‘Devastating’: Herb Conaway Warns Of Medicaid Cut Impacts On Strained Rural Veteran Health Programs

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At a House Veterans’ Affairs Committee hearing before the Congressional recess, Rep. Herb Conaway (D-NJ) expressed concerns around how cuts to Medicaid could negatively affect veterans relying on rural health systems.

Transcript

00:00Thank you very much, Representative King-Hines. The chair now recognizes Dr. Conaway for five minutes for any questions you may have.

00:06Thank you, Madam Chair, and thank you, ladies, for your service and your commitment to veterans and their health care.

00:13I want to make a few comments and observations. Since sitting on this committee and what I've heard today,

00:20I hope there is consensus on this committee and across the House, across the government, that we need to have a strong VA health care system

00:32and that we need community providers because we know the VA doesn't exist everywhere, particularly in rural areas.

00:38And so we know this partnership needs to exist.

00:41One of the problems, as a physician, practicing physician for 30 years myself, worked on an Air Force base in New Jersey taking care of veterans

00:49and in the community and private practice, what my experience tells me and what I have read about and what the research shows

00:58and what we all know with the problems with our information system is that there's not coordination across those systems.

01:04Once you move outside of a system, even within hospitals in my own little state of New Jersey,

01:09getting records to move from hospital to hospital if they're not on the same platform is a very difficult thing to achieve.

01:15And you will have, and particularly, and so you're going to have patients, if they move to different locales, having to repeat their stories.

01:22And it's terrible when it involves things like trauma.

01:25When you're in a teaching institution, your resident might see you, might be a medical student, then a resident, then the attending.

01:32And so this is part of the teaching process and teaching institutions.

01:36And unfortunately, we will hear stories about people being re-traumatized as these, as this information is collected.

01:44But that iterative process and teaching institutions is part of driving great outcomes.

01:49I would also say that, you know, we have to rely on data, as you mentioned, and the data has been consistent over many years and repeated,

01:58that VA care for veterans provides great outcomes, veterans want the care there.

02:07And if you think a moment about the different exposures, the experience in the military, where they have been,

02:13the experience of people taking care of numbers of veterans over the years that is unlikely to be replicated in most communities,

02:21it doesn't surprise me that outcomes are better than the VA system.

02:24Our problem is that it's hard, well, maybe I should speak for myself, but I think I'm speaking for a lot of others, too.

02:30When we understand that the administration is cutting tens of thousands of people out of a system that's already stressed,

02:37it's hard to imagine that you can achieve the kind of outcome standards that you could achieve if those people weren't out of the system.

02:44Now, reform, looking at how things are done, making sure training is correct,

02:48maybe having a special access for women who are having particular problems,

02:53whether it be reproductive health care or sexual trauma in the service.

02:56Those things are important to put in a system.

02:59I think you're more likely to get that in the VA than very often you're in the community, by the way,

03:03because of the sensitivities in the VA system for this.

03:06I suspect, and as I look at the numbers we have about the people who have been, who are leaving the service now,

03:13as I look at the numbers, two-thirds of them are clinical staff, physicians, nurses, support staff.

03:19And so if we were to decide to bring in or try to recruit more women to deal with sexual trauma in the service,

03:26I can't imagine how that wouldn't be decried as a DEI program within the government.

03:31You can't even recognize women who've served honorably overseas because it's recognizing women, never mind people of color.

03:39So I want to ask this question of you, Ms. Newman, because you work in a rural area,

03:45and we know now that there are a number of studies that are coming out showing that these Medicaid cuts

03:49are going to be particularly devastating in rural areas where Medicaid might make up 40 to 50 percent of their revenue.

03:57We've heard 338 hospitals at risk.

04:01You live and others on this panel live and get care in rural areas.

04:05Can you describe how the loss of hospitals in the community is going to impact access to care,

04:14the access that we know veterans need?

04:18Thank you for the question.

04:20Yes, I do live in a rural area.

04:21In my particular area, we already have lost access to hospitals.

04:28We are an independent home care agency, and these cuts are not going to, in particular, impact our agency.

04:37But our people in our area, they're already used to traveling to receive care.

04:45Just reclaiming my time because I'm running out of time, and thank you for that.

04:49I think it is obvious that if hospitals close, there's going to be an access to care problem.

04:57I asked Secretary Collins at a hearing just like this one about whether or not cuts to Medicare

05:03and food assistance is going to impact veterans.

05:07He says, I don't foresee that happening.

05:09Now, well, now it's happened.

05:10And we know, as a result of that big, ugly bill, that we're going to see really quite devastating dislocation

05:18across the land, and particularly in rural areas, and also impacting veterans.

05:22And that's a shame, given the commitment this country needs to keep to our veteran community.

05:27Thank you, Madam Chair.

05:28I yield back.

05:28Thank you, Dr. Kahn.

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