VA Health Care Deal Reached; Miller, Sanders Plan to Announce Monday (Updated)

(Bill Clark/CQ Roll Call File Photo)
(Bill Clark/CQ Roll Call File Photo)
Posted July 27, 2014 at 7:05pm

Updated 9:39 p.m. | A $15 billion VA health care deal has been reached after a weekend of negotiating to resolve differences between the House and Senate.  

House Veterans’ Affairs Chairman Jeff Miller, R-Fla., and Senate Veterans’ Affairs Chairman Bernard Sanders, I-Vt., are planning to outline their agreement on a measure that would overhaul veterans health programs on Monday, aides said Sunday. The two lawmakers have scheduled a news conference for 1:30 p.m. Monday.  

According to a summary of the agreement obtained by CQ Roll Call, the negotiators agreed to $15 billion in emergency mandatory spending — $10 billion for a new private care option for veterans and another $5 billion for improvements within the VA, like hiring doctors and nurses and upgrading facilities. That’s $5 billion more than Miller offered on Thursday and about $10 billion less than Sanders sought.  

To qualify for the private care option, veterans would have to be experiencing long wait times or be located more than 40 miles from a VA facility. They would be able to access providers who already participate in Medicare.  

The news comes as the Senate is also on track to confirm former Proctor & Gamble CEO Robert McDonald as the nation’s next secretary of Veterans Affairs before departing for the August break. In addition, the proverbial smell of August recess jet fumes emanating from Reagan National Airport may alleviate any significant procedural delays.  

Since much of the debate has focused on the cost of increasing access to care for veterans, the Miller-Sanders proposal will come under scrutiny in that context. Sen. Bob Corker, R-Tenn., one of only three to vote against the original Senate-passed bill, said as much in a statement issued Friday.  

“Neither the House nor the Senate should take a vote on the conference legislation until there is a complete score from the Congressional Budget Office so members have the opportunity to review the impact the bill will have on future generations,” Corker said. “I want to thank the conference committee for their work and continue to urge them to keep their assurances that they will find a way to improve the bill and ensure it is totally paid for during the same time the money is being spent.”  

Several senators were vocal in disagreeing with the off-the-charts CBO cost estimates for the base bills. The CBO had estimated both bills would eventually generate about $50 billion a year or so in new costs, mostly from a predicted surge in demand for private care outside of the VA system.  

To alleviate concerns about the deficit, the deal caps the costs. The $15 billion would remain available until expended, with some lawmakers expecting it to last for more than a year.  

The cost of the bill once scored by CBO is likely to be a few billion cheaper, notes Ed Lorenzen, a senior advisor at the Committee for a Responsible Federal Budget. That’s because the CBO has previously estimated that beefed up care at the VA would reduce costs for Medicare, Medicaid and employer-provided health care — generating savings and higher tax revenue elsewhere in the budget.  

The compromise legislation also permits the VA secretary to dismiss or downgrade employees in an expedited fashion based on performance or misconduct. It would also prevent wait-time metrics from being used in determining a VA employee’s eligibility for a bonus, and would authorize the VA to enter into 27 major medical facility leases throughout the country.  

The deal caps a sometimes rocky negotiation between the two lawmakers co-chairing a 28-member conference committee tasked with finding a solution to long wait times at VA hospitals and clinics amid numerous reports that VA employees manipulated the department’s scheduling system to make wait times appear shorter than they really were.  

The two men sparred last week , with Sanders refusing to attend an open conference meeting called by Miller Thursday to announce his offer of a bill capped at $10 billion.  

But any bad blood quickly subsided.  

“I have every intention of getting a conference report done with Sen. Sanders,” Miller told reporters on Friday. “That is the goal and there is no fallback position.”  

Sunday afternoon, it appeared Miller and Sanders had achieved their goal.  

Connor O’Brien and Steven T. Dennis contributed to this report.

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