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

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
Analyst in Health Policy
expenses.

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

the FY2020-enacted amount for the VA of $237.5 billion—which includes regular appropriations
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
Coronavirus Aid, Relief, and Economic Security Act (P.L. 116-136)—this is an increase of $2.752 billion. Additionally, the
budget request includes an advance appropriation request of $239.5 billion for FY2022 to fund the seven advance
appropriations accounts—compensation and pensions, readjustment benefits, insurance and indemnities, medical services,
medical community care, medical support and compliance, and medical facilities.
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 and Veterans Affairs, and Related Agencies
(MILCON-VA) appropriations bill, and the draft bill was approved. On July 9, the House Appropriations Committee held a
markup of the FY2021 MILCON-VA appropriations bill and the bill was ordered reported to the full House on July 13 (H.R.
7609; H.Rept. 116-445). The committee reported bill provides a total of $240.2 billion for the VA, this is a $2.718 billion
increase over the FY2020 enacted amount of $237.5 billion and about $35 million less than the President’s request. The
committee reported bill has designated $12.5 billion from the total amount provided to the department ($240.2 billion) as
emergency funding for VA health care, Electronic Health Record Modernization (EHRM) among others. Comparative
funding levels with amounts enacted for FY2020 and amounts requested and recommended for FY2021 are as follows:
Veterans Benefits Administration (VBA, including General Operating Expenses)
 FY2020 Enacted: $128.7 billion
 FY2021 Request: $138.8 billion
 FY2021 House Committee (H.Rept. 116-445): $138.8 billion
Veterans Health Administration (VHA)
 FY2020 Enacted: $97.9 billion
 FY2021 Request: $90.8 billion
 FY2021 House Committee (H.Rept. 116-445): $90.8 billion
National Cemetery Administration (NCA)
 FY2020 Enacted: $328 million
 FY2021 Request: $360 million
 FY2021 House Committee (H.Rept. 116-445): $349 million
Departmental Administration
 FY2020 Enacted: $10.6 billion
 FY2021 Request: $10.3 billion
 FY2021 House Committee (H.Rept. 116-445): $10.3 billion
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Appendixes
Appendix A. Veteran Population, VA Enrollees, and VA Patients, FY2000-FY2021 ................... 24
Appendix B. Department of Veterans Affairs, Enacted Appropriations FY1995-FY2020 ............ 25

Contacts
Author Information ........................................................................................................................ 38

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Introduction
The Department of Veterans Affairs (VA) provides a range of benefits and services to veterans
who meet certain eligibility criteria. These benefits and services include, among other things,
hospital and medical care;1 disability compensation and pensions;2 education;3 vocational
rehabilitation and employment services;4 assistance to homeless veterans;5 home loan
guarantees;6 administration of life insurance, as well as traumatic injury protection insurance for
servicemembers; and death benefits that cover burial expenses.7
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
care services and medical and prosthetic research programs. The Veterans Benefits
Administration (VBA) is responsible for, among other things, providing compensation, pensions,
and education assistance. The National Cemetery Administration (NCA)8 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 BVA reviews all appeals made by veterans or their
representatives for entitlement to veterans’ benefits, including claims for service connection,
increased disability ratings, pensions, insurance benefits, and educational benefits, among other
things.
Scope and Limitations of This Report
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
constitute the VA’s budget, followed by a brief overview of the FY2020 congressional
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
veterans and administration of the department and congressional consideration. The report
provides funding levels for the accounts as presented in the Military Construction, Veterans
Affairs, and Related Agencies (MILCON-VA) appropriations bill; it does not provide funding
levels at the subaccount, program, or activity levels. Appendix B lists appropriations to the VA
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

1 For more information on programs, see CRS Report R42747, Health Care for Veterans: Answers to Frequently Asked
Questions.
2 For more information on programs, see CRS Report R44837, Benefits for Service-Disabled Veterans; and CRS Report
RS22804, Veterans’ Benefits: Pension Benefit Programs.
3 For a discussion of education benefits, see CRS Report R42755, The Post-9/11 GI Bill: A Primer.
4 For details on VA’s vocational rehabilitation and employment, see CRS Report RL34627, Veterans’ Benefits: The
Vocational Rehabilitation and Employment Program.
5 For detailed information on homeless veterans programs, see CRS In Focus IF10167, Veterans and Homelessness.
6 For details on the home loan guarantee program, see CRS Report R42504, VA Housing: Guaranteed Loans, Direct
Loans, and Specially Adapted Housing Grants.
7 For more information on burial benefits, see CRS Report R41386, Veterans’ Benefits: Burial Benefits and National
Cemeteries.
8 Established by the National Cemeteries Act of 1973 (P.L. 93-43).
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shown in Table 1, which is based on budget authority amounts shown in the committee reports
accompanying the MILCON-VA appropriations bill.
The Department of Veterans Affairs Budget
The VA budget includes both mandatory9 and discretionary funding.10 Mandatory accounts fund
disability compensation for veterans, the survivor’s Dependency and Indemnity Compensation
(DIC) program, pensions, vocational rehabilitation and employment, education, life insurance,
housing, clothing allowances, and burial benefits (such as burial allowances, grave liners, outer
burial receptacles, and headstones and markers), among other benefits and services. Discretionary
accounts fund medical care, medical research, construction programs, information technology, the
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
Fund and the Pershing Hall Revolving Fund; trust funds, such as the Department of Veterans
Affairs Cemetery Gift Fund and the General Post Fund; and special funds, such as the Medical
Care Collections Fund and the Capital Asset Fund.11
Advance Appropriations12
The VA has advance appropriation authority for specified medical care and benefits accounts. In
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
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
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
within the Veterans Benefits Administration: compensation and pensions, readjustment benefits,
and veterans insurance and indemnities. Beginning with the FY2016 Military Construction and
Veterans Affairs, and Related Agencies Appropriations Act (MILCON- VA; P.L. 114-113), those
accounts received advance appropriations for the first time in FY2017, in addition to the three
VHA accounts already authorized to receive advance appropriations.
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

9 Mandatory programs funded through the annual appropriations process are commonly referred to as appropriated
entitlements. In general, appropriators have little control over the amounts provided for appropriated entitlements;
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 R44641, Trends in Mandatory Spending: In Brief.
10 Funding for discretionary programs is provided and controlled through the annual appropriations process. For more
information, see CRS Report R41726, Discretionary Budget Authority by Subfunction: An Overview.
11 For more details about these funds, see Department of Veterans Affairs, FY2016 Congressional Budget Submission,
Supplemental Information and Appendices, vol. 1 of 4, February 2015, pp. Appendix 117-Appendix 126. (This is the
last edition in which this information was published.) For definitions about “revolving funds,” “trust funds,” and
“special funds,” see Executive Office of the President, Office of Management and Budget (OMB), OMB Circular No.
A–11, Section 20- Terms and Concepts, available at https://www.whitehouse.gov/wp-content/uploads/2018/06/s20.pdf.
12 For a detailed discussion of advance appropriations, see CRS Report R43482, Advance Appropriations, Forward
Funding, and Advance Funding: Concepts, Practice, and Budget Process Considerations.
13 Codified at 38 U.S.C. §117.
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care, beginning with the FY2017 appropriations cycle. The Jeff Miller and Richard Blumenthal
Veterans Health Care and Benefits Improvement Act of 2016 (P.L. 114-315) authorized advanced
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
appropriations of new budget authority for these VBA and VHA accounts to prevent potential
delays in the delivery of care and benefits to veterans that may arise in the event of a funding
lapse.
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
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
numbers are noted by the label “memorandum” and in the corresponding fiscal year column.
Historical Perspective
Figure 1 provides funding trends for mandatory, discretionary, and total VA-enacted
appropriations from FY1995 through FY2020. Between FY1995 and FY2020, total mandatory
appropriations grew from $19.5 billion to $124.7 billion in nominal dollars, a compound annual
growth rate (CAGR) of 7.7%.15 During this same period, discretionary appropriations grew from
$18.0 billion to $112.1 billion, a CAGR of 7.6%. The total VA appropriations from FY1995
through FY2020 grew from $37.5 billion to $236.8 billion, a CAGR of 7.7%.
Figure 1. VA Appropriations, FY1995-FY2020

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

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

16 The full legislative text and the explanatory statement of P.L. 116-94 is contained in the House Committee Print
Further Consolidated Appropriations Act, 2020, https://www.govinfo.gov/content/pkg/CPRT-116HPRT38679/pdf/
CPRT-116HPRT38679.pdf.
17 For more details on the VA’s and Congress’s response to the COVID-19 pandemic, see CRS Report R46340,
Federal Response to COVID-19: Department of Veterans Affairs.
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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
included an emergency supplemental appropriations measure. Title X of Division B provides
supplemental appropriations for FY2020, designated as emergency spending, for certain VA
accounts totaling $19.6 billion. Unless otherwise noted below, funds remain available until
September 30, 2021. Funding provided in the CARES Act is broken down as follows (see Table
1):18
 VHA, medical services account, $14.4 billion, for increased telehealth services;
purchasing of additional medical equipment and supplies, testing kits, and
personal protective equipment; and to provide additional support to homeless
veterans, among other things.
 VA, information technology systems account, $2.2 billion, for increased telework
capacity, purchasing additional laptops for telework and telehealth-enabled
laptops for VHA providers to work from home, and to increase bandwidth and IT
infrastructure needs, among other things
 VHA, medical community care account, $2.1 billion, for increased emergency
room and urgent care usage in the community.
 VHA, medical facilities account, $606 million, for the procurement of mobile
treatment facilities, improvements in security, and nonrecurring maintenance
projects.
 VA, grants for construction of state extended care facilities account, $150.0
million, to help state homes renovate, alter, or repair facilities to respond to
COVID-19.
 VHA, medical support and compliance account, $100 million, for the provision
of 24-hour emergency management coordination overtime payments, and for
costs associated with travel and transport of materials.
 VBA, general operating expenses account, $13.0 million, for enhancing telework
support for VBA staff and for additional cleaning contracts.
 VA, Office of Inspector General account, $12.5 million, for increased oversight
of the VA’s preparation and response to COVID-19 (funds remain available until
September 30, 2022).
 VA, general administration account, $6.0 million, for maintaining 24-hour
operations of crisis response and continuity of operations plans at VA facilities,
among other things.

18 Based on Senate Appropriations Committee, Coronavirus Supplemental Appropriations Summary, available at
https://www.appropriations.senate.gov/download/coronavirus-emergency-supplemental-appropriations-summary.
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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.
116-94); the Families First Coronavirus Response Act (P.L. 116-127); the Coronavirus Aid, Relief, and Economic
Security Act (P.L. 116-136) and U.S. Congress, House Committee on Appropriations, 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. 131-141.
Notes: Total budget authority excludes offsetting col ections deposited in the Medical Care Col ections Fund
(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’s budget is requesting $240.2 billion for the VA. This amount includes $135.4 billion in
mandatory benefits funding and $104.8 billion in discretionary funding. When compared with the
FY2020-enacted amount for the VA of $237.5 billion—which includes regular appropriations
provided by the Further Consolidated Appropriations Act, 2020 (P.L. 116-94), and supplemental
funding provided by the Families First Coronavirus Response Act (P.L. 116-127) and the
Coronavirus Aid, Relief, and Economic Security Act (P.L. 116-136)—this an increase of $2.752
billion. Additionally, the Administration’s budget request includes an advance appropriation
request of $239.5 billion for FY2022 to fund the seven advance appropriations accounts—
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compensation and pensions, readjustment benefits, insurance and indemnities, medical services,
medical community care, medical support and compliance, and medical facilities. Figure 3
provides the FY2021 President’s requested mandatory and discretionary appropriations by major
program.
Figure 3. Budget Request, FY2021, by Major Program and Spending Category

Source: Figure prepared by CRS based on U.S. Congress, House Committee on Appropriations, 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. 131-141.
Notes: Total budget authority excludes offsetting col ections deposited in the Medical Care Col ections Fund
(MCCF). Percentages may not add up due to rounding.
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 (MILCON-VA) appropriations bill, and the
draft bill was approved. On July 9, the House Appropriations Committee held a markup of the
FY2021 MILCON-VA appropriations bill and the bill was ordered reported to the full House on
July 13 (H.R. 7609; H.Rept. 116-445). The committee reported bill provides a total of $240.2
billion for the VA, this is a $2.718 billion increase over the FY2020 enacted amount of $237.5
billion and about $35 million less than the President’s request. The committee reported bill (H.R.
7609; H.Rept. 116-445) has designated $12.5 billion from total amount provided to the VA
($240.2 billion) as emergency funding. A discussion on funding for major accounts is provided
below.
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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.
Compensation and Pensions
The Compensation and Pensions category includes payments for benefits such as disability
compensation; dependency and indemnity compensation (DIC); pension benefits for low-income
disabled or elderly wartime veterans and their survivors; burial benefits (allowances, flags,
headstones, etc.); and a clothing allowance for certain disabled veterans.
For FY2021, the VA requested $121.1 billion for the Compensation and Pensions account, an
increase of $2.8 billion over the FY2021 advanced appropriations. The largest portion of this
budget item is disability compensation, which VA estimates to be $115.8 billion in compensation
payments to an estimated 5.3 million veterans, 456,000 survivors, and 1,266 children. Pension
payments are estimated to be $4.9 billion to approximately 231,100 veterans and 161,300
survivors. Finally, an estimated $355 million will be allocated for burial benefits.
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).19 In general,
the average payments for benefits, including disability compensation, pension, and survivor
benefits, are expected to increase due to the annual cost-of-living adjustment (COLA).
The House Appropriations Committee recommended amount is the same as the VA’s requested
amount for the Compensation and Pension account for FY2021 (see Table 1). This amount is
$10.6 billion over the FY2020 enacted amount and reflects the increased number of disability
compensation claims that will be granted and paid out on a monthly basis. These funds will also
continue to support VA programs to address root causes of veterans’ financial hardships and to
improve communications with Veterans Service Organizations (VSOs).20
Readjustment Benefits
The Readjustment Benefits category reflects several benefits related to the transition of
servicemembers from active duty status to veteran status, as well benefits for disabled veterans.
Some of these programs include education benefits for veterans, survivors, and dependents;
vocational rehabilitation and employment training for service-connected disabled veterans; and
financial assistance for adaptive automobiles, equipment, and housing grants for disabled
veterans.
For FY2021, the VA requested appropriations of $12.6 billion to provide sufficient mandatory
funding for Readjustment Benefits, approximately $1.5 billion less than the amount enacted in
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).21

19 For more information, see CRS In Focus IF11368, Expansion of Benefits to Blue Water Navy Vietnam Veterans.
20 U.S. Congress, House Committee on Appropriations, Military Construction, Veterans Affairs, and Related Agencies
Appropriations Bill, 2021, report to accompany H.R. 7609, 116th Cong., 2nd sess., July 13, 2020, H.Rept. 116-445, pp.
36-37.
21 U.S. Department of Veterans Affairs, FY2021 Budget Submission, Benefits and Burial Programs and Departmental
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The House Appropriations Committee recommended amount is the same as the VA’s requested
amount for the Readjustment Benefits account (see Table 1) for FY2021. The committee
highlighted the importance of assistance to transitioning veterans from military life to academic,
vocational, or employment life and therefore encourage VA to continue to expand these
programs.22
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),23 Service-Disabled Veterans Insurance (S-DVI),24 and Veterans
Mortgage Life Insurance (VMLI).25
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.26 The House Appropriations Committee has recommended the same amount
for the Insurance and Indemnities account for FY2021 as requested in the Administration’s
budget request (see Table 1).27

Administration, vol. 3 of 4, February 2020, p. VBA-74, 75.
22U.S. Congress, House Committee on Appropriations, Military Construction, Veterans Affairs, and Related Agencies
Appropriations Bill, 2021, report to accompany H.R. 7609, 116th Cong., 2nd sess., July 13, 2020, H.Rept. 116-445, pp.
37-38.
23 The National Service Life Insurance (NSLI) program was created on October 8, 1940, to handle insurance needs of
World War II veterans. These policies were issued until April 24, 1951, and provided a maximum of $10,000 in
coverage. See https://www.benefits.va.gov/insurance/nsli.asp.
24 The Service-Disabled Veterans Insurance (S-DVI) program was established on April 25, 1951, and remains open for
new policies to service-connected disabled veterans who separated under other than dishonorable conditions. S-DVI
provides up to $10,000 in coverage for which premium relief is available to certain insured veterans. Up to an
additional $30,000 in supplemental coverage may be granted without a waiver of premiums. See https://www.va.gov/
life-insurance/options-eligibility/s-dvi/.
25 The Veterans Mortgage Life Insurance (NSLI) program provides veterans who meet certain requirements, including
having received a grant for specially adapted housing with up to $200,000 of mortgage protection life insurance. This
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/.
26 U.S. Department of Veterans Affairs, FY2021 Budget Submission, Benefits and Burial Programs and Departmental
Administration, vol. 3 of 4, February 2020, p. VBA-131, 133.
27 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. 40.
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Medical Care and Medical Research Discretionary
Programs Funding
Background
The Veterans Health Administration (VHA) operates one of the nation’s largest integrated direct
health care delivery systems.28 Although Medicare, Medicaid, and the Children’s Health
Insurance Program (CHIP) are also publicly funded programs, most health care services under
these programs are delivered by private providers in private facilities. In contrast, the VA health
care system could be categorized as a veteran-specific national health care system, in the sense
that the federal government owns the medical facilities and employs the health care providers.29
The VA’s health care system is organized into 18 geographically defined Veterans Integrated
Service Networks (VISNs). Although policies and guidelines are developed at VA headquarters to
be applied throughout the VA health care system, management authority for basic decision
making and budgetary responsibilities is delegated to the VISNs.30 As of FY2020, the VHA
operates 148 hospitals, 135 nursing homes, 765 community-based outpatient clinics (CBOCs),31
and 300 Readjustment Counseling Centers (Vet Centers).32 In 2009, the VA began a pilot Mobile
Vet Center (MVC) program to improve access to services for veterans in rural areas, and the
department has deployed 80 MVCs, to date.33
Although the VHA provides most health care services to eligible veterans through its integrated
network of facilities, it does pay for care in the community under certain circumstances. The
Veterans Community Care Program (VCCP) applies eligibility for care in the community broadly
to all enrolled veterans based on specific criteria.34 The VA is authorized to provide care in the
community through individual agreements with community providers, called veterans care
agreements. The VA is also authorized to reimburse for emergency care visits if specific criteria
are met.35 Inpatient and outpatient care are provided in the private sector to eligible dependents of
veterans under the Civilian Health and Medical Program of the Department of Veterans Affairs
(CHAMPVA).36 In addition, the VHA provides grants for construction of state-owned nursing

28 U.S. Department of Veterans Affairs, FY 2009 Performance and Accountability Report, Washington, DC, November
16, 2009, p. I-42. Established on January 3, 1946, as the Department of Medicine and Surgery by P.L. 79-293,
succeeded in 1989 by the Veterans Health Services and Research Administration, renamed the Veterans Health
Administration in 1991.
29 Adam Oliver, “The Veterans Health Administration: An American Success Story?” The Milbank Quarterly, vol. 85,
no. 1 (March 2007), pp. 5-35.
30 Kenneth Kizer, John Demakis, and John Feussner, “Reinventing VA health care: Systematizing Quality
Improvement and Quality Innovation,” Medical Care, vol. 38, no. 6 (June 2000), Suppl. 1:17-116.
31 For more information on CBOCs, see CRS Report R41044, Veterans Health Administration: Community-Based
Outpatient Clinics (archived).
32 Vet Centers are a nationwide system of community-based programs separate from VA medical centers (VAMCs).
Client services provided by Vet Centers include psychological counseling and psychotherapy (individual and group),
screening for and treatment of mental health issues, substance abuse screening and counseling,
employment/educational counseling, and bereavement counseling, among other services.
33 U.S. Department of Veterans Affairs, FY2021 Budget Submission, Medical Programs and Information Technology
Programs, vol. 2 of 4, February 2020, p. VHA-333.
34 For more information on the VCCP and the eligibility criteria, see CRS Report R45390, VA Maintaining Internal
Systems and Strengthening Integrated Outside Networks Act of 2018 (VA MISSION Act; P.L.115-182).
35 For more information, see CRS Report R42747, Health Care for Veterans: Answers to Frequently Asked Questions.
36 For details on CHAMPVA, see CRS Report RS22483, Health Care for Dependents and Survivors of Veterans.
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homes and domiciliary facilities37 and collaborates with DOD in sharing health care resources and
services.
Apart from providing direct patient care to veterans,38 the VHA’s other statutory missions are to
conduct medical research,39 serve as a contingency backup to the DOD medical system during a
national security emergency,40 provide support to the National Disaster Medical System and the
Department of Health and Human Services as necessary,41 and train health care professionals to
provide an adequate supply of health personnel for the VA and the nation.42
The Veteran Patient Population43
In FY2020, approximately 9.3 million of the 19.5 million living veterans in the nation were
enrolled in the VA health care system.44 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.45 For FY2021, the VHA
estimates that it will treat about 7.2 million 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 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%.
President’s Request and Congressional Action
The VA’s annual appropriations for the medical services, medical community care, medical
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
enacted. Therefore, funding levels for FY2021 for these four accounts were provided by the

37 Under the grant program, the VA may fund up to 65% of the cost of these state-owned facilities. States must fund the
remaining 35%. The law requires that 75% of the residents in a state-extended care facility must be veterans (38 U.S.C.
§§8131-8138.) All nonveteran residents must be spouses of veterans or parents of children who died while serving in
the U.S. armed forces. The VA is prohibited by law from exercising any supervision or control over the operation of a
state veterans nursing home, including setting admission criteria. Admission requirements are determined exclusively
by the state.
38 38 U.S.C. §7301(b).
39 38 U.S.C. §7303.
40 38 U.S.C. §8111A.
41 38 U.S.C. §8117(e).
42 38 U.S.C. §7302.
43 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 Technology Programs, vol. 2 of 4, February
2020, p. VHA-19. Population estimates were made before the COVID-19 pandemic. The VA response to the pandemic
has the potential to alter the estimated veteran population, enrollees, and patients in both FY2020 and FY2021.
44 In general, a veteran is required to be enrolled in the VA health care system to receive health care services, and once
a veteran is enrolled, that veteran remains enrolled in the VA health care system and maintains access to VA health
care services. For more information on enrollment, see CRS Report R42747, Health Care for Veterans: Answers to
Frequently Asked Questions.
45 A unique veteran patient 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.
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Further Consolidated Appropriations Act, 2020 (P.L. 116-94). However, in any given year the
Administration could request additional funding for the upcoming fiscal year and Congress could
revise these amounts through the annual appropriations process. Across all four accounts, the
President’s budget increases by $2.3 billion over the advance appropriations amount in FY2021.46
The VA attributes the increase largely to revised actuarial trends based on recent data. In total, the
FY2021 budget request for VHA is $95.2 billion, including medical care collections (see Table
1).47
As required by the Veterans Health Care Budget Reform and Transparency Act of 2009 (P.L. 111-
81), the President’s budget is requesting $94.2 billion in advance appropriations for the four
medical care appropriations (medical services, medical community care, medical support and
compliance, and medical facilities) for FY2022, an increase of approximately 3.85% over the
FY2021-requested amount of $90.8 billion for the same four accounts. In FY2022, the
Administration’s budget request would provide $58.9 billion for the medical services account,
$20.1 billion for medical community care, $8.4 billion for the medical support and compliance
account, and $6.7 billion for the medical facilities account (see Table 1).
Amounts requested for each VHA account for FY2021 and House Appropriations Committee
recommend funded levels are detailed in subsequent sections.
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;48 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.

46 U.S. Department of Veterans Affairs, FY2021 Budget Submission, Medical Programs and Information Technology
Programs, vol. 2 of 4, February 2020, p. VHA-9.
47 The committees on appropriations include medical care cost recovery collections when considering funding for the
VHA. Congress has provided VHA the authority to bill some veterans and most health care insurers for nonservice-
connected care provided to veterans enrolled in the VA health care system, to help defray the cost of delivering medical
services to veterans. Funds collected from first- and third-party (copayments and insurance) bills are retained by the
VA health care facility that provided the care for the veteran. The Consolidated Omnibus Budget Reconciliation Act of
1985 (P.L. 99-272), enacted into law in 1986, established means testing for veterans seeking care for nonservice-
connected conditions. The Balanced Budget Act of 1997 (P.L. 105-33) established the Department of Veterans Affairs
Medical Care Collections Fund (MCCF) and gave the VHA the authority to retain these funds in the MCCF. Instead of
returning the funds to the Treasury, the VA can use them, without fiscal year limitations, for medical services for
veterans. In FY2004, the Administration’s budget requested consolidating several existing medical collections accounts
into one MCCF. The conferees of the Consolidated Appropriations Act of 2004 (H.Rept. 108-401) recommended that
collections that would otherwise be deposited in the Health Services Improvement Fund (former name), Veterans
Extended Care Revolving Fund (former name), Special Therapeutic and Rehabilitation Activities Fund (former name),
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.
48 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.
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According to the VA, this increase reflects implementation of the Precision Oncology initiative,
as well as increased staff and funding for pain management and suicide prevention efforts.49
The House Appropriations Committee (H.Rept. 116-445) recommended amount for FY2021 and
the FY2022 advance appropriation amount for the medical services account is the same as the
President’s request (see Table 1). Within the total amount for medical services recommended for
FY2021, which is $56.7 billion, the committee has provided the following:50
 For mental health care, an additional $40 million for a total of $10.3 billion;
 For homelessness initiatives, an additional $40 million for a total of $1.9 billion;
 For rural health, an additional $30 million for a total of $300 million;
 For gender-specific care for women, an additional $35 million for a total of
$660.7 million;
 For Whole Health initiatives, an additional $20 million for a total of $83.6
million;
 For suicide prevention efforts, an additional $85.1 million for a total of $312.6
million;
 For a new Precision Oncology initiative, $75 million;
 For opioid prevention and treatment, an additional $64.7 million for a total of
$503.7 million;
 For medical equipment, $93.8 million; and
 For other committee specified initiatives, $14 million.
Additionally, the House reported bill (H.R. 7609; H.Rept. 116-445) includes new authorizing
language that would permanently authorize the use of medical services funding for assisted
reproductive technology treatment and adoption reimbursement for certain veterans with service-
connected disabilities that results in being unable to procreate without vitro fertilization (IVF)
treatment or other forms of assisted reproductive technology services.51
Medical Community Care
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
care, beginning with the FY2017 appropriations cycle. The Jeff Miller and Richard Blumenthal
Veterans Health Care and Benefits Improvement Act of 2016 (P.L. 114-315) authorized advanced
appropriations for the medical community care account. The account is intended to consolidate all
community care programs under a single appropriation, and it is the funding source for care that
the VHA provides to eligible veterans through community health care providers.

49 The Precision Oncology initiative seeks to improve cancer treatment outcomes and decrease side effects by selecting
treatments based on characteristics of the patient and the cancer. In total, the President’s budget includes $75 million to
support implementation in FY2021.
50 U.S. Congress, House Committee on Appropriations, Military Construction, Veterans Affairs, and Related Agencies
Appropriations Bill, 2021, report to accompany H.R. 7609, 116th Cong., 2nd sess., July 13, 2020, H.Rept. 116-445, p.45.
51 U.S. Congress, House Committee on Appropriations, Military Construction, Veterans Affairs, and Related Agencies
Appropriations Bill, 2021, report to accompany H.R. 7609, 116th Cong., 2nd sess., July 13, 2020, H.Rept. 116-445,
p.104. For more information on In Vitro Fertilization (IVF) services for certain veterans see, CRS In Focus IF11082,
Veterans Health Administration: Gender-Specific Health Care Services for Women Veterans.
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The President’s budget is requesting $18.5 billion for the medical community care account. This
amount is $1.4 billion over the FY2021 advance appropriated amount of $17.1 billion. This
increase is largely driven by more recent projections for community care and the cost of
establishing a community care network.52
The House reported bill (H.R. 7609; H.Rept. 116-445) has recommended the same amounts for
medical community as the FY2021 request and FY2022 advance appropriation request.
Medical Support and Compliance
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.53 The account also funds
21 Veterans Integrated Service Network (VISN)54 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.
The President’s budget is requesting $8.2 billion for the medical support and compliance account.
This amount is $300 million over the FY2021 advance appropriated amount of $7.9 billion.55
The House reported bill (H.R. 7609; H.Rept. 116-445) provides $280 million over the FY2021
advance appropriation of $7.9 billion a decrease of $20 million from the request (see Table 1).
The committee recommends $8.4 billion in advance FY2022 appropriations, same as the
requested amount.
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.
The President’s budget is requesting $6.6 billion for the medical facilities account. This amount is
$150 million over the FY2021 advance appropriated amount of $6.4 billion. This increase is
largely driven by infrastructure improvements to ensure compatibility for the Electronic Health
Record Modernization (EHRM) project.56

52 U.S. Department of Veterans Affairs, FY2021 Budget Submission, Medical Programs and Information Technology
Programs, vol. 2 of 4, February 2020, p. VHA-9.
53 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.
54 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.
55 U.S. Department of Veterans Affairs, FY2021 Budget Submission, Medical Programs and Information Technology
Programs, vol. 2 of 4, February 2020, p. VHA-9.
56 Ibid.
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House Appropriations Committee (H.Rept. 116-445) provides $170 million over the FY2021
advance appropriation, an increase of $20 million from the request for a total amount of $6.6
billion for FY2021. The committee recommends $6.7 billion in advance FY2022 appropriations,
same as the requested amount.
Medical and Prosthetic Research
As required by law, the medical and prosthetic research program (medical research) focuses on
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
clinical trials; and centers of excellence. VA researchers receive funding not only through this
account but also from DOD, the National Institutes of Health (NIH), and private sources.
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, 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.
The President’s budget is requesting approximately $787 million for the medical and prosthetic
research account, an increase of $37 million, or 5%, above the FY2020-enacted amount of $750
million. The VHA’s major research priorities in FY2021 include, among others, suicide
prevention, opioid safety and pain management, post-traumatic stress disorder (PTSD), traumatic
brain injury (TBI), mental health, and Gulf War illness.57
The House reported bill (H.R. 7609; H.Rept. 116-445) provides $840 million for FY2021 for the
medical and prosthetic research account, an increase of $53 million from the request.
Nonmedical Discretionary Programs Funding
National Cemetery Administration (NCA)
The majority of NCA’s discretionary funding falls into the Operations and Maintenance category
with 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 amount
and will provide for hiring an additional 77 full-time equivalents (FTEs).58 In addition, the
increase will help support the costs encountered with opening four new cemeteries in New York,
Indiana, Wyoming, and Utah during 2021. There are also associated expenses for an additional 11
cemeteries transferred from the Department of the Army bringing the total number of national
cemeteries to 156. Finally, the VA anticipates a 2.1% increase in the number of interments during
FY2021 compared with FY2020.59
Within the Operations and Maintenance appropriations category, VA requested funds to support
extending its historical knowledge and public outreach programs. NCA plans to implement these
efforts by continuing its digital memorial platform, which will preserve the 3.5 million veterans
interred and in future phases will allow the public to post memories and photographs of each

57 U.S. Office of Management and Budget (OMB), Appendix, Budget of the United States Government Fiscal Year
2021, Washington, DC, February 10, 2020, p. 1052.
58 U.S. Department of Veterans Affairs, FY2021 Budget Submission, Budget in Brief, February 2020, p. BiB-26-27.
59 U.S. Department of Veterans Affairs, FY2021 Budget Submission, Benefits and Burial Programs and Departmental
Administration, vol. 3 of 4, February 2020, p. NCA-18, 19.
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veteran. To complement NCA’s digital efforts, they will continue to develop onsite interpretive
signs, exhibits, and publications to increase the public’s knowledge of NCA’s history.
The House Appropriations Committee has recommended $349 million for NCA for FY2021 (see
Table 1), $11 million less than the requested amount. The committee believes that these funds
will adequately address the needs of NCA to meet their increased workload and burial
expansions, but stresses that NCA prioritize services at existing cemeteries and opening new
cemeteries for increased burial access.60 An area of concern, that the committee would like NCA
to provide reports to Congress on, is the ways VA is addressing the Prisoner of War headstones
with German inscriptions and emblems on them.61
VBA, General Operating Expenses
The VA is requesting $3.21 billion in funding for VBA general operating expenses for the
FY2021. This is an estimated $69 million increase over the enacted FY2020 budget. The largest
portion of this funding request, approximately $2.5 billion, is for the general operating expenses
associated with the compensation and pension (including burial benefits) categories.62
Within the compensation service category, an estimated $1.9 billion of VBA’s request is for FTE
salaries and benefits. This amount would provide for an additional 691 FTEs in support of the
processing and adjudication of Blue Water Navy claims. With this increase, the VBA projects
having 16,682 FTEs supporting the delivery of veterans’ compensation benefits, equating to 72%
of the program’s operating expenses.63 In addition to staffing, processing, and IT investments to
implement the Blue Water Navy Act, funding allocations will go toward implementing the
Forever GI Bill; supporting economic development initiatives along with transition assistance
programs; and funding mission-critical agency operations.64
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 2020.65
The committee recommended (H.Rept. 116-445) $3.19 billion for VBA operating expenses for
FY2021, $20 million less than VA’s request.66 The committee 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

60 U.S. Congress, House Committee on Appropriations, Military Construction, Veterans Affairs, and Related Agencies
Appropriations Bill, 2021, report to accompany H.R. 7609, 116th Cong., 2nd sess., July 13, 2020, H.Rept. 116-445, p.87.
61 For more information on this issue see CRS In Focus IF11587, Removal of Nazi Symbols and Inscriptions on
Headstones of Prisoners of War in VA National Cemeteries.
62 U.S. Department of Veterans Affairs, FY2021 Budget Submission, Supplemental Information and Appendices, vol. 1
of 4, February 2020, p. Appendix-100.
63 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.
64 U.S. Department of Veterans Affairs, FY2021 Budget Submission, Benefits and Burial Programs and Departmental
Administration, vol. 3 of 4, February 2020, p. VBA-145, 146.
65 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, https://www.whitehouse.gov/wp-content/uploads/2020/02/budget_fy21.pdf.
66 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.
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like to see VBA improve upon during FY2021 including increased timeliness in processing
claims to reduce the existing backlog; movement on determination of four presumptive conditions
associated with Agent Orange; and the implementation of the Inspector General’s
recommendations for better handling of military sexual trauma (MST) claims.67
Information Technology
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
systems and department-wide cybersecurity efforts, among other things.
For FY2021, the Administration is requesting $4.9 billion for the information technology budget.
This amount will fund IT activities across the VA, including modernizing Veterans Benefits
Management to automate Blue Water Navy veterans claims, implementing the VA MISSION Act,
implementing a new health care logistics information system, and improving cybersecurity
among other things.
The House Appropriations Committee (H.Rept. 116-445) recommends $4.9 billion for the IT
systems account, same as the Administration’s request (see Table 1). The committee
recommended amount will provide for the development of clinical applications, maintaining and
improving health management platforms, IT systems associated with veterans’ benefits and
memorial affairs, cybersecurity and information infrastructure, among others.68 Furthermore, the
committee has provided funding within the amount recommended for a digital protection
initiative to protect veterans, and Congressionally Chartered VSOs “from both foreign and
domestic threats across the digital landscape attempting to steal money, pilfer personal
information or peddle foreign influence via social media or other online campaigns.”69
Electronic Health Record Modernization
On May 17, 2018, the VA signed a contract with Cerner Corporation to modernize its electronic
health care record system. This account provides funding for activities required to plan and
deploy the Cerner Millennium electronic health care record system at VA medical facilities.
Beginning with the Military Construction, Veterans Affairs, and Related Agencies Appropriations
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).
The President’s budget proposal is requesting $2.6 billion for activities related to the development
and rollout of VA’s Electronic Health Record Modernization (EHRM) initiative, including
interoperability with the DOD electronic health record.
The House reported MILCON-VA Appropriations bill for FY2021 (H.R. 7609, H.Rept. 116-445)
provides the same amount as the President’s budget request (see Table 1). Funding provided for
this account is available until September 30, 2023, “due to the uncertainty of the timing” of the

67 U.S. Congress, House Committee on Appropriations, Military Construction, Veterans Affairs, and Related Agencies
Appropriations Bill, 2021, report to accompany H.R. 7609, 116th Cong., 2nd sess., July 13, 2020, H.Rept. 116-445,
pp.42-43.
68 U.S. Congress, House Committee on Appropriations, Military Construction, Veterans Affairs, and Related Agencies
Appropriations Bill, 2021, report to accompany H.R. 7609, 116th Cong., 2nd sess., July 13, 2020, H.Rept. 116-445, and
p.92.
69 Ibid., pp. 93-94.
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EHRM initiative.70 The committee further goes on to state that “[the] VA transition to a
commercial-based EHR system continues to be challenging, and it is uncertain if this capability
will be delivered across the enterprise by 2027.”71
Construction
Construction accounts include major construction, minor construction, and construction and
renovation grants for state extended care facilities, as well as grants for state veterans cemeteries.
The major construction account provides funds for capital projects costing $20 million or more
that are intended to design, build, alter, extend, or improve a VHA facility. Projects identified
through the Strategic Capital Investment Planning (SCIP) process are submitted for congressional
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
large ambulatory care centers, and new hospitals or nursing homes.
The minor construction account provides funds for capital projects costing less than $20 million
that are intended to design, build, alter, extend, or improve a VHA facility. The total cost of a
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
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,
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
construction of veterans cemeteries account provides grants to states, territories, and federally
recognized tribal governments for the establishment, expansion, or improvement of state and
tribal veterans cemeteries.
For FY2021, the President’s budget requests $1.9 billion for the VA’s total construction program.
This amount includes $1.77 billion for the VA’s major and minor construction programs, $90
million for construction and renovation grants for state-extended care facilities, and $45 million
for grants for state veterans cemeteries.
The House Committee recommendation (H.R. 7609, H.Rept. 116-445) for the department’s total
construction program for FY2021 is $1.9 billion. All amounts recommended for the VA’s major
and minor construction programs, grants for construction of state extended care facilities, and
grants for construction of veterans cemeteries accounts, are the same as the President’s request
for FY2021 (see Table 1).

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

1,663,000

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

—
Operating
Expenses (VBA)
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link to page 27 Department of Veterans Affairs FY2021 Appropriations

Enacted (P.L. 116-94;
House
P.L. 116-127;
President’s
Committee
P.L. 116-136)
Request
(H.Rept. 116-445)
Program
FY2020
FY2021
FY2021
FY2022
FY2021
FY2022
CARES Act
13,000
—
—
—
—
—
(P.L. 116-136)
Subtotal General
3,138,000
—
3,207,000
—
3,187,000
—
Operating
Expenses (VBA)
Total,
128,692,348
—
138,847,255
—
138,827,278
—
Veterans
Benefits
Administration
(VBA)
Veterans Health Administration
Medical Services
51,411,165
—
56,158,015
—
56,158,015
—
P.L. 116-94
-350,000
—
—
—
—
—
rescission (§253)
Over FY2021
—
—
497,468
—
—
—
Enacted Advance
Appropriations
Families First
30,000
—
—
—
—
—
Coronavirus
Response Act
(P.L. 116-127)
CARES Act
14,432,000
—
—
—
—
—
(P.L. 116-136)
Subtotal Medical
65,523,165
—
56,655,483
—
56,655,483
—
Services
Medical
10,758,399
—
17,131,179
—
17,131,179
—
Community Care
Over FY2020
3,906,400
—
—
—
—
—
Enacted Advance
Appropriations
Over FY2021
—
—
1,380,800
—
1,380,800
—
Enacted Advance
Appropriations
Transfer from
615,000
—
—
—
—
—
Veterans Choice
Fund (VCF) to
Community Care
(P.L. 116-94)a
Families First
30,000
—
—
—
—
—
Coronavirus
Response Act
(P.L. 116-127)
CARES Act
2,100,000
—
—
—
—
—
(P.L. 116-136)
Subtotal Medical
17,409,799
—
18,511,979
—
18,511,979
—
Community Care
Medical Support
7,239,156
—
7,914,191
—
7,914,191
—
and Compliance
Congressional Research Service

20

Department of Veterans Affairs FY2021 Appropriations

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

21

Department of Veterans Affairs FY2021 Appropriations

Enacted (P.L. 116-94;
House
P.L. 116-127;
President’s
Committee
P.L. 116-136)
Request
(H.Rept. 116-445)
Program
FY2020
FY2021
FY2021
FY2022
FY2021
FY2022
CARES Act
6,000
—
—
—
—
—
(P.L. 116-136)
Subtotal General
361,911
—
413,000
—
355,911
—
Administration
Board of
182,000
—
198,000
—
198,000
—
Veterans Appeals
Rescission
-8,000
—
—
—
—
—
(P.L. 116-94)
Subtotal Board of
174,000
—
198,000
—
198,000
—
Veterans Appeals
Information
4,371,615
—
4,912,000
—
4,912,000
—
Technology
CARES Act
2,150,000
—
—
—
—
—
(P.L. 116-136)
Subtotal
6,521,615
—
4,912,000
—
4,912,000
—
Information
Technology
Electronic Health
1,500,000
—
2,627,000
—
2,627,000
—
Record
Modernization
(EHRM)
Rescission
-70,000
—
—
—
—
—
(P.L. 116-94)
Subtotal EHRM
1,430,000
—
2,627,000
—
2,627,000
—
Inspector
210,000
—
228,000
—
228,000
—
General
CARES Act
12,500
—
—
—
—
—
(P.L. 116-136)
Subtotal Inspector
222,500
—
228,000
—
228,000
—
General
Construction,
1,235,200
—
1,373,000
—
1,373,000
—
major projects
Construction,
398,800
—
400,000
—
400,000
—
minor projects
Grants for State
90,000
—
90,000
—
90,000
—
Extended Care
Facilities
CARES Act
150,000
—
—
—
—
—
(P.L. 116-136)
Subtotal grants for
240,000
—
90,000
—
90,000
—
state extended
care facilities
Grants for State
45,000
—
45,000
—
45,000
—
Veterans
Cemeteries
Total,
10,629,026
—
10,286,000
—
10,228,911
—
Departmental
Administration
Congressional Research Service

22

Department of Veterans Affairs FY2021 Appropriations

Enacted (P.L. 116-94;
House
P.L. 116-127;
President’s
Committee
P.L. 116-136)
Request
(H.Rept. 116-445)
Program
FY2020
FY2021
FY2021
FY2022
FY2021
FY2022
Administrative
-15,949
—
—
—
—
—
Rescission
(P.L. 116-94)
Total,
$237,492,225
—
$240,245,173
—
$240,210,107
—
Department of
Veterans
Affairs
(without
MCCF)
Total Mandatory
$125,352,325
—
$135,434,234
—
$135,434,234
—
Total
$112,139,900
—
$104,810,939
—
$104,775,873
—
Discretionary
Memorandum: Advance Appropriations
Compensation
—
$118,246,975
—
$130,227,650
—
$130,227,650
and Pensions
Readjustment
—
12,578,965
—
14,946,618
—
14,946,618
Benefits
Insurance and
—
129,224
—
136,950
—
136,950
Indemnities
Subtotal,
—
130,955,164
—
145,311,218
—
145,311,218
Benefits
Programs
Medical Services
—
56,158,015
—
58,897,219
—
58,897,219
Medical
—
17,131,179
—
20,148,244
—
20,148,244
Community Care
Medical Support
—
7,914,191
—
8,403,117
—
8,403,117
and Compliance
Medical Facilities
—
6,433,265
—
6,734,680
—
6,734,680
Subtotal
—
87,636,650
—
94,183,260
—
94,183,260
Medical Care
Total Advance
—
$218,591,814
—
$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
Families First Coronavirus Response Act (P.L. 116-127); the Coronavirus Aid, Relief, and Economic Security Act
(P.L. 116-136); and U.S. Congress, House Committee on Appropriations, 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. 131-141.
a. The Further Consolidated Appropriations Act, 2020 (P.L. 116-94), authorized a mandatory balance transfer
of $615 mil ion from the Veterans Choice Fund (VCF) established by §802(c)(4) of the Veterans Access,
Choice, and Accountability Act of 2014, as amended (38 U.S.C. §1701 note) to the medical community care
account.
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23

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

24

Department of Veterans Affairs FY2021 Appropriations

Appendix B. Department of Veterans Affairs,
Enacted Appropriations FY1995-FY2020
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
$24,760
$24,890
$38,970
$51,360
$46,450
Indemnities
Education Loan Program
$196
$196
$196
$201
$207
Account
Loan Guaranty Program
$78,035
$75,088
$47,901
—
—
Account
Guaranty & Indemnity Program
$428,120
$569,348
$263,869
—
—
Account
Direct Loan Program
$1,042
$487
$110
—
—
Veterans Housing Benefit
—
—
—
$192,447
$263,587
Program Fund
Veterans Housing Benefit
—
—
—
$160,437
$159,121
Program Fund Administrative
Expenses
Vocational Rehabilitation Loan
$54
$54
$49
$44
$55
Program
Vocational Rehabilitation Loan
$767
$377
$377
$388
$400
Program Administrative
Expenses
Native American Veterans
$218
$205
$205
$515
$515
Housing Loan Program
Administrative Expenses
Subtotal VBA
$19,446,684
$20,447,506
$21,327,936
$22,254,389
$23,502,393
Veterans Health Administration (VHA)
Medical Care
$16,232,756
$16,564,000
$17,013,447
$17,057,396
$17,306,000
Rescission
-$84,762
-$21,250
—
—
-$35,373
Medical Administration and
$69,808
$63,602
$61,207
$59,860
$63,000
Miscellaneous Operating
Expenses (MAMOE)
Rescission
-$44
-$86
—
—
-$67
Health Professional Scholarships
$10,386
—
—
—
—
Medical and Prosthetic Research
$252,000
$257,000
$262,000
$272,000
$316,000
Congressional Research Service

25

Department of Veterans Affairs FY2021 Appropriations

FY1995
FY1996
FY1997
FY1998
FY1999

Enacted
Enacted
Enacted
Enacted
Enacted
Rescission
-$574
-$322
—
—
-$348
Medical Care Col ections Fund
—
—
—
$666,579
$587,000
(MCCF)
Subtotal VHA
$16,479,570
$16,862,944
$17,336,654
$18,055,835
$18,236,212
National Cemetery
$72,663
$72,604
$76,864
$84,183
$92,006
Administration (NCA)
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
$500
—
—
—
—
Philippines
Grants for State Extended Care
$47,397
$47,397
$47,397
$80,000
$90,000
Facilities
Grants for State Veterans
$5,378
$1,000
$1,000
$10,000
$10,000
Cemeteries
Subtotal Departmental
$1,467,264
$1,251,980
$1,312,939
$1,292,148
$1,307,308
Administration
Total Department of
$37,466,053
$38,634,937
$40,054,393
$41,686,555
$43,137,797
Veterans Affairs with MCCF
Total Department of
$37,466,053
$38,634,937
$40,054,393
$41,019,976
$42,550,797
Veterans Affairs without
MCCF
Total Mandatory
$19,445,449
$20,446,674
$21,327,109
$22,092,804
$23,342,095
Total Discretionary with
$18,020,604
$18,188,263
$18,727,284
$19,593,751
$19,795,702
MCCF
Total Discretionary without
$18,020,604
$18,188,263
$18,727,284
$18,927,172
$19,208,702
MCCF
Source: Table prepared by the Congressional Research Service based on data from the Department of Veterans
Affairs, Office of Management, Office of Budget.
Congressional Research Service

26

Department of Veterans Affairs FY2021 Appropriations

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
$28,670
$19,850
$26,200
$27,530
$29,017
Indemnities
Education Loan Program
$215
$221
$65
$71
$71
Account
Guaranteed Transitional
$48,250
—
—
—
—
Housing for Homeless
Veterans
Veterans Housing Benefit
$282,342
$165,740
$203,278
$437,522
$305,834
Program Fund
Veterans Housing Benefit
$156,958
$162,000
$164,497
$168,207
$154,850
Program Fund Administrative
Expenses
Rescission
—
-$356
-$123
-$1,093
-$914
Vocational Rehabilitation Loan
$57
$52
$72
$54
$52
Program
Vocational Rehabilitation Loan
$415
$432
$274
$289
$300
Program Administrative
Expenses
Rescission
—
-$1
—
-$2
-$2
Native American Veterans
$520
$532
$544
$558
$571
Housing Loan Program
Administrative Expenses
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
$59,703
$62,000
$66,731
$74,716
—
Miscellaneous Operating
Expenses (MAMOE)
Rescission
—
-$136
-$50
-$486
—
Medical Services
—
—
—
—
$17,867,220
Rescission
—
—
—
—
-$103,823
Congressional Research Service

27

Department of Veterans Affairs FY2021 Appropriations

FY2000
FY2001
FY2002
FY2003
FY2004

Enacted
Enacted
Enacted
Enacted
Enacted
Medical Administration
—
—
—
—
$5,000,000
Rescission
—
—
—
—
-$29,500
Medical Facilities
—
—
—
—
$4,000,000
Rescission
—
—
—
—
-$23,600
Medical and Prosthetic
$321,000
$351,000
$371,000
$400,000
$408,000
Research
Rescission
—
-$772
-$278
-$2,600
-$2,407
Medical Care Col ections Fund
$563,755
$767,687
$1,133,214
$1,474,716
$1,708,026
(MCCF)
Subtotal VHA
$19,870,939
$21,415,132
$23,027,697
$25,835,650
$28,823,916
National Cemetery
$97,256
$109,889
$121,169
$133,149
$144,203
Administration (NCA)
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
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
$90,000
$100,000
$100,000
$100,000
$102,100
Care Facilities
Rescission
—
-$220
$25,000
-$650
-$602
Grants for State Veterans
$25,000
$25,000
—
$32,000
$32,000
Cemeteries
Rescission
—
-$55
—
-$208
-$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

28

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
$29,407,045
without MCCF
Source: Table prepared by the Congressional Research Service based on data from the Department of Veterans
Affairs, Office of Management, Office of Budget.
Table B-3. Department of Veterans Affairs Enacted Appropriations, FY2005-FY2010
($ in Thousands)
FY2005
FY2006
FY2007
FY2008
FY2009
FY2010

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

29

Department of Veterans Affairs FY2021 Appropriations

FY2005
FY2006
FY2007
FY2008
FY2009
FY2010

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

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

30

Department of Veterans Affairs FY2021 Appropriations

FY2005
FY2006
FY2007
FY2008
FY2009
FY2010

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

31

Department of Veterans Affairs FY2021 Appropriations

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

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

32

Department of Veterans Affairs FY2021 Appropriations

FY2011
FY2012
FY2013
FY2014
FY2015
Enacted
Enacted
Enacted
Enacted
Enacted

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

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

511,200

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

33

Department of Veterans Affairs FY2021 Appropriations

FY2011
FY2012
FY2013
FY2014
FY2015
Enacted
Enacted
Enacted
Enacted
Enacted

Grants for State
$46,000
$46,000
$45,939
$46,000
$46,000
Veterans Cemeteries
Rescission
-$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)
FY2016
FY2017
FY2018
FY2019
FY2020
Enacted
Enacted
Enacted
Enacted
Enacted

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

34

Department of Veterans Affairs FY2021 Appropriations

FY2016
FY2017
FY2018
FY2019
FY2020
Enacted
Enacted
Enacted
Enacted
Enacted

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

35

Department of Veterans Affairs FY2021 Appropriations

FY2016
FY2017
FY2018
FY2019
FY2020
Enacted
Enacted
Enacted
Enacted
Enacted

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

-$1,000
Supplemental
—
—
—

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

Departmental

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

36

Department of Veterans Affairs FY2021 Appropriations

FY2016
FY2017
FY2018
FY2019
FY2020
Enacted
Enacted
Enacted
Enacted
Enacted

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

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

37

Department of Veterans Affairs FY2021 Appropriations

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

Author Information

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

Jared S. Sussman

Analyst in Health Policy

Disclaimer
This document was prepared by the Congressional Research Service (CRS). CRS serves as nonpartisan
shared staff to congressional committees and Members of Congress. It operates solely at the behest of and
under the direction of Congress. Information in a CRS Report should not be relied upon for purposes other
than public understanding of information that has been provided by CRS to Members of Congress in
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