{"id":520,"date":"2026-04-03T12:00:00","date_gmt":"2026-04-03T12:00:00","guid":{"rendered":"https:\/\/golliza.com\/?p=520"},"modified":"2026-04-03T12:00:00","modified_gmt":"2026-04-03T12:00:00","slug":"veterans-out-of-pocket-equity-act-targets-disparities-in-preventive-health-coverage-for-veterans","status":"publish","type":"post","link":"https:\/\/golliza.com\/?p=520","title":{"rendered":"Veterans Out-of-Pocket Equity Act Targets Disparities in Preventive Health Coverage for Veterans"},"content":{"rendered":"<p><\/p>\n<div>\n<p>Sen. Tammy Duckworth (D-IL) and Sen. Susan Collins (R-ME) are introducing the Out-of-Pocket Equity for Veterans Act. This is a law designed to eliminate co-pays for preventive health services provided through the Department of Veterans Affairs.<\/p>\n<p>This bipartisan bill would eliminate copays for preventive drugs and services, align VA prescription copay standards with those used by private insurance and TRICARE, and ensure that all contraceptives approved, licensed, and cleared by the Food and Drug Administration are available at no cost.<\/p>\n<p>\u201cIt is unacceptable that eligible veterans should be singled out and forced to pay out-of-pocket for preventive care after all they have done for our country,\u201d Duckworth said. \u201cThere is no reason why these copays should apply to nearly all ACA patients and not our heroes. Our bipartisan legislation will eliminate these costs and help ensure VA patients are treated more equitably in the health care marketplace.\u201d<\/p>\n<h2><strong>How VA contributions work and who pays them?<\/strong><\/h2>\n<p>The Veterans Affairs Health Care System operates under its own legal framework and is not bound by the preventive care coverage requirements imposed on private insurance under the Affordable Care Act. Instead, the Department of Veterans Affairs assigns veterans to priority groups that determine eligibility and cost-sharing obligations.<\/p>\n<p>Veterans are placed into one of eight priority groups based on factors such as service-related disability rating, income, and military history.<\/p>\n<p>People in higher priority groups, such as veterans with service-connected disabilities rated at 50% or higher, typically pay no copayments. However, veterans in lower priority categories, particularly priority groups 7 and 8, typically have to pay co-pays for outpatient visits and prescription drugs. <\/p>\n<p>These copayments can also be applied to preventive care. For example, veterans in low-priority groups may face copays for cholesterol medications, cancer screenings, and contraceptives, services that are often provided without cost sharing in other health systems.<\/p>\n<h2><strong>Gap in insurance system compared to other medical insurance<\/strong><\/h2>\n<p>Under the Affordable Care Act, most private health insurance plans are required to cover a defined set of preventive services without copays, coinsurance, or deductibles when offered in-network. <\/p>\n<p>These services include screening for conditions such as breast and colorectal cancer, medications to reduce cardiovascular risk, and a wide range of contraceptive options. This policy aims to remove financial barriers to early detection and treatment.<\/p>\n<p>Because VA operates outside of this framework, these protections are not automatically applied. As a result, veterans receiving treatment through the Veterans Administration may have to pay for preventive services that are free to civilians with private insurance and veterans on Tricare.<\/p>\n<p>This discrepancy reflects structural differences in how federal law governs these programs, rather than differences in clinical standards.<\/p>\n<figure role=\"group\">\n<article data-embed-button=\"image\" data-entity-embed-display=\"view_mode:media.with_caption\" data-entity-embed-display-settings=\"[]\" data-entity-type=\"media\" data-entity-uuid=\"a19e8015-9164-41e9-94b9-b7abfe102888\" data-langcode=\"en\" class=\"embedded-entity\">\n<figure>\n<div class=\"field field--image field--label-hidden\">\n<picture><source srcset=\"https:https:https:https:\/\/golliza.com\/wp-content\/uploads\/2026\/04\/Veterans-Out-of-Pocket-Equity-Act-Targets-Disparities-in-Preventive-Health-Coverage.jpg 1x\" media=\"(min-width: 1200px)\" type=\"image\/jpeg\" width=\"621\" height=\"497\"><source srcset=\"https:https:https:https:\/\/golliza.com\/wp-content\/uploads\/2026\/04\/Veterans-Out-of-Pocket-Equity-Act-Targets-Disparities-in-Preventive-Health-Coverage.jpg 1x\" media=\"(min-width: 992px) and (max-width: 1199px)\" type=\"image\/jpeg\" width=\"621\" height=\"497\"><source srcset=\"https:https:https:https:\/\/golliza.com\/wp-content\/uploads\/2026\/04\/Veterans-Out-of-Pocket-Equity-Act-Targets-Disparities-in-Preventive-Health-Coverage.jpg 1x\" media=\"(min-width: 768px) and (max-width: 991px)\" type=\"image\/jpeg\" width=\"621\" height=\"497\"><source srcset=\"https:https:https:https:\/\/golliza.com\/wp-content\/uploads\/2026\/04\/Veterans-Out-of-Pocket-Equity-Act-Targets-Disparities-in-Preventive-Health-Coverage.jpg 1x\" media=\"(max-width: 767px)\" type=\"image\/jpeg\" width=\"621\" height=\"497\"><\/p>\n<p>  <\/source><\/source><\/source><\/source><\/picture>\n<\/p><\/div>\n<\/figure>\n<\/article><figcaption>U.S. Senator Tammy Duckworth speaks with former U.S. Army Ranger and World War II veteran Sergeant John Johnson. Joseph J. Drake before the ceremony awarding Drake the Congressional Gold Medal on June 26, 2025, in Emancipation Hall at the Capitol in Washington, DC. (U.S. Army photo: Bernard Fuller)<\/figcaption><\/figure>\n<h2><strong>What does the law change?<\/strong><\/h2>\n<p>The Veterans&#8217; Co-Pay Fairness Act would eliminate co-pays for preventive services and medications within the VA system, effectively linking them with private insurance and VA compensation.<\/p>\n<p>It would also standardize prescription copay practices and ensure that veterans have access to all FDA-approved contraceptives without a copay. Supporters say these changes will remove financial barriers that often prevent early treatment and routine care.<\/p>\n<h2><strong>Estimated financial impact<\/strong><\/h2>\n<p>At a Senate Veterans Affairs Committee legislative hearing on an earlier version of this proposal, the Department of Veterans Affairs presented cost estimates showing that veterans would retain significant savings if copays for preventive care were eliminated.<\/p>\n<p>The Department of Veterans Affairs estimated that over 10 years, veterans could avoid approximately $49.1 million in outpatient copayments and approximately $399 million in medication copayments, for a total of approximately $448 million in out-of-pocket costs.<\/p>\n<p>These numbers reflect direct savings for veterans and highlight the financial burden associated with current out-of-pocket costs.<\/p>\n<h2><strong>Previous legislative efforts across Congress<\/strong><\/h2>\n<p>Efforts to eliminate co-pays for preventive care within the VA system have been underway across both the House and Senate for several years.<\/p>\n<p>In 2021, Sens. Tammy Duckworth and Susan Collins joined Rep. Lauren Underwood in introducing a bicameral bill targeting the same issue, entitled the Veterans Preventive Health Insurance Fairness Act. The proposal would eliminate co-pays for preventive services and medications and align Veterans Affairs prescription cost sharing with private sector and military veteran standards.<\/p>\n<p>Mr. Underwood continued to pursue the issue in the House of Representatives. In 2025, she testified before the House Veterans Affairs Committee on a bill with a similar purpose, emphasizing the need to eliminate co-pays for preventive services recommended by federal health authorities such as the U.S. Preventive Services Task Force, the Centers for Disease Control and Prevention, and the Health Resources and Services Administration.<\/p>\n<p>Although these early efforts did not become law, they established a consistent legislative record and policy rationale that supports current proposals.<\/p>\n<p>This issue has also been recognized by executives. During the approval process, Veterans Affairs Secretary Doug Collins said the preventive aspect of health care is &#8220;very important&#8221; and expressed his intention to work with lawmakers on preventive care co-pays.<\/p>\n<h2><strong>Fundamental issues addressed by this bill<\/strong><\/h2>\n<p>At its core, the law addresses structural inconsistencies in federal health care policy. Veterans receiving care through the Veterans Administration may be required to pay for preventive services that are treated as free by nearly every other major insurance plan in the United States.<\/p>\n<p>Advocates say the gap is not just a question of equality, but of access. Research shows that when faced with out-of-pocket costs, patients are less likely to use preventive services and can make it difficult to detect health problems early when treatment is more effective and often less expensive.<\/p>\n<p>For veterans in means-tested priority groups, even relatively small out-of-pocket payments can influence health care decisions. These costs can preclude routine testing, delay the use of prophylactic medications, and reduce recommended treatment adherence.<\/p>\n<p>In practical terms, this can mean that symptoms that could have been managed early progress to more serious and complex health problems that require more intensive treatment.<\/p>\n<p>The Veterans&#8217; Out-of-Pocket Fairness Act aims to remove these barriers and align veterans&#8217; health care benefits with a broader shift in U.S. health care policy that emphasizes prevention and early intervention by eliminating copays for preventive care.<\/p>\n<\/p><\/div>\n<p>#Veterans #OutofPocket #Equity #Act #Targets #Disparities #Preventive #Health #Coverage #Veterans<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Sen. Tammy Duckworth (D-IL) and Sen. Susan Collins (R-ME) are introducing the Out-of-Pocket Equity for Veterans Act. This is a law designed to eliminate co-pays for preventive health services provided through the Department of Veterans Affairs. This bipartisan bill would eliminate copays for preventive drugs and services, align VA prescription copay standards with those used &#8230; <a title=\"Veterans Out-of-Pocket Equity Act Targets Disparities in Preventive Health Coverage for Veterans\" class=\"read-more\" href=\"https:\/\/golliza.com\/?p=520\" aria-label=\"Read more about Veterans Out-of-Pocket Equity Act Targets Disparities in Preventive Health Coverage for Veterans\">Read more<\/a><\/p>\n","protected":false},"author":1,"featured_media":521,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1,2],"tags":[2067,884,2069,2066,36,2065,2070,2068,2064],"class_list":["post-520","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-general","category-health-care","tag-act","tag-coverage","tag-disparities","tag-equity","tag-health","tag-outofpocket","tag-preventive","tag-targets","tag-veterans"],"_links":{"self":[{"href":"https:\/\/golliza.com\/index.php?rest_route=\/wp\/v2\/posts\/520","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/golliza.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/golliza.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/golliza.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/golliza.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=520"}],"version-history":[{"count":0,"href":"https:\/\/golliza.com\/index.php?rest_route=\/wp\/v2\/posts\/520\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/golliza.com\/index.php?rest_route=\/wp\/v2\/media\/521"}],"wp:attachment":[{"href":"https:\/\/golliza.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=520"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/golliza.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=520"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/golliza.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=520"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}