Today, as part of its ongoing work to assist the conference committee that is working on H.R. 3230, the Veterans Access to Care Act of 2014, CBO issued an updated and complete estimate of the version of the bill that was passed by the House of Representatives on June 18, 2014. That version of H.R. 3230 would authorize the appropriation of whatever sums are necessary for the Department of Veterans Affairs (VA) to expand, for two years, its use of non-VA health care providers to provide medical services to veterans.
Initially, CBO had issued preliminary estimates for the major provisions of the House-passed and Senate-passed bills. Since then, it has obtained additional information, refined its analysis, and completed estimates of other provisions of those bills. An updated and complete estimate of the Senate version of the bill was issued on July 10. Today, CBO issued an updated and complete estimate of the House version of the bill. Those updated estimates provide a basis for CBO’s analysis of proposals that would modify the earlier versions of the legislation.
Assuming appropriation of the necessary amounts, CBO estimates that implementing the House-passed bill would lead to a net increase of $41 billion in VA’s discretionary spending over the 2014-2017 period, reflecting the expectation that veterans’ utilization of contracted care under this act would ramp up over time. We also estimate that enacting the House version of the bill would reduce direct spending by $80 million during that period. Finally, if the amounts estimated were appropriated, CBO estimates that implementing the bill would lead to savings totaling $7 billion in the Medicare and Medicaid programs and to additional revenues of $2.5 billion over the 2015-2017 period.
The Senate-passed version of H.R. 3230 would authorize and appropriate such sums as may be necessary to carry out a similar expansion of health care services. CBO estimates that enacting the Senate version of H.R. 3230 would increase direct spending by $35 billion and increase revenues by $2.5 billion over the 2014-2024 period, and lead to additional appropriations totaling about $2 billion over the 2014-2019 period.
Sarah Jennings is the Chief of the Defense, International Affairs, & Veterans’ Affairs Cost Estimates Unit. Ann Futrell is an analyst in that unit.