Five Key Facts: Veterans and Medicaid Expansion

Executive Summary

Not all veterans are eligible for coverage from the Department of Veterans Affairs, and others have difficulty accessing services. This fact sheet shows how Medicaid expansion could improve access to coverage and services for veterans.

The Medicaid Expansion is critical to veterans. By accepting federal funding to expand Medicaid, states can improve veterans? access to health care. Here are some key facts:
1. Not all veterans are eligible for health care services through the Department of Veterans Affairs
The Department of Veterans Affairs (?VA?) considers a veteran?s active duty status, condition of discharge, and length of service in determining eligibility for health care services. In addition, the VA uses a priority enrollment system to facilitate the management and delivery of health care services.[1] There are eight priority groups that determine a veteran?s eligibility and priority for using health care services.[2] Priority status is based on several factors, such as service-related disabilities and income-level.Depending on the VA?s medical care budget, veterans in lower priority groups may face restrictions on new enrollment or lose their eligibility.[3]
2. Uninsured veterans have substantial medical needs 
Uninsured veterans have a disproportionate amount and complexity of health issues. Over 40 percent of uninsured veterans report having unmet medical needs.[4] About onethird of uninsured veterans have at least one chronic health condition, while over 15 percent have physical, mental, or emotional health problems.[5]
3. Nearly half of today?s uninsured veterans would get the coverage they need with Medicaid Expansion
There are approximately 1.3 million uninsured veterans nationwide.[6] Nearly half of the uninsured veteran population reports family income below 138% of the federal poverty level, and would get coverage if states accept federal funding to expand Medicaid.[7] Only 10% of these veterans appear eligible for Medicaid under current law.[8]
4. Rural veterans often have no VA facilities near them
Veterans eligible for VA health care services usually receive those services at facilities operated and staffed by the Veterans Health Administration.[9] Proximity to VA facilities may impact the likelihood of veterans seeking health care services.[10] This is particularly true for those in rural communities located far from VA facilities.[11] If these veterans had additional coverage through Medicaid, they could access local providers and get regular care.
5. For some veterans expanding Medicaid automatically improves their standing in the VA?s priority system
Veterans eligible for Medicaid benefits may be placed in a higher priority group in the VA?s priority enrollment system.[12] Therefore, if a state expands Medicaid, in addition to receiving Medicaid coverage, many veterans will also automatically have improved access to health care through the national VA system.
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[1] Congressional Budget Office, Potential Costs of Veterans? Health Care, p. 4, (Washington, DC: Congressional Budget Office, 2010), http://www.cbo.gov/publication/21773.
[2] Id. at 2.
[3] Id. at 4.
[4] Jennifer Haley et al., Uninsured Veterans and Family Members: Who Are They and Where Do They 
Live?, Urban Institute, p. 6, (2012), available at http://www.urban.org/UploadedPDF/412577-UninsuredVeterans-and-Family-Members.pdf
[5] Id.
[6] Id. at 1.
[7] Id. at 3.
[8] Id.
[9] Cong. Budget Office, supra note 1, at 1.
[10] Haley, supra note 4, at 1. For a list of VA facilities by state see U.S. Dep?t of Veterans Affairs, Facilities by State, http://www2.va.gov/directory/guide/home.asp?isflash=1
[11] See U.S. Dep?t of Veterans Affairs, VHA Office of Rural Health, What is ?Rural??, http://www.ruralhealth.va.gov/about/rural-veterans.asp
[12] See U.S. Dep?t of Veterans Affairs, Priority Groups Table, http://www.va.gov/healthbenefits/resources/priority_groups.asp.

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