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Compromise bill on VA health care problems has $17 billion price tag

House Veterans Affairs Committee Chairman Jeff Miller, R-Fla., left, and Senate Veterans Affairs Committee Chairman Bernie Sanders, I-Vt., talk privately Monday before announcing a compromise for reforming the Veterans Affairs Department.

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House Veterans Affairs Committee Chairman Jeff Miller, R-Fla., left, and Senate Veterans Affairs Committee Chairman Bernie Sanders, I-Vt., talk privately Monday before announcing a compromise for reforming the Veterans Affairs Department.

WASHINGTON — House and Senate negotiators unveiled a $17 billion compromise plan Monday to repair a Department of Veterans Affairs mired in controversy over delayed patient care and agency efforts to conceal the problem.

The deal ends weeks of sometimes contentious negotiations between Sen. Bernie Sanders, I-Vt., chairman of the Senate Veterans Affairs Committee, and Rep. Jeff Miller, R-Fla., his counterpart on the House VA panel.

"This VA conference committee legislation is far from what I would have written, but it's a compromise that I strongly support," Sanders said at a news conference with Miller.

The compromise provides $10 billion for veterans to seek private care if they live 40 miles or more from a VA facility and $5 billion for the VA to add doctors and clinicians. It also authorizes funding for the department to enter into leases at 27 medical facilities in 18 states and Puerto Rico.

In addition, the Sanders-Miller plan gives the VA secretary new powers to immediately fire senior executives based on poor job performance, while providing a 21-day appeal process for those terminated.

Sen. Marco Rubio, R-Fla., a member of the House-Senate conference committee that worked on the compromise, called it "an important step forward to begin addressing the dysfunction and incompetence that are plaguing our VA system and hurting our veterans."

White House officials had not seen the details of the compromise Monday afternoon, but called early reports "positive," especially since it contains resources that acting VA Secretary Sloan Gibson had suggested.

"The inclusion of these additional resources at the strong urging of the acting secretary is a positive step in the right direction and something that we think will be very important to the success of some of the reforms that are contemplated by this bill," said White House press secretary Josh Earnest.

After revelations from whistleblowers about lengthy waiting periods at VA facilities, the Senate last month passed a bill, 93-3, that included some of the same key provisions that ended up in the compromise. The House passed a similar bill in June by a 421-0 vote, though it didn't include funding for more physicians.

Now both chambers will try to pass the measure before Congress adjourns Friday for a five-week summer recess. Money could be a problem.

Miller said the $10 billion for private care is "mandatory emergency" money, while the $5 billion for additional staff comes from offsets from programs within the VA. Sanders and Miller expressed confidence that private care funds won't run dry as a result of large numbers of veterans abandoning the system for private care.

If that happens, Sanders said, "It may well be that some point in the future we will need more money and that's a debate we are going to have when we cross that bridge."

That could be a tough sell, especially in the House where conservative and tea party Republicans are preaching fiscal discipline and deficit reduction. Sunday night, Sen. Bob Corker, R-Tenn., urged fellow lawmakers to wait for the Congressional Budget Office to provide information on the true cost of the compromise before supporting it.

Rep. David Jolly, R-Indian Shores, called on lawmakers to pass the legislation by week's end.

"This bill is a good first step and provides some immediate relief," Jolly said. "But we must continue working on a long-term solution to this crisis. We need to give every veteran a choice card so they have complete control of their health care and if they want to go outside the VA system to a private provider they can do so."

Miller told reporters that he had worked in sales prior to arriving on Capitol Hill and was confident that he could convince his House colleagues to support the measure.

"I think we will be able to sell it to our conference, probably not get a unanimous vote as we did when the bill was coming out of the House," he said. "As we go through the process, there will be an education process that has to take place. Obviously some of our members will need a little more educating."

Sen. Patty Murray, D-Wash., said Sanders and Miller forged "a deal that puts our veterans first and gives the VA the tools they need to address immediate challenges."

Lawmakers are seeking a fix after a Veterans Affairs Department audit of its 731 medical facilities last month concluded that a 14-day wait time for an appointment established by former VA Secretary Eric Shinseki was unrealistic and "not obtainable."

The audit found that 57,436 veterans had been waiting 90 days or more for an initial medical appointment. Veterans at some facilities were also waiting as long as 145 days to see their primary care physician or a specialist.

In the audit, 13 percent of schedulers said that supervisors or other co-workers had instructed them to enter different dates in the appointment system than the ones requested by veterans seeking medical and psychological assistance.

VA interviews of 3,772 clinical and administrative staff found that 8 percent of schedulers felt pressured to bypass the VA's official Electronic Wait List system and keep unofficial lists to make waiting times appear shorter than they actually were.

A White House report last month said the Department of Veterans Affairs health branch suffered from a "corrosive culture" that contributed to the delay of timely care for veterans.

VA bill's proposals

Emergency spending: $10 billion to make it easier for veterans who can't get prompt appointments with VA doctors to obtain outside care.

More doctors: $5 billion to hire doctors, nurses and other medical staff.

More clinics: about $1.5 billion to lease 27 new clinics across the country.

Easier firing: grants the VA secretary authority to immediately fire senior executives, while providing employees with streamlined appeal rights.

Associated Press

Compromise bill on VA health care problems has $17 billion price tag 07/28/14 [Last modified: Monday, July 28, 2014 11:26pm]
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