Some senators are questioning an 'astronomical' but preliminary Congressional Budget Office score for the Senate-passed emergency veterans health bill — while promising to find ways to pay for it in conference with the House.
The CBO said the VA bill could cost $50 billion a year in expanded health benefits, but there were questions Thursday about how the CBO came to that figure.
"I think it's astronomical because of some of the CBO assumptions, which among other things assumes that every veteran who qualifies now to get VA services ... who hasn't been using the VA, will all start using the VA and they'll all have their share of health problems," Missouri GOP Sen. Roy Blunt said. "Probably neither of those two things turn out to be the case."
"A big challenge now for the conference committee is to really get that number to where it needs to be and to carefully think about what's mandatory and what's not," Blunt added.
Sen. Tom Coburn, who has been involved in crafting the legislation from the beginning, said he would work with the House on a way to pay for whatever the actual costs are.
The Oklahoma Republican called the CBO figure a "wild guess."
"If the CBO can't tell us things about the Affordable Care Act, they certainly can't tell us about this because this has just as many variables," said Coburn. "It won't come out of the conference unpaid for, I can tell you that; there will be offsets."
"I am working with Jeff Miller and we are going to solve the problem and pay for it and this is the start of multiple things that have to happen at the VA," Coburn said.
House Veterans' Affairs Chairman Jeff Miller, R-Fla., has previously said any final package to provide better access to health care for veterans will have offsets.
Sen. Bob Corker, R-Tenn., was one of only three senators to vote against the veterans' package on Wednesday afternoon, citing the CBO score. In a Thursday statement, he praised Miller for his commitment to paying for the bill.
"Our veterans deserve solutions to the chronic, systemic problems that exist at the VA, but the bill passed by the Senate yesterday, which was rushed through in an effort to hide the massive price tag from the American people, is not the right answer," Corker said. "I thank Chairman Miller for his leadership, and I hope the House will improve the bill and pay for it so I can support it when it comes back to the Senate."
Coburn also said he was reviewing the details of each of the 26 medical facility leases included in the legislation.
"Tulsa [for example] could buy the same space with the same amount of amount of up front money for $14 a foot. They are paying $40 a foot with a $104 riser every year in it. They act like, 'Well, don’t worry about it. We have plenty of money; we will just spend the money,' " Coburn said. "So my staff is digging down on every one of the clinics and when it goes to conference we are going to talk about that stuff."
An authorization for a Tulsa project was removed before finalizing the Senate bill.
Even if the conferees do locate offsets, the measure may just be the start of the debate, however. Blunt also raised the broader question of where the VA health programs fit within the broader budgetary picture.
"A committed as we are to veterans programs, the VA has been discretionary, which means that every year the Congress has to look at what the VA's doing and how they're doing it and appropriate the money," Blunt said. "I think most of VA is one year in advance, which is good because you never run into any kind of sequester problem or anything."