Proposed VA fix would cost $17 billion

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WASHINGTON — Veterans are a step closer to faster and easier access to health care following a conference committee’s agreement on a plan to fix a health care system plagued by long wait times and employees who falsified records to hide problems.

After the House and Senate failed to agree on a fix, a conference worked out a compromise. House Veterans Affairs Committee chairman Jeff Miller, R-Fla., and Sen. Veterans Affairs Committee chairman Bernie Sanders, I-Vt., announced the deal Monday.

The bill now heads to the House and Senate for up-or-down votes with no amendments permitted. Votes are expected by Friday, when Congress adjourns for its August recess.

The plan would authorize funding to lease and staff 27 additional clinics to reduce the backlog. It also would require the government to fund care at outside facilities for veterans who cannot get an appointment at a VA hospital within 30 days or within 40 miles of their homes. It also would allow problem managers to be immediately fired with the opportunity to have appeals heard within three weeks.

The bill would cost about $17 billion over 10 years, according to the Congressional Budget Office. About $5 billion would come from offsets from other VA programs. The rest would come from new spending that would increase the deficit — something Republicans, in particular, are reluctant to do.

Mr. Miller said he believes he can get enough of his fellow GOP members onboard to pass the bill.

“I come from a sales background before I came to Congress, and I think I can do an adequate job,” he told reporters during a news conference with Mr. Sanders Monday afternoon. “The veterans need a quick response, and this is the way we can make sure the veterans are not standing in line as they have been.”

Mr. Miller said veterans’ care is a cost of war just like tanks and guns.

“Sufficient sums of money must be provided so that the VA has the resources to immediately end unacceptably long wait times,” he said. “This bill does that.”

The new Veterans Choice Fund, allowing veterans to seek care from outside the system, is key. The conference report provides $10 billion for that, though it is unclear whether that will be enough or too much.

“We don’t know until we start this program to see how veterans are actually going to [access care]. This first year is going to give us a good benchmark with which to be able to set the future of this program forth,” Mr. Miller said.

The bill also includes measures to improve care to veterans who were sexually assaulted in the military, to provide scholarships to surviving spouses of service members who die in the line of duty, to allow all veterans to qualify for in-state tuition under the Post-9/​11 GI Bill and to reauthorize a program that provides housing for veterans with traumatic brain injuries.

The compromise does not include new requirements for infectious disease reporting, which were put forth by members of the Pennsylvania delegation after a deadly outbreak of Legionnaires’ disease at the Pittsburgh VA. Mr. Sanders and Mr. Miller said that could be addressed in future legislation.

“This is not the end; this is the beginning. We have done good work in addressing the crisis [of long wait times], but God knows there is a lot more work to be done in many, many areas,” Mr. Sanders said.

Mr. Miller said he is concerned about VA failures to report disease outbreaks and said Congress will “try to resolve the veil of secrecy that caused the issue to crop up in Pittsburgh.”

The American Legion wants stricter reporting standards, too, in order to hold VA hospitals accountable and to protect communities from infectious diseases, but the omission of those provisions doesn’t mean the conference committee report is flawed, said its legislative director, Louis Celli.

“This conferenced bill wasn’t designed to be the one bill that addresses all the problems with the VA. It was primarily designed to take care of the backlog of patients waiting for health care, and it does that,” Mr. Celli said in a telephone interview.

He said the American Legion, the nation’s largest veterans’ service organization, is pleased with the bill and hopes that Monday’s compromise sets the stage for more VA overhauls in the fall.

“There are some things that are just good common sense, and if the VA can’t exhibit good common sense on their own, they’re going to have to be legislated to do so,” Mr. Celli said. “Had the VA properly reported the problems they were experiencing, Congress could have addressed this little by little so it didn’t turn into a big scandal.”

Lawmakers including Rep. Tim Murphy, R-Upper St. Clair, and Sen. Bob Casey, D-Pa., say they will continue to press for more stringent reporting standards to prevent employees from hiding life-threatening contamination.

For now, though, they are pleased Congress is moving toward reducing wait times.

“This provides emergency funding to address problems that are pervasive throughout the whole country,” Mr. Murphy said. “Veterans have given so much in sacrifices and service, and we’re not going to leave them hanging.”

Rep. Mike Michaud, D-Maine, ranking member on House Veterans Affairs, said the deal will help ensure millions of veterans get the care they deserve.

After weeks of hearings and negotiations, “our nation’s commitment to providing high-quality services for our veterans — and taking swift action when our veterans are harmed — trumped politics,” Mr. Michaud said.

The weekend deal followed a rancorous week that ended with separate vitriolic news conferences by Mr. Miller and Mr. Sanders.

Lawmakers’ attention has been on the VA since it came to light that workers had been maintaining two sets of records to conceal long wait times for appointments at facilities in Phoenix and elsewhere.

In the Veterans Affairs Pittsburgh Healthcare System, some had been waiting nearly two years for appointments. That drew the attention of members of the Pennsylvania congressional delegation, who first were told that the problem was caused by a single employee who had been managing appointment requests inappropriately. Last week, however, Pittsburgh VA leaders told them in a letter that multiple employees were disciplined because of the problem.

The letter did not specify the number of employees, their names, or how they were disciplined.

That concerns Mr. Murphy, who wants answers and accountability from the Pittsburgh VA and the wider organization.

He said the compromise legislation will help.

“There are a number of positive changes in it,” Mr. Murphy said in an interview.

Rep. Bill Shuster, R-Blair, also was pleased the conference committee reached an agreement.

“Our veterans deserve a VA system that provides them with timely access to quality care and one that holds its employees accountable for the great responsibility of assisting our nation’s heroes,” he said in a written statement.

The VA provides care to about 9 million veterans nationwide.

Washington bureau chief Tracie Mauriello:; 703-996-9292 or on Twitter @pgPoliTweets. First Published July 28, 2014 4:46 PM

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