S. 2558 would require the Department of Veterans Affairs (VA) to make grants to Indian tribes to defray the cost of constructing veterans’ nursing homes on tribal land and to pay a portion of the costs of care provided at those facilities. Under current law, VA pays 65 percent of construction costs for state-operated nursing homes for veterans and subsidizes residents’ care. Over the 2017-2019 period, VA provided about $300 million in construction grants for 30 new state veterans homes (roughly $8 million per grant), and it spent $1.2 billion annually on care for veterans living in existing facilities.
Currently, no veterans’ nursing homes are located on any Indian reservations. On the basis of information from the department, CBO expects that over the 2020-2025 period, VA would make one construction grant for less than the average amount of similar grants, because only about 60,000 veterans (or 0.3 percent of the total veteran population) live on tribal land. Moreover, because CBO expects that the facility would not open until 2026, VA would not pay for care until then. After accounting for the time to select a grantee, CBO estimates that implementing S. 2558 would cost $4 million over the 2022-2025 period, subject to the appropriation of the necessary amounts.
