Republican lawmakers are concerned about the Department of Veterans Affairs' ballooning budget and question the agency's need for yet another huge funding boost, given it has already received $36 billion in pandemic supplements.
The VA is the second-largest federal agency and a complex organization. Its budget has expanded significantly since 9/11. In 2000, the agency's budget was $47 billion; this year, it is $240 billion. With that funding, it provides health care to nine million patients, administers the GI Bill, and facilitates a popular home loan program for veterans.
Between 2020 and 2021, the department's budget jumped 12%, soaring past any other federal agency's rate of growth, including the Defense Department.
Most of the spending can be attributed to an aging population of veterans from 20th-century wars, on top of an influx of a new generation of post-9/11 veterans.
In an interview with Military.com, Rep. Mike Bost, R-Ill., the top Republican on the House Veterans Affairs Committee, acknowledged the difficult balance of paying off America's war tab and providing veteran care, while also holding the VA accountable and making sure every dollar is tracked.
"We gave them a blank check," Bost said about the pandemic relief money. "That's not the best way to handle taxpayer dollars. None of it has oversight."
The 2021 American Rescue Plan Act and the 2020 Coronavirus Aid, Relief, and Economic Security Act, or Cares, Act injected trillions of dollars of coronavirus relief into the economy. The VA got $17 billion and $19.6 billion out of those packages, respectively. Both supplements were intended to help the department with unexpected costs, such as treating long-term health impacts on veterans diagnosed with COVID-19; vaccination efforts; and tackling homelessness and suicide issues in the veteran community that may have been worsened by the pandemic.
The VA has spent 75% of the money from the Cares Act, according to a department spokesperson, who added that it hasn't spent much of the American Rescue Plan cash and plans to use most of it next year.
On top of that huge influx of cash, the Biden administration is asking for an additional $8.5 billion to fund the department, an 8.2% boost. The VA's annual budget is expected to hit around $250 billion, the largest in its history.
Lobbying against any major veteran initiative can be a political minefield because no politician wants to be painted as unsupportive of the troops.
With Biden's request for a surge in VA spending, Bost says it's important to make sure Congress is "getting the most bang for its buck." The White House released its so-called "skinny budget" in April, which outlined broad priorities and funding requests for each department. The more detailed budget is set to be released Friday.
"We're going to go through it line by line with a fine-tooth comb," Bost said. "They've never had this much money."
Bost, along with every other GOP member of the House VA committee, penned a letter to the House Budget Committee earlier this month, highlighting concerns with the VA's budget. They expressed worry over the current rate of funding boosts, which could double the budget by 2030, reaching nearly $500 billion, they said. This rapid increase in spending comes despite only a marginal increase in VA patients.
"The Administration's request begs the question: At what point does VA become adequately funded?" the lawmakers said in their letter. "We believe some level of continued annual increases, above general inflation, would be warranted as long as they were supported by demand and demonstrated as necessary to continue this improvement trend. However, the Administration appears to be operating on a wholly different set of assumptions."
Significant boosts to the VA budget were arguably a key part of former President Donald Trump's legacy. While Trump and congressional Republican gutted the budgets of most federal agencies, the VA saw more than $40 billion in extra funding. During his administration, the VA also dramatically expanded private-sector care through the Mission Act, the long-term costs of which are expected to be enormous.
While Democrats concede the volume of VA patients has risen only moderately, those patients are using the department for the bulk of their care.
"My Republican colleagues regularly argue VA's budget has soared to new heights in recent years, noting both mandatory and discretionary outlays have nearly tripled during this time while the number of veterans using VA benefits and services have 'increased only modestly,'" Rep. Mark Takano, D-Calif., the chair of the House VA committee, said at a hearing Thursday.
He said the GOP's points are accurate "but lack important context," explaining that the VA needs more cash to keep up with its aging infrastructure.
"This view fails to take into account that veterans using the system are utilizing it for more of their care," Takano said. "VA is sitting on $23 billion worth of facility condition deficiencies across its portfolio alone; that is the maintenance backlog. This figure has doubled in 10 years. Clearly, VA's non-recurring maintenance budget is insufficient. Congress, and many others, bear the blame for this funding gap."
The elephant in the room on VA's budget is toxic exposure -- namely, the estimated 3.5 million veterans exposed to burn pits since Operation Desert Storm. Both the House and Senate VA committees are working on toxic exposure packages covering a vast roster of illnesses and are aiming for a floor vote by this fall.
"The long-term trajectory and cost of benefits obligations demand better planning and budgeting," the Republicans wrote in the letter. "We also prioritize expanding access to VA care and benefits for veterans who have experienced toxic exposures during their service."
The House and Senate still need to pass their separate bills, then come together to work out the differences in a final version for President Joe Biden to sign. It's unclear what that compromise bill would look like, but there has been a huge push for presumptive care. That would mean a veteran with a covered condition would not have to prove it's linked to burn pit exposure.
Regardless, the final product is expected to be expensive. A preliminary estimate from the Congressional Budget Office says presumptive care will cost at least $100 billion over a decade, according to the GOP letter. However, that is an unofficial and early projection.
"We are determined to work with the department and veterans service organizations to identify an appropriate offset to ensure that toxic-exposed veterans receive the care and benefits they have earned," the Republican lawmakers added.
-- Steve Beynon can be reached at Steve.Beynon@military.com. Follow him on Twitter @StevenBeynon.