More than one quarter of all military veterans live in rural areas where health care has too often become a challenge to access.

Sustaining necessary health infrastructure has grown increasingly difficult as declining rural populations have caused many hospitals and the medical practices associated with them to close down. Nearly 140 rural hospitals have closed since 2010, with 19 closing in 2020 alone. This increases the distance rural residents must travel for medical appointments and procedures.

Many of our rural-living veterans, due to their service experience or age, require an ambulance to travel from home to a medical facility. Their condition is such that they require a trained medical professional to monitor their health on the long drive. And, of course, many veterans make that trip via ground or air ambulance on an emergency basis.

With more than 15 million veterans eligible for VA care, there are many thousands of ground and air ambulance trips each year and they come at a large financial cost. The VA has quietly decided that the cost today is too great for it to bear, and so has put in place plans to slash reimbursements to veterans for ambulance trips. Beginning in early 2024, reimbursements will be significantly reduced to veterans who receive ambulance rides to VA-approved hospitals. Those who receive ambulance rides to non VA-approved hospitals will see reimbursements cut to near zero.

Why is this happening? According to many who watch the VA closely, the plan is to create a funding gap – a crisis – that will compel other government entities to step forward and fill that void. Some combination of state, county and municipal government would see the crisis unfold and then rush forward with a funding solution because to do this to veterans is unthinkable.

Our first concern is that government does not move that fast and its budgets – most all set annually — are not elastic, it can’t just find the money. It is possible relatively well-off areas would be able to respond, but that doesn’t account for other, more numerous and vast areas that haven’t been blessed with the same bounty of services and wealth. By that we mean rural areas where so many of our fellow veterans live.

That leads to an even greater concern of how affected veterans might respond. Knowing costs are out of reach, will they simply forego medical treatment? Or, might they attempt another, less safe way to travel to a medical facility?

Finally, all of this leads to concerns surrounding the private ambulance industry, especially those that provide service to rural areas. Veterans comprise a large percentage of their business, which means VA funding is a large component of their revenue. Turn off that revenue and they may be forced to exit some areas. Rural areas are at greatest risk, and loss of those services will harm the entire community. Few if any have the financial means to adequately backfill lost ambulance services.

The VA’s cost cutting move is a disaster in the making, but there is a way out. First, congressional leaders should publicly call for a study to be done that examines the effect that changes to ambulance reimbursement would have on our veterans’ health. Second, congressional working groups should be established and informed by veterans’ affairs experts from the local, state and federal levels to determine the possibility of non-VA funding of ambulances for veterans. And, finally, the VA must pause the date that its reimbursement cuts will go into effect until the results of these efforts are fully known and examined publicly.

To bring the VA around to this approach, a stick (versus a carrot) is required. Bi-partisan legislation has been introduced in both chambers of Congress that will prevent the VA from implementing its rule that will cut reimbursements to veterans. The VA rule is scheduled to take effect in February so our legislators need encouragement to swiftly bring the bills to a vote so that they can become law.

This is an enormous crisis in the making whose impact will extend far beyond veterans to their families, friends and the communities in which they live. Action is needed now, before Congress adjourns for the end-of-year holidays, if we are to avert this disaster and determine the fate of this issue with compassion and common sense on behalf of our veterans.

Our Veterans through their heroic service to our country have earned better treatment from their government. Foremost in their minds should not be their ability to pay for an ambulance ride to receive the medical treatment they require.

William Enyart is the retired adjutant general of the Illinois National Guard and a former member of the U.S. House of Representatives. Doug Jameson is a member of the Veterans of Foreign Wars National Committee.

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