Two House Committees May 8 held markups and advanced legislation on Department of Veterans Affairs (VA) issues. The House VA Committee convened to markup various legislation including the community care proposal, while the House Appropriations Committee marked up the fiscal year (FY) 2019 Military Construction, VA, and Related Agencies (MilCon-VA) spending bill.
The House VA Committee’s markup of 16 pieces of legislation included H.R. 5674, the VA Maintaining Internal Systems and Strengthening Integrated Outside Networks (MISSION) Act of 2018. The bill was introduced May 3 by Chairman Phil Roe, MD, (R-Tenn.) and would revise the existing Veterans Choice Program, including various scholarship, loan repayment, and graduate medical education (GME) pilot program provisions [see Washington Highlights, May 4]. The bill was reported favorably out of committee by a vote of 20-2 and will go to the full House for a vote.
The House Appropriations Committee met to markup the FY 2019 MilCon-VA budget bill, following passage out of the MilCon-VA Subcommittee [see Washington Highlights, April 27]. The bill provides $83.5 billion for the VA in FY 2019, matching the total of the President’s budget request and equating to a 4.8 percent increase over FY 2018. For VA Medical and Prosthetic Research, the bill includes $732 million for FY 2019, a $10 million (1.4 percent increase) over the enacted FY 2018 level and $5 million more than the president’s FY 2019 budget request.
The committee rejected the president’s request to merge the VA Medical Services and Community Care accounts, and provides $14.4 billion for FY 2020 Medical Community Care advanced appropriations. This is a 0.85 percent decrease compared to the FY 2019 enacted advanced appropriation. The bill also includes an additional $500 million in the Medical Community Care for FY 2019 to support the existing Veterans Choice Program. The MilCon-VA budget bill was approved with a 47-0 vote.
The Senate MilCon-VA Appropriations Subcommittee held a May 9 budget justification hearing on the VA’s FY 2019 budget request, featuring four witnesses from the VA. Ranking Member Brian Schatz (D-Hawaii) and Senator Patty Murray (D-Wash.) both expressed concern over the President’s proposal to merge the Medical Services and Community Care accounts. Sen. Shelley Moore Capito (R-W.Va.) asked the panel what VA is doing to identify treatment options other than opioids.
Carolyn Clancy, MD, Executive in Charge of the Veterans Health Administration, said the VA is looking into methods including yoga and acupuncture, as well as tracking alternative treatment outcomes. Sens. Tom Udall (D-N.M.) and Jon Tester (D-Mont.) both asked what the VA is doing to address the physician workforce shortage. Dr. Clancy noted that VA is hoping to increase relocation, recruitment, and retention incentives.
Congress continues to push to finalize their work on the Community Care reform bills to revamp the VA Choice program, with a goal of passing new legislation by Memorial Day.