WASHINGTON —— Lawmakers appear ready to ensure that the Department of Veterans Affairs has access to the money it needs to prevent a shutdown of its hospitals this August, but there will probably be strings attached.

WASHINGTON —— Lawmakers appear ready to ensure that the Department of Veterans Affairs has access to the money it needs to prevent a shutdown of its hospitals this August, but there will probably be strings attached.

Before the House and Senate leave for a monthlong August recess, they will have to act to patch a $2.5 billion gap in the agency’s budget, the result of more demand than expected for health services and a lack of flexibility to shift money within the budget, VA officials say.

To cover the gap, VA Secretary Robert McDonald has asked Congress to allow the agency to divert $3 billion from the Choice Program, an emergency fund set up after of last year’s waiting-time scandal, to subsidize non-VA care for veterans and help reduce the time it takes to get medical appointments. It is not the preferred method of funding for Rep. Jeff Miller, R-Fla., chairman of the House Veterans’ Affairs Committee, but he said last week that he was inclined to grant VA’s request, albeit reluctantly.

"I don’t see any other way at this point, and given the information that VA has finally provided us, I don’t know if there is anywhere else to get the money that’s necessary," said Miller, who pointed out Choice Program funds were already appropriated.

Without funding, McDonald warned at a House Veterans’ Affairs hearing on July 22 that hospital services would shut down in August.

The VA is forecasting a $2.5 billion shortfall for the current fiscal year because of increased demand for Care in the Community programs, which permit veterans to obtain medical care outside the VA-run system. The programs are separate from the Choice Program, which was authorized for three years and funded through $10 billion in emergency appropriations that roll over into the next fiscal year if not spent.

VA officials have also pointed to the rising cost of treating hepatitis C, an estimated $1.1 billion this year. In a letter to lawmakers, McDonald said the timing of approval for new hepatitis C treatments by the Food and Drug Administration didn’t allow the VA to budget for the drugs in the current year. As a result, the VA had to shift $697 million to cover the cost of drugs used to treat the condition. Some of the proposed $3 billion would go toward hepatitis C treatments, but would be capped at $500 million under draft legislation submitted to Congress by McDonald.

On Friday, Miller filed legislation that would permit the VA to transfer $3.4 billion in Choice funds for hospital and medical care, including up to $500 million for hepatitis C treatment, through the end of the fiscal year on Oct. 1. It would require the VA to report to Congress every two weeks on how much of the money it has spent.

But the quick-fix legislation will include strings, something Miller indicated he would push for in a budget deal.

"We’re convinced that something has to be done, and within the fix there has to be some things that work to the advantage of the veterans other than the money," Miller said.

To that end, Miller’s legislation also requires the VA to come up with a plan to consolidate all non-VA care programs into a single program, called simply the "Veterans Choice Program," by Nov. 1, and would require that the president’s future budget requests for VA contain an appropriations account for non-VA medical and hospital care programs.

The bill also includes the text of the so-called Hire More Heroes Act. The measure, which was highly touted by House and Senate Republicans, would exempt individuals enrolled in Tricare or VA health care from counting toward the total number of employees that would trigger the employer health care mandate under the 2010 health care overhaul.

Omitted from Miller’s draft legislation is a requirement that the Choice Program be made permanent, an idea he had floated in return for the VA being allowed to raid the fund. Miller, along with many other Republicans who have doubts about the VA’s capacity to deliver quality and timely health care, has advocated allowing the Choice Program to continue past its current authorization permanent.


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