A largely overlooked detail of the debate over the Affordable Care Act is the role it has played in providing care to veterans.
While veterans are entitled to receive care through the Department of Veterans Affairs, roughly 3 million rely on health care outside of the system, according to a study by the Rand Corporation.
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Although they are officially enrolled in the VA, they use providers from outside of the system, often paid for by an employer plan or an individual health plan.
In the wake of Obamacare, says the author of the study, many vets likely purchased plans through Healthcare.gov. If those plans are jeopardized, Rand researcher Carrie Farmer tells NPR, the VA should expect an increase in demand for care.
"I would expect that the number of veterans using VA health care will increase, which will only provide a further challenge for VA to provide timely and accessible care," Farmer says.
The problem is, the anticipated influx of VA patients coincides with a federal hiring freeze ordered by Trump over the weekend. Press secretary Sean Spicer dismissed concerns about the impact the hiring freeze could have on the agency, saying that the embattled department is not understaffed but simply poorly staffed.
"The VA in particular, if you look at the problems that have plagued people, hiring more people isn't the answer. It's hiring the right people," he said Tuesday.
Spicer's claim is contradicted by Trump's own nominee to head the VA.
"We have 45,000 job openings. That's too many," Shulkin tells NPR. "I need to fill every one of those openings in order to make sure that we're doing the very best for our veterans."
Some analysts say the hiring freeze is not as dramatic a move as it is being made out to be. The executive order itself included a vague exemption for any jobs "necessary to meet national security or public safety responsibilities."
"There's less there than meets the eye," Paul Light, a professor of public service at New York University, tells Politico.
More so than any other federal agency, the VA serves a constituency that both political parties claim to fiercely defend. Trump in particular made vets a centerpiece of his campaign for president. As a result, Democrats and others on the left are likely to focus heavily on the VA if any attempt to push back against the repeal of the ACA or the hiring freeze.
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