The House of Representatives voted unanimously on Tuesday to give thousands of veterans emergency access to private care to address a crisis that has embarrassed the Obama administration and worried lawmakers in the run-up to November's mid-term elections.
So many lawmakers wanted to be on record supporting the bill that a second vote was held for a few who missed the initial tally, bringing the total to 426-0.
The Senate is considering a similar bill after the government found clinics run by Veterans Affairs were hiding long wait times, during which some veterans are said to have died.
Both measures would allow veterans access to private healthcare providers at VA expense if they face a long wait or if they live more than 40 miles from a VA facility. The House measure had initially specified a wait-time trigger of more than 30 days, but the passed bill allows the VA to decide, making it consistent with the Senate bill.
Rep. Jeff Miller, a Republican who chairs the House Veterans Affairs Committee, also had initially wanted the private care access to be a permanent feature, but changed this to agree with the Senate plan for a two-year trial period.
Senate Veterans Affairs Committee Chairman Bernie Sanders, an independent, had expressed concern that permanent access would eventually lead to privatization of VA healthcare.
The VA operates the largest U.S. healthcare system, with 151 hospitals and 827 outpatient clinics serving 8.9 million veterans.
The vote came a day after the VA released an internal audit that found more than 100,000 veterans were subjected to a wait of 90 days or more for healthcare appointments, and widespread instances of schemes to mask the delays to meet targets for bonuses.
The deepening scandal prompted the resignation in late May of VA Secretary Eric Shinseki, a retired Army general wounded three times in Vietnam.
The House bill also would ban bonuses for all employees for the 2014 to 2016 fiscal years. Miller said this would free up about $400 million a year that could be used to help pay for any added costs for outside care.
But the House version also orders a top-to-bottom, independent review of all VA healthcare operations, far beyond the proposed review of appointment scheduling systems ordered in the Senate measure.
Republicans, who control the House, said this review, was important to understand the depth of the agency's problems.
House Speaker John Boehner said the issue goes "far beyond phony wait lists," and said Republicans would find out how much officials at VA headquarters in Washington knew about efforts at VA hospitals and clinics to cover up long wait times.
"We need to understand just how sick this patient is before we begin to prescribe some treatments," Boehner said of the VA review efforts.
Senate Majority Leader Harry Reid said on Tuesday that the Senate would vote on its VA bill within the next 48 hours.
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