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Pelosi’s perplexing claim that House bill would ‘cut’ VA medical care funds

House Minority Leader Nancy Pelosi (D-Calif.). (Gabriella Demczuk/Getty Images)
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“It turns a cold shoulder to our veterans and ignores our crumbling infrastructure. In terms of our veterans, you see yesterday, Republicans sought to advance their appropriations bill under the level set by their new budget, which may or may not come to the floor today. But yesterday, the MilCon — military construction veterans bill — that cuts $1.4 billion below President Obama’s budget … and then it cuts $690 million from veterans’ medical care alone, the equivalent of 70,000 fewer veterans receiving V.A. medical care in one year.”

–House Minority Leader Nancy Pelosi (D-Calif.), news conference, April 30, 2015

The House passed its first appropriations bill for fiscal year 2016, largely voting along party lines on the Military Construction and Veterans Affairs bill. House Democrats, Department of Veterans Affairs Secretary Bob McDonald and some veterans groups opposed the bill, saying it inadequately pays for veterans’ medical needs and construction projects that could help expand their access to care. The White House has threatened to veto the measure.

Prior to the House vote, Pelosi said the bill would “cut” $1.4 billion below the president’s budget. She said it “cuts” $690 million of it from veterans’ medical care, the equivalent of 70,000 fewer veterans receiving medical care through VA in one year. Are her statements accurate?

The Facts

The House passed a $171 billion VA and military construction bill, which was a funding increase for both programs over fiscal 2015 levels. That included $163 billion for VA’s fiscal 2016 budget — a $4 billion increase over the fiscal 2015 enacted budget, but a $1.4 billion decrease from the president’s request.

Discretionary funding for VA totaled $69.7 billion — a nearly six percent increase over fiscal 2015. It included funding for treatment of 6.9 million patients and 770 new staff members to address the claims backlog. But the president’s budget request called for $70.2 billion in VA discretionary funds.

For the medical-services portion of the veterans’ health budget, the president’s budget requested $1.1 billion over what already was enacted for fiscal 2016. The appropriations bill agreed to 86 percent of that additional request. The House Appropriations Committee said the request was “unusually large” and that the need likely will decrease after a pending VA policy change.

The committee said it has “continuing concern over VA’s ability to effectively manage the cost of non-VA care,” because it is under-utilizing its community-care program. If VA used that program more, it could decrease costs and improve the convenience of care for patients, it said.

The president’s budget asked for double the current funding for construction projects, but the committee rejected it. McDonald said the House bill would halt major medical center projects and cemetery expansion efforts. But the committee said it is “seriously disturbed” by recent findings of mismanagement of a VA construction project in Colorado that has run more than $1 billion over budget.

House Republicans said the VA secretary — not the House, through its appropriations bill — has the authority to limit the number of veterans enrolled and eligible for VA health care.

The $1.4 billion overall shortfall would cause veterans to suffer, according to McDonald. Pelosi was citing McDonald’s presentation to the House Democratic Caucus from April 29, 2015, in which McDonald used the $690 million and 70,000 veterans figures. The VA arrived at the 70,000 figure by estimating an annual cost of health care per veteran at $9,831 for fiscal 2016.

According to the VA’s white paper, the $690 million shortfall included $360 million in rescissions (a technical term for canceling a previous budget item that Congress had approved). Fiscal 2016 rescissions included bonuses and raises that previously were approved, a transfer into a health care incentive fund, and prior funding for projects that were deemed less mission-critical.

Yet, in addition to this appropriations bill, VA now has access to an extraordinary amount of money to make sure veterans get medical care. In August 2014, Congress passed the Veterans Access, Choice and Accountability Act — a bipartisan response to the scandal that erupted over veterans’ delayed access to medical care at VA facilities across the country.

That legislation allowed VA to spend $5 billion to improve infrastructure and hire physicians and medical staff. Another $10 billion allowed the agency to pay for veterans to get medical care outside of the system if they live far away from a VA facility or if they wait longer than 30 days for an appointment. This is separate from the House appropriations bill. (There is a three-year sunset on the $10 billion portion.)

As of February 2015, VA had spent about $500 million of the $15 billion appropriated through that legislation.

McDonald testified during a House Committee on Veterans’ Affairs budget hearing that VA appreciates the extra $15 billion, but it does not “fully address VA’s longstanding capital infrastructure requirements.”

Some veterans groups said that McDonald’s request was realistic. If the administration’s budget is fully funded, VA could adequately prepare for aging veterans and those returning from deployment, fix claims backlogs, end veteran homelessness, improve medical research and more, they said.

Drew Hammill, Pelosi’s spokesman, wrote to The Fact Checker that the House bill “inadequately addresses the needs of our nation’s veterans as the VFW, American Legion and other advocacy groups noted in letters to Congress. The leader made clear she was referencing this as cut vis-à-vis the president’s budget request. The VA has noted that they have done an extensive analysis of what the needs of our veterans are. This bill fails to address that need.”

The VA issued a statement to The Fact Checker that the appropriations bill is independent of the funding made available through the Choice Act, and that “it is illustrative of the magnitude of the cut to VA’s regular budget in the House-passed 2016 funding bill, compared to the president’s budget.”

The Pinocchio Test

To call the funding in the House bill a “cut” is not accurate. The president’s budget proposal is just that: a proposal. The House bill is, indeed, lower than what the president and VA proposed, and what many veterans groups hoped to see. But the House appropriations bill increased VA’s total budget and its discretionary spending over fiscal 2015 levels. This is more money than the agency ever has had, and the total VA funding has grown by nearly 73 percent since 2009. It is also difficult to see how rescissions of bonuses or pay raises would lead to fewer veterans receiving care.

Aside from this bill, VA also has access to billions of additional dollars that was allotted to deal with its access-to-care problems. The agency has more than $14 billion left to spend. Congress passed the Veterans Access, Choice and Accountability Act specifically to allow veterans to cut through bureaucracy. The argument that 70,000 fewer veterans would access medical care because of the House appropriations bill is perplexing and clearly an exaggeration.

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