Senators Express Dismay Over VA’s Sudden Budget Shortfall

A group of senators has expressed disappointment and confusion with the Veterans Affairs Department for its lack of clarity on the budget for one of its key programs. VA said it had plenty of money to carry the program into the next fiscal year just weeks before requesting an emergency infusion of cash.

The department has put Congress in “yet another precarious situation of the VA’s own making,” Sens. John McCain, R-Ariz.; Jerry Moran, R-Kan.; Thom Tillis, R-N.C.; and Dean Heller, R-Nev., wrote in a letter to Secretary David Shulkin on Wednesday. Shulkin had told Congress the Veterans Choice Program had $1.1 billion left from the original $10 billion total Congress authorized in 2014, which he said would last into fiscal 2018. The Choice Program was scheduled to sunset in August, but President Trump in April signed a bill to eliminate that end date.

Shulkin has since gone back to Congress to inform it more veterans had signed up for Choice to receive health care outside VA facilities than the department had anticipated, leaving the program short on funding. The secretary has asked lawmakers for supplemental funding -- through reprogramming authority -- so the program does not run out of money before October.

VA is asking for a “bail out to address the fiscal year 2017 shortfall or the VA will remove access to care for veterans under the Veterans Choice Program,” the senators wrote in their letter. They demanded a “detailed and thorough explanation” of what VA will need in fiscal 2017 as well as “how VA will keep the Veterans Choice Program up and running into fiscal year 2018.” They faulted the department for already “hastily and carelessly” deciding to cut off certain services. 

The senators derided VA for demonstrating it cannot “accurately forecast the cost of care,” and requested details on how the department is improving its budgeting processes. They asked whether VA has sufficient funding in other accounts it can transfer for support of Choice, or if it instead needs an emergency spending surge.

At a hearing last week, Shulkin conceded their budgeting for the program was "not a science."

"It's an art," the secretary said, "and we're having difficulty with that once again." 

A spokesman for the department said it had received the senators' letter and "will respond directly to them." 

The Choice Program allows veterans more than 40 miles from a VA facility, who require services unavailable at a VA facility or who faced a wait of more than 30 days, to receive private care. Proponents of increased choice for veterans have complained of low usage rates and a recent Government Accountability Office report found a sample of those who did use the program still faced an average of 24-day waits to have their requests for private care referrals approved and an additional 14 days to receive an appointment.

The bill that extended the program aimed to more quickly reimburse private sector providers and share medical records with them.