9 July 2014 Legislative News Update
weekly electronic newsletter, and is published
every Monday when Congress is in session.
In this issue:
- Negotiations Continue On VA Reform Bill
- Speaking of the VA
- $58.6 Billion Requested For 2015 Overseas Contingency Operations
NEGOTIATIONS CONTINUE ON VA REFORM BILL
For the first time in over a decade, House and Senate negotiators held an open conference to iron out differences between the chambers’ respective Veterans’ Affairs reform bills (S.2850 & H.R. 4810).
Much of the discussion centered around the cost of a provision in both bills that would allow veterans to visit private sector doctors if they are unable to get a timely appointment through the VA or if they live 40 miles or more from the closest VA facility.
The Congressional Budget Office (CBO) projected that the provision in the Senate’s plan could cost $50 billion a year while the House’s would come in at $44 billion over the next five years.
The ranking member on the Senate Veterans’ Affairs Committee, Sen. Richard Burr, R-N.C., said that the CBO’s cost projection were “ludicrous” and off base because they projected that millions of veterans would suddenly drop their private health insurance and would become a drain on the system. Burr has asked for another analysis.
House Veterans’ Committee Chairman Rep. Jeff Miller, R-Fla., said that a final bill depended on whether or not better cost projections could be obtained. House conferees are adamant that any new spending has to be offset by reductions elsewhere.
Some Senate conferees disagree. Veterans’ Affairs Committee Chairman Bernie Sanders, I-Vt., said that he still favors his plan to use an emergency funding designation which requires no offset. His fellow conferee, Sen. John McCain, R-Ariz., agrees. “If it is not an emergency to have tens of thousands of veterans not getting the health care they need in a timely manner, then I’m not quite sure what an emergency is,” McCain said.
Other sticking points in the negotiations include:
· Language that authorizes the VA to contract with the private sector for care if the department cannot provide it within a certain time frame. The House bill stipulates a 14 day deadline while the Senate bill directs the VA to identify an acceptable wait-time.
· The method of how the VA would reimburse the private sector. The House bill requires the department to pay any non-VA facility health care at the greater of the Medicare rate, the Tricare rate, or a rate set by the VA. The Senate bill would require that all privately provided care be provided under contract which could allow rates closer to commercial rates in some areas rather than federal levels such as Medicare.
· The timetable for payment by the VA to private doctors or facilities. The House bill sets no timetable while the Senate bill contains a non-enforceable, sense-of-the-Senate provision that calls for timely payments.
Expect more on this in the coming weeks.
SPEAKING OF THE VA…
A report released by a top White House official charged with investigating the VA said that, “A corrosive culture has led to personnel problems across the Department that are seriously impacting morale and by extension, the timeliness of health care. The problems inherent within an agency with an extensive field structure are exacerbated by poor management and communication structures, distrust between some VA employees and management, a history of retaliation toward employees raising issues, and a lack of accountability across all grade levels.”
White House Deputy Chief of Staff Rob Nabors’ report also found that the VA’s 14-day scheduling standard — a rule which bans VA hospitals from keeping patients from seeing a doctor for longer than two weeks — are “ill-defined.” This standard may have contributed to the VA falsifying wait lists for veterans.
“There is a tendency to transfer problems rather than solve problems,” the report found. “This is in part due to the difficulty of hiring and firing in the federal government.”
The report also charged that the VA was slow to adapt to changing demographics among veterans, including an influx of female patients and younger veterans from the wars in Iraq and Afghanistan who have different needs than traditional patients.
$58.6 BILLION REQUESTED FOR 2015 OVERSEAS CONTINGENCY OPERATIONS
The Pentagon’s Overseas Contingency Operations (OCO) request for fiscal 2015 finally arrived on Capitol Hill.
The $58.6 billion request for funding is $20.9 billion less than the $79.4 billion placeholder included in the FY 2015 Budget. The request primarily funds temporary and extraordinary expenses associated with military operations in Afghanistan, as well as activities that support Operation Enduring Freedom (OEF), related follow-on activities, and other critical missions, including counterterrorism, in the region. In addition to funding for the U.S. military mission in Afghanistan and DOD’s supporting presence in the broader region, the OCO submission seeks congressional support for the new $5 billion Counterterrorism Partnerships Fund (CTPF) and $1 billion for the European Reassurance Initiative (ERI).
In support of OEF and related follow-on activities, the funding would support operations and force protection in Afghanistan, including ending combat mission and transitioning to an advisory mission by the end of December 2014. It would also support the repair or replacement of combat-damaged equipment, as well as replenishment of expended munitions and continued counterterrorism efforts in Afghanistan.
The House Armed Services and Budget Committees are scheduled to hold hearings on the OCO request next week.
Meanwhile, in addition to the OCO request, Senate appropriators will also start their work on the Pentagon’s annual spending bill. Mark up by the Defense subcommittee is scheduled to begin on July 15 followed by full committee action on July 17.
The conventional wisdom is that a continuing resolution will be needed by Oct. 1, but the question remains whether Congress will need a stopgap to cover all twelve spending bills or whether some of them can be passed as stand-alone measures.
Appropriations Committee Chairwoman Barbara Mikulski, D-Md., is still hopeful that all of the spending bills can be passed in the two weeks of floor time the leadership has set aside for appropriations bills; however, serious disagreements with the GOP on amendments persist.