The CBO, in a letter to Senate Veterans' Affairs Committee Chairman Bernie Sanders (I-Vt.), said the Senate provision allowing veterans increased access to private providers could eventually cost a whopping $50 billion a year.
Three Senate Republicans objected to the bill due to the potential cost. But others took issue with the CBO's cost projection. “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 (R-Mo.) told Roll Call. “Probably neither of those two things turn out to be the case.”
Sen. Tom Coburn (R-Okla.) agreed, calling the CBO's projection a “wild guess.” He also promised that he would work with congressional Republican leaders to include ways to pay for veterans' care in the legislation.
The CBO cost projection put Republicans in an uncomfortable position because they are caught between their party's political imperatives of supporting veterans' care and not increasing federal spending. That may be why some felt obliged to downplay the CBO's projection of huge new costs associated with the Senate bill.
Currently, Senate and House leaders are working to reconcile differences between their bills. They say they want to have a final bill on the president's desk before July 7.
Rep. Jeff Miller (R-Fla.), chairman of the House Veterans' Affairs Committee, seemed unfazed by the CBO estimate, saying it was about what he expected since the CBO likely assumed a high demand among veterans for health services. He promised to find a way to offset the immediate cost of the bill, estimated at $35 billion over three years. But any possible offsetting cuts, such as reducing costs elsewhere in the VA system or cutting other healthcare or social services, almost certainly would be highly controversial and could scuttle the legislation.
“We're going to pay for it, but CBO has got to score at its most heavily used point,” Miller told Roll Call.
Some political observers said the most likely way Congress will “pay” for the bill is to waive federal pay-for rules that require any new spending measure to be offset with a cut or new revenue from elsewhere, thus increasing the federal deficit. That won't go down well with budget hawks in either party. But they may have to swallow hard and accept it to avoid alienating voters in key election states with heavy concentrations of military veterans.
Follow Virgil Dickson on Twitter: @MHvdickson