Aides said that Sanders and Miller had worked out final language on the agreement, which would be circulated among lawmakers on Monday ahead of the formal announcement. One House aide, not authorized to speak publicly about the talks, said that the final agreement more closely mirrors a Senate measure overwhelmingly approved by Democrats and Republicans last month.
A final cost of the far-reaching measure was not immediately available Sunday but is expected to be critical to determining whether the legislation will enjoy the support of House Republicans, many of whom have been concerned about dramatically increasing costs for government-run programs.
According to a draft summary of the measure provided by House aides, Congress would give eligible military veterans a “Veterans Choice Card” and allow them to seek health care outside the VA medical system from Medicare-eligible providers, other federally qualified health centers or facilities operated by the Defense Department or federal Indian Health Service centers.
Veterans eligible to seek care outside the system would need to be enrolled by Aug. 1, or enroll for VA care within five years of ending their military service in Afghanistan and Iraq, according to the draft agreement. A veteran could leave the VA system if they’re unable to receive an appointment within 14 days — the current VA wait-time goal, or if they live more than 40 miles from a VA facility.
In response to reports that workers improperly compiled written lists of patients waiting more than two weeks for appointments in order to avoid failing to meet VA guidelines on wait times, the new legislation would not allow scheduling and wait-time metrics to be used as factors in determining a worker’s performance. Instead, most performance reviews would focus on the quality of care received by veterans, according to the draft summary.
The measure also would authorize $5 billion in emergency spending to pay for hiring new employees; require VA to enter into 27 leases for new major medical facilities; expand a scholarship program for the surviving spouses of service members who died during conflicts since the Sept. 11, 2001, terrorist attacks; and allow VA to provide counseling care and other services to veterans who suffered sexual trauma while in the ranks. Additionally, VA would be required to conduct regular audits on the accuracy of care and staffing levels at each major medical facility.
Word of a deal comes with just four legislative days left until Congress is scheduled to adjourn for a five-week recess Friday. With several significant, complex issues left unresolved, including President Obama's request for emergency funding to deal with the influx of immigrants along the U.S.-Mexico border, lawmakers have been saying for weeks that leaving for recess without resolving the veterans' health-care crisis would be embarrassing and would justifiably spark voter outrage.
"I'm embarrassed," Sen. John McCain (R-Ariz.), a lead GOP negotiator on the veterans' bill, said last week when asked about the lack of progress. "I'm utterly embarrassed if we leave without doing the VA bill. Are we going to leave our veterans in a lurch on a bill that was 93 to 3 here and unanimous over in the House? And we can't come together? That is obscene."
More than 110 House lawmakers co-signed a letter last week calling on House and Senate leaders to keep Congress in session into August if necessary to finish work on the VA bill.
"There’s no excuse for continued inaction," one of the co-signers, Rep. Tulsi Gabbard (D-Hawaii), an Iraq war veteran, said Friday
In the wake of news reports about veteran health-care problems, the House and the Senate acted quickly but separately on legislative proposals to address allegations of mismanaged and delayed care for thousands of military veterans at VA hospitals and clinics nationwide. Senators voted 93 to 3 last month to approve a bipartisan plan that would allow the VA to contract more with private medical centers to meet demand for care, in addition to granting the department authority to shift $500 million from its budget toward hiring additional medical staff and giving the VA secretary greater power to fire or demote senior executives for poor performance.
The House passed several standalone measures that addressed funding, hiring shortages and changes in hiring policy that would make it easier to remove poor-performing workers. Talks between House and Senate leaders began in June, and after weeks of delay, tensions broke out into the open last week as Democrats and Republicans accused each other of stalling tactics. Facing pressure to resolve differences, Sanders and Miller returned to the negotiating table over the weekend.
Allegations of wrongdoing at the VA forced the White House to conduct a top-to-bottom review of department operations and led to the resignation of Eric K. Shinseki as VA secretary. Obama has nominated Robert McDonald to serve as the veterans affairs secretary. Sanders's committee approved McDonald's nomination last week, and a full Senate confirmation vote is expected this week. Every VA secretary has been confirmed unanimously since the position was created in the late 1980s.