WASHINGTON – When it passed legislation to fix the troubled Veterans Affairs Department, Congress managed to do two things lawmakers have often vowed to avoid: create a new benefit program and fail to pay for it.
The $16.3 billion measure, which President Obama signed into law Thursday, aims to solve the alarming backlog for care at VA facilities by allowing veterans to see private doctors at the government’s expense. Veterans can use the new option if they face a wait of 30 days or more or live more than 40 miles from a VA facility.
Creating that new benefit would allow many more veterans to get care, but would increase spending by $10 billion, added to the deficit. The rest of the money in the bill would go to expand existing VA programs, personnel and facilities and would be offset by reductions elsewhere in the budget.
That could be just for starters. Congress limited the upfront cost of the new private-care option by creating it as a stopgap – a temporary fix for three years or until the money runs out, whichever comes first.
But temporary has a way of becoming permanent in Washington, especially when lawmakers face a group as sympathetic and politically potent as veterans.
The money Congress allocated for private care would run out by the end of next year, the Congressional Budget Office estimates. That would be just as Washington gears up for another election. The odds of Congress pulling the plug on a popular benefit for veterans in an election year seem long, analysts in both parties say.
Just as unlikely is the prospect of the two parties agreeing on tax increases or new spending cuts to fully cover the costs.
If, as many expect, Congress extends the program past its current expiration date, the cost to taxpayers would be at least $7 billion a year and perhaps more, depending on how many veterans choose private care, budget office projections indicate.
“It’s going to be treated like any of the other entitlements: We’re going to pay for it,” said Lawrence J. Korb, a former assistant secretary of defense under President Ronald Reagan and now a senior fellow at the liberal-leaning Center for American Progress. “You show up, we’re going to take care of it and pay the bill.”
The creation of a new benefit for veterans illustrates how even the budget-cutting fervor of House Republicans, who have made reducing federal spending their top priority, can be overturned by a big enough political push.
Earlier this session, the House balked at providing funds for hurricane relief unless the expenditure was fully offset by budget cuts elsewhere. Last week, emergency funds to fight wildfires in the West were blocked in the Senate.
But faced with enormous political pressure to respond to delays at VA medical centers after Veterans Affairs Secretary Eric K. Shinseki resigned, Congress passed the veterans bill with opposition from just five lawmakers in the House and three in the Senate.
“Forty dead veterans that died in line, that was enough for me,” Rep. Steve King, R-Iowa, a conservative stalwart, told reporters last week about his reason for supporting the bill.
Investigators have found long backlogs at VA hospitals across the country and several cases of veterans who died while waiting for appointments, but have not determined whether any veterans died as a result of delays.
While deficit hawks fret about the long-term costs of the private-care option, leaders of many veterans groups worry about a different concern – that in the future, Congress might decide to pay for private care by siphoning off resources and eroding the VA system.
Some members of Congress, primarily conservative Republicans, have for years argued the VA could be largely replaced by government payments to private doctors and hospitals.
VA officials counter that surveys show most of the more than 8 million veterans who utilize VA health care are satisfied with the care they get, although they object to the long waits.
Though the VA’s medical budget has essentially doubled over the decade, VA facilities have been overwhelmed with new patients returning from the recent wars in Iraq and Afghanistan, along with the aging Vietnam War-era population. Liberalized rules, including expanded eligibility for claims of Agent Orange exposure, have also boosted the number of patients.