WASHINGTON -- U.S. military veterans would have easier access to medical care under a rare bipartisan agreement passed Wednesday by the House and set for final Senate passage by the end of the week.
The $16.3 billion measure is intended to help the Department of Veterans Affairs cut long waits for health care, hire more doctors and nurses to treat veterans, and make it easier to fire senior executives at the VA.
The 420-5 vote sends the bill to the Senate, where approval is expected today.
The measure calls for $10 billion in emergency spending to help veterans who can't get prompt appointments with VA doctors to obtain outside care; $5 billion to hire doctors, nurses and other medical staff; and about $1.3 billion to lease 27 new clinics across the country.
Rep. Rick Crawford of Arkansas was one of the five Republicans who voted against the measure.
In a statement, the former Army bomb-disposal technician said the VA already had the money and authority it needed to fix its problems with wait times and care.
"Unfortunately, these shortcomings can't be addressed with money alone," he said. "Sadly, Congress has a history of throwing money at problems and calling them 'solved.'"
Instead, the VA should have to more effectively use its money and ask Congress for more money as needed, he said.
The measure would require the VA to pay private doctors to treat qualifying veterans who can't get prompt appointments at the VA's nearly 1,000 hospitals and outpatient clinics, or those who live at least 40 miles from one of them.
As a cost-saving measure, only veterans who are enrolled in VA care as of Friday or live at least 40 miles away would be eligible to get outside care. Congressional budget analysts projected that tens of thousands of veterans who are not treated by the VA would likely seek VA care if they could see a private doctor paid for by the government.
Congressional budget analysts estimated that as it is now, the bill would cost about $16.3 billion over three years, slightly less than a $17 billion estimate provided by the bill's sponsors.
Still, the bill is expected to add $10 billion to the federal deficit over 10 years after cost-savings such as changes in a veterans retirement program and reimbursements by insurance companies are included, the nonpartisan Congressional Budget Office said.
Also, increased payments in the deal could triple health-care providers' revenue from the VA in the next year, according to a Bloomberg analysis.
Rep. Jeff Miller, R-Fla., chairman of the House Veterans' Affairs Committee, said the bill was urgently needed in the wake of what he called "the biggest scandal in the history of the Department of Veterans Affairs."
While the bill's cost is steep, it is needed to ensure that veterans receive proper care, he said.
Crawford also noted that the vote restored hundreds of millions of dollars in bonuses that the House had voted to strip last month.
"Now [it's] inexplicably placed back in," Crawford said. "Congress can, and should, do better."
The bill restricts funding for annual bonuses for VA employees to $360 million, $40 million less than last year.
Arkansas' three other House members, all Republicans, called the bill a good first step.
"We must remain vigilant and work to ensure this agency is worthy of the sacrifice and dedication of our veterans," Rep. Tom Cotton, a former Army captain, said in a statement.
Reps. Steve Womack, a former Army National Guard colonel, and Tim Griffin, a lieutenant colonel in the Army Reserve, both said they planned to continue working to fix the problems at the VA to ensure proper care for veterans.
The other representatives who voted against the bill Wednesday were Republicans Walter Jones of North Carolina, Jack Kingston of Georgia, Mark Sanford of South Carolina and Steve Stockman of Texas.
House Speaker John Boehner, R-Ohio, said the majority of Republicans supported the measure to ensure veterans will have access to private care. The show of bipartisanship in Congress is so unusual that Boehner described Miller, who negotiated the deal, as a hero.
Senate Majority Leader Harry Reid, D-Nev., has said he's optimistic his chamber can pass legislation before lawmakers leave Washington for a five-week break at week's end. President Barack Obama's administration also welcomed the deal, White House press secretary Josh Earnest said.
Former VA Secretary Eric Shinseki resigned in May after an inspector general report showed widespread mismanagement, including the keeping of phony lists to hide the long waits veterans faced for medical appointments. At least 35 veterans died while awaiting care in Phoenix, acting VA Secretary Sloan Gibson has said.
The House vote came one day after the Senate confirmed former Procter & Gamble Chief Executive Officer Robert McDonald to lead the agency, which provides health care to nearly 9 million enrolled veterans and disability compensation to nearly 4 million veterans.
McDonald, who was sworn in Wednesday, has pledged to transform the VA and said "systematic failures" must be addressed. He said improving patient access to health care was a top priority, along with restoring transparency, accountability and integrity to the VA.
The VA, with a $160 billion budget, runs the nation's largest integrated health care system. An internal audit in June showed that more than 120,000 veterans hadn't received a medical appointment or were waiting more than 90 days for care. That number was reduced to about 42,400 by July 1, VA data show.
"No veteran should be forced to wait for the health care or benefits they have earned," said House Minority Leader Nancy Pelosi, D-Calif., adding that the bill "will help us serve our veterans as well as they have served us."
But Rep. Steny Hoyer of Maryland, the second-ranking Democrat in the House, said he was concerned about a provision in the bill that makes it easier to fire senior executives who are judged to be negligent or underperforming. Fired employees would have seven days to appeal, with a decision by an administrative judge due in 21 days.
Hoyer, whose suburban Washington district includes thousands of government workers, said the bill "undermines civil service protections that have been in place for decades."
Existing protections "strike the right balance between giving agencies the authority to remove personnel without trampling on the due process rights of employees that they need to do their job without fear of political reprisal or arbitrary removal," Hoyer said.
The VA said this week that it wants to fire two supervisors accused of manipulating health care data in Colorado and Wyoming. Four other employees face suspension, demotion or admonishment.
One of the six is Ralph Gigliotti, who oversees VA health care facilities in all or parts of nine states in the Rocky Mountain region. Another is Cynthia McCormack, director of the Cheyenne, Wyo., Medical Center.
The VA did not say whether Gigliotti and McCormack were the supervisors facing dismissal. Neither immediately returned a phone call Wednesday.
The names of the other four employees were not released, but the VA said they worked at the Cheyenne facility or at a clinic in Fort Collins, Colo., which the Cheyenne hospital oversees.
An audit of the Cheyenne hospital released in June found that the average wait time for new patients seeking a primary care doctor was more than 32 days -- more than twice the limit the VA had set as a goal. The VA said at the time that the hospital would be reviewed further.
The U.S. Office of Special Counsel, an independent investigating agency, said whistle-blowers provided information that led to the VA's proposed discipline.
Carolyn Lerner, who leads the office, released a statement calling the VA's action encouraging and praising the whistle-blowers.
"These issues would not have come to light if not for the whistleblowers' courageous actions," she said.
Information for this article was contributed by Michael C. Bender of Bloomberg News; by Matthew Daly, Dan Elliott and staff members of The Associated Press; and by Sarah D. Wire of the Arkansas Democrat-Gazette.
A Section on 07/31/2014
Print Headline: Veterans care fix clears U.S. House in 420-5 vote