Congress Working To Develop Unified VA Health Care Bill

On Tuesday, House and Senate negotiators began work on a unified bill that would increase and improve veterans' access to health care following revelations that many veterans had faced long wait times at various Veterans Affairs health centers, which likely led to numerous deaths of patients, AP/ABC News reports.

Background on House, Senate Bills

The two chambers approved separate but similar bills (S 2450, HR 4810) to address the issues earlier this month.

Both bills would:

• Allow millions of veterans to seek health care outside of the VA health system;
• Authorize VA to lease new facilities;
• Broaden the VA secretary's power to fire or demote senior VA officials; and
• Create restrictions on VA employee bonuses.

Legislative aides say House and Senate lawmakers are hoping to pass a compromise bill by the end of July. However, House Veterans Affairs Committee Chair Jeff Miller (R-Fla.) has declined to set a deadline on the conference efforts.

Cost Could Delay Progress

On Tuesday, Miller noted that the House Republicans want to pass legislation that is funded by existing resources. He said that it might be necessary to "go outside the VA to look for offsets" for the final measure. The Congressional Budget Office has estimated that the Senate bill would cost $35 billion over three years, while the House bill would cost $44 billion over six years.

However, some GOP lawmakers have expressed doubt over the estimates, saying that CBO did not account for various cost saving provisions (Espo, AP/ABC News, 6/24).

Sen. Richard Burr (R-N.C.) said, "It is impossible for us to even start an intelligent conversation on what we put in legislation when we have numbers that are so grotesquely out of line."

Other lawmakers, like Rep. Doug Lamborn (R-Colo.), have argued that VA needs to enforce strong accountability to address cultural issues across the department. Lamborn said, "We can't just fix the problem by simply throwing more money on it" (Klimas, Washington Times, 6/24).

Coburn Issues Report Suggesting 'Pervasive Misconduct' in VA

Meanwhile on Tuesday, Sen. Tom Coburn (R-Okla.) released a report indicating that more than 1,000 veterans might have died and about $845 million in medical malpractice claims has been paid out to veterans and their families as a direct result of improper practices at VA health centers, CQ Roll Call reports (Scully, CQ Roll Call, 6/24).

The report from Coburn, who is the ranking member of the Senate Homeland Security and Governmental Affairs Committee, is the result of an investigation that the lawmaker launched more than one year ago, according to Politico.

According to the report, the deaths stemmed from:

• VA health care providers prescribing unnecessary and unregulated pain medications;
• Delayed treatment leading to undetected cancers; and
• Patients waiting months for medical procedures.

The report states that the deaths resulted in "$200 million in wrongful death settlements," of which "the median payment per victim was $150,000." It also notes that long appointment wait times could exist because VA physicians see fewer patients than those in the private sector. For example, the average primary care physician works on around 2,300 cases annually, while VA physicians work on about 1,200 cases (French, Politico, 6/24).

In addition to falsified wait time records and delayed care, Coburn's report suggests that misconduct such as abuse and neglect, sexual harassment, bullying and other inappropriate behaviors are prevalent across VA health centers.

The report suggests that the Senate increase its oversight of VA to focus more attention on health care outcomes, instead of working to expand a "broken system that has long lacked accountability and failed thousands of veterans."

In addition, Coburn has called on Congress to consider the report while lawmakers work on the compromise legislation to address the issues. He said, "Whatever bill Congress passes cannot ignore the findings of this report. While it is good that Congress feels a sense of urgency we are at this point because Congress has ignored or glossed over too many similar warnings in the past" (CQ Roll Call, 6/24).