The House and Senate have agreed it’s time for reform of the Veterans Affairs Department. Now they have to agree how to pay for it — and they have to do it quickly.
More than two dozen House and Senate lawmakers meet Tuesday to formally begin negotiations aimed at merging the two chambe”s VA reform bills into one. The measures have some minor discrepancies, but the big challenge is how much the reforms will cost and where the federal government will find the funding.
It was a question the chambers largely sidestepped as they rushed to pass reforms in the wake of the VA scandal, which revealed that veterans were being placed on “secret” waiting lists for treatment, and that some had died during the wait.
The Senate deemed the reforms imperative and authorized emergency funding to provide whatever resources necessary to carry them out. Cementing that sentiment, 75 senators voted to waive budget offsetting pay-as-you-go rules to protect that provision. The House bill would instead require that the reforms be funded by Congress’s appropriations process.
The tension over payment has been heightened as the Congressional Budget Office has projected the measures to cost more than expected.
CBO has said the Senate bill could add as much as $35 billion in direct spending over 10 years, and ultimately cost the federal government an additional $50 billion a year as vets pursue additional health care options. The House bill — which seeks to slash health care wait times more expeditiously — is expected to entice more veterans into VA and private health care than the Senate bill would, costing the federal government a projected $54 billion per year.
“Their initial urge was to forget about funding altogether and get it past them, and now, of course, the whole process has slowed down, so now they are stuck with having to deal with budget reality. It’s going to be difficult,” said Joseph Antos, the Wilson H. Taylor Scholar in health care and retirement policy at the conservative American Enterprise Institute. “This is a problem for Republicans and Democrats alike.”
But as Congress explores funding solutions, veterans groups will be watching carefully, pushing the lawmakers to provide specific, long-term funding for the reforms. Temporary funding or budget tricks, the groups say, could lead to a return to the status quo, where veterans continue to suffer from inadequate care.
“Congress and VA must not rely on budgetary gimmicks, such as unrealistic estimates of operational improvements, efficiencies, collections, carryovers, and contingencies. These undocumented ‘savings’ have rarely materialized and have contributed significantly to funding shortfalls that have plagued VA for more than a decade,” the heads of more than a dozen veterans organization wrote to congressional leaders last week.
The groups fear that, given the political sensitivity of the issue and the coming Fourth of July recess, the groups will rush the bill through with an incomplete funding arrangement.
“They are not going back home for the July Fourth recess without having a bill on the president’s desk. They all want something to go home and champion,” said Louis Celli, the legislative director for the American Legion. “I think they have to with all the exposure on this.”¦ The veterans need help, they need to be seen.”
Analysts and congressional aides following the process expect lawmakers to pull out their fiscal tricks, including the use of arguably bogus funding sources or adoption of rose-colored assumptions about cost savings from certain programs. Alternatively, lawmakers could attempt cost-cutting by tightening restrictions on who would be eligible for care or limiting access by other means.
Most of the real wheeling and dealing is expected to take place behind closed doors, and negotiations among staffers have already begun.
Beyond funding woes, the lawmakers have a host of in-the-weeds details to hammer out before sending the bill to President Obama.
Both bills make it easier to fire incompetent senior VA leaders and aim to improve veterans’ access to health care within and outside the VA.
But while the Senate bill would create an appeals process for fired VA leaders to contest their dismissal, the House bill lacks that provision. The Senate bill would also expand the GI bill’s in-state tuition benefits further than separate House legislation would, including funding to the spouses of deceased veterans who would have qualified for the tuition break.
What We're Following See More »
In a long-awaiting new rule, the Food and Drug Administration will ban sale of all tobacco products—including e-cigarettes—to those under 18. The rule takes effect in 90 days. It's part of a larger package of regulations that "gives FDA authority to regulate—but not to ban—all tobacco products, from e-cigarettes to cigars and hookahs." Meanwhile, California Gov. Jerry Brown (D) signed a bill on Wednesday that would bump the legal age to buy all tobacco products from 18 to 21.
Sen. Ben Sasse, the most prominent elected official to declare that he's #NeverTrump, wrote an open letter on Facebook to the "majority of Americans who wonder why the nation that put a man on the moon can’t find a healthy leader who can take us forward together." Calling to mind recent conversations at a Fremont, Neb., Walmart, the senator pitted the presumptive general election battle between Donald Trump and Hillary Clinton as such a "terrible choice" that there would be an appetite for another candidate to emerge. In a parenthetical aside to reporters, Sasse ruled himself out. "Such a leader should be able to campaign 24/7 for the next six months," he wrote. "Therefore he/she likely can’t be an engaged parent with little kids." Meanwhile, his colleague Sen. John McCain (R-AZ) admitted in a private recording obtained by Politico that Trump hurts his reelection chances.
"Judge Emmet G. Sullivan, of the United States District Court for the District of Columbia, approved a joint proposal presented by Judicial Watch and the State Department to take the depositions of officials" involved in the setup and use of Hillary Clinton's private email server, "including Cheryl D. Mills, Clinton's former chief of staff, Huma Abedin, a senior adviser to Clinton, and Bryan Pagliano, a State Department employee who serviced and maintained the server." He said Clinton could be deposed later on, though that may not be necessary.
Donald Trump will not self-finance his general election campaign as he did the primary season, instead relying on "his expansive personal Rolodex" to create what he called a “world-class finance organization."