Senators: Let rural vets use Indian Health Service

The success of an Alaska program that gives veterans the option of being treated at Indian Health Service clinics could be a model for other states, said Sen. Mark Begich, D-Alaska.

“It would not work everywhere, but it could be a benefit in some states for veterans who live far from [Veterans Affairs Department] clinics and medical centers,” Begich said in an interview.

North Dakota Sen. Heidi Heitkamp, a Democrat, is exploring the possibility of having the same option in her state, but there could be opposition from major veterans’ organizations who don’t want VA health programs to be replaced by non-VA care.

The 2-year-old Heroes Health Card program in Alaska was a Begich initiative to address an Alaska-unique issue: many veterans living in areas inaccessible by road. One example, he recalls, was a veteran living in the village of Kwigillingok who had to spend more than $2,000 to travel to Anchorage to receive medical treatment.

“Eighty percent of villages in Alaska are not accessible by road,” Begich said of a state that has about 80,000 veterans, about 14,000 of whom receive compensation for service-connected disabilities.

There is no VA medical center in Alaska. Veterans needing inpatient treatment travel to the nearest VA hospital in Seattle; can be admitted to the military medical center at Joint Base Elmendorf-Richardson outside of Anchorage; or may use a community hospital that has a fee arrangement with VA.

Major veterans groups historically have opposed attempts to replace VA-provided health care with private-sector treatment, believing this could be a first step toward shutting down VA’s extensive system of hospitals and clinics.

However, they accepted Begich’s idea as a solution to dealing with the isolated villages where many Alaska veterans lived, said Raymond Kelley of Veterans of Foreign Wars.

“VFW is fine with using the Indian Health Service in very remote areas, which means where there is no road access,” Kelley said. “This does not mean we would support doing this in other states.”

Begich said in an interview that the Alaska model of using the Indian Health Service could work in some but not all states. The Indian Health Service network has 28 hospitals, 61 health centers and 33 health stations, but Begich said in some areas, the quality and availability of care is inadequate to serve veterans, and a veteran could find the nearest clinic is farther away than the closest VA facility.

The majority of Indian Health Service facilities are in Alaska and western states, but about 30 states have some IHS clinics or hospitals.