At a time when growing demands are being placed on our servicemen and women, and the needs of veterans returning from duty in Iraq and Afghanistan continue to grow, Republicans in the White House and the Senate have failed to live up to their promises to America’s veterans. Under the Bush Administration’s stewardship, veterans’ health care has been under-funded, vital Department of Veterans’ Affairs (VA) programs have suffered under poor leadership and mismanagement, and the necessary steps have not been taken to ensure that the VA is prepared to meet the needs of soldiers returning from Iraq and Afghanistan.
Since Democrats gained control of the Senate, we have taken significant steps to begin to reverse six years of the Bush Administration’s failed policies and broken promises to our nation’s veterans. Under Democratic leadership, the Senate has taken action to enhance VA health care services, improve veterans’ access to critical benefits, and decrease waiting times and bureaucratic obstacles facing veterans at the VA. Senate Democrats recognize and appreciate the sacrifices of our troops and their families and we are committed to continuing to work to fulfill our country’s obligation to veterans.
The Bush Administration Has Failed to Provide the Resources, Leadership, and Management to Meet the Needs of Veterans
In the past two years, Bush Administration mismanagement has resulted in funding shortfalls in the VA’s medical care budget. In a September 2006 report, the Government Accountability Office (GAO) found that flaws in the Administration’s budget formulations were largely to blame for budget shortfalls in veterans’ medical programs in both Fiscal Years 2005 and 2006. According to the report, “unrealistic assumptions, errors in estimation, and insufficient data” contributed to the President’s requests for additional funding, including a $975 million supplemental appropriation request in June 2005 and a $1.977 billion budget amendment in July 2005. In addition to a faulty budgeting process, the GAO found that the Administration failed to report anticipated budget problems to Congress in a timely manner to ensure effective oversight. The VA began to anticipate budget shortfalls as early as October 2004 yet, it did not report these looming problems to Congress until June of 2005. (GAO-06-958, 9/20/06)
The Bush Administration has consistently underestimated the health care needs of veterans returning from Iraq and Afghanistan. The GAO also found that the VA significantly underestimated the needs of veterans returning from service in Iraq and Afghanistan in fiscal years 2005 and 2006 in part, because its budget formulations relied on data that preceded these wars. Last year alone, the VA underestimated veterans’ demand for care by 68 percent. In spite of these findings, the Bush Administration has continued its practice of underestimating the demand for VA services from veterans of the Iraq and Afghanistan wars. According to Senate committee reports, the Bush Administration’s budget projections underestimated the number of veterans who would access the VA health care system by 100,000 patients, or nearly 100 percent, in its Fiscal Year 2007 budget proposal and by 50,000 patients in its Fiscal Year 2008 budget proposal. (GAO-06-958, 9/20/06; Senator Murray, Press Release, 9/29/06; Appropriations Committee Minority Staff, 3/29/07; Veterans’ Affairs Committee Majority Staff, 2/05/07)
Bush Administration policies have created barriers to veterans’ health care. Year after year, Bush Administration budget proposals have included measures that seek to artificially reduce demand for VA services. Measures that limit veterans’ access to VA health care have passed under Republican leadership. In January 2003, the Bush Administration imposed a ban on Priority Group 8 Veterans from enrolling in VA medical care, allegedly due to limited resources. According to VA estimates, this ban has prevented approximately 273,000 of these “middle-income” veterans, whose annual income is as low as $27,790, from accessing VA medical services in Fiscal Year 2006 and 242,000 in Fiscal Year 2007. (CRS RL33993, 5/10/07)
Under the Bush Administration, Veterans Have Not Received the Care They Deserve
Veterans face substandard care and bureaucratic delays at many of our nation’s health care facilities. As the mistreatment of wounded soldiers at the Walter Reed Army Medical Center has highlighted, the Bush Administration has failed to provide the necessary funding or exercise the leadership to ensure quality care to our nation’s veterans. Over the past several months, investigations, Congressional hearings, and media reports have uncovered significant bureaucratic obstacles and substandard medical care at many of our nation’s military and veterans’ health care facilities. These problems have raised concerns about the capacity of the VA medical system to provide outpatient care for returning soldiers and, in particular, to deal with the long-term health care challenges many of our soldiers face as a result of brain injuries, post-traumatic stress, and other debilitating physical and psychological wounds. (New York Times, 4/12/07)
- In a recent Department of Veterans Affairs review, over 1,000 problems were found in VA Centers across the country. As the Washington Post reported, “A review by the Department of Veterans Affairs of 1,400 hospitals and other veterans care facilities…has turned up more than 1,000 reports of substandard conditions – from leaky roofs and peeling paint to bug and bat infestations – as well as a smaller number of potential threats to patient safety, such as suicide risks in psychiatric wards.” (Washington Post, 3/22/07)
- Vet Centers are understaffed. According to VA records, the number of returning Iraq and Afghanistan war veterans who have accessed Vet Centers has more than doubled since 2004, while the staff at these clinics has increased by less than 10 percent. A recent VA survey of Vet Center team leaders found that, in some instances, staff shortages have led to longer wait times for veterans and even limited the treatment and services that the centers are able to provide to veterans. (USA Today, 4/19/07)
Bush Administration mismanagement has rendered mental health care “virtually inaccessible” for veterans. As reported in the May 2006 edition of Psychiatric News, “Frances Murphy, M.D., undersecretary for Health Policy and Coordination at the Department of Veterans Affairs (VA), said the growing numbers of veterans seeking mental health care has put emphasis on areas in which improvement is needed. She noted that some VA clinics do not provide mental health or substance abuse care, or if they do, ‘waiting lists render that care virtually inaccessible.’” With an estimated one-third of veterans returning from Iraq and Afghanistan facing mental health challenges, the lack of access to critical health care for these veterans raises concerns that our nation’s veterans will not be provided the services that they need and deserve. While the VA has claimed to be increasing funding for its mental health programs, in November, the GAO found that the department failed to spend more than $100 million in funds that had been allocated for treating post-traumatic stress disorder and other mental health conditions. (Psychiatric News, 5/5/06; GAO-07-66, November, 2006)
Veterans are forced to endure long delays in the processing of benefits claims. There currently is a backlog of more than 400,000 disability claims at the Veterans Benefits Administration, with more than one quarter (28.4 percent) of these claims pending for more than 180 days. According to the VA, it takes an average of six months (177 days) to process an original claim and nearly two years (657 days) to process an appeal. As media reports have highlighted, these delays are a source of growing frustration for many veterans. And while the system is overburdened today, experts warn that the current strain on the system is likely to grow significantly in the coming years, as troops deployed to Iraq and Afghanistan begin to return home and seek VA services. (Veterans Benefits Administration, Monday Morning Report, 5/19/07; Washington Post, 4/8/07)
Veterans face inequalities in disability ratings and compensation. The GAO, VA Inspector General, and independent groups have raised concerns about inconsistencies in the current system for determining veterans’ disability ratings. In a recent study, the GAO reported that the VA disability system has “not been updated to reflect the current state of science medicine and technology” and that “the criteria for disability decisions are based primarily on estimates made in 1945 about the effect of service-connected impairments on the average individual’s ability to perform jobs requiring manual labor.” (GAO, 3/13/07)
- Data suggests a discrepancy in veterans’ benefits according to the status of their service and geographic location. According to an analysis by the New York Times, “veterans face serious inequalities in compensation for disabilities depending on where they live and whether they were on active duty or were members of the National Guard or the Reserve.” The paper reports significant discrepancies in pay levels between states and also found that Reserve and National Guard members receive lower average disability payments than active-duty soldiers. (New York Times, 3/9/07)
- The current disability system fails to effectively account for PTSD and TBI, the main disabilities affecting Iraq and Afghanistan war veterans. Earlier this month, the Institute of Medicine released a study that identified similar shortcomings in the VA’s benefits system, though focusing specifically on PTSD compensation. The study, which was undertaken at the request of the VA, found that the current criteria for evaluating veterans is out of date, inconsistently applied, and not adequate for addressing the needs of veterans suffering from PTSD. (Washington Post, 5/9/07)
The Bush Administration Has Not Taken the Steps Necessary to Ensure That the VA is Prepared to Meet the Growing Needs of Returning Iraq and Afghanistan War Veterans
Nearly six years into the war in Afghanistan and four years into the war in Iraq, the Bush Administration has failed to put in place a strategy for addressing the needs of the service men and women returning from combat.
The Bush Administration has not prepared for the anticipated influx of Iraq and Afghanistan war veterans in need of VA services in the coming years. To date, more than 1.5 million U.S. service members have been deployed to Iraq and Afghanistan. According to a recent study conducted by Linda Bilmes at Harvard’s Kennedy School of Government, current trends suggest that as many as 700,000 of these soldiers will seek medical care and claim disability compensation through the VA in the next several years. Experts warn that there will be significant long-term costs for caring for these veterans, for which the Bush Administration has failed to budget or adequately plan. (Linda Bilmes, Soldiers Returning from Iraq and Afghanistan: The Long-Term Costs of Providing Veterans’ Medical Care and Disability Benefits, January 2007)
The VA does not have a plan to effectively deal with the long-term needs and complex medical conditions of many veterans returning from Iraq and Afghanistan. In addition to being ill-prepared for the sheer number of Iraq and Afghanistan war veterans, the VA is not prepared to handle the types of physical and mental wounds afflicting many of these veterans. In comparison to previous wars, a much larger proportion of soldiers are surviving wounds from combat operations in Iraq and Afghanistan. While these high survivability rates certainly represent a very positive trend, it has also meant that many of these veterans face significant disabilities. Of the injuries sustained by soldiers, 20 percent have suffered brain trauma, spinal injuries or amputations, while another 20 percent have suffered blindness, partial blindness or deafness or serious burns. With the VA unable to effectively meet current demands for medical health care, and mental health care in particular, experts say that Iraq and Afghanistan war veterans are likely to face considerable challenges in obtaining the health care that they need. (Linda Bilmes, Soldiers Returning from Iraq and Afghanistan: The Long-Term Costs of Providing Veterans’ Medical Care and Disability Benefits, January 2007)
Current trends suggest that the claims backlog will grow significantly in coming years. VA data on OEF/OIF disability claims suggest that claims backlogs are likely to become increasingly problematic as U.S. service members return from Afghanistan and Iraq. In a report released last November, the VA found that 152,669 out of the 631,174 veterans of these wars who were potentially eligible for disability benefits filed claims with the Veterans Benefits Administration (VBA). Given these trends, experts warn that the VA will face a crisis in processing and paying for benefits claims in the coming years, unless it takes significant action now. In a recent study, Harvard economist Linda Bilmes projected that more than 1.2 million Iraq and Afghanistan war veterans will be potentially eligible for disability benefits and that more than 600,000 of these veterans will be granted disability benefits over the next ten years. Bilmes warned that the backlog in claims benefit could reach 750,000 in the next two years, leading to even longer waiting times for veterans. (Linda Bilmes, Soldiers Returning from Iraq and Afghanistan: The Long-Term Costs of Providing Veterans’ Medical Care and Disability Benefits, January 2007)
Senate Democrats’ New Direction: Fulfilling Our Commitment to Veterans
In just four months since Democrats gained majority control in the Senate, we have taken significant steps to begin to reverse the Bush Administration’s record of neglect in caring for our nation’s veterans. Additional authorizations and funds provided in the Fiscal Year 2007 Continuing Appropriations Resolution, Supplemental Appropriations Bill, and the Fiscal Year 2008 Budget Resolution are critical to better meeting veterans’ needs. While the Bush Administration has spent the last six years talking about its support for veterans, in the past few months Senate Democrats have demonstrated our commitment to honoring our country’s obligation to our servicemen and women by providing funds that will help reduce red tape at the VA, improve access to critical benefits, and enhance health care services.
Senate Democrats passed a Revised Continuing Appropriations Resolution for Fiscal Year 2007 that fills critical gaps in funding for veterans’ health care left behind by Republicans. Under the joint funding resolution, Senate Democrats provided a total of $32 billion for VA medical care, which is an increase of $3.5 billion over Fiscal Year 2006 levels, and the funding level approved by the Republican-passed Continuing Resolution during the last Congress. These funds will help to improve mental health services, enhance inpatient and outpatient care for veterans, and also allow the VA to better address its backlog of pending benefits claims.
Senate Democrats secured critical funds for veterans’ health care in the 2007 supplemental appropriations bill. The 2007 Emergency Supplemental would have allocated nearly $1.8 billion in funds to the VA, not requested by the President, to accommodate the increasing number of new veterans returning home from Iraq and Afghanistan, improve metal health and readjustment counseling services, and fund new polytrauma centers for the severely injured. These funds are critical to ensuring that the VA has the capacity to care for the increasing number of veterans who suffer from traumatic brain injuries and post-traumatic stress disorder.
Senate Democrats led the effort to provide $3.5 billion in increased funding to veterans for Fiscal Year 2008. The Senate’S.2008 Budget Resolution allocated $43.1 billion for veterans, which is an increase of $3.5 billion over the President’s request. This amount represents 98 percent of the funding level requested in the Independent Budget, a plan developed by four leading veterans’ service organizations. The resolution also rejected the President’s proposal to impose new fees and higher co-payments on certain veterans, which, according to veterans’ service organizations, would have driven an estimated 200,000 veterans to leave the system and discouraged more than one million veterans from enrolling in VA health care.