WASHINGTON — The Department of Veterans Affairs has new marching orders.
Now, if its doctors can’t provide timely and convenient medical appointments it must allow veterans to go elsewhere for care.
The change is part of a package of reforms meant to reduce wait times at the scandal-plagued agency, where employees have admitted to falsifying records to conceal long wait times — often many months — that veterans endured in the nation’s largest health-care system.
After weeks of rancorous debate, a negotiated fix cleared the Senate on a 91-3 vote. A day earlier, the House approved it 420-5. President Barack Obama is expected to sign the measure into law, but when is unclear.
Meanwhile, Thursday evening, Senate legislation to give Mr. Obama $2.7 billion to deal with tens of thousands of Central American migrant children amassing at the southwestern U.S. border was blocked by Republican opposition. By a vote of 50-44, 10 short of the 60 needed, the bill failed to clear a procedural hurdle. Republicans objected to the cost of the measure and complained that it would not be effective in discouraging rising illegal migration of children from El Salvador, Honduras and Guatemala.
And with time running out to avert cutbacks in federal transportation money due to start today, Senate Democratic leaders agreed to accept a GOP plan to extend funding for highway and transit construction through May 2015, approving it 81-13.
Senate Majority Leader Harry Reid, D-Nev., said he would put the House’s $10.9 billion funding plan to a vote later Thursday evening after the House had rejected a shorter $8.1 billion extension the Senate previously passed. The legislative ping-pong heightened uncertainty over the dwindling Highway Trust Fund as Congress prepared to start a five-week summer recess this weekend.
The VA bill will cost nearly $17 billion over 10 years. About $5 billion would come from savings in other parts of the VA budget, while the rest would add to the deficit. The original Senate fix would have cost $35 billion, while the House-preferred plan would have cost $44 billion.
Leaders of both chambers said they would have preferred their own bills, but that the compromise is a good plan. It was hammered out over the weekend by a conference committee headed by Rep. Jeff Miller, R-Fla., and Sen. Bernie Sanders, I-Vt.
“Planes and tanks and guns are a cost of war,” Mr. Sanders said after the vote. “So is taking care of the men and women who use those weapons and fight our battles.”
The bill authorizes $10 billion to lease and staff 27 additional clinics to reduce the appointment backlog. It also would require the government to pay for care at outside facilities for veterans who cannot get an appointment at a VA facility within 30 days and within 40 miles of their home. It also would allow problematic agency executives to be immediately fired, while implementing a three-week appeals process.
Republican Sens. Tom Coburn of Oklahoma, Bob Corker of Tennessee and Jeff Sessions of Alabama opposed. In floor speeches, Mr. Coburn and Mr. Corker said the legislation would raise the deficit without solving the VA’s core problems.
The VA budget has increased 59 percent in the last five years, and facilities have increased the number of providers by 40 percent, while the number of veterans seeking care has increased just 17 percent, Mr. Coburn said.
“The problem is not money,” he said. “The problem is management, accountability and culture.”
Mr. Sanders countered that the VA’s medical care burden is increasing with the return of 500,000 troops from Iraq and Afghanistan, many of them with debilitating injuries.
Pennsylvania’s two senators, Democrat Bob Casey and Republican Pat Toomey, both voted in favor of the bill.
“The men and women who served in uniform should be first in line for the best-quality medical care in the world,” Mr. Toomey said. “Today, many are not, and this bipartisan compromise is a good step towards tackling this serious problem and restoring accountability.”
Still, he said the bill is imperfect because it is not fully offset by other federal spending cuts, and because provisions for immediate termination are limited to top-level employees.
The legislation also includes measures to improve care for veterans who were sexually assaulted in the military, to provide scholarships to spouses of service members who die in the line of duty, to allow veterans to qualify for in-state tuition rates under the Post-9/11 GI Bill and to reauthorize a housing program for veterans with brain injuries.
The legislation does not include new requirements for infectious disease reporting, which Pennsylvania members sought after a deadly outbreak of Legionnaires’ disease at the Pittsburgh VA.
Mr. Miller, who chairs the House Veterans Affairs Committee, said that issue might be addressed later in separate legislation.
Reuters contributed. Washington Bureau Chief Tracie Mauriello: 703-996-9292, email@example.com, or on Twitter @pgPoliTweets.