During his weekly address on Saturday, President Barack Obama made clear that the United States owes its veterans a debt of gratitude that includes adequate health care. “I’ve often said that my top priority is growing the economy, creating new jobs, and restoring middle-class security. And a very important part of that is making sure that every veteran has every chance to share in the opportunity he or she has helped defend,” said the president. “In addition to the care and benefits they’ve earned — including good mental health care to stay strong — that means a good job, a good education, and a home to call their own.”
But the reality is that gaps in the social safety net and America’s broken health care system leave thousands of veterans out in the cold. Here’s three examples of how.
1. Not all veterans have government health benefits, and sometimes, those who do don’t know they’re eligible for them.
The Veterans Health Administration provides health care services to millions of veterans, but it also leaves many out of the system. There are an estimated 1.3 million veterans who don’t have any health insurance whatsoever, according to a 2012 report by the Urban Institute — a number that grows by almost another million when accounting for veterans’ family members.
Under Obamacare’s Medicaid expansion, nearly half of these uninsured veterans would gain basic health benefits since 48 percent of them have incomes below 133 percent of the Federal Poverty Level (FPL), the expanded Medicaid eligibility threshold under the health law. Unfortunately, GOP-led states refusing the Medicaid expansion will be leaving thousands of veterans and their family members on their own when it comes to paying for medical care.
But even government-sponsored health care is of little use to veterans if they don’t know about their benefits. The Department of Veterans Affairs (VA) doesn’t notify local service agencies when veterans return home from duty, making it very difficult to let them know about the care they’re entitled to.
“It’s been a problem for decades,” said Vietnam veteran Jerry Donnellan, director of the Rockland County Veterans Service Agency, in an interview with the local Hudson Valley publication Lohud.com. “I’ll bet you lunch that there’s a young veteran just out of the service within two miles of where I’m sitting who could use our help. But he doesn’t know we exist and we don’t know where he is.”
The VA is currently reviewing ways to make veterans more aware of all the services and benefits that they’re entitled to.
2. Medical and disability claims can take over a year to process.
VA Secretary Eric Shinseki has come under fire for the massive backlog of medical and disability claims plaguing his agency. In March, the backlog of unprocessed claims peaked at a stunning 900,000 while the number of veterans waiting over a year to receive disability reimbursements reached 256,000 — a 2,000 percent increase from when President Obama first took office.
Efforts to reverse that trend have made a significant dent in that number since then. But the wait times are still considerable, and the VA has missed several self-imposed deadlines for clearing the backlog. SFGate reports that 34,000 veterans are still waiting over a year for compensation and the average wait time is still 168 days. The VA failed its goal of clearing out the entire backlog of year-long disability claims by October, and on Veteran’s Day, over 400,000 veterans’ claims remain unprocessed.
3. Mental health care services are hard to come by.
Veterans — particularly young veterans returning from the Iraq and Afghanistan wars — suffer from record levels of post-traumatic stress disorder (PTSD) and depression. At least 15 percent of these veterans have PTSD by the VA’s own estimates, and surveys have shown the number may actually be as high as 30 percent. About 730,000 veterans have some sort of mental health condition, according to the National Council on Behavioral Health.
These psychological scars aren’t just a consequence of witnessing death and destruction, either. Recent American veterans are also susceptible to the considerable mental stresses of economic inequality when they come back home. Although veterans only make up seven percent of the population, 13 percent of all adults experiencing homelessness are veterans and over 986,000 veterans under age 64 reported being in poverty in the previous year. This is particularly concerning since some studies have suggested that lack of economic opportunity and social exclusion are even bigger predictors of mental illness than warfare itself.
Veterans’ families don’t fare much better when it comes to mental health, either. A report by the American Academy of Pediatrics (AAP) found that over 2 million American children in military families are at risk for a mental illness because of the anxieties related to a loved one’s deployment in active duty combat.
“[O]ne in four children of active-duty service members experience symptoms of depression, one in two report trouble sleeping, and about one in three children of active-duty military personnel experience excessive worrying,” wrote AAP researchers. Unfortunately for both veterans and their families, U.S. mental health services are notoriously pricey and hard to access — if they’re even accessed at all. The National Council on Behavioral Health found that a staggering 70 percent of veterans with mental illnesses either get sub-par treatment or skip out on it entirely.
A shocking review by the Atlanta Journal-Constitution found that some veterans who do seek out care are committing suicide while waiting for therapy appointments and mental health treatments. Many of these veterans’ requests for care are simply falling through the cracks due to poor communication and botched referrals and payments between the VA and local service contractors.
As for families, the AAP report points out that over 50 percent of military children seek their mental care outside of the military health system. But private insurance coverage for mental health care has long been so meager that many psychologists don’t even accept it, leaving tens of thousands without affordable options. Many insurance policies place strict limits on things like the number of times you can visit a doctor for mental treatments and checkups.
This is one area where recent regulations may help make a big difference. Last week, the Obama administration proposed long-awaited rules that will require all American insurance plans to cover mental health services on equal footing with more traditional care. The regulations are expected to significantly expand mental health benefits to millions of Americans.