Veterans Affairs Secretary Dr. David Shulkin defended Wednesday a proposal in President Donald Trump's federal budget plan that would cut a benefit paying thousands of dollars annually to disabled elderly veterans.
The issue involved Shulkin's push for an expanded choice program allowing veterans to opt for private care and the offset from veterans' benefits to pay for more choice.
The proposal on the tradeoff to pay for the $2.9 billion choice expansion aroused the concerns of veterans service organizations. The vets' groups were also concerned about the long-term impact on VA care from the renewed emphasis on private care.
"We are very concerned the administration's request to make the Veterans Choice Program a permanent, mandatory program could lead to a gradual erosion of the VA health care system," the Veterans of Foreign Wars said in written testimony to a hearing of the House Veterans Affairs Committee.
One of the proposed offsets for the choice program would be a new age restriction on veterans' eligibility for the VA's Individual Unemployability (IU) benefit.
Veterans eligible now for the program have a 60 to 100 percent disability rating but are all paid at the 100 percent rate because a service-connected disability makes them unable to work. The budget proposal would cut off the payments once the veteran reached the minimum age for Social Security.
Rep. Mark Takano, D-Hawaii, said, "If a veteran was provided this benefit because of the inability to maintain gainful employment, particularly at a young age, he or she would not have been able to pay for Social Security or put money into a 401K or other retirement savings account."
He asked Shulkin, "If you end the (Individual Unemployability) payments for veterans like this, don't you risk plunging them into poverty?"
Shulkin responded that the VA was "sensitive to the issue" but had to find savings to pay for other programs. The change in eligibility for Individual Employability would save an estimated $3.2 billion in fiscal 2018 and $40.8 billion in 10 years, he said.
"This is a way we think of appropriately utilizing the mandatory funds and looking at where we can make the (IU) program more responsible," Shulkin said.
Shulkin acknowledged that about 7,000 veterans over age 80 currently receive IU out of a total of about 225,000 veterans getting IU. Payments from IU can reach about $22,000 annually.
John Rowan, national president of Vietnam Veterans of America, said the IU cuts and the entire Trump budget proposal would "completely abandon many of the most severely disabled veterans of the Vietnam generation and could make thousands of elderly veterans homeless."
"We're extremely alarmed by this budget proposal, because this is the opposite of what President Trump promised veterans," Rowan said.
Other testimony at the hearing disclosed that massive cuts at other agencies under Trump's proposed federal budget could send more veterans seeking care to an already overwhelmed Department of Veterans Affairs.
Shulkin said he had been in touch with Housing and Urban Development Secretary Dr. Ben Carson to get assurance that housing vouchers for homeless veterans would continue despite the proposed cuts at HUD.
Dealing with the homeless veteran problem "requires interagency cooperation," Shulkin said. "I have reached out to Secretary Carson. He has assured me he remains committed," he said.
The overall $1.1 trillion proposed federal budget offered by the White House Tuesday boosted the VA's budget by six percent while cutting most other agencies and slashing a range of anti-poverty programs, including food stamps.
Shulkin has also warned that proposed cuts to Medicaid under the Affordable Health Care Act recently passed by the House could also result in more vets turning to the VA for care.
At the hearing, Rep. Tim Walz (D-Minn.), the ranking Democrat on the Committee, noted the six percent increase for the VA in the Trump budget and told Shulkin "we're certainly glad you didn't get the fate of almost every other agency."
However, "Demands on (VA) assistance could very well increase" from veterans who now "rely on services from many other agencies," Walz said. "My fear is that the budget does not account for the demand on VA care when they're shifted over from other agencies and programs."
In response to questions, Shulkin said the proposed Fiscal Year 2018 budget for the VA of $186.5 billion, a $6.4 billion increase over fiscal 2017, reflected Trump's "strong commitment" to veterans and would aid in expanding and reforming the current choice program allowing veterans to opt for private care, increase service timeliness and boost programs to reduce veteran suicides.
"It still is too complex a system," Shulkin said of the choice program for vets to use private care when they live more than 40 miles from a VA facility or have to wait more than 30 days for an appointment. "It's filled with too much bureaucracy. Our veterans don't understand it," Shulkin said.
"The FY 2018 budget includes $82.1 billion in discretionary funding, largely for health care, and $104.3 billion in mandatory funding for benefit programs, such as disability compensation and pensions, and for continuation of the Veterans Choice Program," the VA said in its statement on the budget.
The proposed budget included $13.2 billion for community care; $8.8 billion for long-term care; $8.4 billion for mental health care; $1.7 billion for programs for homeless and at-risk veterans; $751 million for Hepatitis-C treatment; $604 million for Caregivers' benefits; and $316 million for treatment of traumatic brain injuries, the VA said.
On other issues, Shulkin praised moves in the House and Senate to give him more authority to fire and discipline poorly performing and incompetent employees and managers. "We have too many employees that, frankly, have taken veterans for granted," he said.
He offered no immediate solution to the complaints of several Committee members about the antiquated and inefficient information technology systems still in use at the VA. Shulkin said he was looking to install an entirely new off-the-shelf IT system and would make a decision by July. 1.
Shulkin also made another pitch to get rid of vacant or underused VA facilities to free up funds for veterans care. "We need to dispose of property that we can't use to support veterans," he said.
-- Richard Sisk can be reached at Richard.Sisk@Military.com.