By Tom Philpott
Like a waiter bringing the check after a high-spirited meal in a fine restaurant, the Congressional Budget Office has dampened some good vibes among lawmakers who rushed to solve the access-to-care crisis for veterans.
CBO estimates the cost of requiring the Department of Veterans Affairs to provide non-VA medical care to any enrolled veteran who cannot get a VA medical appointment within 30 days, or who lives more than 40 miles from a VA medical facility, at a stunning $54 billion annually.
That estimate takes into account language in both the House and Senate versions of the bill that would end new guarantees on access to non-VA care after two years. But by then, CBO predicts, 2 million more vets who don’t use VA care today will be drawn to it by new ease of access.
Veterans service organizations, though grateful overall, are worried about unintended consequences of HR 4810, as passed by the House, and of HR 3230, as modified and passed by the Senate. If politicians aren’t truly committed to treating more vets, then VA budgets to run existing facilities could be put at risk, and many vets won’t see gains in access long term.
Executives of 17 major veterans groups and military associations shared these and more concerns in a June 17 letter to chairmen and ranking members of the House and Senate veterans affairs committees. They will lead House-Senate conferees in ironing out differences between their separate bills. Plans are to have a final bill to President Obama by July 4.
“While we appreciate the speed with which you have moved, the opportunity for veterans organizations and other key stakeholders to provide substantive input to the process has been limited,” warned the executives.
One big worry is that, in mandating expansion of VA’s purchased care authority, Congress must commit to forcing VA to accurately estimate and budget for the added health costs. Congress, in turn, must fully fund the new authorities and not rely on budget “gimmicks” or shift funds from accounts needed to run VA hospitals, clinics and other health care programs.
Tom Philpott can be contacted at Military Update, P.O. Box 231111, Centreville, Va. 20120-1111, or by e-mail at: