H.R. 5674 would change how the Department of Veterans Affairs (VA) purchases medical care and services for veterans from health care providers in the private sector. The bill also would expand the caregivers program and make other changes to VA’s health care programs and compensation of employees. In total, CBO estimates that implementing the bill would cost $46.5 billion over the 2019-2023 period, assuming appropriation of the necessary amounts.
In addition, H.R. 5674 would directly appropriate $5.2 billion for the Veterans Choice
Program (VCP), increase the fees charged to veterans who obtain loans guaranteed by VA, and extend the current limit on pensions that can be paid to certain veterans who receive benefits from Medicaid. In total, CBO estimates that enacting the bill would increase direct spending by $4.5 billion over the 2018-2028 period.