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VA looks likely to get its billions, but begrudgingly

VA looks likely to get its billions, but begrudgingly

Lawmakers take agency to task for budget shortfall it pins on care ordered by Congress

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VETERANS HEALTH CARE

WASHINGTON — In the end, Congress will almost certainly step in to help the Veterans Affairs Department with a $2.5 billion budget shortfall and avoid VA facilities shutting down next month.

But lawmakers aren't happy about it.

VA Secretary Robert Mc-Donald got a big dose of their displeasure Wednesday when he testified before the House Veterans Affairs Committee.

Rep. Jeff Miller, R-Fla., the committee chairman, described the shortfall as an unprecedented scandal of poor budget management. And he said it's not the first time the department has come to Congress at the last minute and asked to be bailed out of a problem it created.

"While we will not penalize veterans for VA's management or transparency failures, the days when VA can come to Congress and just say, 'Cut us a check,' are gone," Miller said.

But McDonald said the shortfall stems mainly from an increase in care provided to veterans, something Congress has set as a priority.

"Last year, you talked about mismanagement being not giving veterans care," McDonald said. "Now mismanagement is giving veterans too much care. You know, the Congress passes the laws ..."

A key aspect of the VA shortfall debate is a new three-year, $10 billion "Choice" program that Congress created after a scandal blew up over long wait times. The new program allows veterans to receive care outside

BEHIND THE RED INK

The VA's budget shortfall stems from an increase in care provided to vets, argues VA Secretary Robert McDonald.

7 million

Additional health care appointments in past year

12,000

Additional staff members since April 2014

1.7 million

Additional square feet in VA facilities the VA framework.

Most of the "Choice" money hasn't been spent yet, and McDonald wants to tap it to cover spending from other VA budget accounts that have run dry.

"We've reached a decision point," McDonald testified. "Congress can either shape a different benefit profile for veterans or give VA the flexibility and money for legislated entitlements. My worst nightmare is a veteran going without care because I have the money in the wrong pocket."

McDonald told the committee that veterans are getting more care as a result of the department's efforts. For example, he said veterans have received 7 million more appointments than a year ago — 2.5 million within the VA system and 4.5 million with private doctors.

Since April 2014, he said, the VA has boosted staffing by more than 12,000, including more than 1,000 new physicians. And he said VA facilities have added 1.7 million square feet of space, including more primary care exam rooms.

But that increase has come at a cost, he said, and spending on expensive medicine for hepatitis C is up too. McDonald said the department initially thought it could manage the shortfall, but that has proven not to be the case because budget restrictions outline how the department can spend its money.

Because of the shortfall, the VA Nebraska-Western Iowa Health Care System has announced that it won't cover adult day care and other forms of nonskilled nursing care after July 31. Elsewhere, the budget problem threatens to close some VA facilities entirely.

Some members of the committee said the VA's record of poor management — including a suburban Denver construction project that is seriously behind schedule and massively over budget — is a good reason to keep the budget restrictions that McDonald wants to ease.

And they specifically questioned whether the shortfall was the product of the department trying to undermine the Choice program — a suggestion that McDonald denied.

Lawmakers' impatience with the department was bipartisan.

Rep. Kathleen Rice, D-N.Y., said it felt like the movie "Groundhog Day," with the department once again in a crisis. She said the VA was demanding more money with an "utter lack of accountability."

And she took issue with some of McDonald's comments.

"What I think is disgraceful ... is for you to insinuate by not giving money, no one on this committee cares about veterans," Rice said. "I am so sick and tired of that insinuation."

McDonald responded that he was making no such insinuation. He said it's clear the members care a great deal about veterans.

"I get letters from all of you every single day trying to give more benefits to more veterans, and I'm all for it, but we've got to have the money to do it," McDonald said.

After the hearing, Miller said the VA needs to be more transparent about its budgeting process and come to Congress sooner with its problems.

"Once again the Congress is going to come to the rescue of this administration," Miller said. "But I can tell you, members are getting very tired of having to put out these fires."

Contact the writer: joe.morton@owh.com, twitter.com/MortonOWH

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