WASHINGTON (AP) — Stung by sticker shock, members of Congress are scrambling to lower the cost of a bill to fix veterans' health care amid a growing uproar over long waits for appointments and falsification of records to cover up the delays at Veterans Affairs hospitals.
At the same time, deficit hawks fear that letting veterans turn more to providers outside the VA for health care could cost far more if Congress, under pressure from powerful veterans groups, decides to renew that program rather than let it expire in two years.
Lawmakers in both parties agree on the need to reform the Veterans Affairs Department's health care network — the largest in the country — following reports of veterans dying while awaiting appointments at VA hospitals or clinics. The resulting election-year firestorm forced VA Secretary Eric Shinseki to resign in May. A half-dozen other VA officials have resigned or retired since then.
The VA's inspector general has confirmed that at least 35 veterans died while awaiting appointments at the agency's Phoenix medical center alone, but he has yet to report on the results of investigations into whether delays in treatment were responsible for any of the deaths.
The latest analysis by the nonpartisan Congressional Budget Office estimates a Senate-passed bill would cost $35 billion through 2016 to build new clinics, hire doctors and make it easier for veterans who can't get prompt appointments with VA doctors to get outside care. The CBO put the price tag of a similar measure passed by the House at $44 billion.
More troubling for lawmakers are long-term costs. As currently designed, the legislation would relieve a big backlog of veterans awaiting appointments by letting them seek care outside the VA system, but that the expansion would expire after two years. Fiscal conservatives worried about swelling deficits fear lawmakers will yield to inevitable pressure from veterans to keep it.
"Once a benefit is provided to a large group of people it is hard to take it away, so there will be intense pressure on Congress to continue the benefit," said Ed Lorenzen of the Committee for a Responsible Federal Budget, a Washington-based group that advocates for lower deficits.
"I believe in choice and I hope that we will be able to continue to allow the policy change for choice to continue beyond the two years," said Rep. Jeff Miller, R-Fla., chairman of the House Veterans Affairs Committee. "But what we're faced with now is trying to erase the backlog that is plaguing VA and preventing veterans from getting timely access to their earned benefit of health care."
Once fully in place, the provision granting veterans easier access to private care could cost the government about $38 billion a year — almost as much as the $44 billion the government now spends annually on medical care for veterans, the budget office says.
Miller and other lawmakers have questioned the CBO estimates, saying the budget agency used faulty assumptions and did not account for provisions that would save money.
"I believe we can come up with very strong legislation at a lower cost than the initial CBO estimate," said Sen. Bernie Sanders, I-Vt., chairman of the Senate veterans panel.