H.R. 5286 would authorize the Department of Veterans Affairs (VA) to enter into leases for 18 medical facilities and enhanced-use leases to provide supportive housing for veterans. The bill also would modify disability compensation for veterans by rounding payments down to the next lower dollar and authorizing payments to veterans who have lost certain organs. CBO estimates that enacting H.R. 5286 would reduce net direct spending by $846 million over the 2017-2026 period (see Table 1). Because enacting the bill would affect direct spending, pay-as-you-go procedures apply. Enacting the bill would not affect revenues.
The bill also would make changes to VA’s health care programs, including giving VA temporary authority to enter into certain agreements with health care providers in the private sector and expanding availability of some health care services. In addition, H.R. 5286 would require VA to begin a research program on the intergenerational effects of exposure to toxic substances. In total, CBO estimates that implementing H.R. 5286 would require $291 million in discretionary spending over the 2017-2026 period, subject to appropriation of the necessary amounts (see Table 2). That estimate excludes the effects of section 304, which CBO has not yet been able to estimate.
