Deal allots $17 billion to fix problems at VA

$10 billion of bill allows outside care

Senate Veterans’ Affairs Committee Chairman Sen. Bernie Sanders, I-Vt., right and House Veterans’ Affairs Committee Chairman Rep. Jeff Miller, R-Fla., take the stairs to a news conference on Capitol Hill, in Washington, Monday, July 28, 2014, about a bipartisan deal to improve veterans' health care that would authorize at least $17 billion to fix the health program scandalized by long patient wait times and falsified records covering up delays. (AP Photo/J. Scott Applewhite)
Senate Veterans’ Affairs Committee Chairman Sen. Bernie Sanders, I-Vt., right and House Veterans’ Affairs Committee Chairman Rep. Jeff Miller, R-Fla., take the stairs to a news conference on Capitol Hill, in Washington, Monday, July 28, 2014, about a bipartisan deal to improve veterans' health care that would authorize at least $17 billion to fix the health program scandalized by long patient wait times and falsified records covering up delays. (AP Photo/J. Scott Applewhite)

WASHINGTON -- A bipartisan deal announced Monday would authorize about $17 billion to help veterans avoid long waits for health care, hire more doctors and nurses to treat veterans, and make it easier to fire executives at the Department of Veterans Affairs.

An agreement announced by the chairmen of the House and Senate Veterans' Affairs committees is intended to fix a veterans health program scandalized by long patient wait times and falsified records covering up delays.

The bill includes $10 billion in emergency spending to make it easier for veterans who can't get prompt appointments with VA doctors to obtain outside care; $5 billion to hire doctors, nurses and other medical staff; and about $1.5 billion to lease 27 new clinics across the country, lawmakers said.

The bill also would expand a scholarship program for veterans, allow all veterans to qualify for in-state college tuition and grant the VA secretary authority to immediately fire senior executives, while providing employees with streamlined appeal rights.

"This bill makes certain that we address the immediate crisis of veterans being forced onto long waiting lists for health care," said Sen. Bernie Sanders, I-Vt., chairman of the Senate Veterans Affairs panel.

The measure also "strengthens the VA so that it will be able to hire the doctors, nurses and medical personnel it needs so we can permanently put an end to the long waiting lists," Sanders said at a news conference with Rep. Jeff Miller, R-Fla., his House counterpart.

Miller said the bill would "go a long way to resolve the crisis" that is gripping the VA. The agency has been rocked by reports of patients dying while awaiting treatment and mounting evidence that workers falsified or omitted appointment schedules to mask frequent, long delays. The fallout forced VA Secretary Eric Shinseki to resign in late May.

Sanders and Miller reached agreement on a plan to reform the VA over the weekend after more than six weeks of talks.

The compromise measure would require the VA to pay private doctors to treat qualifying veterans who can't get prompt appointments at the VA's nearly 1,000 hospitals and outpatient clinics, or those who live at least 40 miles from one of them. Only veterans who are enrolled in VA care as of Aug. 1 or live at least 40 miles away would be eligible to get outside care.

The proposed restrictions are important in controlling costs for the program. Congressional budget analysts had projected that tens of thousands of veterans who currently are not treated by the VA would likely seek VA care if they could see a private doctor paid for by the government.

Sanders and Miller acknowledged the bill's steep cost but said it would include about $12 billion in new spending after accounting for about $5 billion in unspecified spending cuts from the VA's budget.

"Funding for veterans' needs must be considered a 'cost of war' and appropriated as emergency spending," Sanders said. "Planes and tanks and guns are a cost of war. So is taking care of the men and women who fight our battles."

The deal requires a vote by a conference committee of House and Senate negotiators and votes in the full House and Senate. Miller and Sanders both predicted passage of the bill by the end of the week, when Congress is set to leave town for a five-week recess.

It could face a tougher sell in the Republican-led House, where lawmakers aligned with the Tea Party have opposed attempts to spend emergency money.

Miller said he was confident he'd get the measure through the House, conceding that the vote probably won't be unanimous. He said he's been speaking with lawmakers about the measure at Republican conference meetings in recent weeks.

"As we've discussed in our conference throughout this process, taking care of our veterans is not inexpensive," Miller said.

The House and Senate passed differing proposals to provide more funding and streamline waiting times, and a conference committee was appointed to come up with a final plan. The measure passed by the House cost $44 billion, while the Senate plan was $35 billion.

Republicans and Democrats involved in the negotiations had said they agreed on most policy changes, though financing remained a sticking point late last week.

Sanders on Thursday accused Republicans of being "not serious about negotiations," while Miller said Sanders had "moved the goal posts."

If approved by Congress and signed by President Barack Obama, the veterans bill would be one of the few significant bills signed into law this year.

"We are here together having done something that happens quite rarely in the United States Congress," said Sanders, referring to the two chambers as a "dysfunctional institution."

White House press secretary Josh Earnest said Obama welcomes the bipartisan deal.

"There are much-needed reforms that need to be implemented" at the VA, Earnest said Monday.

The White House is especially pleased that the bill includes emergency spending "to provide VA the additional resources necessary to deliver timely, high-quality care to veterans through a strengthened VA system," Earnest said.

Increased payments in the deal could triple health care provider revenue from the VA in the next year, according to Bloomberg Intelligence analysts Brian Friel and Jason McGorman. HCA Holdings Inc. and Universal Health Services Inc. hospitals had the most admissions among publicly traded hospitals in California, Texas and Florida, the three states with the most veterans.

Garry Augustine, executive director of the Disabled American Veterans, called the compromise a promising first step to rebuild the VA and provide enrolled veterans with timely health care.

"While no veteran should be forced to wait too long or travel too far to get their care, we remain concerned that simply giving veterans plastic cards and wishing them good luck in the private sector is not a substitute for a coordinated system of care," Augustine said. "The VA must remain fully responsible for ensuring the best health outcomes for veterans."

An updated audit by the VA this month showed that about 10 percent of veterans seeking medical care at VA hospitals and clinics still have to wait at least 30 days for an appointment. About 46,000 veterans have had to wait at least three months for initial appointments, the report said, and an additional 7,000 veterans who asked for appointments over the past decade never got them.

Acting VA Secretary Sloan Gibson has said the VA is making improvements, but veterans in many communities still have to wait too long to receive care. The VA provides health care to nearly 9 million enrolled veterans.

The Senate is expected to vote this week to confirm former Procter & Gamble Chief Executive Officer Robert McDonald as the new VA secretary.

Information for this article was contributed by Matthew Daly and Nedra Pickler of The Associated Press and by Michael C. Bender and Derek Wallbank of Bloomberg News.

A Section on 07/29/2014

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