House and Senate negotiators announced a $17 billion deal Monday to begin fixing the troubled Department of Veterans Affairs health care system, settling on a pilot program that will fund private sector care for some veterans caught in long wait lines.
The agreement, which was still being finalized Monday, also calls for new facilities and for hiring more doctors and nurses to speed up treatment within the VA. It earmarks $10 billion to set up the private care program for recently discharged combat veterans and those already enrolled in the VA who have waited longer than 30 days for an appointment or live more than 40 miles from a facility.
“This bill makes certain that we address the immediate crisis of veterans being forced onto long waiting lists for health care,” said Sen. Bernard Sanders, Vermont independent and chairman of the Senate Committee on Veterans’ Affairs, who wrote the deal with his House counterpart, Rep. Jeff Miller, Florida Republican.
House and Senate negotiators still need to approve their own agreement in the conference committee, then send it to the two chambers for final ratification — a goal they are trying to reach this week before they flee town for a monthlong summer vacation.
Veterans advocacy groups were supportive of the bill, though they warned that it should be viewed as a start to the conversation on fixing the VA, not a final solution.
“This measure is a critical component in developing a long-term solution to problems that have dogged the VA for years,” said Daniel M. Dellinger, national commander of the American Legion. “We know that Sen. Sanders and Rep. Miller have labored diligently to reach bipartisan consensus. But it would be a great mistake to see this legislation as a one-time fix for all the woes that have been hobbling VA’s performance and credibility.”
The bill calls for $5 billion to be spent on the hiring of more doctors and some minor construction to improve the VA’s physical infrastructure — about $12 billion less than the Obama administration said it would take. It also includes 27 new medical facility leases across the country, improvements in care for survivors of military sexual assault and an extension of a traumatic brain injury program.
The VA has been under fire since whistleblowers earlier this year said dozens of veterans at the Phoenix VA stuck on secret waiting lists died while awaiting care. Internal investigations have since found waiting list problems throughout the department and have identified a culture within the VA that rewarded speed at the expense of proper care.
President Obama accepted the resignations of a handful of top VA officials, and both the House and Senate passed bills to try to get a handle on the problems. But those efforts stalled over disputes about the cost of reforms, which some estimates put as high as $50 billion a year by the end of this decade.
One of the major costs of previous bills was the potential flood of veterans into the system once the government had to pay for outside care, according to Congressional Budget Office estimates. Limiting this bill’s scope to recent veterans or those already receiving care at the VA as of Aug. 1 likely cut down on the cost significantly.
Monday’s agreement bridges the gap by only allocating $10 billion in emergency spending on expanded care, while leaving bigger long-term funding decisions to future Congresses. Fully funding the new private-care program over the next decade would be expensive, however.
The negotiators said they found $5 billion of spending cuts elsewhere within the VA — though they hadn’t given specifics as of Monday afternoon.
Lawmakers said the bill is expected to add $12 billion to the deficit, though Sen. Bob Corker, Tennessee Republican, warned lawmakers not to vote on the proposal until it had been scored by the Congressional Budget Office.
“Planes, tanks and guns are a cost of war. So is taking care of the men and women who used these weapons,” Mr. Sanders said.
Mr. Miller said he expects the compromise to pass the GOP-controlled House despite the deficit increase, though he said it likely won’t be a unanimous vote. It’s also not a blank check: Future spending would have to go through the normal appropriations process, where it would be stacked up against other needs, he said.