President Bush has not submitted an adequate budget for the Department of Veterans Affairs since he took office. Year after year, he has offered budgets that have sought to make veterans pay more and more out of their own pockets for health care. Not only has the Bush Administration tried - and been successful in one case - to dramatically increase copayments for prescription drugs, the Administration has also proposed various methods of generating additional revenue and artificially reducing demand for VA health care. The Administration uses the projections from these measures to pad their inadequate budget requests for veterans' services so that they can claim budget increases. Some examples of this include the counting of revenue from copayments and third-party insurers as part of the President's request, which has become standard practice for the Administration, and shifting retirement funds from another government agency. The following is a year-by-year summary of the President's budget proposals for veterans' programs.

Fiscal Year 2005: Increased Fees and Longer Waits, Even as Troops Come Home

Inadequate funding. This year, President Bush's proposal would increase VA health care spending by $500 million, an increase that would fail to provide the VA with enough resources to maintain current services. With 60,000 veterans already on waiting lists for health care, and tens of thousands of military personnel scheduled to return from Iraq and Afghanistan as the newest generation of veterans, this underfunding will only further reduce the quality and availability of veterans' health care.

VA Secretary Anthony Principi admitted at the House Veterans' Affairs Committee's budget hearing that he asked the White

House for $1.2 billion more than what VA received. As a direct result of President Bush's failure to meet Secretary Principi's request, valuable specialty services like long-term care and mental health treatment will see significant cuts in capacity and staffing - at a time when the demand for these services is increasing. Moreover, the President's budget slashes $50 million from critical medical and prosthetic research programs at the VA.

Deja vu: more proposals for increased fees and copayments. Just as he did in his Fiscal Year 2004 budget, President Bush again attempts to mask the inadequacy of his VA budget by driving veterans out of the system, and by using those veterans who remain behind as revenue sources. The President's budget estimates that these policies will drive over 10 percent of enrolled veterans - more than 800,000 individuals - out of the VA system.

• In his Fiscal Year 2005 budget, the President proposes implementing a $250 enrollment fee for middle-income veterans. However, in an attempt to conceal the size of this fee, the President's proposal breaks it down into a month by month payment schedule.
  
  
• The Administration's budget also seeks, again, to raise the prescription drug copayment from $7 to $15 for lower-income veterans.
  
  
• As in Fiscal Years 2003 and 2004, no new Priority 8 veterans would be allowed to enroll under President Bush's budget for Fiscal Year 2005.
  

Exacerbated claims backlog. Finally, despite a 348,000-person disability claims backlog which has the average veteran waiting more than six months for his or her disability claim to be processed, President Bush's budget proposes eliminating 540 claims processing staff.

New generation of veterans. Meanwhile, 150,000 soldiers are expected to return home this year after completing deployments in Iraq, and an additional 110,000 will return from Iraq in 2005. Members of the National Guard and Reserve are eligible to receive priority health care at the VA for two years after demobilization. In addition, more than 3,000 soldiers have been injured during Operation Iraqi Freedom and many of them are likely to enroll in the VA system over the next few years.

Rising health care costs for veterans under the Bush Administration. In the President's budget documents, collected receipts from veterans - that is, copayments, fees, deductibles, and other charges for service - are labeled "First Party Collections." Under President Bush, these first party collections have risen nearly 500 percent, an unacceptable increase in the financial burden placed on our nation's veterans.

Fiscal Year 2004: New Fees and Copayments

Increased fees and copayments. With over 300,000 veterans in lines waiting to see VA doctors, the VA faced the highest demand ever for its services. Rather than seeking to provide these veterans with the care they need and deserved, the Administration's budget proposal was loaded with measures designed to artificially reduce enrollment and generate additional revenue out of the pockets of veterans:

• President Bush's proposal sought to increase drug copayments yet again - from $7 to $15.
  
  
• The proposal attempted to establish a $250 annual enrollment fee for middle-income veterans.
  
  
• As part of the President's budget proposal, the VA raised the primary care copayment from $15 to $20 - after it had just been lowered to $15 as a result of a Congressional mandate.
  
  

Limited access. In addition to driving up the costs borne by veterans, the Administration worked to artificially reduce demand for services by limiting the access of certain veterans to a number of programs.

• The Administration attempted to limit access to vital long-term care services.
  
  
• Continuing a policy established during Fiscal Year 2003, the President's budget announced the ongoing ban against any new Priority 8 veteran enrolling in the VA system.
  
  

Fiscal Year 2003: Priority 8 Veterans Barred From Receiving Benefits

Enron accounting. To avoid telling the nation's veterans about the extent to which his budget would underfund the VA, President Bush used accounting gimmicks to make his proposal look more generous. The Administration shifted accured pension costs for retired VA employees from the Office of Personnel Management account into the VA Health Care function, a shift which made the VA health care budget appear to rise by an additional $800 million.

Inadequate funding. The Bush Administration proposed a minimal increase of $1.4 billion to the VA budget - again failing to provide any additional funds over inflation and cost of living adjustments for VA employees. The Veterans Independent Budget, which is prepared by nonpartisan veterans' organizations, stated that $1.7 billion in funding would need to be added to the Bush proposal in order to allow the VA to meet its needs.

• In an attempt to pad the numbers of its bare-bones increase, the Administration proposed a 45 percent copayment for health care, capped at $1,500 per year, for middle-income veterans who made as little as $24,000 a year.
  
  
• Released just a few months after the September 11, 2001 terrorist attacks, the President's VA budget for Fiscal Year 2003 failed to provide adequate funding so that the VA could meet its "Fourth Mission": emergency medical preparedness for providing medical care to veterans, military personnel, and the public during Department of Defense contingencies and other emergencies.
  
  

Priority 8 ban. In the middle of Fiscal Year 2003, the Bush Administration decided to bar Priority 8 veterans - those making over means test thresholds for their place of residence - from enrolling in the VA system. Before this decision, more than half of all new enrollees were categorized as Priority 8. As a result, hundreds of thousands of these so-called "higher-income" veterans will be prohibited from obtaining health care. In order to be classified as "Priority 8" in 2004, veterans could have an annual income as low as $25,000.

Fiscal Year 2002: Bush Doesn't Spend Appropriated Money to Reduce VA Deficit

Opposition to funding increase. As a result of the President's budget decisions, the VA was running a $400 million deficit by the beginning of Fiscal Year 2002. In response, Congress appropriated $417 million to fill this gap. Despite the significant shortfalls, President Bush refused to declare a fiscal emergency at the VA and refused to spend $275 of the $417 million designated by Congress as an emergency appropriation.

Inadequate funding. The Bush Administration proposed a VA budget increase of $1 billion, knowing that this amount would barely cover medical inflation and payroll costs. The President's budget fell more than $1.5 billion short of the amount recommended by the Veterans Independent Budget, and the proposed funding level would have rendered VA unable to adequately address the treatment of Hepatitis C, emergency medical services, increased costs due to medical inflation, and long-term care initiatives.

American Legion National Commander Ray G. Smith said the following about the Fiscal Year 2002 budget:

"[This budget] is not good enough. It's not good enough to provide quality health care to those who provided honorable military service to our nation. It's not good enough to address emerging veterans' health care concerns such as hepatitis C treatment and long-term care mandates contained in the Veterans' Millennium Health Care and Benefits Act. It's not good enough to hire enough claims adjudicators to expedite the delivery of benefits; it takes months, sometimes years, to get a claim processed. It's not even good enough to simultaneously offset inflation and universally extend homeless, dental, mental health, spinal cord, and other services systemwide. Frankly, this budget is insufficient to fulfill the campaign promises George W. Bush made."

Increased copayments. In conjunction with the President's proposal, the VA increased the prescription drug copayment from $2 to $7 - a 350 percent increase. The VA then blocked efforts by Congress to obtain relief for low-income veterans from the higher drug costs.

Congress, Not Bush, Drives VA Budget Increases

Some have argued that Veterans Health Administration (VHA) funding under President Bush has risen by more than 25 percent. However, as the table below demonstrates, Congress has been far more responsible for the rise in VHA spending than President Bush. In fact, if Congress had simply approved each of President Bush's first 3 VA budgets (Fiscal Years 02-04), the VHA would have lost over $2.1 billion in funding.