Senate bill likely to draw more vets into VA health care system, CBO says

A Senate bill aimed at improving veterans' access to care at the Department of Veterans Affairs could carry a hefty price tag, according to a preliminary assessment of one portion of the bill by the Congressional Budget Office.

A Senate bill aimed at improving veterans' access to care at the Department of Veterans Affairs could carry a hefty price tag, according to a preliminary assessment of one portion of the bill by the Congressional Budget Office. The office delivered the preliminary numbers in a letter to Senate Veterans Affairs Committee Chairman Bernie Sanders (I-Vt.).

CBO analyzed a part of the legislation—Title III of the Veterans’ Access to Care through Choice Act (S. 2450)—which it notes will give VA "expansive authority for the next few years to contract with health care providers who are not employed by the VA, and VA would be required to use that authority to ensure that all eligible veterans would receive requested health care in a timely fashion."

The budget office reasons that expanding access to those health care services will translate into veterans seeking to get more healthcare from the VA than they currently acquire from the department.

CBO said that VA currently has about 8.4 million veterans enrolled in its health care program—and estimates that another 8 million qualify to enroll, but have not done so. VA currently spends about $44 billion a year providing health care services to vets—about $5,200 per enrollee—or about 30 percent of the total amount of health care those vets use overall.

But under Title III, CBO estimates, enrolled vets likely would want to increase the amount of care they receive from VA by about 60 percent—and some portion of other eligible vets who have not enrolled may do so because of improved access to care.

"Most of the costs incurred to provide that care would be for care financed by other payers, including Medicare; a portion of those costs would thus be offset by savings to the Medicare program," CBO said in its letter. "All told, CBO expects that veterans would ultimately seek additional care that would cost the federal government about $50 billion a year, on net." CBO also estimated that implementing Title III would cost about $500 million in 2014, $10 billion in 2015, and $25 billion in 2016.

Despite the preliminary estimates, CBO said that the "the magnitude of those budgetary effects is highly uncertain." While "a significant number" of vets may well tap into expanded health care benefits under the bill, the office said the exact number of vets—and the resulting costs—would depend on a range of other factors that are "very difficult to predict."

As a result, CBO report stated, "this estimate should be viewed as falling in the middle of a wide range of possible outcomes."

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