A primer on how the VA crisis broke the usual congressional gridlock

The Veterans Affairs healthcare scandal has done something that few other issues have achieved in this hyper-partisan Congress: Unite members of opposing parties in support of swift action to reduce veterans’ waits for care and hold VA officials accountable for misrepresenting waiting times.

The bipartisanship was apparent Tuesday as the House overwhelmingly approved a bill that would allow veterans facing long waits for VA care to see private doctors, suspend VA bonuses and require an outside assessment of the VA healthcare system.

The vote came less than 24 hours after an audit showed more than 57,000 veterans have waited at least three months for an appointment at VA facilities. It also followed a recent report by the department’s inspector general that found a systemic problem nationwide in scheduling veterans for healthcare in a timely manner, including instances where VA staff falsified records to cover up long waits.

The Senate is expected to take up a VA reform bill this week.

“We have a systemic failure of an entire department of our government,’’ House Speaker John A. Boehner (R-Ohio) said Tuesday.


Here is a look at the key measures, differences in House and Senate versions and prospects for passage.

Permitting veterans facing long waits for care at VA facilities to see private doctors

This enjoys bipartisan support. Both the “Veterans Access to Care Act,’’ which cleared the House on Tuesday, and a Senate bill by Sens. Bernie Sanders (I-Vt.), chairman of the Senate Veterans Affairs Committee, and John McCain (R-Ariz.) would allow veterans facing long waits for VA care or living more than 40 miles from a VA facility to seek care from private doctors.

Rep. Jeff Miller (R-Fla.), chairman of the House Veterans Committee, told colleagues Tuesday that while the VA already allows veterans to seek private care, the decision is left to bureaucrats. The legislation, he said, would give veterans the choice of seeking private care.

Both bills would allow veterans to seek private care if they are unable to receive an appointment at a VA facility within the department’s wait-time goals.

The Sanders-McCain bill also would authorize the VA to lease more than two dozen new medical facilities, something that the House has already agreed to.

One potential issue in House-Senate negotiations on a final bill could be Sanders’ efforts to authorize $500 million for hiring more VA doctors and nurses.

Expanding the VA secretary’s authority to fire or demote senior staff for poor performance

This, too, enjoys bipartisan support. But there are differences between the House-passed bill and the Senate bill that could become a tricky issue during negotiations on a final measure.

The House-passed VA Management Accountability Act has drawn criticism from employee groups who warn it could politicize the VA.

“Nothing in the bill prevents a secretary from cleaning house under the guise of performance,’’ the Senior Executives Assn. said in a letter to lawmakers. Sanders, who caucuses with Democrats, has included due-process protections to prevent “wholesale political firings.’’

Eliminating VA bonuses

The bill that passed the House on Tuesday would prohibit paying VA bonuses for fiscal 2014 through 2016.

The VA paid a total of 280,998 monetary awards and bonuses totaling about $410 million in fiscal 2011, according to a congressional source.

The Senate bill would eliminate the use of wait times as a factor in awarding bonuses. It also would require the VA to establish disciplinary procedures for employees who knowingly falsify wait time data.

VA employees were said to have falsified records to conceal long wait times for care so they could receive bonuses.

Requiring an independent review of the VA’s massive health system

This is virtually certain to be in any legislation. “We need to understand just how sick this patient is before we begin to prescribe some treatment,’’ Boehner said Tuesday. The VA announced Tuesday that its staff will meet with private healthcare industry leaders to discuss best practices and policies for scheduling patients.

Giving veterans more information

The Senate bill would require the VA to post on the Internet current wait times for appointments in primary and specialty care at each VA medical center.