VA health care eligible for Medicaid through Obamacare
June 05, 2013
When Daniel Cruz
left the U.S. Marine Corps in August 2006, he became one of thousands of
Illinois veterans without health insurance, despite being eligible for
coverage through the Department of Veterans Affairs.
“I never went to the VA afterwards,” Cruz, 29, of Chicago, said. “I got
unemployment, and that was my benefit. I didn't know any better.”
More than half a million uninsured veterans could start receiving health
care when Medicaid expansions that are part of the Affordable Care Act
kick in next year, even though many of them also qualify for treatment
through the VA system. Nationally, 1.3 million nonelderly veterans have
no health insurance.
“Uninsurance among veterans is associated with greater problems
accessing needed care,” said Jennifer Haley, research associate at the
Health Policy Center at the Urban Institute, who co-led the study.
“Increased Medicaid coverage could close coverage gaps and increase the
likelihood that their health care needs are being met.”
Four in 10 uninsured veterans have incomes below 138 percent of the
federal poverty line, which means that under the new terms of the
Affordable Care Act, these veterans might qualify for health insurance
or subsidies for coverage if they live in participating states,
according to a study released in March by the Urban Institute and the
Robert Wood Johnson Foundation.
About 42 of every 1,000 veterans in Illinois have no insurance,
according to the study, which translates to nearly 34,000 uninsured
Illinois veterans. Nationwide, 1 in 10 veterans under the age of 65 is
uninsured. The data used to power the study comes from the U.S. Census
Bureau and does not report why uninsured veterans do not use VA health
VA care is only available through VA providers, so the location can be a
problem if no VA facility is convenient, said Haley, adding that
proximity issues particularly affect rural communities.
“Medicaid providers could be more convenient for [these veterans], if
the VA facility is too far away,” she said.
Proximity may not be the only issue at hand, however. Some veterans may
be avoiding VA care by choice.
Cruz, who served with the Marines for five years, had no health
insurance until he became a full-time student at Northeastern Illinois
University in August 2007. His desire for insurance was a factor in the
decision, he said, and added that being uninsured also changed his
“I didn't get into motorcycles because I don’t want a motorcycle
accident. I didn't get into any kind of sports at school,” he said.
After he was discharged, Cruz received enrollment paperwork from the VA,
as well as a deadline to submit it, he said.
“It just seemed so complex that I would rather just suck it up than go
through the hassle,” he said. “I just wanted to enjoy some freedom and
not deal with their system.”
Eligible veterans can apply for VA health benefits online, over the
phone or in person at a local VA health facility, according to the VA
website. The online application involves an interactive PDF document,
which requires a specific software update and does not display on
Multiple calls to VA representatives for comment were not returned.
For Cruz, it’s not just a matter of avoiding bureaucracy and
time-consuming paperwork. Military culture itself may have a hand in why
he doesn’t seek VA health care, he said.
“For me, it’s a bit of a pride thing,” he said. “I don't know if that’s
something embedded in me when I served, or something that I got from the
media, but I do feel pride that I don't collect benefits from the
The simplest answer for why veterans go uninsured may be one of
knowledge gaps, according to Haley.
“Most veterans are unaware that once they leave the military, they can
still enroll in VA care,” she said. “It could be that the VA needs to
better publicize that the VA care is available.”
Cruz said that he has changed his mind about applying for VA coverage,
and that he feels he has nothing to lose from trying to supplement his
“That pride thing, you have to put that aside and get what you deserve,”
he said. “I’m being more open to actually going through the process
right now than when I first got out.”