CHI analysis: 45% of eligible Colorado veterans not enrolled in VA health coverage

A new analysis from the Colorado Health Institute (CHI) reveals that 45% of the approximately 314,000 Colorado veterans who are eligible for health care through the US Department of Veterans Affairs (VA) aren’t enrolled. These individuals are missing out on free or low-cost health care services due to factors like access barriers, mistrust, and unawareness of eligibility. 

CHI conducted the analysis using data from the US Census Bureau and the VA as of March 2021.

 

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While around 97% of Colorado veterans have some sort of health coverage, this data shows many are missing out on potentially advantageous VA benefits. Benefits include stipends for nursing home care, reduced care costs for disabled veterans, and access to providers who are familiar with veteran health.

Mountain resort communities like Pitkin (82%) and Eagle (84%) Counties had the highest rates of unenrolled, eligible veterans while southern and western counties like Mineral (16%) and Mesa (18%) had the lowest. CHI says this may be attributable to VA facility locations, which are mostly in the Front Range and Mesa County.

 

Image: Colorado Health Institute

 

Colorado has two VA medical centers and 18 community-based outpatient clinics in which VA enrollees can receive primary and specialty care.

Through conversations with veterans, policymakers, and veteran-serving organizations (VSOs), CHI identified four main barriers to enrollment. The first is a complex enrollment process, which requires most veterans to understand the VA’s eligibility criteria and which benefits apply to them, and to file the enrollment paperwork. This complicated process prevents many eligible veterans from receiving benefits, CHI says.

The second barrier is that many veterans aren’t aware of their eligibility for VA health insurance. According to CHI, around 30% of US veterans don’t know the eligibility criteria for enrolling in the VA. Some veterans cut ties with the military after their service, while others don’t receive adequate eligibility information when leaving the military.

Thirdly, some eligible veterans choose not to enroll in VA benefits because VA facilities can be hard to access, depending on a veteran’s location. For veterans living in more urban areas or in Front Range and Mesa County, opting for private insurance — which perhaps offers easier-to-access facilities — might make more sense. But for the state’s 48,000 rural veterans, alternative care facilities might not be so readily available. Limited transportation options for these individuals exacerbate the issue.

One VSO representative told CHI:

“We [VSOs] have vans that will take veterans to Denver for services. But the issue is, we are talking about a four-hour drive and that requires a very early morning. You go to Denver, and you might get to your appointment, and you might not. They come back at 2 p.m. whether you are seen or not.”

The final barrier is mistrust in the VA. CHI cites an instance in which 40 veterans died in Arizona while waiting to receive care from a VA facility as an example of stories that decrease veterans’ trust in the administration. As the demographics of the military change, some female, LGBTQ+, and non-white veterans feel that the VA’s services haven’t accommodated to the increasing diversity of veterans and choose not to enroll.

CHI offers multiple solutions for policymakers and VSOs to pursue in order to increase enrollment among eligible veterans. This includes simplifying the enrollment system — for instance, an “opt-out” policy could automatically enroll eligible veterans into VA health benefits and allow veterans to choose to opt out of the program.

Another solution is to educate veterans more about their benefits. CHI lists Colorado legislation like HB 18-1337, which created a service center in Grand Junction that provided veterans in the area with information about their benefits, as an example of how to achieve this. 

Educational outreach should also be conducted after veterans arrive home from service, CHI says, as veterans are currently told about their VA benefits when they are about to leave service — a time when they’re likely focused on transitioning back to home life, not on how to enroll in VA benefits.