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H.R. 3230, the Veterans Access, Choice, and Accountability Act of 2014 1 (July 31, 2014)

handle is hein.congrec/cbo1828 and id is 1 raw text is: CONGRESSIONAL BUDGET OFFICE Douglas W. Elmendorf, Director U.S. Congress Washington, DC 20515 July 31, 2014 Honorable Jeff Sessions Ranking Member Committee on the Budget United States Senate Washington, DC 20510 Dear Senator: As you requested, this letter provides more detail about the cost estimate that CBO prepared on July 29, 2014, for the conference agreement on H.R. 3230, the Veterans Access, Choice, and Accountability Act of 2014, as reported on July 28, 2014. That act would appropriate $15 billion to increase veterans' access to health care by expanding the use of care provided by entities other than the Department of Veterans Affairs (VA); to improve the department's infrastructure; to hire medical staff; and to extend the Health Professionals Educational Assistance Program. The act would also authorize VA to enter into a number of leases for medical facilities and would modify a number of veterans' benefits programs. The following are the provisions of the legislation that would affect direct spending (see enclosed table for estimated budgetary effects by provision): Title I- Improvement ofAccess to Care from Non-Department of Veterans Affairs Providers. Title I would expand VA's ability to pay for health care services provided to currently enrolled veterans and newly separated combat veterans. Section 802 would appropriate a specific amount-$10 billion-for that purpose, which would result in direct spending of $10 billion over the 2014-2019 period. The authority to provide expanded care would expire when the appropriated funds were expended, which CBO estimates would be early in fiscal year 2016. By CBO's estimate, title I would result in a reduction of $1.7 billion in spending for Medicare and Medicaid (because VA would be paying for some health care services that would have been financed by those programs); additional collections of $200 million in copayments that would be considered savings in direct spending; and a loss of about $80 million in tax revenues (because, with some costs covered by VA, some veterans' use of health care covered by employer-sponsored health insurance would increase).

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