Veterans’ Medical Care:
FY2015 Appropriations
Sidath Viranga Panangala
Specialist in Veterans Policy
October 9, 2014
Congressional Research Service
7-5700
www.crs.gov
R43547

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Veterans’ Medical Care: FY2015 Appropriations

Summary
The Department of Veterans Affairs (VA) provides benefits to veterans who meet certain
eligibility criteria. Benefits to veterans range from disability compensation and pensions to
hospital and medical care. The VA provides these benefits through three major operating units:
the Veterans Health Administration (VHA), the Veterans Benefits Administration (VBA), and the
National Cemetery Administration (NCA). This report focuses on funding for the VHA. The
VHA is primarily a direct service provider of primary care, specialized care, and related medical
and social support services to veterans through the nation’s largest integrated health care system.
Eligibility for VA health care is based primarily on previous military service, disability, and
income.
The President’s FY2015 budget request was submitted to Congress on March 4, 2014. The
President’s budget is requesting $158.6 billion in budget authority for the VA as a whole. This
includes $93.5 billion in mandatory funding and $65.1 billion in discretionary funding. For
FY2015, the Administration is requesting $56.6 billion for VHA. This includes $45.4 billion for
the medical services account, $5.9 billion for the medical support and compliance account, $4.7
billion for the medical facilities account, and nearly $589 million for the medical and prosthetic
research account. Furthermore, as required by the Veterans Health Care Budget Reform and
Transparency Act of 2009 (P.L. 111-81), the President’s budget is requesting $58.6 billion in
advance appropriations for the three medical care accounts (medical services, medical support
and compliance, and medical facilities) for FY2016.
On April 3, 2014, the House Military Construction and Veterans Affairs Subcommittee approved
its version of a Military Construction and Veterans Affairs and Related Agencies Appropriations
bill for FY2015 (MILCON-VA Appropriations bill). The full House Appropriations Committee
approved a draft measure by voice vote on April 9, 2014, and the House passed MILCON-VA
Appropriations bill for FY2015 (H.R. 4486; H.Rept. 113-416) on April 30, 2014. The House-
passed version of the MILCON-VA Appropriations bill for FY2015 proposes a total of $158.2
billion for the VA as whole. For FY2015, H.R. 4486 proposes $56.2 billion for VHA. This
includes $45 billion for the medical services account, $5.9 billion for the medical support and
compliance account, $4.7 billion for the medical facilities account, and nearly $589 million for
the medical and prosthetic research account. H.R. 4486 (H.Rept. 113-416) includes $58.6 billion
in advance FY2016 funding for the medical services, medical support and compliance, and
medical facilities accounts—the same level included in the President’s request.
On May 20, 2014, the Senate Military Construction, Veterans Affairs, and Related Agencies
Subcommittee marked up its version of the MILCON-VA Appropriations bill for FY2015. The
full Senate Appropriations Committee approved the measure (H.R. 4486 ; S.Rept. 113-174) on
May 22. The committee-approved bill proposes $158.6 billion for the VA as a whole. For
FY2015, H.R. 4486 (S.Rept. 113-174) proposes $56.4 billion for VHA. This includes $45.1
billion for the medical services account, $5.9 billion for the medical support and compliance
account, $4.9 billion for the medical facilities account, and nearly $589 million for the medical
and prosthetic research account. H.R. 4486 (S.Rept. 113-174) includes $58.6 billion in advanced
FY2016 appropriations similar to the House-passed amount and the President’s request.


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Veterans’ Medical Care: FY2015 Appropriations

Contents
Introduction ...................................................................................................................................... 1
The Veteran Patient Population ........................................................................................................ 2
Advance Appropriations ............................................................................................................ 5
Department of Veterans Affairs Budget ........................................................................................... 6
Overview of Veterans Health Administration’s Budget Formulation .............................................. 8
Funding for the VHA ............................................................................................................... 10
Medical Services ..................................................................................................................... 11
Medical Support and Compliance (Previously Medical Administration) ................................ 11
Medical Facilities .................................................................................................................... 12
Medical and Prosthetic Research ............................................................................................. 12
Medical Care Collections Fund (MCCF) ................................................................................ 12
FY2014 Budget Summary ............................................................................................................. 13
Consolidated Appropriations Act, 2014 (P.L. 113-76) ............................................................. 13
House and Senate Action ................................................................................................... 13
FY2015 VHA Budget .................................................................................................................... 14
President’s Request .................................................................................................................. 14
House Action ........................................................................................................................... 14
Senate Committee Action ........................................................................................................ 15
Continuing Appropriations Resolution, 2015 (P.L. 113-164) .................................................. 15

Figures
Figure 1. FY2014 VA Budget Allocations ....................................................................................... 7
Figure 2. FY2015 VA Budget Request............................................................................................. 8

Tables
Table 1. VHA Unique Enrollees, FY2011-FY2015 ......................................................................... 3
Table 2. VHA Unique Patients, FY2011-FY2015 ........................................................................... 4
Table 3. Department of Veterans Affairs, Budget Formulation Time Line .................................... 10
Table 4. VA and VHA Appropriations, FY2014-FY2015, and Advance Appropriations,
FY2016 ....................................................................................................................................... 17
Table 5. VHA Appropriations by Account, FY2014-FY2015, and Advance
Appropriations, FY2016 ............................................................................................................. 19
Table A-1. Priority Groups and Their Eligibility Criteria .............................................................. 21
Table B-1. Department of Veterans Affairs Enacted Appropriations, FY1995-FY1999................ 23
Table B-2. Department of Veterans Affairs Enacted Appropriations, FY2000- FY2004............... 26
Table B-3. Department of Veterans Affairs Enacted Appropriations, FY2005-FY2009................ 29
Table B-4. Department of Veterans Affairs Enacted Appropriations, FY2010-FY2014................ 32
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Appendixes
Appendix A. Priority Groups ......................................................................................................... 21
Appendix B. Department of Veterans Affairs, Enacted Appropriations FY1995-FY2014 ............ 23

Contacts
Author Contact Information........................................................................................................... 35
Acknowledgments ......................................................................................................................... 35

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Introduction
The Department of Veterans Affairs (VA) provides a range of benefits and services to veterans1
who meet certain eligibility rules; these benefits include medical care, disability compensation
and pensions,2 education,3 vocational rehabilitation and employment services,4 assistance to
homeless veterans,5 home loan guarantees,6 administration of life insurance as well as traumatic
injury protection insurance for servicemembers,7 and death benefits that cover burial expenses.8
The VA carries out its programs nationwide through three administrations and the Board of
Veterans Appeals (BVA).9 The Veterans Benefits Administration (VBA) is responsible for, among
other things, providing compensation, pensions, and education assistance. The National Cemetery
Administration (NCA)10 is responsible for 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 eligible persons, among other things.
The Veterans Health Administration (VHA) is responsible for health care services and medical
and prosthetic research programs.11 The VHA is primarily a direct service provider of primary
care, specialized care, and related medical and social support services to veterans through the
nation’s largest integrated health care system. Inpatient and outpatient care are also provided in
the private sector to eligible dependents of veterans under the Civilian Health and Medical

1 In general, payments of benefits made to, or on account of, a beneficiary under any law administered by the VA are
exempt from federal taxation. Furthermore, benefits are exempt, in most cases, from “attachment, levy, or seizure by or
under any legal or equitable process whatever, either before or after receipt by the beneficiary’’ (38 U.S.C.
§5301(a)(1)).
2 For a detailed description of disability compensation and pension programs, see CRS Report R42324, “Who is a
Veteran?”—Basic Eligibility for Veterans’ Benefits, by Umar Moulta-Ali; CRS Report RL34626, Veterans’ Benefits:
Disabled Veterans, by Umar Moulta-Ali et al.; and CRS Report RS22804, Veterans’ Benefits: Pension Benefit
Programs, by Umar Moulta-Ali and Carol D. Davis.
3 For a discussion of education benefits see, CRS Report R42785, GI Bills Enacted Prior to 2008 and Related
Veterans’ Educational Assistance Programs: A Primer, by Cassandria Dortch; and CRS Report R42755, The Post-9/11
Veterans Educational Assistance Act of 2008 (Post-9/11 GI Bill): Primer and Issues, by Cassandria Dortch.
4 For details on VA’s vocational rehabilitation and employment see, CRS Report RL34627, Veterans’ Benefits: The
Vocational Rehabilitation and Employment Program, by Benjamin Collins; and CRS Report R42790, Employment for
Veterans: Trends and Programs, coordinated by Benjamin Collins.
5 For detailed information on homeless veterans programs see, CRS Report RL34024, Veterans and Homelessness, by
Libby Perl.
6 For details on guaranteed loans, direct loans, and specially adapted housing grants see, CRS Report R42504, VA
Housing: Guaranteed Loans, Direct Loans, and Specially Adapted Housing Grants, by Libby Perl.
7 For details on insurance programs see, CRS Report R41435, Veterans’ Benefits: Current Life Insurance Programs, by
Umar Moulta-Ali.
8 For details on death benefits, see CRS Report R41386, Veterans’ Benefits: Burial Benefits and National Cemeteries,
by Umar Moulta-Ali.
9 The BVA is part of the Department of Veterans Affairs, located in Washington, DC, and makes the final
determination on an appeal within the VA. The BVA reviews all appeals for entitlement to veterans’ benefits, including
claims for service connection, increased disability ratings, pension, insurance benefits, educational benefits, home loan
guaranties, vocational rehabilitation, dependency and indemnity compensation, health care services, and fiduciary
matters. For more information see CRS Report R42609, Overview of the Appeal Process for Veterans’ Claims, by
Daniel T. Shedd.
10 Established by the National Cemeteries Act of 1973 (P.L. 93-43).
11 38 U.S.C. §7301 and 38 U.S.C. §7303.
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Program of the Department of Veterans Affairs (CHAMPVA).12 The VHA is also a provider of
health care education and training for physician residents and other health care trainees.13 The
other statutory missions of VHA are to serve as a contingency backup to the Department of
Defense (DOD) medical system during a national security emergency,14 and to provide support to
the National Disaster Medical System and the Department of Health and Human Services as
necessary.15
In general, eligibility for VA health care is based on previous military service,16 presence of
service-connected disabilities,17 and/or other factors.18 Veterans generally must enroll in the VA
health care system to receive medical care. Once enrolled, veterans are assigned to one of eight
categories (see Appendix A).19 It should be noted that in any given year, not all enrolled veterans
obtain their health care services from the VA. While some veterans may rely solely on the VA for
their care, others may receive the majority of their health care services from other sources, such
as Medicare, Medicaid, private health insurance, and the military health system (TRICARE).20
VA-enrolled veterans do not pay premiums or enrollment fees to receive care from the VA;
however, they may incur out-of-pocket costs for VA care related to conditions that are not service-
connected.21
The Veteran Patient Population
In FY2014, there were approximately 21.9 million living veterans in the nation whose service
ranged from World War II, Korea, Vietnam, the Gulf War (which includes Operation Enduring
Freedom/Operation Iraqi Freedom/Operation New Dawn (OEF/OIF/OND)) and the intervening
periods. Of this number approximately 9.1 million were estimated to be enrolled in the VA health

12 For more information on CHAMPVA see, CRS Report RS22483, Health Care for Dependents and Survivors of
Veterans, by Sidath Viranga Panangala.
13 38 U.S.C. §7302.
14 38 U.S.C. §8111A.
15 38 U.S.C. §1785.
16 Veteran status is established by active-duty status in the U.S. Armed Forces and a discharged or released there from
under conditions other than dishonorable (38 U.S.C.§101(2); 38 C.F.R. §3.1(d)). Generally, persons enlisting in one of
the Armed Forces after September 7, 1980, and officers commissioned after October 16, 1981, must have completed
two years of active duty or the full period of their initial service obligation to be eligible for VA health care benefits.
An exception may be granted if the servicemember was discharged or released because of an early out or hardship (10
U.S.C. §§1171 or 1173); was discharged or released for a service-connected disability directly due to service; or, has a
compensable service-connected disability (38 U.S.C. §5303A; 38 C.F.R. §3.12a).
17 A service-connected disability is a disability that was incurred or aggravated in the line of duty in the U.S. Armed
Forces (38 U.S.C. §101 (16). VA determines whether veterans have service-connected disabilities, and for those with
such disabilities, assigns ratings from 0% to 100% based on the severity of the disability. Percentages are assigned in
increments of 10 (38 C.F.R. §§4.1-4.31).
18 For information on eligibility for VA health care see, CRS Report R42747, Health Care for Veterans: Answers to
Frequently Asked Questions, by Sidath Viranga Panangala and Erin Bagalman.
19 Ibid.
20 TRICARE provides medical care to active duty servicemembers and other eligible beneficiaries (such as military
retirees) through a combination of direct care in military clinics and hospitals and civilian-purchased care. For more
information on TRICARE see, CRS Report RL33537, Military Medical Care: Questions and Answers, by Don J.
Jansen.
21 For more information on VA cost-sharing requirements see, CRS Report R42747, Health Care for Veterans:
Answers to Frequently Asked Questions, by Sidath Viranga Panangala and Erin Bagalman.
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care system (see Table 1). From FY2011 through FY2014 the total number of enrollees has
increased by 6.3%. Of the total number of enrolled veterans in FY2014, VA anticipated treating
approximately 5.9 million unique veteran patients (see Table 2).22 For FY2015, VHA estimates
that it will treat about 6 million unique veteran patients, and of these, VA anticipates treating more
than 757,000 Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF), and Operation
New Dawn (OND) veterans.23 In FY2015, OEF, OIF, and OND patients would represent
approximately 11.2% of the overall patients served by the VA.
VHA also provides medical care to certain non-veterans; in FY2015 this population is expected to
increase by more than 14,000 patients over the FY2014 level.24 In total, including non-veterans, it
is estimated the VHA will treat nearly 6.7 million patients in 2015, a slight increase of 1.9% over
the number of patients treated in FY2014 (see Table 2). Between FY2011 and FY2015, the
number of patients treated by VA has grown by 9.3%.
The total number of outpatient visits, including visits to Vet Centers, reached 91.7 million during
FY2013 and is projected to increase to approximately 94.6 million in FY2014 and 97.2 million in
FY2015.25
Table 1. VHA Unique Enrollees, FY2011-FY2015
FY2011
FY2012
FY2013
FY2014
FY2015
Priority Groups
Actual
Actual
Actual
Estimate
Estimate
1
1,385,482 1,539,632
1,712,369 1,755,002 1,857,218
2
656,828 680,339
704,737 719,218 736,422
3
1,154,954 1,173,673
1,200.952 1,208,263 1,224,544
4
242,385 241,626
242,257 236,709 234,797
5
2,243,148 2,215,449
2,147,686 2,238,782 2,251,917
6
569,400 593,478
610,414 603,393 603,818
Subtotal Priority
6,252,197 6,444,197
6,618,415 6,761,367 6,908,717
Groups 1-6
7
188,823 171,031
196,593 234,115 242,999
8
2,133,178 2,147,320
2,111,538 2,116,473 2,135,577

22 In a given year not all enrolled veterans receive care from the VA, either because they are not sick or they have other
sources of care such as the private sector.
23 On September 1, 2010, the combat mission in Iraq (Operation Iraqi Freedom, OIF) formally ended and transitioned
to Operation New Dawn (OND), which ended on December 15, 2011. VA considers OND to be part of the same
contingency operation that was formerly called OIF. Therefore, VA considers participants in OND to be eligible for
health care under the legal authorities pertaining to OIF. OEF/OIF/OND data from Department of Veterans Affairs,
FY2015 Budget Submission, Medical Programs and Information Technology Programs, Volume 2 of 4, March 2014,
p.VHA-7.
24 Non-veterans include Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA)
patients (certain dependents of veterans), reimbursable patients in VA affiliated hospitals and clinics, care provided on
a humanitarian basis, veterans of World War II allied nations, and employees receiving preventative occupational
immunizations such as Hepatitis A&B and flu vaccinations.
25 Department of Veterans Affairs, FY2015 Budget Submission, Medical Programs and Information Technology
Programs, Volume 2 of 4, March 2014, p.VHA-33.
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FY2011
FY2012
FY2013
FY2014
FY2015
Priority Groups
Actual
Actual
Actual
Estimate
Estimate
Subtotal Priority
2,322,001 2,318,351
2,308,131 2,350,588 2,378,575
Groups 7-8
Total Enrollees
8,574,198
8,762,548
8,926,546
9,111,955
9,287,292
Source: Table prepared by the Congressional Research Service based on data from the Department of Veterans
Affairs and data from Department of Veterans Affairs, FY2015 Budget Submission, Medical Programs and Information
Technology Programs, Volume 2 of 4, March 2014, pp.VHA-32.
Note: For a description of Priority Groups see Appendix A.
Table 2. VHA Unique Patients, FY2011-FY2015
FY2011
FY2012
FY2013
FY2014
FY2015
Priority Groups
Actual
Actual
Actual
Estimate
Estimate
1
1,179,333 1,307,750 1,451,707 1,537,467 1,648,369
2
442,665 456,050 473,841 482,363 491,612
3
687,284 697,548 721,576 727,075 735,975
4
191,177 191,521 192,241 189,436 188,883
5
1,487,637 1,464,198 1,409,341 1,407,554 1,390,365
6
266,374 272,043 275,799 272,927 274,137
Subtotal Priority Groups 1-6
4,254,470
4,389,110 4,524,505 4,616,822 4,729,341
7
170,690 155,093 167,538 180,357 179,561
8
1,157,011 1,136,171 1,111,487 1,110,863 1,109,638
Subtotal Priority Groups 7-8
1,327,701
1,291,264 1,279,385 1,291,220 1,289,119
Subtotal Unique
Veteran Patients
5,582,171 5,680,374 5,803,890 5,908,042 6,018,540
OEF/OIF/OND veterans
included in the above total
470,755 539,970 616,487 689,974 757,674
Non-veteransa
584,020 652,717 680,774 708,921 723,393
Total Unique Veteran
and non-Veteran
6,166,191 6,333,091 6,484,664 6,616,963 6,741,933
Patients
Source: Table prepared by the Congressional Research Service based on data from the Department of Veterans
Affairs and data from Department of Veterans Affairs, FY2015 Budget Submission, Medical Programs and Information
Technology Programs, Volume 2 of 4, March 2014, pp.VHA-32. OEF/OIF/OND data from Department of Veterans
Affairs, FY2015 Budget Submission, Medical Programs and Information Technology Programs, Volume 2 of 4, March
2014, p.VHA-7.
Notes: For a description of Priority Groups see the Appendix A. Unique patients are those that receive at
least one episode of care from the VA or whose treatment is paid for by the VA and is counted only once in a
given fiscal year.
a. Non-veterans include Civilian Health and Medical Program of the Department of Veterans Affairs
(CHAMPVA) patients (certain dependents of veterans), reimbursable patients with VA affiliated hospitals
and clinics, care provided on a humanitarian basis, veterans of World War II allied nations, and employees
receiving preventative occupational immunizations such as Hepatitis A&B and flu vaccinations.
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The rest of this report focuses on appropriations for VHA. It begins with a brief overview of
VHA’s budget formulation, a description of the accounts that fund the VHA, and a summary of
the FY2014 VHA budget. The report ends with a section discussing recent legislative
developments pertaining to the FY2015 VHA budget.
Advance Appropriations26
In order to understand annual appropriations for the Veterans Health Administration (VHA), it is
essential to understand the role of advance appropriations. In 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 accounts that comprise VHA: medical services,
medical support and compliance, and medical facilities.27 The fourth account, the medical and
prosthetic research account, is not funded with an advance appropriation. P.L. 111-81 also
required the Department of Veterans Affairs to submit a request for advance appropriations for
VHA with its budget request each year. Congress first provided advance appropriations for the
three VHA accounts in the FY2010 appropriations cycle; the Consolidated Appropriations Act,
2010 (P.L. 111-117), provided advance appropriations for FY2011. Subsequently, each
successive appropriation measure has provided advance appropriations for the VHA accounts: the
Department of Defense and Full-Year Continuing Appropriations Act, 2011 (P.L. 112-10),
provided advance appropriations for FY2012; the Consolidated Appropriations Act, 2012 (P.L.
112-74), provided advance appropriations for FY2013; the Consolidated and Further Continuing
Appropriations Act, 2013 (P.L. 113-6), provided advance appropriations for FY2014; and the
Consolidated Appropriations Act, 2014 (P.L. 113-76) provided advance appropriations for
FY2015. The Military Construction, Veterans Affairs, and Related Agencies Appropriations Bill,
2015 (H.R. 4486) as reported by the House Appropriations Committee provides advance
appropriations for FY2016.
Under current budget scoring guidelines, advance appropriations of budget authority are scored as
new budget authority in the fiscal year in which the funds become newly available for obligation,
and not in the fiscal year the appropriations are enacted.28 Therefore, throughout the funding
tables of this report, advance appropriations numbers are shown under the label “memorandum”
and in the corresponding fiscal year column. For example, the Consolidated Appropriations Act,
2014 (P.L. 113-76) provided advance appropriations for FY2015. Funding shown for FY2014
does not include advance appropriations provided in FY2014 by P.L. 113-76 for use in FY2015.
Instead, the advance appropriation provided in FY2014 for use in FY2015 is shown in the
memorandum in the FY2015 column.

26 In general, an appropriations act makes budget authority available beginning on October 1 of the fiscal year for
which the appropriations act is passed (“budget year”). However, there are some types of appropriations that do not
follow this pattern; among them are advance appropriations. An advance appropriation means appropriation of new
budget authority that becomes available one or more fiscal years beyond the fiscal year for which the appropriations act
was passed (i.e., beyond the budget year). For more information on advance appropriations, see CRS Report R43482,
Advance Appropriations, Forward Funding, and Advance Funding: Concepts, Practice, and Budget Process
Considerations, by Jessica Tollestrup
27 Codified at 38 U.S.C. §117.
28 Executive Office of the President, Office of Management and Budget (OMB), Appendix A-Scorekeeping Guidelines,
OMB Circular No. A–11, PART 7, July 2013, p. 2.
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Department of Veterans Affairs Budget
The VA budget includes both mandatory29 and discretionary funding.30 Mandatory accounts fund
disability compensation, pensions, vocational rehabilitation and employment, education, life
insurance, housing, and burial benefits (such as graveliners, outer burial receptacles, and
headstones), among other benefits and services. Discretionary accounts fund medical care,
medical research, construction programs, information technology, and general operating
expenses, among other things. Appendix B provides enacted appropriations from FY1995 to
FY2014 for the VA, including all three administrations that compose the VA: VBA, VHA, and
NCA.
Figure 1 provides a breakdown of FY2014 budget allocations for both mandatory and
discretionary programs. In FY2014, the total VA budget authority was approximately $147.9
billion; discretionary budget authority accounted for about 42.8% ($63.2 billion) of the total, with
about 86.9% ($54.9 billion) of this discretionary funding going toward supporting VA health care
programs, including medical and prosthetic research. The VA’s mandatory budget authority
accounted for about 57.4% ($84.7 billion) of the total VA budget authority, with about 84.4%
($71.4 billion) of this mandatory funding going toward disability compensation and pension
programs.

29 Mandatory programs funded through the annual appropriations process are commonly referred to as appropriated
entitlements. In general, appropriators have little control over the amounts provided for appropriated entitlements;
rather, the authorizing statute establishes the program parameters (e.g., eligibility rules, benefit levels) that entitle
certain recipients to payments. If Congress does not appropriate the money necessary to meet these commitments,
entitled recipients (e.g., individuals, states, or other entities) may have legal recourse. For an overview of mandatory
spending see, CRS Report RL33074, Mandatory Spending Since 1962, by Mindy R. Levit and D. Andrew Austin.
30 Funding for discretionary programs are provided and controlled through the annual appropriations process. For more
information see, CRS Report R41726, Discretionary Budget Authority by Subfunction: An Overview, by D. Andrew
Austin.
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Figure 1. FY2014 VA Budget Allocations
Total Budget Authority = $147.9 Billion
Construction
Information
0.8%
Technology
(Discretionary)
2.5%
Discretionary Benefits
(Discretionary)
Programs
1.9%
Medical Programs
37.1%
(Discretionary)
Mandatory Benefits
Programs
57.4%
Departmental
Administration
0.3%
(Discretionary)

Source: Chart prepared by the Congressional Research Service based on U.S. Congress, House Committee on
Appropriations, Subcommittee on Military Construction, Veterans Affairs, and Related Agencies, Military
Construction, Veterans Affairs, And Related Agencies Appropriations Bill, 2015, report to accompany H.R. 4486, 113th
Congress, 2nd session, April 17, 2014, H.Rept. 113-416, pp. 6-10.
Notes: Discretionary budget authority includes medical programs; information technology; construction; other
discretionary benefits, such as operation and maintenance of VA’s national cemeteries; and departmental
administration. Mandatory benefits include disability compensation, pensions, education, vocational rehabilitation
and employment services, among other benefits and services. Totals may not add due to rounding.
Figure 2 provides a breakdown of the FY2015 President’s budget request for both mandatory and
discretionary programs. For FY2015, the Administration requested approximately $158.6 billion.
This includes approximately $65.1 billion in discretionary funding and $93.5 billion in mandatory
funding. A major portion of the mandatory benefits will be for compensation and pension benefits
for veterans and surviving spouses, dependent children, and dependent parents.
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Figure 2. FY2015 VA Budget Request
Total Budget Request = $158.6 Billion
Information
Construction
Technology
0.8%
2.5%
(Discretionary)
(Discretionary)
Discretionary Benefit
Medical Programs
Programs
34.4%
1.8%
(Discretionary)
Mandatory Benefit
Programs
60.2%
Departmental
Administration
0.3%
(Discretionary)

Source: Chart prepared by the Congressional Research Service based on U.S. Congress, House Committee on
Appropriations, Subcommittee on Military Construction, Veterans Affairs, and Related Agencies, Military
Construction, Veterans Affairs, And Related Agencies Appropriations Bill, 2015, report to accompany H.R. 4486, 113th
Congress, 2nd session, April 17, 2014, H.Rept. 113-416, pp. 6-10.
Notes: Discretionary budget authority includes medical programs; information technology; construction; other
discretionary benefits, such as operation and maintenance of VA’s national cemeteries; and departmental
administration. Mandatory benefits include disability compensation, pensions, education, vocational rehabilitation
and employment services, among other benefits and services. Totals may not add due to rounding.
Overview of Veterans Health Administration’s
Budget Formulation31
Similar to most federal agencies, the VA begins formulating its budget request approximately 10
months before the President submits the budget to Congress, generally in early February. VHA’s
budget request to Congress begins with the formulations of the budget based on the Enrollee

31 A major part of this discussion was drawn from U.S. Government Accountability Office, Veterans’ Health Care: VA
Uses a Projection Model to Develop Most of Its Health Care Budget Estimate to Inform the President’s Budget
Request, GAO-11-205, January 2011, pp. 4-8; and U.S. Government Accountability Office, Veterans’ Health Care
Budget: Better Labeling of Services and More Detailed Information Could Improve the Congressional Budget
Justification, GAO-12-908, September 2012, pp. 5-6.
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Health Care Projection Model (EHCPM), 32 and the Civilian Health and Medical Program
Veterans Administration (CHAMPVA) Model. The two models collectively estimate the amount
of budgetary resources VHA will need to meet the expected demand for most of the health care
services it provides.
The EHCPM’s estimates are based on three basic components: the projected number of veterans
who will be enrolled in VA health care, the projected utilization of VA’s health care services—that
is, the quantity of health care services enrollees are expected to use—and the projected unit cost
of providing these services. Each component is subject to a number of adjustments to account for
the characteristics of VA health care and the veterans who access VA’s health care services. The
EHCPM makes projections three or four years into the future. Each year, VHA updates the
EHCPM estimates to “incorporate the most recent data on health care utilization rates, actual
program experience, and other factors, such as economic trends in unemployment and
inflation.”33 For instance, in 2013, VHA used data from FY2012 to develop its health care budget
estimate for the FY2015 request, including the advance appropriations request for FY2016.34
The CHAMPVA Model is a more recent model adopted by VHA in 2010. The CHAMPVA model
projects the cost of providing medical coverage to CHAMPVA eligible beneficiaries.35 The
CHAMPVA Model is composed of two major components: the enrollment model and the claims
cost model. The enrollment model projects the number of beneficiaries enrolled in CHAMPVA,
and the claims cost model projects expenditures for providing care to beneficiaries. According to
the VHA, the “2013 CHAMPVA Model was developed using data from fiscal years 2005 to 2012,
publically available research, and input from a development team (including subject matter
experts from VHA and VHA’s CHAMPVA program).”36
Table 3 provides a detailed timeline for formulating the FY2015 budget request and the FY2016
advance appropriations request.


32 The Veterans’ Health Care Eligibility Reform Act of 1996 (P.L. 104-262) required the VHA to manage the provision
of hospital care and medical services through an enrollment system based on a system of priorities.
33 Department of Veterans Affairs, FY2014 Budget Submission, Medical Programs and Information Technology
Programs, Volume 2 of 4, February 2013, p. 1A-6.
34 VHA uses methodologies other than the EHCPM to develop estimates of the amount of resources needed for state-
based long-term care programs, readjustment counseling, legislation recently enacted, expansions to homeless veterans
programs, and care provided to non-veterans patients.
35 For more information on CHAMPVA see, CRS Report RS22483, Health Care for Dependents and Survivors of
Veterans, by Sidath Viranga Panangala.
36 Department of Veterans Affairs, FY2015 Budget Submission, Medical Programs and Information Technology
Programs, Volume 2 of 4, March 2014, p. VHA-46.
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Table 3. Department of Veterans Affairs, Budget Formulation Time Line
(FY2015 budget request)
Month, Year
Activity
April, 2013
VA issues internal call letter for FY2015/FY2016 budget
proposals.
May, 2013
VA Administrations (VBA; VHA; and NCA) develop
FY2015 budget, program, and legislative proposals; VHA
also develops the FY2016 Advance Appropriations
request for medical care.
June, 2013
VA construction budget proposals for FY2015 prioritized
through Strategic Capital Investment Planning (SCIP)
process.
July, 2013
VA leadership considers the FY2015/FY2016 budget
proposals.
August, 2013
VA prepares the budget submission to Office of
Management and Budget (OMB)
September, 2013
VA submits 2015 budget to OMB and the FY2016
Advance Appropriations request for medical care.
November, 2013
VA receives OMB Passback of 2015/2016 budget
decisions.
December, 2013
VA and OMB reach agreement on budget amounts.
January, 2014
VA prepares the FY2015 Congressional Budget
Submissions.
February, 2014a
President’s FY2015 Budget Request and the Advance
Appropriations request for medical care for FY2016
Submitted to Congress.


Source: Table prepared by CRS based on U.S. Congress, House Committee on Veterans' Affairs, U.S.
Department of Veterans Affairs Budget Request For Fiscal Year 2013,112th Congress, 2nd session, February 15, 2012,
p. 143.
a. The President’s FY2014 budget request was submitted in March 2014.
Funding for the VHA
As noted previously, VHA is funded through four appropriations accounts. These are
supplemented by other sources of revenue. Although the appropriations account structure has
been subject to change from year to year, the appropriation accounts used to support the VHA
traditionally include medical care, medical and prosthetic research, and medical administration.
Congress also appropriates funds for construction of medical facilities through a larger
appropriations account for construction for all VA facilities. In FY2004, “to provide better
oversight and [to] receive a more accurate accounting of funds,” Congress changed the VHA’s
appropriations structure.37 Specifically, the Department of Veterans Affairs and Housing and
Urban Development and Independent Agencies Appropriations Act, 2004 (P.L. 108-199,

37 U.S. Congress, Conference Committees, Consolidated Appropriations Act, 2004, conference report to accompany
H.R. 2673, 108th Cong., 1st sess., H.Rept. 108-401, p. 1036.
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H.Rept. 108-401), funded VHA through four accounts: (1) medical services, (2) medical
administration (currently known as medical support and compliance), (3) medical facilities, and
(4) medical and prosthetic research. Brief descriptions of these accounts are provided below.
Medical Services
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;
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
operations;38 aid to state veterans’ homes; and assistance and support services for family
caregivers of veterans authorized by the Caregivers and Veterans Omnibus Health Services Act of
2010 (P.L. 111-163). For FY2013, the President’s budget request proposed the transfer of
funding for biomedical engineering services from the medical facilities account to this account.39
The Consolidated and Further Continuing Appropriations Act, 2013 (P.L. 113-6), approved this
transfer. The President’s budget request for FY2014 proposed to continue funding for biomedical
engineering services in the medical services account. The Military Construction and Veterans
Affairs, and Related Agencies Appropriations bill for FY2014 (H.R. 2216; H.Rept. 113-90) that
was passed by the House of Representatives June 4, 2013, and the Senate Appropriations
Committee reported version of H.R. 2216 (S.Rept. 113-48) continued this transfer for FY2014.
The Military Construction, Veterans Affairs, and Related Agencies Appropriations Bill, 2015
(H.R. 4486) continues to fund bioengineering services under the medical services account.
Medical Support and Compliance (Previously
Medical Administration)
This account provides for expenses related to the management, security, and administration of the
VA health care system through the operation of VA medical centers, and other medical facilities
such as community-based outpatient clinics (CBOCs) and Vet Centers.40 It also funds 21 Veterans
Integrated Service Network (VISN)41 offices and facility director offices; chief of staff
operations; public health and environmental hazard programs; quality and performance
management programs; medical inspection; human research oversight; training programs and
continuing education; security; volunteer operations; and human resources management.

38 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 support hospital food service workers,
provisions, and supplies related to the direct care of patients.
39 Biomedical engineering services include the maintenance and repair of all medical equipment used in the treatment,
monitoring, diagnosis, or therapy of patients.
40 Vet Centers are community-based counseling centers that provide a wide range of social and psychological services
such as professional readjustment counseling to veterans who have served in a combat zone, military sexual trauma
(MST) counseling, bereavement counseling for families who experience an active duty death, substance abuse
assessments and referral, medical referral, veterans’ benefits explanation and referral, and employment counseling,
among other services.
41 VISN offices provide management and oversight to the medical centers and clinics within their assigned geographic
areas. Each VISN office is responsible for allocating funds to facilities, clinics, and programs within its region and
coordinating the delivery of health care to veterans.
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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
funds leases, laundry services, grounds maintenance, trash removal, housekeeping, fire
protection, pest management, and property disposition and acquisition.
Medical and Prosthetic Research
As required by law, the medical and prosthetic research program (medical research) focuses on
research into the special health care needs of veterans.42 This account provides funding for many
types of research, such as investigator-initiated research; mentored research; large-scale, multi-
site clinical trials; and centers of excellence. VA researchers receive funding not only through this
account but also from the Department of Defense (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 investigators
at VA facilities and approved off-site locations. Unlike other federal agencies, such as NIH and
DOD, VA does not have the statutory authority to make research grants to colleges and
universities, cities and states, or any other non-VA entities.
Medical Care Collections Fund (MCCF)
In addition to the appropriations accounts mentioned above, 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.43 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. VA is expecting MCCF total collections to be approximately $2.5 billion
in 2015.

42 38 U.S.C. §7303(a)(3). The Office of Research and Development (ORD) within the Veterans Health Administration
(VHA) manages the medical research program. The medical research program encompasses, among other things,
biomedical laboratory research, clinical trials, health services research, and rehabilitation research.
43 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), 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.
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FY2014 Budget Summary44
Consolidated Appropriations Act, 2014 (P.L. 113-76)
House and Senate Action
Congress was unable to complete action on any of the FY2014 appropriation acts prior to the
beginning of the new fiscal year. Lawmakers also failed to agree on language in a FY2014
continuing resolution (CR). With no agreement in place on October 1, 2013, the resulting lapse in
funding led to a partial shutdown of government operations. Congress finally reached agreement
on a temporary CR on October 16, 2013, and the President signed the Continuing Appropriations
Act, 2014 (P.L. 113-46) the following day to reopen the government. That CR (P.L. 113-46)
funded most of the VA (excluding the three medical care accounts: medical services, medical
support and compliance, and medical facilities) through January 15, 2014. P.L. 113-73 extended
the CR through January 18, allowing extra time for legislative consideration of an omnibus
appropriation bill. On January 17, 2014, the President signed into law the Consolidated
Appropriations Act, 2014 (P.L. 113-76). Division J of this act included the Military Construction
and Veterans Affairs, and Related Agencies Appropriations Act, 2014 (MILCON-VA
Appropriations Act, 2014).
In total the MILCON-VA Appropriations Act, 2014 provides a total of $147.9 billion in budget
authority for VA programs in FY2014. Of this amount $54.9 billion is provided for VHA which
comprises four accounts: medical services, medical support and compliance, medical facilities,
and medical and prosthetic research accounts. P.L. 113-76 provides $40 million for FY2014 for
the medical services account in addition to the advance appropriation of $43.6 billion which was
provided in P.L. 113-6 (see Table 5). Furthermore, the MILCON-VA Appropriations Act, 2014
provides $85 million for FY2014 for the medical facilities account in addition to the advance
appropriation of $4.9 billion provided in P.L. 113-6. This additional funding will be used to
address the backlog of non-recurring maintenance needs at existing VA hospitals and clinics. As
required by the Veterans Health Care Budget Reform and Transparency Act of 2009 (P.L. 111-81),
the MILCON-VA Appropriations Act, 2014 provides advance appropriations of $55.6 billion for
FY2015 for three VHA accounts (medical services, medical support and compliance, and medical
facilities). Furthermore, P.L. 113-76 rescinds $229 million from the FY2014 VHA accounts (see
Table 5).45

44 For a detailed discussion of the VHA appropriations for FY2014, see CRS Report R43179, Veterans’ Medical Care:
FY2014 Appropriations, by Sidath Viranga Panangala.
45 Section 226 of Division J of P.L. 113-76 rescinds FY2014 medical account funding and re-appropriates it to be
available for two years. The provision rescinds and re-appropriates $1,400,000,000 for the medical services account,
rescinds $150,000,000 for the medical support and compliance account and re-appropriates $100,000,000 for that
account, and rescinds and re-appropriates $250,000,000 for medical facilities account (Explanatory Statement
Regarding the House Amendment to the Senate Amendment on H.R. 3547, Consolidated Appropriations Act, 2014,”
House, Congressional Record, vol. 160, Book II (January 15, 2014), p. H1150.).
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FY2015 VHA Budget
President’s Request
The President submitted his FY2015 budget request to Congress in March 2014. The FY2015
President’s Budget is requesting $158.6 billion for the VA as a whole (see Table 4). For VA
medical services, the Administration’s budget is requesting $367.8 million in additional funding
above the FY2015 advance appropriations of $45 billion provided in FY2014. In total, the
President is requesting $56.6 billion for VHA for FY2015. This includes $45.4 billion for the
medical services account, $5.9 billion for the medical support and compliance account, $4.7
billion for the medical facilities account, and nearly $589 million for the medical and prosthetic
research account (see Table 5). As required by the Veterans Health Care Budget Reform and
Transparency Act of 2009 (P.L. 111-81), the President’s budget is requesting $58.6 billion in
advance appropriations for the three medical care appropriations (medical services, medical
support and compliance, and medical facilities) for FY2016 (see Table 5). This request for
advance appropriations would provide care for over 6.8 million unique patients in FY2016.
House Action
On April 3, 2014, the House Military Construction and Veterans Affairs Subcommittee approved
its version of a Military Construction and Veterans Affairs and Related Agencies Appropriations
bill for FY2015 (MILCON-VA Appropriations bill). The full House Appropriations Committee
approved a draft version of the measure by voice vote in an April 9, 2014, and the House passed
the MILCON-VA Appropriations bill for FY2015 (H.R. 4486; H.Rept. 113-416) on April 30,
2014. H.R. 4486 proposes a total of $158.2 billion for the VA (see Table 4). The total includes
$93.5 billion for mandatory programs, and $64.7 billion for discretionary programs (see Table 4).
H.R. 4486 (H.Rept. 113-416) as passed by the House proposes $56.2 billion for VHA for FY2015
(see Table 5), which comprises four accounts: medical services, medical support and compliance,
medical facilities, and medical and prosthetic research. The House-passed measure does not
include the additional funding amount of $367.8 million (above the FY2015 advance
appropriations) for the medical services account that was requested by the President for FY2015.
According to H.Rept. 113-416, “with $450 million in unobligated, balances expected to be
available and a drop of $690 million in projected medical services expenditures, the committee
believes that the identified need can be absorbed within existing resources.”46 H.R. 4486 proposes
$58.6 billion in advance FY2016 funding for the medical services, medical support and
compliance, and medical facilities accounts—the same level as the President’s request (see Table
5).

46 U.S. Congress, House Committee on Appropriations, Subcommittee on Military Construction, Veterans Affairs, and
Related Agencies, Military Construction, Veterans Affairs, And Related Agencies Appropriations Bill, 2015, report to
accompany H.R. 4486, 113th Cong., 2nd sess., April 17, 2014, H.Rept. 113-416, p. 31.
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Senate Committee Action
On May 20, 2014, the Senate Military Construction, Veterans Affairs, and Related Agencies
Subcommittee marked up its version of the MILCON-VA Appropriations bill for FY2015. The
full Senate Appropriations Committee approved the measure (H.R. 4486 ; S.Rept. 113-174) on
May 22. The committee-approved bill proposes $158.6 billion for the VA as a whole (see Table
4). This includes $93.5 billion for mandatory programs and $65.1 billion for discretionary
programs.
The MILCON-VA Appropriations bill for FY2015 (H.R. 4486; S.Rept. 113-174) approved by the
Senate Appropriations Committee proposes $56.4 billion for VHA (see Table 5). This includes
$45.1 billion for the medical services account, including an additional $1 million over the
FY2015 advanced appropriations—instead of $367.8 million as requested by the President for the
medical services account. The committee recommendation for the medical facilities account is
$4.8 billion, which includes an additional $125 million over the FY2015 advanced
appropriations. According to the committee report to accompany H.R. 4486, “the Committee
remains very concerned about the backlog of maintenance needs at existing VHA hospitals and
clinics and has included this additional funding to address this need.” 47 Additionally, the
committee recommendation includes $5.9 billion for the medical support and compliance account
and approximately $589 million for the medical and prosthetic research account. The MILCON-
VA Appropriations bill for FY2015 (H.R. 4486; S.Rept. 113-174) also proposes an advance
appropriation of $58.6 billion for medical services, medical support and compliance, and medical
facilities accounts for FY2016—the same level as the President’s request (see Table 5).
Veterans Access, Choice, and Accountability Act of 2014
(H.R. 3230; P.L. 113-146)
On August 7 2014, the President signed into law the Veterans Access, Choice, and Accountability Act of 2014.
Section 802 of P.L. 113-146 appropriated $10 billion for the Veterans Choice Fund, which would be available until
expended, and will be used for paying for a new temporary program to provide hospital care and medical services to
certain eligible veterans in non-VA facilities or through non-VA providers. This appropriation of funds provided in P.L.
113-146 is not shown in the Table 4 or Table 5 of this report.
For more information on the Veterans Access, Choice, and Accountability Act of 2014, see CRS Report R43704,
Veterans Access, Choice, and Accountability Act of 2014 (H.R. 3230; P.L. 113-146), by Sidath Viranga Panangala et al.
Continuing Appropriations Resolution, 2015 (P.L. 113-164)
Since none of the regular appropriations bills—including the Military Construction and Veterans
Affairs, and Related Agencies Appropriations bill—were passed by the end of the fiscal year, the
House and Senate passed a Continuing Appropriations Resolution (CR), 2015, on September 17
and 18, respectively. The President signed the CR into law (P.L. 113-164) on September 19, 2014.
The Continuing Appropriations Resolution will fund government agencies and programs,
including the Department of Veterans Affairs, at an across-the-board reduction of 0.0554% below
the Consolidated Appropriations Act, 2014 (P.L. 113-76). However, since P.L. 113-76 provided
advance appropriations for the VA’s medical care accounts—medical services, medical support
and compliance, and medical facilities—for FY2015, these accounts will not be affected by the

47 U.S. Congress, Senate Committee on Appropriations, The Military Construction and Veterans Affairs, and Related
Agencies Appropriations Bill, 2015, report to accompany H.R. 4486, 113th Cong., 2nd sess., May 22, 2014, p. 58.
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Continuing Appropriations Resolution, 2015 (H.J.Res. 124; P.L. 113-164). However, the across-
the-board reduction of 0.0554% will be applied to the advance appropriation accounts as well.48
The CR also includes some anomalies that affect other components of the VA: Section 142 of the
CR would provide the Veterans Benefit Administration (VBA) with a funding level49 of $2.5
billion (an increase of $58.7 million over FY2014) for administrative expenses related to
disability claims processing, and Section 143 would provide the VA’s Office of the Inspector
General with a funding level of $126.4 million (an increase of $5 million over FY2014), which
includes funds for continued investigations into potential improper conduct related to wait times
at VA facilities.50

48 Section 115 of P.L. 113-164.
49 For more a more general discussion on how CR’s provide funding for programs, see CRS Report R42647,
Continuing Resolutions: Overview of Components and Recent Practices, by Jessica Tollestrup.
50 CRS Report IN10063, Wait Times for Veterans Health Not New, by Sidath Viranga Panangala.
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Table 4. VA and VHA Appropriations, FY2014-FY2015, and Advance Appropriations, FY2016
($ in thousands)
House
Consolidated Appropriations
(H.R. 4486;
Senate Committee

Act, 2014 (P.L. 113-76)
President’s Request
H.Rept. 113-416)
(H.R. 4486; S.Rept. 113-174)
FY2015 FY2016
FY2014
FY2015
FY2015
FY2016
FY2015
FY2016
Total Department
of Veterans Affairs
(VA)
$147,934,261
—
$158,639,938
— $158,220,762
— $158,613,053
—
Total
Mandatory
$84,869,569
—
$93,512,828
— $93,512,828
— $93,512,828
—
Total
Discretionary
$63,244,692
—
$65,127,110
— $64,707,934
— $65,100,225
—
Total Veterans
Health
$54,943,664
—
$56,591,034
— $56.223,149
— $56,448,149
—
Administration
(VHA)a
Memorandum: b
Advance
appropriations
— $55,634,227 — $58,662,202 — $58,662,202
— $58,662,202
VHA
Source: Table prepared by the Congressional Research Service based on U.S. Congress, House Committee on Appropriations, Subcommittee on Military
Construction, Veterans Affairs, and Related Agencies, Military Construction, Veterans Affairs, And Related Agencies Appropriations Bill, 2015, report to accompany
H.R. 4486, 113th Congress, 2nd session, April 17, 2014, H.Rept. 113-416, pp. 6-10; and U.S. Congress, Senate Committee on Appropriations, Subcommittee on
Military Construction, Veterans Affairs, and Related Agencies, Military Construction, Veterans Affairs, And Related Agencies Appropriations Bill, 2015, report to
accompany H.R. 4486,113th Congress, 2nd session, May 22, 2014, S.Rept. 113-174, pp.111-113.
a. Includes funding for medical services, medical support and compliance, medical facilities, and medical and prosthetic research accounts, and excludes col ections
deposited into the Medical Care Collections Fund (MCCF).
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b. The Veterans Health Care Budget Reform and Transparency Act 2009 (P.L. 111-81; codified at 38 U.S.C. §117) provided for advance appropriations (appropriations
that become available one fiscal year after the fiscal year for which the appropriations act was enacted) for VA’s medical services, medical support and compliance,
and medical facilities appropriations accounts, and requires the VA to submit a request for advance appropriation with its annual congressional budget submission.
Under current budget scoring guidelines new budget authority for an advance appropriation is scored in the fiscal year in which the funds become available for
obligation. Therefore, in this table the advance appropriations budget authority for FY2015 is recorded in the FY2015 column. Likewise, the Administration’s
advance appropriations request for FY2016 and advance appropriations budget authority for FY2016 proposed in the Military Construction and Veterans Affairs, and
Related Agencies Appropriations bill, 2015 are recorded in the FY2016 column.

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Table 5. VHA Appropriations by Account, FY2014-FY2015, and Advance Appropriations, FY2016
($ in thousands)
Consolidated
Appropriations Act, 2014
House (H.R. 4486;
Senate Committee
(P.L. 113-76)
President’s Request
H.Rept. 113-416)
(H.R. 4486; S.Rept. 113-174)
Account
FY2014 FY2015
FY2015
FY2016
FY2015 FY2016
FY2015 FY2016
Medical Services
$43,557,000
—
$45,015,527
—
$45,015,527
—
$45,015,527
—
Additional funding over FY2014
40,000
— — —
—
— — —
Advance Appropriation
Additional funding over FY2015
— — 367,885
—
—
—
100,000
—
Advance Appropriation
Rescission

(179,000)
— — —
—
— — —
Subtotal Medical Services
43,418,000
—
45,383,412
—
45,015,527
—
45,115,527
—
Medical Support and Compliance
6,033,000
—
5,879,700
—
5,879,700
—
5,879,700
—
Subtotal Medical Support and
Compliance
6,033,000
— 5,879,700
—
5,879,700
—
5,879,700
—
Medical Facilities
4,872,000
—
4,739,000
—
4,739,000
—
4,739,000
—
Additional funding over FY2014
Advance Appropriation
85,000
— — —
—
— — —
Additional funding over FY2015
Advance Appropriation
— — — —
—
—
125,000
—
Subtotal Medical Facilities
4,957,000
—
4,739,000
—
4,739,000
—
4,864,000
—
Medical and Prosthetic Research
585,664
—
588,922
—
588,922
—
588,922
—
Subtotal Medical and Prosthetic
Research
585,664 —
588,922
— 588,922
—
588,922
—
Across-the-Board Administrative
Rescission
(50,000)
— — —
—
— — —
Total VHA Appropriations
(without collections)
54,943,664
—
56,591,034
—
56,223,149
—
56,448,149
—
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Consolidated
Appropriations Act, 2014
House (H.R. 4486;
Senate Committee
Account
(P.L. 113-76)
President’s Request
H.Rept. 113-416)
(H.R. 4486; S.Rept. 113-174)
Medical Care Collection Fund
2,485,000 —
2,456,000
—
2,456,000
—
2,456,000
—
(MCCF)
Total VHA Appropriations
$57,428,664
—
$59,047,034
—
$58,679,149
—
$58,904,149
—
(with collections)
Memorandum:a
FY2014 FY2015
FY2015
FY2016
FY2015 FY2016
FY2015 FY2016
Advance Appropriations
Medical Services
— $45,015,527
—
$47,603,202
—
$47,603,202
—
$47,603,202
Medical Support and Compliance
— 5,879,700
—
6,144,000
—
6,144,000
—
6,144,000
Medical Facilities
— 4,739,000
—
4,915,000
—
4,915,000
—
4,915,000
Total VHA Advance
—
$55,634,227
—
$58,662,202
—
$58,662,202
— $58,662,202
Appropriations
Source: Table prepared by the Congressional Research Service based on U.S. Congress, House Committee on Appropriations, Subcommittee on Military Construction,
Veterans Affairs, and Related Agencies, Military Construction, Veterans Affairs, And Related Agencies Appropriations Bill, 2015, report to accompany H.R. 4486, 113th Congress,
2nd session, April 17, 2014, H.Rept. 113-416, pp. 6-10; and U.S. Congress, Senate Committee on Appropriations, Subcommittee on Military Construction, Veterans
Affairs, and Related Agencies, Military Construction, Veterans Affairs, And Related Agencies Appropriations Bill, 2015, report to accompany H.R. 4486,113th Congress, 2nd
session, May 22, 2014, S.Rept. 113-174, pp. 111-113.
a. The Veterans Health Care Budget Reform and Transparency Act 2009 (P.L. 111-81; codified at 38 U.S.C. §117) provided for advance appropriations (appropriations
that become available one fiscal year after the fiscal year for which the appropriations act was enacted) for VA’s medical services, medical support and compliance,
and medical facilities appropriations accounts, and requires the VA to submit a request for advance appropriation with its annual congressional budget submission.
Under current budget scoring guidelines new budget authority for an advance appropriation is scored in the fiscal year in which the funds become available for
obligation. Therefore, in this table the advance appropriations budget authority for FY2015 is recorded in the FY2015 column. Likewise, the Administration’s
advance appropriations request for FY2016 and advance appropriations budget authority for FY2016 proposed in the Military Construction and Veterans Affairs, and
Related Agencies Appropriations bill, 2015 are recorded in the FY2016 column.

CRS-20

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Veterans’ Medical Care: FY2015 Appropriations

Appendix A. Priority Groups
Table A-1. Priority Groups and Their Eligibility Criteria
Priority Group 1
Veterans with service-connected disabilities rated 50% or more disabling
Veterans determined by VA to be unemployable due to service-connected conditions
Priority Group 2
Veterans with service-connected disabilities rated 30% or 40% disabling
Priority Group 3
Veterans who are former POWs a
Veterans awarded the Purple Heartb
Veterans in receipt of the Medal of Honorc
Veterans whose discharge was for a disability that was incurred or aggravated in the line of duty
Veterans with service-connected disabilities rated 10% or 20% disabling
Veterans awarded special eligibility classification under Title 38, U.S.C., Section 1151, “benefits for individuals disabled
by treatment or vocational rehabilitation”
Priority Group 4
Veterans who are receiving aid and attendance or housebound benefits
Veterans who have been determined by VA to be catastrophical y disabled
Priority Group 5
Nonservice-connected veterans and noncompensable service-connected veterans rated 0% disabled whose annual
income and net worth are below the established VA means test thresholds
Veterans receiving VA pension benefits
Veterans eligible for Medicaid benefits
Priority Group 6
Compensable 0% service-connected veterans
Mexican Border War veterans
Veterans solely seeking care for disorders associated with:
—exposure to herbicides while serving in Vietnam; or
—ionizing radiation during atmospheric testing or during the occupation of Hiroshima and Nagasaki; or
—for disorders associated with service in the Gulf War; or
—for any illness associated with service in combat in a war after the Gulf War or during a period of hostility
after November 11, 1998, as follows:
—Veterans discharged from active duty on or after January 28, 2003, who were enrol ed as of January 28,
2008, and veterans who apply for enrol ment after January 28, 2008, for five years post discharge
—Veterans discharged from active duty before January 28, 2003, who apply for enrol ment after January 28,
2008, until January 27, 2011
Veterans who served on active duty at Camp Lejeune in North Carolina for not less than 30 days during the period
beginning on January 1, 1957, and ending on December 31, 1987, for any of the 15 medical conditions specified in 38
U.S.C. 1710(e)(1)(F). d
Congressional Research Service
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Veterans’ Medical Care: FY2015 Appropriations

Priority Group 7
Veterans who agree to pay specified copayments with income and/or net worth above the VA means test threshold
and income below the VA national geographic income thresholds
Priority Group 8
Veterans who agree to pay specified copayments with income and/or net worth above the VA means test threshold
and the VA national geographic threshold
Subpriority a: Noncompensable 0% service-connected and enrol ed as of January 16, 2003, and who have remained
enrolled since that date and/or placed in this subpriority due to changed eligibility status
Subpriority b: Noncompensable 0% service-connected and enrol ed on or after June 15, 2009, whose income exceeds
the current VA means test threshold or VA national geographic income thresholds by 10% or less
Subpriority c: Nonservice-connected veterans enrol ed as of January 16, 2003, and who have remained enrol ed since
that date and/or placed in this subpriority due to changed eligibility status
Subpriority d: Nonservice-connected veterans enrol ed on or after June 15, 2009, whose income exceeds the current
VA means test threshold or VA national geographic income thresholds by 10% or less
Subpriority e: Noncompensable 0% service-connected veterans not meeting the above criteria (Currently not
eligible for enrollment)
Subpriority g: Nonservice-connected veterans not meeting the above criteria (Currently not eligible for
enrollment)
Source: Department of Veterans Affairs.
Notes: Service-connected disability means, with respect to disability, that such disability was incurred or
aggravated in the line of duty in the active military, naval or air service.
a. Veterans who are former Prisoners of War (POWs) are placed in Priority Group 3. This change occurred
with the enactment of the Former Prisoner of War Benefits Act of 1981(P.L. 97-37) on August 14, 1981.
b. Veterans in receipt of a Purple Heart are in Priority Group 3. This change occurred with the enactment of
the Veterans Millennium Health Care and Benefits Act (P.L. 106-117) on November 30, 1999.
c. Veterans in receipt of the Medal of Honor are in Priority Group 3. This change occurred with the
enactment of the Caregiver and Veterans Omnibus Health Services Act of 2010 (P.L. 111-163) on May 5,
2010.
d. Veterans who served on active duty at Camp Lejeune in North Carolina between January 1, 1957 and
December 31, 1987 are placed in Priority Group 6. These veterans are eligible to receive free medical care
for the following fifteen illnesses or conditions: esophageal cancer; lung cancer; breast cancer; bladder
cancer; kidney cancer; leukemia; multiple myeloma; myleodysplasic syndromes; renal toxicity; hepatic
steatosis; female infertility; miscarriage; scleroderma; neurobehavioral effects; and non-Hodgkin’s lymphoma.
This change occurred with the enactment of the Honoring America’s Veterans and Caring for Camp
Lejeune Families Act of 2012 (P.L. 112-154) on August 6, 2012.

Congressional Research Service
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Appendix B. Department of Veterans Affairs, Enacted Appropriations
FY1995-FY2014
Table B-1. Department of Veterans Affairs Enacted Appropriations, FY1995-FY1999
($ in Thousands)
FY1995
FY1996
FY1997
FY1998
FY1999

Enacted
Enacted
Enacted
Enacted
Enacted
Veterans Benefits Administration (VBA)





Compensation
and
Pensions
$17,626,892 $18,331,561 $18,671,259 $19,932,997 $21,857,058
Supplemental
—
$100,000
$928,000
$550,000
—
Readjustment
Benefits
$1,286,600 $1,345,300 $1,377,000 $1,366,000 $1,175,000
Veterans Insurance and Indemnities
$24,760
$24,890
$38,970
$51,360
$46,450
Education Loan Program Account
$196
$196
$196
$201
$207
Loan Guaranty Program Account
$78,035
$75,088
$47,901
—
—
Guaranty & Indemnity Program Account
$428,120
$569,348
$263,869
—
—
Direct Loan Program
$1,042
$487
$110
—
—
Veterans Housing Benefit Program Fund
—
—
—
$192,447
$263,587
Veterans Housing Benefit Program Fund Administrative Expenses
—
—
—
$160,437
$159,121
Vocational Rehabilitation Loan
Program

$54 $54 $49 $44 $55
Vocational Rehabilitation Loan Program Administrative Expenses
$767
$377
$377
$388
$400
Native American Veterans Housing Loan Program Administrative Expenses
$218
$205
$205
$515
$515
Subtotal VBA
$19,446,684 $20,447,506 $21,327,936 $22,254,389 $23,502,393
Veterans Health Administration (VHA)





Medical
Care
$16,232,756 $16,564,000 $17,013,447 $17,057,396 $17,306,000
Rescission
-$84,762
-$21,250
—
—
-$35,373
CRS-23

---

FY1995
FY1996
FY1997
FY1998
FY1999

Enacted
Enacted
Enacted
Enacted
Enacted
Medical Administration and Miscellaneous Operating Expenses (MAMOE)
$69,808
$63,602
$61,207
$59,860
$63,000
Rescission
-$44
-$86
—
—
-$67
Health
Professional
Scholarships
$10,386 — — —
—
Medical and Prosthetic Research
$252,000
$257,000
$262,000
$272,000
$316,000
Rescission
-$574
-$322
—
—
-$348
Medical Care Collections Fund (MCCF)
— — —
$666,579
$587,000
Subtotal VHA
$16,479,570 $16,862,944 $17,336,654 $18,055,835 $18,236,212
National Cemetery Administration (NCA)
$72,663 $72,604 $76,864 $84,183 $92,006
Rescission
-$128
-$97
—
—
-$122
Subtotal NCA
$72,535 $72,507 $76,864 $84,183 $91,884
Departmental Administration





General
Operating
Expenses
$890,600 $848,143 $827,584 $786,135 $855,661
Rescission
-$879
-$1,127
—
—
-$1,558
Office
of
Inspector
General
$31,819 $30,900 $30,900 $31,013 $36,000
Rescission
-$32
-$42
—
—
-$43
Construction,
Major
Projects
$355,612 $136,155 $250,858 $175,000 $142,300
Rescission -$32,337
-$186
-$32,100

—
-$13
Construction,
Minor
Projects
$153,540 $190,000 $175,000 $177,900 $175,000
Rescission -$634
-$260

—
—
-$16
Supplemental
—
—
—
$32,100
—
Parking Fund
$16,300
—
$12,300
—
—
Rescission
— — — —
-$23
Grants to Republic of the Philippines
$500
—
—
—
—
CRS-24

---

FY1995
FY1996
FY1997
FY1998
FY1999

Enacted
Enacted
Enacted
Enacted
Enacted
Grants for State Extended Care Facilities
$47,397
$47,397
$47,397
$80,000
$90,000
Grants for State Veterans Cemeteries
$5,378
$1,000
$1,000
$10,000
$10,000
Subtotal Departmental Administration
$1,467,264 $1,251,980 $1,312,939 $1,292,148 $1,307,308
Total Department of Veterans Affairs with MCCF
$37,466,053 $38,634,937 $40,054,393 $41,686,555 $43,137,797
Total Department of Veterans Affairs without MCCF
$37,466,053 $38,634,937 $40,054,393 $41,019,976 $42,550,797
Total Mandatory
$19,445,449 $20,446,674 $21,327,109 $22,092,804 $23,342,095
Total Discretionary with MCCF
$18,020,604 $18,188,263 $18,727,284 $19,593,751 $19,795,702
Total Discretionary without MCCF
$18,020,604 $18,188,263 $18,727,284 $18,927,172 $19,208,702
Source: Table prepared by the Congressional Research Service based on data from the Department of Veterans Affairs, Office of Management, Office of Budget.

CRS-25

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Table B-2. Department of Veterans Affairs Enacted Appropriations, FY2000- FY2004
($ in Thousands)
FY2000
FY2001
FY2002
FY2003
FY2004

Enacted
Enacted
Enacted
Enacted
Enacted
Veterans Benefits Administration (VBA)





Compensation and Pensions
$21,568,364
$22,766,276
$24,944,288
$28,949,000
$29,845,127
Supplemental
—
$589,413
$1,100,000
—
—
Readjustment
Benefits
$1,469,000 $1,634,000
$2,135,000 $2,264,808 $2,529,734
Supplemental
—
$347,000
—
—
—
Veterans Insurance and Indemnities
$28,670
$19,850
$26,200
$27,530
$29,017
Education Loan Program Account
$215
$221
$65
$71
$71
Guaranteed Transitional Housing for Homeless Veterans
$48,250
—
—
—
—
Veterans Housing Benefit Program Fund
$282,342
$165,740
$203,278
$437,522
$305,834
Veterans Housing Benefit Program Fund Administrative Expenses
$156,958
$162,000
$164,497
$168,207
$154,850
Rescission
—
-$356
-$123
-$1,093
-$914
Vocational Rehabilitation Loan
Program
$57 $52
$72 $54 $52
Vocational Rehabilitation Loan Program Administrative Expenses
$415
$432
$274
$289
$300
Rescission
—
-$1
—
-$2
-$2
Native American Veterans Housing Loan Program Administrative Expenses
$520
$532
$544
$558
$571
Rescission
—
-$1
—
-$4
-$3
Subtotal
VBA
$23,554,791 $25,685,156
$28,574,095 $31,846,939 $32,864,636
Veterans Health Administration (VHA)





Medical Care
$19,006,000
$20,281,587
$21,331,164
$23,889,304
—
Supplemental
—
—
$142,000
—
—
Rescission -$79,519
-$46,234
-$16,084
—

—
Medical Administration and Miscel aneous Operating Expenses (MAMOE)
$59,703
$62,000
$66,731
$74,716
—
CRS-26

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FY2000
FY2001
FY2002
FY2003
FY2004

Enacted
Enacted
Enacted
Enacted
Enacted
Rescission
—
-$136
-$50
-$486
—
Medical Services
— —
— —
$17,867,220
Rescission
—
—
—
—
-$103,823
Medical Administration
—
—
—
—
$5,000,000
Rescission —
—
—

—
-$29,500
Medical Facilities
—
—
—
—
$4,000,000
Rescission
—
—
—
—
-$23,600
Medical and Prosthetic Research
$321,000
$351,000
$371,000
$400,000
$408,000
Rescission
—
-$772
-$278
-$2,600
-$2,407
Medical Care Collections Fund (MCCF)
$563,755
$767,687
$1,133,214
$1,474,716
$1,708,026
Subtotal
VHA
$19,870,939 $21,415,132
$23,027,697 $25,835,650 $28,823,916
National Cemetery Administration (NCA)
$97,256 $109,889
$121,169 $133,149 $144,203
Rescission
—
-$241
-$91
-$865
—
Supplemental
—
$217
—
—
-$851
Subtotal NCA
$97,256 $109,865
$121,078 $132,284 $143,352
Departmental Administration:





General
Operating
Expenses
$912,594 $1,050,000
$1,195,728 $1,254,000 $1,283,272
Rescission
— -$2,382 -$900 -$8,151 -$7,571
Supplemental
—
—
$2,000
$100,000
—
Office of Inspector General
$43,200
$46,464
$52,308
$58,000
$62,000
Rescission
—
-$102
-$39
-$377
-$366
Construction, Major Projects
$65,140
$66,040
$183,180
$99,777
$273,190
Rescission
—
-$145
—
-$649
-$1,612
CRS-27

---

FY2000
FY2001
FY2002
FY2003
FY2004

Enacted
Enacted
Enacted
Enacted
Enacted
Construction, Minor Projects
$160,000
$162,000
$210,900
$226,000
$252,144
Rescission
—
-$366
—
-$1,469
-$1,488
Supplemental
—
$8,840
—
—
—
Parking Fund
—
—
$4,000
—
—
Rescission
—
-$14
—
—
—
Grants for State Extended Care Facilities
$90,000
$100,000
$100,000
$100,000
$102,100
Rescission
—
-$220
$25,000
-$650
-$602
Grants for State Veterans Cemeteries
$25,000
$25,000
—
$32,000
$32,000
Rescission
—
-$55
—
-$208
-$189
Subtotal Departmental Administration
$1,295,934
$1,455,060
$1,772,177
$1,858,273
$1,992,878
Total Department of Veterans Affairs with MCCF
$44,818,920 $48,665,214
$53,495,047 $59,673,147 $63,824,783
Total Department of Veterans Affairs without MCCF
$44,255,165 $47,897,527 52,361,833 $58,198,431 $62,116,757
Total Mandatory
$23,348,376 $25,522,279
$28,408,766 $31,678,860 $32,709,712
Total Discretionary with MCCF
$21,470,544 $23,142,935
$25,086,281 $27,994,287 $31,115,071
Total Discretionary without MCCF
$20,906,789 $22,375,248
$23,953,067 $26,519,571 $29,407,045
Source: Table prepared by the Congressional Research Service based on data from the Department of Veterans Affairs, Office of Management, Office of Budget.

CRS-28

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Table B-3. Department of Veterans Affairs Enacted Appropriations, FY2005-FY2009
($ in Thousands)
FY2005
FY2006
FY2007
FY2008
FY2009

Enacted
Enacted
Enacted
Enacted
Enacted
Veterans Benefits Administration (VBA)





Compensation and Pensions
$32,607,688
$33,897,787
$38,172,360
$41,236,322
$43,111,681
Supplemental
—
—
—
—
$700,000
Readjustment Benefits
$2,556,232
$3,309,234
$3,262,006
$3,300,289
$3,832,944
Veterans Insurance and Indemnities
$44,380
$45,907
$49,850
$41,250
$42,300
Veterans Housing Benefit Program Fund
$43,784
$64,586
$66,234
$17,389
$2,000
Credit Subsidy
—
—
—
-$108,000
—
Veterans Housing Benefit Program Fund Administrative Expenses
$154,075
$153,575
$154,284
$154,562
$157,210
Rescission
-$1,233
—
—
—
—
Vocational Rehabilitation Loan Program
$47
$53
$53
$71
$61
Vocational Rehabilitation Loan Program Administrative Expenses
$311
$305
$306
$311
$320
Rescission
-$2.865
—
—
—
—
Native American Veterans Housing Loan Program Administrative Expenses
$571
$580
$584
$628
$646
Rescission
-$4.569
—
—
—
—
Subtotal VBA
$35,405,848
$37,472,027
$41,705,677
$44,642,822
$47,847,162
Veterans Health Administration (VHA)



Medical Services
$19,472,777 $21,322,141 $25,518,254 $29,104,220
$30,969,903
Budget Supplemental
$1,500,000
$1,225,000
$466,800
—
—
Hurricane Supplemental
$38,783
$198,265
—
—
—
Pandemic Influenza Supplemental
—
$27,000
—
—
—
Rescission
-$155,782
—
—
—
—
CRS-29

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FY2005
FY2006
FY2007
FY2008
FY2009

Enacted
Enacted
Enacted
Enacted
Enacted
Total Medical Services
$20,855,778
$22,772,406
$25,985,054
$29,104,220
$30,969,903
Medical Administration
$4,705,000
$2,858,442
$3,177,968
$3,517,000
$4,450,000
Supplemental
$1,940
—
$250,000
—
—
Rescission
-$37,640
—
—
—
—
Medical Facilities
$3,745,000
$3,297,669
$3,569,533
$4,100,000
$5,029,000
Supplemental
$46,909
—-
$595,000
—
$1,000,000
Rescission
-$29,960
—
—
—
—
Medical and Prosthetic Research
$405,593
$412,000
$413,980
$480,000
$510,000
Supplemental
—
—
$32,500
—
—
Rescission
-$3,245
—
—
—
—
Medical Care Collections Fund (MCCF)
$1,953,020 $2,170,000 $2,198,154 $2,414,000
$2,544,000
Subtotal VHA
$31,642,395
$31,510,517
$36,222,190
$39,615,220
$44,502,903
National Cemetery Administration (NCA)
$148,925 $156,447 $160,747 $195,000
$230,000
Rescission
-$1,191
—
—
—
$50,000
Supplemental
$50
$200
—
—

Subtotal NCA
$147,784
$156,647
$160,747
$195,000
$280,000
Departmental Administration:




General Operating Expenses
$1,324,753
$1,410,520
$1,481,472
$1,605,000
$1,801,867
Rescission
-$10,598
—
—
—
—
Supplemental
$545
$24,871
$83,200
$100,000
$157,100
Filipino Veterans Equity Compensation Fund
—
—
—
—
$198,000
Office of Inspector General
$69,711
$70,174
$70,641
$80,500
$87,818
Rescission
-$558
—
—
—
$1,000
Information Technology
—
$1,213,820
$1,213,820
$1,966,465
$2,489,391
CRS-30

---

FY2005
FY2006
FY2007
FY2008
FY2009

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

CRS-31

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Table B-4. Department of Veterans Affairs Enacted Appropriations, FY2010-FY2014
($ in Thousands)
FY2010
FY2011
FY2012
FY2013
FY2014
Enacted
Enacted
Enacted
Enacted
Enacted
Veterans Benefits Administration (VBA)
Compensation
and
Pensions
$47,396,106 $53,978,000 $51,237,567 $60,599,855
$71,476,104
Readjustment
Benefits
$9,232,369 $10,396,245 $12,108,488 $12,023,458
$13,135,898
Veterans Insurance and Indemnities
$49,288
$77,589
$100,252
$104,600
$77,567
Veterans Housing Benefit Program Fund
$23,553
$19,078
$318,612
$184,859
—
Veterans Housing Benefit Program Fund Administrative Expenses
$165,082
$165,082
$154,698
$157,605
$158,430
Rescission
—
-$330
—
—
—
Vocational Rehabilitation Loan
Program
$29 $29 $19 $19
$5
Rescission
—
-$1
—
—
—
Vocational Rehabilitation Loan Program Administrative Expenses
$328
$337
$343
$346
$354
Rescission
—
-$10
—
—
—
Native American Veterans Housing Program Administrative Expenses
$664
$707
$1,116
$1,087
$1,109
Rescission
—
-$44
—
—
—
Subtotal
VBA
$56,867,419 $64,636,683 $63,921,095 $73,071,830
$84,849,467
Veterans Health Administration (VHA)





Medical Services
$34,707,500 $37,136,000 $39,649,985 $41,509,000
$43,557,000
Budget Supplemental
—
—
—
— $40,000
Hurricane Supplemental
— — —
$21,000
—
Rescission
—
-$74,272
—
-$14,937
-$179,000
Total Medical Services
$34,707,500 $37,061,728 $39,649,985 $41,515,063
$43,418,000
Medical
Administration
$4,930,000 $5,307,000 $5,535,000 $5,746,000
$6,033,000
CRS-32

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FY2010
FY2011
FY2012
FY2013
FY2014
Enacted
Enacted
Enacted
Enacted
Enacted
Rescission
—
-$44,546
—
-$2,039
-$50,000
Medical
Facilities
$4,859,000 $5,740,000 $5,426,000 $5,441,000
$4,872,000
Supplemental
—
—
—
$6,000
$85,000
Rescission
—
-$26,450
—
-$1,991
—
Medical and Prosthetic Research
$581,000
$590,000
$581,000
$581,905
$585,664
Rescission
—
-$10,162
—
—
—
Medical Care Collections Fund (MCCF)
$2,847,565 $2,775,214 $2,830,302 $2,903,092
$2,935,000
Subtotal VHA
$47,925,065 $51,392,784 $54,022,287 $56,189,031
$57,878,664
National Cemetery Administration (NCA)
$250,000 $250,000 $250,934 $258,284
$250,000
Rescission
—
-$500
—
-$341
-$1,000
Supplemental
—
—
—
$2,100
—
Subtotal NCA
$250,000 $249,500 $250,934 $260,043
$249,000
Departmental Administration:

VBA - General Operating Expenses
$2,086,707
$2,622,110
$2,018,764
$2,164,074
$2,465,490
Rescission
-$6,100
-$87,834
—
-$2,856
—
General
Administration
—
— $416,737 $424,737
$415,885
Rescission
—
—
—
-$561
-$2,000
Office
of
Inspector
General
$109,000 $109,367 $112,391 $114,848
121,411
Rescission
—
-$585
—
—
—
Information
Technology
$3,307,000 $3,307,000 $3,111,376 $3,323,053
$3,703,344

Supplemental
—
-$166,396 — —
—
Construction, Major Projects
$1,194,000
$1,151,036
$589,604
$531,767
$342,130
Rescission
—
-$2,302
—
—
—
CRS-33

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FY2010
FY2011
FY2012
FY2013
FY2014
Enacted
Enacted
Enacted
Enacted
Enacted
Construction,
Minor
Projects
$703,000 $467,700 $482,386 $606,728
$714,870
Rescission
—
-$935
—
—
—
Grants for State Extended Care Facilities
$100,000
$85,000
$85,000
$84,888
$85,000
Rescission
—
-$170
—
—
—
Grants for State Veterans Cemeteries
$46,000
$46,000
$46,000
$45,939
$46,000
Rescission
—
-$92
—
—
—
Subtotal
Departmental
Administration
$7,539,607 $7,529,899 $6,862,258 $6,871,298
$7,892,130
Total Department of Veterans Affairs with MCCF
$112,582,091 $123,808,866 $125,056,574 $136,392,201
$150,869,261
Total Department of Veterans Affairs without MCCF
$109,734,526
$121,033,652
$122,226,272
$133,489,109
$147,934,261
Total Mandatory
$56,701,316 $64,470,912 $63,764,919 $72,912,772
$84,689,569
Total Discretionary with MCCF
$55,880,775 $59,338,338 $61,291,655 $63,479,429
$66,179,692
Total Discretionary without MCCF
$53,033,210 $56,563,124 $58,461,353 $60,576,337
$63,244,692
Source: Table prepared by the Congressional Research Service based on data from the Department of Veterans Affairs, Office of Management, Office of Budget.

CRS-34

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Veterans’ Medical Care: FY2015 Appropriations


Author Contact Information
Sidath Viranga Panangala
Specialist in Veterans Policy
spanangala@crs.loc.gov, 7-0623

Acknowledgments
Austin R. Frerick, a Research Assistant in the Domestic Social Policy Division, provided assistance with
preparing the tables in this report.
Congressional Research Service
35

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