Department of Veterans Affairs FY2021 Appropriations

Changes from July 21, 2020 to December 14, 2020

This page shows textual changes in the document between the two versions indicated in the dates above. Textual matter removed in the later version is indicated with ~~red strikethrough~~ and textual matter added in the later version is indicated with blue.

Department of Veterans Affairs
~~July 21~~December 14, 2020 , 2020
FY2021 Appropriations
Sidath Viranga Panangala
The Department of Veterans Affairs (VA) administers numerous programs that provide benefits The Department of Veterans Affairs (VA) administers numerous programs that provide benefits
Specialist in Veterans Specialist in Veterans
and services to eligible veterans and their families. These benefits include medical care; disability and services to eligible veterans and their families. These benefits include medical care; disability
Policy Policy
compensation and pensions; education; vocational rehabilitation and employment services; compensation and pensions; education; vocational rehabilitation and employment services;

assistance to homeless veterans; home loan guarantees; administration of life insurance, as well assistance to homeless veterans; home loan guarantees; administration of life insurance, as well
Jared S. Sussman
as traumatic injury protection insurance for servicemembers; and death benefits that cover burial as traumatic injury protection insurance for servicemembers; and death benefits that cover burial
Analyst in Health Policy Analyst in Health Policy
expenses. expenses.

President Trump submitted his budget proposal for FY2021 on February 10, 2020. The President Trump submitted his budget proposal for FY2021 on February 10, 2020. The
Heather M. Salazar
President’s budget is requesting $240.2 billion for the VA. This amount includes $135.4 billion President’s budget is requesting $240.2 billion for the VA. This amount includes $135.4 billion
Analyst in Veterans Policy Analyst in Veterans Policy
in mandatory benefits funding and $104.8 billion in discretionary funding. When compared with in mandatory benefits funding and $104.8 billion in discretionary funding. When compared with

the FY2020-enacted amount for the VA of $237.5 billion—which includes regular appropriations the FY2020-enacted amount for the VA of $237.5 billion—which includes regular appropriations
provided by the Further Consolidated Appropriations Act, 2020 (P.L. 116-94), and supplemental provided by the Further Consolidated Appropriations Act, 2020 (P.L. 116-94), and supplemental

funding provided by the Families First Coronavirus Response Act (P.L. 116-127) and the funding provided by the Families First Coronavirus Response Act (P.L. 116-127) and the
Coronavirus Aid, Relief, and Economic Security Act (P.L. 116-136)—this is an increase of $2.752 billion. Additionally, the Coronavirus Aid, Relief, and Economic Security Act (P.L. 116-136)—this is an increase of $2.752 billion. Additionally, the
budget request includes an advance appropriation request of $239.5 billion for FY2022 to fund the seven advance budget request includes an advance appropriation request of $239.5 billion for FY2022 to fund the seven advance
appropriations accounts—compensation and pensions, readjustment benefits, insurance and indemnities, medical services, appropriations accounts—compensation and pensions, readjustment benefits, insurance and indemnities, medical services,
medical community care, medical support and compliance, and medical facilities. medical community care, medical support and compliance, and medical facilities.
On July On July ~~6, 2020, the House Committee on Appropriations, Subcommittee on Military Construction, Veterans Affairs, and~~
~~Related Agencies~~9, the House Appropriations Committee held a markup of the FY2021 Military Construction and Veterans Affairs, and Related Agencies held a markup of the FY2021 Military Construction and Veterans Affairs, and Related Agencies
(MILCON-VA) appropriations bill, and the (MILCON-VA) appropriations bill, and the ~~draft bill was approved. On July 9, the House Appropriations Committee held a~~
~~markup of the FY2021 MILCON-VA appropriations bill and the bill was ordered reported to the full House on July 13 (H.R.~~
~~7609; H.Rept. 116-445). The committee reported bill provides a total of $240.2 billion for the VA, this is a $2.718 billion~~
~~increase over the FY2020 enacted amount of $237.5 billion and about $35 million less than the President’s request. The~~
~~committee reported bill has designated $12.5 billion from the total amount provided to the department ($240.2 billion) as~~
~~emergency funding for VA health care, Electronic Health Record Modernization (EHRM) among others~~bill was ordered reported to the full House on July 13 (H.R. 7609; H.Rept. 116-445). Subsequently, the text of H.R. 7609 was included in a four-bill appropriations package (H.R. 7608, the State, Foreign Operations, Agriculture, Rural Development, Interior, Environment, Military Construction, and Veterans Affairs Appropriations bill 2021) and passed by the full House on July 24. The House-passed bill (Division D of H.R. 7608) provides $240.2 billion for the VA, including $135.4 billion in mandatory spending and $104.8 billion in discretionary spending. On November 10, the chair of the Senate Committee on Appropriations, Senator Richard Shelby, released a draft MILCON-VA appropriations bill along with a draft accompanying explanatory statement. The release of the draft bill was intended to further negotiations on annual appropriations between the House and the Senate. The Senate Appropriations Committee Majority Draft recommends $243.1 billion for the VA, including $138.7 billion in mandatory spending and $104.4 billion in discretionary spending. Comparative . Comparative
funding levels with amounts enacted for FY2020funding levels with amounts enacted for FY2020 ~~and amounts requested and recommended for FY2021 are as follows:~~
Veterans Benefits Administration (VBA, including General Operating Expenses)
~~ FY2020 Enacted: $128.7 billion~~
~~ FY2021 Request: $138.8 billion~~
~~ FY2021 House Committee (H.Rept. 116-445): $138.8 billion~~
~~Veterans Health Administration (VHA)~~
~~ FY2020 Enacted: $97.9 billion~~
~~ FY2021 Request: $90.8 billion~~
~~ FY2021 House Committee (H.Rept. 116-445): $90.8 billion~~
~~National Cemetery Administration (NCA)~~
~~ FY2020 Enacted: $328 million~~
~~ FY2021 Request: $360 million~~
~~ FY2021 House Committee (H.Rept. 116-445): $349 million~~
~~Departmental Administration~~
~~ FY2020 Enacted: $10.6 billion~~
~~ FY2021 Request: $10.3 billion~~
~~ FY2021 House Committee (H.Rept. 116-445): $10.3 billion~~
, amounts requested and provided by the House-passed measure, and recommended by the Senate Appropriations Committee majority MILCON-VA draft bill for FY2021 are as follows: FY2021 Senate Appropriations FY2021 House- Committee Majority FY2020 Enacted FY2021 Request passed Draft Veterans Benefits $128.7 bil ion $138.8 bil ion $138.8 bil ion $142.1bil ion Administration (VBA, including General Operating Expenses) Veterans Health $97.9 bil ion $90.8 bil ion $90.8 bil ion $90.8 bil ion Administration (VHA) National Cemetery $328 mil ion $360 mil ion $349 mil ion $352 mil ion Administration (NCA) Departmental $10.6 bil ion $10.3 bil ion $10.2 bil ion $10.2 bil ion Administration Since no regular appropriations bills were enacted at the beginning of FY2021 on October 1, 2020, certain VA accounts (excluding the seven advance appropriations accounts that received FY2021 budget authority in P.L. 116-94) are funded through the Continuing Appropriations Act, 2021, and Other Extensions Act (P.L. 116-159) and the Further Continuing Appropriations Act, 2021, and Other Extensions Act (P.L. 116-215) through December 18, 2020 at FY2020 levels. Congressional Research Service Congressional Research Service

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39

Appendixes
Appendix A. Veteran Population, VA Enrollees, and VA Patients, FY2000-FY2021 ................... 2429
Appendix B. Department of Veterans Affairs, Enacted Appropriations FY1995-FY2020 ............ 2530

Contacts
Author Information ........................................................................................................................ 3843

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Introduction
The Department of Veterans Affairs (VA) provides a range of benefits and services to veterans The Department of Veterans Affairs (VA) provides a range of benefits and services to veterans
who meet certain eligibility criteria. These benefits and services include, among other things, who meet certain eligibility criteria. These benefits and services include, among other things,
hospital and medical care;1 disability compensation and pensions;2 education;3 vocational hospital and medical care;1 disability compensation and pensions;2 education;3 vocational
rehabilitation and employment services;4 assistance to homeless veterans;5 home loan rehabilitation and employment services;4 assistance to homeless veterans;5 home loan
guarantees;6 administration of life insurance, as well as traumatic injury protection insurance for guarantees;6 administration of life insurance, as well as traumatic injury protection insurance for
servicemembers; and death benefits that cover burial expenses.7 servicemembers; and death benefits that cover burial expenses.7
The department carries out its programs nationwide through three administrations and the Board The department carries out its programs nationwide through three administrations and the Board
of Veterans Appeals (BVA). The Veterans Health Administration (VHA) is responsible for health of Veterans Appeals (BVA). The Veterans Health Administration (VHA) is responsible for health
care services and medical and prosthetic research programs. The Veterans Benefits care services and medical and prosthetic research programs. The Veterans Benefits
Administration (VBA) is responsible for, among other things, providing compensation, pensions, Administration (VBA) is responsible for, among other things, providing compensation, pensions,
and education assistance. The National Cemetery Administration (NCA)8 is responsible for and education assistance. The National Cemetery Administration (NCA)8 is responsible for
maintaining national veterans cemeteries; providing grants to states for establishing, expanding, maintaining national veterans cemeteries; providing grants to states for establishing, expanding,
or improving state veterans cemeteries; and providing headstones and markers for the graves of or improving state veterans cemeteries; and providing headstones and markers for the graves of
eligible persons, among other things. The BVA reviews all appeals made by veterans or their eligible persons, among other things. The BVA reviews all appeals made by veterans or their
representatives for entitlement to veterans’ benefits, including claims for service connection, representatives for entitlement to veterans’ benefits, including claims for service connection,
increased disability ratings, pensions, insurance benefits, and educational benefits, among other increased disability ratings, pensions, insurance benefits, and educational benefits, among other
things. things.
Scope and Limitations of This Report
This report provides an overview of the FY2021 President’s request for the VA and subsequent This report provides an overview of the FY2021 President’s request for the VA and subsequent
congressional action. It begins with a discussion of various appropriations and funds that congressional action. It begins with a discussion of various appropriations and funds that
constitute the VA’s budget, followed by a brief overview of the FY2020 congressional constitute the VA’s budget, followed by a brief overview of the FY2020 congressional
appropriations process and enacted amounts for FY2020, including coronavirus supplemental appropriations process and enacted amounts for FY2020, including coronavirus supplemental
funding. It then discusses the President’s request for FY2021 for care, benefits, and services for funding. It then discusses the President’s request for FY2021 for care, benefits, and services for
veterans and administration of the department and congressional consideration. The report veterans and administration of the department and congressional consideration. The report
provides funding levels for the accounts as presented in the Military Construction, Veterans provides funding levels for the accounts as presented in the Military Construction, Veterans
Affairs, and Related Agencies (MILCON-VA) appropriations bill; it does not provide funding Affairs, and Related Agencies (MILCON-VA) appropriations bill; it does not provide funding
levels at the subaccount, program, or activity levellevels at the subaccount, program, or activity levels. Appendix B lists appropriations to the VA lists appropriations to the VA
from FY1995 to FY2020. Funding amounts shown in the appendices of this report may include from FY1995 to FY2020. Funding amounts shown in the appendices of this report may include
transfers in and out of accounts as calculated by the VA and therefore may be different from those transfers in and out of accounts as calculated by the VA and therefore may be different from those

1 For more information on programs, see CRS Report R42747, 1 For more information on programs, see CRS Report R42747, Health Care for Veterans: Answers to Frequently Asked
Questions. .
2 For more information on programs, see CRS Report R44837, 2 For more information on programs, see CRS Report R44837, Benefits for Service-Disabled Veterans; and CRS Report ; and CRS Report
RS22804, RS22804, Veterans’ Benefits: Pension Benefit Programs. .
3 For a discussion of education benefits, see CRS Report R42755, 3 For a discussion of education benefits, see CRS Report R42755, The Post-9/11 GI Bill: A Primer. .
4 For details on VA’s vocational rehabilitation and employment, see CRS Report RL34627, 4 For details on VA’s vocational rehabilitation and employment, see CRS Report RL34627, Veterans’ Benefits: The
Vocational Rehabilitation and Employment Program. .
5 For detailed information on homeless veterans programs, see CRS In Focus IF10167, 5 For detailed information on homeless veterans programs, see CRS In Focus IF10167, Veterans and Homelessness. .
6 For details on the home loan guarantee program, see CRS Report R42504, 6 For details on the home loan guarantee program, see CRS Report R42504, VA Housing: Guaranteed Loans, Direct
Loans, and Specially Adapted Housing Grants. .
7 For more information on burial benefits, see CRS Report R41386, 7 For more information on burial benefits, see CRS Report R41386, Veterans’ Benefits: Burial Benefits and National
Cemeteries. .
8 Established by the National Cemeteries Act of 1973 (P.L. 93-43). 8 Established by the National Cemeteries Act of 1973 (P.L. 93-43).
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shown in shown in Table 1, which is based on budget authority amounts shown in the which is based on budget authority amounts shown in the ~~committee reports~~
~~accompanying the MILCON-VA appropriations bill.~~
MILCON-VA appropriations bills and accompanying committee reports or draft explanatory statements. The Department of Veterans Affairs Budget
The VA budget includes both mandatory9 and discretionary funding.10 Mandatory accounts fund The VA budget includes both mandatory9 and discretionary funding.10 Mandatory accounts fund
disability compensation for veterans, the survivor’s Dependency and Indemnity Compensation disability compensation for veterans, the survivor’s Dependency and Indemnity Compensation
(DIC) program, pensions, vocational rehabilitation and employment, education, life insurance, (DIC) program, pensions, vocational rehabilitation and employment, education, life insurance,
housing, clothing allowances, and burial benefits (such as burial allowances, grave liners, outer housing, clothing allowances, and burial benefits (such as burial allowances, grave liners, outer
burial receptacles, and headstones and markers), among other benefits and services. Discretionary burial receptacles, and headstones and markers), among other benefits and services. Discretionary
accounts fund medical care, medical research, construction programs, information technology, the accounts fund medical care, medical research, construction programs, information technology, the
Office of Inspector General, BVA, and general operating expenses, among other things. These Office of Inspector General, BVA, and general operating expenses, among other things. These
accounts are further supplemented by revolving funds, such as the Canteen Service Revolving accounts are further supplemented by revolving funds, such as the Canteen Service Revolving
Fund and the Pershing Hall Revolving Fund; trust funds, such as the Department of Veterans Fund and the Pershing Hall Revolving Fund; trust funds, such as the Department of Veterans
Affairs Cemetery Gift Fund and the General Post Fund; and special funds, such as the Medical Affairs Cemetery Gift Fund and the General Post Fund; and special funds, such as the Medical
Care Collections Fund and the Capital Asset Fund.11 Care Collections Fund and the Capital Asset Fund.11
Advance Appropriations12
The VA has advance appropriation authority for specified medical care and benefits accounts. In The VA has advance appropriation authority for specified medical care and benefits accounts. In
2009, Congress enacted the Veterans Health Care Budget Reform and Transparency Act of 2009 2009, Congress enacted the Veterans Health Care Budget Reform and Transparency Act of 2009
(P.L. 111-81), authorizing advance appropriations for three of the four VHA accounts: medical (P.L. 111-81), authorizing advance appropriations for three of the four VHA accounts: medical
services, medical support and compliance, and medical facilities.13 In 2014, Congress passed the services, medical support and compliance, and medical facilities.13 In 2014, Congress passed the
Consolidated and Further Continuing Appropriations Act, 2015 (H.R. 83; P.L. 113-235), which Consolidated and Further Continuing Appropriations Act, 2015 (H.R. 83; P.L. 113-235), which
amended 38 U.S.Camended 38 U.S.C. §117 and included three more accounts to the advance appropriations list of §117 and included three more accounts to the advance appropriations list of
accounts. This act authorized advance appropriations for three mandatory VA benefits programs accounts. This act authorized advance appropriations for three mandatory VA benefits programs
within the Veterans Benefits Administration: compensation and pensions, readjustment benefits, within the Veterans Benefits Administration: compensation and pensions, readjustment benefits,
and veterans insurance and indemnities. Beginning with the FY2016 Military Construction and and veterans insurance and indemnities. Beginning with the FY2016 Military Construction and
Veterans Affairs, and Related Agencies Appropriations Act (MILCON- VA; P.L. 114-113), those Veterans Affairs, and Related Agencies Appropriations Act (MILCON- VA; P.L. 114-113), those
accounts received advance appropriations for the first time in FY2017, in addition to the three accounts received advance appropriations for the first time in FY2017, in addition to the three
VHA accounts already authorized to receive advance appropriations. VHA accounts already authorized to receive advance appropriations.
Section 4003 of the Surface Transportation and Veterans Health Care Choice Improvement Act of Section 4003 of the Surface Transportation and Veterans Health Care Choice Improvement Act of
2015 (P.L. 114-41) required the establishment of a separate new account for medical community 2015 (P.L. 114-41) required the establishment of a separate new account for medical community

9 Mandatory programs funded through the annual appropriations process are commonly referred to as 9 Mandatory programs funded through the annual appropriations process are commonly referred to as appropriated
entitlements. In general, appropriators have little control over the amounts provided for appropriated entitlements; . In general, appropriators have little control over the amounts provided for appropriated entitlements;
rather, the authorizing statute establishes the program parameters (e.g., eligibility rules, benefit levels) that entitle rather, the authorizing statute establishes the program parameters (e.g., eligibility rules, benefit levels) that entitle
certain recipients to payments. If Congress does not appropriate the money necessary to meet these commitments, certain recipients to payments. If Congress does not appropriate the money necessary to meet these commitments,
entitled recipients (e.g., individuals, states, or other entities) may have legal recourse. For an overview of mandatory entitled recipients (e.g., individuals, states, or other entities) may have legal recourse. For an overview of mandatory
spending, see CRS Report R44641, spending, see CRS Report R44641, Trends in Mandatory Spending: In Brief. .
10 Funding for discretionary programs is provided and controlled through the annual appropriations process. For more 10 Funding for discretionary programs is provided and controlled through the annual appropriations process. For more
information, see CRS Report R41726, information, see CRS Report R41726, Discretionary Budget Authority by Subfunction: An Overview.
11 For more details about these funds, see Department of Veterans Affairs, 11 For more details about these funds, see Department of Veterans Affairs, FY2016 Congressional Budget Submission, ,
Supplemental Information and Appendices, vol. 1 of 4, February 2015, pp. Appendix 117-Appendix 126. (This is the Supplemental Information and Appendices, vol. 1 of 4, February 2015, pp. Appendix 117-Appendix 126. (This is the
last edition in which this information was published.) For definitions about “revolving funds,” “trust funds,” and last edition in which this information was published.) For definitions about “revolving funds,” “trust funds,” and
“special funds,” see Executive Office of the President, Office of Management and Budget (OMB), OMB Circular No. “special funds,” see Executive Office of the President, Office of Management and Budget (OMB), OMB Circular No.
A–11, A–11, Section 20- Terms and Concepts,, available at https://www.whitehouse.gov/wp-content/uploads/2018/06/s20.pdf. available at https://www.whitehouse.gov/wp-content/uploads/2018/06/s20.pdf.
12 For a detailed discussion of advance appropriations, see CRS Report R43482, 12 For a detailed discussion of advance appropriations, see CRS Report R43482, Advance Appropriations, Forward
Funding, and Advance Funding: Concepts, Practice, and Budget Process Considerations. .
13 Codified at 38 U.S.C. §117. 13 Codified at 38 U.S.C. §117.
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8 Department of Veterans Affairs FY2021 Appropriations

care, beginning with the FY2017 appropriations cycle. The Jeff Miller and Richard Blumenthal care, beginning with the FY2017 appropriations cycle. The Jeff Miller and Richard Blumenthal
Veterans Health Care and Benefits Improvement Act of 2016 (P.L. 114-315) authorized advanced Veterans Health Care and Benefits Improvement Act of 2016 (P.L. 114-315) authorized advanced
appropriations for the medical community care account. appropriations for the medical community care account.
Congress has authorized (through P.L. 111-81, P.L. 113-235, and P.L. 114-315) advance Congress has authorized (through P.L. 111-81, P.L. 113-235, and P.L. 114-315) advance
appropriations of new budget authority for these VBA and VHA accounts to prevent potential appropriations of new budget authority for these VBA and VHA accounts to prevent potential
delays in the delivery of care and benefits to veterans that may arise in the event of a funding delays in the delivery of care and benefits to veterans that may arise in the event of a funding
lapse. lapse.
Under present budget scoring guidelines, advance appropriations are scored as new budget Under present budget scoring guidelines, advance appropriations are scored as new budget
authority in the fiscal year in which they become available for obligation, not in the fiscal year the authority in the fiscal year in which they become available for obligation, not in the fiscal year the
appropriations are enacted and required to be accommodated within the statutory spending caps appropriations are enacted and required to be accommodated within the statutory spending caps
for that year.14 Therefore, throughout the funding tables in this report, advance appropriations for that year.14 Therefore, throughout the funding tables in this report, advance appropriations
numbers are noted by the label “memorandum” and in the corresponding fiscal year column. numbers are noted by the label “memorandum” and in the corresponding fiscal year column.
Historical Perspective
Figure 1 provides funding trends for mandatory, discretionary, and total VA-enacted provides funding trends for mandatory, discretionary, and total VA-enacted
appropriations from FY1995 through FY2020. Between FY1995 and FY2020, total mandatory appropriations from FY1995 through FY2020. Between FY1995 and FY2020, total mandatory
appropriations grew from $19.5 billion to $124.7 billion in nominal dollars, a compound annual appropriations grew from $19.5 billion to $124.7 billion in nominal dollars, a compound annual
growth rate (CAGR) of 7.7%.15 During this same period, discretionary appropriations grew from growth rate (CAGR) of 7.7%.15 During this same period, discretionary appropriations grew from
$18.0 billion to $112.1 billion, a CAGR of 7.6%. The total VA appropriations from FY1995 $18.0 billion to $112.1 billion, a CAGR of 7.6%. The total VA appropriations from FY1995
through FY2020 grew from $37.5 billion to $236.8 billion, a CAGR of 7.7%. through FY2020 grew from $37.5 billion to $236.8 billion, a CAGR of 7.7%.
~~Figure 1. VA Appropriations, FY1995-FY2020~~

Source: Figure prepared by CRS based on figures from the Department of Veterans Affairs, Office of
~~Management, Office of Budget (see, Appendix B).~~
Notes: Amounts in in nominal, or non-inflation-adjusted, dol ars, and discretionary funding excludes offsetting
~~col ections deposited in the Medical Care Col ections Fund (MCCF).~~

14 Executive Office of the President, Office of Management and Budget (OMB), OMB Circular No. A–11, 14 Executive Office of the President, Office of Management and Budget (OMB), OMB Circular No. A–11, Section 20-
Terms and Concepts, 2017,2017, p. 16, available at https://www.whitehouse.gov/sites/whitehouse.gov/files/omb/assets/p. 16, available at https://www.whitehouse.gov/sites/whitehouse.gov/files/omb/assets/
a11_current_year/a11_2017/s20.pdf; also see OMB Circular No. A–11, a11_current_year/a11_2017/s20.pdf; also see OMB Circular No. A–11, Appendix A -Scorekeeping Guidelines, 2017, p. 2017, p.
2, available at https://www.whitehouse.gov/sites/whitehouse.gov/files/omb/assets/a11_current_year/a11_2017/2, available at https://www.whitehouse.gov/sites/whitehouse.gov/files/omb/assets/a11_current_year/a11_2017/
app_a.pdf. app_a.pdf.
15 CAGR is annualized average rate of growth between two given years, calculated as CAGR, year FY1995 to year 15 CAGR is annualized average rate of growth between two given years, calculated as CAGR, year FY1995 to year
FY2020 = [(value in year 2020/value in year 1995) ^ (1/25)-1]. FY2020 = [(value in year 2020/value in year 1995) ^ (1/25)-1].
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34 Department of Veterans Affairs FY2021 Appropriations Figure 1. VA Appropriations, FY1995-FY2020 Source: Figure prepared by CRS based on figures from the Department of Veterans Affairs, Office of Management, Office of Budget (see, Appendix B). Notes: Amounts in in nominal, or noninflation-adjusted, dol ars, and discretionary funding excludes offsetting col ections deposited in the Medical Care Col ections Fund (MCCF).
FY2020 Budget Summary
President Trump submitted his FY2020 budget request for the VA on March 11, 2019. The President Trump submitted his FY2020 budget request for the VA on March 11, 2019. The
Administration requested a total $216.1 billion for the VA. This amount included $123.2 billion in Administration requested a total $216.1 billion for the VA. This amount included $123.2 billion in
mandatory appropriations and $92.9 billion in discretionary funding. The President’s request also mandatory appropriations and $92.9 billion in discretionary funding. The President’s request also
included advance appropriations for FY2021 for specific medical care and mandatory veterans’ included advance appropriations for FY2021 for specific medical care and mandatory veterans’
benefit programs. For medical care accounts, the budget request included $87.6 billion in benefit programs. For medical care accounts, the budget request included $87.6 billion in
discretionary advance appropriations and $129.5 billion in advance appropriations for mandatory discretionary advance appropriations and $129.5 billion in advance appropriations for mandatory
benefits. benefits.
On May 9, 2019, the House Appropriations Committee approved the FY2020 Military On May 9, 2019, the House Appropriations Committee approved the FY2020 Military
Construction, Veterans Affairs, and Related Agencies (MILCON-VA) bill (H.R. 2745; H.Rept. Construction, Veterans Affairs, and Related Agencies (MILCON-VA) bill (H.R. 2745; H.Rept.
116-63). The Senate Appropriations Committee did not mark up or report its version of the 116-63). The Senate Appropriations Committee did not mark up or report its version of the
FY2020 MILCON-VA bill. After the passage of several continuing resolutions (CRs), on FY2020 MILCON-VA bill. After the passage of several continuing resolutions (CRs), on
December 20, 2019, the President signed the Further Consolidated Appropriations Act, 2020 December 20, 2019, the President signed the Further Consolidated Appropriations Act, 2020
(H.R. 1865; P.L. 116-94), providing regular appropriations for FY2020. Division F of this act (H.R. 1865; P.L. 116-94), providing regular appropriations for FY2020. Division F of this act
contained the Military Construction, Veterans Affairs, and Related Agencies Appropriations contained the Military Construction, Veterans Affairs, and Related Agencies Appropriations
(MILCON-VA) Act, 2020.16 The act provides $217.9 billion for the VA. This amount includes (MILCON-VA) Act, 2020.16 The act provides $217.9 billion for the VA. This amount includes
$125.4 billion in mandatory appropriations and $92.5 billion in discretionary funding. P.L. 116-94 $125.4 billion in mandatory appropriations and $92.5 billion in discretionary funding. P.L. 116-94
provided advance appropriations for FY2021 totaling $87.6 billion for medical care accounts provided advance appropriations for FY2021 totaling $87.6 billion for medical care accounts
(medical services, medical community care, medical support and compliance, and medical (medical services, medical community care, medical support and compliance, and medical
facilities) and $131 billion for mandatory veterans benefits (compensation and pensions, facilities) and $131 billion for mandatory veterans benefits (compensation and pensions,
16 The full legislative text and the explanatory statement of P.L. 116-94 is contained in the House Committee Print Further Consolidated Appropriations Act, 2020, at https://www.govinfo.gov/content/pkg/CPRT-116HPRT38679/pdf/CPRT-116HPRT38679.pdf. Congressional Research Service 4 link to page 28 link to page 10 link to page 28 link to page 28 link to page 28 Department of Veterans Affairs FY2021 Appropriations readjustment benefits, and veterans insurance and indemnities). All amounts are prior to the readjustment benefits, and veterans insurance and indemnities). All amounts are prior to the
enactment of COVID-19 supplemental fundingenactment of COVID-19 supplemental funding.
. Table 1 provides total funding levels that include the regular appropriations provided in P.L. 116-provides total funding levels that include the regular appropriations provided in P.L. 116-
94 and the supplemental appropriations discussed below94 and the supplemental appropriations discussed below. Figure 2 provides an overview of provides an overview of
FY2020-enacted mandatory and discretionary appropriations. FY2020-enacted mandatory and discretionary appropriations.
COVID-19 Pandemic FY2020 Supplemental Appropriations17
In response to the rapidly evolving COVID-19 pandemic, Congress provided supplemental In response to the rapidly evolving COVID-19 pandemic, Congress provided supplemental
funding for FY2020 for several VA accounts. The total amount of supplemental funding for funding for FY2020 for several VA accounts. The total amount of supplemental funding for
FY2020 is $19.63 billion. This amount includes $60.0 FY2020 is $19.63 billion. This amount includes $60.0 million provided in the Families First provided in the Families First
Coronavirus Response Act (P.L. 116-127) and $19.6 billion provided in the Coronavirus Aid, Coronavirus Response Act (P.L. 116-127) and $19.6 billion provided in the Coronavirus Aid,
Relief, and Economic Security Act, “CARES Act” (P.L. 116-136). Relief, and Economic Security Act, “CARES Act” (P.L. 116-136).
Families First Coronavirus Response Act (P.L. 116-127)
On March 18, 2020, the President signed into law the Families First Coronavirus Response Act On March 18, 2020, the President signed into law the Families First Coronavirus Response Act
(P.L. 116-127). The act provides $30 million for VHA’s medical services account to fund health (P.L. 116-127). The act provides $30 million for VHA’s medical services account to fund health
services and related items pertaining to COVID-19, and $30 million for VHA’s medical services and related items pertaining to COVID-19, and $30 million for VHA’s medical
community care account (seecommunity care account (see Table 1). These funds are designated as emergency spending and . These funds are designated as emergency spending and
are to remain available until September 30, 2022. are to remain available until September 30, 2022.

~~16 The full legislative text and the explanatory statement of P.L. 116-94 is contained in the House Committee Print~~
~~Further Consolidated Appropriations Act, 2020, https://www.govinfo.gov/content/pkg/CPRT-116HPRT38679/pdf/~~
~~CPRT-116HPRT38679.pdf.~~
~~17 For more details on the VA’s and Congress’s response to the COVID-19 pandemic, see CRS Report R46340,~~
Federal Response to COVID-19: Department of Veterans Affairs.
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~~link to page 23 link to page 23~~ ~~Department of Veterans Affairs FY2021 Appropriations~~

Coronavirus Aid, Relief, and Economic Security Act, "CARES Act" (P.L. 116-
136)
On March 27, the President signed into law the CARES Act (P.L. 116-136). Division B of this act On March 27, the President signed into law the CARES Act (P.L. 116-136). Division B of this act
included an emergency supplemental appropriations measure. Title X of Division B provides included an emergency supplemental appropriations measure. Title X of Division B provides
supplemental appropriations for FY2020, designated as emergency spending, for certain VA supplemental appropriations for FY2020, designated as emergency spending, for certain VA
accounts totaling $19.6 billion. Unless otherwise noted below, funds remain available until accounts totaling $19.6 billion. Unless otherwise noted below, funds remain available until
September 30, 2021. Funding provided in the CARES Act is broken down as follows (seeSeptember 30, 2021. Funding provided in the CARES Act is broken down as follows (see Table
1):18 18
 VHA, medical services account, $14.4 billion, for increased telehealth services;  VHA, medical services account, $14.4 billion, for increased telehealth services;
purchasing of additional medical equipment and supplies, testing kits, and purchasing of additional medical equipment and supplies, testing kits, and
personal protective equipment; and to provide additional support to homeless personal protective equipment; and to provide additional support to homeless
veterans, among other things. veterans, among other things.
 VA, information technology systems account, $2.2 billion, for increased telework  VA, information technology systems account, $2.2 billion, for increased telework
capacity, purchasing additional laptops for telework and telehealth-enabled capacity, purchasing additional laptops for telework and telehealth-enabled
laptops for VHA providers to work from home, and to increase bandwidth and IT laptops for VHA providers to work from home, and to increase bandwidth and IT
infrastructure needs, among other thingsinfrastructure needs, among other things.
 VHA, medical community care account, $2.1 billion, for increased emergency  VHA, medical community care account, $2.1 billion, for increased emergency
room and urgent care usage in the community. room and urgent care usage in the community.
 VHA, medical facilities account, $606 million, for the procurement of mobile  VHA, medical facilities account, $606 million, for the procurement of mobile
treatment facilities, improvements in security, and nonrecurring maintenance treatment facilities, improvements in security, and nonrecurring maintenance
projects. projects.
17 For more details on the VA’s and Congress’s response to the COVID-19 pandemic, see CRS Report R46340, Federal Response to COVID-19: Department of Veterans Affairs. 18 Based on Senate Appropriations Committee, Coronavirus Supplemental Appropriations Summary, available at https://www.appropriations.senate.gov/download/coronavirus-emergency-supplemental-appropriations-summary. Congressional Research Service 5 Department of Veterans Affairs FY2021 Appropriations  VA, grants for construction of state extended care facilities account, $150.0  VA, grants for construction of state extended care facilities account, $150.0
million, to help state homes renovate, alter, or repair facilities to respond to million, to help state homes renovate, alter, or repair facilities to respond to
COVID-19. COVID-19.
 VHA, medical support and compliance account, $100 million, for the provision  VHA, medical support and compliance account, $100 million, for the provision
of 24-hour emergency management coordination overtime payments, and for of 24-hour emergency management coordination overtime payments, and for
costs associated with travel and transport of materials. costs associated with travel and transport of materials.
 VBA, general operating expenses account, $13.0 million, for enhancing telework  VBA, general operating expenses account, $13.0 million, for enhancing telework
support for VBA staff and for additional cleaning contracts. support for VBA staff and for additional cleaning contracts.
 VA, Office of Inspector General account, $12.5 million, for increased oversight  VA, Office of Inspector General account, $12.5 million, for increased oversight
of the VA’s preparation and response to COVID-19 (funds remain available until of the VA’s preparation and response to COVID-19 (funds remain available until
September 30, 2022). September 30, 2022).
 VA, general administration account, $6.0 million, for maintaining 24-hour  VA, general administration account, $6.0 million, for maintaining 24-hour
operations of crisis response and continuity of operations plans at VA facilities, operations of crisis response and continuity of operations plans at VA facilities,
among other things. among other things.

~~18 Based on Senate Appropriations Committee, Coronavirus Supplemental Appropriations Summary, available at~~
~~https://www.appropriations.senate.gov/download/coronavirus-emergency-supplemental-appropriations-summary.~~
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~~Department of Veterans Affairs FY2021 Appropriations~~

Figure 2. Enacted Appropriations, FY2020, by Major Program and
Spending Category

Source: Figure prepared by CRS based on based on the Further Consolidated Appropriations Act, 2020 (P.L. Figure prepared by CRS based on based on the Further Consolidated Appropriations Act, 2020 (P.L.
116-94); the Families First Coronavirus Response Act (P.L. 116-127); the Coronavirus Aid, Relief, and Economic 116-94); the Families First Coronavirus Response Act (P.L. 116-127); the Coronavirus Aid, Relief, and Economic
Security Act (P.L. 116-136) and U.S. Congress, House Committee on Appropriations, Security Act (P.L. 116-136) and U.S. Congress, House Committee on Appropriations, Military Construction,
Congressional Research Service 6 link to page 12 Department of Veterans Affairs FY2021 Appropriations Veterans Affairs, and Related Agencies Appropriations Bill, 2021, report to accompany H.R. 7609, 116th Cong., 2nd , report to accompany H.R. 7609, 116th Cong., 2nd
sess., July 13, 2020, H.Rept. 116-445, pp. 131-141. sess., July 13, 2020, H.Rept. 116-445, pp. 131-141.
Notes: Total budget authority excludes offsetting col ections deposited in the Medical Care Col ections Fund Total budget authority excludes offsetting col ections deposited in the Medical Care Col ections Fund
(MCCF). Percentages may not add up due to rounding. (MCCF). Percentages may not add up due to rounding.
Budget Request for FY2021 and
Congressional Action
President Trump submitted his budget proposal for FY2021 on February 10, 2020. The President Trump submitted his budget proposal for FY2021 on February 10, 2020. The
President’s budget is requesting $240.2 billion for the VA. This amount includes $135.4 billion in President’s budget is requesting $240.2 billion for the VA. This amount includes $135.4 billion in
mandatory benefits funding and $104.8 billion in discretionary funding. When compared with the mandatory benefits funding and $104.8 billion in discretionary funding. When compared with the
FY2020-enacted amount for the VA of $237.5 billion—which includes regular appropriations FY2020-enacted amount for the VA of $237.5 billion—which includes regular appropriations
provided by the Further Consolidated Appropriations Act, 2020 (P.L. 116-94), and supplemental provided by the Further Consolidated Appropriations Act, 2020 (P.L. 116-94), and supplemental
funding provided by the Families First Coronavirus Response Act (P.L. 116-127) and the funding provided by the Families First Coronavirus Response Act (P.L. 116-127) and the
Coronavirus Aid, Relief, and Economic Security Act (P.L. 116-136)—this an increase of $2.752 Coronavirus Aid, Relief, and Economic Security Act (P.L. 116-136)—this an increase of $2.752
billion. Additionally, the Administration’s budget request includes an advance appropriation billion. Additionally, the Administration’s budget request includes an advance appropriation
request of $239.5 billion for FY2022 to fund the seven advance appropriations accounts—request of $239.5 billion for FY2022 to fund the seven advance appropriations accounts—
~~Congressional Research Service~~

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~~link to page 11~~

~~Department of Veterans Affairs FY2021 Appropriations~~

compensation and pensions, readjustment benefits, insurance and indemnities, medical services, compensation and pensions, readjustment benefits, insurance and indemnities, medical services,
medical community care, medical support and compliance, and medical facilities.medical community care, medical support and compliance, and medical facilities. Figure 3
provides the FY2021 President’s requested mandatory and discretionary appropriations by major provides the FY2021 President’s requested mandatory and discretionary appropriations by major
program. program.
Congressional Research Service 7 Department of Veterans Affairs FY2021 Appropriations Figure 3. Budget Request, FY2021, by Major Program and Spending Category

Source: Figure prepared by CRS based on U.S. Congress, House Committee on Appropriations, Figure prepared by CRS based on U.S. Congress, House Committee on Appropriations, Military
Construction, Veterans Affairs, and Related Agencies Appropriations Bill, 2021, report to accompany H.R. 7609, 116th , report to accompany H.R. 7609, 116th
Cong., 2nd sess., July 13, 2020, H.Rept. 116-445, pp. 131-141. Cong., 2nd sess., July 13, 2020, H.Rept. 116-445, pp. 131-141.
Notes: Total budget authority excludes offsetting col ections deposited in the Medical Care Col ections Fund Total budget authority excludes offsetting col ections deposited in the Medical Care Col ections Fund
(MCCF). Percentages may not add up due to rounding. (MCCF). Percentages may not add up due to rounding.
On July 6, 2020, the House Committee on Appropriations, Subcommittee on Military On July 6, 2020, the House Committee on Appropriations, Subcommittee on Military
Construction, Veterans Affairs, and Related Agencies held a markup of the FY2021 Military Construction, Veterans Affairs, and Related Agencies held a markup of the FY2021 Military
Construction, Veterans Affairs, and Related Agencies (MILCON-VA) appropriations bill, and the Construction, Veterans Affairs, and Related Agencies (MILCON-VA) appropriations bill, and the
draft bill was approved. On July 9, the House Appropriations Committee held a markup of the draft bill was approved. On July 9, the House Appropriations Committee held a markup of the
FY2021 MILCON-VA appropriations bill and the bill was ordered reported to the full House on FY2021 MILCON-VA appropriations bill and the bill was ordered reported to the full House on
July 13 (H.R. 7609; H.Rept. 116-445). July 13 (H.R. 7609; H.Rept. 116-445). ~~The committee reported bill provides a total of $240.2~~
~~billion for the VA, this is a $2.718 billion increase over the FY2020 enacted amount of $237.5~~
~~billion and about $35 million less than the President’s request. The committee reported bill (H.R.~~
~~7609; H.Rept. 116-445) has designated $12.5 billion from total amount provided to the VA~~
~~($240.2 billion) as emergency funding. A discussion on funding for major accounts is provided~~
~~below.~~
~~Congressional Research Service~~

7

~~link to page 23~~Subsequently, the text of H.R. 7609 was included in a four-bill appropriations package (H.R. 7608, the State, Foreign Operations, Agriculture, Rural Development, Interior, Environment, Military Construction, and Veterans Affairs Appropriations bill 2021) and passed by the full House on July 24. The House-passed measure (Division D of H.R. 7608) provides a total of $240.2 billion for the VA, which includes $135.4 billion in mandatory funding and $104.8 billion in discretionary funding. Within the overall total of $104.8 billion in discretionary funding, $12.5 billion is designated as emergency funding. On November 10, 2020, the chair of the Senate Committee on Appropriations, Senator Richard Shelby, released drafts of all 12 annual appropriations bills along with draft accompanying Congressional Research Service 8 link to page 28 Department of Veterans Affairs FY2021 Appropriations explanatory statements including the FY2021 MILCON-VA appropriations bill.19 The release of the draft bills was intended to further negotiations on annual appropriations between the House and the Senate.20 The majority draft FY2021 MILCON-VA appropriations bill recommends $243.1 billion for the VA, including $138.7 billion in mandatory spending and $104.4 billion in discretionary spending. Similar to the House-passed measure, the Senate majority draft version of the MILCON-VA appropriations bill has designated $12.5 billion as emergency spending within the recommended $104.4 billion discretionary spending level. ~~Department of Veterans Affairs FY2021 Appropriations~~

Mandatory Programs Funding
Major mandatory program funding includes VA’s disability compensation program; pensions to Major mandatory program funding includes VA’s disability compensation program; pensions to
low-income veterans, their surviving spouses, and dependent children; education and vocational low-income veterans, their surviving spouses, and dependent children; education and vocational
rehabilitation assistance; and the provision of life insurance. rehabilitation assistance; and the provision of life insurance.
Compensation and Pensions
The Compensation and Pensions category includes payments for benefits such as disability The Compensation and Pensions category includes payments for benefits such as disability
compensation; dependency and indemnity compensation (DIC); pension benefits for low-income compensation; dependency and indemnity compensation (DIC); pension benefits for low-income
disabled or elderly wartime veterans and their survivors; burial benefits (allowances, flags, disabled or elderly wartime veterans and their survivors; burial benefits (allowances, flags,
headstones, etc.); and a clothing allowance for certain disabled veterans. headstones, etc.); and a clothing allowance for certain disabled veterans.
For FY2021, the VA requested $121.1 billion for the Compensation and Pensions account, an For FY2021, the VA requested $121.1 billion for the Compensation and Pensions account, an
increase of $2.8 billion over the FY2021 advanced appropriations. The largest portion of this increase of $2.8 billion over the FY2021 advanced appropriations. The largest portion of this
budget item is disability compensation, which VA estimates to be $115.8 billion in compensation budget item is disability compensation, which VA estimates to be $115.8 billion in compensation
payments to an estimated 5.3 million veterans, 456,000 survivors, and 1,266 children. Pension payments to an estimated 5.3 million veterans, 456,000 survivors, and 1,266 children. Pension
payments are estimated to be $4.9 billion to approximately 231,100 veterans and 161,300 payments are estimated to be $4.9 billion to approximately 231,100 veterans and 161,300
survivors. Finally, an estimated $355 million will be allocated for burial benefits. survivors. Finally, an estimated $355 million will be allocated for burial benefits.
An increase in disability compensation obligations most significantly comes from the expansion An increase in disability compensation obligations most significantly comes from the expansion
of benefits under the Blue Water Navy Vietnam Veterans Act of 2019 (P.L. 116-23).of benefits under the Blue Water Navy Vietnam Veterans Act of 2019 (P.L. 116-23).1921 In general, In general,
the average payments for benefits, including disability compensation, pension, and survivor the average payments for benefits, including disability compensation, pension, and survivor
benefits, are expected to increase due to the annual cost-of-living adjustment (COLA). benefits, are expected to increase due to the annual cost-of-living adjustment (COLA).
The House The House ~~Appropriations Committee recommended amount~~-passed amount of $121.1 billion is the same as the VA’s requested is the same as the VA’s requested
amount for the Compensation and Pension account for FY2021amount for the Compensation and Pension account for FY2021 ~~(see Table 1). This amount is~~
~~$10.6 billion over the FY2020 enacted amount and reflects~~. This amount is $10.6 billion over the FY2020 enacted amount. In comparison, the Senate Appropriations Committee increased the recommended allocation to $124.4 billion for FY2021. This is $13.9 billion over the FY2020-enacted amount and $3.3 billion over VA’s requested amount for FY2021 (see Table 1). These increases reflect the increased number of disability the increased number of disability
compensation claims that will be granted and paid out on a monthly basis. These funds will also compensation claims that will be granted and paid out on a monthly basis. These funds will also
continue to support VA programs to address root causes of veterans’ financial hardships and to continue to support VA programs to address root causes of veterans’ financial hardships and to
improve communications with Veterans Service Organizations (VSOs).improve communications with Veterans Service Organizations (VSOs).20
22 The Senate majority draft explanatory statement raised concerns 19 The 12 draft bills and explanatory statements are on the committee’s website linked to the majority press release at https://www.appropriations.senate.gov/news/committee-releases-fy21-bills-in-effort-to-advance-process-produce-bipartisan-results. 20 Ibid. See also the statement from the Senate Appropriations Committee Vice Chair, Senator Patrick Leahy, at https://www.appropriations.senate.gov/news/minority/senate-approps-vice-chair-leahy-statement-on-the-release-of-the-fy-2021-senate-appropriations-bills-. 21 For more information, see CRS In Focus IF11368, Expansion of Benefits to Blue Water Navy Vietnam Veterans. 22 U.S. Congress, House Committee on Appropriations, Military Construction, Veterans Affairs, and Related Agencies Appropriations Bill, 2021, report to accompany H.R. 7609, 116th Cong., 2nd sess., July 13, 2020, H.Rept. 116-445, pp. Congressional Research Service 9 link to page 28 Department of Veterans Affairs FY2021 Appropriations about VA’s accounting measures for this account and has directed VA to submit a plan to both the Senate and House Appropriations Committees addressing required accounting adjustments and reconciliation of FY2020 funds. The committee requests this plan to be submitted no later than 60 days after the FY2021 MILCON-VA appropriations bill is enacted.23 Readjustment Benefits
The Readjustment Benefits category reflects several benefits related to the transition of The Readjustment Benefits category reflects several benefits related to the transition of
servicemembers from active duty status to veteran status, as well benefits for disabled veterans. servicemembers from active duty status to veteran status, as well benefits for disabled veterans.
Some of these programs include education benefits for veterans, survivors, and dependents; Some of these programs include education benefits for veterans, survivors, and dependents;
vocational rehabilitation and employment training for service-connected disabled veterans; and vocational rehabilitation and employment training for service-connected disabled veterans; and
financial assistance for adaptive automobiles, equipment, and housing grants for disabled financial assistance for adaptive automobiles, equipment, and housing grants for disabled
veterans. veterans.
For FY2021, the VA requested appropriations of $12.6 billion to provide sufficient mandatory For FY2021, the VA requested appropriations of $12.6 billion to provide sufficient mandatory
funding for Readjustment Benefits, approximately $1.5 billion less than the amount enacted in funding for Readjustment Benefits, approximately $1.5 billion less than the amount enacted in
FY2020. The decrease in readjustment benefits funding between FY2020 and FY2021 is largely FY2020. The decrease in readjustment benefits funding between FY2020 and FY2021 is largely
due to the carryover of $2.9 billion in unobligated benefits from prior years and $191.2 million in due to the carryover of $2.9 billion in unobligated benefits from prior years and $191.2 million in
offsetting collections from the Department of Defense (DOD).offsetting collections from the Department of Defense (DOD).21

~~19 For more information, see CRS In Focus IF11368, Expansion of Benefits to Blue Water Navy Vietnam Veterans.~~
~~20 U.S. Congress, House Committee on Appropriations,~~ ~~Military Construction, Veterans Affairs, and Related Agencies~~
~~Appropriations Bill, 2021, report to accompany H.R. 7609, 116th Cong., 2nd sess., July 13, 2020, H.Rept. 116-445, pp.~~
~~36-37.~~
21 U.S. Department of Veterans Affairs, FY2021 Budget Submission, Benefits and Burial Programs and Departmental
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~~link to page 23 link to page 23~~ ~~Department of Veterans Affairs FY2021 Appropriations~~

~~The House Appropriations Committee recommended amount is~~24 For readjustment and rehabilitation benefits, the House-passed measure (Division D of H.R. 7608) provides the same as the VA’s requested the same as the VA’s requested
amount for the Readjustment Benefits account amount for the Readjustment Benefits account ~~(se~~e(see Table 1 )) for FY2021. The committee for FY2021. The committee
~~highlighted~~highlights the importance of assistance to the importance of assistance to ~~transitioning veterans~~veterans transitioning from military life to academic, from military life to academic,
vocational, or employment life and therefore encourage VA to continue to expand these vocational, or employment life and therefore encourage VA to continue to expand these
~~programs.22~~programs.25 In the same manner, the Senate Appropriations committee majority draft bill recommends the same amount as VA’s requested amount for FY2021.
Veterans Insurance and Indemnities (VI&I)
The Veterans Insurance and Indemnities (VI&I) account is the mandatory funding mechanism for The Veterans Insurance and Indemnities (VI&I) account is the mandatory funding mechanism for
several government life insurance programs for veterans. In addition to direct payments made to several government life insurance programs for veterans. In addition to direct payments made to
insured veterans and their beneficiaries, this category includes supplemental funding for National insured veterans and their beneficiaries, this category includes supplemental funding for National
36-37. 23 Senate Appropriations Committee, “Majority draft Military Construction, Veterans Affairs, and Related Agencies, 2021 Explanatory Statement,” p. 28, at https://www.appropriations.senate.gov/download/fy21-mcva-report. 24 U.S. Department of Veterans Affairs, FY2021 Budget Submission, Benefits and Burial Programs and Departmental Administration, vol. 3 of 4, February 2020, pp. VBA-74, 75. 25U.S. Congress, House Committee on Appropriations, Military Construction, Veterans Affairs, and Related Agencies Appropriations Bill, 2021, report to accompany H.R. 7609, 116th Cong., 2nd sess., July 13, 2020, H.Rept. 116-445, pp. 37-38. Congressional Research Service 10 link to page 28 link to page 28 Department of Veterans Affairs FY2021 Appropriations Service Life Insurance (NSLI),26~~Service Life Insurance (NSLI),23~~ Service-Disabled Veterans Insurance (S-DVI), Service-Disabled Veterans Insurance (S-DVI),2427 and Veterans and Veterans
Mortgage Life Insurance (VMLI).Mortgage Life Insurance (VMLI).2528
For FY2021, VA estimates $6.3 million in collections from premiums, interest on investments, For FY2021, VA estimates $6.3 million in collections from premiums, interest on investments,
and extra hazard payments from military service branches. In addition, the VA has $2.2 million in and extra hazard payments from military service branches. In addition, the VA has $2.2 million in
previously appropriated funds to use until expended. In addition to the advanced appropriated previously appropriated funds to use until expended. In addition to the advanced appropriated
funds, VA requested $129.2 million, bringing the total amount to $131.4 million, an estimated funds, VA requested $129.2 million, bringing the total amount to $131.4 million, an estimated
$2.4 million increase from the FY2020-enacted budget. This increase will enable the VA to $2.4 million increase from the FY2020-enacted budget. This increase will enable the VA to
transfer $40,000 to the NSLI, program, $43 million to the VMLI program, and $96.6 million to transfer $40,000 to the NSLI, program, $43 million to the VMLI program, and $96.6 million to
the S-DVI program.the S-DVI program.2629 The House The House ~~Appropriations Committee has recommended~~bill has provided the same amount the same amount
for the Insurance and Indemnities account for FY2021 as requested in the Administration’s for the Insurance and Indemnities account for FY2021 as requested in the Administration’s
budget request (budget request (seesee Table 1).30 Similarly, the Senate Appropriations Committee majority draft bill recommends the same amount as VA’s requested amount for FY2021. Medical Care and Medical Research Discretionary Programs Funding Background The Veterans Health Administration (VHA) operates one of the nation’s largest integrated direct health care delivery systems.31 Although Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP) are also publicly funded programs, most health care services under these programs are delivered by private providers in private facilities. In contrast, the VA health care system could be categorized as a veteran-specific national health care system, in the sense that the federal government owns the medical facilities and employs the health care providers.32 The VA’s health care system is organized into 18 geographically defined Veterans Integrated Service Networks (VISNs). Although policies and guidelines are developed at VA headquarters to 261)~~.27~~

Administration, vol. 3 of 4, February 2020, p. VBA-74, 75.
~~22U.S. Congress, House Committee on Appropriations,~~ ~~Military Construction, Veterans Affairs, and Related Agencies~~
~~Appropriations Bill, 2021, report to accompany H.R. 7609, 116th Cong., 2nd sess., July 13, 2020, H.Rept. 116-445, pp.~~
~~37-38.~~
23 The National Service Life Insurance (NSLI) program was created on October 8, 1940, to handle insurance needs of The National Service Life Insurance (NSLI) program was created on October 8, 1940, to handle insurance needs of
World War II veterans. These policies were issued until April 24, 1951, and provided a maximum of $10,000 in World War II veterans. These policies were issued until April 24, 1951, and provided a maximum of $10,000 in
coverage. See https://www.benefits.va.gov/insurance/nsli.asp. coverage. See https://www.benefits.va.gov/insurance/nsli.asp.
2427 The Service-Disabled Veterans Insurance (S-DVI) program was established on April 25, 1951, and remains open for The Service-Disabled Veterans Insurance (S-DVI) program was established on April 25, 1951, and remains open for
new policies to service-connected disabled veterans who separated under other than dishonorable conditions. S-DVI new policies to service-connected disabled veterans who separated under other than dishonorable conditions. S-DVI
provides up to $10,000 in coverage for which premium relief is available to certain insured veterans. Up to an provides up to $10,000 in coverage for which premium relief is available to certain insured veterans. Up to an
additional $30,000 in supplemental coverage may be granted without a waiver of premiums. See https://www.va.gov/additional $30,000 in supplemental coverage may be granted without a waiver of premiums. See https://www.va.gov/
life-insurance/options-eligibility/s-dvi/. life-insurance/options-eligibility/s-dvi/.
2528 The Veterans Mortgage Life Insurance (NSLI) program provides veterans who meet certain requirements, including The Veterans Mortgage Life Insurance (NSLI) program provides veterans who meet certain requirements, including
having received a grant for specially adapted housing with up to $200,000 of mortgage protection life insurance. This having received a grant for specially adapted housing with up to $200,000 of mortgage protection life insurance. This
program pays the benefit directly to the bank or lender of the veteran’s mortgage. See https://www.va.gov/life-program pays the benefit directly to the bank or lender of the veteran’s mortgage. See https://www.va.gov/life-
insurance/options-eligibility/vmli/. insurance/options-eligibility/vmli/.
2629 U.S. Department of Veterans Affairs, U.S. Department of Veterans Affairs, FY2021 Budget Submission, Benefits and Burial Programs and Departmental
Administration, vol. 3 of 4, February 2020, , vol. 3 of 4, February 2020, ppp. VBA-131, 133. . VBA-131, 133.
2730 U.S. Congress, House Committee on Appropriations, U.S. Congress, House Committee on Appropriations, Military Construction, Veterans Affairs, and Related Agencies
Appropriations Bill, 2021, report to accompany H.R. 7609, 116th Cong., 2nd sess., July 13, 2020, H.Rept. 116-445,, report to accompany H.R. 7609, 116th Cong., 2nd sess., July 13, 2020, H.Rept. 116-445, p. p. 40. 31 U.S. Department of Veterans Affairs, FY 2009 Performance and Accountability Report, Washington, DC, November 16, 2009, p. I-42. Established on January 3, 1946, as the Department of Medicine and Surgery by P.L. 79-293, succeeded in 1989 by the Veterans Health Services and Research Administration, renamed the Veterans Health Administration in 1991. 32 Adam Oliver, “The Veterans Health Administration: An American Success Story?” The Milbank Quarterly, vol. 85, no. 1 (March 2007), pp. 5-35. Congressional Research Service 11 Department of Veterans Affairs FY2021 Appropriations be applied throughout the VA health care system, management authority for basic decisionmaking and budgetary responsibilities is delegated to the VISNs.33~~40.~~
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~~Department of Veterans Affairs FY2021 Appropriations~~

~~Medical Care and Medical Research Discretionary~~
~~Programs Funding~~
~~Background~~
~~The Veterans Health Administration (VHA) operates one of the nation’s largest integrated direct~~
~~health care delivery systems.28 Although Medicare, Medicaid, and the Children’s Health~~
~~Insurance Program (CHIP) are also publicly funded programs, most health care services under~~
~~these programs are delivered by private providers in private facilities. In contrast, the VA health~~
~~care system could be categorized as a veteran-specific national health care system, in the sense~~
~~that the federal government owns the medical facilities and employs the health care providers.29~~
~~The VA’s health care system is organized into 18 geographically defined Veterans Integrated~~
~~Service Networks (VISNs). Although policies and guidelines are developed at VA headquarters to~~
~~be applied throughout the VA health care system, management authority for basic decision~~
~~making and budgetary responsibilities is delegated to the VISNs.30~~ As of FY2020, the VHA As of FY2020, the VHA
operates 148 hospitals, 135 nursing homes, 765 community-based outpatient clinics (CBOCs),operates 148 hospitals, 135 nursing homes, 765 community-based outpatient clinics (CBOCs),31
34 and 300 Readjustment Counseling Centers (Vet Centers).and 300 Readjustment Counseling Centers (Vet Centers).3235 In 2009, the VA began a pilot Mobile In 2009, the VA began a pilot Mobile
Vet Center (MVC) program to improve access to services for veterans in rural areas, and the Vet Center (MVC) program to improve access to services for veterans in rural areas, and the
department has deployed 80 MVCs, to date.department has deployed 80 MVCs, to date.3336
Although the VHA provides most health care services to eligible veterans through its integrated Although the VHA provides most health care services to eligible veterans through its integrated
network of facilities, it does pay for care in the community under certain circumstances. The network of facilities, it does pay for care in the community under certain circumstances. The
Veterans Community Care Program (VCCP) applies eligibility for care in the community broadly Veterans Community Care Program (VCCP) applies eligibility for care in the community broadly
to all enrolled veterans based on specific criteria.to all enrolled veterans based on specific criteria.3437 The VA is authorized to provide care in the The VA is authorized to provide care in the
community through individual agreements with community providers, called community through individual agreements with community providers, called veterans care
agreements. The VA is also authorized to reimburse for emergency care visits if specific criteria . The VA is also authorized to reimburse for emergency care visits if specific criteria
are met.are met.3538 Inpatient and outpatient care are provided in the private sector to eligible dependents of Inpatient and outpatient care are provided in the private sector to eligible dependents of
veterans under the Civilian Health and Medical Program of the Department of Veterans Affairs veterans under the Civilian Health and Medical Program of the Department of Veterans Affairs
(CHAMPVA).(CHAMPVA).3639 In addition, the VHA provides grants for construction of state-owned nursing In addition, the VHA provides grants for construction of state-owned nursing

~~28 U.S. Department of Veterans Affairs, FY 2009 Performance and Accountability Report, Washington, DC, November~~
~~16, 2009, p. I-42. Established on January 3, 1946, as the Department of Medicine and Surgery by P.L. 79-293,~~
~~succeeded in 1989 by the Veterans Health Services and Research Administration, renamed the Veterans Health~~
~~Administration in 1991.~~
~~29 Adam Oliver, “The Veterans Health Administration: An American Success Story?” The Milbank Quarterly, vol. 85,~~
~~no. 1 (March 2007), pp. 5-35.~~
30homes and domiciliary facilities40 and collaborates with DOD in sharing health care resources and services. Apart from providing direct patient care to veterans,41 the VHA’s other statutory missions are to conduct medical research,42 serve as a contingency backup to the DOD medical system during a national security emergency,43 provide support to the National Disaster Medical System and the Department of Health and Human Services as necessary,44 and train health care professionals to provide an adequate supply of health personnel for the VA and the nation.45 33 Kenneth Kizer, John Demakis, and John Feussner, “Reinventing VA health care: Systematizing Quality Kenneth Kizer, John Demakis, and John Feussner, “Reinventing VA health care: Systematizing Quality
Improvement and Quality Innovation,” Improvement and Quality Innovation,” Medical Care, vol. 38, no. 6 (June 2000), Suppl. 1:17-116. , vol. 38, no. 6 (June 2000), Suppl. 1:17-116.
3134 For more information on CBOCs, see CRS Report R41044, For more information on CBOCs, see CRS Report R41044, Veterans Health Administration: Community-Based
Outpatient Clinics (archived). (archived).
3235 Vet Centers are a nationwide system of community-based programs separate from VA medical centers (VAMCs). Vet Centers are a nationwide system of community-based programs separate from VA medical centers (VAMCs).
Client services provided by Vet Centers include psychological counseling and psychotherapy (individual and group), Client services provided by Vet Centers include psychological counseling and psychotherapy (individual and group),
screening for and treatment of mental health issues, substance abuse screening and counseling, screening for and treatment of mental health issues, substance abuse screening and counseling,
employment/educational counseling, and bereavement counseling, among other services. employment/educational counseling, and bereavement counseling, among other services.
3336 U.S. Department of Veterans Affairs, U.S. Department of Veterans Affairs, FY2021 Budget Submission, Medical Programs and Information Technology
Programs, vol. 2 of 4, February 2020, p. VHA-333. , vol. 2 of 4, February 2020, p. VHA-333.
3437 For more information on the VCCP and the eligibility criteria, see CRS Report R45390, For more information on the VCCP and the eligibility criteria, see CRS Report R45390, VA Maintaining Internal
Systems and Strengthening Integrated Outside Networks Act of 2018 (VA MISSION Act; P.L.115-182). .
3538 For more information, see CRS Report R42747, For more information, see CRS Report R42747, Health Care for Veterans: Answers to Frequently Asked Questions. .
3639 For details on CHAMPVA, see CRS Report RS22483, For details on CHAMPVA, see CRS Report RS22483, Health Care for Dependents and Survivors of Veterans. .
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~~homes and domiciliary facilities37 and collaborates with DOD in sharing health care resources and~~
~~services.~~
~~Apart from providing direct patient care to veterans,38 the VHA’s other statutory missions are to~~
~~conduct medical research,39 serve as a contingency backup to the DOD medical system during a~~
~~national security emergency,40 provide support to the National Disaster Medical System and the~~
~~Department of Health and Human Services as necessary,41 and train health care professionals to~~
~~provide an adequate supply of health personnel for the VA and the nation.42~~
~~The Veteran Patient Population43~~
~~In FY2020, approximately 9.3 million of the 19.5 million living veterans in the nation were~~
40 Under the grant program, the VA may fund up to 65% of the cost of these state-owned facilities. States must fund the remaining 35%. The law requires that 75% of the residents in a state-extended care facility must be veterans (38 U.S.C. §§8131-8138.) All nonveteran residents must be spouses of veterans or parents of children who died while serving in the U.S. Armed Forces. The VA is prohibited by law from exercising any supervision or control over the operation of a state veterans nursing home, including setting admission criteria. Admission requirements are determined exclusively by the state. 41 38 U.S.C. §7301(b). 42 38 U.S.C. §7303. 43 38 U.S.C. §8111A. 44 38 U.S.C. §8117(e). 45 38 U.S.C. §7302. Congressional Research Service 12 link to page 33 link to page 33 link to page 28 link to page 28 Department of Veterans Affairs FY2021 Appropriations The Veteran Patient Population46 In FY2020, approximately 9.3 million of the 19.5 million total veterans were enrolled in the VA health care system.enrolled in the VA health care system.4447 The VA estimates that in FY2021, enrollment will grow The VA estimates that in FY2021, enrollment will grow
by 33 thousand. Of the total number of enrolled veterans in FY2020, the VA anticipated treating by 33 thousand. Of the total number of enrolled veterans in FY2020, the VA anticipated treating
approximately 7.1 million unique veteran and nonveteran patients.approximately 7.1 million unique veteran and nonveteran patients.4548 For FY2021, the VHA For FY2021, the VHA
estimates that it will treat about 7.2 million unique veteran patients, or 1.0% over the FY2020 estimates that it will treat about 7.2 million unique veteran patients, or 1.0% over the FY2020
estimate (estimate (~~see~~see Appendix A for veteran population, VA enrollees, and VA patients from FY2000-for veteran population, VA enrollees, and VA patients from FY2000-
FY2021). FY2021).
The VHA also estimates that outpatient visits will increase from 123.8 million in FY2020 to The VHA also estimates that outpatient visits will increase from 123.8 million in FY2020 to
126.5 million in FY2021, an increase of 2.7 million, or 2.2%. It also anticipates an increase in 126.5 million in FY2021, an increase of 2.7 million, or 2.2%. It also anticipates an increase in
inpatients treated from 928,552 in FY2020 to 936,639 in FY2021, an increase of 8,087, or 0.9%. inpatients treated from 928,552 in FY2020 to 936,639 in FY2021, an increase of 8,087, or 0.9%.
President’s Request and Congressional Action
The VA’s annual appropriations for the medical services, medical community care, medical The VA’s annual appropriations for the medical services, medical community care, medical
support and compliance, and medical facilities accounts include advance appropriations that support and compliance, and medical facilities accounts include advance appropriations that
become available one fiscal year after the fiscal year for which the appropriations act was become available one fiscal year after the fiscal year for which the appropriations act was
enacted. Therefore, funding levels for FY2021 for these four accounts were provided by the enacted. Therefore, funding levels for FY2021 for these four accounts were provided by the

~~37 Under the grant program, the VA may fund up to 65% of the cost of these state-owned facilities. States must fund the~~
~~remaining 35%. The law requires that 75% of the residents in a state-extended care facility must be veterans (38 U.S.C.~~
~~§§8131-8138.) All nonveteran residents must be spouses of veterans or parents of children who died while serving in~~
~~the U.S. armed forces. The VA is prohibited by law from exercising any supervision or control over the operation of a~~
~~state veterans nursing home, including setting admission criteria. Admission requirements are determined exclusively~~
~~by the state.~~
~~38 38 U.S.C. §7301(b).~~
~~39 38 U.S.C. §7303.~~
~~40 38 U.S.C. §8111A.~~
~~41 38 U.S.C. §8117(e).~~
~~42 38 U.S.C. §7302.~~
43Further Consolidated Appropriations Act, 2020 (P.L. 116-94). However, in any given year the Administration could request additional funding for the upcoming fiscal year and Congress could revise these amounts through the annual appropriations process. Across all four accounts, the President’s budget increases by $2.3 billion over the advance appropriations amount in FY2021.49 The VA attributes the increase largely to revised actuarial trends based on recent data. In total, the FY2021 budget request for VHA is $95.2 billion, including medical care collections (see Table 1).50 46 Data in this section adapted from Office of Management and Budget (OMB), Data in this section adapted from Office of Management and Budget (OMB), Appendix, Budget of the United States
Government Fiscal Year 2021, Washington, DC, February 10, 2020, pp. 1045-1055, and Department of Veterans , Washington, DC, February 10, 2020, pp. 1045-1055, and Department of Veterans
Affairs, Affairs, FY2021 Budget Submission, Medical Programs and Information Technology Programs, vol. 2 of 4, February , vol. 2 of 4, February
2020, p. VHA-19. Population estimates were made before the COVID-19 pandemic. The VA response to the pandemic 2020, p. VHA-19. Population estimates were made before the COVID-19 pandemic. The VA response to the pandemic
has the potential to alter the estimated veteran population, enrollees, and patients in both FY2020 and FY2021. has the potential to alter the estimated veteran population, enrollees, and patients in both FY2020 and FY2021.
4447 In general, a veteran is required to be enrolled in the VA health care system to receive health care services, and once In general, a veteran is required to be enrolled in the VA health care system to receive health care services, and once
a veteran is enrolled, that veteran remains enrolled in the VA health care system and maintains access to VA health a veteran is enrolled, that veteran remains enrolled in the VA health care system and maintains access to VA health
care services. For more information on enrollment, see CRS Report R42747, care services. For more information on enrollment, see CRS Report R42747, Health Care for Veterans: Answers to
Frequently Asked Questions. .
4548 A A unique veteran patient means each patient is counted only once in each fiscal year. However, there could be means each patient is counted only once in each fiscal year. However, there could be
multiple visits (clinical encounters) per unique veteran patient in a given fiscal year. multiple visits (clinical encounters) per unique veteran patient in a given fiscal year.
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~~Further Consolidated Appropriations Act, 2020 (P.L. 116-94). However, in any given year the~~
~~Administration could request additional funding for the upcoming fiscal year and Congress could~~
~~revise these amounts through the annual appropriations process. Across all four accounts, the~~
~~President’s budget increases by $2.3 billion over the advance appropriations amount in FY2021.46~~
~~The VA attributes the increase largely to revised actuarial trends based on recent data. In total, the~~
~~FY2021 budget request for VHA is $95.2 billion, including medical care collections (see~~ ~~Table~~
1).47
49 U.S. Department of Veterans Affairs, FY2021 Budget Submission, Medical Programs and Information Technology Programs, vol. 2 of 4, February 2020, p. VHA-9. 50 The committees on appropriations include medical care cost recovery collections when considering funding for the VHA. Congress has provided VHA the authority to bill some veterans and most health care insurers for nonservice-connected care provided to veterans enrolled in the VA health care system, to help defray the cost of delivering medical services to veterans. Funds collected from first- and third-party (copayments and insurance) bills are retained by the VA health care facility that provided the care for the veteran. The Consolidated Omnibus Budget Reconciliation Act of 1985 (P.L. 99-272), enacted into law in 1986, established means testing for veterans seeking care for nonservice-connected conditions. The Balanced Budget Act of 1997 (P.L. 105-33) established the Department of Veterans Affairs Medical Care Collections Fund (MCCF) and gave the VHA the authority to retain these funds in the MCCF. Instead of returning the funds to the Treasury, the VA can use them, without fiscal year limitations, for medical services for veterans. In FY2004, the Administration’s budget requested consolidating several existing medical collections accounts into one MCCF. The conferees of the Consolidated Appropriations Act of 2004 (H.Rept. 108-401) recommended that collections that would otherwise be deposited in the Health Services Improvement Fund (former name), Veterans Extended Care Revolving Fund (former name), Special Therapeutic and Rehabilitation Activities Fund (former name), Congressional Research Service 13 link to page 28 link to page 28 Department of Veterans Affairs FY2021 Appropriations As required by the Veterans Health Care Budget Reform and Transparency Act of 2009 (P.L. 111- As required by the Veterans Health Care Budget Reform and Transparency Act of 2009 (P.L. 111-
81), the President’s budget is requesting $94.2 billion in advance appropriations for the four 81), the President’s budget is requesting $94.2 billion in advance appropriations for the four
medical care appropriations (medical services, medical community care, medical support and medical care appropriations (medical services, medical community care, medical support and
compliance, and medical facilities) for FY2022, an increase of approximately 3.85% over the compliance, and medical facilities) for FY2022, an increase of approximately 3.85% over the
FY2021-requested amount of $90.8 billion for the same four accounts. In FY2022, the FY2021-requested amount of $90.8 billion for the same four accounts. In FY2022, the
Administration’s budget request would provide $58.9 billion for the medical services account, Administration’s budget request would provide $58.9 billion for the medical services account,
$20.1 billion for medical community care, $8.4 billion for the medical support and compliance $20.1 billion for medical community care, $8.4 billion for the medical support and compliance
account, and $6.7 billion for the medical facilities account (account, and $6.7 billion for the medical facilities account (~~see Table 1).~~
~~Amounts requested for each VHA account for FY2021 and House Appropriations Committee~~
~~recommend funded levels are detailed in subsequent sections.~~
see Table 1). Both The House-passed version of the MILCON-VA appropriations bill (H.R. 7608; H.Rept. 116-445) and the Senate Appropriations Committee majority draft bill provide FY2021 VHA appropriations higher than the President’s request ($67.5 million and $13 million higher, respectively). Amounts requested for each VHA account for FY2021 in both the House-passed bill and the Senate Appropriations Committee majority draft bill recommended amounts for each account are detailed in subsequent sections. Medical Services
The medical services account covers expenses for furnishing inpatient and outpatient care and The medical services account covers expenses for furnishing inpatient and outpatient care and
treatment of veterans and certain dependents, including care and treatment in non-VA facilities; treatment of veterans and certain dependents, including care and treatment in non-VA facilities;
outpatient care on a fee basis; medical supplies and equipment; salaries and expenses of outpatient care on a fee basis; medical supplies and equipment; salaries and expenses of
employees hired under Title 38, employees hired under Title 38, United States Code (U.S.C.); cost of hospital food service (U.S.C.); cost of hospital food service
operations;operations;4851 aid to state veterans’ homes; and assistance and support services for family aid to state veterans’ homes; and assistance and support services for family
caregivers. caregivers.
For FY2021, the President’s budget is requesting $56.7 billion for the medical services account. For FY2021, the President’s budget is requesting $56.7 billion for the medical services account.
This amount is $497.5 million over the FY2021 advance appropriated amount of $56.2 billion. This amount is $497.5 million over the FY2021 advance appropriated amount of $56.2 billion.

~~46 U.S. Department of Veterans Affairs,~~ ~~FY2021 Budget Submission, Medical Programs and Information Technology~~
~~Programs, vol. 2 of 4, February 2020, p. VHA-9.~~
~~47 The committees on appropriations include medical care cost recovery collections when considering funding for the~~
~~VHA. Congress has provided VHA the authority to bill some veterans and most health care insurers for nonservice-~~
~~connected care provided to veterans enrolled in the VA health care system, to help defray the cost of delivering medical~~
~~services to veterans. Funds collected from first- and third-party (copayments and insurance) bills are retained by the~~
~~VA health care facility that provided the care for the veteran. The Consolidated Omnibus Budget Reconciliation Act of~~
~~1985 (P.L. 99-272), enacted into law in 1986, established means testing for veterans seeking care for nonservice-~~
~~connected conditions. The Balanced Budget Act of 1997 (P.L. 105-33) established the Department of Veterans Affairs~~
~~Medical Care Collections Fund (MCCF) and gave the VHA the authority to retain these funds in the MCCF. Instead of~~
~~returning the funds to the Treasury, the VA can use them, without fiscal year limitations, for medical services for~~
~~veterans. In FY2004, the Administration’s budget requested consolidating several existing medical collections accounts~~
~~into one MCCF. The conferees of the Consolidated Appropriations Act of 2004 (H.Rept. 108-401) recommended that~~
~~collections that would otherwise be deposited in the Health Services Improvement Fund (former name), Veterans~~
~~Extended Care Revolving Fund (former name), Special Therapeutic and Rehabilitation Activities Fund (former name),~~
According to the VA, this increase reflects implementation of the Precision Oncology initiative, as well as increased staff and funding for pain management and suicide prevention efforts.52 The House-passed version of the MILCON-VA appropriations bill (H.R. 7608; H.Rept. 116-445) amount for FY2021 is $514 million over the FY2021 advance appropriation amount. This is $16.5 million more than the President’s request while the FY2022 advance appropriation amount for the medical services account is the same as the President’s request. The Senate Appropriations Committee majority draft bill recommended amount for FY2021 and for the FY2022 advance appropriations is the same as the President’s request (see Table 1). Within the total amount for medical services in the House-passed bill for FY2021, which is $56.7 billion, the committee has provided the following:53 Medical Facilities Revolving Fund (former name), and the Parking Revolving Fund (former name) should be deposited Medical Facilities Revolving Fund (former name), and the Parking Revolving Fund (former name) should be deposited
in MCCF. The Consolidated Appropriations Act of 2005 (P.L. 108-447, H.Rept. 108-792) provided the VA with in MCCF. The Consolidated Appropriations Act of 2005 (P.L. 108-447, H.Rept. 108-792) provided the VA with
permanent authority to deposit funds from these five accounts into the MCCF. permanent authority to deposit funds from these five accounts into the MCCF.
4851 In its FY2008 budget request to Congress, the VA requested the transfer of food service operations costs from the In its FY2008 budget request to Congress, the VA requested the transfer of food service operations costs from the
medical facilities appropriations to the medical services appropriations. The House and Senate Appropriations medical facilities appropriations to the medical services appropriations. The House and Senate Appropriations
Committees concurred with this request. The cost of food service operations supports hospital food service workers, Committees concurred with this request. The cost of food service operations supports hospital food service workers,
provisions, and supplies related to the direct care of patients. provisions, and supplies related to the direct care of patients.
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~~According to the VA, this increase reflects implementation of the Precision Oncology initiative,~~
~~as well as increased staff and funding for pain management and suicide prevention efforts.49~~
~~The House Appropriations Committee (H.Rept. 116-445) recommended amount for FY2021 and~~
~~the FY2022 advance appropriation amount for the medical services account is the same as the~~
~~President’s request (see Table 1). Within the total amount for medical services recommended for~~
~~FY2021, which is $56.7 billion, the committee has provided the following:50~~
~~ For mental health care, an additional $40 million for a total of $10.3 billion;~~
~~ For homelessness initiatives, an additional $40 million for a total of $1.9 billion;~~
~~ For rural health, an additional $30 million for a total of $300 million;~~
~~ For gender-specific care for women, an additional $35 million for a total of~~
~~$660.7 million;~~
~~ For Whole Health initiatives, an additional $20 million for a total of $83.6~~
~~million;~~
~~ For suicide prevention efforts, an additional $85.1 million for a total of $312.6~~
~~million;~~
~~ For a new Precision Oncology initiative, $75 million;~~
~~ For opioid prevention and treatment, an additional $64.7 million for a total of~~
~~$503.7 million;~~
~~ For medical equipment, $93.8 million; and~~
~~ For other committee specified initiatives, $14 million.~~
~~Additionally, the House reported bill (H.R. 7609; H.Rept. 116-445)~~52 The Precision Oncology initiative seeks to improve cancer treatment outcomes and decrease side effects by selecting treatments based on characteristics of the patient and the cancer. In total, the President’s budget includes $75 million to support implementation in FY2021. 53 U.S. Congress, House Committee on Appropriations, Military Construction, Veterans Affairs, and Related Agencies Appropriations Bill, 2021, report to accompany H.R. 7609, 116th Cong., 2nd sess., July 13, 2020, H.Rept. 116-445, p. 45. Congressional Research Service 14 Department of Veterans Affairs FY2021 Appropriations  for mental health care, an additional $40 million, for a total of $10.3 billion;  for homelessness initiatives, an additional $40 million, for a total of $1.9 billion;  for rural health, an additional $30 million, for a total of $300 million;  for gender-specific care for women, an additional $35 million, for a total of $660.7 million;  for Whole Health initiatives, an additional $20 million, for a total of $83.6 million;  for suicide prevention efforts, an additional $85.1 million, for a total of $312.6 million;  for a new Precision Oncology initiative, $75 million; and  for opioid prevention and treatment, an additional $64.7 million, for a total of $503.7 million; Within the total amount for medical services in the Senate Appropriations Committee majority draft bill for FY2021, which is $56.7 billion, the committee has provided the following:  for mental health care, an additional $40 million, for a total of $10.3 billion;  for homelessness initiatives, an additional $40 million, for a total of $1.9 billion;  for telehealth, a total of $1.3 million, equivalent to the request; and  for suicide prevention efforts, an additional $85.1 million, for a total of $312.6 million. In addition, the House-passed bill includes new authorizing includes new authorizing
language that would permanently authorize the use of medical services language that would permanently authorize the use of medical services ~~funding~~appropriations for assisted for assisted
reproductive technology treatment and adoption reimbursement for certain veterans with service-reproductive technology treatment and adoption reimbursement for certain veterans with service-
connected disabilities that results in being unable to procreate without connected disabilities that results in being unable to procreate without in vitro fertilization (IVF) vitro fertilization (IVF)
treatment or other forms of assisted reproductive technology services.treatment or other forms of assisted reproductive technology services.51
54 The Senate Appropriations Committee majority draft bill temporarily authorizes the use of medical services appropriations for the same services.55 Medical Community Care
Section 4003 of the Surface Transportation and Veterans Health Care Choice Improvement Act of Section 4003 of the Surface Transportation and Veterans Health Care Choice Improvement Act of
2015 (P.L. 114-41) required the establishment of a separate new account for medical community 2015 (P.L. 114-41) required the establishment of a separate new account for medical community
care, beginning with the FY2017 appropriations cycle. The Jeff Miller and Richard Blumenthal care, beginning with the FY2017 appropriations cycle. The Jeff Miller and Richard Blumenthal
Veterans Health Care and Benefits Improvement Act of 2016 (P.L. 114-315) authorized advanced Veterans Health Care and Benefits Improvement Act of 2016 (P.L. 114-315) authorized advanced
~~appropriations for the medical community care account. The account is intended to consolidate all~~
~~community care programs under a single appropriation, and it is the funding source for care that~~
~~the VHA provides to eligible veterans through community health care providers.~~

~~49 The Precision Oncology initiative seeks to improve cancer treatment outcomes and decrease side effects by selecting~~
~~treatments based on characteristics of the patient and the cancer. In total, the President’s budget includes $75 million to~~
~~support implementation in FY2021.~~
~~50 U.S. Congress, House Committee on Appropriations,~~ ~~Military Construction, Veterans Affairs, and Related Agencies~~
~~Appropriations Bill, 2021, report to accompany H.R. 7609, 116th Cong., 2nd sess., July 13, 2020, H.Rept. 116-445, p.45.~~
~~51 U.S. Congress, House Committee on Appropriations,~~ 54 U.S. Congress, House Committee on Appropriations, Military Construction, Veterans Affairs, and Related Agencies Appropriations Bill, 2021, report to accompany H.R. 7609, 116th Cong., 2nd sess., July 13, 2020, H.Rept. 116-445, p. 104. For more information on In Vitro Fertilization (IVF) services for certain veterans see, CRS In Focus IF11082, Veterans Health Administration: Gender-Specific Health Care Services for Women Veterans. 55 This policy has been authorized in appropriations acts since FY2017. Section 260 of the Continuing Appropriations and Military Construction, Veterans Affairs, and Related Agencies Appropriations Act, 2017, and the Zika Response and Preparedness Act (P.L. 114-223) permitted the VA to use funds from the Medical Services account for this purpose for FY2017. Section 236 of Division J of the Military Construction, Veterans Affairs, and Related Agencies Appropriations Act, 2018 (P.L. 115-141), continued this policy for FY2018 and FY2019. Section 235 of the Energy and Water, Legislative Branch, and Military Construction and Veterans Affairs Appropriations Act, 2019 (P.L. 115-244), continued this policy for FY2019 and FY2020. Section 235 of the Military Construction, Veterans Affairs, and Related Agencies
Appropriations ~~Bill, 2021, report to accompany H.R. 7609, 116th Cong., 2nd sess., July 13, 2020, H.Rept. 116-445,~~
~~p.104. For more information on In Vitro Fertilization (IVF) services for certain veterans see, CRS In Focus IF11082,~~
Veterans Health Administration: Gender-Specific Health Care Services for Women Veterans.
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~~link to page 23~~Act, 2020 (Division F of the Further Consolidated Appropriations Act, 2020; P.L. 116-94), allows the VHA to use FY2020 appropriations and FY2021 advance appropriations to continue providing IVF services to certain veterans and their spouses. Congressional Research Service 15 link to page 28 link to page 28 link to page 28 Department of Veterans Affairs FY2021 Appropriations appropriations for the medical community care account. The account is intended to consolidate all community care programs under a single appropriation, and it is the funding source for care that the VHA provides to eligible veterans through community health care providers. ~~Department of Veterans Affairs FY2021 Appropriations~~

The President’s budget is requesting $18.5 billion for the medical community care account. This The President’s budget is requesting $18.5 billion for the medical community care account. This
amount is $1.amount is $1.4381 billion over the FY2021 advance appropriated amount of $17.1 billion. This billion over the FY2021 advance appropriated amount of $17.1 billion. This
increase is largely driven by more recent projections for community care and the cost of increase is largely driven by more recent projections for community care and the cost of
establishing a community care network.establishing a community care network.5256
The House The House ~~reported bill (H.R. 7609; H.Rept. 116-445) has recommended the same amounts for~~
~~medical community as the FY2021 request and FY2022 advance appropriation request.~~
-passed version of the MILCON-VA appropriations bill (H.R. 7608; H.Rept. 116-445) amount for FY2021 is $1.377 billion over the FY2021 advance appropriation amount. This is $4.0 million less than the FY2021 request, while the FY2022 advance appropriation amount is the same as the request. The Senate Appropriations Committee majority draft bill recommended amount for FY2021 and the FY2020 advance appropriation is the same as the President’s request (see Table 1). Medical Support and Compliance
This account provides for expenses related to the management, security, and administration of the This account provides for expenses related to the management, security, and administration of the
VA health care system through the operation of VA medical centers and other medical facilities, VA health care system through the operation of VA medical centers and other medical facilities,
such as community-based outpatient clinics (CBOCs) and Vet Centers.such as community-based outpatient clinics (CBOCs) and Vet Centers.5357 The account also funds The account also funds
21 Veterans Integrated Service Network (VISN)21 Veterans Integrated Service Network (VISN)5458 offices and facility director offices; chief of offices and facility director offices; chief of
staff operations; public health and environmental hazard programs; quality and performance staff operations; public health and environmental hazard programs; quality and performance
management programs; medical inspection; human research oversight; training programs and management programs; medical inspection; human research oversight; training programs and
continuing education; security; volunteer operations; and human resources management. continuing education; security; volunteer operations; and human resources management.
The President’s budget is requesting $8.2 billion for the medical support and compliance account. The President’s budget is requesting $8.2 billion for the medical support and compliance account.
This amount is $300 million over the FY2021 advance appropriated amount of $7.9 billion.This amount is $300 million over the FY2021 advance appropriated amount of $7.9 billion.5559
The House The House ~~reported bill (H.R. 7609~~-passed version of the MILCON-VA appropriations bill (H.R. 7608; H.Rept. 116-445) provides $; H.Rept. 116-445) provides $~~280~~282 million over the FY2021 million over the FY2021
advance appropriation of $7.9 billionadvance appropriation of $7.9 billion, a decrease of $ a decrease of $20 18 million from the requestmillion from the request ~~(see Table 1).~~
~~The committee recommends $8.4 billion in advance FY2022 appropriations, same as the~~
~~requested amount~~, while the FY2022 advance appropriation amount is the same as the request. The Senate Appropriations Committee majority draft bill recommended amount for FY2021 and the FY2020 advance appropriation is the same as the President’s request (see Table 1). .
Medical Facilities
The medical facilities account funds expenses pertaining to the operations and maintenance of the The medical facilities account funds expenses pertaining to the operations and maintenance of the
VHA’s capital infrastructure. These expenses include utilities and administrative expenses related VHA’s capital infrastructure. These expenses include utilities and administrative expenses related
~~to planning, designing, and executing construction or renovation projects at VHA facilities. It also~~
~~funds leases, laundry services, grounds maintenance, trash removal, housekeeping, fire~~
~~protection, pest management, and property disposition and acquisition.~~
~~The President’s budget is requesting $6.6 billion for the medical facilities account. This amount is~~
~~$150 million over the FY2021 advance appropriated amount of $6.4 billion. This increase is~~
~~largely driven by infrastructure improvements to ensure compatibility for the Electronic Health~~
~~Record Modernization (EHRM) project.56~~

52 56 U.S. Department of Veterans Affairs, U.S. Department of Veterans Affairs, FY2021 Budget Submission, Medical Programs and Information Technology
Programs, vol. 2 of 4, February 2020, p. VHA-9. , vol. 2 of 4, February 2020, p. VHA-9.
5357 Vet Centers are community-based counseling centers that provide a wide range of social and psychological services, Vet Centers are community-based counseling centers that provide a wide range of social and psychological services,
such as professional readjustment counseling to veterans who have served in a combat zone, military sexual trauma such as professional readjustment counseling to veterans who have served in a combat zone, military sexual trauma
(MST) counseling, bereavement counseling for families who experience an active duty death, substance abuse (MST) counseling, bereavement counseling for families who experience an active duty death, substance abuse
assessments and referral, medical referral, veterans’ benefits explanation and referral, and employment counseling, assessments and referral, medical referral, veterans’ benefits explanation and referral, and employment counseling,
among other services. among other services.
5458 VISN offices provide management and oversight to the medical centers and clinics within their assigned geographic VISN offices provide management and oversight to the medical centers and clinics within their assigned geographic
areas. Each VISN office is responsible for allocating funds to facilities, clinics, and programs within its region and areas. Each VISN office is responsible for allocating funds to facilities, clinics, and programs within its region and
coordinating the delivery of health care to veterans. coordinating the delivery of health care to veterans.
5559 U.S. Department of Veterans Affairs, U.S. Department of Veterans Affairs, FY2021 Budget Submission, Medical Programs and Information Technology
Programs, vol. 2 of 4, February 2020, p. VHA-9, vol. 2 of 4, February 2020, p. VHA-9.
~~56 Ibid~~. .
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1416 link to page 28 link to page 28 link to page 28 Department of Veterans Affairs FY2021 Appropriations to planning, designing, and executing construction or renovation projects at VHA facilities. It also funds leases, laundry services, grounds maintenance, trash removal, housekeeping, fire protection, pest management, and property disposition and acquisition. The President’s budget is requesting $6.6 billion for the medical facilities account. This amount is $150 million over the FY2021 advance appropriated amount of $6.4 billion. This increase is largely driven by infrastructure improvements to ensure compatibility for the Electronic Health Record Modernization (EHRM) project.60 The House-passed version of the MILCON-VA appropriations bill (H.R. 7608;

~~Department of Veterans Affairs FY2021 Appropriations~~

~~House Appropriations Committee (~~H.Rept. 116-445) provides $170 million over the FY2021 H.Rept. 116-445) provides $170 million over the FY2021
advance appropriationadvance appropriation of $6.4 billion, an increase of $20 , an increase of $20 million from the request, while the FY2022 advance appropriation amount is the same as the request. The Senate Appropriations Committee majority draft bill recommended amount for FY2021 and the FY2020 advance appropriation is the same as the President’s request (see Table 1). ~~million from the request for a total amount of $6.6~~
~~billion for FY2021. The committee recommends $6.7 billion in advance FY2022 appropriations,~~
~~same as the requested amount.~~
Medical and Prosthetic Research
As required by law, the medical and prosthetic research program (medical research) focuses on As required by law, the medical and prosthetic research program (medical research) focuses on
research into the special health care needs of veterans. This account provides funding for many research into the special health care needs of veterans. This account provides funding for many
types of research, such as investigator-initiated research; mentored research; large-scale, multisite types of research, such as investigator-initiated research; mentored research; large-scale, multisite
clinical trials; and centers of excellence. VA researchers receive funding not only through this clinical trials; and centers of excellence. VA researchers receive funding not only through this
account but also from DOD, the National Institutes of Health (NIH), and private sources. account but also from DOD, the National Institutes of Health (NIH), and private sources.
In general, VA’s research program is intramural; that is, research is performed by VA In general, VA’s research program is intramural; that is, research is performed by VA
investigators at VA facilities and approved off-site locations. Unlike other federal agencies, such investigators at VA facilities and approved off-site locations. Unlike other federal agencies, such
as NIH and DOD, the VA does not have the statutory authority to make research grants to as NIH and DOD, the VA does not have the statutory authority to make research grants to
colleges and universities, cities and states, or any other non-VA entities. colleges and universities, cities and states, or any other non-VA entities.
The President’s budget is requesting approximately $787 million for the medical and prosthetic The President’s budget is requesting approximately $787 million for the medical and prosthetic
research account, an increase of $37 million, or 5%, above the FY2020-enacted amount of $750 research account, an increase of $37 million, or 5%, above the FY2020-enacted amount of $750
million. The VHA’s major research priorities in FY2021 include, among others, suicide million. The VHA’s major research priorities in FY2021 include, among others, suicide
prevention, opioid safety and pain management, post-traumatic stress disorder (PTSD), traumatic prevention, opioid safety and pain management, post-traumatic stress disorder (PTSD), traumatic
brain injury (TBI), mental health, and Gulf War illness.brain injury (TBI), mental health, and Gulf War illness.5761
The House The House ~~reported bill (H.R. 7609~~-passed version of the MILCON-VA appropriations bill (H.R. 7608; H.Rept. 116-445) provides $840 million for FY2021 for the ; H.Rept. 116-445) provides $840 million for FY2021 for the
medical and prosthetic research account, an increase of medical and prosthetic research account, an increase of $53 million from the request. The Senate Appropriations Committee majority draft bill recommended amount for FY2021 is $800 million, an increase of $13 million from the President’s request (see Table 1). ~~$53 million from the request.~~
Nonmedical Discretionary Programs Funding
National Cemetery Administration (NCA)
The majority of NCA’s discretionary funding falls into the Operations and Maintenance category The majority of NCA’s discretionary funding falls into the Operations and Maintenance category
with with the VA requesting a total of $360 million in FY2021 for this account. This is a $32 million, or VA requesting a total of $360 million in FY2021 for this account. This is a $32 million, or
9.8%, increase for NCA’s operations and maintenance expenses over the FY2020 enacted 9.8%, increase for NCA’s operations and maintenance expenses over the FY2020 enacted 60 Ibid. 61 U.S. Office of Management and Budget (OMB), Appendix, Budget of the United States Government Fiscal Year 2021, Washington, DC, February 10, 2020, p. 1052. Congressional Research Service 17 link to page 28 Department of Veterans Affairs FY2021 Appropriations amount ~~amount~~
and will provide for hiring an additional 77 full-time equivalents (FTEs).and will provide for hiring an additional 77 full-time equivalents (FTEs).5862 In addition, the In addition, the
increase will help support the costs encountered with opening four new cemeteries in New York, increase will help support the costs encountered with opening four new cemeteries in New York,
Indiana, Wyoming, and Utah during 2021. There are also associated expenses for an additional 11 Indiana, Wyoming, and Utah during 2021. There are also associated expenses for an additional 11
cemeteries transferred from the Department of the Army bringing the total number of national cemeteries transferred from the Department of the Army bringing the total number of national
cemeteries to 156. Finally, the VA anticipates a 2.1% increase in the number of interments during cemeteries to 156. Finally, the VA anticipates a 2.1% increase in the number of interments during
FY2021 compared with FY2020.FY2021 compared with FY2020.5963
Within the Operations and Maintenance appropriations category, Within the Operations and Maintenance appropriations category, the VA requested funds to support VA requested funds to support
extending its historical knowledge and public outreach programs. NCA plans to implement these extending its historical knowledge and public outreach programs. NCA plans to implement these
efforts by continuing its digital memorial platform, which will preserve the 3.5 million veterans efforts by continuing its digital memorial platform, which will preserve the 3.5 million veterans
interred and in future phases will allow the public to post memories and interred and in future phases will allow the public to post memories and photographs of each ~~photographs of each~~

~~57 U.S. Office of Management and Budget (OMB),~~ ~~Appendix, Budget of the United States Government Fiscal Year~~
~~2021, Washington, DC, February 10, 2020, p. 1052.~~
~~58 U.S. Department of Veterans Affairs, FY2021 Budget Submission, Budget in Brief, February 2020, p. BiB-26-27.~~
~~59 U.S. Department of Veterans Affairs,~~ ~~FY2021 Budget Submission, Benefits and Burial Programs and Departmental~~
~~Administration, vol. 3 of 4, February 2020, p. NCA-18, 19.~~
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veteran. To complement NCA’s digital efforts, they will continue to develop onsite interpretive veteran. To complement NCA’s digital efforts, they will continue to develop onsite interpretive
signs, exhibits, and publications to increase the public’s knowledge of NCA’s signs, exhibits, and publications to increase the public’s knowledge of NCA’s history. The House-passed version of the MILCON-VA bill provides $349 million for NCA expenses for FY2021, $11 million less than VA’s requested amount64 (see Table 1). The committee report accompanying the bill explains that~~history.~~
~~The House Appropriations Committee has recommended $349 million for NCA for FY2021 (see~~
Table 1)~~, $11 million less than the requested amount. The~~ committee believes that these funds committee believes that these funds
will adequately address the needs of NCA to meet will adequately address the needs of NCA to meet ~~their~~its increased workload and burial increased workload and burial
expansions, but stresses that NCA prioritize services at existing cemeteries and opening new expansions, but stresses that NCA prioritize services at existing cemeteries and opening new
cemeteries for increased burial access.cemeteries for increased burial access.6065 An area of concern An area of concern, that the committee would like NCA that the committee would like NCA
to provide reports to Congress to provide reports to Congress on~~on,~~ is the ways is the ways the VA is addressing the Prisoner of War headstones VA is addressing the Prisoner of War headstones
with German inscriptions and with German inscriptions and emblems on them.66 The Senate Appropriations Committee majority draft bill recommends $352 million for NCA expenses for FY2021. This recommendation is $23 million more than the FY2020-enacted amount but $8 million less than VA’s request for FY2021. The Senate Appropriations Committee majority draft explanatory statement recognizes the advancement NCA has completed in expanding burial spaces to underserved populations in rural communities; however, the committee remains concerned about limited infrastructure at these sites that could detract from cemetery operations and committal services.67 VBA, General Operating Expenses The VA is requesting $3.21 billion in funding for VBA general operating expenses for the FY2021. This is an estimated $69 million increase over the enacted FY2020 budget. The largest 62 U.S. Department of Veterans Affairs, FY2021 Budget Submission, Budget in Brief, February 2020, p. BiB-26-27. 63 U.S. Department of Veterans Affairs, FY2021 Budget Submission, Benefits and Burial Programs and Departmental Administration, vol. 3 of 4, February 2020, pp. NCA-18, 19. 64 U.S. Congress, House Committee on Appropriations, Military Construction, Veterans Affairs, and Related Agencies Appropriations Bill, 2021, report to accompany H.R. 7609, 116th Cong., 2nd sess., July 13, 2020, H.Rept. 116-445, p. 86. 65 U.S. Congress, House Committee on Appropriations, Military Construction, Veterans Affairs, and Related Agencies Appropriations Bill, 2021, report to accompany H.R. 7609, 116th Cong., 2nd sess., July 13, 2020, H.Rept. 116-445, p. 87. 66 For more information on this issue, see CRS In Focus IF11587, Removal of Nazi Symbols and Inscriptions on Headstones of Prisoners of War in VA National Cemeteries. 67 Senate Appropriations Committee, “Majority Draft Military Construction, Veterans Affairs, and Related Agencies, 2021 Explanatory Statement,” pp. 62-63, at https://www.appropriations.senate.gov/download/fy21-mcva-report. Congressional Research Service 18 link to page 28 Department of Veterans Affairs FY2021 Appropriations ~~emblems on them.61~~
~~VBA, General Operating Expenses~~
~~The VA is requesting $3.21 billion in funding for VBA general operating expenses for the~~
~~FY2021. This is an estimated $69 million increase over the enacted FY2020 budget. The largest~~
portion of this funding request, approximately $2.5 billion, is for the general operating expenses portion of this funding request, approximately $2.5 billion, is for the general operating expenses
associated with the compensation and pension (including burial benefits) categories.associated with the compensation and pension (including burial benefits) categories.6268
Within the compensation service category, an estimated $1.9 billion of VBA’s request is for FTE Within the compensation service category, an estimated $1.9 billion of VBA’s request is for FTE
salaries and benefits. This amount would provide for an additional 691 FTEs in support of the salaries and benefits. This amount would provide for an additional 691 FTEs in support of the
processing and adjudication of Blue Water Navy claims. With this increase, the VBA projects processing and adjudication of Blue Water Navy claims. With this increase, the VBA projects
having 16,682 FTEs supporting the delivery of veterans’ compensation benefits, equating to 72% having 16,682 FTEs supporting the delivery of veterans’ compensation benefits, equating to 72%
of the program’s operating expenses.of the program’s operating expenses.6369 In addition to staffing, processing, and IT investments to In addition to staffing, processing, and IT investments to
implement the Blue Water Navy Act, funding allocations will go toward implementing the implement the Blue Water Navy Act, funding allocations will go toward implementing the
Forever GI Bill; supporting economic development initiatives along with transition assistance Forever GI Bill; supporting economic development initiatives along with transition assistance
programs; and funding mission-critical agency operations.programs; and funding mission-critical agency operations.6470
On January 1, 2020, VBA began to process and adjudicate claims under the Blue Water Navy Act On January 1, 2020, VBA began to process and adjudicate claims under the Blue Water Navy Act
of 2019. The President’s budget includes $137 million to support the processing of these claims. of 2019. The President’s budget includes $137 million to support the processing of these claims.
In addition, the funding is intended to give the VA the ability to hire new claims processors to In addition, the funding is intended to give the VA the ability to hire new claims processors to
augment staffing capacity and complete scanning requirements not completed during 2020.augment staffing capacity and complete scanning requirements not completed during 2020.65
~~The committee recommended (H.Rept. 116-445)~~71 The House-passed version of the MILCON-VA bill provides $3.19 billion for VBA operating expenses for $3.19 billion for VBA operating expenses for
FY2021, $20 million less than VA’s FY2021, $20 million less than VA’s ~~request.66 The committee~~request72 (see Table 1). The committee report accompanying the bill stressed the importance of stressed the importance of
continued reports to Congress on the timeliness and approval/denial rates of claims associated continued reports to Congress on the timeliness and approval/denial rates of claims associated
with the Blue Water Navy Act as the committee continues to provide funding for staffing, with the Blue Water Navy Act as the committee continues to provide funding for staffing,
scanning, and correspondence with veterans. The scanning, and correspondence with veterans. The committee did highlight a few items they would like to see VBA improve upon during FY2021, including increased timeliness in processing claims to reduce the existing backlog, movement on determination of four presumptive conditions associated with Agent Orange, and the implementation of the Inspector General’s recommendations for better handling of military sexual trauma (MST) claims.73 The Senate Appropriations committee majority draft bill recommends $3.16 billion for VBA general operating benefits for FY2021, $47 million less than VA’s request.74 In the accompanying majority draft explanatory statement, the committee highlights several areas for VA to address and work toward ensuring the accessibility of benefits to veterans. These areas include efforts to mitigate veterans underemployment; studying the feasibility of funding a veteran benefit counselor position within states’ VA departments; expanding the Solid Start program for 68~~committee did highlight a few items they would~~

~~60 U.S. Congress, House Committee on Appropriations,~~ ~~Military Construction, Veterans Affairs, and Related Agencies~~
~~Appropriations Bill, 2021, report to accompany H.R. 7609, 116th Cong., 2nd sess., July 13, 2020, H.Rept. 116-445, p.87.~~
~~61 For more information on this issue see CRS In Focus IF11587,~~ ~~Removal of Nazi Symbols and Inscriptions on~~
~~Headstones of Prisoners of War in VA National Cemeteries~~.
62 U.S. Department of Veterans Affairs, U.S. Department of Veterans Affairs, FY2021 Budget Submission, Supplemental Information and Appendices, vol. 1 , vol. 1
of 4, February 2020, p. Appendix-100. of 4, February 2020, p. Appendix-100.
6369 U.S. Department of Veterans Affairs, U.S. Department of Veterans Affairs, FY2021 Budget Submission, Benefits and Burial Programs and Departmental
Administration, vol. 3 of 4, February 2020, p. VBA-169. , vol. 3 of 4, February 2020, p. VBA-169.
6470 U.S. Department of Veterans Affairs, U.S. Department of Veterans Affairs, FY2021 Budget Submission, Benefits and Burial Programs and Departmental
Administration, vol. 3 of 4, February 2020, , vol. 3 of 4, February 2020, ppp. VBA-145, 146. . VBA-145, 146.
6571 U.S. Office of Management and Budget (OMB), U.S. Office of Management and Budget (OMB), A Budget For America’s Future – President’s Budget FY 2021, ,
Washington, DC, February 10, 2020, p. 91, Washington, DC, February 10, 2020, p. 91, at https://www.whitehouse.gov/wp-content/uploads/2020/02/budget_fy21.pdf. https://www.whitehouse.gov/wp-content/uploads/2020/02/budget_fy21.pdf.
6672 U.S. Congress, House Committee on Appropriations, U.S. Congress, House Committee on Appropriations, Military Construction, Veterans Affairs, and Related Agencies
Appropriations Bill, 2021, report to accompany H.R. 7609, 116th Cong., 2nd sess., July 13, 2020, H.Rept. 116-445, p., report to accompany H.R. 7609, 116th Cong., 2nd sess., July 13, 2020, H.Rept. 116-445, p. 42. 73 U.S. Congress, House Committee on Appropriations, Military Construction, Veterans Affairs, and Related Agencies Appropriations Bill, 2021, report to accompany H.R. 7609, 116th Cong., 2nd sess., July 13, 2020, H.Rept. 116-445, pp. 42-43. 74 Senate Appropriations Committee, “Majority Draft Military Construction, Veterans Affairs, and Related Agencies, 2021 Explanatory Statement,” pp. 31-32, at https://www.appropriations.senate.gov/download/fy21-mcva-report. ~~42.~~
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~~like to see VBA improve upon during FY2021 including increased timeliness in processing~~
~~claims to reduce the existing backlog; movement on determination of four presumptive conditions~~
~~associated with Agent Orange; and the implementation of the Inspector General’s~~
~~recommendations for better handling of military sexual trauma (MST) claims.67~~
transitioning servicemembers; and expanding awareness and use of GI Bill apprenticeships and on-the-job training. In addition, the committee requests a report from the VA to both Houses’ Appropriations Committees on Open Air Burn Pit claims within 180 days of the enactment of the act. The report is to include a list of conditions for which veterans filed benefits, the locations veterans are claiming exposure, and the reasons for the denial of claims.75 Information Technology
The information technology (IT) account provides funding for department-wide IT activities such The information technology (IT) account provides funding for department-wide IT activities such
as IT and telecommunications support, management of data systems, and acquisition of IT as IT and telecommunications support, management of data systems, and acquisition of IT
systems and department-wide cybersecurity efforts, among other things. systems and department-wide cybersecurity efforts, among other things.
For FY2021, the Administration is requesting $4.9 billion for the information technology budget. For FY2021, the Administration is requesting $4.9 billion for the information technology budget.
This amount will fund IT activities across the VA, including modernizing Veterans Benefits This amount will fund IT activities across the VA, including modernizing Veterans Benefits
Management to automate Blue Water Navy veterans claims, implementing the VA MISSION Act, Management to automate Blue Water Navy veterans claims, implementing the VA MISSION Act,
implementing a new health care logistics information system, and improving cybersecurity implementing a new health care logistics information system, and improving cybersecurity
among other things. among other things.
The House The House ~~Appropriations Committee (H.Rept. 116-445) recommends~~-passed bill (Division D of H.R. 7608) provides approximately $4.9 billion for the IT $4.9 billion for the IT
systems account, systems account, ~~same as the Administration~~$8.5 million less than the President’s request (see’s request (see Table 1)~~. The committee~~
~~recommended amount~~ ). This level of funding will provide for will provide for ~~the development of~~developing clinical applications, maintaining and clinical applications, maintaining and
improving health management platforms, IT systems associated with veterans’ benefits and improving health management platforms, IT systems associated with veterans’ benefits and
memorial affairs, cybersecurity and information infrastructure, among others.memorial affairs, cybersecurity and information infrastructure, among others.6876 Furthermore, the Furthermore, the
committeecommittee (H.Rept. 116-445) has provided funding within the has provided funding within the ~~amount recommended~~$4.9 billion for a digital protection for a digital protection
initiative to protect veterans, and Congressionally Chartered VSOs “from both foreign and initiative to protect veterans, and Congressionally Chartered VSOs “from both foreign and
domestic threats across the digital landscape attempting to steal money, pilfer personal domestic threats across the digital landscape attempting to steal money, pilfer personal
information or peddle foreign influence via social media or other online campaigns.”information or peddle foreign influence via social media or other online campaigns.”69
~~Electronic Health Record Modernization~~
~~On May 17, 2018, the VA signed a contract with Cerner Corporation to modernize its electronic~~
~~health care record system. This account provides funding for activities required to plan and~~
~~deploy the Cerner Millennium electronic health care record system at VA medical facilities.~~
~~Beginning with the Military Construction, Veterans Affairs, and Related Agencies Appropriations~~
77 The Senate Appropriations Committee majority draft bill recommends $4.9 billion for IT systems, and this amount is equal to the President’s request. To provide better oversight on how IT funds are executed by the VA, the Senate Appropriations Committee majority draft explanatory statement has provided funding for the IT systems account as three subaccounts: $1.2 billion for salaries and expenses, $3.2 billion for operation and maintenance of existing IT systems, and $495.5 million for IT program development.78 Electronic Health Record Modernization On May 17, 2018, the VA signed a contract with Cerner Corporation to modernize its electronic health care record system. This account provides funding for activities required to plan and deploy the Cerner Millennium electronic health care record system at VA medical facilities. Beginning with the Military Construction, Veterans Affairs, and Related Agencies Appropriations 75 Senate Appropriations Committee, “Majority Draft Military Construction, Veterans Affairs, and Related Agencies, 2021 Explanatory Statement,” pp. 32-34, at https://www.appropriations.senate.gov/download/fy21-mcva-report. 76 U.S. Congress, House Committee on Appropriations, Military Construction, Veterans Affairs, and Related Agencies Appropriations Bill, 2021, report to accompany H.R. 7609, 116th Cong., 2nd sess., July 13, 2020, H.Rept. 116-445, and p. 92. 77 Ibid., pp. 93-94. 78 Senate Appropriations Committee, “Majority Draft Military Construction, Veterans Affairs, and Related Agencies, 2021 Explanatory Statement,” p. 65, at https://www.appropriations.senate.gov/download/fy21-mcva-report. Congressional Research Service 20 link to page 28 Department of Veterans Affairs FY2021 Appropriations Act for FY2018 (P.L. 115-141), Congress established this new account, “intended to be the single Act for FY2018 (P.L. 115-141), Congress established this new account, “intended to be the single
source of funding within VA for the electronic health record effort” (H.Rept. 115-673). source of funding within VA for the electronic health record effort” (H.Rept. 115-673).
The President’s budget proposal is requesting $2.6 billion for activities related to the development The President’s budget proposal is requesting $2.6 billion for activities related to the development
and rollout of VA’s Electronic Health Record Modernization (EHRM) initiative, including and rollout of VA’s Electronic Health Record Modernization (EHRM) initiative, including
interoperability with the DOD electronic health record. interoperability with the DOD electronic health record.
The House The House ~~reported~~-passed MILCON-VA Appropriations bill for FY2021 ( MILCON-VA Appropriations bill for FY2021 (Division D of H.R. 7608; ~~H.R. 7609,~~ H.Rept. 116-445) H.Rept. 116-445)
provides the same amount as the President’s budget request (seeprovides the same amount as the President’s budget request (see Table 1). Funding provided for . Funding provided for
this account is available until September 30, 2023, “due to the uncertainty this account is available until September 30, 2023, “due to the uncertainty of the timing” of the EHRM initiative.79 The committee report accompanying the MILCON-VA Appropriations bill further goes on to state that “[the] VA transition to a commercial-based EHR system continues to be challenging, and it is uncertain if this capability will be delivered across the enterprise by 2027.”80 The Senate Appropriations Committee majority draft MILCON-VA Appropriations bill for FY2021 recommends the same amount as the budget request. Additionally, the majority draft bill has included an administrative provision that makes 25% of funding based on certification by the Secretary regarding any changes to the EHRM deployment schedule. ~~of the timing” of the~~

~~67 U.S. Congress, House Committee on Appropriations,~~ ~~Military Construction, Veterans Affairs, and Related Agencies~~
~~Appropriations Bill, 2021, report to accompany H.R. 7609, 116th Cong., 2nd sess., July 13, 2020, H.Rept. 116-445,~~
~~pp.42-43.~~
~~68 U.S. Congress, House Committee on Appropriations,~~ ~~Military Construction, Veterans Affairs, and Related Agencies~~
~~Appropriations Bill, 2021, report to accompany H.R. 7609, 116th Cong., 2nd sess., July 13, 2020, H.Rept. 116-445, and~~
~~p.92.~~
~~69 Ibid., pp. 93-94.~~
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~~EHRM initiative.70 The committee further goes on to state that “[the] VA transition to a~~
~~commercial-based EHR system continues to be challenging, and it is uncertain if this capability~~
~~will be delivered across the enterprise by 2027.”71~~
Construction
Construction accounts include major construction, minor construction, and construction and Construction accounts include major construction, minor construction, and construction and
renovation grants for state extended care facilities, as well as grants for state veterans cemeteries. renovation grants for state extended care facilities, as well as grants for state veterans cemeteries.
The major construction account provides funds for capital projects costing $20 million or more The major construction account provides funds for capital projects costing $20 million or more
that are intended to design, build, alter, extend, or improve a VHA facility. Projects identified that are intended to design, build, alter, extend, or improve a VHA facility. Projects identified
through the Strategic Capital Investment Planning (SCIP) process are submitted for congressional through the Strategic Capital Investment Planning (SCIP) process are submitted for congressional
authorization. Congress reviews, approves, and funds major construction on a project-by-project authorization. Congress reviews, approves, and funds major construction on a project-by-project
basis. Typical major construction projects are replacements of hospital buildings, the addition of basis. Typical major construction projects are replacements of hospital buildings, the addition of
large ambulatory care centers, and new hospitals or nursing homes. large ambulatory care centers, and new hospitals or nursing homes.
The minor construction account provides funds for capital projects costing less than $20 million The minor construction account provides funds for capital projects costing less than $20 million
that are intended to design, build, alter, extend, or improve a VHA facility. The total cost of a that are intended to design, build, alter, extend, or improve a VHA facility. The total cost of a
minor construction project cannot be greater than this statutory threshold. Minor construction minor construction project cannot be greater than this statutory threshold. Minor construction
projects are approved by the Office of Capital Asset Management and Support at the VA Central projects are approved by the Office of Capital Asset Management and Support at the VA Central
Office through the SCIP process. The grants to state-extended care facilities account provides Office through the SCIP process. The grants to state-extended care facilities account provides
grants to states for construction or acquisition of state home facilities, including funds to remodel, grants to states for construction or acquisition of state home facilities, including funds to remodel,
modify or alter existing buildings used for furnishing domiciliary, nursing home or hospital care modify or alter existing buildings used for furnishing domiciliary, nursing home or hospital care
to veterans. A grant may not exceed 65% of the total cost of the project. Lastly, the grants for to veterans. A grant may not exceed 65% of the total cost of the project. Lastly, the grants for
construction of veterans cemeteries account provides grants to states, territories, and federally construction of veterans cemeteries account provides grants to states, territories, and federally
recognized tribal governments for the establishment, expansion, or improvement of state and recognized tribal governments for the establishment, expansion, or improvement of state and
tribal veterans cemeteries. tribal veterans cemeteries.
For FY2021, the President’s budget requests $1.9 billion for the VA’s total construction program. For FY2021, the President’s budget requests $1.9 billion for the VA’s total construction program.
This amount includes $1.77 billion for the VA’s major and minor construction programs, $90 This amount includes $1.77 billion for the VA’s major and minor construction programs, $90
million for construction and renovation grants for state-extended care facilities, and $45 million million for construction and renovation grants for state-extended care facilities, and $45 million
for grants for state veterans cemeteries. for grants for state veterans cemeteries.
The House The House ~~Committee recommendation (H.R. 7609,~~-passed bill (Division D of H.R. 7608; H.Rept. 116-445) provides approximately $1.9 billion ~~H.Rept. 116-445)~~ for the department’s total for the department’s total
construction program for FY2021construction program for FY2021 ~~is $1.9 billion. All amounts recommended~~ . All amounts recommended 79 Ibid., p. 94. 80 Ibid., p. 96. Congressional Research Service 21 link to page 28 link to page 28 Department of Veterans Affairs FY2021 Appropriations for the VA’s major for the VA’s major
and minor construction programs, and minor construction programs, ~~grants for construction of state extended care facilities, and~~
~~grants for construction of veterans cemeteries accounts, are the same as~~and grants for construction of veterans cemeteries accounts, are the same as the President’s request for FY2021 (see Table 1). However, for grants for construction of state extended care facilities the measure provides $93 million—$3 million more than the Administration’s request. The Senate Appropriations Committee majority draft bill recommends approximately $1.8 billion for the department’s total construction program for FY2021, which is $67 million below budget request. For the major construction projects the committee recommendation is $57 million below the requested amount of $1.37 billion, and for minor construction projects the majority draft bill recommendation is $10 million below the President’s request of $400 million ~~the President’s request~~
~~for FY2021 (see Table 1).~~

~~70 Ibid., p. 94.~~
~~71 Ibid., p. 96.~~
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~~Table 1. VA FY2020-FY2021 Appropriations and FY2022 Advance Appropriations~~
~~($ in Thousands)~~
~~Enacted (P.L. 116-94;~~
~~House~~
~~P.L. 116-127;~~
~~President’s~~
~~Committee~~
~~P.L. 116-136)~~
~~Request~~
~~(H.Rept. 116-445)~~
~~Program~~
~~FY2020~~
~~FY2021~~
~~FY2021~~
~~FY2022~~
~~FY2021~~
~~FY2022~~
~~Veterans Benefits Administration (VBA)~~
~~Compensation~~
~~$109,017,152~~
—
~~$118,246,975~~
—
~~$118,246,975~~
—
~~and Pensions~~
~~Over FY2020~~
~~1,439,931~~
—
—
—
—
—
~~Enacted Advance~~
~~Appropriations~~
~~Over FY2021~~
—
—
~~2,813,922~~
—
~~2,813,922~~
—
~~Enacted Advance~~
~~Appropriations~~
~~Subtotal~~
~~110,457,083~~
—
~~121,060,897~~
—
~~121,060,897~~
—
~~Compensation and~~
~~Pensions~~
~~Readjustment~~
~~14,065,282~~
—
~~12,578,965~~
—
~~12,578,965~~
—
~~Benefits~~
~~Insurance and~~
~~111,340~~
—
~~129,224~~
—
~~129,224~~
—
~~Indemnities~~
~~Over FY2020~~
~~17,620~~
—
—
—
—
—
~~Enacted Advance~~
~~Appropriations~~
~~Over FY2021~~
—
—
~~2,148~~
—
~~$2,148~~
—
~~Enacted Advance~~
~~Appropriations~~
~~Subtotal Insurance~~
~~128,960~~
—
~~131,372~~
—
~~131,372~~
—
~~and Indemnities~~
~~Housing Benefit~~
~~701,000~~

~~1,663,000~~

~~1,663,000~~
—
~~Program Fund~~
~~Credit Subsidy~~
~~Housing Benefit~~
~~200,377~~
—
~~204,400~~
—
~~204,400~~
—
~~Program Fund~~
~~Administrative~~
~~Expenses~~
~~Vocational~~
58
—
34
—
34
—
~~Rehabilitation~~
~~Loan Program~~
~~Vocational~~
~~402~~
—
~~424~~
—
~~424~~
—
~~Rehabilitation~~
~~Loan Program~~
~~Administrative~~
~~Expenses~~
~~Native American~~
~~1,186~~
—
~~1,163~~
—
~~1,186~~
—
~~Housing Loan~~
~~Program~~
~~General~~
~~3,125,000~~
—
~~3,207,000~~
—

—
~~Operating~~
~~Expenses (VBA)~~
~~Congressional Research Service~~

19

~~link to page 27~~ ~~Department of Veterans Affairs FY2021 Appropriations~~

~~Enacted (P.L. 116-94;~~
~~House~~
~~P.L. 116-127;~~
~~President’s~~
~~Committee~~
~~P.L. 116-136)~~
~~Request~~
~~(H.Rept. 116-445)~~
~~Program~~
~~FY2020~~
~~FY2021~~
~~FY2021~~
~~FY2022~~
~~FY2021~~
~~FY2022~~
~~CARES Act~~
~~13,000~~
—
—
—
—
—
~~(P.L. 116-136)~~
~~Subtotal General~~
~~3,138,000~~
—
~~3,207,000~~
—
~~3,187,000~~
—
~~Operating~~
~~Expenses (VBA)~~
~~Total,~~
~~128,692,348~~
—
~~138,847,255~~
—
~~138,827,278~~
—
~~Veterans~~
~~Benefits~~
~~Administration~~
~~(VBA)~~
~~Veterans Health Administration~~
~~Medical Services~~
~~51,411,165~~
—
~~56,158,015~~
—
~~56,158,015~~
—
~~P.L. 116-94~~
~~-350,000~~
—
—
—
—
—
~~rescission (§253)~~
~~Over FY2021~~
—
—
~~497,468~~
—
—
—
~~Enacted Advance~~
~~Appropriations~~
~~Families First~~
~~30,000~~
—
—
—
—
—
~~Coronavirus~~
~~Response Act~~
~~(P.L. 116-127)~~
(see Table 1). Continuing Appropriations (P.L. 116-159; P.L. 116-215)81 Since none of the regular appropriations bills were enacted at the beginning of the fiscal year on October 1, Congress passed two continuing resolutions (CRs). The Continuing Appropriations Act, 2021, and Other Extensions Act (P.L. 116-159) provided budget authority for FY2021 at FY2020 levels through December 11, 2020, and the Further Continuing Appropriations Act, 2021, and Other Extensions Act (P.L. 116-215), provides continuing FY2021 appropriations through December 18, 2020. Since seven accounts (compensation and pensions, readjustment benefits, insurance and indemnities, medical services, medical community care, medical support and compliance, and medical facilities) received advance appropriations budget authority for FY2021 in P.L. 116-94, these accounts were not affected by the CR. However, the first CR (Division A of P.L. 116-159) provided exceptions to specific accounts, or programs below. Section 161—Compensation and Pensions Section 161 makes a technical correction to the Military Construction, Veterans Affairs, and Related Agencies Appropriations Act, 2020 (Division F of P.L. 116-94) related to the Department of Veterans Affairs’ (VA) “Compensation and Pensions” account. This provision authorizes advance appropriations for the “Compensation and Pensions” account provided in P.L. 116-94 that became available on October 1, 2020, to remain available until expended. This change would also allow unobligated carryover appropriations and funds in this account to remain available beyond FY2021. Section 162—Veterans Electronic Health Record Section 162 provides authority to the VA to apportion funds up to the rate of operations necessary for activities related to the implementation, preparation, development, management, rollout, and maintenance of the veterans Electronic Health Record (EHR) system, including salaries and expenses of VA employees associated with the development and deployment of the EHR system. Section 163—Canteen Service Revolving Fund Section 163 provides authority to the VA during FY2021 to transfer up to $140 million of unobligated balances provided by the CARES Act (P.L. 116-136) for the Medical Services account to the Canteen Service Revolving Fund. Operations of the Canteen Service Revolving Fund are generally financed by collections from the sale of meals, merchandise, and services at 81 For more details on the continuing resolution, see CRS Report R46582, Overview of Continuing Appropriations for FY2021 (P.L. 116-159). Congressional Research Service 22 Department of Veterans Affairs FY2021 Appropriations VA medical facilities. However, due to a decline in collections as a result of the COVID-19 pandemic, the Administration requested this transfer authority to offset these losses. Congressional Research Service 23 Table 1. VA FY2020-FY2021 Appropriations and FY2022 Advance Appropriations ($ in Thousands) Enacted (P.L. 116-94; P.L. 116-127; President’s House-Passed Senate Appropriations P.L. 116-136) Request (Division D- H.R. 7608) Committee Majority Draft Program FY2020 FY2021 FY2021 FY2022 FY2021 FY2022 FY2021 FY2022 Veterans Benefits Administration (VBA) Compensation and Pensions $109,017,152 — $118,246,975 — $118,246,975 — $118,246,975 — Over FY2020 Enacted Advance Appropriations 1,439,931 — — — — — — — Over FY2021 Enacted Advance Appropriations — — 2,813,922 — 2,813,922 — 6,110,252 — Subtotal Compensation and Pensions 110,457,083 — 121,060,897 — 121,060,897 — 124,357,227 — Readjustment Benefits 14,065,282 — 12,578,965 — 12,578,965 — 12,578,965 — Insurance and Indemnities 111,340 — 129,224 — 129,224 — 129,224 — Over FY2020 Enacted Advance Appropriations 17,620 — — — — — — Over FY2021 Enacted Advance Appropriations — — 2,148 — $2,148 — 2,148 — Subtotal Insurance and Indemnities 128,960 — 131,372 — 131,372 — 131,372 — Housing Benefit Program Fund Credit Subsidy 701,000 1,663,000 1,663,000 — 1,663,000 — Housing Benefit Program Fund Administrative 200,377 — 204,400 — 204,400 — 204,400 — Expenses Vocational Rehabilitation Loan Program 58 — 34 — 34 — 34 — Vocational Rehabilitation Loan Program 402 — 424 — 424 — 424 — Administrative Expenses Native American Housing Loan Program 1,186 — 1,163 — 1,186 — 1,163 — General Operating Expenses (VBA) 3,125,000 — 3,207,000 — 3,186,000 — — CARES Act 13,000 — — — — — — (P.L. 116-136) Subtotal General Operating Expenses (VBA) 3,138,000 — 3,207,000 — 3,186,000 — 3,160,000 — Total, Veterans Benefits Administration 128,692,348 — 138,847,255 — 138,826,278 — 142,096,585 — (VBA) Veterans Health Administration CRS-24 link to page 32 Enacted (P.L. 116-94; P.L. 116-127; President’s House-Passed Senate Appropriations P.L. 116-136) Request (Division D- H.R. 7608) Committee Majority Draft Program FY2020 FY2021 FY2021 FY2022 FY2021 FY2022 FY2021 FY2022 Medical Services 51,411,165 — 56,158,015 — 56,158,015 — 56,158,015 — P.L. 116-94 rescission (§253) -350,000 — — — — — — — Over FY2021 Enacted Advance Appropriations — — 497,468 — 513,968 — 5,594,318 — Families First Coronavirus Response Act 30,000 — — — — — — — (P.L. 116-127) CARES Act 14,432,000 — — — —~~CARES Act~~
~~14,432,000~~
—
—
— —
— —
— —
(P.L. 116-136) (P.L. 116-136)
Rescission §252 — — — — — — -5,096,850 — Subtotal Medical Services ~~Subtotal Medical~~
65,523,165
— —
56,655,483
— —
56,671,983~~56,655,483~~
— —
~~Services~~
~~Medical~~
56,655,483 — Medical Community Care 10,758,399 10,758,399
— —
17,131,179 17,131,179
— —
17,131,179 17,131,179
— —
~~Community Care~~
~~Over FY2020~~
17,131,179 — Over FY2020 Enacted Advance Appropriations 3,906,400 3,906,400
— —
— —
— —
— —
— —
~~Enacted Advance~~
~~Appropriations~~
~~Over FY2021~~
— — Over FY2021 Enacted Advance Appropriations — —
— —
1,380,800 1,380,800
— —
1, 1,~~380~~376,800 — 3,847,180 — Transfer from Veterans Choice Fund (VCF) to~~,800~~
—
~~Enacted Advance~~
~~Appropriations~~
~~Transfer from~~
615,000 615,000
— —
— —
— —
— —
— —
~~Veterans Choice~~
~~Fund (VCF) to~~— —
Community Care Community Care
(P.L. 116-(P.L. 116-94)a
Families First Families First
Coronavirus Response Act 30,000 30,000
— —
— —
— —
— —
— —
~~Coronavirus~~
~~Response Act~~
— — (P.L. 116-127) (P.L. 116-127)
CARES Act CARES Act
2,100,000 2,100,000
— —
— —
— —
— —
— —
— — (P.L. 116-136) (P.L. 116-136)
~~Subtotal Medical~~Rescission §252 — — — — — — -2,466,380 — Subtotal Medical Community Care
17,409,799
— —
18,511,979
— —
18,~~511~~507,979
— —
~~Community Care~~
18,511,979 — Medical Support Medical Support
and Compliance 7,239,156 7,239,156
— —
7,914,191 7,914,191
— —
7,914,191 7,914,191
— —
~~and Compliance~~
~~Congressional Research Service~~

20

~~Department of Veterans Affairs FY2021~~7,914,191 — Over FY2020 Enacted Advance Appropriations 98,800 — — — — — — Over FY2021 Enacted Advance Appropriations — — 300,000 — $281,880 — 886,235 — P.L. 116-94 rescission (§253) -10,000 — — — — — — — CARES Act 100,000 — — — — — — — (P.L. 116-136) Rescission §252 — — — — — — -586,235 — CRS-25 Enacted (P.L. 116-94; P.L. 116-127; President’s House-Passed Senate Appropriations P.L. 116-136) Request (Division D- H.R. 7608) Committee Majority Draft Program FY2020 FY2021 FY2021 FY2022 FY2021 FY2022 FY2021 FY2022 Subtotal Medical Support and Compliance

~~Enacted (P.L. 116-94;~~
~~House~~
~~P.L. 116-127;~~
~~President’s~~
~~Committee~~
~~P.L. 116-136)~~
~~Request~~
~~(H.Rept. 116-445)~~
~~Program~~
~~FY2020~~
~~FY2021~~
~~FY2021~~
~~FY2022~~
~~FY2021~~
~~FY2022~~
~~Over FY2020~~
~~98,800~~
—
—
—
—
—
~~Enacted Advance~~
~~Appropriations~~
~~Over FY2021~~
—
—
~~300,000~~
—
~~279,880~~
—
~~Enacted Advance~~
~~Appropriations~~
~~P.L. 116-94~~
~~-10,000~~
—
—
—
—
—
~~rescission (§253)~~
~~CARES Act~~
~~100,000~~
—
—
—
—
—
~~(P.L. 116-136)~~
~~Subtotal Medical~~
7,427,956
— —
8,214,191
— —
8,196~~8,194~~,071 ,071
— —
~~Support and~~
~~Compliance~~
8,214,191 — Medical Facilities Medical Facilities
6,141,880 6,141,880
— —
6,433,265 6,433,265
— —
6,433,265 6,433,265 — 6,433,265
— —
CARES Act CARES Act
606,000 606,000
— —
— —
— —
— —
— —
— — (P.L. 116-136) (P.L. 116-136)
Over FY2021 Over FY2021
Enacted Advance Appropriations — —
— —
150,000 150,000
— —
170,120 170,120
— —
~~Enacted Advance~~
~~Appropriations~~
~~Subtotal Medical~~
441,385 — Rescission §252 — — — — — — -291,385 Subtotal Medical Facilities 6,747,880 6,747,880
— —
6,583,265
— —
6,603,385 6,603,385
— —
~~Facilities~~
~~Medical and~~6,583,265 — Medical and Prosthetic Research
800,000 800,000
— —
787,000 787,000
— —
840,000 840,000
— —
~~Prosthetic~~
~~Research~~
800,000 — Rescission Rescission
-50,000 -50,000
— —
— —
— —
— —
— —
— — (P.L. 116-94) (P.L. 116-94)
Subtotal Medical
and Prosthetic Research 750,000
— —
787,000
— —
840,000
— —
~~and Prosthetic~~
~~Research~~
800,000 — Medical Care Medical Care
Col ection Fund (MCCF) 3,729,000 3,729,000
— —
4,403,000 4,403,000
— —
4,403,000 4,403,000
— —
~~Col ection Fund~~
~~(MCCF)~~
~~Total,~~4,403,000 — Total, Veterans Health Administration
97,858,800
— —
90,751,918
— —
90,~~804,918~~819,418 — 90,764,918 —
—
~~Veterans~~
~~Health~~
~~Administration~~
(VHA)
Total VHA
with MCCF 101,587,800
— —
95,154,918
— —
95,~~207,918~~222,418
— —
~~with MCCF~~
95,167,918 — National Cemetery Administration (NCA)
NCA NCA
329,000 329,000
— —
360,000 360,000
— —
349,000 349,000 — 352,000
— —
P.L. 116-94 P.L. 116-94
rescission (§253) -1,000 -1,000
— —
— —
— —
— —
— —
~~rescission (§253)~~
— Total, NCA
328,000
— —
360,000
— —
349,000
— —
~~Departmental Administration~~
~~General~~352,000 — Departmental Administration General Administration
355,911 355,911
— —
413,000 413,000
— —
~~355,911~~
—
~~Administration~~
~~Congressional Research Service~~

21

~~Department of Veterans Affairs FY2021 Appropriations~~

~~Enacted (P.L. 116-94;~~
~~House~~
~~P.L. 116-127;~~
~~President’s~~
~~Committee~~
~~P.L. 116-136)~~
~~Request~~
~~(H.Rept. 116-445)~~
~~Program~~
~~FY2020~~
~~FY2021~~
~~FY2021~~
~~FY2022~~
~~FY2021~~
~~FY2022~~
~~Administrative~~
~~-15,949~~
—
—
—
—
—
~~Rescission~~
~~(P.L. 116-94)~~
~~Total,~~
~~$237,492,225~~
—
~~$240,245,173~~
—
~~$240,210,107~~
—
~~Department of~~
~~Veterans~~
~~Affairs~~
~~(without~~
~~MCCF)~~
~~Total Mandatory~~
~~$125,352,325~~
—
~~$135,434,234~~
—
~~$135,434,234~~
—
~~Total~~
~~$112,139,900~~
—
~~$104,810,939~~
—
~~$104,775,873~~
—
~~Discretionary~~
~~Memorandum: Advance Appropriations~~
~~Compensation~~
—
~~$118,246,975~~
—
~~$130,227,650~~
—
~~$130,227,650~~
~~and Pensions~~
~~Readjustment~~
—
~~12,578,965~~
—
~~14,946,618~~
—
~~14,946,618~~
~~Benefits~~
~~Insurance and~~
—
~~129,224~~
—
~~136,950~~
—
~~136,950~~
~~Indemnities~~
~~Subtotal,~~346,111 — 365,911 — CARES Act 6,000 — — — — — — — (P.L. 116-136) Subtotal General Administration 361,911 — 413,000 — 346,111 — 365,911 — Board of Veterans Appeals 182,000 — 198,000 — 198,000 — — CRS-26 Enacted (P.L. 116-94; P.L. 116-127; President’s House-Passed Senate Appropriations P.L. 116-136) Request (Division D- H.R. 7608) Committee Majority Draft Program FY2020 FY2021 FY2021 FY2022 FY2021 FY2022 FY2021 FY2022 Rescission -8,000 — — — — — — — (P.L. 116-94) Subtotal Board of Veterans Appeals 174,000 — 198,000 — 198,000 — 198,000 — Information Technology 4,371,615 — 4,912,000 — 4,903,500 — 4,912,000 — CARES Act 2,150,000 — — — — — — — (P.L. 116-136) Subtotal Information Technology 6,521,615 — 4,912,000 — 4,903,500 — 4,912,000 — Electronic Health Record Modernization 1,500,000 — 2,627,000 — 2,627,000 — 2,627,000 — (EHRM) Rescission -70,000 — — — — — — — (P.L. 116-94) Subtotal EHRM 1,430,000 — 2,627,000 — 2,627,000 — 2,627,000 — Inspector General 210,000 — 228,000 — 229,300 — 228,000 — CARES Act 12,500 — — — — — — — (P.L. 116-136) Subtotal Inspector General 222,500 — 228,000 — 229,300 — 228,000 — Construction, major projects 1,235,200 — 1,373,000 — 1,373,000 — 1,316,000 — Construction, minor projects 398,800 — 400,000 — 400,000 — 390,000 — Grants for State Extended Care Facilities 90,000 — 90,000 — 93,000 — 90,000 — CARES Act 150,000 — — — — — — — (P.L. 116-136) Subtotal grants for state extended care facilities 240,000 — 90,000 — 93,000 — 90,000 — Grants for State Veterans Cemeteries 45,000 — 45,000 — 45,000 — 45,000 — Total, Departmental Administration 10,629,026 — 10,286,000 — 10,214,911 — 10,163,911 — Administrative Rescission -15,949 — — — — — — — (P.L. 116-94) Administrative Provisions (§253) — — — — — — -257,462 — CRS-27 Enacted (P.L. 116-94; P.L. 116-127; President’s House-Passed Senate Appropriations P.L. 116-136) Request (Division D- H.R. 7608) Committee Majority Draft Program FY2020 FY2021 FY2021 FY2022 FY2021 FY2022 FY2021 FY2022 Total, Department of Veterans Affairs $237,492,225 — $240,245,173 — $240,209,607 — $243,119,952 — (without MCCF) Total Mandatory $125,352,325 — $135,434,234 — $104,775,373 — $104,389,388 — Total Discretionary $112,139,900 — $104,810,939 — $135,434,234 — $138,730,564 — Memorandum: Advance Appropriations Compensation and Pensions — $118,246,975 — $130,227,650 — $130,227,650 — $130,227,650 Readjustment Benefits — 12,578,965 — 14,946,618 — 14,946,618 — 14,946,618 Insurance and Indemnities — 129,224 — 136,950 — 136,950 — 136,950 Subtotal, Benefits Programs — 130,955,164 — 145,311,218 — 145,311,218 — 145,311,218
—
~~130,955,164~~
—
~~145,311,218~~
—
~~145,311,218~~
~~Benefits~~
~~Programs~~
Medical Services Medical Services
— —
56,158,015 56,158,015
— —
58,897,219 58,897,219
— —
58,897,219 58,897,219
~~Medical~~— Medical Community Care
— —
17,131,179 17,131,179
— —
20,148,244 20,148,244
— —
20,148,244 20,148,244
~~Community Care~~
~~Medical Support~~— Medical Support and Compliance
— —
7,914,191 7,914,191
— —
8,403,117 8,403,117
— —
8,403,117 8,403,117
~~and Compliance~~
— 8,403,117 Medical Facilities Medical Facilities
— —
6,433,265 6,433,265
— —
6,734,680 6,734,680
— —
6,734,680 6,734,680
~~Subtotal~~— 6,734,680 Subtotal Medical Care
— —
87,636,650
— —
94,183,260
— —
94,183,260
~~Medical Care~~
— 94,183,260 Total Advance
Appropriation — —
$218,591,814
— —
$239,494,478
— —
$239,494,478
~~Appropriation~~— $239,494,478
Source: Table prepared by CRS based on the Further Consolidated Appropriations Act, 2020 (P.L. 116-94); the Table prepared by CRS based on the Further Consolidated Appropriations Act, 2020 (P.L. 116-94); the
Families First Coronavirus Response Act (P.L. 116-127); the Coronavirus Aid, Relief, and Economic Security Act Families First Coronavirus Response Act (P.L. 116-127); the Coronavirus Aid, Relief, and Economic Security Act
(P.L. 116-136); (P.L. 116-136); ~~and~~ U.S. Congress, House Committee on Appropriations, U.S. Congress, House Committee on Appropriations, Military Construction, Veterans Affairs, and
Related Agencies Appropriations Bill, 2021, report to accompany H.R. 7609, 116th Cong., 2nd sess., July 13, 2020, , report to accompany H.R. 7609, 116th Cong., 2nd sess., July 13, 2020,
H.Rept. 116-445, pp. 131-141H.Rept. 116-445, pp. 131-141.
; Division D of H.R. 7608; and Senate Appropriations Committee majority draft explanatory statement released on November 10, 2020, pp.98-108. a. The Further Consolidated Appropriations Act, 2020 (P.L. 116-94), authorized a mandatory balance transfer a. The Further Consolidated Appropriations Act, 2020 (P.L. 116-94), authorized a mandatory balance transfer
of $615 mil ion from the Veterans Choice Fund (VCF) of $615 mil ion from the Veterans Choice Fund (VCF) established by §802(c)(4) of the Veterans Access, established by §802(c)(4) of the Veterans Access,
Choice, and Accountability Act of 2014, as amended (38 U.S.C. §1701 note) to the medical community care Choice, and Accountability Act of 2014, as amended (38 U.S.C. §1701 note) to the medical community care
account. account.
~~Congressional Research Service~~

23 CRS-28

Department of Veterans Affairs FY2021 Appropriations

Appendix A. Veteran Population, VA Enrollees, and
VA Patients, FY2000-FY2021
Table A-1. Veteran Population, VA Enrollees, and VA Patients, FY2000-FY2021
Patients Using VA Health Care During the Year
Total Veteran
VA-Enrolled
Year
Population
Veterans
Veterans
Nonveterans
Total Patients
FY2000 FY2000
26,745,368 26,745,368
4,936,259 4,936,259
3,462,082 3,462,082
355,191 355,191
3,817,273 3,817,273
FY2001 FY2001
26,092,046 26,092,046
6,073,264 6,073,264
3,890,871 3,890,871
356,333 356,333
4,247,204 4,247,204
FY2002 FY2002
25,627,596 25,627,596
6,882,488 6,882,488
4,246,084 4,246,084
380,320 380,320
4,671,037 4,671,037
FY2003 FY2003
25,217,342 25,217,342
7,186,643 7,186,643
4,504,508 4,504,508
417,023 417,023
4,961,453 4,961,453
FY2004 FY2004
24,862,857 24,862,857
7,419,851 7,419,851
4,713,583 4,713,583
453,250 453,250
5,166,833 5,166,833
FY2005 FY2005
24,521,247 24,521,247
7,746,201 7,746,201
4,862,992 4,862,992
445,322 445,322
5,308,314 5,308,314
FY2006 FY2006
24,179,183 24,179,183
7,872,438 7,872,438
5,030,582 5,030,582
435,488 435,488
5,466,070 5,466,070
FY2007 FY2007
23,816,018 23,816,018
7,833,445 7,833,445
5,015,689 5,015,689
463,240 463,240
5,478,929 5,478,929
FY2008 FY2008
23,442,489 23,442,489
7,834,763 7,834,763
5,078,269 5,078,269
498,420 498,420
5,576,689 5,576,689
FY2009 FY2009
23,066,965 23,066,965
8,048,560 8,048,560
5,221,583 5,221,583
523,110 523,110
5,744,693 5,744,693
FY2010 FY2010
23,031,892 23,031,892
8,343,117 8,343,117
5,441,059 5,441,059
559,051 559,051
6,000,110 6,000,110
FY2011 FY2011
22,676,149 22,676,149
8,574,198 8,574,198
5,582,171 5,582,171
584,020 584,020
6,166,191 6,166,191
FY2012 FY2012
22,328,279 22,328,279
8,762,548 8,762,548
5,680,374 5,680,374
652,717 652,717
6,333,091 6,333,091
FY2013 FY2013
21,972,964 21,972,964
8,926,546 8,926,546
5,803,890 5,803,890
680,774 680,774
6,484,664 6,484,664
FY2014 FY2014
21,999,108 21,999,108
9,078,615 9,078,615
5,955,725 5,955,725
677,010 677,010
6,632,735 6,632,735
FY2015 FY2015
21,680,534 21,680,534
8,965,923 8,965,923
6,047,750 6,047,750
694,120 694,120
6,741,870 6,741,870
FY2016 FY2016
21,368,156 21,368,156
9,124,712 9,124,712
6,168,606 6,168,606
705,743 705,743
6,874,349 6,874,349
FY2017 FY2017
21,065,561 21,065,561
9,247,803 9,247,803
6,277,360 6,277,360
715,928 715,928
6,993,288 6,993,288
FY2018 FY2018
20,333,894 20,333,894
9,178,149 9,178,149
6,170,756 6,170,756
744,740 744,740
6,915,496 6,915,496
FY2019 FY2019
19,928,795 19,928,795
9,237,638 9,237,638
6,271,019 6,271,019
764,777 764,777
7,035,796 7,035,796
FY2020 FY2020
19,541,961 19,541,961
9,281,963 9,281,963
6,334,802 6,334,802
782,316 782,316
7,117,118 7,117,118
FY2021 FY2021
19,162,515 19,162,515
9,315,153 9,315,153
6,392,577 6,392,577
799,359 799,359
7,191,936 7,191,936
Sources: Total Veteran Population numbers are from VetPop2018 (FY2018-FY2021), available at Total Veteran Population numbers are from VetPop2018 (FY2018-FY2021), available at
http://www.va.gov/vetdata/Veteran_Population.asp, and an archived copy of an earlier version no longer available http://www.va.gov/vetdata/Veteran_Population.asp, and an archived copy of an earlier version no longer available
on the website (FY2000-FY2017). VA-Enrol ed Veterans numbers and Patients Using VA Health Care During the on the website (FY2000-FY2017). VA-Enrol ed Veterans numbers and Patients Using VA Health Care During the
Year numbers were obtained from the Department of Veterans Affairs (VA) and/or the VA budget submissions Year numbers were obtained from the Department of Veterans Affairs (VA) and/or the VA budget submissions
to Congress for FY2002-FY2021; the number for each fiscal year is taken from the budget submission two years to Congress for FY2002-FY2021; the number for each fiscal year is taken from the budget submission two years
later (e.g., the FY2000 number is from the FY2002 budget submission). later (e.g., the FY2000 number is from the FY2002 budget submission).
Notes: FY2020 and FY2021 numbers are estimates. FY2020 and FY2021 numbers are estimates.
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Appendix B. Department of Veterans Affairs,
Enacted Appropriations FY1995-FY2020
Table B-1. Department of Veterans Affairs Enacted Appropriations, FY1995-FY1999
($ in Thousands) ($ in Thousands)
FY1995
FY1996
FY1997
FY1998
FY1999

Enacted
Enacted
Enacted
Enacted
Enacted
Veterans Benefits Administration (VBA)
Compensation and Pensions Compensation and Pensions
$17,626,892 $17,626,892
$18,331,561 $18,331,561
$18,671,259 $18,671,259
$19,932,997 $19,932,997
$21,857,058 $21,857,058
Supplemental Supplemental
— —
$100,000 $100,000
$928,000 $928,000
$550,000 $550,000
— —
Readjustment Benefits Readjustment Benefits
$1,286,600 $1,286,600
$1,345,300 $1,345,300
$1,377,000 $1,377,000
$1,366,000 $1,366,000
$1,175,000 $1,175,000
Veterans Insurance and Veterans Insurance and
$24,760 $24,760
$24,890 $24,890
$38,970 $38,970
$51,360 $51,360
$46,450 $46,450
Indemnities Indemnities
Education Loan Program Education Loan Program
$196 $196
$196 $196
$196 $196
$201 $201
$207 $207
Account Account
Loan Guaranty Program Loan Guaranty Program
$78,035 $78,035
$75,088 $75,088
$47,901 $47,901
— —
— —
Account Account
Guaranty & Indemnity Program Guaranty & Indemnity Program
$428,120 $428,120
$569,348 $569,348
$263,869 $263,869
— —
— —
Account Account
Direct Loan Program Direct Loan Program
$1,042 $1,042
$487 $487
$110 $110
— —
— —
Veterans Housing Benefit Veterans Housing Benefit
— —
— —
— —
$192,447 $192,447
$263,587 $263,587
Program Fund Program Fund
Veterans Housing Benefit Veterans Housing Benefit
— —
— —
— —
$160,437 $160,437
$159,121 $159,121
Program Fund Administrative Program Fund Administrative
Expenses Expenses
Vocational Rehabilitation Loan Vocational Rehabilitation Loan
$54 $54
$54 $54
$49 $49
$44 $44
$55 $55
Program Program
Vocational Rehabilitation Loan Vocational Rehabilitation Loan
$767 $767
$377 $377
$377 $377
$388 $388
$400 $400
Program Administrative Program Administrative
Expenses Expenses
Native American Veterans Native American Veterans
$218 $218
$205 $205
$205 $205
$515 $515
$515 $515
Housing Loan Program Housing Loan Program
Administrative Expenses Administrative Expenses
Subtotal VBA
$19,446,684
$20,447,506
$21,327,936
$22,254,389
$23,502,393
Veterans Health Administration (VHA)
Medical Care Medical Care
$16,232,756 $16,232,756
$16,564,000 $16,564,000
$17,013,447 $17,013,447
$17,057,396 $17,057,396
$17,306,000 $17,306,000
Rescission Rescission
-$84,762 -$84,762
-$21,250 -$21,250
— —
— —
-$35,373 -$35,373
Medical Administration and Medical Administration and
$69,808 $69,808
$63,602 $63,602
$61,207 $61,207
$59,860 $59,860
$63,000 $63,000
Miscellaneous Operating Miscellaneous Operating
Expenses (MAMOE) Expenses (MAMOE)
Rescission Rescission
-$44 -$44
-$86 -$86
— —
— —
-$67 -$67
Health Professional Scholarships Health Professional Scholarships
$10,386 $10,386
— —
— —
— —
— —
Medical and Prosthetic Research Medical and Prosthetic Research
$252,000 $252,000
$257,000 $257,000
$262,000 $262,000
$272,000 $272,000
$316,000 $316,000
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FY1995
FY1996
FY1997
FY1998
FY1999

Enacted
Enacted
Enacted
Enacted
Enacted
Rescission Rescission
-$574 -$574
-$322 -$322
— —
— —
-$348 -$348
Medical Care Col ections Fund Medical Care Col ections Fund
— —
— —
— —
$666,579 $666,579
$587,000 $587,000
(MCCF) (MCCF)
Subtotal VHA
$16,479,570
$16,862,944
$17,336,654
$18,055,835
$18,236,212
National Cemetery
$72,663 $72,663
$72,604 $72,604
$76,864 $76,864
$84,183 $84,183
$92,006 $92,006
Administration (NCA)
Rescission Rescission
-$128 -$128
-$97 -$97
— —
— —
-$122 -$122
Subtotal NCA
$72,535
$72,507
$76,864
$84,183
$91,884
Departmental Administration
General Operating Expenses General Operating Expenses
$890,600 $890,600
$848,143 $848,143
$827,584 $827,584
$786,135 $786,135
$855,661 $855,661
Rescission Rescission
-$879 -$879
-$1,127 -$1,127
— —
— —
-$1,558 -$1,558
Office of Inspector General Office of Inspector General
$31,819 $31,819
$30,900 $30,900
$30,900 $30,900
$31,013 $31,013
$36,000 $36,000
Rescission Rescission
-$32 -$32
-$42 -$42
— —
— —
-$43 -$43
Construction, Major Projects Construction, Major Projects
$355,612 $355,612
$136,155 $136,155
$250,858 $250,858
$175,000 $175,000
$142,300 $142,300
Rescission Rescission
-$32,337 -$32,337
-$186 -$186
-$32,100 -$32,100
— —
-$13 -$13
Construction, Minor Projects Construction, Minor Projects
$153,540 $153,540
$190,000 $190,000
$175,000 $175,000
$177,900 $177,900
$175,000 $175,000
Rescission Rescission
-$634 -$634
-$260 -$260
— —
— —
-$16 -$16
Supplemental Supplemental
— —
— —
— —
$32,100 $32,100
— —
Parking Fund Parking Fund
$16,300 $16,300
— —
$12,300 $12,300
— —
— —
Rescission Rescission
— —
— —
— —
— —
-$23 -$23
Grants to Republic of the Grants to Republic of the
$500 $500
— —
— —
— —
— —
Philippines Philippines
Grants for State Extended Care Grants for State Extended Care
$47,397 $47,397
$47,397 $47,397
$47,397 $47,397
$80,000 $80,000
$90,000 $90,000
Facilities Facilities
Grants for State Veterans Grants for State Veterans
$5,378 $5,378
$1,000 $1,000
$1,000 $1,000
$10,000 $10,000
$10,000 $10,000
Cemeteries Cemeteries
Subtotal Departmental
$1,467,264
$1,251,980
$1,312,939
$1,292,148
$1,307,308
Administration
Total Department of
$37,466,053
$38,634,937
$40,054,393
$41,686,555
$43,137,797
Veterans Affairs with MCCF
Total Department of
$37,466,053
$38,634,937
$40,054,393
$41,019,976
$42,550,797
Veterans Affairs without
MCCF
Total Mandatory
$19,445,449
$20,446,674
$21,327,109
$22,092,804
$23,342,095
Total Discretionary with
$18,020,604
$18,188,263
$18,727,284
$19,593,751
$19,795,702
MCCF
Total Discretionary without
$18,020,604
$18,188,263
$18,727,284
$18,927,172
$19,208,702
MCCF
Source: Table prepared by the Congressional Research Service based on data from the Department of Veterans Table prepared by the Congressional Research Service based on data from the Department of Veterans
Affairs, Office of Management, Office of Budget. Affairs, Office of Management, Office of Budget.
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Table B-2. Department of Veterans Affairs Enacted Appropriations, FY2000- FY2004
($ in Thousands) ($ in Thousands)
FY2000
FY2001
FY2002
FY2003
FY2004

Enacted
Enacted
Enacted
Enacted
Enacted
Veterans Benefits Administration (VBA)
Compensation and Pensions Compensation and Pensions
$21,568,364 $21,568,364
$22,766,276 $22,766,276
$24,944,288 $24,944,288
$28,949,000 $28,949,000
$29,845,127 $29,845,127
Supplemental Supplemental
— —
$589,413 $589,413
$1,100,000 $1,100,000
— —
— —
Readjustment Benefits Readjustment Benefits
$1,469,000 $1,469,000
$1,634,000 $1,634,000
$2,135,000 $2,135,000
$2,264,808 $2,264,808
$2,529,734 $2,529,734
Supplemental Supplemental
— —
$347,000 $347,000
— —
— —
— —
Veterans Insurance and Veterans Insurance and
$28,670 $28,670
$19,850 $19,850
$26,200 $26,200
$27,530 $27,530
$29,017 $29,017
Indemnities Indemnities
Education Loan Program Education Loan Program
$215 $215
$221 $221
$65 $65
$71 $71
$71 $71
Account Account
Guaranteed Transitional Guaranteed Transitional
$48,250 $48,250
— —
— —
— —
— —
Housing for Homeless Housing for Homeless
Veterans Veterans
Veterans Housing Benefit Veterans Housing Benefit
$282,342 $282,342
$165,740 $165,740
$203,278 $203,278
$437,522 $437,522
$305,834 $305,834
Program Fund Program Fund
Veterans Housing Benefit Veterans Housing Benefit
$156,958 $156,958
$162,000 $162,000
$164,497 $164,497
$168,207 $168,207
$154,850 $154,850
Program Fund Administrative Program Fund Administrative
Expenses Expenses
Rescission Rescission
— —
-$356 -$356
-$123 -$123
-$1,093 -$1,093
-$914 -$914
Vocational Rehabilitation Loan Vocational Rehabilitation Loan
$57 $57
$52 $52
$72 $72
$54 $54
$52 $52
Program Program
Vocational Rehabilitation Loan Vocational Rehabilitation Loan
$415 $415
$432 $432
$274 $274
$289 $289
$300 $300
Program Administrative Program Administrative
Expenses Expenses
Rescission Rescission
— —
-$1 -$1
— —
-$2 -$2
-$2 -$2
Native American Veterans Native American Veterans
$520 $520
$532 $532
$544 $544
$558 $558
$571 $571
Housing Loan Program Housing Loan Program
Administrative Expenses Administrative Expenses
Rescission Rescission
— —
-$1 -$1
— —
-$4 -$4
-$3 -$3
Subtotal VBA
$23,554,791
$25,685,156
$28,574,095
$31,846,939
$32,864,636
Veterans Health Administration (VHA)
Medical Care Medical Care
$19,006,000 $19,006,000
$20,281,587 $20,281,587
$21,331,164 $21,331,164
$23,889,304 $23,889,304
— —
Supplemental Supplemental
— —
— —
$142,000 $142,000
— —
— —
Rescission Rescission
-$79,519 -$79,519
-$46,234 -$46,234
-$16,084 -$16,084
— —
— —
Medical Administration and Medical Administration and
$59,703 $59,703
$62,000 $62,000
$66,731 $66,731
$74,716 $74,716
— —
Miscellaneous Operating Miscellaneous Operating
Expenses (MAMOE) Expenses (MAMOE)
Rescission Rescission
— —
-$136 -$136
-$50 -$50
-$486 -$486
— —
Medical Services Medical Services
— —
— —
— —
— —
$17,867,220 $17,867,220
Rescission Rescission
— —
— —
— —
— —
-$103,823 -$103,823
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FY2000
FY2001
FY2002
FY2003
FY2004

Enacted
Enacted
Enacted
Enacted
Enacted
Medical Administration Medical Administration
— —
— —
— —
— —
$5,000,000 $5,000,000
Rescission Rescission
— —
— —
— —
— —
-$29,500 -$29,500
Medical Facilities Medical Facilities
— —
— —
— —
— —
$4,000,000 $4,000,000
Rescission Rescission
— —
— —
— —
— —
-$23,600 -$23,600
Medical and Prosthetic Medical and Prosthetic
$321,000 $321,000
$351,000 $351,000
$371,000 $371,000
$400,000 $400,000
$408,000 $408,000
Research Research
Rescission Rescission
— —
-$772 -$772
-$278 -$278
-$2,600 -$2,600
-$2,407 -$2,407
Medical Care Col ections Fund Medical Care Col ections Fund
$563,755 $563,755
$767,687 $767,687
$1,133,214 $1,133,214
$1,474,716 $1,474,716
$1,708,026 $1,708,026
(MCCF) (MCCF)
Subtotal VHA
$19,870,939
$21,415,132
$23,027,697
$25,835,650
$28,823,916
National Cemetery
$97,256 $97,256
$109,889 $109,889
$121,169 $121,169
$133,149 $133,149
$144,203 $144,203
Administration (NCA)
Rescission Rescission
— —
-$241 -$241
-$91 -$91
-$865 -$865
— —
Supplemental Supplemental
— —
$217 $217
— —
— —
-$851 -$851
Subtotal NCA
$97,256
$109,865
$121,078
$132,284
$143,352
Departmental Administration
General Operating Expenses General Operating Expenses
$912,594 $912,594
$1,050,000 $1,050,000
$1,195,728 $1,195,728
$1,254,000 $1,254,000
$1,283,272 $1,283,272
Rescission Rescission
— —
-$2,382 -$2,382
-$900 -$900
-$8,151 -$8,151
-$7,571 -$7,571
Supplemental Supplemental
— —
— —
$2,000 $2,000
$100,000 $100,000
— —
Office of Inspector General Office of Inspector General
$43,200 $43,200
$46,464 $46,464
$52,308 $52,308
$58,000 $58,000
$62,000 $62,000
Rescission Rescission
— —
-$102 -$102
-$39 -$39
-$377 -$377
-$366 -$366
Construction, Major Projects Construction, Major Projects
$65,140 $65,140
$66,040 $66,040
$183,180 $183,180
$99,777 $99,777
$273,190 $273,190
Rescission Rescission
— —
-$145 -$145
— —
-$649 -$649
-$1,612 -$1,612
Construction, Minor Projects Construction, Minor Projects
$160,000 $160,000
$162,000 $162,000
$210,900 $210,900
$226,000 $226,000
$252,144 $252,144
Rescission Rescission
— —
-$366 -$366
— —
-$1,469 -$1,469
-$1,488 -$1,488
Supplemental Supplemental
— —
$8,840 $8,840
— —
— —
— —
Parking Fund Parking Fund
— —
— —
$4,000 $4,000
— —
— —
Rescission Rescission
— —
-$14 -$14
— —
— —
— —
Grants for State Extended Grants for State Extended
$90,000 $90,000
$100,000 $100,000
$100,000 $100,000
$100,000 $100,000
$102,100 $102,100
Care Facilities Care Facilities
Rescission Rescission
— —
-$220 -$220
$25,000 $25,000
-$650 -$650
-$602 -$602
Grants for State Veterans Grants for State Veterans
$25,000 $25,000
$25,000 $25,000
— —
$32,000 $32,000
$32,000 $32,000
Cemeteries Cemeteries
Rescission Rescission
— —
-$55 -$55
— —
-$208 -$208
-$189 -$189
Subtotal Departmental
$1,295,934
$1,455,060
$1,772,177
$1,858,273
$1,992,878
Administration
Total Department of
$44,818,920
$48,665,214
$53,495,047
$59,673,147
$63,824,783
Veterans Affairs with
MCCF
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FY2000
FY2001
FY2002
FY2003
FY2004

Enacted
Enacted
Enacted
Enacted
Enacted
Total Department of
$44,255,165
$47,897,527
52,361,833
$58,198,431
$62,116,757
Veterans Affairs without
MCCF
Total Mandatory
$23,348,376
$25,522,279
$28,408,766
$31,678,860
$32,709,712
Total Discretionary with
$21,470,544
$23,142,935
$25,086,281
$27,994,287
$31,115,071
MCCF
Total Discretionary
$20,906,789
$22,375,248
$23,953,067
$26,519,571
$29,407,045
without MCCF
Source: Table prepared by the Congressional Research Service based on data from the Department of Veterans Table prepared by the Congressional Research Service based on data from the Department of Veterans
Affairs, Office of Management, Office of Budget. Affairs, Office of Management, Office of Budget.
Table B-3. Department of Veterans Affairs Enacted Appropriations, FY2005-FY2010
($ in Thousands) ($ in Thousands)
FY2005
FY2006
FY2007
FY2008
FY2009
FY2010

Enacted
Enacted
Enacted
Enacted
Enacted
Enacted
Veterans Benefits Administration (VBA)
Compensation and Compensation and
$32,607,688 $32,607,688
$33,897,787 $33,897,787
$38,172,360 $38,172,360
$41,236,322 $41,236,322
$43,111,681 $43,111,681
$47,396,106 $47,396,106
Pensions Pensions
Supplemental Supplemental
— —
— —
— —
— —
$700,000 $700,000
— —
Readjustment Readjustment
$2,556,232 $2,556,232
$3,309,234 $3,309,234
$3,262,006 $3,262,006
$3,300,289 $3,300,289
$3,832,944 $3,832,944
$9,232,369 $9,232,369
Benefits Benefits
Veterans Insurance Veterans Insurance
$44,380 $44,380
$45,907 $45,907
$49,850 $49,850
$41,250 $41,250
$42,300 $42,300
$49,288 $49,288
and Indemnities and Indemnities
Veterans Housing Veterans Housing
$43,784 $43,784
$64,586 $64,586
$66,234 $66,234
$17,389 $17,389
$2,000 $2,000
$23,553 $23,553
Benefit Program Benefit Program
Fund Fund
Credit Subsidy Credit Subsidy
— —
— —
— —
-$108,000 -$108,000
— —
— —
Veterans Housing Veterans Housing
$154,075 $154,075
$153,575 $153,575
$154,284 $154,284
$154,562 $154,562
$157,210 $157,210
$165,082 $165,082
Benefit Program Benefit Program
Fund Administrative Fund Administrative
Expenses Expenses
Rescission Rescission
-$1,233 -$1,233
— —
— —
— —
— —
— —
Vocational Vocational
$47 $47
$53 $53
$53 $53
$71 $71
$61 $61
$29 $29
Rehabilitation Loan Rehabilitation Loan
Program Program
Vocational Vocational
$311 $311
$305 $305
$306 $306
$311 $311
$320 $320
$328 $328
Rehabilitation Loan Rehabilitation Loan
Program Program
Administrative Administrative
Expenses Expenses
Rescission Rescission
-$2.865 -$2.865
— —
— —
— —
— —
— —
Native American Native American
$571 $571
$580 $580
$584 $584
$628 $628
$646 $646
$664 $664
Veterans Housing Veterans Housing
Loan Program Loan Program
Administrative Administrative
Expenses Expenses
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FY2005
FY2006
FY2007
FY2008
FY2009
FY2010

Enacted
Enacted
Enacted
Enacted
Enacted
Enacted
Rescission Rescission
-$4.569 -$4.569
— —
— —
— —
— —
— —
Subtotal VBA
$35,405,848 $37,472,027
$41,705,677 $44,642,822
$47,847,162
$56,867,419
Veterans Health Administration (VHA)
Medical Services Medical Services
$19,472,777 $19,472,777
$21,322,141 $21,322,141
$25,518,254 $25,518,254
$29,104,220 $29,104,220
$30,969,903 $30,969,903
$34,707,500 $34,707,500
Budget Budget
$1,500,000 $1,500,000
$1,225,000 $1,225,000
$466,800 $466,800
— —
— —
— —
Supplemental Supplemental
Hurricane Hurricane
$38,783 $38,783
$198,265 $198,265
— —
— —
— —
— —
Supplemental Supplemental
Pandemic Pandemic
— —
$27,000 $27,000
— —
— —
— —
— —
Influenza Influenza
Supplemental Supplemental
Rescission Rescission
-$155,782 -$155,782
— —
— —
— —
— —
— —
Total Medical Total Medical
$20,855,778 $20,855,778
$22,772,406 $22,772,406
$25,985,054 $25,985,054
$29,104,220 $29,104,220
$30,969,903 $30,969,903
$34,707,500 $34,707,500
Services Services
Medical Medical
$4,705,000 $4,705,000
$2,858,442 $2,858,442
$3,177,968 $3,177,968
$3,517,000 $3,517,000
$4,450,000 $4,450,000
$4,930,000 $4,930,000
Administration Administration
Supplemental Supplemental
$1,940 $1,940
— —
$250,000 $250,000
— —
— —
— —
Rescission Rescission
-$37,640 -$37,640
— —
— —
— —
— —
— —
Medical Facilities Medical Facilities
$3,745,000 $3,745,000
$3,297,669 $3,297,669
$3,569,533 $3,569,533
$4,100,000 $4,100,000
$5,029,000 $5,029,000
$4,859,000 $4,859,000
Supplemental Supplemental
$46,909 $46,909
—- —-
$595,000 $595,000
— —
$1,000,000 $1,000,000
— —
Rescission Rescission
-$29,960 -$29,960
— —
— —
— —
— —
— —
Medical and Medical and
$405,593 $405,593
$412,000 $412,000
$413,980 $413,980
$480,000 $480,000
$510,000 $510,000
$581,000 $581,000
Prosthetic Research Prosthetic Research
Supplemental Supplemental
— —
— —
$32,500 $32,500
— —
— —
— —
Rescission Rescission
-$3,245 -$3,245
— —
— —
— —
— —
— —
Medical Care Medical Care
$1,953,020 $1,953,020
$2,170,000 $2,170,000
$2,198,154 $2,198,154
$2,414,000 $2,414,000
$2,544,000 $2,544,000
$2,847,565 $2,847,565
Col ections Fund Col ections Fund
(MCCF) (MCCF)
Subtotal VHA
$31,642,395 $31,510,517
$36,222,190 $39,615,220
$44,502,903
$47,925,065
National
$148,925 $148,925
$156,447 $156,447
$160,747 $160,747
$195,000 $195,000
$230,000 $230,000
$250,000 $250,000
Cemetery
Administration
(NCA)
Rescission Rescission
-$1,191 -$1,191
— —
— —
— —
$50,000 $50,000
— —

Supplemental Supplemental
$50 $50
$200 $200
— —
— —
— —
Subtotal NCA
$147,784
$156,647
$160,747
$195,000
$280,000
$250,000
Departmental Administration
General Operating General Operating
$1,324,753 $1,324,753
$1,410,520 $1,410,520
$1,481,472 $1,481,472
$1,605,000 $1,605,000
$1,801,867 $1,801,867
$2,086,707 $2,086,707
Expenses Expenses
Rescission Rescission
-$10,598 -$10,598
— —
— —
— —
— —
-$6,100 -$6,100
Supplemental Supplemental
$545 $545
$24,871 $24,871
$83,200 $83,200
$100,000 $100,000
$157,100 $157,100
— —
Congressional Research Service Congressional Research Service

3035

Department of Veterans Affairs FY2021 Appropriations

FY2005
FY2006
FY2007
FY2008
FY2009
FY2010

Enacted
Enacted
Enacted
Enacted
Enacted
Enacted
Filipino Veterans Filipino Veterans
— —
— —
— —
— —
$198,000 $198,000
— —
Equity Equity
Compensation Fund Compensation Fund
Office of Inspector Office of Inspector
$69,711 $69,711
$70,174 $70,174
$70,641 $70,641
$80,500 $80,500
$87,818 $87,818
$109,000 $109,000
General General
Rescission Rescission
-$558 -$558
— —
— —
— —
$1,000 $1,000
— —
Information Information
— —
$1,213,820 $1,213,820
$1,213,820 $1,213,820
$1,966,465 $1,966,465
$2,489,391 $2,489,391
$3,307,000 $3,307,000
Technology Technology
Supplemental Supplemental
— —
— —
$35,100 $35,100
$20,000 $20,000
$50,100 $50,100
— —
Construction, Construction,
$458,800 $458,800
$607,100 $607,100
$399,000 $399,000
$1,069,100 $1,069,100
$923,382 $923,382
$1,194,000 $1,194,000
Major Projects Major Projects
Rescission Rescission
-$3,670 -$3,670
— —
— —
— —
— —
— —
Supplemental Supplemental
— —
$953,419 $953,419
— —
$396,377 $396,377
— —
— —
Construction, Construction,
$230,779 $230,779
$198,937 $198,937
$198,937 $198,937
$630,535 $630,535
$741,534 $741,534
$703,000 $703,000
Minor Projects Minor Projects
Rescission Rescission
-$1,846 -$1,846
— —
— —
— —
— —
— —
Supplemental Supplemental
$36,343 $36,343
$1,800 $1,800
$326,000 $326,000
— —
— —
— —
Grants for State Grants for State
$105,163 $105,163
$85,000 $85,000
$85,000 $85,000
$165,000 $165,000
$175,000 $175,000
$100,000 $100,000
Extended Care Extended Care
Facilities Facilities
Rescission Rescission
-$841 -$841
— —
— —
— —
$150,000 $150,000
— —
Grants for State Grants for State
$32,000 $32,000
$32,000 $32,000
$32,000 $32,000
$39,500 $39,500
$42,000 $42,000
$46,000 $46,000
Veterans Veterans
Cemeteries Cemeteries
Rescission Rescission
-$256 -$256
— —
— —
— —
— —
— —
Subtotal
$2,240,324
$4,597,641
$3,925,171
$6,072,477
$6,817,192
$7,539,607
Departmental
Administration
Total
$69,436,351 $73,736,832
$82,013,784 $90,525,519
$99,447,257 $112,582,091
Department of
Veterans Affairs
with MCCF
Total
$67,483,331 $71,566,832
$79,815,630 $88,111,519
$96,903,257 $109,734,526
Department of
Veterans Affairs
without MCCF
Total Mandatory
$35,252,084 $37,317,514
$41,550,450 $44,487,250
$47,688,925
$56,701,316
Total
$34,184,267 $36,419,318
$40,463,334 $46,038,269
$51,758,332
$55,880,775
Discretionary
with MCCF
Total
$32,231,247 $34,249,318
$38,265,180 $43,624,269
$49,214,332
$53,033,210
Discretionary
without MCCF
Source: Table prepared by the Congressional Research Service based on data from the Department of Veterans Table prepared by the Congressional Research Service based on data from the Department of Veterans
Affairs, Office of Management, Office of Budget. Affairs, Office of Management, Office of Budget.
Congressional Research Service Congressional Research Service

3136

Department of Veterans Affairs FY2021 Appropriations

Table B-4. Department of Veterans Affairs Enacted Appropriations, FY2011-FY2015
($ in Thousands) ($ in Thousands)
FY2011
FY2012
FY2013
FY2014
FY2015
Enacted
Enacted
Enacted
Enacted
Enacted

Veterans Benefits Administration (VBA)
Compensation and Compensation and
$53,978,000 $53,978,000
$51,237,567 $51,237,567
$60,599,855 $60,599,855
$71,476,104 $71,476,104
$79,071,000 $79,071,000
Pensions Pensions
Readjustment Benefits Readjustment Benefits
$10,396,245 $10,396,245
$12,108,488 $12,108,488
$12,023,458 $12,023,458
$13,135,898 $13,135,898
$14,997,136 $14,997,136
Veterans Insurance and Veterans Insurance and
$77,589 $77,589
$100,252 $100,252
$104,600 $104,600
$77,567 $77,567
$63,257 $63,257
Indemnities Indemnities
Veterans Housing Veterans Housing
$19,078 $19,078
$318,612 $318,612
$184,859 $184,859
— —
— —
Benefit Program Fund Benefit Program Fund
Veterans Housing Veterans Housing
$165,082 $165,082
$154,698 $154,698
$157,605 $157,605
$158,430 $158,430
$160,881 $160,881
Benefit Program Fund Benefit Program Fund
Administrative Administrative
Expenses Expenses
Rescission Rescission
-$330 -$330
— —
— —
— —
— —
Vocational Vocational
$29 $29
$19 $19
$19 $19
$5 $5
$10 $10
Rehabilitation Loan Rehabilitation Loan
Program Program
Rescission Rescission
-$1 -$1
— —
— —
— —
— —
Vocational Vocational
$337 $337
$343 $343
$346 $346
$354 $354
$361 $361
Rehabilitation Loan Rehabilitation Loan
Program Program
Administrative Administrative
Expenses Expenses
Rescission Rescission
-$10 -$10
— —
— —
— —
— —
Native American Native American
$707 $707
$1,116 $1,116
$1,087 $1,087
$1,109 $1,109
$1,130 $1,130
Veterans Housing Veterans Housing
Program Program
Administrative Administrative
Expenses Expenses
Rescission Rescission
-$44 -$44
— —
— —
— —
— —
Subtotal VBA
$64,636,683
$63,921,095
$73,071,830
$86,886,074
$94,753,582
Veterans Health Administration (VHA)
Medical Services Medical Services
$37,136,000 $37,136,000
$39,649,985 $39,649,985
$41,509,000 $41,509,000
$43,557,000 $43,557,000
$45,015,527 $45,015,527
Budget Budget
— —
— —
— —
209,189 209,189
Supplemental Supplemental
$40,000 $40,000
Hurricane Hurricane
— —
— —
$21,000 $21,000
— —
— —
Supplemental Supplemental
Rescission Rescission
-$74,272 -$74,272
— —
-$14,937 -$14,937
-$179,000 -$179,000
-28,829.839 -28,829.839
Total Medical
$37,061,728
$39,649,985
$41,515,063
$43,418,000
$45,195,886.161
Services
Medical Administration Medical Administration
$5,307,000 $5,307,000
$5,535,000 $5,535,000
$5,746,000 $5,746,000
$6,033,000 $6,033,000
$5,879,700 $5,879,700
Rescission Rescission
-$44,546 -$44,546
— —
-$2,039 -$2,039
-$50,000 -$50,000
-5,609.461 -5,609.461
Congressional Research Service Congressional Research Service

3237

Department of Veterans Affairs FY2021 Appropriations

FY2011
FY2012
FY2013
FY2014
FY2015
Enacted
Enacted
Enacted
Enacted
Enacted

Medical Facilities Medical Facilities
$5,740,000 $5,740,000
$5,426,000 $5,426,000
$5,441,000 $5,441,000
$4,872,000 $4,872,000
$4,739,000 $4,739,000
Supplemental Supplemental
— —
— —
$6,000 $6,000
$85,000 $85,000
— —
Rescission Rescission
-$26,450 -$26,450
— —
-$1,991 -$1,991
— —
-1,999.835 -1,999.835
Medical and Prosthetic Medical and Prosthetic
$590,000 $590,000
$581,000 $581,000
$581,905 $581,905
$585,664 $585,664
$588,922 $588,922
Research Research
Rescission Rescission
-$10,162 -$10,162
— —
— —
— —
-409.359 -409.359
Medical Care Medical Care
$2,775,214 $2,775,214
$2,830,302 $2,830,302
$2,903,092 $2,903,092
— —
— —
Col ections Fund Col ections Fund
(MCCF) (MCCF)
Subtotal VHA
$51,392,784
$54,022,287
$56,189,031 $58,031,653.610 $59,619,421.506
National Cemetery
$250,000 $250,000
$250,934 $250,934
$258,284 $258,284
$250,000 $250,000
$256,800 $256,800
Administration
(NCA)
Rescission Rescission
-$500 -$500
— —
-$341 -$341
-$1,000 -$1,000
-169.500 -169.500
Supplemental Supplemental
— —
— —
$2,100 $2,100
— —
— —
Subtotal NCA
$249,500
$250,934
$260,043
$249,000
$256,630.500
Departmental Administration
VBA—General VBA—General
$2,622,110 $2,622,110
$2,018,764 $2,018,764
$2,164,074 $2,164,074
$2,465,490 $2,465,490
$2,534,254 $2,534,254
Operating Expenses Operating Expenses
Rescission Rescission
-$87,834 -$87,834
— —
-$2,856 -$2,856
— —
-2,355.482 -2,355.482
General General
— —
$416,737 $416,737
$424,737 $424,737
$415,885 $415,885
$321,591 $321,591
Administration Administration
Rescission Rescission
— —
— —
-$561 -$561
-$2,000 -$2,000
-446.436 -446.436
Office of Inspector Office of Inspector
$109,367 $109,367
$112,391 $112,391
$114,848 $114,848
121,411 121,411
$126,411 $126,411
General General
Rescission Rescission
-$585 -$585
— —
— —
— —
— —
Information Information
$3,307,000 $3,307,000
$3,111,376 $3,111,376
$3,323,053 $3,323,053
$3,703,344 $3,703,344
$3,903,344 $3,903,344
Technology Technology
Rescission Rescission

— —
-1,066 -1,066
Supplemental Supplemental
-$166,396 -$166,396
— —
— —
— —
— —
Construction, Major Construction, Major
$1,151,036 $1,151,036
$589,604 $589,604
$531,767 $531,767
$342,130 $342,130
$561,800 $561,800
Projects Projects
Rescission Rescission
-$2,302 -$2,302
— —
— —
— —
— —
Construction, Minor Construction, Minor
$467,700 $467,700
$482,386 $482,386
$606,728 $606,728
$714,870 $714,870
$495,200 $495,200
Projects Projects
Rescission Rescission
-$935 -$935
— —
— —
— —
— —
Supplemental Supplemental

511,200 511,200

Grants for State Grants for State
$85,000 $85,000
$85,000 $85,000
$84,888 $84,888
$85,000 $85,000
$90,000 $90,000
Extended Care Extended Care
Facilities Facilities
Rescission Rescission
-$170 -$170
— —
— —
— —
— —
Congressional Research Service Congressional Research Service

3338

Department of Veterans Affairs FY2021 Appropriations

FY2011
FY2012
FY2013
FY2014
FY2015
Enacted
Enacted
Enacted
Enacted
Enacted

Grants for State Grants for State
$46,000 $46,000
$46,000 $46,000
$45,939 $45,939
$46,000 $46,000
$46,000 $46,000
Veterans Cemeteries Veterans Cemeteries
Rescission Rescission
-$92 -$92
— —
— —
— —
— —
Subtotal
$7,529,899
$6,862,258
$6,871,298 $8,403,330,000
$8,173,911.996
Departmental
Administration
Total Department
$123,808,866
$125,056,574
$136,392,201 $153,570,057.610 $162,803,546.002
of Veterans Affairs
with MCCF
Total Department
$121,033,652
$122,226,272
$133,489,109
$150,482,068 $159,579,614.002
of Veterans Affairs
without MCCF
Total Mandatory
$64,470,912
$63,764,919
$72,912,772
$101,726,176
$94,591,200
Total Discretionary
$59,338,338
$61,291,655
$63,479,429 $66,843,881.610 $68,212,346.002
with MCCF
Total Discretionary
$56,563,124
$58,461,353
$60,576,337
$63,755,892 $64,988,414.002
without MCCF

Table B-5 Department of Veterans Affairs Enacted Appropriations, FY2016-FY2020
($ in Thousands) ($ in Thousands)
FY2016
FY2017
FY2018
FY2019
FY2020
Enacted
Enacted
Enacted
Enacted
Enacted

Veterans Benefits Administration (VBA)
Compensation and Compensation and
$76,865,545 $76,865,545
$86,083,128 $86,083,128
$90,119,449 $90,119,449
$100,762,828 $100,762,828
$110,457,083 $110,457,083
Pensions Pensions
Readjustment Benefits Readjustment Benefits
$14,313,357 $14,313,357
$16,340,828 $16,340,828
$13,708,648 $13,708,648
$11,832,175 $11,832,175
$14,065,282 $14,065,282
Veterans Insurance and Veterans Insurance and
$77,160 $77,160
$108,525 $108,525
$120,338 $120,338
$109,090 $109,090
$128,960 $128,960
Indemnities Indemnities
Veterans Housing Veterans Housing
$509,008 $509,008
— —
— —
— —
— —
Benefit Program Fund Benefit Program Fund
Veterans Housing Veterans Housing
$164,558 $164,558
$198,856 $198,856
$178,626 $178,626
$200,612 $200,612
$200,377 $200,377
Benefit Program Fund Benefit Program Fund
Administrative Administrative
Expenses Expenses
Rescission Rescission
— —
— —
— —
— —
— —
Vocational Vocational
$31 $31
$36 $36
$30 $30
$39 $39
$58 $58
Rehabilitation Loan Rehabilitation Loan
Program Program
Rescission Rescission
— —
— —
— —
— —
— —
Vocational Vocational
$367 $367
$389 $389
$395 $395
$396 $396
$402 $402
Rehabilitation Loan Rehabilitation Loan
Program Program
Congressional Research Service Congressional Research Service

3439

Department of Veterans Affairs FY2021 Appropriations

FY2016
FY2017
FY2018
FY2019
FY2020
Enacted
Enacted
Enacted
Enacted
Enacted

Administrative Administrative
Expenses Expenses
Rescission Rescission
— —
— —
— —
— —
— —
Native American Native American
$1,114 $1,114
$1,163 $1,163
$1,163 $1,163
$1,143 $1,143
$1,186 $1,186
Veterans Housing Veterans Housing
Program Program
Administrative Administrative
Expenses Expenses
Rescission Rescission
— —
— —
— —
— —
— —
Subtotal VBA
$91,931,140 $102,732,905 $104,128,649 $112,906,283 $124,853,348
Veterans Health Administration (VHA)
Medical Services Medical Services
$47,603,202 $47,603,202
$51,673,000 $51,673,000
$44,886,554 $44,886,554
$49,944,165 $49,944,165
$51,411,165 $51,411,165
Budget Budget
$2,369,158 $2,369,158
1,078,993 1,078,993
$1,962,984 $1,962,984
— —
— —
Supplemental Supplemental
Hurricane Hurricane
— —
— —
$11,075 $11,075
— —
— —
Supplemental Supplemental
P.L. 115-31, P.L. 115-31,
— —
$50,000 $50,000
— —
— —
— —
(Opioid (Opioid
Supplemental) Supplemental)
Families First Families First
— —
— —
— —
— —
$30,000 $30,000
Coronavirus Coronavirus
Response Act (P.L. Response Act (P.L.
116-127) 116-127)
CARES Act (P.L. CARES Act (P.L.
— —
— —
— —
— —
$14,432,000 $14,432,000
116-136) 116-136)
Rescission Rescission
— —
-$7,380,181 -$7,380,181
-$751,000 -$751,000
— —
-$350,000 -$350,000
Total Medical
$49,972,360
$45,421,812
$49,109,613
$49,944,165
$ $65,523,165
Services
Medical Community Medical Community
— —
7,246,181 7,246,181
$9,409,613 $9,409,613
$9,384,704 $9,384,704
$15,279,799 $15,279,799
Care Care
Budget Budget
— —
— —
$419,176 $419,176
— —
— —
Supplemental Supplemental
Families First Families First
— —
— —
— —
— —
$30,000 $30,000
Coronavirus Coronavirus
Response Act (P.L. Response Act (P.L.
116-127) 116-127)
CARES Act (P.L. CARES Act (P.L.
— —
— —
— —
— —
$2,100,000 $2,100,000
116-136) 116-136)
Total Medical
—
$7,246,181
$9,828,294
$9,384,704
$17,409,799
Community Care
Medical Administration Medical Administration
$6,144,000 $6,144,000
$6,524,000 $6,524,000
$6,654,480 $6,654,480
$7,028,156 $7,028,156
$7,239,156 $7,239,156
Budget Budget
— —
— —
$100,000 $100,000
— —
$98,800 $98,800
Supplemental Supplemental
Hurricane Hurricane
— —
— —
$3,209 $3,209
— —
— —
Supplemental Supplemental
Congressional Research Service Congressional Research Service

3540

Department of Veterans Affairs FY2021 Appropriations

FY2016
FY2017
FY2018
FY2019
FY2020
Enacted
Enacted
Enacted
Enacted
Enacted

Rescission Rescission
— —
-$26,000 -$26,000
— —
— —
-$10,000 -$10,000
CARES Act (P.L. CARES Act (P.L.
— —
— —
— —
— —
$100,000 $100,000
116-136) 116-136)
Total Medical Total Medical
$6,144,000 $6,144,000
$6,498,000 $6,498,000
$6,757,689 $6,757,689
$7,028,156 $7,028,156
$7,427,956 $7,427,956
Administration Administration
Medical Facilities Medical Facilities
$4,915,000 $4,915,000
$5,074,000 $5,074,000
$5,434,880 $5,434,880
$6,804,468 $6,804,468
$6,141,880 $6,141,880
Supplemental Supplemental
$105,312 $105,312
$247,668 $247,668
$707,000 $707,000
— —
— —
P.L. 115-141, P.L. 115-141,
— —
— —
$1,000,000 $1,000,000
— —
— —
Section 255 Section 255
Hurricane Hurricane
— —
— —
$75,108 $75,108
$3,000 $3,000
— —
Supplemental Supplemental
Rescission Rescission
— —
-$9,000 -$9,000
— —
— —
— —
CARES Act (P.L. CARES Act (P.L.
— —
— —
— —
— —
$606,000 $606,000
116-136) 116-136)
Total Medical
$5,020,312
$5,312,668
$7,216,988
$6,807,468
$6,747,880
Facilities
Medical and Prosthetic Medical and Prosthetic
$630,735 $630,735
$675,366 $675,366
$722,262 $722,262
$779,000 $779,000
$800,000 $800,000
Research Research
Rescission Rescission
— —
-$2,000 -$2,000
— —
— —
-$50,000 -$50,000
Total Medical and
$630,735
$673,366
$722,262
$779,000
$750,000
Prosthetic Research
Medical Care Medical Care
$3,503,146 $3,503,146
$3,561,642 $3,561,642
$3,515,635 $3,515,635
$3,915,045 $3,915,045
$3,912,000 $3,912,000
Col ections Fund Col ections Fund
(MCCF) (MCCF)
Subtotal VHA
$62,270,373
$ $68,713,669
$ $74,150,481
$ $77,858,538 $101,770,800
Veterans Choice Act Veterans Choice Act
— —
$2,100,000 $2,100,000
$7,300,000 $7,300,000
— —
-$615,000 -$615,000
Mandatory Funds Mandatory Funds
National Cemetery
$271,220 $271,220
$286,193 $286,193
$306,193 $306,193
$315,836 $315,836
$329,000 $329,000
Administration
(NCA)
Rescission Rescission
— —
— —
— —

-$1,000 -$1,000
Supplemental Supplemental
— —
— —
— —

Subtotal NCA
$271,220
$286,193
$306,193
$ $315,836
$ $328,000

Departmental

Administration:
VBA—General VBA—General
$2,707,734 $2,707,734
$2,856,160 $2,856,160
$2,910,000 $2,910,000
$2,956,316 $2,956,316
$3,125,000 $3,125,000
Operating Expenses Operating Expenses
Rescission Rescission
— —
-$12,000 -$12,000
— —
— —
-$258 -$258
CARES Act (P.L. CARES Act (P.L.
— —
— —
— —
— —
13,000 13,000
116-136) 116-136)
General General
$336,659 $336,659
$345,391 $345,391
$335,891 $335,891
$355,897 $355,897
$355,911 $355,911
Administration Administration
Congressional Research Service Congressional Research Service

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Department of Veterans Affairs FY2021 Appropriations

FY2016
FY2017
FY2018
FY2019
FY2020
Enacted
Enacted
Enacted
Enacted
Enacted

Rescission Rescission
— —
— —
— —
— —
-$15,949 -$15,949
CARES Act (P.L. CARES Act (P.L.
— —
— —
— —
— —
$6,000 $6,000
116-136) 116-136)
Board of Veterans Board of Veterans
$109,884 $109,884
$156,096 $156,096
$161,048 $161,048
$174,748 $174,748
$182,000 $182,000
Appeals Appeals
Rescission Rescission
— —
-$500 -$500
— —
— —
-$8,000 -$8,000
Office of Inspector Office of Inspector
$136,766 $136,766
$160,106 $160,106
$164,000 $164,000
$192,000 $192,000
$210,000 $210,000
General General
Rescission Rescission
— —
-$500 -$500
— —
— —
— —
CARES Act (P.L. CARES Act (P.L.
— —
— —
— —
— —
$12,500 $12,500
116-136) 116-136)
Information Information
$4,133,363 $4,133,363
$4,278,259 $4,278,259
$4,055,500 $4,055,500
$4,103,000 $4,103,000
$4,371,615 $4,371,615
Technology Technology
Rescission Rescission
— —
-$8,000 -$8,000
— —
— —
— —
CARES Act (P.L. CARES Act (P.L.
— —
— —
— —
— —
$2,150,000 $2,150,000
116-136) 116-136)
Electronic Health Electronic Health
— —
— —
$782,000 $782,000
$1,107,000 $1,107,000
$1,500,000 $1,500,000
Records Records
Modernization (EHRM) Modernization (EHRM)
Rescission Rescission
— —
— —
— —
— —
-$70,000 -$70,000
Construction, Major Construction, Major
$1,243,800 $1,243,800
$528,110 $528,110
$512,430 $512,430
$2,177,486 $2,177,486
$1,235,200 $1,235,200
Projects Projects
Rescission Rescission
— —
-$20,322 -$20,322
— —

Construction, Minor Construction, Minor
$406,200 $406,200
$372,069 $372,069
$767,570 $767,570
$799,514 $799,514
$398,800 $398,800
Projects Projects
Rescission Rescission
— —
— —
— —
— —
— —
Supplemental Supplemental
— —
— —
$4,088 $4,088
— —
— —
Grants for State Grants for State
$120,000 $120,000
$90,000 $90,000
$685,000 $685,000
$150,000 $150,000
$90,000 $90,000
Extended Care Extended Care
Facilities Facilities
Rescission Rescission
— —
— —
— —
— —
— —
CARES Act (P.L. CARES Act (P.L.
— —
— —
— —
— —
$150,000 $150,000
116-136) 116-136)
Grants for State Grants for State
$46,000 $46,000
$45,000 $45,000
$45,000 $45,000
$45,000 $45,000
$45,000 $45,000
Veterans Cemeteries Veterans Cemeteries
Rescission Rescission
— —
— —
— —
— —
— —
Subtotal
$9,240,406
$ $8,789,869
$ $10,422,527
$ $12,060,961
$ $13,750,819
Departmental
Administration
Total Department
$166,713,139 $$180,522,636 $$189,007,850 $$203,141,618 $$240,702,967
of Veterans Affairs
with MCCF
Congressional Research Service Congressional Research Service

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Department of Veterans Affairs FY2021 Appropriations

Total Department
$163,209,993 $$176,960,994 $$185,492,215 $$199,226,573 $$236,790,967
of Veterans Affairs
without MCCF
Total Mandatory
$91,765,678 $$102,532,481 $$103,948,435 $$112,704,093 $$124,651,325
Total Discretionary
$74,948,069
$ $77,990,155
$ $85,059,415
$ $90,437,525 $$116,051,642
with MCCF
Total Discretionary
$71,444,923
$ $74,428,513
$ $81,543,780
$ $86,522,480 $$112,139,642
without MCCF
Source: Table prepared by the Congressional Research Service based on data from the Department of Veterans Table prepared by the Congressional Research Service based on data from the Department of Veterans
Affairs, Office of Management, Office of Budget. Affairs, Office of Management, Office of Budget.

Author Information

Sidath Viranga Panangala Sidath Viranga Panangala
Heather M. Salazar Heather M. Salazar
Specialist in Veterans Policy Specialist in Veterans Policy
Analyst in Veterans Policy Analyst in Veterans Policy

Jared S. Sussman Jared S. Sussman

Analyst in Health Policy Analyst in Health Policy

Disclaimer
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