Pressure is building on House and Senate lawmakers to reach a deal this month on legislation to reform the troubled Veterans Affairs Department.
Congress has only 28 workdays left before Election Day, leaving little time for negotiators to hammer out differences between competing bills approved by the House and Senate.
A final bill is expected to make it easier to fire incompetent executives at the VA, and grant veterans more options to seek care outside the agency’s healthcare system.
It seems unimaginable that Congress would not get a VA bill done given the controversy this spring surrounding reports that veterans waited months to get appointments, and that their long waits were covered up by administrators.
Yet significant differences remain over how to pay for the final costs of a package, and time is running short.
“Is there time to do it? Yes. If they could agree on what the bill said, yeah,” according to a Capitol Hill aide familiar with the negotiations. “I’ve heard nobody say” that the bill won’t get done before the August break, the aide added.
Veterans groups warn there will be hell to pay if Congress fails to reach a deal.
If negotiators don’t have a bill passed before they break for the next recess “they better just shelter in place because veterans back home are going to lose their minds that Congress is stalling something after it’s been identified as a problem,” said Raymond Kelley, legislative director for the influential Veterans of Foreign Wars.
The House and Senate will take August off, and are only scheduled to be in Washington for a handful of days in September and October as they ready for the midterm elections.
That will put enormous pressure on Congress to get the Veterans Affairs bill done in July, the last full month that lawmakers will be working on legislation.
Kelley expressed confidence that it will get done.
“This is a priority for Congress. It’s going to happen,” he said. “Everything else will take a backseat, legislatively. This works needs to be done.”
Negotiators were dealt an unexpected shock when the non-partisan Congressional Budget Office estimated the Senate’s proposal would cost $50 billion a year to carry out, while the House plan would cost at least $44 billion over five years.
That’s complicated the debate over how to pay for the bill. The Senate would have any costs of the package be added to the deficit, while Republicans in the House say the bill’s costs should be offset with other spending cuts.
Republicans and Democrats on the conference committee dismissed the CBO’s prediction as wildly inaccurate, and members met with CBO chief Douglas Elmendorf last week, the Capitol Hill aide said.
Those discussions are aimed at finding ways to reduce the score of a conference committee agreement.
Both the CBO and VA are “working on reports for a number of different reform scenarios,” a House aide said.
The aide added that this would add to the time crunch, since lawmakers are depending on information from the two agencies and this would “impact the pace of the committee’s negotiations.”
Lawmakers are looking at a few ways to possibly drive down costs.
They could tweak a proposed two-year program that allows veterans to seek care from non-VA doctors if wait times are excessive or the nearest facility is more than 40 miles away.
By extending distance requirement to something like 60 or 80 miles it “reduces the number of people who would be eligible for private care” and keeps them in the VA system, according to the Hill aide.
Negotiators could also limit the eligibility for the private care option to veterans who are currently enrolled in the VA network and have had to wait at least 30 days to get an appointment, the Hill aide said.
That proposal would blunt a prediction made by CBO that millions of veterans not on the department’s patient rolls would drop their private healthcare in order to join the VA system, the aide explained, shrinking the universe of patient who would qualify for coverage to 500,000 or less.
The differences over how to fund a joint bill may not be “as wide a gulf as we’ve been assuming,” according to Alex Nicholson, legislative director for Iraq and Afghanistan Veterans of America.
He said fiscally conservative panel members could be open to legislation that would add to the debt if VA submits a detailed plan on how it would spend the cash infusion.
Kelley said conferees are “going to have to come to the realization that some form of emergency funding is going to have to happen,” predicting riders could be attached to the final bill requiring greater transparency and better management from VA officials.
Nicholson blasted lawmakers for the “wholly unnecessary” televised start of negotiations on June 24, where each of the bipartisan panel’s 28 members gave a five-minute speech about their hopes for the bill but no real work was done.
“They could have gotten down to work that last week before they left and been a week ahead of where they are now but chose to schedule the grandstanding opportunity,” he said.
Nicholson noted that lawmakers would have had six weeks to come up with a final package before August.
“If they can’t get it done in six weeks, they shouldn’t go on August recess,” he said, adding "service members are not allowed to go on leave with some huge, unfinished task.”