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Plans For Vet Care Disappointing

Cox News Service
February 15, 2005

WACO, Texas - If proposed federal Department of Veterans Affairs budgets fail to make you happy, then you may not jump for joy over the 2006 version.

Plans to double prescription co-payments and impose enrollment fees for certain veterans are back again as part of the new budget submitted by President Bush. And while the budget calls for $33.4 billion in discretionary funding that is mostly for health care, it also proposes slashing millions for nursing home care needed by an aging veterans population.

These total discretionary funds proposed are an increase of 2.7 percent more than this year's levels, according to the VA. The department also points out that with this plan the VA will have increased veterans medical funding by 47 percent since Bush took office in 2001.

But veterans advocates say the VA health-care budget is habitually under-funded and that what they see as a miserly increase would be paid for out of the veterans' pocket.

"This budget proposal is bad news for the nation's veterans, made even more distressing in light of the war in Iraq and military operations in Afghanistan and elsewhere," said James E. Sursely, the national Disabled American Veterans commander, in a news release.

Former military members who have no service-connected illness or injury and whose incomes are above a certain threshold would pay a $250 enrollment fee annually for VA health care. Prescription co-payments for a 30-day supply of medicine would increase from $7 to $15 for those veterans.

Affected would be those folks who are sometimes portrayed as "wealthy" veterans. But that is far from the stuff of champagne wishes and caviar dreams.

Area-specific income levels determining federal housing program eligibility are what the VA uses to determine who pays a co-payment for drugs. Where I live, this is $26,200 for a single person and $37,450 for a family of four. Such income levels are may be useful in deciding who gets what federal dollars. But people with such incomes are hardly rolling in dough.

"It's not a lot of money to live on. But it is a cutoff for a lot of programs," said Michael Morris, an economics professor at the University of New Orleans.

VA officials say the hike in prescription co-payments and the user fees from higher-income veterans would help treat 100,000 more patients under the 2006 budget than in the current fiscal year.

"We expect those two revenue proposals - user fee and increased co-pay for outpatient prescriptions _ will generate $424 million which we will plow back into the medical-care program to extend the reach of our health-care services to more veterans in the high-priority categories: service-connected veterans and veterans of modest means," said Terry Jemison, a VA spokesman at the department's Washington headquarters, in a reply by e-mail to questions I posed.

Jemison emphasized that these proposals only pertain to the two lowest of the eight priority groups the VA uses in apportioning health care to veterans.

Such proposals to help fund VA health care have been tried before, only to fail in Congress. But it is a new budget and a new day in Washington, so your guess is as good - or probably better - than mine as to what funding for veterans programs will ultimately look like.

Susan Edgerton says that perhaps more alarming than the fee and co-payment plans are the proposed cuts in nursing home care for veterans. Edgerton is staff director for the Democratic side of the House Veterans Affairs Health Subcommittee.

Funding for such programs under the Bush budget would be cut by $351 million. Budget figures indicate 28,851 fewer patients would be treated in VA-operated nursing homes, in private facilities that contract with the VA, and in those operated by states that the VA helps fund.

"They are cutting on nursing-home beds already at a peak for the World War II generation and the Korea and Vietnam veterans will soon appear," Edgerton told me recently.

Those cuts could particularly be troublesome for the program in which the VA can provide up to 65 percent of funding to build state nursing homes for veterans.

"I think it means closure at a lot of state homes," Edgerton said.

The new chairman of the House Veterans Affairs Committee has said that he wants to see the VA return to its "core constituency" of caring for disabled and indigent veterans. But an aide to the chairman, Republican Steve Buyer, of Indiana, did not offer any insight into his thoughts on the budget.

"Over the next few weeks the whole committee will be going over testimony to see if the needs of veterans coming home today and in the past are met," Laura Zuckerman, a committee spokeswoman, told me.

The tentative 2006 VA budget also would provide $750 million for the program realigning VA medical care known as CARES, for Capital Asset Realignment for Enhanced Services.

Under the 2006 budget for CARES, 28 new outpatient clinics are proposed as well as funding for design work for two new medical facilities in Biloxi, Miss., and Fayetteville, Ark. The total investment into the program to date is $2.5 billion, according to the VA, and the new dollars also would help fund five other major construction projects in Las Vegas, Cleveland, Pittsburgh, Gainesville, Fla., and Anchorage, Alaska.

Health care for veterans seems to be wracked with uncertainty each year. But Rep. Lane Evans, the ranking Democrat on the House veterans committee, is among some congressional and veterans leaders who say such uncertainty can be eliminated.

The Illinois congressman recently introduced a bill that would establish mandatory dollars for veterans health care rather than depending on the crapshoot of discretionary funds from Congress. The large veterans service organizations support mandatory funding. Whether enough support can be mustered in Congress is the big question.

Overall, the administration is seeking $70.8 billion for the VA. This includes $37.4 billion in mandatory funding that is mostly for compensation, pension and various benefit programs. The VA also is asking for about $290 million in the 2006 budget for its cemetery system, which includes burial benefits. This amount is about $17 million, or 6.4 percent, more than in the funding level for this year.

Are you jumping for joy yet?