by Tom Philpott
For a while it seemed 2016 would be the year Congress phased in a $3 billion plan to give older generations of severely injured veterans the same caregiver benefits enacted six years ago for post-9/11 injured veterans.
It also seemed Congress in 2016 would modernize the VA’s archaic appeals process for veteran claims, and would impose stiff new accountability requirements on VA employees who are incompetent or misbehave.
It even seemed possible this year that lawmakers would strengthen the Veterans Choice program by establishing prompt payment standards and by streamlining requirements for community medical care providers to enter into service agreements with the VA.
Early election-year cheers of real progress on these issues by leaders of the House and Senate veteran affairs committees became whispers by year’s end, due to fiscal realities and disagreements over reform priorities.
The major veterans’ bill passed in the 114th Congress is titled The Jeff Miller and Richard Blumenthal Veterans Health Care and Benefits Improvement Act of 2016 (HR 6416) to honor the retiring chairman of the House Veterans Affairs Committee and the ranking Democrat on the Senate committee who will step from that position in the next Congress.
Signed into law Dec. 16, it is long on ordering more studies of VA issues, and on tweaking current programs, but fails to make truly significant, and costly, program improvements. For proof, follow the money.
The Congressional Budget Office projects Miller-Blumenthal will raise VA appropriations by only $33 million over the next five years. A third of spending is for “reports, studies and surveys.” Over the next decade, the new law is projected to lower VA direct spending by $40 million.
From the perspective of major veteran service organizations, the roadblock to critical reforms of benefits and services are budget controls that the veteran committees must operate under.
“Either the House or the Senate passed nearly everything that we, as an organization, felt needed to be accomplished in the 114th Congress,” said Raymond C. Kelley, director of National Legislative Service for Veterans of Foreign Wars. “Except they couldn’t get it to the finish line — passed by both chambers and onto the president — because of the inability to fund it.”
VFW and other vet groups “continue to beat the drum for ending [budget] sequestration, realigning budget caps to meet need, and [lifting] most other budgetary triggers pressing on Congress. The authorizers know what needs to be done,” Kelley said. But until caps are removed, Congress can only approve major new benefits by making cuts to existing programs.
The Senate committee’s much touted Veterans First Act, which a bipartisan majority approved in May, had a host of substantive initiatives. The centerpiece was expansion of the VA caregiver benefit to families of older generations of severely injured veterans back to World War II.
The price tag was $3 billion, however, which the committee proposed to cover by raising interest rates on veterans reusing their home loan benefit, by rounding down disability compensation payments and by dampening the housing allowance stipend for the post-9/11 GI Bill benefit. Lawmakers know those are hard tradeoffs for veteran groups to accept.
“As a veteran service organization,” Kelley said, “we cannot allow Congress to pay for one benefit with another benefit. We just can’t go down that road,” even though VFW eagerly supports expanding caregiver eligibility.
Another Senate initiative, to consolidate outside provider payments to improve access to community health care, would cost $34 billion over 10 years, an impossible expense to absorb with existing budget caps.
On the House side, Miller, a champion for forcing the VA to punish wrongdoers among its workforce, linked reform of the VA claims appeal process to tougher employee accountability rules, which federal employee unions vehemently opposed and senators rejected. So, in the end, the final catchall Miller-Blumenthal package had no truly major reforms to tout.
Arguably the most welcomed provision bestows honorary “veteran” status on many Reserve and National Guard retirees who, until now, have not been recognized as such. The new law specifically states that no added benefits will flow from the recognition so there’s no budgetary effect.
Affected retirees spent careers in reserve components, attending monthly and annual drills, but never having completed a qualifying period of active duty service under Title 10 to meet the legal definition of veteran and receive a DD-214 “Certificate of Release or Discharge from Active Duty.” Today, however, they are able to be called, and to call themselves, veterans.
Other provisions take steps to narrowly improve access to health care, disability and education benefits and assistance to the homeless. Sen. Johnny Isakson (R-Ga.), chairman of the Senate committee, called HR 6416 a “down payment on the debt” owe to veterans.
“Though HR 6416 reflects just a fraction of our collaborative efforts, it nonetheless contains many important provisions,” Miller told colleagues.
Blumenthal noted that among 76 separate provisions passed, some allow hiring of more mental health counselors and emergency room doctors while others expand eligibility for homelessness prevention programs and extend some education benefits. The latter refers to a provision extending the deadline for using the full 36-month Fry Scholarship for surviving spouses who lost service members early in the Iraq and Afghanistan wars. They will have until Jan. 1, 2021, instead of April 1, 2017, to obtain their educations using the benefit. CBO estimates the added cost at $16 million.
The original Fry Scholarship program gave the children of service members who died in the line of duty after Sept. 10, 2001, full post-9/11 GI Bill benefits. Congress extended it to surviving spouses in 2014.
Other highlights of Miller-Blumenthal will:
Require the VA to enter into an agreement with the National Academy of Medicine to conduct an assessment on scientific research relating to the descendants of individuals exposed to toxins including Agent Orange. Estimated cost is $16 million over five years.
Relax a rule that VA staff physicians can’t work more than 80 hours in any two-week period, which has handcuffed the department in using its full-time doctors more efficiently.
Direct the VA to provide, in lieu of a headstone or marker, a medallion to be affixed to a privately purchased headstone or marker of an individual, signifying their status as a veteran, if they served in the Armed Forces on or after April 6, 1917. Estimated cost is $5 million over the next decade.
Require the VA to arrange for an independent assessment of exams it gives individuals seeking disability compensation for traumatic brain injury. Estimated cost: $2 million over five years.
Authorize contract physicians to conduct compensation and pension examinations at any location in any state as long as exams are within the scope of the authorized duties under the contract.
Expand the U.S. Court of Appeals for Veterans Claims from seven judges to nine through 2020 to help address a backlog of claim appeals. Estimated cost: $3 million.
Send comments to Military Update, P.O. Box 231111, Centreville, VA, 20120, email milupdate@aol.com or twitter: Tom Philpott @Military_Update.
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