Issue link: https://www.epageflip.net/i/331028
ByMatthewDaly AssociatedPress WASHINGTON >> Spending on veterans' health care could double in three years under the Sen- ate's solution to the long waits experienced by thou- sands seeking medical care at VA hospitals and clinics, according to congressional budget experts. Analyzing a bill the Sen- ate passed overwhelmingly last week, the Congressio- nal Budget Office estimates the measure would cost $35 billion over the next three years to build new clin- ics, hire doctors and make it easier for veterans who can't get prompt appoint- ments with VA doctors to get outside care. Once the program was fully in place, the budget of- fice said it "expects that vet- erans would ultimately seek additional care that would cost the federal government about $50 billion a year" in new spending — more than double the $44 billion the government now spends an- nually on medical care for veterans. Both the Senate bill and a House version also passed this past week would dra- matically expand govern- ment-paid health care. They would require the Veterans Affairs Department to pay private providers to treat qualifying veterans who can't get prompt appoint- ments at the VA's nearly 1,000 hospitals and outpa- tient clinics or who live at least 40 miles from one of them. The bills are Congress's response to a growing up- roar over patients dying while awaiting VA treat- ment and mounting evi- dence that workers falsi- fied or omitted appoint- ment schedules to mask frequent, long delays. The resulting election-year fire- storm forced VA Secretary Eric Shinseki to resign two weeks ago. An audit released last week showed that more than 57,000 veterans have had to wait at least three months for initial ap- pointments. An additional 64,000 veterans who asked for appointments over the past decade never got them. The VA has confirmed that at least 35 veterans died while awaiting ap- pointments at VA facili- ties in the Phoenix area, although officials say they can't say whether not get- ting VA treatment caused any of the deaths. More than 8 million of the nation's 21 million veter- ans are now enrolled in VA health care although only about 6.5 million seek VA treatment every year. The CBO analysts said VA now covers about 30 percent, or an average $5,200, of those veterans' annual health care costs, excluding long- term care. The Senate bill would open up VA health care to as many as 8 million vet- erans who now qualify for VA health care but have not enrolled, the budget of- fice said. By making it eas- ier to get outside care, the Sen- ate bill and a compan- ion measure in the House also would encourage vet- erans to seek VA coverage for a bigger portion of their health care, the report said. Both bills would make it easier to fire or demote se- nior agency officials, and both would end bonuses to regional VA officials and other administrators based on meeting patient schedul- ing goals — a practice in- vestigators say led some officials to create phony waiting lists to "game" the system. But the Senate bill also would devote at least $1 bil- lion to leasing 26 facilities in 17 states and Puerto Rico for use as new VA hospitals or clinics and $500 more million for hiring more VA doctors and nurses. De- claring the long appoint- ment waits an emergency, the Senate averted having to raise taxes or find spend- ing cuts elsewhere to cover the bill's costs. "By resorting to abus- ing the emergency escape clause, Washington is once again looking for the easy way out," said Maya Mac- Guineas, president of the Committee for a Responsi- ble Federal Budget, a bipar- tisan policy group devoted to cutting federal deficits. MacGuineas' group crit- icized the Senate's bill in a lengthy blog post after it passed, saying it would swell the government's debt by creating a new unfunded entitlement program big- ger than Congress's expan- sion of Medicare in 2003 to cover prescription drugs. "We can't just write a blank check and think it will solve these problems," said Sen. Jeff Sessions, R- Ala., one of three senators who voted against the bill. He said "veterans deserve better than that." Sen. John McCain, R- Ariz., one of the bill's au- thors, lashed back, "If it is not an emergency that we have neglected the brave men and women who have served this country and keep us free, then I do not know what an emergency is." Sen. Bernie Sanders, I-Vt., the chairman of the Senate Veterans' Affairs Committee, said the bill was expensive, but so were the wars that veterans have served in. Wars in Iraq and Afghanistan alone will have cost at least $3 trillion, he said. "If we can spend that kind of money to go to war ... surely we can spend (less than) 1 percent of that amount to take care of the men and women who fought those wars," he said. The CBO did not provide a complete cost estimate on the House bill, which includes no provisions for new hospitals or clinics or hiring more VA doctors and nurses. Both measures would spend billions to provide outside care for veterans, al- though the House would re- quire Congress to appropri- ate money for it each year. House Veterans' Affairs Committee Chairman Jeff Miller, R-Fla., said Congress would have to cover the costs, but he didn't know where the money would come from. "We'll have to find a way," he told reporters after the Senate bill passed. "It's not going to be cheap. We know it." Miller also said there would be negotiations with the Senate over final legisla- tion. "We're not just accept- ing the Senate bill," he said. Sanders was optimistic that a quick deal could be reached. "I've worked with Jeff Miller. I think we can work things out," he said. VETERANS HEALTH Bi ll w ou ld d ou bl e he al th s pe nd in g APPHOTO This June 10, 2014, file photo shows Senate Minority Leader Mitch McConnell of Ky., and GOP lawmakers, from le , Sen. John Barrasso, R-Wyo., Sen. John Thune, R-S.D., and Senate Minority Whip John Cornyn of Texas, talking to reporters on Capitol Hill in Washington a er a Republican caucus meeting. Both the Senate and a House version of the veteran's health care bill, both passed this week, would dramatically expand government-paid health care, and require the Department of Veterans Affairs to pay private providers to treat veterans who canít get prompt appointments at VA hospitals and clinics. The Congressional Budget Office estimates the Senate bill ultimately could cost about $50billion a year _ double current spending. By David Gorn California Healthline Sacramento Bureau Debate over health care- related issues produced a high level of angst among California legislators in the final hours of budget dis- cussions Sunday night. The Legislature yester- day passed a $108 billion budget and trailer bills on time, about four hours ahead of the Sunday mid- night deadline. That doesn't mean there was universal accord, at least around health care is- sues. The budget advanced several health-related pro- grams, but shelved others. Budget highlights include: Rejection of a plan to get matching federal funds from a California Endow- ment grant to help enroll and renew Medi-Cal bene- ficiaries. Rejection of proposal to include autism therapy as a Medi-Cal benefit: and Rejection of proposal to reinstate Children's Den- tal Disease Prevention Pro- gram; Rejection of proposal to reinstate Early Mental Health Initiative; Rejection of proposal to restore 10% reduction in Medi-Cal reimbursements made in 2011; Rejection of proposal to restore 7% cut in In-Home Supportive Services hours; Retention of overtime pay for home health care workers; Restoration of the $3.9 million Black Infant Health Program; The decision not to re- store Medi-Cal provider re- imbursement rates stirred people up on both sides of the aisle, in both houses. "The state won high praise for signing so many more people up [under] Medi-Cal expansion," said Assembly member Marie Waldron (R-Escondido). "And we all know access was already extremely lack- ing. These low reimburse- ment rates have made it impossible to find care in Medi-Cal." "We have to be honest, the expansion of coverage is for the most part, illu- sory. I find it harder and harder to find any medical providers who can afford to do this," said Sen. Mark Wyland (R-Escondido). "At some point … if we want to provide the care, we're go- ing to have to look at these rates, and frankly not just restore the reductions, but increase them." Assembly member Nancy Skinner (D-Berkeley), who presented the legislation in the Assembly, said to wait till next year. "We will monitor and we need to know the impacts of the rate cuts, and other data necessary to adjust this pro- vider rate issue," Skinner said. "And then we make it a priority this coming year." 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