Marcos Muniz, right, a sergeant in the Army, jokes with his friend Nathan Greene, a fellow sergeant, after arriving at Landstuhl Regional Medical Center in 2006 in Landstuhl, Germany. The military has treated some 40,000 survivors with severe to moderate brain injuries suffered in connection with the wars, according to the Congressional Research Service.
The cost of veterans care is only a fraction of that. Bilmes estimates the two wars will cost the United States $4 trillion to $6 trillion, with a variety of expenses including interest on the debt used to fund military operations and the replacement of equipment used abroad. She puts the costs of the future medical care and disability benefits for the Department of Veterans Affairs at a total of $707 billion within 40 years, with the costs of caring for veterans rising as they age.
With its expanding spending, the VA is an outlier in this time of tight budgets and is likely to be so for years to come. Veterans benefits were not subject to the sequester in the current fiscal year, and annual spending for the VA is on track to nearly quadruple from $45 billion in fiscal 2001, the last full budget year before the start of the war in Afghanistan, to $170.9 billion in fiscal 2018, according to Office of Management and Budget data. The VA share of federal operating expenses, or discretionary outlays, is likely to grow by more than half to 3.8 percent, as budgets on many domestic programs shrink by this measure.
The House in June passed, 421-4, a fiscal 2014 spending bill (HR 2216) that would provide the VA with $147.6 billion, an increase of 10 percent. The Senate Appropriations Committee has proposed providing it with $147.9 billion.
Lawmakers and presidents tend to focus most on the annual fray over spending bills, while nodding toward five-year and 10-year budget cycles. There’s little discussion and few good estimates of what the costs of veterans benefits might be stretching out decades, Bilmes said. Other budget experts agree that this is a short-sighted view that masks the steadily accumulating obligations that will weigh on the VA in coming years.
“The problem is far worse than people think,” said Rep. Jim Cooper, D-Tenn., a budget hawk who teaches part time at Vanderbilt University’s Owen Graduate School of Management.
Several lawmakers are trying to get a better understanding of what the VA’s budget might look like in the years ahead.
The House Veterans’ Affairs Committee is slated to discuss at a July 17 hearing a draft bill from its ranking Democrat, Michael H. Michaud of Maine, that would create a position for a chief strategy officer to aid in long-range planning and to bolster the VA’s analytical and cost-estimation capabilities. Patty Murray, the No. 4 Senate Democrat, held a Veterans’ Affairs Committee hearing in 2011 on the lifetime costs of caring for those harmed in the Iraq and Afghanistan wars. She says she remains concerned about funding these needs.
“It’s not just the number of new veterans that pose a challenge. It’s also the extent of their wounds, both visible and invisible, and the resources it will take to provide them with quality care,” Murray said. “The commitment we have to our veterans is non-negotiable. Not just today, but far into the future.”
There’s also concern that as the U.S. continues to extract troops from the countries, and as the wars recede, today’s fervent support for veterans also will fade.