House, Senate Committee Reaches Compromise to Reform the VA

This story has been updated.

Just three days ago, urgent efforts to reform the Department of Veterans Affairs in the wake of the latest scandal over wait times at VA health facilities and the resignation of VA Secretary Eric Shinseki rapidly unraveled, with both sides pulling threads.

But on Monday, Sen. Bernie Sanders, I-Vt., and Rep. Jeff Miller, R-Fla., announced a $17 billion deal sewn together from bills passed by both chambers, with some $12 billion coming from new, emergency funding and $5 billion offset from within the VA.

“This VA conference committee legislation that we are bringing forward today is far from what I would’ve written if I had to do it alone, and I would suspect it’s fair to say it is also not what Chairman Miller would’ve done,” Sanders said in a joint press conference with Miller on Monday afternoon. “It is a compromise.”

Miller and Sanders said they anticipate the conference committee that has been working for weeks to hammer out differences between the House and Senate legislation will give the 133-page bill its stamp of approval by the end of the day, just barely squeezing the measure into the window of time required for consideration before the summer recess.

While both lawmakers acknowledged the difficulty of the process and the reality that the bill does not contain everything they wanted, they patted themselves on the back for a rare achievement in the 113^th Congress: getting something done.

“The United States Congress today, in my view, is a dysfunctional institution,” Sanders said. “There are [sic] major issue after major issue, where virtually nothing is happening and important legislation needs to be happening. So rather than go through, ‘Why we didn’t do this a month ago and get it done?’ the important point is we are here together having done something, and that happens quite rarely in the United States Congress.”

The VA reform compromise addresses several of the most intractable issues at the root of the VA crisis. In the last four years alone, the VA has seen more than 2 million more veterans coming into the VA system, a net increase of one and a half million patients, according to a Sanders statement.

The legislation provides the VA $5 billion to add doctors and other medical personnel and address wait times and overcrowding at VA facilities, and $1.5 billion to enter into leases at 27 medical facilities in 18 states and Puerto Rico. It also provides $10 billion for contracting out VA health care to private providers for eligible veterans who live in a state without a VA health facility or reside 40 or more miles away from one, or cannot be seen within 30 days. Currently enrolled veterans and veterans returning from Iraq and Afghanistan who meet these requirements will be eligible for the private care choice, according to Miller. Robert McDonald, who lawmakers said is expected to be confirmed this week as the new VA secretary, will have more power to fire senior employees for poor job performance or manipulating data. The employee will get a 21-day appeals period, but the ultimate decision after that time will be final, Sanders said.

The legislation also includes funds dedicated to improving care for veterans who experienced sexual trauma, expanding a scholarship program to include surviving spouses of members of the armed forces who died in the line of duty after Sept. 10, 2011, qualifying all veterans for in-state tuition under the Post-9/11 GI bill, and prolonging the life of a program providing housing for veterans suffering from traumatic brain injury until March 1, 2015.

Negotiations had stalled over the legislation’s price tag and how to pay for it. The Congressional Budget Office estimated the legislation could cost $30 billion to $50 billion annually. The Senate initially passed a $35 billion version, and the House a $44 billion version. As Sanders and other senators argued that the bill should be paid for with emergency funding, House members pushed back that any cost should be offset.

In the end, the substantially slashed bill would be funded both ways.

“Funding for veterans’ needs must be considered a cost of war and appropriated as emergency spending," Sanders said Monday.

Miller said he agreed to the roughly $10 billion in emergency funding “because the veterans need quick response, and this is the way that we need to be able to make sure that veterans are not standing in line.”

Miller’s spokesman Curt Cashour said the $5 billion in offsets will come from home loan fees, pension limitation in veterans- and Medicaid- financed nursing homes, and department wide bonus limitations. Though Miller and others wanted to originally get rid of bonuses altogether, the committee agreed to a cap at $400 million over 10 years.

Even with the breakthrough, time is still tight to get the legislation on President Barack Obama’s desk by Aug. 1. Miller must sell the bill to a caucus reluctant to spend any money. “Taking care of veterans is not an inexpensive proposition, and our members understand that,” Miller said.

Miller said the bill is merely the start of the conversation – if more money is needed, it would have to be sought through the typical appropriations process for the VA spending bill, subject to the Budget Control Act caps.

“The VA is not sacred,” Miller said. “The veteran is. And that’s the most important thing for all of us to remember.”

Shortly before midnight, House and Senate negotiators on the conference committee signed off on the compromise bill, according to Sanders spokesman Michael Briggs. Now the measure goes before the House and Senate for a vote, with the House expected to act first. The bipartisan duo behind the breakthrough is pushing for a vote this week.

Read the bill text here, and the conference committee report here.