Major VA workforce, health care bill passes House once more

The House is preparing for the final passage of legislation that would deliver a historic expansion of health care benefits at the Department of Veterans Affairs.

The bill, however, faces partisan challenges over changes it would bring to the VA’s budget process.

The House Rules Committee on Tuesday advanced a revised version of the Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics (Honoring Our PACT) Act that the Senate passed month, but addresses technical drafting errors.

The House expects the bill will receive a final floor vote this week. From there, the Senate will need to pass the legislation for a second time before it heads to President Joe Biden’s desk.

“This time around, we will send this critical bill to the president’s desk,” Committee Chairman Jim McGovern (D-R.I.) said during the hearing.

The legislation, at its core, would expand disability compensation and health care benefits for veterans exposed to toxic substances during their military service.

But the legislation would also give VA the resources it needs to prepare its health care workforce to treat up to 3.5 million additional veterans. The PACT Act would give the VA much-needed authority to set higher pay caps for certain health care positions.

It would also give the VA up to $40 million a year to buy out the contracts of certain private-sector health care professionals in exchange for employment at rural VA facilities.

The bill also expands recruitment and retention bonuses for VA employees, including merit awards and pay incentives for employees that have a “high-demand skill or skill that is at a shortage.” The critical-skills pay incentive cannot exceed 25% of an employee’s base pay.

The bill gives the VA a year to submit to the House and Senate committees a plan on how it will recruit and retain HR employees.

The bill, however, would also make new and existing VA health care spending mandatory in future congressional appropriations, which has led to some House and Senate Republicans opposing the bill.

Sen. Pat Toomey (R-Pa.) said last month that the VA is already obligated under law to spend nearly $400 billion over 10 years to pay for veteran health care related to toxic exposure. Discretionary spending is capped under sequestration rules.

Toomey said the PACT Act would make about $280 billion in new spending over the next 10 years mandatory, and would also make the $400 billion in previous spending mandatory.

Toomey said he’s fighting to keep existing VA health care spending under discretionary spending caps.

“My objection isn’t about the substances of this bill, it’s about this budgetary gimmick that’s designed to allow hundreds of billions of dollars of additional spending on totally unrelated, who know what categories,” he said on June 23.

House VA Committee Chairman Mark Takano (D-Calif). told the House Rules Committee that the PACT Act doesn’t necessarily free up more room under the discretionary spending cap, but simply ensures Congress doesn’t have to find room in each year’s annual spending bill to cover the bill’s costs.

“We wouldn’t argue about how we’re going to pay for the things that a service member needs in the heat of battle. Why is it that when we shift 10 years down the road, and whether we’re dealing with a cancer that is associated with a burn pit, or a family that needs benefits because that service member has died, why suddenly is it now a question of how we pay for it?” Takano said.

“It’s not about that we’re going to have more ability to spend more discretionary money. It’s that we’re not pitting the veteran against everybody else,” Takano said.

House VA Committee Ranking Member Mike Bost (R-Ill.) told the rules committee that the PACT Act is “not perfect,” and “also is not cheap,” but said the legislation reflects compromises between both parties.

“There is no doubt about it. This version of the pact act is better than the one we voted on in March. It is a product of bipartisan negotiations, and includes work from lawmakers on both sides of the aisle,” Bost said.

Bost said he supports an amendment that would keep the nearly $400 billion in VA health care under discretionary spending caps, but said he still supports the legislation in its current form.

I think our colleagues will have a problem with that. Some of them, I hope that they understand how important this issue is, and that’s why I’m supporting,” Bost said.

Bost said the PACT Act includes $285 billion in new spending.

“That’s not an insignificant amount. But as a VA committee leader, a veteran, a military father, and a grandfather, I believe it is what is needed to care for our veterans and survivors.”

Takano urged the House to pass the PACT Act, noting that the bill now includes provisions will strengthen the VA workforce and approves additional leases for VA health care facilities.

“This is a very good bill, one that draws from Democratic and Republican legislation alike, and represents a crucial and long overdue down payment on the care and attention that our toxic-exposed veterans demand and deserve,” Takano said.

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