“NO” on Miller-Sanders Veterans Bill (H.R. 3230)

This week, the Senate will vote on the Veterans Access, Choice and Accountability Act of 2014 (H.R. 3230). The conference committee report, agreed to by Rep. Jeff Miller (R-FL) 83% and Sen. Bernard Sanders (I-VT) 23%, would, according to the Congressional Budget Office (CBO), increase direct spending by $15 billion over 10 years. Of that cost, $10 billion in emergency mandatory funding would go towards an external care option for vets who face wait times of longer than 30 days or live more than 40 miles from a VA facility. The remaining $5 billion would expand existing VA operations and other miscellaneous veterans-related programs. This $5 billion would be offset over 10 years from reforms within the VA, though the merits of those offsets are highly questionable.

Though the CBO’s recent projection reflects a total emergency cost of $10 billion, properly understood, the conference committee’s solution to the VA’s systemic inefficiencies amounts to the creation of a new entitlement that will likely increase at a rapid rate.

After the House and Senate passed their respective versions of this legislation, the CBO released a report predicting that the cost of this program would eventually rise to roughly $50 billion per year. This projection was based on the well-founded assumptions about increased utilization by current VA enrollees, as well as increased VA enrollment due to the availability of the external care option. While the final agreement makes some tweaks and compromises on eligibility for the program, it does little to fundamentally alter the size and scope of the program that CBO’s previous estimates suggested could generate a $500 billion price tag over the standard 10-year congressional budget window — that is more expensive than Medicare Part D.

The Conference Committee has only been able to sidestep this cost issue by capping the “emergency” spending provision at $10 billion. This careful language was effective in engineering a CBO score that took the capped cost at face value. Such manipulation is no guard against the inevitable expansion of the new entitlement though, and is nothing more than dishonest budgeting.  For this estimate to be proven accurate, however, the anticipated expansions of the external care program must not materialize. This is an untenable assumption, given both the dysfunction of the VA itself, the natural growth of new entitlement programs, and the common-sense assumptions and predictions CBO made in its previous estimates.

It is important to note that this new spending is in addition to current costs of VA health care, which in 2013, amounted to $52.5 billion. Since 2009, total VA spending has risen by 58% (from $97 billion to $152 billion this year). Congress cannot continue to capitulate to the impulse to pour more money into a broken system.

The Miller-Sanders Veterans package not only fails to address to the systemic failures at the VA, but it creates an unproven new entitlement that sets taxpayers on a course to spend half a trillion dollars over the next decade.  As Heritage Action’s south central regional coordinator and military veteran Wade Miller explained, “A functional, cost-effective VA health care system is crucial not just for the vets of this generation, but to tomorrow’s servicemen and women, as well. Any solution that is not sustainable in the long term leaves future veterans in the lurch.

Heritage Action opposes H.R. 3230 and will include it as a key vote on our legislative scorecard.

Legislative Scorecard
Heritage: VA Compromise Bill Ignores Budget Rules and Employs Gimmicks
Heritage Action Urges Fiscally Responsible Approach
The Hill: Congress should be fiscally prudent with VA funding