Tax reform fight complicates committee vote on VA Choice overhaul
By NIKKI WENTLING | STARS AND STRIPES Published: December 19, 2017
WASHINGTON — The fight over tax reform muddied debate Tuesday on legislation that would significantly change the system that veterans use to receive private-sector health care.
After an hourlong argument that focused mostly on the GOP tax bill, the House Committee on Veterans’ Affairs approved legislation to end the Veterans Choice Program and implement new rules about when and where veterans can seek medical treatment from private facilities. The 14-9 committee vote was along party lines, with every Democrat opposing the bill. It now goes to the full House.
Throughout the year, members of the House VA committee have been cordial with one another usually, having successfully negotiated several large bipartisan bills. However, the discussion Tuesday was uncommonly strained.
“There’s a lot of rhetoric about this being a bipartisan committee,” said Rep. Bruce Poliquin, R-Maine. “I thought we were supposed to be talking about health care for our veterans, but the ranking member and other folks are bringing the tax cut into this issue.”
Democrats argued the issues were connected. They cited concerns about the government having the ability to fund an overhaul of VA community care programs in the long-term if cuts created by the Tax Cuts and Jobs Act were implemented.
The Joint Committee on Taxation, Congress’s official scorekeeper, estimated the tax reform bill would cost about $1.5 trillion for 10 years. Estimates by the Tax Foundation, a Washington think tank, showed it would add $448 billion to the national deficit.
“We are not ripping into the tax bill because ideologically we are opposed to it. We think it ties directly into this,” said Rep. Tim Walz, D-Minn., the ranking Democrat on the committee.
Rep. Phil Roe, R-Tenn., the chairman of the committee, responded: “We have always provided for our veterans. We always found those funds.”
The Congressional Budget Office estimated the bill, H.R. 4242, would total approximately $39 billion for five years.
The bill would do away with a controversial rule that allows veterans to seek private-sector care only if they can’t get an appointment within 30 days or if they live more than 40 miles driving distance from a Department of Veterans Affairs facility. Instead, the legislation leaves the decision to veterans and their VA doctors.
In November, the Senate Veterans’ Affairs Committee approved its own version, estimated at $54 billion for 10 years. Besides reforming community care programs, the bill includes several unrelated measures, such as a provision popular among veterans organizations to expand VA caregiver benefits to veterans injured before 9/11. It’s uncertain when the legislation will be scheduled for a vote on the Senate floor.
Walz on Tuesday introduced a substitute to the House bill that closely mirrored the Senate’s version, but Republicans struck it down, saying it veered too far from the intent to reform community care programs.
Roe said he was disappointed after every Democrat on the committee voted against H.R. 4242. The legislation had been negotiated between parties since March, and all committee members are listed as cosponsors on the bill. Democrats said they signed on as cosponsors months ago, before the Congressional Budget Office had provided a cost estimate for it.
VA Secretary David Shulkin has urged Congress for months to pass reform legislation. Shulkin has yet to support any one bill, but has asked lawmakers to choose an option and move forward quickly.
During the past year, disagreements over how to reform the program have focused on costs, concerns from Democrats over privatization and fears from Republicans about veterans remaining trapped inside the VA system.
But all lawmakers agree the Choice program needs to be overhauled. As is, its funding is unpredictable. It nearly ran out of money in mid-August before Congress passed an emergency funding bill to keep it going. Four months later, it’s in the same situation again.
Shulkin told Congress last week veterans’ health care would be severely affected if more money wasn’t approved by the end of the year. Congress is expected to leave Friday for holiday recess and as of Tuesday hadn’t yet funded the program.
Shulkin warned a lack of funding would immediately lead to “decreased access to care, damaged community partnerships and interrupted care continuity for veterans.”