Department of Veterans Affairs FY2021 Appropriations

Changes from December 14, 2020 to June 30, 2021

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
~~December 14, 2020~~June 30, 2021
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 President’s budget ~~is requesting~~requested $240.2 billion for $240.2 billion for ~~the~~ VA. This amount VA. This amount ~~includes~~included $135.4 billion $135.4 billion
in Analyst in Veterans Policy Analyst in Veterans Policy
in mandatory benefits funding and $104.8 billion in discretionary funding. When compared with mandatory benefits funding and $104.8 billion in discretionary funding. When compared with
the
~~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),provided by the Further Consolidated Appropriations Act, 2020 (P.L. 116-94), and supplemental and supplemental

funding provided by the Families First Coronavirus Response Act (P.L. 116-127) funding provided by the Families First Coronavirus Response Act (P.L. 116-127) and the and the
Coronavirus Aid, Relief, and Economic Security Act (P.L. 116-136)—this Coronavirus Aid, Relief, and Economic Security Act (P.L. 116-136)—this iswas an increase of $2.752 billion. an increase of $2.752 billion. ~~Additionally~~In addition, the , the
budget request budget request ~~includes~~included an advance appropriation request of $239.5 billion for FY2022 an advance appropriation request of $239.5 billion for FY2022 to fund the seven advance to fund the seven advance
appropriations accountsappropriations accounts—: 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 facilitiesmedical community care, medical support and compliance, and medical facilities . .
On July On July ~~9, the House Appropriations Committee held a markup of the FY2021 Military Construction and Veterans Affairs,~~
~~and Related Agencies (MILCON-VA) appropriations bill, and the 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,~~24, 2020, the House-passed H.R. 7608. Division D of this measure included the Military Construction, and Military Construction, and
Veterans Veterans Affairs appropriations (MILCON-VA) bill for FY2021. The House-passed bill provided $240.2 billion for ~~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 $135.4VA, including $135.4 billion in mandatory spending and $104.8 billion in billion in mandatory spending and $104.8 billion in
discretionary spending. discretionary spending. ~~On November 10,~~ The Senate did not introduce a Military Construction, and Veterans Affairs appropriations bill for FY2021. However, on November 10, 2020, the chair of the Senate Committee on Appropriations, Senator Richard Shelby, 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 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.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,~~ After passing a series of continuing resolutions to continue funding government agencies at the FY2020 level, on December 27, 2020, the Consolidated Appropriations Act, 2021 (P.L. 116-260) was enacted. Division J of P.L. 116-260 included the MILCON-VA Appropriations Act, FY2021. The act provided $243.2 billion for VA for FY2021, including $138.7 billion in mandatory including $138.7 billion in mandatory
spending and $104.4 billion in discretionary spending. Comparative funding levels with amounts enacted for FY2020,spending and $104.4 billion in discretionary spending. Comparative funding levels with amounts enacted for FY2020,
amounts requested and provided by the House-passed measure, amounts requested and provided by the House-passed measure, ~~and~~ recommended by the Senate Appropriations Committee recommended by the Senate Appropriations Committee
majority MILCON-VA draft bill for FY2021majority MILCON-VA draft bill for FY2021 ~~are as follows:~~
~~FY2021 Senate~~
~~Appropriations~~
~~FY2021 House-~~
~~Committee Majority~~, and the Consolidated Appropriations Act, 2021 (P.L. 116-260) are as follows: FY2021 House- FY2021 Senate Consolidated passed Appropriations Appropriations (Division D of Committee Act, 2021 (Div. J;

FY2020 Enacted
FY2021 Request
~~passed~~
H.R. 7608) Majority Draft P.L. 116-260) ~~Draft~~
Veterans Benefits Veterans Benefits
$128.7 bil ion $128.7 bil ion
$138.8 bil ion $138.8 bil ion
$138.8 bil ion $138.8 bil ion
$142.1bil ion $142.1bil ion
$142.1 bil ion Administration (VBA, Administration (VBA,
including including ~~General~~
~~Operating~~ General Operating Expenses) Expenses)
Veterans Health Veterans Health
$97.9 bil ion $97.9 bil ion
$90.8 bil ion $90.8 bil ion
$90.8 bil ion $90.8 bil ion
$90.8 bil ion $90.8 bil ion
$90.6 bil ion Administration (VHA) Administration (VHA)
National Cemetery National Cemetery
$328 mil ion $328 mil ion
$360 mil ion $360 mil ion
$349 mil ion $349 mil ion
$352 mil ion $352 mil ion
$352 mil ion Administration Administration (NCA) Congressional Research Service Department of Veterans Affairs FY2021 Appropriations FY2021 House- FY2021 Senate Consolidated passed Appropriations Appropriations (Division D of Committee Act, 2021 (Div. J; FY2020 Enacted FY2021 Request H.R. 7608) Majority Draft P.L. 116-260) Departmental $10.6 bil ion $10.3 bil ion $10.2 bil ion $10.2 bil ion $10.1 bil ion Administration Congressional Research Service link to page 6 link to page 6 link to page 7 link to page 7 link to page 8 link to page 9 link to page 10 link to page 10 link to page 10 link to page 10 link to page 12 link to page 14 link to page 14 link to page 14 link to page 14 link to page 14 link to page 15 link to page 15 link to page 15 link to page 16 link to page 17 link to page 18 link to page 18 link to page 19 link to page 19 link to page 25 link to page 25 link to page 26 link to page 27 link to page 28 link to page 29 link to page 9 link to page 11 link to page 13 link to page 31 link to page 38~~(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~~

~~link to page 38 link to page 41 link to page 43 link to page 33 link to page 34 link to page 47~~ ~~Department of Veterans Affairs FY2021 Appropriations~~

36 Table B-3. Department of Veterans Affairs Enacted Appropriations, FY2005-FY2010 .............~~.. 34~~ 38
Table B-4. Department of Veterans Affairs Enacted Appropriations, FY2011-FY2015 .............~~.. 37~~ 41
Table B-5 Department of Veterans Affairs Enacted Appropriations, FY2016-FY2020 ..............~~.. 39~~ 43

Appendixes
Appendix A. Veteran Population, VA Enrollees, and VA Patients, FY2000-FY2021 .................~~.. 29~~ 33
Appendix B. Department of Veterans Affairs, Enacted Appropriations FY1995-FY2020 ..........~~.. 30~~ 34

Contacts
Author Information .......................................................................................................~~................. 43~~ 47

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Introduction
The Department of Veterans Affairs (VA)The Department of Veterans Affairs (VA) provides a range of benefits and services to veterans provides a range of benefits and services to veterans
who meet certain eligibilitywho meet certain eligibility criteria. These benefits and services include, among other things, 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
rehabilitationrehabilitation and employment services;4 assistance to homeless veterans;5 home loan and employment services;4 assistance to homeless veterans;5 home loan
guarantees;6 administration of life insurance, as guarantees;6 administration of life insurance, as ~~well~~ wel as traumatic injury protection insurance for 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
eligibleeligible persons, among other things. The BVA reviews persons, among other things. The BVA reviews ~~all~~ al appeals made by veterans or their 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 Affairs, and Related Agencies (MILCON-VA) appropriations ~~bill~~bil ; it does not provide funding ; it does not provide funding
levels at the subaccount, program, or activity levels at the subaccount, program, or activity ~~level~~s. 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 CRS1 For more information on programs, see CRS Report R42747, Report R42747, Health Care for Veterans: Answers to Frequently Asked
Questions. .
2 For more information on programs, see CRS 2 For more information on programs, see CRS Report R44837, Report R44837, Benefits for Service-Disabled Veterans;; and CRSand CRS Report Report
RS22804, RS22804, Veterans’ Benefits: Pension Benefit ~~Programs~~.
Program s. 3 For a discussion3 For a discussion of education benefits, see CRSof education benefits, see CRS Report R42755, Report R42755, The Post-9/11 GI Bill: A Primer. .
4 For details on VA’s4 For details on VA’s vocational rehabilitation and employment, see CRSvocational rehabilitation and employment, see CRS Report RL34627, Report RL34627, Veterans’ Benefits: The
Vocational Rehabilitation and ~~Employment~~Em ploym ent Program . .
5 For detailed 5 For detailed information on homeless veterans programs, see CRSinformation on homeless veterans programs, see CRS In FocusIn Focus IF10167, IF10167, Veterans and Homelessness. .
6 For details on the home loan guarantee program, see CRS6 For details on the home loan guarantee program, see CRS Report R42504, Report R42504, VA Housing: Guaranteed Loans, Direct
Loans, and Specially Adapted Housing Grants. .
7 For more information on burial benefits, see 7 For more information on burial benefits, see ~~CRS~~ CRS Report R41386, Report R41386, Veterans’ Benefits: Burial Benefits and National
~~Cemeteries~~Cem eteries. .
8 Established by 8 Established by the National Cemeteries Act of 1973 (P.L. 93-43). the National Cemeteries Act of 1973 (P.L. 93-43).
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shown shown inin Table 1, which is based on budget authority amounts shown in the MILCON-VA which is based on budget authority amounts shown in the MILCON-VA
appropriations appropriations ~~bills and~~bil s, accompanying committee reports accompanying committee reports ~~or draft~~, and explanatory statements. 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
disabilitydisability compensation for veterans, the survivor’s Dependency and Indemnity Compensation 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 housing, clothing ~~allowances~~al owances, and burial benefits (such as burial , and burial benefits (such as burial ~~allowances~~al owances, grave liners, outer , 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 Fund and the Pershing ~~Hall~~ Hal Revolving Fund; trust funds, such as the Department of Veterans 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.11Care 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.C. §117 and included three more accounts to the advance appropriations list of amended 38 U.S.C. §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. Beginningand veterans insurance and indemnities. Beginning with the FY2016 Militarywith the FY2016 Military Construction and 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~~ VHA accounts already authorized to receive advance appropriations.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~~entitlem ents. 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 doescertain recipients to payments. If Congress does not appropriate the money necessary to meet these commitments, not appropriate the money necessary to meet these commitments,
entitled recipients (e.g., individuals,entitled recipients (e.g., individuals, states, or other entities) may have legal recourse. For an overview of mandatory states, or other entities) may have legal recourse. For an overview of mandatory
spending, see CRSspending, see CRS Report R44641, Report R44641, Trends in Mandatory Spending: In Brief. .
10 Funding 10 Funding for discretionary programs is provided and controlled through the annual appropriations process. For more for discretionary programs is provided and controlled through the annual appropriations process. For more
information, see CRSinformation, see CRS Report R41726, Report R41726, Discretionary Budget Authority by Subfunction: An Overview.
11 For more details about these funds, 11 For more details about these funds, see Department of Veterans Affairs, 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.)last edition in which this information was published.) For definitions about “revolving funds,” “trust funds,” and For definitions about “revolving funds,” “trust funds,” and
“special funds,”“special funds,” see Executive Office of the President, Office of Management and Budgetsee Executive Office of the President, Office of Management and Budget (OMB), OMB Circular(OMB), OMB Circular No. No.
A–11, A–11, Section 20- ~~Terms~~Term s and Concepts,, availableavailable at https://www.whitehouse.gov/wp-content/uploads/2018/06/s20.pdf. at https://www.whitehouse.gov/wp-content/uploads/2018/06/s20.pdf.
12 For a detailed discussion 12 For a detailed discussion of advance appropriations, see CRSof advance appropriations, see CRS Report R43482, Report R43482, Advance Appropriations, Forward
Funding, and Advance Funding: Concepts, Practice, and Budget Process Considerations. .
13 Codified 13 Codified at 38 U.S.C.at 38 U.S.C. §117. §117.
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care, beginning with the FY2017 appropriations cycle. The Jeff care, beginning with the FY2017 appropriations cycle. The Jeff ~~Miller~~Mil er and Richard Blumenthal and Richard Blumenthal
Veterans Health Care and Benefits Improvement Act of 2016 (P.L. 114-315) authorized Veterans Health Care and Benefits Improvement Act of 2016 (P.L. 114-315) authorized ~~advanced~~
advance 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 VHAappropriations of new budget authority for these VBA and VHA accounts to prevent potential 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 labelnumbers are noted by the label “memorandum” and in the“memorandum” and in the corresponding fiscal year column. 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 appropriations grew from $19.5 ~~billion~~bil ion to $124.7 to $124.7 ~~billion~~bil ion in nominal dollars, a compound annual 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 $18.0 ~~billion~~ bil ion to $112.1 to $112.1 ~~billion~~bil ion, a CAGR of 7.6%. The total VA appropriations from FY1995 , a CAGR of 7.6%. The total VA appropriations from FY1995
through FY2020 grew from $37.5 through FY2020 grew from $37.5 ~~billion~~bil ion to $236.8 to $236.8 ~~billion~~bil ion, a CAGR of 7.7%. , a CAGR of 7.7%.

14 Executive Office of the President, Office of Management and Budget14 Executive Office of the President, Office of Management and Budget (OMB), OMB Circular(OMB), OMB Circular No. A–11, No. A–11, Section 20-
~~Terms~~Term s 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 Circulara11_current_year/a11_2017/s20.pdf; also see OMB Circular No. A–11, No. A–11, Appendix A -Scorekeeping Guidelines, 2017, p. 2017, p.
2, available2, available at https://www.whitehouse.gov/sites/whitehouse.gov/files/omb/assets/a11_current_year/a11_2017/at https://www.whitehouse.gov/sites/whitehouse.gov/files/omb/assets/a11_current_year/a11_2017/
app_a.pdf. app_a.pdf.
15 CAGR15 CAGR is annualizedis annualized average rate of growth between two given years, calculatedaverage rate of growth between two given years, calculated as CAGR,as CAGR, year FY1995 to year year FY1995 to year
FY2020 = [(value in year 2020/value in year 1995) ^ (1/25)FY2020 = [(value in year 2020/value in year 1995) ^ (1/25) -1]. -1].
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Figure 1. VA Appropriations, FY1995-FY2020

Source: Figure prepared by CRS based on figures from the Department of Veterans Affairs,Figure prepared by CRS based on figures from the Department of Veterans Affairs, ~~Office~~ Office of of
Management, Office of Budget (seeManagement, Office of Budget (see, , Appendix B).
Notes: Amounts in in nominal, Amounts in in nominal, or noninflation-adjusted, dol ars,or noninflation-adjusted, dol ars, and discretionary funding excludes offsetting and discretionary funding excludes offsetting
col ectionscol ections deposited in the Medical Care Col ectionsdeposited in the Medical Care Col ections Fund (MCCF). 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 Administration requested a total $216.1 ~~billion~~ bil ion for the VA. This amount included $123.2 for the VA. This amount included $123.2 ~~billion~~ bil ion in in
mandatory appropriations and $92.9 mandatory appropriations and $92.9 ~~billion~~bil ion in discretionary funding. The President’s request also 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 benefit programs. For medical care accounts, the budget request included $87.6 ~~billion~~bil ion in in
discretionary advance appropriations and $129.5 discretionary advance appropriations and $129.5 ~~billion~~bil ion in advance appropriations for mandatory 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) Construction, Veterans Affairs, and Related Agencies (MILCON-VA) ~~bill~~ bil (H.R. 2745; H.Rept. (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 FY2020 MILCON-VA ~~bill~~bil . After the passage of several continuing resolutions (CRs), on . 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 Militarycontained the Military Construction, Veterans Affairs, and Related Agencies Appropriations Construction, Veterans Affairs, and Related Agencies Appropriations
(MILCON-VA) Act, 2020.16 The act provides $217.9 (MILCON-VA) Act, 2020.16 The act provides $217.9 ~~billion~~bil ion for the VA. This amount includes for the VA. This amount includes
$125.4 $125.4 ~~billion~~ bil ion in mandatory appropriations and $92.5 in mandatory appropriations and $92.5 ~~billion~~bil ion in discretionary funding. P.L. 116-94 in discretionary funding. P.L. 116-94
provided advance appropriations for FY2021 totaling $87.6 provided advance appropriations for FY2021 totaling $87.6 ~~billion~~ bil ion for medical care accounts 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 facilities) and $131 ~~billion~~ bil ion for mandatory veterans benefits (compensation and pensions, for mandatory veterans benefits (compensation and pensions,

~~16 The~~ 16 T he full legislative text and the explanatory statement of P.L. 116-94 is contained in the House Committee Print 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/CPRTFurther Consolidated Appropriations Act, 2020, at https://www.govinfo.gov/content/pkg/CPRT -116HPRT38679/pdf/-116HPRT38679/pdf/
CPRTCPRT~~-116HPRT38679~~ -116HPRT 38679.pdf. .pdf.
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readjustment benefits, and veterans insurance and indemnities). readjustment benefits, and veterans insurance and indemnities). ~~All~~ Al amounts are prior to the amounts are prior to the
enactment of COVID-19 supplemental enactment of COVID-19 supplemental ~~funding~~funding. Table 1 provides total funding levels that include provides total funding levels that include
the regular appropriations provided in P.L. 116-94 and the supplemental appropriations discussed the regular appropriations provided in P.L. 116-94 and the supplemental appropriations discussed
belowbelow. Figure 2 provides an overview of FY2020-enacted mandatory and discretionary provides an overview of FY2020-enacted mandatory and discretionary
appropriations. 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 VAfunding for FY2020 for several VA accounts. The total amount of supplemental funding for accounts. The total amount of supplemental funding for
FY2020 is $19.63 FY2020 is $19.63 ~~billion~~bil ion. This amount includes $60.0 . 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 Coronavirus Response Act (P.L. 116-127) and $19.6 ~~billion~~bil ion provided in the Coronavirus Aid, 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 (P.L. 116-127). The act provides $30 ~~million~~mil ion for VHA’s medical services account to fund health for VHA’s medical services account to fund health
services and related items pertaining to COVID-19, and $30 services and related items pertaining to COVID-19, and $30 ~~million~~ mil ion for VHA’s medical for VHA’s medical
community care account (community care account (~~see~~see Table 1). These funds are designated as emergency spending and . These funds are designated as emergency spending and
are to remain availableare to remain available until September 30, 2022. until September 30, 2022.
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 accounts totaling $19.6 ~~billion~~bil ion. Unless otherwise noted below, funds remain available until . Unless otherwise noted below, funds remain available until
September 30, 2021. Funding provided in the CARES Act is broken down as follows (September 30, 2021. Funding provided in the CARES Act is broken down as follows (~~see~~see Table
1):18 18
 VHA,  VHA, medical services account, $14.4 medical services account, $14.4 ~~billion~~bil ion, for increased telehealth services; , 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  VA, information technology systems account, $2.2 ~~billion~~bil ion, for increased telework , for increased telework
capacity, purchasing additional laptops for telework and telehealth-enabled capacity, purchasing additional laptops for telework and telehealth-enabled
laptops for VHAlaptops for VHA providers to work from home, and to increase bandwidth and IT providers to work from home, and to increase bandwidth and IT
infrastructure needs, among other things. infrastructure needs, among other things.
 VHA,  VHA, medical community care account, $2.1 medical community care account, $2.1 ~~billion~~bil ion, for increased emergency , for increased emergency
room and urgent care usage in the community. room and urgent care usage in the community.
 VHA,  VHA, medical facilities account, $606 medical facilities account, $606 ~~million~~mil ion, for the procurement of mobile , 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’s17 For more details on the VA’s and Congress’sand Congress’s response to the COVID-19 pandemic, see CRSresponse to the COVID-19 pandemic, see CRS Report R46340, Report R46340,
Federal Response to COVID-19: ~~Department~~Departm ent of Veterans Affairs. .
18 Based18 Based on Senate Appropriations Committee, Coronavirus Supplemental Appropriations Summary, available at on Senate Appropriations Committee, Coronavirus Supplemental Appropriations Summary, available at
https://www.appropriations.senate.gov/download/coronavirus-emergency-supplemental-appropriations-summary. https://www.appropriations.senate.gov/download/coronavirus-emergency-supplemental-appropriations-summary.
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 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,~~ mil ion, to help state homes renovate, alter, or repair facilities to respond to to help state homes renovate, alter, or repair facilities to respond to
COVID-19. COVID-19.
 VHA,  VHA, medical support and compliance account, $100 medical support and compliance account, $100 ~~million~~mil ion, for the provision , 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,  VBA, general operating expenses account, $13.0 general operating expenses account, $13.0 ~~million~~mil ion, for enhancing telework , 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  VA, Office of Inspector General account, $12.5 ~~million~~mil ion, for increased oversight , 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.
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 Families116-94); the Families First CoronavirusFirst Coronavirus Response Act (P.L. 116-127); the Coronavirus Aid,Response Act (P.L. 116-127); the Coronavirus Aid, Relief,Relief, and Economic and Economic
Security Act (P.L. 116-136) and U.S. Congress, House CommitteeSecurity Act (P.L. 116-136) and U.S. Congress, House Committee on Appropriations, on Appropriations, Military Construction,
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Veterans Affairs, and Related Agencies Appropriations Bil ~~Bill~~, 2021, report to accompany H.R. 7609, 116th Cong., 2nd , report to accompany H.R. 7609, 116th Cong., 2nd
sess.,sess., July 13, 2020, H.Rept. 116-445, pp. 131-141. 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 Total budget authority excludes offsetting col ections deposited in the Medical Care Col ections Fund 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 President’s budget ~~is requesting $240.2 billion for the~~requested $240.2 bil ion for VA. This amount VA. This amount ~~includes~~included $135.4 $135.4 ~~billion~~ bil ion in in
mandatory benefits funding and $104.8 mandatory benefits funding and $104.8 ~~billion~~bil ion in discretionary funding. When compared with the in discretionary funding. When compared with the
FY2020-enacted amount for FY2020-enacted amount for ~~the~~ VA of $237.5 VA of $237.5 ~~billion—which includes~~bil ion—which included regular appropriations 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 Coronavirus Aid, Relief, and Economic Security Act (P.L. 116-136)—this was an increase of an increase of $2.752 bil ion. Additional y, ~~$2.752~~
~~billion. Additionally,~~ the Administration’s budget request the Administration’s budget request ~~includes~~included an advance appropriation an advance appropriation
request of $239.5 request of $239.5 ~~billion~~bil ion for FY2022 to fund the seven advance appropriations accounts— for FY2022 to fund the seven advance appropriations accounts—
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 provides the FY2021 President’s requested mandatory and discretionary appropriations by major by major
program. program.
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Figure 3. Budget Request, FY2021, by Major Program and Spending Category

Source: Figure prepared by CRS based on U.S. Congress, House Committee Figure prepared by CRS based on U.S. Congress, House Committee on Appropriations,on Appropriations, Military
Construction, Veterans Affairs, and Related Agencies Appropriations Bil ~~Bill~~, 2021, report to accompany H.R. 7609, 116th , report to accompany H.R. 7609, 116th
Cong., 2nd sess.,Cong., 2nd sess., July 13, 2020, H.Rept. 116-445, pp. 131-141. 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 Total budget authority excludes offsetting col ections deposited in the Medical Care Col ections Fund 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 Construction, Veterans Affairs, and Related Agencies (MILCON-VA) appropriations ~~bill~~bil , and the , and the
draft draft ~~bill~~ bil was approved. On July 9, the House Appropriations Committee held a markup of the was approved. On July 9, the House Appropriations Committee held a markup of the
FY2021 MILCON-VA appropriations FY2021 MILCON-VA appropriations ~~bill~~ bil and the and the ~~bill~~ bil was ordered reported to the full House on 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 July 13 (H.R. 7609; H.Rept. 116-445). Subsequently, the text of H.R. 7609 was included in a
four-four-~~bill~~ bil appropriations package (H.R. 7608, the State, Foreign Operations, Agriculture, Rural appropriations package (H.R. 7608, the State, Foreign Operations, Agriculture, Rural
Development, Interior, Environment, Military Construction, and Veterans Affairs Appropriations Development, Interior, Environment, Military Construction, and Veterans Affairs Appropriations
~~bill~~ bil 2021) and passed by the full House on July 24. The House-passed measure (Division D of 2021) and passed by the full House on July 24. The House-passed measure (Division D of
H.R. 7608) H.R. 7608) ~~provides~~provided a total of $240.2 a total of $240.2 ~~billion for the~~bil ion for VA, which VA, which ~~includes~~included $135.4 $135.4 ~~billion in~~
bil ion in mandatory funding and $104.8 mandatory funding and $104.8 ~~billion~~bil ion in discretionary funding. Within the in discretionary funding. Within the ~~overall~~ overal total of $104.8 total of $104.8
~~billion~~bil ion in in discretionary funding, $12.5 discretionary funding, $12.5 ~~billion~~bil ion is designated as emergency funding. is designated as emergency funding.
On November 10, 2020, the chair of the Senate Committee on Appropriations, Senator Richard On November 10, 2020, the chair of the Senate Committee on Appropriations, Senator Richard
Shelby, released drafts of Shelby, released drafts of ~~all~~ al 12 annual appropriations 12 annual appropriations ~~bills~~bil s along with draft accompanying along with draft accompanying
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explanatory statements including the FY2021 MILCON-VA explanatory statements including the FY2021 MILCON-VA ~~appropriations bill~~ appropriations bil .19 The release of .19 The release of
the draft the draft ~~bills~~bil s was intended to further negotiations on annual appropriations between the House was intended to further negotiations on annual appropriations between the House
and the Senate.20 The majority draft FY2021 MILCON-VA appropriations and the Senate.20 The majority draft FY2021 MILCON-VA appropriations ~~bill recommends~~
~~$243.1 billion for the~~bil recommended $243.1 bil ion for VA, including $138.7 VA, including $138.7 ~~billion~~ bil ion in mandatory spending and $104.4 in mandatory spending and $104.4 ~~billion~~bil ion in in
discretionary spending. Similar to the House-passed measure, the Senate majority draft version of discretionary spending. Similar to the House-passed measure, the Senate majority draft version of
the MILCON-VAthe MILCON-VA appropriations appropriations ~~bill~~ bil has designated $12.5 has designated $12.5 ~~billion~~ bil ion as emergency spending within as emergency spending within
the recommended $104.4 the recommended $104.4 ~~billion~~bil ion discretionary spending level. discretionary spending level.
~~Mandatory Programs Funding~~
~~Major mandatory program funding includes VA’s disability compensation program; pensions to~~
~~low-income veterans, their surviving spouses, and dependent children; education and vocational~~
~~rehabilitation~~ Continuing Appropriations (P.L. 116-159; P.L. 116-215; P.L. 116-225; P.L. 116-226; P.L. 116-246)21 Since none of the regular appropriations bil s were enacted at the beginning of the fiscal year on October 1, Congress passed five continuing resolutions (CRs) to continue funding at FY2020 levels. 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 CRs. 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 made 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’s) “Compensation and Pensions” account. This provision authorized 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 al owed 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 mil ion 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 general y financed by collections from the sale of meals, merchandise, and services at 19 T he 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 details on the continuing resolution, see CRS Report R46582, Overview of Continuing Appropriations for FY2021 (P.L. 116-159). Congressional Research Service 9 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. Consolidated Appropriations Act, 2021 (P.L. 116-260) Based on negotiations between the House and Senate Appropriations Committees, the then-Chairwoman of the House Committee on Appropriations, Representative Nita Lowey, offered a House amendment to the Senate amendment to H.R. 133. On December 21, 2020, both the House and Senate agreed to the measure, and President Trump signed the legislation on December 27, 2020, as the Consolidated Appropriations Act, 2021 (H.R. 133, P.L. 116-260). Division J of this act contained the FY2021 Military Construction, Veterans Affairs, and Related Agencies (MILCON-VA) Appropriations Act. The act provides $243.2 bil ion for VA for FY2021, which includes $104.4 bil ion in discretionary funding and $138.7 bil ion in mandatory funding (Table 1). In March 2021, the American Rescue Plan Act (P.L. 117-2) was enacted and provided approximately $17.1 bil ion in mandatory funding in addition to amount enacted in P.L. 116-260 (see text box below). American Rescue Plan Act of 2021 (P.L. 117-2) On March 11, 2021, President Biden signed into law the American Rescue Plan Act of 2021. This legislation was crafted by authorizing committees, instead of appropriations committees, using the budget reconciliation process. The Veterans’ Affairs Committee provisions (TITLE VIII of 117-2) provides approximately $17.1 bil ion for VA programs and activities. Since it is unclear how funding wil be al ocated by VA to various accounts, this report does not include any discussion of funding in either the narrative or tables of this report. For example, authority to expend funds in support of medical care, information technology, and medical facility requirements are clustered together in the act. Therefore, it is not clear how the department would al ocate funding among the accounts that comprise those categories. In addition, VA has not publicly released a state-by-state breakdown of American Rescue Plan Act of 2021 funding provided to VA. A summary of key provisions in the act fol ows:  $272 mil ion for benefit claims and appeals processing.  $14.5 bil ion for medical care and health needs.  $100 mil ion for supply chain modernization.  $750 mil ion for state veteran homes.  $10 mil ion for the Office of Inspector General.  $386 mil ion for COVID-19 veteran rapid retraining assistance program.  $1 bil ion for expenses related to prohibition on col ecting any copayments or other cost sharing requirements from veterans during the COVID-19 emergency.  $80 mil ion for the VA Employee Leave Fund. Mandatory Programs Funding Major mandatory program funding includes VA’s disability compensation program; pensions to low-income veterans, their surviving spouses, and dependent children; education and vocational rehabilitation assistance; and the provision of life insurance. 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 (disabled or elderly wartime veterans and their survivors; burial benefits (~~allowances~~al owances, flags, , flags,
headstones, etc.); and a clothing headstones, etc.); and a clothing ~~allowance~~al owance for certain disabled veterans. for certain disabled veterans.
Congressional Research Service 10 link to page 31 Department of Veterans Affairs FY2021 Appropriations For FY2021, ~~For FY2021, the~~ VA requested $121.1 VA requested $121.1 ~~billion~~bil ion for the Compensation and Pensions account, an for the Compensation and Pensions account, an
increase of $2.8 increase of $2.8 ~~billion~~bil ion over the FY2021 over the FY2021 ~~advanced~~advance appropriations. The largest portion of this appropriations. The largest portion of this
budget item is disabilitybudget item is disability compensation, which VA compensation, which VA ~~estimates to~~estimated would be $115.8 be $115.8 ~~billion in~~ bil ion in compensation compensation
payments to an estimated 5.3 payments to an estimated 5.3 ~~million~~mil ion veterans, 456,000 survivors, and 1,266 children. Pension veterans, 456,000 survivors, and 1,266 children. Pension
payments payments ~~are~~were estimated to be $4.9 estimated to be $4.9 ~~billion~~bil ion to approximately 231,100 veterans to approximately 231,100 veterans and 161,300 and 161,300
survivors. survivors. ~~Finally~~Final y, an estimated $355 , an estimated $355 ~~million will be allocated~~mil ion would be al ocated for burial benefits. 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).2122 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, benefits, ~~are~~would be expected to increase due to the annual cost-of-living adjustment (COLA). expected to increase due to the annual cost-of-living adjustment (COLA).
The The ~~House-passed amount of $121.1 billion is the same as the VA’s requested amount for the~~
Consolidated Appropriations Act, 2021 (H.R. 133, P.L. 116-260) provides $124.4 bil ion for VA’s FY2021 Compensation and Pension accountCompensation and Pension account ~~for FY2021. 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~~. This is $13.9 bil ion over the FY2020-enacted amount, $6.1 bil ion over the FY2021 advance appropriations, and $3.3 bil ion over VA’s requested amount for FY2021 ( over VA’s requested amount for FY2021 (~~see~~see Table 1). These . These
increases reflect the increased number of increases reflect the increased number of ~~disability~~ disability compensation claims that compensation claims that ~~will~~ wil be granted and be granted and
paid out on a monthly basis. These funds paid out on a monthly basis. These funds ~~will~~ wil also continue to support VA programs to address also continue to support VA programs to address
root causes of veterans’ financial hardships root causes of veterans’ financial hardships and to improve communications with Veterans and to improve communications with Veterans
Service Organizations (VSOs).Service Organizations (VSOs).~~22 The Senate majority draft~~ 23 The explanatory statement explanatory statement ~~raised~~raises concerns about VA’s accounting measures for this account and directs VA to submit a plan to both the Senate and House Appropriations Committees addressing required accounting adjustments and reconciliation of FY2020 funds. The committees requested this plan to be submitted no later than 60 days after the FY2021 MILCON-VA appropriations bil is enacted.24 The explanatory statement also expresses concern about the high denial rate for Gulf War veterans disability claims and directs VA to submit a report on its efforts to improve the claim approval rate and the feasibility of eliminating the deadline for filing presumptive claims for Gulf War veterans. The committees request this report no later than 180 days after FY2021 MILCON-VA appropriations bil is enacted.25 ~~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.~~
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~~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 servicemembers from active duty status to veteran status, as ~~well~~ wel benefits for disabled veterans. 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, For FY2021, ~~the~~ VA requested appropriations of $12.6 VA requested appropriations of $12.6 ~~billion~~bil ion to provide sufficient mandatory to provide sufficient mandatory
funding for Readjustment Benefits, approximately $1.5 funding for Readjustment Benefits, approximately $1.5 ~~billion~~ bil ion less than the amount enacted in less than the amount enacted in
FY2020. The decrease in readjustment benefits funding between FY2020 and FY2021 is largely 22 For more information, see CRS In Focus IF11368, Expansion of Benefits to Blue Water Navy Vietnam Veterans. 23 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. 24 U.S. Congress, House Committee on Appropriations, Committee Print of the Committee on Appropriations U.S. House of Representatives on H.R. 133/P.L. 116-260, committee print, 117th Cong., 1st sess., March 2021, pp. 1853-1854, at https://www.govinfo.gov/content/pkg/CPRT -117HPRT43750/pdf/CPRT -117HPRT43750.pdf. 25 U.S. Congress, House Committee on Appropriations, Committee Print of the Committee on Appropriations U.S. House of Representatives on H.R. 133/P.L. 116-260, committee print, 117th Cong., 1st sess., March 2021, p. 1854, at https://www.govinfo.gov/content/pkg/CPRT -117HPRT43750/pdf/CPRT -117HPRT43750.pdf. Congressional Research Service 11 link to page 31 link to page 31 Department of Veterans Affairs FY2021 Appropriations due to the carryover of $2.9 bil ion in unobligated benefits from prior years and $191.2 mil ion in offsetting collections from the Department of Defense (DOD).26 P.L. 116-260 provides $12.6 bil ion for FY2021, the same as VA’s requested amount, for the Readjustment Benefits account (see Table 1). In the explanatory statement, the committees direct VA to submit a report on the feasibility and advisability of, and a cost estimate for, granting eligible disabled veterans with an additional adaptive automobile grant if at least 10 years have passed since their initial grant or assistance. The Committees on Appropriations request the report within 270 days of the enactment of this act.27 Veterans Insurance and Indemnities (VI&I) 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 insured veterans and their beneficiaries, this category includes supplemental funding for National Service Life Insurance (NSLI),28 Service-Disabled Veterans Insurance (S-DVI),29 and Veterans Mortgage Life Insurance (VMLI).30 For FY2021, VA estimates $6.3 mil ion in collections from premiums, interest on investments, and extra hazard payments from military service branches. In addition, VA has $2.1 mil ion in previously appropriated funds to use until expended. In addition to the advance appropriated funds, VA requested $129.2 mil ion, bringing the total amount to $131.4 mil ion, an estimated $2.4 mil ion increase from the FY2020-enacted budget. This increase would enable VA to transfer $40,000 to the NSLI, program, $43 mil ion to the VMLI program, and $96.6 mil ion to the S-DVI program.31 P.L. 116-260 provides~~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~~
~~offsetting collections from the Department of Defense (DOD).24~~
~~For readjustment and rehabilitation benefits, the House-passed measure (Division D of H.R.~~
~~7608) provides the same as the VA’s requested amount for the Readjustment Benefits account~~
~~(see Table 1 ) for FY2021. The committee highlights the importance of assistance to veterans~~
~~transitioning from military life to academic, vocational, or employment life and therefore~~
~~encourage VA to continue to expand these 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~~
~~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~~

~~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.~~
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~~link to page 28 link to page 28~~ ~~Department of Veterans Affairs FY2021 Appropriations~~

~~Service Life Insurance (NSLI),26 Service-Disabled Veterans Insurance (S-DVI),27 and Veterans~~
~~Mortgage Life Insurance (VMLI).28~~
~~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~~
~~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~~
~~$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~~
~~the S-DVI program.29 The House bill has provided~~ the same amount for the Insurance and the same amount for the Insurance and
Indemnities account for Indemnities account for FY2021 as requested in the Administration’s budget request (FY2021 as requested in the Administration’s budget request (~~see~~see 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~~

~~26 The National Service Life Insurance (NSLI) program was~~ 1).32 26 U.S. Department of Veterans Affairs, FY2021 Budget Submission, Benefits and Burial Programs and Departmental Adm inistration, vol. 3 of 4, February 2020, pp. VBA-74, 75. 27 U.S. Congress, House Committee on Appropriations, Committee Print of the Committee on Appropriations U.S. House of Representatives on H.R. 133/P.L. 116-260, committee print, 117th Cong., 1st sess., March 2021, p. 1854 at https://www.govinfo.gov/content/pkg/CPRT -117HPRT43750/pdf/CPRT -117HPRT43750.pdf. 28 T he National Service Life Insurance (NSLI) program was created on October 8, 1940, to handle insurance needs of created on October 8, 1940, to handle insurance needs of
World War II veterans. World War II veterans. ~~These~~T hese policies were issued policies were issued until April 24, 1951, and provided a maximum of $10,000 in until April 24, 1951, and provided a maximum of $10,000 in
coverage. Seecoverage. See https://www.benefits.va.gov/insurance/nsli.asp. https://www.benefits.va.gov/insurance/nsli.asp.
~~27 The~~29 T he Service-Disabled Service-Disabled Veterans Insurance (S-DVI)Veterans Insurance (S-DVI) program wasprogram was ~~established~~ established on April 25, 1951, and remains open for on April 25, 1951, and remains open for
newnew policies to service-connected disabledpolicies to service-connected disabled veterans who separated under other than dishonorable conditions. S-DVI 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 waiveradditional $30,000 in supplemental coverage may be granted without a waiver of premiums. Seeof premiums. See https://www.va.gov/https://www.va.gov/
life-insurance/options-eligibility/s-dvi/. life-insurance/options-eligibility/s-dvi/.
~~28 The~~30 T he Veterans Mortgage Life Insurance (NSLI) program provides veterans who meet certain requirements, including 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. having received a grant for specially adapted housing with up to $200,000 of mortgage protection life insurance. ~~This~~T his
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/.
2931 U.S. U.S. Department of Veterans Affairs, Department of Veterans Affairs, FY2021 Budget Submission, Benefits and Burial Programs and Departmental
~~Administration~~Adm inistration, vol. 3 of 4, February 2020, pp. VBA-131, 133. , vol. 3 of 4, February 2020, pp. VBA-131, 133.
3032 U.S. U.S. Congress, HouseCongress, House Committee on Appropriations, 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.
40. 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.~~
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~~Department of Veterans Affairs FY2021 Appropriations~~
Congressional Research Service 12 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.33 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.34 The VA’s health care system is organized into 18 geographical y 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 decisionmaking be applied throughout the VA health care system, management authority for basic decisionmaking
and budgetary responsibilities is delegated to the VISNs.and budgetary responsibilities is delegated to the VISNs.3335 As of FY2020, the VHA As of FY2020, the VHA operates 148 operates 148
hospitals, 135 nursing homes, 765 community-based outpatient clinics (CBOCs),hospitals, 135 nursing homes, 765 community-based outpatient clinics (CBOCs),3436 and 300 and 300
Readjustment Counseling Centers (Vet Centers).Readjustment Counseling Centers (Vet Centers).3537 In 2009, the VA began a pilot Mobile Vet In 2009, the VA began a pilot Mobile Vet
Center (MVC) program to improve access to services for veterans in rural areas, and the 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.3638
Although the VHA Although the VHA provides most health care services to eligible veterans through its integrated 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 eligibilityVeterans Community Care Program (VCCP) applies eligibility for care in the community broadly for care in the community broadly
to to ~~all~~ al enrolled veterans based on specific criteria.enrolled veterans based on specific criteria.3739 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, community through individual agreements with community providers, ~~called~~cal ed 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.3840 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 Civilianveterans under the Civilian Health and Medical Program of the Department of Veterans Affairs Health and Medical Program of the Department of Veterans Affairs
(CHAMPVA).(CHAMPVA).39 41 In addition, the VHAIn addition, the VHA provides grants for construction of state-owned nursing 33 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. 34 Adam Oliver, “T he Veterans Health Administration: An American Success Story?” The Milbank Quarterly, vol. 85, no. 1 (March 2007), pp. 5-35. 35 Kenneth Kizer, John Demakis, and John Feussner, ~~provides grants for construction of state-owned nursing~~
~~homes 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 “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.
3436 For more information on CBOCs, see CRS For more information on CBOCs, see CRS Report R41044, Report R41044, Veterans Health Administration: Community-Based
Outpatient Clinics (archived). (archived).
3537 Vet Centers are a nationwide system of community-based programs separate from VA Vet Centers are a nationwide system of community-based programs separate from VA medical centers (VAMCs). medical centers (VAMCs).
Client services provided by Vet Client services provided by Vet ~~Centers include~~ Cent ers include psychological counseling and psychotherapy (individual and group), psychological counseling and psychotherapy (individual and group),
screening for and treatment of mental health issues, substance abusescreening for and treatment of mental health issues, substance abuse screening and counseling, screening and counseling,
employment/educational counseling, and bereavement counseling, among other employment/educational counseling, and bereavement counseling, among other ~~services.~~
~~36 U.S.~~ service s. 38 U.S. Department of Veterans Affairs, Department of Veterans Affairs, FY2021 Budget Submission, Medical Programs and Information Technology
~~Programs~~Program s, vol. 2 of 4, February 2020, p. VHA-333. , vol. 2 of 4, February 2020, p. VHA-333.
3739 For more information on the VCCP and the eligibility criteria, see CRS For more information on the VCCP and the eligibility criteria, see CRS Report R45390, Report R45390, VA Maintaining Internal
~~Systems~~System s and Strengthening Integrated Outside Networks Act of 2018 (VA MISSION Act; P.L.115 -182). .
3840 For more information, see CRS For more information, see CRS Report R42747, Report R42747, Health Care for Veterans: Answers to Frequently Asked Questions. .
3941 For details on CHAMPVA, For details on CHAMPVA, ~~see CRS~~ see CRS Report RS22483, Health Care for Dependents and Survivors of Veterans. Congressional Research Service 13 link to page 38 link to page 38 Department of Veterans Affairs FY2021 Appropriations homes and domiciliary facilities42 and collaborates with DOD in sharing health care resources and services. Apart from providing direct patient care to veterans,43 the VHA’s other statutory missions are to conduct medical research,44 serve as a contingency backup to the DOD medical system during a national security emergency,45 provide support to the National Disaster Medical System and the Department of Health and Human Services as necessary,46 and train health care professionals to provide an adequate supply of health personnel for the VA and the nation.47 The Veteran Patient Population48 In FY2020, approximately 9.3 mil ion of the 19.5 mil ion total veterans were enrolled in the VA health care system.49 The VA estimates that in FY2021, enrollment wil grow by 33 thousand. Of the total number of enrolled veterans in FY2020, the VA anticipated treating approximately 7.1 mil ion unique veteran and nonveteran patients.50 For FY2021, the VHA estimates that it wil treat about 7.2 mil ion unique veteran patients, or 1.0% over the FY2020 estimate (see Appendix A for veteran population, VA enrollees, and VA patients from FY2000-FY2021). The VHA also estimates that outpatient visits wil increase from 123.8 mil ion in FY2020 to 126.5 mil ion in FY2021, an increase of 2.7 mil ion, or 2.2%. It also anticipates an increase in ~~Report RS22483, Health Care for Dependents and Survivors of Veterans.~~
~~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.~~
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~~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.47 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 approximately 7.1~~
~~million unique veteran and nonveteran patients.48 For FY2021, the VHA estimates that it will~~
~~treat about 7.2 million unique veteran patients, or 1.0% over the FY2020 estimate (se~~e ~~Appendix~~
A ~~for veteran population, VA enrollees, and VA patients from FY2000-FY2021).~~
~~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~~
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
Further Consolidated Appropriations Act, 2020 (P.L. 116-94). However, in any given year the 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 FY2021.49~~
~~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),~~ ~~Appendix, Budget of the United States~~
~~Government Fiscal Year 2021, Washington, DC, February 10, 2020, pp. 1045-1055, and Department of Veterans~~
~~Affairs,~~ ~~FY2021 Budget Submission, Medical Programs and Information~~ 42 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%. T he 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. T he 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. Also see CRS In Focus IF11656, State Veterans Hom es. 43 38 U.S.C. §7301(b). 44 38 U.S.C. §7303. 45 38 U.S.C. §8111A. 46 38 U.S.C. §8117(e). 47 38 U.S.C. §7302. 48 Data in this section adapted from Office of Management and Budget (OMB), Appendix, Budget of the United States Governm ent Fiscal Year 2021, Washington, DC, February 10, 2020, pp. 1045 -1055, and Department of Veterans Affairs, FY2021 Budget Subm ission, Medical Program s and Inform ation 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. 2020, p. VHA-19. Population estimates were made before the COVID-19 pandemic. ~~The VA~~ T he VA response to the pandemic 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.
47 49 In general, a veteran is required In general, a veteran is required to be enrolled in the VAto be enrolled in the VA health care system to receive health care services, and once 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 VAa veteran is enrolled, that veteran remains enrolled in the VA health care system and maintains access to VA health health
care services. For more information on enrollment, see CRScare services. For more information on enrollment, see CRS Report R42747, Report R42747, Health Care for Veterans: Answers to
Frequently Asked Questions. .
4850 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.
~~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),~~
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~~link to page 28 link to page 28~~ ~~Department of Veterans Affairs FY2021 Appropriations~~
Congressional Research Service 14 link to page 31 link to page 31 Department of Veterans Affairs FY2021 Appropriations Administration could request additional funding for the upcoming fiscal year and Congress could revise these amounts through the annual appropriations process. Across al four accounts, the President’s budget increased by $2.3 bil ion over the advance appropriations amount in FY2021.51 The VA attributed the increase largely to revised actuarial trends based on recent data. In total, the FY2021 budget request for VHA was $95.2 bil ion, including medical care collections (see Table 1).52
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 81), the President’s budget ~~is requesting $94.2 billion~~requested $94.2 bil ion in advance appropriations for the four in advance appropriations for the four
medical medical care appropriations (medical services, medical community care, medical support and 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 FY2021-requested amount of $90.8 ~~billion~~bil ion for the same four accounts. In FY2022, the for the same four accounts. In FY2022, the
Administration’s budget request would Administration’s budget request would ~~provide $58.9 billion~~have provided $58.9 bil ion for the medical services account, for the medical services account,
$20.1 $20.1 ~~billion~~ bil ion for medical community care, $8.4 for medical community care, $8.4 ~~billion~~bil ion for the medical support and compliance for the medical support and compliance
account, and account, and $6.7 bil ion ~~$6.7 billion~~ for the medical facilities account (for the medical facilities account (~~see~~see Table 1)..
Both Both ~~The~~the House-passed version of the MILCON-VA appropriations House-passed version of the MILCON-VA appropriations ~~bill~~ bil (H.R. 7608; H.Rept. 116-(H.R. 7608; H.Rept. 116-
445) and the Senate Appropriations Committee majority draft 445) and the Senate Appropriations Committee majority draft ~~bill provide~~bil provided FY2021 VHA FY2021 VHA
appropriations higher than the President’s request ($67.5 appropriations higher than the President’s request ($67.5 ~~million~~mil ion and $13 and $13 ~~million~~ mil ion higher, respectively). The Consolidated Appropriations Act, 2021 (P.L. 116-260), provides VHA appropriations of $90.6 bil ion ($160 mil ion less than the request) for FY2021. ~~higher,~~
~~respectively).~~ Amounts requested for each VHA account for FY2021 in both the House-passed Amounts requested for each VHA account for FY2021 in both the House-passed
~~bill~~ bil and the Senate Appropriations Committee majority draft and the Senate Appropriations Committee majority draft ~~bill~~ bil recommended amounts, as wel as the final amounts provided by the Consolidated Appropriations Act, 2021,~~recommended amounts~~ for each for each
account are detailed in account are detailed in subsequent sections. 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, United States Code (U.S.C.); cost of hospital food service 51 U.S. Department of Veterans Affairs, FY2021 Budget Submission, Medical Programs and Information Technology Program s, vol. 2 of 4, February 2020, p. VHA-9. 52 T he 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. T he 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 T reasury, the VA can use them, without fiscal year limit ations, for medical services for veterans. In FY2004, the Administration’s budget requested consolidating several existing medical collections accounts into one MCCF. T he 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 T herapeutic and Rehabilitation Activities Fund (former name), Medical Facilities Revolving Fund (former name), and the Parking Revolving Fund (former name) should be deposited in MCCF. T he 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. Congressional Research Service 15 link to page 31 Department of Veterans Affairs FY2021 Appropriations operations;53 aid to state veterans’ homes; and assistance and support services for family caregivers. For FY2021, the President’s budget requested $56.7 bil ion for the medical services account. This amount is $497.5 mil ion over the FY2021 advance appropriated amount of $56.2 bil ion. According to the VA, this increase reflects implementation of the Precision Oncology initiative, as wel as increased staff and funding for pain management and suicide prevention efforts.54 The House-passed version of the MILCON-VA appropriations bil (H.R. 7608; H.Rept. 116-445) amount for FY2021 was $514 mil ion over the FY2021 advance appropriation amount. This was $16.5 mil ion more than the President’s request while the FY2022 advance appropriation amount for the medical services account was the same as the President’s request. The Senate Appropriations Committee majority draft bil recommended amount for FY2021 and for the FY2022 advance appropriations was the same as the President’s request (see Table 1). Within the total amount for medical services in the House-passed bil for FY2021, which is $56.7 bil ion, the committee provided the following:55  for mental health care, an additional $40 mil ion, for a total of $10.3 bil ion;  for homelessness initiatives, an additional $40 mil ion, for a total of $1.9 bil ion;  for rural health, an additional $30 mil ion, for a total of $300 mil ion;  for gender-specific care for women, an additional $35 mil ion, for a total of $660.7 mil ion;  for Whole Health initiatives, an additional $20 mil ion, for a total of $83.6 mil ion;  for suicide prevention efforts, an additional $85.1 mil ion, for a total of $312.6 mil ion;  for a new Precision Oncology initiative, $75 mil ion; and  for opioid prevention and treatment, an additional $64.7 mil ion, for a total of $503.7 mil ion; Within the total amount for medical services in the Senate Appropriations Committee majority draft bil for FY2021, which is $56.7 bil ion, the committee provided the following:  for mental health care, an additional $40 mil ion, for a total of $10.3 bil ion;  for homelessness initiatives, an additional $40 mil ion, for a total of $1.9 bil ion;  for telehealth, a total of $1.3 mil ion, equivalent to the request; and  for suicide prevention efforts, an additional $85.1 mil ion, for a total of $312.6 mil ion. 53 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. T he House and Senate Appropriations Committees concurred with this request. T he cost of food service operations supports hospital food service workers, provisions, and supplies related to the direct care of patients. 54 T he 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. 55 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 16 Department of Veterans Affairs FY2021 Appropriations In addition, the House-passed bil included~~employees hired under Title 38, United States Code (U.S.C.); cost of hospital food service~~
~~operations;51 aid to state veterans’ homes; and assistance and support services for family~~
~~caregivers.~~
~~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.~~
~~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~~
~~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.~~
~~51 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~~
~~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.~~
~~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~~

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~~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 language that would permanently new authorizing language that would permanently
authorize the use of medical services appropriations for assisted reproductive technology authorize the use of medical services appropriations for assisted reproductive technology
treatment and adoption reimbursement for certain veterans with service-connected disabilities that treatment and adoption reimbursement for certain veterans with service-connected disabilities that
results in being unable to procreate without in vitro fertilization (IVF) treatment or other forms of results in being unable to procreate without in vitro fertilization (IVF) treatment or other forms of
assisted reproductive technology services.assisted reproductive technology services.5456 The Senate Appropriations Committee majority draft The Senate Appropriations Committee majority draft
~~bill temporarily authorizes~~bil temporarily would have authorized the use of medical services appropriations for the same the use of medical services appropriations for the same ~~services.55~~
~~Medical Community Care~~
services.57 The Consolidated Appropriations Act, 2021 (P.L. 116-260), provides $56.6 bil ion for the Medical Services Account in FY2021 and $58.9 bil ion in advance appropriations for FY2022. The explanatory statement accompanying the act included a number of initiatives funded through the Medical Services account.58 Some are highlighted below:  for caregiver support, a total of $1.2 bil ion to fund a recent expansion of the program;  for mental health and suicide prevention, a total of $10.3 bil ion, with language encouraging the VA to use machine-learning software to prevent suicide, add functionality to the veterans crisis line, and utilize a specified pilot program;  for homelessness initiatives, a total of $1.9 bil ion;  for rural health care, a total of $300 mil ion;  for telehealth, a total of $1.3 bil ion; and  for gender-specific care for women, a total of $661 mil ion. 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 care, beginning with the FY2017 appropriations cycle. The Jeff ~~Miller~~Mil er and Richard Blumenthal and Richard Blumenthal
Veterans Health Care and Benefits Improvement Act of 2016 (P.L. 114-315) authorized Veterans Health Care and Benefits Improvement Act of 2016 (P.L. 114-315) authorized ~~advanced~~

~~54 U.S. Congress, House~~ advance appropriations for the medical community care account. The account is intended to consolidate al 56 U.S. Congress, House Committee on Appropriations, 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.
104. For more information on In Vitro Fertilization (104. For more information on In Vitro Fertilization (~~IVF~~I VF) services for certain veterans see, CRS) services for certain veterans see, CRS In Focus IF11082, In Focus IF11082,
Veterans ~~Health Administration~~ Health Adm inistration: Gender-Specific Health Care Services for ~~Women~~Wom en Veterans. .
~~55 This~~57 T his policy has been authorized in appropriations acts since FY2017. Section 260 of the Continuing Appropriations policy has been authorized in appropriations acts since FY2017. Section 260 of the Continuing Appropriations
and Military Construction, Veterans Affairs, and Related Agenciesand Military Construction, Veterans Affairs, and Related Agencies Appropriations Act, 2017, and the Zika Response Appropriations Act, 2017, and the Zika Response
and Preparedness Act (P.L. 114-223) permitted the VA to useand Preparedness Act (P.L. 114-223) permitted the VA to use funds from the Medical Servicesfunds from the Medical Services account for this purpose account for this purpose
for FY2017. Section 236 of Division Jfor FY2017. Section 236 of Division J of the Military Construction, Veterans Affairs, and Related Agencies 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 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-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 244), continued this policy for FY2019 and FY2020. Section 235 of the Military Construction, Veterans Affairs, and
Related AgenciesRelated Agencies Appropriations Act, 2020 (Division F of the Further Consolidated Appropriations Act, 2020; P.L. Appropriations Act, 2020 (Division F of the Further Consolidated Appropriations Act, 2020; P.L.
116-94), allows the VHA116-94), allows the VHA to useto use FY2020 appropriations and FY2021 advance appropriations to continue providing IVF FY2020 appropriations and FY2021 advance appropriations to continue providing IVF
services to certain veterans and their spouses. services to certain veterans and their spouses.
58 U.S. Congress, House Committee on Appropriations, Committee Print of the Committee on Appropriations U.S. House of Representatives on H.R. 133/P.L. 116-260, committee print, 117th Cong., 1st sess., March 2021, p. 1858, at https://www.govinfo.gov/content/pkg/CPRT -117HPRT43750/pdf/CPRT -117HPRT43750.pdf. Congressional Research Service 17~~Congressional Research Service~~

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~~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 community care programs under a single appropriation, and it is the funding source for care that
the VHAthe VHA provides to eligibleprovides to eligible veterans through community health care providers. veterans through community health care providers.
The President’s budget The President’s budget ~~is requesting $18.5 billion~~requested $18.5 bil ion for the medical community care account. This for the medical community care account. This
amount is $1.381 amount is $1.381 ~~billion~~ bil ion over the FY2021 advance appropriated amount of $17.1 over the FY2021 advance appropriated amount of $17.1 ~~billion~~bil ion. This . This
increase increase iswas largely driven by more recent projections for community care and the cost of largely driven by more recent projections for community care and the cost of
establishing a community care network.establishing a community care network.5659
The House-passed version of the MILCON-VA appropriations The House-passed version of the MILCON-VA appropriations ~~bill~~ bil (H.R. 7608; H.Rept. 116-445) (H.R. 7608; H.Rept. 116-445)
amount for FY2021 amount for FY2021 iswas $1.377 $1.377 ~~billion~~bil ion over the FY2021 advance appropriation amount. This over the FY2021 advance appropriation amount. This iswas
$4.0 $4.0 ~~million~~ mil ion less than the FY2021 request, while the FY2022 advance appropriation amount less than the FY2021 request, while the FY2022 advance appropriation amount is was the the
same as the request. The Senate Appropriations Committee majority draft same as the request. The Senate Appropriations Committee majority draft ~~bill~~ bil recommended recommended
amount for FY2021 and the FY2020 advance appropriation amount for FY2021 and the FY2020 advance appropriation iswas the same as the President’s request. The Consolidated Appropriations Act, 2021 (P.L. 116-260), provides $18.5 bil ion for the Medical Community Care account in FY2021 and $20.1 bil ion in advance appropriations for FY2022, the same as the President’s ~~the same as the President’s~~ request request
(se(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 VA health care system through the operation of VA medical centers and other medical facilities, 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.5760 The account also funds The account also funds
21 Veterans Integrated Service Network (VISN)21 Veterans Integrated Service Network (VISN)5861 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 The President’s budget ~~is requesting $8.2 billion~~requested $8.2 bil ion for the medical support and compliance account. for the medical support and compliance account.
This amount is $300 This amount is $300 ~~million~~ mil ion over the FY2021 advance appropriated amount of $7.9 over the FY2021 advance appropriated amount of $7.9 ~~billion.59~~bil ion.62
The House-passed version of the MILCON-VA appropriations The House-passed version of the MILCON-VA appropriations ~~bill~~ bil (H.R. 7608; H.Rept. 116-445) (H.R. 7608; H.Rept. 116-445)
~~provides $282 million~~ provided $282 mil ion over the FY2021 advance appropriation of $7.9 over the FY2021 advance appropriation of $7.9 ~~billion~~bil ion, a decrease of $18 , a decrease of $18
~~million~~ mil ion from the request, while the FY2022 advance appropriation amount from the request, while the FY2022 advance appropriation amount iswas the same as the the same as the
request. The Senate Appropriations Committee majority draft request. The Senate Appropriations Committee majority draft ~~bill~~ bil recommended amount for recommended amount for
FY2021 and the FY2020 advance appropriation FY2021 and the FY2020 advance appropriation iswas the same as the President’s request. The Consolidated Appropriations Act, 2021 (P.L. 116-260), provides $8.2 bil ion for medical support and compliance in FY2021 and $8.4 bil ion in advance appropriations for FY2022 (see Table 1). 59 U.S. ~~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~~
~~VHA’s capital infrastructure. These expenses include utilities and administrative expenses related~~

~~56 U.S.~~ Department of Veterans Affairs, Department of Veterans Affairs, FY2021 Budget Submission, Medical Programs and Information Technology
~~Programs~~Program s, vol. 2 of 4, February 2020, p. VHA-9. , vol. 2 of 4, February 2020, p. VHA-9.
5760 Vet Centers are community-based counseling Vet Centers are community-based counseling centers that provide a widecenters that provide a wide range of social and psychological services, range of social and psychological services,
such assuch as professional readjustment counseling to veterans who have served in a combat zone, military sexual trauma professional readjustment counseling to veterans who have served in a combat zone, military sexual trauma
(MST(MST ) counseling,) counseling, bereavement counseling for families who experience an active duty death, substancebereavement counseling for families who experience an active duty death, substance abuse 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.
5861 VISN VISN offices provide management and oversight to the medical centers and clinics within their assigned geographic offices provide management and oversight to the medical centers and clinics within their assigned geographic
areas. Each VISNareas. Each VISN office is responsibleoffice is responsible for allocating funds to facilities, clinics, and programs within its region and 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.
5962 U.S. U.S. Department of Veterans Affairs, Department of Veterans Affairs, FY2021 Budget Submission, Medical Programs and Information Technology
~~Programs~~Program s, vol. 2 of 4, February 2020, p. VHA-9. , vol. 2 of 4, February 2020, p. VHA-9.
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Medical Facilities 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 to planning, designing, and executing construction or renovation projects at VHA facilities. It also to planning, designing, and executing construction or renovation projects at VHA facilities. It also
funds leases, laundry services, grounds maintenance, trash removal, housekeeping, fire funds leases, laundry services, grounds maintenance, trash removal, housekeeping, fire
protection, pest management, and property disposition and acquisition. protection, pest management, and property disposition and acquisition.
The President’s budget The President’s budget ~~is requesting $6.6 billion~~requested $6.6 bil ion for the medical facilities account. This amount is for the medical facilities account. This amount is
$150 $150 ~~million~~ mil ion over the FY2021 advance appropriated amount of $6.4 over the FY2021 advance appropriated amount of $6.4 ~~billion~~bil ion. This increase . This increase is
was largely driven by infrastructure improvements to ensure compatibility for the Electronic Health largely driven by infrastructure improvements to ensure compatibility for the Electronic Health
Record Modernization (EHRM) project.Record Modernization (EHRM) project.6063
The House-passed version of the MILCON-VA appropriations The House-passed version of the MILCON-VA appropriations ~~bill~~ bil (H.R. 7608; H.Rept. 116-445) (H.R. 7608; H.Rept. 116-445)
~~provides $170 million~~ provided $170 mil ion over the FY2021 advance appropriation of $6.4 over the FY2021 advance appropriation of $6.4 ~~billion~~bil ion, an increase of $20 , an increase of $20
~~million~~ mil ion from the request, while the FY2022 advance appropriation amount from the request, while the FY2022 advance appropriation amount iswas the same as the the same as the
request. The Senate Appropriations Committee majority draft request. The Senate Appropriations Committee majority draft ~~bill~~ bil recommended amount for recommended amount for
FY2021 and the FY2020 advance appropriation FY2021 and the FY2020 advance appropriation iswas the same as the President’s request. The Consolidated Appropriations Act, 2021 (P.L. 116-260), provides $6.4 bil ion for Medical Facilities in FY2021 and $6.7 bil ion in advance appropriations for FY2022, the same as the ~~the same as the~~ President’s request (President’s request (~~see~~see Table
1)..
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 clinical trials; and centers of ~~excellence~~excel ence. VA researchers receive funding not only through this . 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 VAinvestigators at VA facilities and approved off-site locations. Unlike other federal agencies, such 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 The President’s budget ~~is requesting~~requested approximately $787 approximately $787 ~~million~~mil ion for the medical and prosthetic for the medical and prosthetic
research account, an increase of $37 research account, an increase of $37 ~~million~~mil ion, or 5%, above the FY2020-enacted amount of $750 , or 5%, above the FY2020-enacted amount of $750
~~million.~~ mil ion. The VHA’s major research priorities in FY2021 include, among others, suicide 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 brain injury (TBI), mental health, and Gulf War ~~illness.61~~il ness.64
The House-passed version of the MILCON-VA appropriations The House-passed version of the MILCON-VA appropriations ~~bill~~ bil (H.R. 7608; H.Rept. 116-445) (H.R. 7608; H.Rept. 116-445)
~~provides $840 million~~ provided $840 mil ion for FY2021 for the medical and prosthetic research account, an increase of for FY2021 for the medical and prosthetic research account, an increase of
$53 $53 ~~million~~ mil ion from the request. The Senate Appropriations Committee majority draft from the request. The Senate Appropriations Committee majority draft ~~bill~~
bil recommended amount for FY2021 is $800 recommended amount for FY2021 is $800 ~~million~~mil ion, an increase of $13 , an increase of $13 ~~million~~mil ion from the President’s request. The Consolidated Appropriations Act, 2021 (P.L. 116-260), provides $795 mil ion for Medical and Prosthetic Research in FY2021 (see Table 1). 63 Ibid. 64 U.S. Office of Management and Budget ~~from the~~
~~President’s request (see Table 1).~~
~~Nonmedical Discretionary Programs Funding~~
~~National Cemetery Administration (NCA)~~
~~The majority of NCA’s discretionary funding falls into the Operations and Maintenance category~~
~~with the 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~~

~~60 Ibid.~~
~~61 U.S. Office of Management and Budget~~ (OMB), (OMB), Appendix, Budget of the United States Government Fiscal Year
2021, Washington, DC, February 10, 2020, p. 1052. , Washington, DC, February 10, 2020, p. 1052.
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~~amount and will provide~~Nonmedical Discretionary Programs Funding National Cemetery Administration (NCA) The majority of NCA’s discretionary funding fal s into the Operations and Maintenance category. VA requested a total of $360 mil ion in FY2021 for this account. This is a $32 mil ion, or 9.8%, increase for NCA’s operations and maintenance expenses over the FY2020 enacted amount and would have provided for hiring an additional 77 full-time equivalents (FTEs). for hiring an additional 77 full-time equivalents (FTEs).6265 In addition, In addition,
the increase the increase ~~will help support~~would have supported the costs encountered with opening four new cemeteries in New the costs encountered with opening four new cemeteries in New
York, Indiana, Wyoming, and Utah during 2021. There are also associated expenses for an York, 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 additional 11 cemeteries transferred from the Department of the Army bringing the total number
of national cemeteries to 156. of national cemeteries to 156. ~~Finally, the VA anticipates~~Final y, VA anticipated a 2.1% increase in the number of a 2.1% increase in the number of
interments interments during FY2021 compared with FY2020.during FY2021 compared with FY2020.6366
Within the Operations and Maintenance appropriations category, Within the Operations and Maintenance appropriations category, ~~the~~ VA requested funds to VA requested funds to
support support extending its historical knowledge and public outreach programs. NCA plans to extending its historical knowledge and public outreach programs. NCA plans to
implement these efforts by continuing its digital memorial platform, which implement these efforts by continuing its digital memorial platform, which ~~will~~ wil preserve the 3.5 preserve the 3.5
~~million~~mil ion veterans interred and in future phases veterans interred and in future phases ~~will allow~~wil al ow the public to post memories and the public to post memories and
photographs of each veteran. To complement NCA’s digital efforts, they photographs of each veteran. To complement NCA’s digital efforts, they ~~will~~ wil continue to develop continue to develop
onsite interpretive 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~~history. P.L. 116-260 provides $352 mil ion for NCA expenses for for NCA expenses for
FY2021, $FY2021, $~~11 million~~8 mil ion less than VA’s requested less than VA’s requested ~~amount64~~amount, but $23 mil ion more than the FY2020-enacted amount 67 (se (see Table 1)~~. The committee report~~
. The explanatory statement accompanying the accompanying the ~~bill~~ bil explains that committee believes that these funds explains that committee believes that these funds ~~will~~ wil adequately address adequately address
the needs of NCA to meet its increased workload and burial expansions, but stresses that NCA the needs of NCA to meet its increased workload and burial expansions, but stresses that NCA
should prioritize services at existing cemeteries and opening new cemeteries for increased burial prioritize services at existing cemeteries and opening new cemeteries for increased burial
access.access.~~65 An area of concern that the committee would like NCA to provide reports to Congress~~
~~on is the ways the~~68 An area of ongoing concern is the way VA is addressing the Prisoner of War headstones with German inscriptions and VA is addressing the Prisoner of War headstones 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~~
emblems on them and how VA plans to provide historical context for the headstones of prisoners of war.69 The committee would like NCA to continue providing reports to Congress on this matter. The explanatory statement also recognizes the advancement NCA has achieved in expanding burial spaces to underserved populations in rural communities; however, the expanding burial spaces to underserved populations in rural communities; however, the
committee remains committee remains concerned about limited infrastructure at these sites that could detract from concerned about limited infrastructure at these sites that could detract from
cemetery operations cemetery operations and committal services. Therefore, the committees direct VA to assess the potential for permanent infrastructure enhancements at each Rural Initiative national cemetery and to submit a report to the Committees on Appropriations no later than 180 days after enactment of this act.70 65 U.S. ~~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, Department of Veterans Affairs, FY2021 Budget Submission, Budget in Brief, February 2020, p. BiB-26-27. February 2020, p. BiB-26-27.
6366 U.S. U.S. Department of Veterans Affairs, Department of Veterans Affairs, FY2021 Budget Submission, Benefits and Burial Programs and Departmental
~~Administration~~Adm inistration, vol. 3 of 4, February 2020, pp. NCA-18, 19. , vol. 3 of 4, February 2020, pp. NCA-18, 19.
6467 U.S. U.S. Congress, HouseCongress, House Committee on Appropriations, 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~~ Committee Print of the Committee on Appropriations U.S. House of Representatives on H.R. 133/P.L. 116-260, committee print, 117th Cong., 1st sess., March 2021, pp. 1870-1871, at https://www.govinfo.gov/content/pkg/CPRT -117HPRT43750/pdf/CPRT -117HPRT43750.pdf. 68 U.S. Congress, House Committee on Appropriations, Committee Print of the Committee on Appropriations U.S. House of Representatives on H.R. 133/P.L. 116-260, committee print, 117th Cong., 1st sess., March 2021, pp. 1870-1871, at https://www.govinfo.gov/content/pkg/CPRT -117HPRT43750/pdf/CPRT -117HPRT43750.pdf. 69 For more information on this issue, see CRS In Focus IF11587, 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~~ in VA Nationa l Cem eteries. 70 U.S. Congress, House Committee on Appropriations, Committee Print of the Committee on Appropriations U.S. House of Representatives on H.R. 133/P.L. 116-260, committee print, 117th Cong., 1st sess., March 2021, p. 1871, at Congressional Research Service 20 link to page 31 Department of Veterans Affairs FY2021 Appropriations VBA, General Operating Expenses VA requested $3.21 bil ion in funding for VBA general operating expenses for FY2021. This was an estimated $69 mil ion increase over the enacted FY2020 budget. The largest ~~Department of Veterans Affairs FY2021 Appropriations~~

portion of this funding request, approximately $2.5 portion of this funding request, approximately $2.5 ~~billion, is~~bil ion, was for the general operating expenses for the general operating expenses
associated associated with the compensation and pension (including burial benefits) categories.with the compensation and pension (including burial benefits) categories.68
71 Within the compensation service category, an estimated $1.9 Within the compensation service category, an estimated $1.9 ~~billion~~bil ion of VBA’s request of VBA’s request iswas for FTE for FTE
salaries and benefits. This amount would salaries and benefits. This amount would ~~provide~~have provided for an additional 691 FTEs in support of the for an additional 691 FTEs in support of the
processing and adjudication of Blue Water Navy claims. With this increase, processing and adjudication of Blue Water Navy claims. With this increase, ~~the VBA projects~~
VBA projected 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.6972 In addition to staffing, processing, and IT investments to In addition to staffing, processing, and IT investments to
implement the Blue Water Navy Actimplement the Blue Water Navy Act~~, funding allocations will go~~ (P.L. 116-23), funding al ocations would have gone toward implementing the toward implementing the
Forever GI Forever GI ~~Bill~~Bil (P.L. 115-48); supporting economic development ; supporting economic development ~~initiatives~~ initiatives along with transition assistance along with transition assistance
programs; and funding mission-critical agency programs; and funding mission-critical agency operations.operations.70
~~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.~~
~~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 2020.71~~
~~The House-passed version of the MILCON-VA bill provides $3.19 billion for VBA operating~~
~~expenses for FY2021, $20 million less than VA’s request72 (see Table 1). The committee report~~
~~accompanying the bill stressed the importance of 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, 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 U.S. Department of Veterans Affairs, FY2021 Budget Submission, Supplemental Information and Appendices, vol. 1~~
~~of 4, February 2020, p. Appendix-100.~~
~~69 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.~~
~~70 U.S. Department of Veterans Affairs,~~ ~~FY2021 Budget Submission, Benefits and Burial Programs and Departmental~~
~~Administration, vol. 3 of 4, February 2020, pp. VBA-145, 146.~~
~~71 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, at https://www.whitehouse.gov/wp-content/uploads/2020/02/~~
~~budget_fy21.pdf.~~
~~72 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.~~
~~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.~~
~~Congressional Research Service~~

19

~~link to page 28~~ ~~Department of Veterans Affairs FY2021 Appropriations~~

~~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~~73 The Consolidated Appropriations Act provides $3.19 bil ion for VBA operating expenses for FY2021, $27 mil ion less than VA’s request (see Table 1).74 The committee report stresses the importance of timely processing of claims, including those associated with the Blue Water Navy Act (P.L. 116-23). The committee did highlight a few items it would like to see VBA improve upon during FY2021, including ways to improve the accessibility of benefits to veterans. These areas include efforts to mitigate veteran underemployment; studying the feasibility of funding a veteran benefit counselor position within states’ VA departments; expanding the Solid Start program for transitioning servicemembers; and expanding awareness and use of GI Bil apprenticeships and on-the-job training. In addition, the committee requests a report from VA to both 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. Final y, the accompanying report directs VA to assess the feasibility to expand eligibility for VA benefits to individuals who served honorably in Laotian and Hmong Special Gueril a Units and other irregular forces supporting the U.S. during the Vietnam War. This report should include a cost estimate and is to be submitted to the Committees on Appropriations no later than a year after enactment of this act.75 https://www.govinfo.gov/content/pkg/CPRT -117HPRT43750/pdf/CPRT -117HPRT43750.pdf. 71 U.S. Department of Veterans Affairs, FY2021 Budget Submission, Supplemental Information and Appendices, vol. 1 of 4, February 2020, p. Appendix-100. 72 U.S. Department of Vet erans Affairs, FY2021 Budget Submission, Benefits and Burial Programs and Departmental Adm inistration, vol. 3 of 4, February 2020, p. VBA-169. 73 U.S. Department of Veterans Affairs, FY2021 Budget Submission, Benefits and Burial Programs and Departmental Adm inistration, vol. 3 of 4, February 2020, pp. VBA-145, 146. 74 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. 42. 75 U.S. Congress, House Committee on Appropriations, Committee Print of the Committee on Appropriations U.S. House of Representatives on H.R. 133/P.L. 116-260, committee print, 117th Cong., 1st sess., March 2021, pp. 1855-1856, at https://www.govinfo.gov/content/pkg/CPRT -117HPRT43750/pdf/CPRT -117HPRT43750.pdf. Congressional Research Service 21 link to page 31 Department of Veterans Affairs FY2021 Appropriations
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 For FY2021, the Administration ~~is requesting $4.9 billion~~requested $4.9 bil ion for the information technology budget. for the information technology budget.
This amount This amount ~~will fund~~would have funded IT activities across the VA, including modernizing Veterans Benefits IT activities across the VA, including modernizing Veterans Benefits
Management to automate Blue Water Navy veteransManagement to automate Blue Water Navy veterans’ claims, implementing the VA MISSION Act, claims, implementing the VA MISSION Act,
implementing a new health care logistics information system, and improving implementing a new health care logistics information system, and improving cybersecurity cybersecurity
among other things. among other things.
The House-passed The House-passed ~~bill~~ bil (Division D of H.R. 7608) (Division D of H.R. 7608) ~~provides~~provided approximately $4.9 approximately $4.9 ~~billion~~ bil ion for the IT for the IT
systems account, $8.5 systems account, $8.5 ~~million~~mil ion less than the President’s request ( less than the President’s request (~~see~~see Table 1 )). This level of . This level of
funding funding ~~will provide~~would have provided for developing clinical applications, maintaining and improving health for developing clinical applications, maintaining and improving health
management platforms, IT systems associated with veterans’ benefits and memorial affairs, management platforms, IT systems associated with veterans’ benefits and memorial affairs,
cybersecurity and information infrastructure, among others.76 Furthermore, the committee cybersecurity and information infrastructure, among others.76 Furthermore, the committee
(H.Rept. 116-445) (H.Rept. 116-445) ~~has~~ provided funding within the $4.9 provided funding within the $4.9 ~~billion~~ bil ion for a digitalfor a digital protection initiative to protection initiative to
protect veterans, and protect veterans, and ~~Congressionally~~Congressional y Chartered VSOs “from both foreign and domestic threats Chartered VSOs “from both foreign and domestic threats
across the digital landscape attempting to steal money, pilfer personal information or peddle across the digital landscape attempting to steal money, pilfer personal information or peddle
foreign influence via social media or other online campaigns.”77foreign influence via social media or other online campaigns.”77
The Senate Appropriations Committee majority draft The Senate Appropriations Committee majority draft ~~bill recommends $4.9 billion~~bil recommended $4.9 bil ion for IT ~~for IT~~ systems, systems,
and this amount and this amount iswas equal to the President’s request. To provide better oversight on how IT funds 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 are executed by the VA, the Senate Appropriations Committee majority draft explanatory
statement statement ~~has~~ provided funding for the IT systems account as three subaccounts: $1.2 provided funding for the IT systems account as three subaccounts: $1.2 ~~billion~~bil ion for for
salaries and expenses, $3.2 salaries and expenses, $3.2 ~~billion~~bil ion for operation and maintenance of existing IT systems, and for operation and maintenance of existing IT systems, and
$495.5 $495.5 ~~million~~mil ion for IT program development.78 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~~ The Consolidated Appropriations Act, 2021 (P.L. 116-260), provides $4.9 bil ion for the IT systems account (see Table 1). This amount includes a $37.5 mil ion rescission as required by Section 254 of the MILCON-VA Appropriations Act, 2021 (Division J of P.L. 116-260). The explanatory statement to accompany the Consolidated Appropriations Act, 2021, includes $1.2 bil ion for staff salaries and expenses, $3.2 bil ion for operation and maintenance of existing IT systems, and $495.5 mil ion for IT program development.79 Within this account, $111.1 mil ion is provided for the Financial Management Business Transformation (FMBT) program.80 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, p. 92. 77 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, ~~and~~
~~p. 92.~~
~~77 Ibid.,~~ pp. 93-94. pp. 93-94.
78 Senate Appropriations Committee, “Majority Draft Military Construction, Veterans Affairs, and Related Agencies, 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. 2021 Explanatory Statement,” p. 65, at https://www.appropriations.senate.gov/download/fy21-mcva-report.
79 U.S. Congress, House Committee on Appropriations, Consolidated Appropriations Act, 2021 , committee print, prepared by House Committee on Appropriations, H.R. 133/P.L. 116-260 [Legislative T ext and Explanatory Statement] Book 2 of 2 Divisions G–L, 116th Cong., 2nd sess., March 2021 (Washington: GPO, 2021), p. 1816. 80 In 2016, the VA embarked on a new financial management modernization program known as the Financial Management Business T ransformation (FMBT ) program. T he program in general would, among other things, standardize and streamline budgeting, procurement, accounting, resource management, and financial reporting. Congressional Research Service 22 ~~Congressional Research Service~~

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link to page link to page 2831 Department of Veterans Affairs FY2021 Appropriations

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 Mil ennium electronic health care record system at VA medical facilities. Beginning with the Military Construction, Veterans Affairs, and Related Agencies 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 The President’s budget proposal ~~is requesting $2.6 billion~~requested $2.6 bil ion for activities related to the development for activities related to the development
and rollout of VA’s Electronic Healthand rollout of VA’s Electronic Health Record Modernization (EHRM) initiative,Record Modernization (EHRM) initiative, including including
interoperability with the DOD electronic health record. interoperability with the DOD electronic health record.
The House-passed MILCON-VA Appropriations The House-passed MILCON-VA Appropriations ~~bill~~ bil for FY2021 (Division D of H.R. 7608; for FY2021 (Division D of H.R. 7608;
H.Rept. 116-445) H.Rept. 116-445) ~~provides~~provided the same amount as the President’s budget request ( the same amount as the President’s budget request (~~see~~see Table 1). .
Funding provided for this account is available until September 30, 2023, “due to the uncertainty Funding provided for this account is available until September 30, 2023, “due to the uncertainty
of the timing” of the EHRMof the timing” of the EHRM initiative.initiative.7981 The committee report accompanying the MILCON-VA The committee report accompanying the MILCON-VA
Appropriations Appropriations ~~bill further goes~~bil went on to state that “[the] VA transition to a commercial-based EHR on to state that “[the] VA transition to a commercial-based EHR
system continues to be system continues to be ~~challenging~~chal enging, and it is uncertain if this capability , and it is uncertain if this capability ~~will~~ wil be delivered across be delivered across
the the enterprise by 2027.”enterprise by 2027.”80
82 The Senate Appropriations Committee majority draft MILCON-VA Appropriations The Senate Appropriations Committee majority draft MILCON-VA Appropriations ~~bill~~ bil for for
FY2021 FY2021 ~~recommends~~recommended the same amount as the budget request. the same amount as the budget request. ~~Additionally~~Additional y, the majority draft , the majority draft ~~bill~~
~~has~~ bil included an administrative provision that makes 25% of funding based on certification by the included an administrative provision that makes 25% of funding based on certification by the
Secretary regarding any changes to the EHRM deployment schedule.Secretary regarding any changes to the EHRM deployment schedule.83 The Consolidated Appropriations Act, 2021 provides $2.6 bil ion for the EHRM program (see Table 1). This amount includes a $20 mil ion rescission as required by Section 254 of the MILCON-VA Appropriations Act, 2021(Division J of P.L. 116-260). The explanatory statement to accompany P.L. 116-260 requires VA to provide regular status updates to the Senate and House Appropriations Committees on the progress of the EHRM program including spending and oversight of the program. While the Committees remain supportive of the EHRM initiative, as with any acquisition of this size and magnitude, there are implementation concerns, including maintaining budget, scope, implementation and deployment schedules, security, reporting, and interoperability. As such, the agreement directs the Secretary to continue to provide quarterly reporting of obligations, expenditures, and deployment implementation by facility. Additionally, the agreement directs the Department to provide updates on plans and efforts to integrate community care providers into the system. Such updates should be submitted concurrently with the quarterly reports. Moreover, the agreement directs the Department to continue quarterly briefings on performance milestones, costs, and progress towards or changes to implementation and management plans, and directs the Department to provide an accurate up-to-date deployment schedule with each quarterly briefing. Should 81 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. 94. 82U.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. 96. 83 VA is required to notify Congress and get approval on revisions to EHRM deployment timeline. For example, because of the COVID-19 pandemic impacts, VA revised the EHRM deploymen t schedule that was included in VA’s FY2021 congressional budget submission. Congress approved the revised timeline in August 2020. Congressional Research Service 23 link to page 31 Department of Veterans Affairs FY2021 Appropriations there be any deviation from the deployment schedule, the agreement directs the Department to formally submit in writing a proposed updated deployment schedule within seven days of notification of any potential change, and prior to implementation of the updated deployment schedule, to the Committees. The Secretary is not provided transfer authority and is directed to continue using this account as the sole source of funding within the Department for EHRM. Further, the agreement continues to direct the Secretary to manage EHRM at the headquarters level in the Office of the Deputy Secretary. 84
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 renovation grants for state extended care facilities, as ~~well~~ wel as grants for state veterans cemeteries. as grants for state veterans cemeteries.
The major construction account provides funds for capital projects costing $20 The major construction account provides funds for capital projects costing $20 ~~million~~mil ion or more or more
that are intended to design, build, alter, extend, or improve a VHAthat are intended to design, build, alter, extend, or improve a VHA facility. Projects identified 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 The minor construction account provides funds for capital projects costing less than $20 ~~million~~mil ion
that are intended to design, build, alter, extend, or improve a VHAthat are intended to design, build, alter, extend, or improve a VHA facility. The total cost of a 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 construction of veterans cemeteries account provides grants to states, territories, and ~~federally~~federal y
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 For FY2021, the President’s budget ~~requests $1.9 billion~~requested $1.9 bil ion for the VA’s total construction program. for the VA’s total construction program.
This amount This amount ~~includes $1.77 billion~~included $1.77 bil ion for the VA’s major and minor construction for the VA’s major and minor construction programs, $90 programs, $90
~~million~~mil ion for construction and renovation grants for state-extended care facilities, for construction and renovation grants for state-extended care facilities, and $45 and $45 ~~million~~
mil ion for grants for state veterans cemeteries. for grants for state veterans cemeteries.
The House-passed The House-passed ~~bill~~ bil (Division D of H.R. 7608; H.Rept. 116-445) (Division D of H.R. 7608; H.Rept. 116-445) ~~provides~~provided approximately $1.9 approximately $1.9
~~billion~~ bil ion for the department’s total construction program for FY2021. for the department’s total construction program for FY2021. ~~All~~ Al amounts recommended ~~amounts recommended~~

~~79 Ibid., p. 94.~~
~~80 Ibid., p. 96.~~
~~Congressional Research Service~~

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~~link to page 28 link to page 28~~ ~~Department of Veterans Affairs FY2021 Appropriations~~

for the VA’s major and minor construction programs, and grants for construction of veteransfor the VA’s major and minor construction programs, and grants for construction of veterans’
cemeteries accounts, cemeteries accounts, ~~are~~were the same as the President’s request for FY2021 ( the same as the President’s request for FY2021 (~~see~~see Table 1). . However, However,
for grants for construction of state extended care facilities the measure for grants for construction of state extended care facilities the measure ~~provides $93 million—$3~~
~~million~~ provided $93 mil ion—$3 mil ion more than the Administration’s request. more than the Administration’s request.
The Senate Appropriations Committee majority draft The Senate Appropriations Committee majority draft ~~bill recommends~~bil recommended approximately $1.8 approximately $1.8 ~~billion~~
bil ion for the department’s total construction program for FY2021, which is $67 for the department’s total construction program for FY2021, which is $67 ~~million~~mil ion below below budget budget
request. For the major construction projects the committee recommendation request. For the major construction projects the committee recommendation ~~is $57 million~~ was $57 mil ion below below
the requested amount of $1.37 the requested amount of $1.37 ~~billion~~bil ion, and for minor construction projects the 84 U.S. Congress, House Committee on Appropriations, Consolidated~~, and for minor construction projects the majority draft bill~~
~~recommendation is $10 million below the President’s request of $400 million (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 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~~ Act, 2021 , committee print, prepared by House Committee on Appropriations, H.R. 133/P.L. 116-260 [Legislative T ext and Explanatory Statement] Book 2 of 2 Divisions G–L, 116th Cong., 2nd sess., March 2021 (Washington: GPO, 2021), p. 1875. Congressional Research Service 24 link to page 31 Department 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~~

23of Veterans Affairs FY2021 Appropriations majority draft bil recommendation was $10 mil ion below the President’s request of $400 mil ion (see Table 1). The Consolidated Appropriations Act, 2021, provides approximately $1.8 bil ion for the total construction program. This includes $1.3 bil ion for the major construction program and $354.3 mil ion for the construction minor program, which includes $35.7 million rescission as required by Section 254 of the MILCON-VA Appropriations Act, 2021(Division J of P.L. 116-260), $90 mil ion for construction and renovation grants for state-extended care facilities, and $45 mil ion for grants for state veterans cemeteries (see Table 1). Congressional Research Service 25

Table 1. VA FY2020-FY2021 Appropriations and FY2022 Advance Appropriations
($ in Thousands) ($ in Thousands)
Enacted (P.L. 116-94;
Consolidated P.L. 116-127;
President’s
House-Passed
Senate Appropriations
Appropriations Act, 2021 P.L. 116-136)
Request
(~~Division~~Div. D- H.R. 7608)
Committee Majority Draft
(Div. J; P.L. 116-260) Program
FY2020
FY2021
FY2021
FY2022
FY2021
FY2022
FY2021
FY2022
~~Veterans~~ FY2021 FY2022 Veterans Benefits Administration (VBA)

Compensation and PensionsCompensation and Pensions
$109,017,152 $109,017,152
— —
$118,246,975 $118,246,975
— —
$118,246,975 $118,246,975
— —
$118,246,975 $118,246,975 — $118,246,975
— —
Over FY2020 Enacted Advance Over FY2020 Enacted Advance ~~Appropriations~~
1,439,931 1,439,931
— —
— —
— —
— —
— —
— —
— —
— — Appropriations Over FY2021 Enacted Advance Over FY2021 Enacted Advance ~~Appropriations~~
— —
— —
2,813,922 2,813,922
— —
2,813,922 2,813,922
— —
6,110,252 6,110,252
— —
~~Subtotal Compensation and Pensions~~6,110,252 — Appropriations Subtotal Compensation and
110,457,083
— —
121,060,897
— —
121,060,897
— —
124,357,227
— —
124,357,227 — Pensions Readjustment Benefits Readjustment Benefits
14,065,282 14,065,282
— —
12,578,965 12,578,965
— —
12,578,965 12,578,965
— —
12,578,965 12,578,965 — 12,578,965
— —
Insurance and Indemnities Insurance and Indemnities
111,340 111,340
— —
129,224 129,224
— —
129,224 129,224
— —
129,224 129,224 — 129,224
— —
Over FY2020 Enacted Advance Over FY2020 Enacted Advance ~~Appropriations~~
17,620 17,620
— —
— —
— —
— —
— —
— — — — Appropriations
—
Over FY2021 Enacted Advance Over FY2021 Enacted Advance ~~Appropriations~~ — — 2,148
—
— —
$2,148 2,148
— —
$2,148 2,148
— —
2,148 2,148
— —
Appropriations Subtotal Insurance and Indemnities
128,960
— —
131,372
— —
131,372
— —
131,372 — 131,372
— —
Housing Benefit Program Housing Benefit Program ~~Fund Credit Subsidy~~
Fund 701,000 701,000

1,663,000 1,663,000

1,663,000 1,663,000
— —
1,663,000 1,663,000
— —
1,663,000 — Credit Subsidy Housing Benefit ProgramHousing Benefit Program ~~Fund Administrative~~
Fund 200,377 200,377
— —
204,400 204,400
— —
204,400 204,400
— —
204,400 204,400
— —
204,400 — Administrative Expenses Expenses
Vocational Rehabilitation Loan Vocational Rehabilitation Loan ~~Program~~
58 58 — 34
— —
34 34
— —
34 34
— —
34 34
— —
Program Vocational Rehabilitation Loan Vocational Rehabilitation Loan ~~Program~~
~~402~~ 402 — 424
— —
424 424
— —
424 424
— —
424 424
— —
Program Administrative Expenses Administrative Expenses
Native AmericanNative American Housing LoanHousing Loan ~~Program~~
1,186 1,186
— —
1,163 1,163
— —
1,186 1,186
— —
1,163 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~~
—
—
—
—
—
—
—
~~(P.L. 116-136)~~

~~Rescission~~ 1,186 — Program CRS-26 Enacted (P.L. 116-94; Consolidated P.L. 116-127; President’s House-Passed Senate Appropriations Appropriations Act, 2021 P.L. 116-136) Request (Div. D- H.R. 7608) Committee Majority Draft (Div. J; P.L. 116-260) Program FY2020 FY2021 FY2021 FY2022 FY2021 FY2022 FY2021 FY2022 FY2021 FY2022 General Operating Expenses 3,125,000 — 3,207,000 — 3,186,000 — 3,160,000 3,180,000 — (VBA) CARES Act 13,000 — — — — — — — — — (P.L. 116-136) P.L.116-260 rescission (§254) — — — — — — — — -16,000 — Subtotal General Operating 3,138,000 — 3,207,000 — 3,186,000 — 3,160,000 — 3,164,000 — Expenses (VBA) Total, Veterans Benefits 128,692,348 — 138,847,255 — 138,826,278 — 142,096,585 — 142,100,608 — Administration (VBA) Veterans Health Administration Medical Services 51,411,165 — 56,158,015 — 56,158,015 — 56,158,015 — 56,158,015 — P.L. 116-94 rescission (§253) -350,000 — — — — — — — — — Over FY2021 Enacted Advance — — 497,468 — 513,968 — 5,594,318 — 497,468 — Appropriations Families First Coronavirus 30,000 — Response Act — — — — — — — — (P.L. 116-127) CARES Act 14,432,000 — — — — — — — — — (P.L. 116-136) Rescission §252 — — — — — — -5,096,850 — — — P.L.116-260 rescission (§254) -100,000 Subtotal ~~§252~~
—
—
—
—
—
—
~~-5,096,850~~
—
~~Subtotal~~ Medical Services
65,523,165
— —
56,655,483
— —
56,671,983
— —
56,655,483 — 56,555,483
— —
Medical Community Care Medical Community Care
10,758,399 10,758,399
— —
17,131,179 17,131,179
— —
17,131,179 17,131,179
— —
17,131,179 17,131,179 — 17,131,179
— —
Over FY2020 Enacted Advance Over FY2020 Enacted Advance ~~Appropriations~~
3,906,400 3,906,400
— —
— —
— —
— —
— —
— —
— —
— — Appropriations Over FY2021 Enacted Advance Over FY2021 Enacted Advance ~~Appropriations~~
— —
— —
1,380,800 1,380,800
— —
1,376,800 1,376,800
— —
3,847,180 3,847,180
— —
~~Transfer from Veterans Choice Fund (VCF) to~~
~~615,000~~
—
—
—
—
—
—
—
1,380,800 — Appropriations CRS-27 link to page 37 Enacted (P.L. 116-94; Consolidated P.L. 116-127; President’s House-Passed Senate Appropriations Appropriations Act, 2021 P.L. 116-136) Request (Div. D- H.R. 7608) Committee Majority Draft (Div. J; P.L. 116-260) Program FY2020 FY2021 FY2021 FY2022 FY2021 FY2022 FY2021 FY2022 FY2021 FY2022 Transfer from Veterans Choice 615,000 — — — — — — — — — Fund (VCF) to Community Care (P.L. 116-Community Care (P.L. 116-94)a
FamiliesFamilies First Coronavirus First Coronavirus ~~Response Act~~
30,000 30,000
— —
— —
— —
— —
— —
— —
— —
— — 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)
RescissionRescission §252 §252
— —
— —
— —
— —
— —
— —
-2,466,380 -2,466,380
— —
~~Subtotal~~ — — Subtotal Medical Community Care
17,409,799
— —
18,511,979
— —
18,507,979
— —
18,511,979 — 18,511,979
— —
Medical Support and Medical Support and ~~Compliance~~
7,239,156 7,239,156
— —
7,914,191 7,914,191
— —
7,914,191 7,914,191
— —
7,914,191 7,914,191
— —
7,914,191 — Compliance Over FY2020 Enacted Advance Over FY2020 Enacted Advance ~~Appropriations~~
98,800 98,800
— —
— —
— —
— —
— —

— —
— — Appropriations Over FY2021 Enacted Advance Over FY2021 Enacted Advance ~~Appropriations~~
— —
— —
300,000 300,000
— —
$281,880 $281,880
— —
886,235 886,235
— —
300,000 — Appropriations P.L. 116-94 rescissionP.L. 116-94 rescission (§253) (§253)
-10,000 -10,000
— —
— —
— —
— —
— —
— —
— —
— — CARES Act CARES Act
100,000 100,000
— —
— —
— —
— —
— —
— —
— —
— — (P.L. 116-136) (P.L. 116-136)
RescissionRescission §252 §252
— —
— —
— —
— —
— —
— —
-586,235 -586,235
— —
~~CRS-25~~

~~Enacted (P.L. 116-94;~~— — P.L.116-260 rescission (§254) — — — — — — — — -15,000 — Subtotal Medical Support and
~~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~~
7,427,956
— —
8,214,191
— —
8,196,071
— —
8,214,191
— —
8,199,191 — Compliance 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 6,433,265
— —
6,433,265 — CARES Act CARES Act
606,000 606,000
— —
— —
— —
— —
— —
— —
— —
— — (P.L. 116-136)(P.L. 116-136)
Over FY2021 Enacted Advance Over FY2021 Enacted Advance ~~Appropriations~~
— —
— —
150,000 150,000
— —
170,120 170,120
— —
441,385 441,385
— —
~~Rescission~~ 150,000 — Appropriations Rescission §252 §252
— —
— —
— —
— —
— —
— —
-291,385 -291,385

~~Subtotal~~ — — CRS-28 Enacted (P.L. 116-94; Consolidated P.L. 116-127; President’s House-Passed Senate Appropriations Appropriations Act, 2021 P.L. 116-136) Request (Div. D- H.R. 7608) Committee Majority Draft (Div. J; P.L. 116-260) Program FY2020 FY2021 FY2021 FY2022 FY2021 FY2022 FY2021 FY2022 FY2021 FY2022 Subtotal Medical Facilities
6,747,880 6,747,880
— —
6,583,265
— —
6,603,385
— —
6,583,265
— —
6,583,265 — Medical and Prosthetic Research Medical and Prosthetic Research
800,000 800,000
— —
787,000 787,000
— —
840,000 840,000
— —
800,000 800,000
— —
~~Rescission~~
815,000 — Rescission -50,000 -50,000
— —
— —
— —
— —
— —
— —
— —
— — (P.L. 116-94) (P.L. 116-94)
~~Subtotal~~ P.L.116-260 rescission (§254) — — — — — — — — -20,000 — Subtotal Medical and Prosthetic ~~Research~~
750,000
— —
787,000
— —
840,000
— —
800,000
— —
795,000 — Research Medical Care Col ectionMedical Care Col ection ~~Fund (MCCF)~~
Fund 3,729,000 3,729,000
— —
4,403,000 4,403,000
— —
4,403,000 4,403,000
— —
4,403,000 4,403,000
— —
4,403,000 — (MCCF) Total, Veterans Health ~~Administration~~
97,858,800
— —
90,751,918
— —
90,819,418
— —
90,764,918
— —
90,644,918 — Administration (VHA)
Total VHA with MCCF
101,587,800
— —
95,154,918
— —
95,222,418
— —
95,167,918
— —
~~National Cemetery Administration (NCA)~~95,047,918 — National Cemetery Administration (NCA)

NCA NCA
329,000 329,000
— —
360,000 360,000
— —
349,000 349,000
— —
352,000 352,000
— —
352,000 — P.L. 116-94 rescissionP.L. 116-94 rescission (§253) (§253)
-1,000 -1,000
— —
— —
— —
— —
— —

— —
— — Total, NCA
328,000
— —
360,000
— —
349,000
— —
352,000
— —
352,000 — Departmental ~~Administration~~ Administration

General General AdministrationAdministration
355,911 355,911
— —
413,000 413,000
— —
346,111 346,111
— —
365,911 365,911
— —
365,911 — CARES Act CARES Act
6,000 6,000
— —
— —
— —
— —
— —
— —
— —
— — (P.L. 116-136) (P.L. 116-136)
~~Subtotal~~ P.L.116-260 rescission (§254) -12,000 Subtotal General Administration
361,911
— —
413,000
— —
346,111
— —
365,911 — 353,911
— —
Board of Veterans Appeals Board of Veterans Appeals
182,000 182,000
— —
198,000 198,000
— —
198,000 198,000
— —

—
~~CRS-26~~

~~Enacted (P.L. 116-94;~~
190,000 — 196,000 — Rescission -8,000 — — — — — — — — — (P.L. 116-94) Subtotal Board of Veterans Appeals 174,000 — 198,000 — 198,000 — 190,000 — 196,000 — Information Technology 4,371,615 — 4,912,000 — 4,903,500 — 4,912,000 — 4,912,000 — CRS-29 Enacted (P.L. 116-94; Consolidated P.L. 116-127;
President’s
House-Passed
Senate Appropriations
Appropriations Act, 2021 P.L. 116-136)
Request
(~~Division~~Div. D- H.R. 7608)
Committee Majority Draft
(Div. J; P.L. 116-260) Program
FY2020
FY2021
FY2021
FY2022
FY2021
FY2022
FY2021
FY2022
~~Rescission~~
-8FY2021 FY2022 CARES Act 2,150,000 ,000
— —
— —
— —
— —
— —
— —
— —
~~(P.L. 116-94)~~
~~Subtotal Board of Veterans Appeals~~
~~174,000~~— — (P.L. 116-136) P.L.116-260 rescission (§254) — — — —
—
~~198,000~~
—
~~198,000~~ — — — — -37,500 Subtotal Information Technology 6,521
—
~~198,000~~
—
~~Information Technology~~
~~4,371~~,615 ,615
— —
4,912,000 4,912,000
— —
4,903,500 4,903,500
— —
4,912,000 — 4,874,500 — Electronic Health Record 1,500,000 — 2,627,000~~4,912,000~~
—
~~CARES Act~~
~~2,150,000~~
—
—
—
—
—
—
—
~~(P.L. 116-136)~~
~~Subtotal Information Technology~~
~~6,521,615~~
—
~~4,912~~ — 2,627,000
— —
~~4,903,500~~2,627,000
— —
~~4,912,000~~
—
~~Electronic Health Record Modernization~~
~~1,500,000~~
—
~~2,627,000~~
—
~~2,627,000~~
—
~~2,627,000~~
—
~~(EHRM)~~
~~Rescission~~
~~-70,000~~2,627,000 — Modernization (EHRM) Rescission -70,000 — — — — — — — — — (P.L. 116-94) P.L.116-260 rescission (§254) — — — — — — — — -20,000 Subtotal
—
—
—
—
—
—
—
~~(P.L. 116-94)~~
~~Subtotal~~ EHRM
1,430,000
— —
2,627,000
— —
2,627,000
— —
2,627,000
— —
2,607,000 — Inspector General Inspector General
210,000 210,000
— —
228,000 228,000
— —
229,300 229,300
— —
228,000 — 228,000
— —
CARES Act CARES Act
12,500 12,500
— —
— —
— —
— —
— —
— —
— —
— — (P.L. 116-136) (P.L. 116-136)
Subtotal Inspector General
222,500
— —
228,000
— —
229,300
— —
228,000
— —
228,000 — Construction, major projects Construction, major projects
1,235,200 1,235,200
— —
1,373,000 1,373,000
— —
1,373,000 1,373,000
— —
1,316,000 1,316,000
— —
1,316,000 — Construction, minor projects Construction, minor projects
398,800 398,800
— —
400,000 400,000
— —
400,000 400,000
— —
390,000 390,000
— —
~~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~~390,000 — P.L.116-260 rescission (§254) — — — — — — — — -35,700 Subtotal Construction, minor 398,800 — 400,000 — 400,000 390,000 354,300 projects — — Grants for State Extended Care 90,000
— —
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;~~
90,000 — Facilities CARES Act 150,000 — — — — — — — — — (P.L. 116-136) Subtotal grants for state extended 240,000 — 90,000 — 93,000 — 90,000 — 90,000 — care facilities Grants for State Veterans 45,000 — 45,000 — 45,000 — 45,000 — 45,000 — Cemeteries CRS-30 Enacted (P.L. 116-94; Consolidated P.L. 116-127;
President’s
House-Passed
Senate Appropriations
Appropriations Act, 2021 P.L. 116-136)
Request
(~~Division~~Div. D- H.R. 7608)
Committee Majority Draft
(Div. J; P.L. 116-260) Program
FY2020
FY2021
FY2021
FY2022
FY2021
FY2022
FY2021
FY2022
~~Total, Department of Veterans Affairs~~FY2021 FY2022 Total, Departmental 10,629,026 — 10,286,000 — 10,214,911 — 10,163,911 — 10,064,711 — Administration Administrative Rescission -15,949 — — — — — — — — — (P.L. 116-94) Administrative Provisions (§253) — — — — — — -257,462 — — — Total, Department of
$237,492,225
— —
$240,245,173
— —
$240,209,607
— —
$243,119,952
— —
$243,162,237 — Veterans Affairs (without MCCF)
Total Mandatory Total Mandatory
$125,352,325 $125,352,325
— —
$135,434,234 $135,434,234
— —
$104,775,373 $104,775,373
— —
$104,389,388 $104,389,388 — $104,431,673
— —
Total Discretionary Total Discretionary
$112,139,900 $112,139,900
— —
$104,810,939 $104,810,939
— —
$135,434,234 $135,434,234
— —
$138,730,564 $138,730,564
— —
$138,730,564 — Memorandum: Advance Appropriations

Compensation and Pensions Compensation and Pensions
— —
$118,246,975 $118,246,975
— —
$130,227,650 $130,227,650
— —
$130,227,650 $130,227,650
— —
$130,227 $130,227,650 — $130,227,650 ,650
Readjustment Benefits Readjustment Benefits
— —
12,578,965 12,578,965
— —
14,946,618 14,946,618
— —
14,946,618 14,946,618
— —
14,946,618 14,946,618 — 14,946,618
Insurance and Indemnities Insurance and Indemnities
— —
129,224 129,224
— —
136,950 136,950
— —
136,950 136,950
— —
136,950 136,950
~~Subtotal, Benefits~~ — 136,950 Subtotal, Benefits Programs
— —
130,955,164
— —
145,311,218
— —
145,311,218
— —
145,311,218 — 145,311,218
Medical Services Medical Services
— —
56,158,015 56,158,015
— —
58,897,219 58,897,219
— —
58,897,219 58,897,219
— —

58,897,219 — 58,897,219 Medical Community Care Medical Community Care
— —
17,131,179 17,131,179
— —
20,148,244 20,148,244
— —
20,148,244 20,148,244
— —

20,148,244 — 20,148,244 Medical Support and Medical Support and ~~Compliance~~
— —
7,914,191 7,914,191
— —
8,403,117 8,403,117
— —
8,403,117 8,403,117
—8,403,117
8,403,117 8,403,117 Compliance — —
Medical Facilities Medical Facilities
— —
6,433,265 6,433,265
— —
6,734,680 6,734,680
— —
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
— —
94,183,260
— 94,183,260 Total Advance ~~Appropriation~~
— —
$218,591,814
— —
$239,494,478
— —
$239,494,478
—$239,494,478
$239,494,478
Appropriation — — Source: Table prepared by CRS based on the Further Consolidated Appropriations Act, 2020 (P.L. 116-94); the FamiliesTable 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); First Coronavirus Response Act (P.L. 116-127);
the Coronavirus Aid, Relief,the Coronavirus Aid, Relief, and Economic Security Act (P.L. 116-136); U.S. Congress,and Economic Security Act (P.L. 116-136); U.S. Congress, House CommitteeHouse Committee on Appropriations,on Appropriations, Military Construction, Veterans Affairs, and
Related Agencies Appropriations Bil ~~Bill~~, 2021, report to accompany H.R. 7609, 116th Cong., 2nd sess.,, report to accompany H.R. 7609, 116th Cong., 2nd sess., July 13, 2020, H.Rept. 116-445, pp. 131-141; Division D of H.R. 7608; July 13, 2020, H.Rept. 116-445, pp. 131-141; Division D of H.R. 7608; ~~and~~
Senate Appropriations CommitteeSenate Appropriations Committee ~~majority~~ majority draft explanatory statement releaseddraft explanatory statement released on November 10, 2020, pp.98-108; and U.S. Congress, House Committee on CRS-31 Appropriations, Consolidated Appropriations Act, 2021, committee print, prepared by House Committee on Appropriations, H.R. 133/Public Law 116–260 [Legislative Text and Explanatory Statement] Book 2 of 2 Divisions G–L, 116th Cong., 2nd sess., March 2021 (Washington: GPO, 2021), pp. 1885-1903~~on November 10, 2020, pp.98-108~~. .
a. The Further Consolidated Appropriationsa. The Further Consolidated Appropriations Act, 2020 (P.L. 116-94), authorized a mandatory balance transfer of $615 mil ionAct, 2020 (P.L. 116-94), authorized a mandatory balance transfer of $615 mil ion from the Veterans Choice Fund (VCF) 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.Choice, and Accountability Act of 2014, as amended (38 U.S.C. §1701 note) to the medical§1701 note) to the medical community care community care
account. account.

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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 earlierhttp://www.va.gov/vetdata/Veteran_Population.asp, and an archived copy of an earlier version no longer available 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 wereYear numbers were obtained from the Department of Veterans Affairs (VA) and/or the VA budget submissions 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 submissionto Congress for FY2002-FY2021; the number for each fiscal year is taken from the budget submission two years two years
later (e.g., the FY2000 number is fromlater (e.g., the FY2000 number is from the FY2002 budget submission).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 Direct Loan Program 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 Native American Veterans Veterans
$218 $218
$205 $205
$205 $205
$515 $515
$515 $515
Housing Loan Program Housing Loan Program
AdministrativeAdministrative Expenses 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 Medical Administration and and
$69,808 $69,808
$63,602 $63,602
$61,207 $61,207
$59,860 $59,860
$63,000 $63,000
~~Miscellaneous~~ Miscel aneous Operating Operating
Expenses (MAMOE) Expenses (MAMOE)
Rescission Rescission
-$44 -$44
-$86 -$86
— —
— —
-$67 -$67
Health Professional Health Professional Scholarships 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 Medical Care Col ections Fund 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 General Operating Expenses 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
$19,208,702
MCCF
Source: Table prepared by the CongressionalTable prepared by the Congressional Research ServiceResearch Service based on data from the Department of Veterans based on data from the Department of Veterans
Affairs,Affairs, Office of Management, Office of Budget. Office of Management, Office of Budget.
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Table B-2. Department of Veterans Affairs Enacted Appropriations, FY2000- FY2004
($ 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 Native American Veterans Veterans
$520 $520
$532 $532
$544 $544
$558 $558
$571 $571
Housing Loan Program Housing Loan Program
AdministrativeAdministrative Expenses 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 Medical Administration and and
$59,703 $59,703
$62,000 $62,000
$66,731 $66,731
$74,716 $74,716
— —
~~Miscellaneous~~ Miscel aneous Operating 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 Medical Care Col ections Fund 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 General Operating Expenses 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
Congressional Research Service Congressional Research Service

3337

Department of Veterans Affairs FY2021 Appropriations

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
$29,407,045
without MCCF
Source: Table prepared by the CongressionalTable prepared by the Congressional Research ServiceResearch Service based on data from the Department of Veterans based on data from the Department of Veterans
Affairs,Affairs, Office of Management, Office of Budget. Office of Management, Office of Budget.
Table B-3. Department of Veterans Affairs Enacted Appropriations, FY2005-FY2010
($ 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
Congressional Research Service Congressional Research Service

3438

Department of Veterans Affairs FY2021 Appropriations

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 Col ections Fund 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 General Operating 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

3539

Department of Veterans Affairs FY2021 Appropriations

FY2005
FY2006
FY2007
FY2008
FY2009
FY2010

Enacted
Enacted
Enacted
Enacted
Enacted
Enacted
Filipino Filipino Veterans 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 CongressionalTable prepared by the Congressional Research ServiceResearch Service based on data from the Department of Veterans based on data from the Department of Veterans
Affairs,Affairs, Office of Management, Office of Budget. Office of Management, Office of Budget.
Congressional Research Service Congressional Research Service

3640

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

3741

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 Col ections Fund 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

3842

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
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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 Families First 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 Families First 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
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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 Col ections Fund 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
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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
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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 Table prepared by the Congressional Research ServiceResearch Service based on data from the Department of Veterans based on data from the Department of Veterans
Affairs,Affairs, Office of Management, Office of Budget. 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

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