service-connected disabled veterans covered under CHAMPVA.

While legislation has been introduced to address some of these issues, it has drawn little attention as much of the focus in Congress has been on implementing or defunding the ACA altogether, Blake said. “Any new changes made to the ACA are impossible because of the split in the parties,” he said. “There is no interest [among parties] in making changes at this point.”

The VA is promoting a new section of their website on the ACA and its impact on veterans. Paralyzed Veterans of America also recommends that the Health and Human Services Department ensure that veterans and service members coming to the health care exchanges are made aware of the option of enrolling in VA health care.

Learn more about Paralyzed Veterans of America's advocacy efforts on behalf of all people with disabilities 

Brittany Ballenstedt is a freelance journalist whose work has appeared in several publications, including Government Executive, National Journal, Technology Daily and  


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