Congress begins work on election-year budget.

With the November election on the horizon, lawmakers on both sides of the political aisle are under pressure to rein in federal spending, but they also want to appear supportive of veterans, a key constituent group. The proof of their support for veterans health care and benefits, however, will come later when they decide how much money the Department of Veterans Affairs can spend.

Although the veterans budget has increased in recent years, there still is a significant gap in funding to meet the needs of sick and disabled veterans. This year the DAV is urging Congress to increase the overall VA medical care budget by 11 percent over the 2006 level, to $32.8 billion. Included in that amount is a 13 percent boost for direct medical services to sick and disabled veterans and a 10 percent increase in funding for medical and prosthetic research.

The DAV again strongly recommends replacing the current discretionary appropriations method with full mandatory funding, or some combination of discretionary and mandatory funding. This fundamental budget reform proposal will take the politics, guesswork and political gamesmanship out of VA health care.

Other recommendations from the DAV include $1.4 billion for the Veterans Benefits Administration to hire additional staff and to improve training and information technology within the Compensation and Pension Service. The DAV also calls for adding staff and program improvements within the VA's Vocational Rehabilitation and Employment Service.

"So far, we've gotten mixed signals from Congress on funding for veterans programs and services," said National Legislative Director Joseph A. Violante. "When the President's budget came out, it proposed--for the fourth year in a row--an annual enrollment fee and steep increases in prescription co-payments for certain veterans seeking VA health care. Congress has rejected those proposals in the past."

The President's budget requests $80.6 billion for the VA in the fiscal year that begins Oct. 1. It includes $24.7 billion in appropriations for direct medical services to veterans and relies on $2.8 billion in collections to help pay for patient care.

The DAV and other major veterans service organizations are united in calling on Congress to provide about $26 billion for veterans medical services, almost $1.3 billion more than the President has requested.

"Also of critical concern to the DAV is the delivery of claims benefits," Violante said. "Despite its best efforts, the VA has been unable to completely conquer its quality and timeliness problems. The VA must be given sufficient resources to put in place serious reforms to solve its problems. It is a grave injustice to deny America's disabled veterans accurate and timely decisions on their claims for benefits."

The President's budget provides $1.2 billion for the Veterans Benefits Administration and would increase staffing in the education, vocational rehabilitation, and employment programs. However, the plan calls for reducing the current staffing levels by 149 employees in VA's Compensation and Pension Service.

"There are serious concerns about long-standing problems and chronic understaffing and an expected increase in disability claims. So, The Independent Budget has recommended adding 1,300 claims workers," said Violante.

There is bipartisan opposition in the House to the administration's plan for collecting $795 million in co-payment increases and health care user fees from veterans. Both the Republican chairman and Democrat ranking member of the House Veterans' Affairs Committee have come out against having the fee increases in the 2007 budget.

But the Senate Budget Committee included new user fees and higher co-pays in its draft of the budget blueprint, which was approved by a partisan 11-10 vote. Sen. Larry Craig (R-Idaho), who chairs the Senate Veterans' Affairs Committee, said he was willing to accept the Bush administration proposal.

However, during floor debate on their version of budget resolution, Senators unanimously approved an amendment offered by Sen. Conrad Burns (R-Mont.) that adds money to the VA health care budget to cover the fees, plus $27 million for prosthetic research, which the Bush administration proposed cutting. The increases would be offset with cuts from other discretionary spending items.

That amendment passed after Craig, who had supported the President's fee plan, said he would back Burns.

"The VA budget proposes $795 million in savings by increasing fees placed on Priority 7 and 8 veterans. The suggested increases include a $250 annual enrollment fee and more than doubling prescription co-pays, from $7 to $15. This increased burden placed on our veterans is not acceptable," Burns said in introducing the amendment.

Senators, by a 46-54 vote, defeated an amendment offered by Sen. Daniel Akaka (D-Hawaii), ranking member of the Senate Veterans' Affairs Committee. The amendment would have increased VA medical services funding by $1.5 billion in fiscal year 2007 to be paid for by closing corporate tax loopholes. All 44 Democrats, one Republican and one Independent voted in favor of the amendment.

In introducing the amendment, Akaka said, "We are all too familiar with the scenario last year. You remember the VA wildly underestimated the number of younger vets returning from Iraq and Afghanistan. And this year, the administration thinks even fewer vets will come for care. This is a terrific gamble, as this miscalculation was one of the primary causes of last year's shortfall."

Senators also rejected an amendment offered by Sen. Debbie A. Stabenow (D-Mich.) that would convert veterans health benefits into a mandatory spending program. The estimated cost of $104 billion over five years would be offset by eliminating tax breaks for individuals with annual incomes of more than $1 million and certain corporate tax breaks. Two Republicans voted for the amendment, and one Democrat voted against it.

"We need to finally move this into a category where every year those veterans coming home who need health care will know that the dollars are there based on their eligibility, based on their service, based on their need--not based on a debate on the floor in the Congress about how much we are willing to spend to address their health care needs. This should not be a year-to-year debate and commitment; this should be an assured commitment that the dollars will be there," Stabenow said in introducing the amendment.

"It's unclear how far above the President's budget request Congress is willing to go in funding veterans health care and the benefits delivery system," said Violante. "Even though the Senate blueprint added funds for the VA, here's no guarantee that the House will go along with them in its budget resolution. And, besides, the budget resolution only provides spending guidelines; congressional appropriators ultimately decide how much money the VA will receive for the coming fiscal year."

"That means, the DAV will have to continue educating lawmakers about the importance of providing the VA with the resources it needs to provide veterans with timely access to top-quality care and improve the benefits delivery system," Violante said. "It will take an all-out grassroots campaign to urge Senators and Representatives to support an adequate appropriation for the VA."

For more information on recommended funding levels and public policy priorities for veterans programs and services, visit the DAV's Web site, www.dav.org, and click on "Legislation" at the top of the screen. You can also contact the National Legislative Department, National Service and Legislative Headquarters, 807 Maine Ave., SIN, Washington, DC 20024.

Fiscal Year 2007 VA Budget Comparison
(Budget Authority in Millions)

                                    Fiscal Year 2006   Fiscal Year 2007
Selected Programs                     Appropriations      President's
and Budget Accounts                       Enacted       Budget Request

Medical Services                       $   22,547        $   24,716 *
Medical Administration                 $    2,858        $    3,177
Medical Facilities                     $    3,298        $    3,589
Medical/Prosthetic Research            $      412        $      399
  Subtotal, Veterans Health            $   29,115            31,861
    Administration
Veterans Benefits Administration       $    1,054        $    1,168
General Administration                 $      357        $      313
  Subtotal, General Operating          $    1,411        $    1,481
    Expenses
Construction, Major Projects           $      607        $      399
Construction, Minor Projects           $      199        $      198
Grants for State Extended              $       85        $       85
  Care Facilities
Grants for Construction of State       $       32        $       32
  Veterans Cemeteries
National Cemetery Administration       $      156        $      161
  Total, Discretionary                 $   33,044        $   35,697

                                    Fiscal Year 2007
Selected Programs                  Independent Budget
and Budget Accounts                  Recommendation

Medical Services                       $   25,990
Medical Administration                 $    2,939
Medical Facilities                     $    3,461
Medical/Prosthetic Research            $      460
  Subtotal, Veterans Health            $   32,851
    Administration
Veterans Benefits Administration       $    1,411
General Administration                 $      416
  Subtotal, General Operating          $    1,827
    Expenses
Construction, Major Projects           $    1,477
Construction, Minor Projects                  505
Grants for State Extended              $      150
  Care Facilities
Grants for Construction of State       $       37
  Veterans Cemeteries
National Cemetery Administration       $      214
  Total, Discretionary                 $   38,515 *

* This figure does not include the President's proposed $795 million in
co-payment increases and user fees.