Let’s examine the bill’s provisions, including their costs, to find out exactly what Congress would be adopting if it passes the measure. One caveat: the cost estimates are preliminary, since the nonpartisan Congressional Budget Office has not had a chance to score the proposals.
Firing provision (Funding: $0)
The bill would allow the VA secretary to fire or demote senior executives for poor performance and misconduct. Employees would have one week to appeal decisions, and the Merit Systems Protection Board would have to issue a ruling within three weeks, or else the agency’s decision would stand.
Critics say this provision would roll back civil-service protections for VA employees and discourage talented professionals from joining the agency. They have also raised concerns about a slippery slope, saying the policy could eventually be used at other agencies.
Veterans Choice Card (Funding: $10 billion)
The legislation would provide veterans with a card that allows them to seek care from non-VA health-care providers if they have waited more than 30 days for an appointment or if they live more than 40 miles from a VA medical center.
It’s worth noting that this plan could cost much more than $10 billion, depending how many veterans take advantage of the option. If the costs exceed $10 billion, the VA would have to ask Congress for additional money, and the request would probably go through the normal appropriations process — as opposed to another round of emergency funding.
Staffing and clinics (Funding: $5 billion)
The bill would provide $5 billion to hire additional primary and specialty health-care providers and more clinical staff, as well as to enter emergency leases for extra space. The goal is to add capacity and open clinics closer to veterans’ homes.
Miscellaneous support (Funding: $2 billion)
The legislation would require in-state tuition for certain post-9/11 veterans and extend educational benefits to surviving spouses of service members who died in the line of duty while on active duty, in addition to enhancing the delivery of care for troops who experience sexual trauma while serving in the military and continuing a program about to expire for veterans struggling with traumatic brain injuries.
These provisions were part of a previous bill from Senate Veterans Affairs Committee Chairman Bernie Sanders (I-Vt.). The measure died in the Senate after failing to win enough Republican votes to lift the statutory cap on VA spending that Congress and President Obama established in the last budget deal.
Offsets ($5 billion)
The estimated $17 billion cost of the bill would be offset by $5 billion in savings, bringing the price tag down to about $12 billion.
The lead negotiators for this deal, who include Sanders and House Veterans Affairs Committee Chairman Jeff Miller (R-Fla.), have offered no details about what the offsets would entail, except to say that they would come from “programs within the jurisdiction of the Senate and House veterans affairs committees.”