http://www.chron.com/cs/CDA/ssistory.mpl/nation/3040042

A NEW BATTLE ON THEIR HANDS

'It's a stab in the back,' vets say

They are angry over a Bush plan to charge a co-pay for VA medical care

By KIM COBB
February 14, 2005
Houston Chronicle

President Bush wants military veterans of at least modest means to pay $250 a year just to get in the door for VA medical care, and vets like Al Marlowe of Houston are furious about it.

"It's a stab in the back," said Marlowe, 75, a Korean War veteran. "This is what they do behind closed doors in Washington, if you want the real truth.

"The White House says the fee is needed, in a time of federal budget deficits, to make sure the Department of Veterans Affairs is able to help veterans who need it the most.

This is the third time the president has proposed a fee for the approximately 1.3 million non-disabled, higher-income veterans among the 7 million people enrolled in the VA medical system. Congress has been unwilling to go along with him.

But with the federal government under economic strain and two new Republican committee chairmen overseeing the VA budget, veterans' lobbying groups don't know what to expect.

The Senate Committee on Veterans Affairs is scheduled to take up the proposal today, )and the corresponding House committee will consider it Wednesday.

National veterans groups lobbying Congress and some Houston vets trying to manage their own medical care say the fee and a companion proposal to double prescription co-pays for many vets would drive away many men and women who depend on the VA for care.

What makes them angriest, vets say, is that the government continues to renege on a promise of free medical care for people who served their country in uniform.

"Congress just keeps taking away our money, and veterans need to find a way to fight back," Marlowe said.Others say the federal government is doing its best for its former warriors.

"This budget demonstrates the president's ongoing commitment to provide the very best health care and benefits to those veterans who count on VA the most," Secretary of Veterans Affairs Jim Nicholson said when the president's budget proposal was released last week.

'Less friendly'

In January, Senate committee chairman Larry Craig, R-Idaho, told Nicholson, "The fiscal environment that you inherit will be considerably less friendly than the relatively flush times the VA has enjoyed over the last four years." The VA requires a veteran with no dependents and an income of $25,162 to make co-payments toward his medical care. Factors like non-homestead property and length of military service also can come into play when determining who has to help foot their medical bills.

The president proposes to increase VA medical care spending to $22.4 billion a year from $21.6 billion, with much of the extra money coming from the annual fee and prescription co-pays rising from $7 to $15 for the same non-disabled, higher-income group.

The VA started considering veterans' assets in 1986, when budget deficits during President Reagan's second term left lawmakers scrambling for spending cuts.

Veterans with service-related disabilities (category A) and low-income vets (category B) continued to get free care. All others (category C) had to ante up for part of their medical costs. However, category C vets were seen only on a space-available basis, which means they were virutally shut out of care.

The Clinton administration in 1996 restored service to all veterans, though with co-pays for some, and shifted substantial amounts of money into outpatient care.

Prescription costs

The Michael E. DeBakey VA & Medical Center in Houston is the primary health care provider for more than 137,000 vets in Southeast Texas. Marlowe is categorized as a vet whose income and health require that he make co-payments to see a doctor and to get his prescriptions filled. He says he can probably scrape up the money for the annual fee and double the money he pays for six prescriptions.

Others can't, he said.

A spokesman for the Vietnam Veterans of America said many vets choose the VA system, even if they have Medicare benefits or private insurance, because it's the only way they can afford their prescriptions.

"Nobody should have to pay anything," said Marlowe, 8th District commander for 17 Houston-area American Legion posts.