House and Senate negotiators have agreed to a $17 billion bill meant to reform the Veterans Affairs Department, setting up a scramble this week to send the legislation to President Obama’s desk.
The new bill would provide $10 billion for veterans to seek private care at hospitals and clinics outside the VA, and $5 billion to allow the department to hire more doctors, nurses and medical staff. Another $1.5 billion could be spent on leases to use other medical facilities at 27 sites around the country.
Both Republicans and Democrats accepted concessions to reach a deal, some of which could cost them votes.
The final bill is smaller than the Senate’s original three-year bill, which the Congressional Budget Office said would add $35 billion to the deficit over the next decade. It includes new restrictions that limit the number of veterans who could seek private care to those who are enrolled in the Veterans Affairs system as of Aug. 1.
Once the $10 billion in funding for veterans to seek private care runs out, the VA will have to come back to Congress through the normal appropriations process to win more funding.
Republicans, for their part, conceded that $12 billion of the bill’s costs would be considered emergency mandatory spending that would add to the deficit. Republicans had wanted to offset all the costs with spending cuts.
The other $5 billion would be offset by other spending cuts within the agency, including through a cap on the performance bonuses doled out by the department — something demanded by Republicans.
House Veterans’ Affairs Committee Chairman Jeff Miller (R-Fla.) predicted the bonus limit would let the government recoup $400 million over 10 years. Senate Veterans’ Affairs Committee Chairman Bernie SandersBernie SandersFive takeaways from Trump's inauguration Trump takes reins of divided nation Trump's inaugural from the eyes of a Bernie Sanders delegate MORE (I-Vt.), who negotiated the deal with Miller, said he was “comfortable” with the balance between emergency spending and spending cuts.
Miller acknowledged he will lose some Republican votes because the final measure adds to the deficit, but said it was important that lawmakers leave Washington for their five-week recess with a deal approved.
“It goes without saying that we have a VA that is in crisis today — this agreement will go a long way to resolve the crisis,” Miller said during a joint press conference with Sanders.
Miller said he approved of adding to the deficit in this instance “because the veterans need a quick response.”
He also expressed confidence that he would be able to convince fiscally conservative GOP and Tea Party members to vote for a compromise bill that boosts spending.
“There will be an education process that will have to take place,” Miller added. “Obviously, some of our members will need a little more educating than others.”
Later on Monday, Miller said he expected the House would vote on the legislation Wednesday.
Sen. Bob Corker (R-Tenn.) on Friday urged lawmakers to not vote on a bill until it is scored by the Congressional Budget Office.
Minority Leader Nancy Pelosi (D-Calif.) in a statement praised Miller and Rep. Mike Michaud (Maine), the panel’s ranking Democrat, for getting a deal put together. Pelosi’s statement suggests the bill will get broad Democratic support.
Pelosi also jabbed at Speaker John Boehner (R-Ohio), saying there should be no “further delay” in bringing the bill to the floor.
The agreement comes days after negotiators appeared deadlocked. But after Sanders and Miller exchanged barbs last week and Senate Democrats boycotted a conference meeting, the two began talking again on Thursday night.
The renewed talks also followed an unusual vote in the House in which 13 Republicans voted in favor of a Democratic measure instructing the House conferees on the VA bill to agree to the Senate’s bill. The vote underscored the fact that many rank-and-file Republicans wanted to see a deal.
“Rather than go through why we didn’t do this a month ago and get it done, the important point is that we are here together having done something,” Sanders said on Monday. “I’m proud of what we have accomplished.”
The controversy surrounding the Veterans Affairs Department exploded after reports that veterans had died while waiting for care despite a maximum 14-day waiting period set by the VA. Internal reports subsequently revealed that officials at the VA had covered up instances in which veterans waited for months before receiving care.
The scandal cost Veterans Affairs Secretary Eric Shinseki his job; he resigned at the end of May. Robert McDonald, a former Procter & Gamble CEO, could be confirmed by the Senate this week as his successor.
The compromise bill will grant the secretary new powers to fire employees. Those deemed to be underperforming would have an unpaid, 21-day window to appeal their dismissal, a provision Sanders fought for throughout the talks.
The compromise measure allows veterans to get care from non-Veterans Affairs physicians who participate in Medicare if they live more than 40 miles away from a VA facility, or if agency doctors cannot see them within 30 days.
The department would be required to conduct regular audits on the accuracy of care and staffing levels at each major medical facility.
A Sanders spokesman said legislative text of the bipartisan bill likely would not be available until Monday night.
This story was posted at 2 p.m. and updated at 7:07 p.m.