Sen. Johnny Isakson (R-Ga.), new chairman of the Senate Veterans Affairs Committee, promises to push for two critical changes to soften a restrictive 40-mile rule on user eligibility under the VA Choice Card program. If Isakson succeeds, thousands more veterans would gain routine access to government-paid healthcare in the private sector. His challenge is that the changes sought could drive up health care costs for the Department of Veterans Affairs by billions of dollars annually.