The VA’s data on patient wait times is so bad that Congress’s official scorekeeper can’t even calculate the costs for fixing the agency, and that has become a major hurdle as lawmakers push for a quick fix on Capitol Hill.
The House and Senate each have passed bills to try to get a handle on the wait times and other problems afflicting care at VA clinics, but when negotiators from each chamber met last month to try to hammer out a compromise, they ran into problems over the cost.
Sen. Richard Burr, North Carolina Republican, said they couldn’t even begin to debate what’s in the bill because the cost estimate produced by the Congressional Budget Office was “grotesquely out of line.”
But the CBO, which acknowledged the uncertainties in its estimate, had to face a series of problems when trying to come up with a dollar figure — including dealing with the cooked books and bogus data that landed the Veterans Affairs Department in trouble in the first place.
“It’s a difficult thing to score,” said Douglas Holtz-Eakin, a former CBO director who is now president of the American Action Forum. “There’s a lot of uncertainty about how many veterans are out there awaiting care.”
Both the House and Senate bills would let veterans see a private practice doctor if they have been stuck on a waiting list for too long. The House bill says that would be after two weeks, while the Senate bill says they would have to wait for a month before seeing an outside physician.
The CBO said costs could be as high as $50 billion a year once the program is up and running — but said there’s so much uncertainty that it’s difficult to arrive at a specific figure.
Chris Edwards, editor of DownsizingGovernment.org at the Cato Institute, said the CBO estimate can only be as good as it data it uses, and it would need detailed facility-by-facility data to accurately predict the cost of this bill. The VA has been accused of manipulating its wait time data and, as a result, not knowing how long some veterans have been waiting for an appointment.
“If the CBO is to make an accurate estimate, they need accurate data,” Mr. Edwards said. “If the VA has been manipulating and hiding the current data, then CBO isn’t going to be able to make an accurate cost estimate.”
Mr. Edwards also said the CBO wouldn’t have a model already created to predict the budgetary effect of opening up private care to vets since it’s a brand new idea.
“It’s not something the CBO would have estimated in the past, whereas if a congressman had a bill to raise the eligibility age of social security, they’ve estimated that dozens of times, there are three or four analysts who know issue inside and out,” he said. “Here, the CBO doesn’t have experience in estimating these sorts of costs.”
Part of the criticism on Capitol Hill may also be anger that the costs are so high for a proposal to do something good for vets that everyone agrees on, Mr. Holtz-Eakin said.
“It’s always tough for members when something turns out to be expensive and that makes them unhappy with the number. I think that’s probably a lot of what’s going on,” he said.
Negotiations among lawmakers continued during the weeklong Fourth of July vacation, but there’s no set time limit to reach a deal, according to a House Veterans Affairs’ Committee staff member.
The CBO is “continuing to work on reports for a number of different reform scenarios,” the staffer said, though many Republican lawmakers have insisted on offsetting the bill, while Democrats argue it’s emergency spending that should be tacked on to the deficit.