House, Senate Negotiators Reach Deal To Address VA Wait Times

Over the weekend, House and Senate negotiators reached a deal on legislation to address long wait times for care at Veterans Affairs health centers, the Washington Post's "Post Politics" reports.

Rep. Jeff Miller (R-Fla.) and Sen. Bernie Sanders (I-Vt.), who each chair their chamber's respective committees on veterans' affairs, worked on the deal over the weekend and made "significant progress," according to congressional aides (O'Keefe, "Post Politics," Washington Post, 7/27). Miller and Sanders will outline the compromise bill during a news conference on Monday afternoon (Cooney, Reuters, 7/27).

House and Senate negotiators last month began working 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 VA health centers, which likely led to numerous deaths of patients. Both the House and Senate passed similar bills (S 2450, HR 4810) intended to address the allegations.

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 (California Healthline, 7/22).

News of the deal comes after prior negotiations stalled on the effort because of differences between the House and Senate on the total cost of a bill and how to fund it (Oppel, New York Times, 7/27).

Agreement Details

Aides noted that the bill addresses VA's short-term and long-term needs (Mascaro, "Nation Now," Los Angeles Times, 7/27). They added that both sides made compromises to reach the deal, which also considers requests from acting VA Secretary Sloan Gibson (Kesling, Wall Street Journal, 7/27).

According to a draft summary of the deal, the legislation would likely allow veterans facing long wait times or distances to seek private health care outside of the VA health system. The bill would give a "Veterans Choice Card" to those enrolled in the VA health system by Aug. 1 and those who enroll within five years of ending their military service in Afghanistan or Iraq. The card would allow veterans to seek care at private facilities if they are not able to receive an appointment at a VA health center within 14 days or if they live more than 40 miles from a VA center.

In addition, the compromise bill likely would:

• Prohibit wait-time metrics from being tied to employee incentives;
• Allow VA to provide counseling and other services to veterans who experienced sexual trauma during their time of service;
• Require VA to conduct regular assessments of care and staffing levels ("Post Politics," Washington Post, 7/27);
• Provide funding for VA to upgrade its appointment scheduling system (New York Times, 7/27); and
• Allow the VA Secretary more power to fire or demote employees based on their performance.

According to Roll Call's "#WGDB," the compromise measure includes a total of $15 billion in emergency spending, including $5 billion for hiring additional providers and improving VA facilities and $10 billion for the private care option. Costs are capped at $15 billion, but there is no time limit within which the funding must be used (Lesniewski/O'Brien, "#WGDB," Roll Call, 7/27).

Next Steps

According to legislative aides, the new deal will be circulated among lawmakers on Monday before Miller and Sanders formally announce the compromise ("Post Politics," Washington Post, 7/27). Legislators will have about five working days to recommend changes to the deal and approve the agreement before Congress recesses for the summer (Hicks, "Federal Eye," Washington Post, 7/28).

The deal must be approved by a conference committee before it is sent to the full House and Senate for consideration (New York Times, 7/27). Last week, Miller said he hoped Congress could approve legislation on the issue and send it to President Obama by Aug. 1 (French, Politico, 7/27).