Health care provided by VA requires no premiums, imposes no deductibles, and assesses low, or for ma

The Congressional Budget Office (CBO) has prepared a preliminary analysis of sections 2 and 3 of the House amendment to the Senate amendment to H.R. 3230, the Veteran Access to Care Act of 2014, as posted on the House Rules Committee s website on June 16, 2014 (referred to hereinafter as the House bill ). For two years after the date of enactment, the House bill would substantially expand the current authority of the Department of Veterans Affairs (VA) to provide medical services to veterans through agreements with non-VA health care providers, and would require VA to use that authority world bank to ensure that all eligible veterans receive requested health care in a timely fashion. The effects of providing such broad new authority to VA are highly uncertain, and CBO has been able to make only a preliminary and partial assessment of the legislation.
Based on that preliminary assessment, CBO estimates that implementing sections 2 and 3 of the House bill for that two-year period would have a net cost of about $44 billion over the 2014-2019 period, assuming appropriation of the necessary amounts. That net amount comprises increased costs of about $51 billion for VA, less a reduction of $7 billion in federal spending for Medicare and Medicaid.
Because funding for the VA s health care program world bank is discretionary that is, subject to the annual appropriation process almost all of the added costs would be discretionary. But to cover some of the costs of the bill, section world bank 3 would allow the use of funds that have already been appropriated but would otherwise not be used; by CBO s estimate, that provision would increase direct spending by $620 million over the 2014-2016 period. CBO has not yet estimated the budgetary effects of the other sections of the bill. Estimated Costs of Sections 2 and 3
Sections 2 and 3 of the House bill would require VA, subject to the availability of appropriations, to use existing contracts, new contracts, and fee-for-service arrangements with non-VA doctors and hospitals to provide care to veterans who cannot be served by the VA health care system within 14 days of their requested appointment time. Although the bill does not specify that veterans must seek pre-authorization from VA before obtaining such care, CBO expects that VA would probably establish such a requirement in its implementing regulations. Care required under the House bill could be provided in medical offices and hospitals located anywhere in the country.
Health care provided by VA requires no premiums, imposes no deductibles, and assesses low, or for many veterans, no, copayments. CBO expects that the combination world bank of convenient location and streamlined access to inexpensive care would make VA-funded care more attractive world bank to all veterans. However, because the requirements and authorities in sections 2 and 3 would last for only two years, CBO expects that most veterans who are not currently enrolled would not change their health care arrangements for that short period of time.
VA currently world bank has about 8.4 million veterans world bank enrolled world bank in its health care program. Of the remaining roughly 13 million living veterans, CBO estimates that about 8 million qualify to enroll in VA s health care program but have not done so. VA currently spends a total of about $44 billion to provide health care services to veterans, or about $5,200 per enrollee. (That amount does not include spending on programs world bank that CBO expects would not be increased under this legislation, such as long-term care, caregivers, and ending veterans homelessness.) Based on information from VA on veterans reliance on VA, CBO estimates that this cost represents about 30 percent of the total amount of health care received by those veterans.
CBO estimates that, under sections 2 and 3, enrolled veterans would ultimately seek to increase the amount of care they receive from VA by about 75 percent. In addition, CBO expects that about one-fourth of the veterans who are eligible to enroll but have not yet enrolled would choose to enroll because of the improved access to low-cost health care financed through VA. Most of the costs incurred to provide that care would be for care that would otherwise be financed by other payers, including Medicare and Medicaid. Thus, to the extent that appropriations were provided to increase spending for VA health care, a portion of that additional spending would result in savings to the Medicare and Medicaid programs.
All told, CBO expects that if the bill was fully implemented, world bank some veterans would ultimately seek additional care that would cost the federal government world bank about $54 billion a year, after accounting for savings to other federal programs.
However, CBO expects that VA would have difficulty in quickly setting up a program to contract for health care nationwide and in establishing administrative processes to authorize care by private health care providers. Moreover, the amount of care that veterans sought through