In light of recent congressional attention on deficiencies associated with VA medical facilities, both the House and Senate introduced legislation to address wait lists for medical care, as well as broader reforms to the Department of Veterans Affairs. As both bills passed with overwhelming bipartisan support, a congressional conference committee will soon reconcile the bills’ differences before final passage. While the policy changes regarding veterans care are similar in both bills, the conferees will most certainly have to contend with the overall cost of the bill and whether to adhere to “pay-as-you-go” rules to offset that cost. Should the legislation require offsets, the implications for stakeholders across the health care spectrum could be significant.

On June 10, the House voted 421-0 to pass H.R.4810, the Veteran Access to Care Act. The bill—introduced by Veterans’ Affairs Committee Chairman Jeff Miller (R-FL)—enables veterans on wait lists to seek medical care outside of the system established by the Department of Veterans Affairs. Although the Congressional Budget Office (CBO) did not provide a complete cost estimate on the bill, the measure is estimated to cost $35 billion to $50 billion dollars. Chairman Miller has said that the final bill must include offsets to account for the costs associated with providing veterans outside care.