Reforming Veterans Health Care Funding
While great strides have been made in Congress to increase the level of funding
during the past several years, there is a long history of significant delays in
receiving those funds. Unlike Medicare or Medicaid, the Department of Veterans Affairs
(VA) must rely on Congress and the President to pass a new appropriations law each
year to provide VA hospitals and clinics with the funding they need to treat veterans.
For the past decade, DAV and its allies in the Partnership for Veterans Health Care
Budget Reform have sought to fundamentally change the way veterans health care is
funded. While mandatory funding has been the focus over the past several years,
the Partnership has developed an alternative approach to achieve the same goals
as mandatory funding. The Veterans Health Care Budget Reform Act, new legislation
introduced in September 2008, would help to ensure that veterans health care funding
is sufficient, timely, and predictable.
- VA has received its annual funding for veterans’ health care late 19 of the last
22 years. Over the past seven years, VA has received its final budget an average
of three months after the start of the new fiscal year.
- Political wrangling has deadlocked the federal budget process, and in turn, the
funding for VA hospital and clinics around the country. In addition, VA officials
don’t know the size of their budget in advance. Not knowing when or at what level
of funding VA will receive from year to year – or whether Congress will approve
or oppose the Administration’s proposals – hinders the ability of VA officials to
efficiently plan and responsibly manage their health care system.
- Compounding the problem are the new demands placed on the VA system. Since 2001,
the number of VA patients has risen by two million – a 50 percent increase. And
our newest generation of veterans has increasingly complex mental and physical healthcare
needs that may require a lifetime of care.
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- In too many cases, VA is unable to properly treat the physical and mental scars
of war, in part because its budget is late and unpredictable. Such an irrational
financing system causes unnecessary delays, hold ups, and backlogs in the system.
Hiring key staff is put off, or just not done, while injuries like post-traumatic
stress disorder or traumatic brain injury are too often not diagnosed or treated
in a timely manner.
- A 2007 report by the VA’s own Office of Inspector General concluded that 27 percent
of the injured veterans seeking treatment at the VA had to wait more than 30 days
for an appointment. These men and women had severe service-related injuries.
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- DAV and its allies in the Partnership for Veterans Health Care Budget Reform (“Partnership”)
– a coalition of nine veteran service organizations with a combined membership of
8 million veterans – helped develop and fully endorse the Veterans Health Care Budget
Reform Act. This bill authorizes Congress to appropriate the funding for veterans’
health care one year in advance, and adds greater transparency to VA’s internal
budget process to ensure sufficient funding is approved.
- Congress has exercised and continues to exercise its power to approve advance appropriation
laws. Currently, Congress funds a number of programs through an advance appropriations
budget process, including the Low Income Home Energy Assistance Program (LIHEAP)
and Section 8 housing programs
- Unlike the mandatory funding provided to the Medicare and Medicaid systems, advance
appropriations would allow Congress to approve funding each year and retain all
of its oversight authority over VA programs.
- The Veterans Health Care Budget Reform Act (S. 3527 and H.R. 6939) was introduced
in September 2008 by Senate Veterans’ Affairs Committee Chairman Daniel Akaka (D-Hawaii)
and House Veterans’ Affairs Committee Chairman Bob Filner (D-Calif.).
- The proposal received bipartisan support from other leaders in Congress, including
Sen. Barack Obama (D-Ill.) and Sen. John McCain (R-Ariz.). In fact, during the presidential
campaign, President-elect Obama pledged to push for advance appropriations legislation
in his first year in office.
- The legislation has also been endorsed by The Military Coalition, comprised of 35
organizations representing more than 5.5 million members of the uniformed services--active,
reserve, retired, survivors, veterans--and their families.
- In addition, a growing list of more than two dozen former VA medical center directors,
regional healthcare network directors, Under Secretaries and Assistant Secretaries,
and other senior VA officials have joined together to support the proposed funding
reform.
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