This week, two prominent House Republicans addressed a letter to the Department of Veterans Affairs (VA) Secretary Denis McDonough. The correspondence, from Military Construction and Veterans Affairs Subcommittee Chairman John Carter (R-TX) and House Committee on Veterans’ Affairs Chairman Mike Bost (R-IL), concerns a reported $12 billion healthcare budget shortfall within the Veterans Health Administration (VHA).
The letter was prompted by the completion of Congress's work on the Veterans Benefits Continuity and Accountability Supplemental Appropriations Act (P.L. 118-82) on September 19, 2024. On September 23rd, the VA provided additional information regarding its budgetary challenges.
"We are fully focused on monitoring VA’s use of the additional benefits funding and getting to the bottom of the health care shortfall while the Office of Inspector General (OIG) undertakes its forensic audit," stated Carter and Bost in their letter.
They emphasized that it is crucial for Secretary McDonough and his team to reconcile accounts for fiscal year 2024 before making definitive statements about resources needed for fiscal year 2025. "Given VA’s ongoing difficulties estimating demand, utilization, and costs, it would be irresponsible for Congress to appropriate extra taxpayer dollars based on speculation," they noted.
Concerns were raised over VHA's increased pharmaceutical costs and service contract spending. "In particular, we share our colleagues’ concerns that VHA’s dramatically increased pharmaceutical costs may be partly the result of prescribing practices that warrant further inquiry," they wrote.
The chairmen requested answers to several questions by October 18, 2024. These include providing obligation figures for various benefits as well as details about unobligated funding remaining in different accounts as of October 1, 2024.
The letter also asked for specifics regarding prosthetics costs contributing to the shortfall. This includes identifying emerging technologies or expensive items involved, estimates of veterans requiring prosthetics in fiscal year 2025, and factors driving these needs.
Further inquiries covered expenditure growth rates for community care in VA's fiscal year 2025 budget request and VHA's current estimate. They sought clarification on spending related to certain pharmaceuticals like tirzepatide and semaglutide.
Additionally, explanations were requested concerning non-recurring maintenance costs totaling $223 million for fiscal year 2024 but not included in fiscal year 2025 budgeting.
Finally, Carter and Bost reiterated previous requests from Chairman Bost for briefings on pharmaceutical and prosthetics costs along with other financial details impacting veteran care programs.
"Congress has always provided the resources for veterans’ care and benefits...and we remain committed to doing this in a responsible way," concluded Carter and Bost.
