Legislation assuring automatic VA enrollment is more vital than ever before

After attempting suicide while serving on active duty in Iraq, Kristofer Goldsmith was given a general discharge by the Army and little else. The overwhelmed 21-year-old returned to his hometown on Long Island, N.Y., totally unaware that he was eligible for care from the Veterans Health Administration (VA). “I had just lost my income, my support network, my identity, and almost my life. I was in a total mental health crisis,” Goldsmith told us.

During the critical months following his transition to civilian life, he went without desperately needed services. If his mother hadn’t forced him to go to the VA, Goldsmith, who credits the VA with helping him rebuild his life, doesn’t know what would have happened to him. Of this, however, he is certain, “If I had heard from my local VA informing me of what benefits I had and that I’d been enrolled in the system, it would have changed my life drastically.” 

Assuring future cohorts of veterans — including those struggling with the Taliban triumph in Afghanistan — don’t go without health care during their transition from military to civilian life is the worthy goal of a new bill introduced by Rep. Mark Takano (D-Calif.), chairman of the House Committee on Veterans’ Affairs. The Ensuring Veterans’ Smooth Transition Act (EVEST) provides automatic enrollment in the VA for all transitioning service members, and veterans who don’t want to obtain its services have the easy choice of opting out. Without adding any new entitlements, it expedites the use of health care benefits that veterans already earned. It was passed in a committee hearing on July 28, with all the committee’s Democratic members in favor and all Republican members opposing. It now awaits a full House vote.

This bill would help thousands of veterans who need services for the multitude of conditions acquired or exacerbated by military service but are confused about how to access them. These ailments include everything from respiratory problems caused by burn-pit toxic exposure to signature combat conditions such as Traumatic Brain Injury (TBI) and Post-Traumatic Stress Disorder (PTSD). 

For all these problems, prompt attention means everything. For example, research shows that veterans who received care soon after the end of their service “had lower levels of PTSD upon follow-up a year after they initiated care. For each year that a veteran waited to initiate treatment, there was about a 5 percent increase in the odds of their PTSD either not improving or worsening.”

The bill applies to all new veterans but has particular relevance to the approximately 175,000 Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF) and Operation New Dawn (OND) combat service members who leave the military annually and qualify for five years of free VA medical care under the Dignity for Warriors Act of 2008 for conditions related to their service. A large percentage of them are unaware of their eligibility for this care and never enroll to receive it. 

In 2018, the National Academies of Sciences, Engineering and Medicine found that post-9/11 veterans who had not sought VA mental health care didn’t know how to apply for benefits — or were unsure whether they were even eligible. Some didn’t know what services the VA offered or felt that they didn’t deserve care even if they could get it. Some women veterans are similarly unsure whether VA services are even available to their gender.

The EVEST legislation will not only be key to eliminating these barriers but also to reducing the veteran suicide crisis. A disproportionate number of veterans die by suicide during the initial months and years following separation from military service. Veterans ages 18 to 34 have the highest rate of suicide. Automatic pre-enrollment could be lifesaving during a crisis when speed is of the essence. Furthermore, the risk of suicide (and opioid overuse) will likely diminish as veterans gain treatment for common problems like chronic pain resulting from damage to their joints by carrying 60- to 100-pound packs, as well as heavy protective armor.  

The bill would require the Department of Defense (DOD) to provide VA with information about transitioning service members. VA would then reach out to them about the scope of, and access to, benefits. The bill does not change eligibility standards for VA care, i.e., a service-related condition and low income.

Smoother access to VA health care has never been more important than it is today. The tumultuous end of the war in Afghanistan is intensifying mental health symptoms within the veteran population. If members of Congress from both sides of the aisle want to better serve veterans and reduce veteran suicide, the passage of this invaluable legislation must be a priority.  

Russell Lemle was chief psychologist at the San Francisco VA Health Care System and is a senior policy analyst at the Veterans Healthcare Policy Institute

Suzanne Gordon is author of “Wounds of War,” and is a senior policy analyst at the Veterans Healthcare Policy Institute.