巨大的退伍军人预算缺口在拨款过程中造成了漏洞
https://rollcall.com/2024/07/26/massive-veterans-budget-gap-rips-hole-in-appropriations-process/
退伍军人事务部迟迟告诉国会，他们需要另外 150 亿美元用于福利和医疗保健
作者：Aidan Quigley 2024 年 7 月 26 日
退伍军人事务部本财年和下一财年面临近 150 亿美元的总预算缺口，国会共和党人对最后一刻通知的资金危机表示不满，立法者几乎没有时间尝试解决。
退伍军人事务部官员于 7 月 15 日告诉立法者，该机构需要 29 亿美元的强制性支出用于退伍军人养老金和其他福利，以弥补截至 9 月 30 日的财政年度剩余几个月的缺口。此外，除了 3 月份的拨款方案或 2025 财年众议院和参议院军事建设-退伍军人事务部法案中提供的资金外，他们还需要为明年提供另外 120 亿美元的可自由支配的医疗保健资金。
众议院于 6 月 5 日通过了 2025 财年军事建设-退伍军人事务部法案，参议院拨款委员会于 7 月 11 日对其版本进行了标记，之后发布了该通知。
据参议院退伍军人事务委员会排名成员杰里·莫兰 (Jerry Moran) 称，如果国会在 9 月 20 日之前不采取行动，退伍军人事务部估计，700 万退伍军人及其遗属可能无法在 10 月 1 日收到福利金。两院的共和党人都认为，退伍军人事务部和白宫管理和预算办公室要么应该预见到这一缺口，要么故意向立法者隐瞒这一缺口。
“我认为这是退伍军人事务部严重的财务管理不善和/或无能，”堪萨斯州共和党议员莫兰周四表示。“我非常担心，退伍军人事务部和行政管理和预算办公室的管理部门在几个月内误导了国会，让他们误以为退伍军人事务部的状况以及照顾退伍军人及其遗属所需的资源水平。”
众议院退伍军人事务部主席、伊利诺伊州共和党议员迈克·博斯特在 7 月 17 日的一封信中敦促该机构就资金短缺问题作出解释，他将资金短缺归咎于“令人不安的未列入预算的预期成本组合，以及其他缺乏充分解释或推测的成本。”
博斯特写道，资金短缺的一部分包括近 39 亿美元的药品和假肢成本，其中包括 10 亿美元用于管理“慢性病”，可能与肥胖和昂贵的减肥药 Ozempic 有关。他还表示，这是因为 VA 正在快速招聘，预计将招聘 22,304 名新全职员工。
创纪录的需求
据该机构官员称，问题的关键在于，在实施 2022 年法律的过程中，对医疗保健服务的需求增加，该法律扩大了在战区服役期间接触燃烧坑和其他毒素的退伍军人的医疗服务。以前，生病的退伍军人需要证明他们的疾病与他们的军事服务直接相关；现在，人们推测这些疾病与服役有关。
VA 新闻秘书 Terrence Hayes 周四表示，在过去 365 天里，有 412,867 名退伍军人参加了 VA 的护理，比上一年增加了 27%。
[退伍军人有毒物质暴露法案在曲折道路后获得参议院批准]
不过，莫兰表示，没有理由不早点通知立法者。在 2025 财年加价开始之前，参议院拨款委员会主席、华盛顿州民主党议员帕蒂·默里和缅因州共和党议员苏珊·柯林斯达成协议，在常规预算上限的基础上拨款 345 亿美元用于紧急支出，如果他们知道 VA 的资金短缺，他们就可以将其纳入谈判中。
“只有在我们完成工作后，我们才会被告知这个问题，”莫兰说。“在我看来，VA 或 OMB 不可能直到那时才知道这些事实。”
白宫预算办公室将问题转交给 VA。
该机构在其 2025 财年预算申请中假设退伍军人医疗保健账户将大量动用未承付余额来维持收支平衡，这让他们有空间在 2025 财年申请比上一财年拨款更少的资金。
这为其他国内支出腾出了空间，同时仍保持在去年债务上限协议的预算上限之内——柯林斯和其他共和党高层对此表示担忧。
“我们曾对过度依赖未承诺的结转资金提出质疑，然后我们发现存在巨大的缺口，可能会危及福利，”柯林斯说。“这是完全不可接受的。我很难相信这件事没有对我们隐瞒。”
退伍军人事务部部长丹尼斯·麦克多诺在周二的新闻发布会上表示，他已经向立法者明确表示，他会在需要时回到国会并要求额外的资源。
“我一直说我们相信我们已经拥有了我们需要的资源，但如果我们需要更多，我们会回来要求，因为我们想要退伍军人
选择 V??A，”他说。“而且，退伍军人选择 VA 的人数创下了历史新高。”
据该部门称，退伍军人在 2023 年提交了 243 万份索赔申请，比以往任何时候都多，比 2022 年高出 39%。
VA 发言人海耶斯表示，VA 为退伍军人提供的护理和福利比以往任何时候都多，2022 年法律出台后的需求“甚至超出了最激进的预测和预期”。
“VA 正在与国会和管理与预算办公室密切合作，以防止对退伍军人产生任何不利影响的方式满足这些需求——并允许我们继续以创纪录的速度向退伍军人提供护理和福利，”海耶斯说。
创可贴修复？
目前尚不清楚立法者将如何采取行动解决短缺问题。参议院退伍军人事务主席、蒙大拿州民主党人乔恩·泰斯特 (Jon Tester) 表示，该部门可能能够使用本财年的未承付余额来维持运营。
“这个问题可能会通过结转或拨款来解决。结转可以解决这个问题，我还没有看到具体数字，我不知道他们还剩下多少钱，”泰斯特说，他是一位陷入困境的现任议员，在一个深红色州面临着艰难的连任竞选。
虽然近 30 亿美元的强制性福利资金可能被纳入短期权宜之计，预计在 9 月底之后政府将保持运转，但这不太可能在 VA 按时支付数百万美元的 9 月 20 日截止日期之前完成。
关于 2025 财年 120 亿美元的医疗保健资金，官员们表示，如果没有额外资金，VA 将做出调整，以在可用预算范围内生活，同时仍提供优质医疗服务。但该机构已明确表示，获得额外资金会更好，他们没有详细说明如果没有这笔资金，需要做出什么样的权衡。
就柯林斯而言，她“不知道”如何解决资金短缺问题。由于这一问题现在才刚刚浮出水面，它可能会成为在决定白宫、参议院和众议院控制权的关键11月选举之前的竞选话题。
Massive veterans budget gap rips hole in appropriations process
https://rollcall.com/2024/07/26/massive-veterans-budget-gap-rips-hole-in-appropriations-process/
VA belatedly tells Congress they need another $15 billion for benefits, health care
By Aidan Quigley July 26, 2024
The Department of Veterans Affairs is facing a nearly $15 billion combined budget shortfall this fiscal year and next, and congressional Republicans are crying foul at the last-minute notification about a funding crisis lawmakers have little time to try to fix.
The notification came after the House passed its fiscal 2025 Military Construction-VA bill on June 5, and after the Senate Appropriations Committee marked up its version on July 11.
If Congress does not act by Sept. 20, the VA estimates that 7 million veterans and their survivors may not receive their benefits payments on Oct. 1, according to Senate Veterans’ Affairs Committee ranking member Jerry Moran. Republicans in both chambers believe that the VA and White House Office of Management and Budget either should have seen this shortfall coming, or deliberately hid it from lawmakers.
“I think this is significant financial mismanagement, and/or incompetence at the Department of Veterans Affairs,” Moran, R-Kan., a senior Appropriations Committee member, said Thursday. “And I am gravely concerned that the administration, both the VA and OMB, specifically misled Congress for months about the state of affairs at the VA and the level of resources that are actually needed to care for veterans and their survivors.”
House Veterans’ Affairs Chairman Mike Bost, R-Ill., pushed the agency for answers about the shortfall in a July 17 letter, where he blamed the shortfall on a “troubling mix of anticipated costs that were not budgeted for and other costs that lack sufficient explanation or are speculative.”
Bost wrote that part of the shortfall consists of nearly $3.9 billion for pharmaceutical and prosthetics costs, including $1 billion to manage “chronic disease,” possibly related to obesity and the pricey weight loss drug Ozempic. He also suggested it was because of the VA’s rapid hiring, projected at 22,304 new full-time employees.
Record demand
According to agency officials, the crux of the issue is increased demand for health care services amid implementation of a 2022 law that expanded access for veterans exposed to burn pits and other toxins while serving in combat zones. Previously, veterans who got sick needed to prove their illnesses were directly tied to their military service; now, the presumption is such diseases are service-connected.Over the last 365 days, 412,867 veterans have enrolled in VA care — a 27 percent increase compared to the previous year, VA press secretary Terrence Hayes said Thursday.
[Veterans toxic exposure bill clears Senate after tortuous path]
Still, Moran said there’s no reason why lawmakers couldn’t have been informed sooner. Before their fiscal 2025 markups began, Senate Appropriations Chair Patty Murray, D-Wash., and ranking member Susan Collins, R-Maine, reached a deal to allocate $34.5 billion in emergency spending on top of regular budget caps, and had they known about the VA shortfall, they could have factored it into their negotiations.
“Only after we did our work are we informed of this problem,” Moran said. “And it could not, in my view, been only then that VA or OMB knew these facts.”
The White House budget office referred questions to the VA.
The agency in its fiscal 2025 budget request assumed veterans health care accounts would dip heavily into unobligated balances to make ends meet, giving them room to request less overall in fiscal 2025 money than was appropriated for the previous fiscal year.
That freed up room for other domestic spending, while remaining within budget caps from last year’s debt ceiling agreement — something Collins and other top Republicans expressed concern about.
“We had raised questions about the over-reliance on unobligated carryover funds, and then we find that there is this enormous shortfall that could jeopardize benefits,” Collins said. “And that is just completely unacceptable. It’s hard for me to believe that this wasn’t concealed from us.”
VA Secretary Denis McDonough said during a Tuesday press conference that he has been clear to lawmakers that he would come back to Congress and ask for additional resources when they were needed.
“I kept saying we believe we have what we need, but if we need more, we’re going to come back and ask for it, because we want veterans to choose VA,” he said. “And at record levels, veterans are choosing VA.”
Veterans submitted 2.43 million claims applications in 2023, more than ever before and 39 percent higher than in 2022, according to the department.
Hayes, the VA spokesman, said the VA is delivering more care and benefits to veterans than ever, and the demand following the 2022 law has “exceeded even the most aggressive projections and expectations.”
“VA is working closely with Congress and the Office of Management and Budget to address these needs in a way that prevents any adverse impacts on veterans — and allow us to continue to deliver care and benefits to veterans at record rates,” Hayes said.
Band-Aid fix?
It’s not clear how lawmakers will move to address the shortfall. Senate Veterans’ Affairs Chairman Jon Tester, D-Mont., said the department may be able to get by using unobligated balances from this fiscal year.“It will probably get fixed with carryover or appropriations. It could be taken care of with carryover, I haven’t seen the figures yet, I don’t know what kind of money they have left over,” said Tester, an embattled incumbent facing a tough reelection bid in a deep-red state.
While the nearly $3 billion in mandatory benefits funding could be included in the short-term stopgap measure that is expected to be needed to keep the government open after the end of September, it is unlikely that will be done by the VA’s Sept. 20 deadline to make millions of payments on time.
Regarding the $12 billion in fiscal 2025 health care funds, officials say if no additional funds are provided, the VA will make adjustments to live within the available budget while still providing quality care. But the agency has made clear receiving additional money would be preferable, and they aren’t detailing what sort of trade-offs would be necessary without it.
For her part, Collins said she had “no idea” how the shortfall will be addressed. And with this issue only emerging now, it could wind up in campaign talking points ahead of critical November elections to determine control of the White House, Senate and House.
