Department of Veterans Affairs
November 12, 2021
FY2022 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 Joe Biden submitted his formal budget proposal for FY2022 on May 28, 2021. The
Heather M. Salazar
Administration requested $268.41 billion for VA. This amount included $155.44 billion in
Analyst in Veterans Policy
mandatory funding and $112.97 billion in discretionary funding—a 10.38% increase compared

with the $243.16 billion enacted in FY2021 (excluding FY2021 funding provided in the
American Rescue Plan Act of 2021, P.L. 117-2). The President’s budget also proposed using a
For a copy of the full report,
please call 7-5700 or visit
Recurring Expenses Transformational Fund, established by the Consolidated Appropriations Act
www.crs.gov.
of 2016 (P.L. 114-113), to transfer $820 million of unobligated balances at the end of FY2021 to
supplement the discretionary budget request for FY2022. In addition, the budget request included an advance appropriation
request of $267.87 billion for FY2023 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 29, 2021, the House passed H.R. 4502, consisting of seven appropriations bills. Division F of H.R. 4502 (H.Rept.
117-81) included the Military Construction, Veterans Affairs, and Related Agencies (MILCON-VA) appropriations bill for
FY2022. The House-passed bill provides $268.59 billion for VA, including $155.44 billion in mandatory spending and
$113.15 billion in discretionary spending. On August 4, 2021, the Senate Appropriations Committee reported its version of
the MILCON-VA bill for FY2022 (S. 2604; S.Rept. 117-35). The Senate Appropriations Committee-reported bill
recommends $268.37 billion for VA for FY2022, including $155.44 billion in mandatory spending and $112.93 billion in
discretionary spending. Both the House-passed and Senate-reported versions of the MILCON-VA bill for FY2022 include
$267.87 billion in advance appropriations for FY2023. Because none of the regular appropriations bills were enacted at the
start FY2022, the President signed into law the Extending Government Funding and Delivering Emergency Assistance Act
(H.R. 5305; P.L. 117-43) on September 30, 2021. The act provides continuing appropriations through December 3, 2021.
Accounts that received advance appropriations budget authority for FY2022 in Division J of P.L. 116-260 are not affected by
the continuing resolution (CR).
Comparative funding levels with amounts enacted for FY2021 (excluding FY2021 funding provided in the American Rescue
Plan Act of 2021, P.L. 117-2), amounts requested by the President and provided by the House-passed measure (Division F of
H.R. 4502), and amounts recommended by the Senate Appropriations Committee MILCON-VA bill for FY2022 (S. 2604;
S.Rept. 117-35) are as follows:
FY2022 Senate
FY2022
Appropriations

FY2021 Enacted
FY2022 Request
House-Passed
Committee
Veterans Benefits
$142.10 bil ion
$159.09 bil ion
$159.09 bil ion
$159.16 bil ion
Administration (VBA,
including General
Operating Expenses)
Veterans Health
$90.64 bil ion
$98.33 bil ion
$98.46 bil ion
$98.33 bil ion
Administration (VHA)
National Cemetery
$352 mil ion
$394 mil ion
$392 mil ion
$394 mil ion
Administration (NCA)
Departmental
$10.06 bil ion
$10.59 bil ion
$10.65 bil ion
$10.48 bil ion
Administration

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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,
and 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 FY2022 President’s request for VA and subsequent
congressional action. It begins with a discussion of various appropriations and funds that
constitute VA’s budget, followed by a brief overview of the FY2021 congressional appropriations
process and enacted amounts for FY2021, including American Rescue Plan (ARP) Act (P.L. 117-
2) funding. It then discusses the President’s request for FY2022 for care, benefits, and services
for veterans and administration of the department, followed by congressional action on the
FY2022 request. 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. Generally, VA accounts
are purpose specific rather than program specific. For example, VHA’s supply chain
modernization effort could include funding from the medical support and compliance account and
the information technology account. Appendix B lists appropriations to VA from FY1995 to
FY2021. Funding amounts shown in the appendices of this report may include transfers in and

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
Veteran Readiness 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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out of accounts as calculated by VA; therefore, those amounts may be different from those shown
in Table 2, which is based on budget authority amounts shown in the MILCON-VA
appropriations bills and accompanying committee reports.
The Department of Veterans Affairs Budget
VA’s 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
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

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/a11.pdf.
12 In general, advance appropriations refer to budget authority provided in an appropriations act that becomes available
for obligation one or more fiscal years after the year covered by the act. 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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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
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 advance
appropriations for the medical community care account.
Congress had 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 have arisen 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 are 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 FY2021. Between FY1995 and FY2021, total mandatory
appropriations grew from $19.45 billion to $154.15 billion in nominal dollars, a compound
annual growth rate (CAGR) of 8.29%.15 During this same period, discretionary appropriations
grew from $18.02 billion to $104.43 billion, a CAGR of 6.99%. The total VA appropriations from
FY1995 through FY2021 grew from $37.47 billion to $258.58 billion, a CAGR of 7.71%.

14 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; also see OMB
Circular No. A–11, Appendix A -Scorekeeping Guidelines, available at https://www.whitehouse.gov/wp-content/
uploads/2018/06/a11.pdf.
15 CAGR is annualized average rate of growth between two given years, calculated as CAGR; year FY1995 to year
FY2021 = [(value in year 2021/value in year 1995) ^ (1/26)-1].
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Figure 1. VA Appropriations, FY1995-FY2021

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 nominal, or noninflation-adjusted, dol ars, and discretionary funding excludes offsetting
col ections deposited in the Medical Care Col ections Fund (MCCF).
FY2009: American Recovery and Reinvestment Act (P.L. 111-5) provided supplemental funding, VHA received
$1.0 bil ion for the medical facilities account, and the $700 mil ion was for the economic recovery payments. The
supplemental $700 mil ion is not included in the discretionary subtotal but included in overall VA total.
FY2014: Amounts include $15 bil ion in mandatory funding provided in the Veterans Choice Act (P.L. 113-146).
FY2021: Amounts include American Rescue Plan (ARP) Act (P.L. 117-2) funding.
FY2021 Budget Summary16
President Donald Trump submitted his budget proposal for FY2021 on February 10, 2020. The
President’s budget requested $240.25 billion for VA. This amount included $135.43 billion in
mandatory benefits funding and $104.81billion in discretionary funding.
On July 9, 2020, 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). Subsequently, the text of H.R. 7609 was included in a four-bill appropriations
package (H.R. 7608, the State, Foreign Operations, Agriculture, Rural Development, Interior,
Environment, Military Construction, and Veterans Affairs Appropriations bill 2021) and passed
by the full House on July 24. The House-passed measure (Division D of H.R. 7608) provided a
total of $240.21 billion for VA, which included $135.43 billion in mandatory funding and
$104.78 billion in discretionary funding.
On November 10, 2020, the chair of the Senate Committee on Appropriations, Senator Richard
Shelby, released drafts of all 12 annual appropriations bills along with draft accompanying
explanatory statements, including the FY2021 MILCON-VA appropriations bill.17 The release of

16 For complete details on FY2021 VA appropriations, see CRS Report R46459, Department of Veterans Affairs
FY2021 Appropriations.
17 The 12 draft bills and explanatory statements are on the committee’s website, linked to the majority press release, at
https://www.appropriations.senate.gov/news/committee-releases-fy21-bills-in-effort-to-advance-process-produce-
bipartisan-results.
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the draft bills was intended to further negotiations on annual appropriations between the House
and the Senate.18 The majority draft FY2021 MILCON-VA appropriations bill recommended
$243.12 billion for VA, including $138.73 billion in mandatory spending and $104.39 billion in
discretionary spending.
Because no regular appropriations bills were enacted at the beginning of FY2021 on October 1,
2020, certain VA accounts (excluding the seven advance appropriations accounts that received
FY2021 budget authority in P.L. 116-94) were funded through a series of continuing resolutions
(CRs).
On December 27, 2020, the Consolidated Appropriations Act, 2021 (H.R. 133, P.L. 116-260), was
enacted into law. Division J of this act contained the FY2021 Military Construction, Veterans
Affairs, and Related Agencies (MILCON-VA) Appropriations Act. The act provided $243.16
billion for VA for FY2021, which included $138.73 billion in mandatory funding and $104.43
billion in discretionary funding. Figure 2 provides funding levels for VHA, VBA, and
Departmental Administration, which includes the following accounts: general administration,
BVA, information technology systems (IT systems); veterans electronic health record
modernization (EHRM), Office of Inspector General, construction major and minor accounts,
grants for construction of state extended care facilities; and grants for the construction of veterans
cemeteries.
Figure 2. FY2021 VA-Enacted Appropriations

Source: Figure prepared by CRS based on U.S. Congress, House Committee on Appropriations, Consolidated
Appropriations Act, 2021, committee print, prepared by House Committee on Appropriations, H.R. 133/P.L. 116-
260 [Legislative Text and Explanatory Statement] Book 2 of 2 Divisions G–L, 116th Cong., 2nd sess., 2021
(Washington: GPO, 2021), pp. 1885-1903.
Notes: FY2021-enacted amounts exclude offsetting col ections deposited in the Medical Care Col ections Fund
(MCCF) and American Rescue Plan (ARP) Act (P.L. 117-2) supplemental appropriations.

18 Ibid. See also the statement from the Senate Appropriations Committee Vice Chair, Senator Patrick Leahy, at
https://www.appropriations.senate.gov/news/minority/senate-approps-vice-chair-leahy-statement-on-the-release-of-the-
fy-2021-senate-appropriations-bills-.
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American Rescue Plan Act of 2021 (P.L. 117-2)
On March 11, 2021, President Biden signed into law the American Rescue Plan Act of 2021 (P.L.
117-2). This legislation was crafted by authorizing committees, instead of appropriations
committees, using the budget reconciliation process.19 The Veterans’ Affairs Committee
provisions (Title VIII of P.L. 117-2) provide approximately $17.08 billion in mandatory funds for
VA programs and activities. The law provided funding based on several broad categories and
allowed VA to allocate funding at the account level (see Figure 3).
Figure 3. American Rescue Plan Act of 2021 Funding

Source: Figure prepared by CRS based on Department of Veterans Affairs, FY2022 Budget Submission,
Supplemental Information and Appendices, vol. 1of 4, May 28, 2021, p. Supplemental Information – 11.
Note: Al ocations are estimates and subject to change, based on FY2021 actual spending and changes
throughout FY2022.
A summary of VA provisions follows, and Table 1 provides VA’s estimated allocations by
account level. Final FY2022 funding allocations are subject to change based on FY2021 actual
spending and changes throughout FY2022.
 Section 8001 provided $272 million for VBA, general operating expenses
account, and the Board of Veterans Appeals, to remain available until September
30, 2023, for processing disability claims and appeals for entitlement to veterans’
benefits.
 Section 8002 provided $14.48 billion to remain available until September 30,
2023, for allocation to VA medical care accounts. VA established the Veterans
Medical Care and Health Fund to execute Section 8002 of P.L. 117-2.
 Section 8003 provided $100 million to remain available until September 30,
2022, for the supply chain modernization initiative.
 Section 8004 provided $250 million for a one-time only obligation and
expenditure to existing state extended care facilities for payment of per diem
payments during March 11, 2021, through September 30, 2022. This section also
provided $500 million to remain available until expended for grants to assist
states to acquire, construct, remodel, modify, or alter state extended care
facilities.

19 For background information on the reconciliation process, see CRS Report R44058, The Budget Reconciliation
Process: Stages of Consideration, and CRS Report R46675, S.Con.Res. 5: The Budget Resolution for FY2021.
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 Section 8005 provided $10 million for the Office of Inspector General to remain
available until expended.
 Section 8006 provided $386 million for VBA for the Veterans Rapid Retraining
Assistance Program (VRRAP), which was established by the American Rescue
Plan Act of 2021.
 Section 8007 provided $1 billion to remain available until expended to provide
for any health care copayment or other cost sharing, and to reimburse any veteran
who already paid a copayment or other cost sharing, for care and prescriptions
during the period beginning on April 6, 2020, and ending on September 30, 2021.
 Section 8008 provided $80 million for Emergency Department of Veterans
Affairs Employee Leave Fund to remain available from March 11, 2021, through
September 20, 2022. The fund would pay for paid leave for VHA employees
appointed under Chapter 74 of 38 United States Code (U.S.C.) who are unable to
work due to the Coronavirus Disease 2019 (COVID-19) pandemic.
Table 1. American Rescue Plan Act (P.L. 117-2) Allocations
($ in Thousands)
Estimated
Account
Allocation
Veterans Benefits Administration (VBA) - General Operating Expenses (GOE)
$262,000
Board of Veterans Appeals
10,000
Section 8001 Subtotal
272,000
Veterans Medical Care and Health Fund (VMCHF)

Medical Services
9,020,443
Medical Community Care
1,901,196
Medical Support and Compliance
978,433
Medical Facilities
2,572,928
Medical and Prosthetic Research
9,000
Section 8002 Subtotal
14,482,000
Information Technology
100,000
Section 8003 Subtotal
100,000
Medical Community Care
250,000
Grants for Construction of State Extended Care Facilities
500,000
Section 8004 Subtotal
750,000
Office of Inspector General
10,000
Section 8005 Subtotal
10,000
Veterans Benefits Administration (VBA) General Operating Expenses (GOE)- Veteran Rapid
386,000
Retraining Assistance Program
Section 8006 Subtotal
386,000
Medical Services
627,900
Medical Community Care
72,100
Medical Care Col ections Fund
300,000
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Estimated
Account
Allocation
Section 8007 Subtotal
1,000,000
Emergency Department of Veterans Affairs Employee Leave Fund
80,000
Section 8008 Subtotal
80,000
Total TITLE VIII of American Rescue Plan Act (P.L. 117-2)
$17,080,000
Source: Table prepared by CRS based on Department of Veterans Affairs, FY2022 Budget Submission,
Supplemental Information and Appendices, vol. 1of 4, May 28, 2021, p. Supplemental Information – 11; Department
of Veterans Affairs, FY2022 Budget Submission, Medical Programs and Information Technology Programs, vol. 2 of 4,
May 28, 2021; and information from VA Office of Management, Office of Budget.
Note: VA established the Veterans Medical Care and Health Fund (VMCHF) to execute Section 8002 and
Section 8007, with the estimated allocation of funding for copayments not col ected.
Budget Request for FY2022 and
Congressional Action
President’s Request
On April 9, 2021, President Biden submitted his discretionary funding request for FY2022.20 The
formal budget request for FY2022 was submitted on May 28. The President’s budget requests
$268.41 billion for VA. This amount includes $155.44 billion in mandatory funding and $112.97
billion in discretionary appropriations. In addition, the Administration is proposing to use $820
million from the Recurring Expenses Transformational Fund to supplement the discretionary
budget request. The Recurring Expenses Transformational Fund was established by the
Consolidated Appropriations Act, 2016 (P.L. 114-113, Division J, Title II, Section 243). The law
allows unobligated balances of expired discretionary appropriations, in FY2016 or any
succeeding fiscal year, to be transferred from the General Fund of the Treasury to VA and
deposited in the Recurring Expenses Transformational Fund at the end of the fifth fiscal year after
the last fiscal year for which such funds were available. The law stipulates that amounts deposited
in the fund may be available for facility infrastructure improvements, including nonrecurring
maintenance, at existing VA hospitals and clinics, and information technology systems
improvements and sustainment, subject to approval by the Office of Management and Budget
(OMB) and House and Senate Appropriations Committees.21
The President’s budget request for FY2022 includes $159.09 billion for VBA, including general
operating expenses; $98.33 billion for VHA; $394 million for NCA; and $10.59 billion for
departmental administration, which includes the following accounts: general administration,
BVA, and information technology systems (IT systems); veterans electronic health record
modernization (EHRM), Office of Inspector General, construction major and minor accounts, and
grants for construction of state extended care facilities; and grants for the construction of veterans
cemeteries (see Figure 4).

20 Office of Management and Budget (OMB), “Office of Management and Budget Releases the President’s Fiscal Year
2022 Discretionary Funding Request,” press release, April 9, 2021, https://www.whitehouse.gov/wp-content/uploads/
2021/04/FY2022-Discretionary-Request-Press-Release.pdf.
21 38 U.S.C. §313 note.
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The President’s budget also requests $156.59 billion in advance appropriations for FY2023 for
VBA mandatory accounts and $111.29 billion in advance appropriations for FY2023 for VHA
discretionary accounts.
Figure 4. FY2022 Budget Request

Source: Figure prepared by CRS based on U.S. Congress, House Committee on Appropriations, Military
Construction, Veterans Affairs, and Related Agencies Appropriations Bill, 2022, report to accompany H.R. 4355, 117th
Cong., 1st sess., July 2, 2021, H.Rept. 117-81.
Notes: Total budget authority excludes offsetting col ections deposited in the Medical Care Col ections Fund
(MCCF).
House Action
On June 25, 2021, the House Committee on Appropriations, Subcommittee on Military
Construction, Veterans Affairs, and Related Agencies, held a markup of the FY2022 Military
Construction, Veterans Affairs, and Related Agencies (MILCON-VA) appropriations bill, and
approved the draft bill. On June 30, the House Appropriations Committee held a markup of the
FY2022 MILCON-VA appropriations bill, and the bill was ordered reported to the full House on
July 2 (H.R. 4355; H.Rept. 117-81). Subsequently, the text of H.R. 4355 was included in a seven-
bill appropriations package (H.R. 4502), consisting of the FY2022 Labor, Health and Human
Services, Education; Agriculture, Rural Development; Energy and Water Development; Financial
Services and General Government; Interior, Environment; Military Construction, Veterans
Affairs; Transportation, and Housing and Urban Development appropriations bills (House
Committee Print 117-12). H.R. 4502 was passed by the House on July 29. Division F of H.R.
4502 contained the FY2022 MILCON-VA appropriations bill. The full House-passed measure
provides $268.59 billion for VA, including $155.44 billion in mandatory funding and $113.15
billion in discretionary appropriations. Division F of H.R. 4502 also provides $159.09 billion for
VBA, including general operating expenses; $98.46 billion for VHA; $392 million for NCA; and
$10.65 billion for departmental administration accounts. The House Committee report (H.Rept.
117-81) does not address the Administration’s proposal to use the Recurring Expenses
Transformational Fund to supplement VA’s discretionary budget amount.
Senate Action
On August 4, 2021, the Senate Committee on Appropriations held a markup of its version of the
FY2022 MILCON-VA appropriations bill (S. 2604; S.Rept. 117-35) and reported it out of
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committee.22 The Senate-reported FY2022 MILCON-VA appropriations bill recommends $268.37
billion for VA. This amount includes $155.44 billion in mandatory funding and $112.93 billion in
discretionary funding. The Senate Appropriations committee report indicates agreement with the
Administration’s proposal to use the Recurring Expenses Transformational Fund to supplement
VA’s discretionary budget amount. According to the committee report, the FY2022 Recurring
Expenses Transformational Fund balance is approximately $842 million, out of which VA
proposed to allocate $820 million, with approximately $670 million for minor construction
projects and the balance for IT systems.23 S. 2604 (S.Rept. 117-35) also recommends $159.16
billion for VBA, including general operating expenses; $98.33 billion for VHA; $394 million for
NCA; and $10.48 billion for departmental administration accounts.
On October 18, Senate Appropriations Committee Chairman Patrick Leahy released a draft
version of the FY2022 Department of Defense Appropriations bill, among other bills. Division C
of this draft committee bill included the Military Construction and Veterans Affairs, Additional
Appropriations bill. This bill made certain amendments to S. 2604 to comply with the FY2022
budget resolution (S.Con.Res. 14), which grants special budgetary treatment to certain types of
spending, essentially exempting such spending from budget enforcement rules. S.Con.Res. 14
applies such special budgetary treatment to veterans’ medical care within the Medical Services,
Medical Community Care, Medical Support and Compliance, and Medical Facilities accounts of
the Veterans Health Administration. The exemption applies to spending provided in excess of
$89,849,000,000, but may not exceed $7,602,000,000. Accordingly, the Senate bill provides the
$98.33 billion recommended for VHA, with approximately $7.60 billion provided pursuant to
S.Con.Res. 14.
Continuing Appropriations (Extending Government Funding and
Delivering Emergency Assistance Act, H.R. 5305; P.L. 117-43)
Because none of the regular appropriations bills were enacted at the beginning of the fiscal year
on October 1, Congress passed a continuing resolution (CR), the Extending Government Funding
and Delivering Emergency Assistance Act (H.R. 5305; P.L. 117-43), which the President signed
into law on September 30, 2021. The act provides continuing appropriations for VA through
December 3, 2021, at FY2021 funding levels, with certain exceptions.24 Since seven accounts
(compensation and pensions, readjustment benefits, insurance and indemnities, medical services,
medical community care, medical support and compliance, and medical facilities) received
advance appropriations budget authority for FY2022 in the Military Construction, Veterans
Affairs, and Related Agencies Appropriations Act, 2021 (Division J of P.L. 116-260), these
accounts are not affected by the CR.
However, Section 151 of Division A of the Extending Government Funding and Delivering
Emergency Assistance Act provides VA with transfer authority to transfer up to $193.5 million of
FY2021 unobligated balances from the medical services account to the following three accounts,
specifying that

22 The Subcommittee on Military Construction, Veterans Affairs, and Related Agencies did not hold a planned
subcommittee markup on August 2, 2021.
23 U.S. Congress, Senate Committee on Appropriations, Military Construction, Veterans Affairs, and Related Agencies
Appropriation Bill, 2022, report to accompany S. 2604, 117th Cong., 1st sess., August 4, 2021, S.Rept. 117-35, p. 67.
24 The FY2021 rate of operations does not apply to transfer authorities of unobligated balances from title X of Division
B of the Coronavirus Aid, Relief, and Economic Security Act (P.L. 116-136), provided in Division J of the
Consolidated Appropriations Act, 2021 (H.R. 133, P.L. 116-260).
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 up to $178 million may be transferred to VBA general operating expenses
account,
 up to $5.8 million may be transferred to BVA, and
 up to $9.7 million may be transferred to the information technology systems
account.
These transferred amounts are to be used for expenses related to the processing of disability
claims for asthma, rhinitis, and sinusitis on a presumptive basis due to presumed exposure to
particulate matter (such as burn pit emissions) during servicemembers’ deployment to countries
in Southwest Asia and certain other countries.25
The next sections discuss account-level details of the President’s FY2022 request and
congressional action on regular VA appropriations. Comparisons to FY2021-enacted funding
amounts do not include funding from the American Rescue Plan Act (P.L. 117-2).
Mandatory Programs Funding
Major mandatory program funding includes compensation and pensions (VA’s disability
compensation program; pensions to low-income veterans, their surviving spouses, and dependent
children); readjustment benefits (education and vocational rehabilitation assistance); and veterans
insurance and indemnities (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 FY2022, VA requested $137.58 billion for the Compensation and Pensions account, an
increase of $13.22 billion over the FY2021-enacted level of funding and $7.3 billion over the
FY2022 advanced appropriations request (see Table 2).26 The largest portion of the budget is
disability compensation, and VA estimates that $133.8 billion in compensation payments would
go to an estimated 5.5 million veterans, 475,146 survivors, and 1,281 children in FY2022.
Pension payments are estimated to be $4.8 billion to approximately 209,355 veterans and 147,472
survivors. Finally, an estimated $418.0 million would be allocated for burial benefits.27
The funding request increase includes $3.0 billion in obligations during FY2022 for the three new
Agent Orange presumptive conditions identified in P.L. 116-283: Parkinson’s-like symptoms,
bladder cancer, and hypothyroidism. VA estimates that these new conditions qualifying for
disability compensation include approximately $2.2 billion in retroactive benefits.28 In general,

25 For more information, see CRS Insight IN11724, VA Now Processing Gulf War Veterans’ Disability Claims for New
Respiratory Presumptive Conditions. Also see Department of Veterans Affairs, “Interim Final Rule-Presumptive
Service Connection for Respiratory Conditions Due to Exposure to Particulate Matter,” 86 Federal Register 42724-
42733, August 5, 2021.
26 U.S. Department of Veterans Affairs, FY2022 Budget Submission, Benefits and Burial Programs and Departmental
Administration, vol. 3 of 4, May 2021, p. VBA-52.
27 U.S. Department of Veterans Affairs, FY2022 Budget Submission, Benefits and Burial Programs and Departmental
Administration, vol. 3 of 4, May 2021, p. VBA-52-53.
28 U.S. Department of Veterans Affairs, FY2022 Budget Submission, Benefits and Burial Programs and Departmental
Administration, vol. 3 of 4, May 2021, p. VBA-53.
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the average payments for benefits, including disability compensation, pension, and survivor
benefits, would be expected to increase due to the annual cost-of-living adjustment (COLA).
Division F of H.R. 4502 recommended for FY2021 an appropriation of $137.58 billion for VA’s
Compensation and Pensions account, which is the exact amount VA requested (see Table 2).29
The House Appropriations Committee, in its report (H.Rept. 117-81), highlighted various areas of
interest and directive actions. The committee encourages VA to continue implementing GAO’s
recommendations to improve regional office processing of claims, increase communication with
Veterans Service Organizations (VSOs), and discuss the feasibility of locating satellite
congressional offices within VA Medical Centers. In addition, the committee remains concerned
with the backlog of disability claims and the processing of dependency and indemnity
compensation (DIC) claims when the cause of death is listed as COVID-19. The committee
directs VA to provide additional guidance on how a survivor can request a medical opinion to
determine if a service-connected illness or disability contributed to the veteran’s death, and
directs VA to continue providing quarterly reports on the disability backlog.30
In S. 2604, the Senate Appropriations Committee recommends providing $7.35 billion in
additional funding to the $130.23 billion provided in advanced appropriations for FY2022. This
amount provides VA with a total budget of $137.58 billion, equal to VA’s FY2022 request (see
Table 2).31 The committee’s report, S.Rept. 117-35, explained that the increase in appropriations
reflects the increased obligations VA faces with disability compensation payments, the
implementation of new laws, and the requirement to adjudicate disability claims for Blue Water
Navy veterans.32
Readjustment Benefits
The Readjustment Benefits category reflects several benefits related to the transition of
servicemembers from active duty status to veteran status, as well as 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
helping individual veterans purchase and/or rehabilitate homes.
For FY2022, VA requested appropriations of $14.95 billion to provide funding for Readjustment
Benefits, which is approximately $2.37 billion more than the amount enacted in FY2021 (see
Table 2). In addition to the appropriated funds, VA will combine $174.3 million in offsetting
collections from the Department of Defense (DOD), and an estimated unobligated balance of $3.7
billion from FY2021 to sufficiently provide the benefits required. The increase in readjustment
benefits funding is due, in part, to two legislative directives. First, P.L. 116-140, the Student
Veteran Coronavirus Response Act of 2020, changed education and VR&E benefits due to the
pandemic and required the continuation of benefits paid that otherwise may have stopped due to

29 U.S. Congress, House Committee on Appropriations, Military Construction, Veterans Affairs, and Related Agencies
Appropriations Bill, 2022, report to accompany H.R. 4355, 117th Cong., 1st sess., July 2, 2021, H.Rept. 117-81, p. 29.
30 U.S. Congress, House Committee on Appropriations, Military Construction, Veterans Affairs, and Related Agencies
Appropriations Bill, 2022, report to accompany H.R. 4355, 117th Cong., 1st sess., July 2, 2021, H.Rept. 117-81, p. 30-
31.
31 U.S. Congress, Senate Committee on Appropriations, Military Construction, Veterans Affairs, and Related Agencies
Appropriation Bill, 2022, report to accompany S. 2604, 117th Cong., 1st sess., August 4, 2021, S.Rept. 117-35, p. 33-34.
32 U.S. Congress, Senate Committee on Appropriations, Military Construction, Veterans Affairs, and Related Agencies
Appropriation Bill, 2022, report to accompany S. 2604, 117th Cong., 1st sess., August 4, 2021,<LISRef number="35"
congress="117" title="*" type="senateReport" url="http://www.congress.gov/cgi-
lis/cpquery/R?cp117:FLD010:@1(sr35):" id="3753990749" /> p. 34.
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educational institutions closing or the shift to a virtual learning environment.33 Second, P.L. 116-
315, the Johnny Isakson and David P. Roe, M.D. Veterans Health Care and Benefits Improvement
Act of 2020, enhanced and expanded the eligibility for the Edith Nourse Rogers STEM
Scholarship and the Fry Scholarship.34
Division F of H.R. 4502 provides $14.95 billion for Readjustment Benefits in FY2022, the exact
amount requested by VA.35 The House Appropriations Committee, in its report (H.Rept. 117-81),
highlighted several VA efforts to help veterans transition to civilian life and requested that VA
continue and enhance those efforts. The committee believes that VA should increase coordination
with the Departments of Defense, Education, and Labor to ensure that veterans can successfully
transition into jobs, receive employment training, and understand options available for repayment
or forgiveness of student loans. The committee also requests that VA explore possible options to
continue the payment of benefits after December 21, 2021, with the possibility of educational
institutions continuing with virtual or hybrid programs.
In the same manner as the House Appropriations Committee, the Senate Appropriations
Committee recommended $14.95 billion for Readjustment Benefits in FY2022, the exact amount
requested by VA in S. 2604.36 The committee report, S.Rept. 117-35, addressed one program
within VA’s Readjustment Benefits, the Veteran Employment Through Technology Education
Courses (VET TEC) Program. The committee supports this program and calls on VA to consider
expanding the program to address increased demand.37
Veterans Insurance and Indemnities (VI&I)
The Veterans Insurance and Indemnities 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

33 U.S. Department of Veterans Affairs, FY2022 Budget Submission, Benefits and Burial Programs and Departmental
Administration, vol. 3 of 4, May 2021, p. VBA-78.
34 The Edith Nourse Rogers STEM Scholarship is a program for eligible veterans and dependents who are enrolled in
an undergraduate STEM program or who have earned a post-secondary graduate degree and are working toward a
certification or are in a clinical training program. The scholarship would allow all beneficiaries to extend their Post-
9/11 Bill or Fry Scholarship benefits. The Fry Scholarship is a scholarship for children and spouses of certain veterans
who died in the line of duty on or after September 11, 2001, or a member of the Selected Reserve who died from a
service-connected disability.
35 U.S. Congress, House Committee on Appropriations, Military Construction, Veterans Affairs, and Related Agencies
Appropriations Bill, 2022, report to accompany H.R. 4355, 117th Cong., 1st sess., July 2, 2021, H.Rept. 117-81, p. 31.
36 U.S. Congress, Senate Committee on Appropriations, Military Construction, Veterans Affairs, and Related Agencies
Appropriation Bill, 2022, report to accompany S. 2604, 117th Cong., 1st sess., August 4, 2021, S.Rept. 117-35, p. 34.
37 U.S. Congress, Senate Committee on Appropriations, Military Construction, Veterans Affairs, and Related Agencies
Appropriation Bill, 2022, report to accompany S. 2604, 117th Cong., 1st sess., August 4, 2021, p. 34.
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Life Insurance (NSLI),38 Service-Disabled Veterans Insurance (S-DVI),39 and Veterans Mortgage
Life Insurance (VMLI).40
For FY2022, VA estimates that this account will require $136.95 million, approximately $5.58
million more than the FY2021-enacted funding.41 This funding will help provide life insurance to
5.6 million veterans, servicemembers, and dependents. Provided appropriations would enable VA
to transfer $20,000 to the NSLI program, $32.3 million to the VMLI program, and $104.7 million
to the S-DVI program. In addition, VA will have an estimated $6.0 million in collections from
premiums, interest on investments, and extra hazard payments from military service branches. VA
also requested $109.87 million in advance appropriations for FY2023.42
In H.R. 4502 and S. 2604, both the House and Senate Appropriations Committees recommend
appropriating $136.95 million to VA’s insurance and indemnity account, which is the amount VA
requested.43
Medical Care and Medical Research Discretionary
Programs Funding
Background
The Veterans Health Administration operates one of the nation’s largest integrated direct health
care delivery systems.44 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 veterans-specific national health care system, in the sense that
the federal government owns the medical facilities and employs the health care providers.45

38 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.
39 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/.
40 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/.
41 U.S. Department of Veterans Affairs, FY2022 Budget Submission, Budget in Brief, May 2021, p. BiB-28.
42 U.S. Department of Veterans Affairs, FY2022 Budget Submission, Benefits and Burial Programs and Departmental
Administration, vol. 3 of 4, May 2021, p. VBA-129, 131.
43 U.S. Congress, House Committee on Appropriations, Military Construction, Veterans Affairs, and Related Agencies
Appropriations Bill, 2022, report to accompany H.R. 4355, 117th Cong., 1st sess., July 2, 2021, H.Rept. 117-81, p. 33;
and U.S. Congress, Senate Committee on Appropriations, Military Construction, Veterans Affairs, and Related
Agencies Appropriation Bill, 2022, report to accompany S. 2604, 117th Cong., 1st sess., August 4, 2021, S.Rept. 117-35,
p. 35.
44 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, and renamed the Veterans Health
Administration in 1991.
45 Adam Oliver, “The Veterans Health Administration: An American Success Story?” The Milbank Quarterly, vol. 85,
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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 decisionmaking
and budgetary responsibilities is delegated to the VISNs.46 As of September 30, 2020, the VHA
operated 146 hospitals, 134 nursing homes, 775 community-based outpatient clinics (CBOCs),47
and 300 Readjustment Counseling Centers (Vet Centers).48 In 2009, VA began a pilot Mobile Vet
Center (MVC) program to improve access to services for veterans in rural areas, and the
department has deployed 83 MVCs to date.49
Although 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.50 VA is authorized to provide care in the
community through individual agreements with community providers, called veterans care
agreements. VA is also authorized to reimburse for emergency care visits if specific criteria are
met.51 Inpatient and outpatient care is provided in the private sector to eligible dependents of
veterans under the Civilian Health and Medical Program of the Department of Veterans Affairs
(CHAMPVA).52 In addition, VHA provides grants for construction of state-owned nursing homes
and domiciliary facilities53 and collaborates with the Department of Defense in sharing health
care resources and services.
Apart from providing direct patient care to veterans,54 VHA’s other statutory missions are to
conduct medical research,55 serve as a contingency backup to the DOD medical system during a
national security emergency,56 provide support to the National Disaster Medical System and the

no. 1 (March 2007), pp. 5-35.
46 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.
47 For more information on CBOCs, see CRS Report R41044, Veterans Health Administration: Community-Based
Outpatient Clinics (archived).
48 Department of Veterans Affairs, FY2022 Budget Submission, Medical Programs and Information Technology
Programs, vol. 2 of 4, May 28, 2021, p. VHA-443. 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.
49 Department of Veterans Affairs, FY2022 Budget Submission, Medical Programs and Information Technology
Programs, vol. 2 of 4, May 28, 2021, p. VHA-443.
50 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).
51 For more information, see CRS Report R42747, Health Care for Veterans: Answers to Frequently Asked Questions.
52 For details on CHAMPVA, see CRS Report RS22483, Health Care for Dependents and Survivors of Veterans.
53 Under the grant program, 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. VA is prohibited by law from exercising any supervision or control over the operation of a
state veterans nursing home, including setting admission criteria. Admission requirements are determined exclusively
by the state. Also see CRS In Focus IF11656, State Veterans Homes.
54 38 U.S.C. §7301(b).
55 38 U.S.C. §7303.
56 38 U.S.C. §8111A.
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Department of Health and Human Services as necessary,57 and train health care professionals to
provide an adequate supply of health personnel for VA and the nation.58
The Veteran Patient Population59
In FY2021, approximately 9.2 million of the 19.5 million total veterans were enrolled in VA’s
health care system.60 VA estimates that in FY2022, enrollment will grow by approximately 5,000.
In FY2021, of the total number of enrolled veterans, VA anticipated treating approximately 7.0
million unique veteran and nonveteran patients.61 For FY2022, VHA estimates that it will treat
about 7.2 million unique veteran patients, or 1.0% over the FY2021 estimate (see Table A-1 for
veteran population, VA enrollees, and VA patients from FY2000 to FY2022).
In addition, VHA estimates that outpatient visits will increase from 114.72 million visits in
FY2021 to 118.99 million visits in FY2022, an increase of 4.27 million, or 3.7%. VHA
anticipates a decrease in the total number of inpatients treated in all inpatient facilities from 1.05
million patients in FY2021 to 1.03 million patients in FY2022, a decrease of 1.9%.62
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 FY2022 for these four accounts were provided by the
Consolidated Appropriations Act, 2021 (Div. J; P.L. 116-260). 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 increased by $3.27 billion over the advance appropriations amount in
FY2022.63 This increase from the FY2022 request was driven by readjusted actuarial estimates
for the medical community care account. In total, the FY2022 budget request for VHA is $101.72
billion, including medical care collections (see Table 2).64

57 38 U.S.C. §8117(e).
58 38 U.S.C. §7302.
59 Department of Veterans Affairs, FY2022 Budget Submission, Medical Programs and Information Technology
Programs, vol. 2 of 4, May 28, 2021, p. VHA-38.
60 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.
61 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.
62 Department of Veterans Affairs, FY2022 Budget Submission, Medical Programs and Information Technology
Programs, vol. 2 of 4, May 28, 2021, p. VHA-40.
63 Department of Veterans Affairs, FY2022 Budget Submission, Medical Programs and Information Technology
Programs, vol. 2 of 4, May 28, 2021, p. VHA-11.
64 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
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As required by the Veterans Health Care Budget Reform and Transparency Act of 2009 (P.L. 111-
81), the President’s budget requests $111.29 billion in advance appropriations for the four
medical care appropriations (medical services, medical community care, medical support and
compliance, and medical facilities) for FY2023, an increase of approximately 14.2% over the
FY2022-requested amount of $97.45 billion for the same four accounts. In FY2023, the
Administration’s budget request would provide $70.32 billion for the medical services account,
$24.16 billion for medical community care, $9.67 billion for the medical support and compliance
account, and $7.13 billion for the medical facilities account (see Table 2).
The House-passed version of the MILCON-VA appropriations bill (Division F of H.R. 4502;
H.Rept. 117-81) provides a higher VHA appropriation than the President’s request ($123 million
higher), while the Senate Appropriations Committee MILCON-VA bill for FY2022 (S. 2604;
S.Rept. 117-35) recommends the same amount as the President’s request. The sections below
detail the amounts requested for each VHA account for FY2022 and the funds provided in the
House-passed bill and recommended in the Senate Appropriations Committee bill for each
account.
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;65 grants for adaptive sports programs for disabled veterans and members of the Armed
Forces, beneficiary travel, prosthetics, Long-Term Services and Supports (LTSS), aid to state
veterans’ homes; and assistance and support services for family caregivers, and costs associated
with activation of newly constructed or leased VA medical care facilities, among other distinct
activities.66
For FY2022, the President’s budget requests $58.90 billion for the medical services account. This
amount is equal to the FY2022 advance appropriated amount. According to VA, when combined
with $9.6 billion of unobligated balances from funding provided in the American Rescue Plan
Act, this amount fully funds all resources.
The House-passed version of the MILCON-VA appropriations bill (Division F of H.R. 4502;
H.Rept. 117-81) provides $106 million over the FY2022 President’s request. The Senate
Appropriations Committee MILCON-VA bill recommendation for FY2022 is the same as the
President’s request. Both the House-passed bill and the Senate Appropriations Committee bill

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, 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.
65 In its FY2008 budget request to Congress, 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.
66 Department of Veterans Affairs, FY2022 Budget Submission, Medical Programs and Information Technology
Programs, vol. 2 of 4, May 28, 2021, p. VHA-306.
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provide FY2023 advance appropriations equal to the President’s request of $70.32 billion (see
Table 2).
Within the total amount provided for medical services in the House-passed bill for FY2022 ($59.0
billion), the committee provides an additional $10 million over the request for the whole health
initiative ($83.60 million total), an additional $1 million for suicide prevention ($599 million
total), an additional $73 million for gender-specific care for women ($778.50 million total), and
an additional $2.51 million for mental health ($13.18 billion total).
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 advance
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
VHA provides to eligible veterans through community health care providers. These programs
include the Veterans Community Care Program (VCCP), the Camp Lejeune Family Member
Program (CLFMP), CHAMPVA, the Foreign Medical Program (FMP), the Spina Bifida Health
Care Program, the Children of Women Vietnam Veterans Health Care Benefits Program
(CWVV), and the Indian Health Service (IHS)/Tribal Health Programs (THP) Reimbursement
Agreements Program.
Some expenses related to the community care program are funded through the medical support
and compliance account and the Information Technology account. These expenses include
administrative expenses related to claims processing performed by the Third Party Administrators
(TPAs) and VHA, and software required for information technology (IT) systems related to the
community care program.67
The President’s budget requests $23.42 billion for the medical community care account. This
amount is $3.27 billion over the FY2022 advance appropriated amount of $20.15 billion. This
increase was largely driven by readjusted actuarial estimates for the medical community care
account.68
The House-passed version of the MILCON-VA appropriations bill (Division F of H.R. 4502;
H.Rept. 117-81) provides $3.26 million more than the FY2022 advance appropriation amount.
This is $5 million less than the FY2022 request. The Senate Appropriations Committee bill
recommends the same amount as the FY2022 request. Both bills provide FY2023 advance
appropriation amounts equivalent to the President’s request (see Table 2).
Medical Support and Compliance
This account provides for expenses related to the management, security, and administration of
VA’s health care system through the operation of VA medical centers (VAMCs) and other medical
facilities, such as community-based outpatient clinics (CBOCs) and Vet Centers. This includes
among other things, VMAC leadership teams (Director, Chief of Staff, Chief Medical Officer, and

67 Department of Veterans Affairs, FY2022 Budget Submission, Medical Programs and Information Technology
Programs, vol. 2 of 4, May 28, 2021, p. VHA-334.
68 Department of Veterans Affairs, FY2022 Budget Submission, Medical Programs and Information Technology
Programs, vol. 2 of 4, May 28, 2021, p. VHA-11.
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Chief Nurse) and VAMC support functions, such as “quality of care oversight, security services,
legal services, billing and coding activities, acquisition, procurement, and logistics activities,
human resource management, logistics and supply chain management, and financial
management.”69 This account also funds 18 Veterans Integrated Service Network (VISN)70
offices, which include network management activities such as the following network leadership
teams within each VISN: Network Director, Deputy Network Director, Chief Financial Officer,
Chief Medical Officer, and Chief Information Officer.71 This account also provides for expenses
related to VHA Central Office (VHACO) operating units, such as offices of the Assistant Under
Secretary for Community Care and Deputy Assistant Under Secretary for Community Care, the
Office of the Assistant Under Secretary for Health for Clinical Services and the Chief Medical
Officer (AUSH/CS), and the Office of Discovery, Education, and Affiliate Networks (DEAN),
among other offices and suboffices.
The President’s budget requests $8.40 billion for the medical support and compliance account.
This amount is equivalent to the FY2022 advance appropriated amount.72
Both the House-passed version of the MILCON-VA appropriations bill (Division F of H.R. 4502;
H.Rept. 117-81) and the Senate Appropriations Committee bill provide the same amount as the
President’s request (see Table 2).
Medical Facilities
The medical facilities account funds expenses pertaining to the operations and maintenance of
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 medical facility leases, including clinical space in CBOCs, engineering and environmental
management, grounds maintenance, fire protection, nonrecurring maintenance, recurring
maintenance and repairs, textile care processing and maintenance, and operating equipment
maintenance and repairs, among others.
The President’s budget requests $6.73 billion for the medical facilities account. This amount is
equivalent to the FY2022 advance appropriated amount.73
Both the House-passed version of the MILCON-VA appropriations bill (Division F of H.R. 4502;
H.Rept. 117-81) and the Senate Appropriations Committee bill provide the same amount as the
President’s request (see Table 2).
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

69 Department of Veterans Affairs, FY2022 Budget Submission, Medical Programs and Information Technology
Programs, vol. 2 of 4, May 28, 2021, p. VHA- 351.
70 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.
71 Department of Veterans Affairs, FY2022 Budget Submission, Medical Programs and Information Technology
Programs, vol. 2 of 4, May 28, 2021, p. VHA- 352.
72 Department of Veterans Affairs, FY2022 Budget Submission, Medical Programs and Information Technology
Programs, vol. 2 of 4, May 28, 2021, p. VHA-19.
73 Department of Veterans Affairs, FY2022 Budget Submission, Medical Programs and Information Technology
Programs, vol. 2 of 4, May 28, 2021, p. VHA-19.
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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. The
medical services, medical support and compliance, and medical facilities accounts also provide
funds for additional expenses required for VAMCs supporting research activities.
In general, VA’s research program is intramural; VA investigators conduct research at VA
facilities and in approved off-site space occupied by VA under a legal agreement. Unlike other
federal agencies, such as NIH and DOD, VA does not have the statutory authority to make
research grants to colleges and universities, cities and states, or any other non-VA entities.
The President’s budget requests $882 million for the medical and prosthetic research account, an
increase of $87 million, or 10.9%, above the FY2021-enacted amount of $795 million. The
VHA’s major research priorities in FY2022 include, among others, traumatic brain injury (TBI),
military exposures, and Coronavirus-related research and impact, cloud computing and storage,
data security/counterintelligence, precision oncology, and collaboration with Department of
Energy.74
The House-passed version of the MILCON-VA appropriations bill (Division F of H.R. 4502;
H.Rept. 117-81) provides $22 million more than the FY2022 request. The amount recommended
by the Senate Appropriations Committee bill for FY2022 is the same as the request (see Table 2).
Nonmedical Discretionary Programs Funding
National Cemetery Administration (NCA)
The majority of NCA’s discretionary funding falls into the Operations and Maintenance category.
VA requested a total of $394 million in FY2022 for this account (see Table 2)—a $42 million, or
12%, increase for NCA’s operations and maintenance expenses over the FY2021-enacted
amount. The requested funding will provide for an estimated 136,000 interments, perpetual care
of 4 million gravesites, and the operations and maintenance of 158 national cemeteries and 34
additional sites.75 The request also includes funding to support hiring an additional 97 full-time
equivalents (FTEs), bringing the total number of FTEs from 2,120 in FY2021 to 2,217 in
FY2022.76
As VA continues to work toward its goal of providing 95% of veterans with access to a cemetery
within 75 miles of their homes, the VA request includes $7.6 million for the continued activation
of the rural cemeteries in Fargo, ND; Cheyenne, WY; and Northwoods, WI; and for initial
activation of the New York and Indianapolis columbarium-only cemeteries and the Cedar City,
UT, rural cemetery. With the addition of these new cemeteries and the increased workload
anticipated during FY2022, VA requested $7.7 million and 35 new FTEs to address these needs.77
Within the Operations and Maintenance appropriations category, VA requested funds to support
the agency’s programs and initiatives to memorialize the veterans in the cemeteries. The funds

74 Department of Veterans Affairs, FY2022 Budget Submission, Medical Programs and Information Technology
Programs, vol. 2 of 4, May 28, 2021, p. VHA-544.
75 U.S. Department of Veterans Affairs, FY2022 Budget Submission, Budget in Brief, May 2021, p. BiB-32-33.
76 U.S. Department of Veterans Affairs, FY2022 Budget Submission, Budget in Brief, May 2021, p. BiB-33.
77 U.S. Department of Veterans Affairs, FY2022 Budget Submission, Benefits and Burial Programs and Departmental
Administration, vol. 3 of 4, May 2021, pp. NCA-23, 24.
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would be used to continue developing the Veterans Legacy Memorial (VLM) and to incorporate
millions of veterans’ records from non-VA national cemeteries. To complement NCA’s digital
efforts, NCA will continue to develop onsite interpretive signs, exhibits, and publications to
increase the public’s knowledge of NCA’s history. To commemorate its 50th anniversary, NCA is
to produce a book that would be the “first comprehensive history of NCA highlighting its
establishment and transformation to the present.”78
Division F of H.R. 4502 provides $392 million for NCA expenses in FY2022, which is $2 million
less than the requested amount but $40 million over the FY2021-enacted amount (see Table 2).79
The House Appropriations Committee, in its report (H.Rept. 117-81), explained that NCA should
prioritize two key goals: (1) maintaining the current level of services at existing cemeteries and
(2) activating new cemeteries to increase burial access. In addition, the committee highlighted
two items it would like to see more action on: (1) completing the replacement of the headstones
of prisoners of war that have a German insignia on them and (2) pursing efforts to expand and
ensure burial access to veterans in rural communities.80
In comparison, the Senate Appropriations Committee, in S. 2604, recommended $394 million for
NCA expenses in FY2022, which is equivalent to the requested amount and $42 million over the
FY2021-enacted amount.81 The committee report, S.Rept. 117-35, addressed three NCA projects
that are in progress. First, the committee directs VA to establish a pilot program to partially or
fully enclose committal shelters at national cemeteries located in various climates. Second, the
committee is pleased with the progress toward completion of the Western New York National
Cemetery and requests a timeline for completion within 60 days after enactment of the act.
Finally, the committee supports additional infrastructure at rural cemeteries, but requests VA to
also consider any necessary water, sewer, and electric utilities needed for these projects.82
VBA, General Operating Expenses
VA requested $3.423 billion in funding for VBA general operating expenses for FY2022. This
amount was an estimated $243 million, or 7.6%, increase over the enacted FY2021 budget and
will support 25,303 FTEs, an increase of 560 over FY2021 (see Table 2).83 In addition, VA’s two
key priorities for FY2022 are benefits delivery and suicide prevention.84 To address these
priorities, VA requested $81.5 million to modernize the Education Service platform to improve
claims processing, collaboration with stakeholders, and communications through an online
platform. In addition, VA requested $3.6 million to develop and implement a pilot program that

78 U.S. Department of Veterans Affairs, FY2022 Budget Submission, Benefits and Burial Programs and Departmental
Administration, vol. 3 of 4, May 2021, pp. NCA-25.
79 U.S. Congress, House Committee on Appropriations, Military Construction, Veterans Affairs, and Related Agencies
Appropriations Bill, 2022, report to accompany H.R. 4355, 117th Cong., 1st sess., July 2, 2021, H.Rept. 117-81, p. 72.
80 U.S. Congress, House Committee on Appropriations, Military Construction, Veterans Affairs, and Related Agencies
Appropriations Bill, 2022, report to accompany H.R. 4355, 117th Cong., 1st sess., July 2, 2021, H.Rept. 117-81, p. 73.
81 U.S. Congress, Senate Committee on Appropriations, Military Construction, Veterans Affairs, and Related Agencies
Appropriation Bill, 2022, report to accompany S. 2604, 117th Cong., 1st sess., August 4, 2021, S.Rept. 117-35, p. 65-66.
82 U.S. Congress, Senate Committee on Appropriations, Military Construction, Veterans Affairs, and Related Agencies
Appropriation Bill, 2022, Report to Accompany, 117th Cong., 1st sess., August 4, 2021, p. 66.
83 U.S. Department of Veterans Affairs, FY2022 Budget Submission, Benefits and Burial Programs and Departmental
Administration, vol. 3 of 4, May 2021, pp. VBA-147.
84 U.S. Department of Veterans Affairs, FY2022 Budget Submission, Budget in Brief, May 2021, p. BiB-28.
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would provide employment opportunities to veterans and servicemembers with service-connected
disabilities, and to use this program to learn more about ways to assist disabled veterans.85
Division F of H.R. 4502 provides $3.417 billion for VBA General Operating Expenses in
FY2022, which is $5.6 million less than the requested amount but $237.4 million over the
FY2021-enacted amount (see Table 2).86 The committee stated that “VBA should prioritize use of
these funds to process claims, including claims related to new Agent Orange presumptive
conditions, and reduce the claims backlog.”87 In addition, the committee identifies several areas
that it would like VA to address. The committee encourages VA to create a transparent and
evidence-based framework to expeditiously establish new presumptions for illnesses and
disability associated with toxic exposures. It also directs VA to partner with DOD, TRICARE,
private sector health providers, and the Centers for Medicare & Medicaid Services (CMS) to
complete a report that examines the total number of veterans who have filed claims for disability
compensation related to burn pits, along with the demographic information, medical diagnoses,
location of burn pits, and the approval and denial rates and rationale for denials.88
In comparison, the Senate Appropriations Committee, in S. 2604, recommends $3.486 billion for
VBA general operating expenses in FY2022. This funding is $63 million above VA’s requested
amount and $306 million over the FY2021-enacted amount.89 The committee report, S.Rept. 117-
35, addressed several issues, such as, but not limited to, compensation and pension exams,
digitization of military records, and a national training curriculum. The committee expressed its
concern about VBA’s increased reliance on contract examiners for compensation and pension
exams and urged VA to make these exams available at VA facilities “with the capability to
conduct them in a safe and thorough manner.”90 The committee also requests VA to work in
coordination with the Archivist of the United States to provide an update, in the form of a report,
on the progress made by the National Personnel Records Center on improving veterans’ access to
military records and on the effort to digitize outstanding personnel records for the year 1990 and
earlier. Finally, the committee encourages VA to improve its training of disability claim
processors to ensure they are correctly adjudicating claims of veterans suffering from
posttraumatic stress disorder (PTSD).91

85 U.S. Department of Veterans Affairs, FY2022 Budget Submission, Benefits and Burial Programs and Departmental
Administration, vol. 3 of 4, May 2021, pp. VBA-150.
86 U.S. Congress, House Committee on Appropriations, Military Construction, Veterans Affairs, and Related Agencies
Appropriations Bill, 2022, report to accompany H.R. 4355, 117th Cong., 1st sess., July 2, 2021, H.Rept. 117-81, p. 35.
87 U.S. Congress, House Committee on Appropriations, Military Construction, Veterans Affairs, and Related Agencies
Appropriations Bill, 2022, report to accompany , 117th Cong., 1st sess., July 2, 2021 p. 35.
88 U.S. Congress, House Committee on Appropriations, Military Construction, Veterans Affairs, and Related Agencies
Appropriations Bill, 2022, report to accompany H.R. 4355, 117th Cong., 1st sess., July 2, 2021, H.Rept. 117-81, p. 36-
37.
89 U.S. Congress, Senate Committee on Appropriations, Military Construction, Veterans Affairs, and Related Agencies
Appropriation Bill, 2022, report to accompany S. 2604, 117th Cong., 1st sess., August 4, 2021, S.Rept. 117-35, p. 37.
90 U.S. Congress, Senate Committee on Appropriations, Military Construction, Veterans Affairs, and Related Agencies
Appropriation Bill, 2022, report to accompany S. 2604, 117th Cong., 1st sess., August 4, 2021, S.Rept. 117-35, p. 37.
91 U.S. Congress, Senate Committee on Appropriations, Military Construction, Veterans Affairs, and Related Agencies
Appropriation Bill, 2022, report to accompany S. 2604, 117th Cong., 1st sess., August 4, 2021, S.Rept. 117-35, p. 38-39.
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Board of Veterans’ Appeals
The Board of Veterans’ Appeals is an agency within VA established in 1933.92 The BVA’s role is
to conduct hearings and make final decisions on behalf of the VA Secretary regarding appeals for
veterans’ benefits and services from VBA, VHA, and NCA, as well as the Office of General
Counsel (OGC), that are presented to BVA for appellate review.93
The FY2022 request for BVA is $228 million, a $32 million increase over the FY2021-enacted
amount of $196 million (see Table 2). This amount would support 129 new full time equivalent
(FTE) staff, including 35 additional Veteran Law Judges (VLJs).
The House-passed version of the MILCON-VA appropriations bill (Division F of H.R. 4502;
H.Rept. 117-81) provides $228 million as requested, along with authority to carry over 10%
percent of this funding into FY2023.
The Senate Committee version MILCON-VA bill for FY2022 (S. 2604; S.Rept. 117-35), similar
to the House-passed bill, recommends the same amount as the President’s request. The committee
report, while acknowledging the current appeals backlog, states: “[the] Department is currently
experiencing a backlog of disability claims, which has only been exacerbated by the COVID–19
pandemic. The Committee recognizes veterans’ expectations regarding timely and accurate
appeals processing, and supports full funding of the [BVA] to increase personnel, reduce the
backlog of claims and get veterans the timely answers they deserve.”94
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.
The President’ FY2022 IT budget request is $4.843 billion, a decrease of $31.7 million below the
2021-enacted budget (see Table 2). Of this amount, $297 million would be for IT development,
such as building new software applications; $3.13 billion would be for operations and
maintenance (O&M); and $1.414 billion would be for staffing and administrative support
services. The Administration’s budget is proposing to supplement the IT budget request with
$670 million from the Recurring Expenses Transformational Fund in FY2022.95 The budget

92 38 U.S.C. §§ 7101-7113.
93 Department of Veterans Affairs, Board of Veterans’ Appeals Annual Report, Fiscal Year (FY) 2020, December 2020,
p. 5.
94 U.S. Congress, Senate Committee on Appropriations, Military Construction, Veterans Affairs, and Related Agencies
Appropriation Bill, 2022, report to accompany S. 2604, 117th Cong., 1st sess., August 4, 2021, S.Rept. 117-35, p.69.
95 The Recurring Expenses Transformational Fund was established by the Consolidated Appropriations Act, 2016 (P.L.
114-113, Division J, Title II, Section 243). The law allows unobligated balances of expired discretionary
appropriations, in FY2016 or any succeeding fiscal year, to be transferred from the General Fund of the Treasury to VA
and deposited in the Recurring Expenses Transformational Fund at the end of the fifth fiscal year after the last fiscal
year for which such funds were available. The law stipulates that amounts deposited in the fund may be available for
facility infrastructure improvements, including nonrecurring maintenance, at existing VA hospitals and clinics, and
information technology systems improvements and sustainment, subject to approval by the Office of Management and
Budget (OMB) and House and Senate Appropriations Committees.
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proposes to use the Transformational Fund to support IT infrastructure readiness, Financial
Management Business Transformation (FMBT),96 and modernizing human resources systems.97
The House-passed bill (Division F of H.R. 4502) provides approximately $4.842 billion for the IT
systems account for FY2022, which is approximately $1 million less than the request (see Table
2). Within this total, the House-passed measure allocates $297 million for IT development, such
as building new software applications; $3.13 billion for operations and maintenance (O&M); and
$1.413 billion for staffing and administrative support services. H.Rept. 117-81 directs the Office
of Information Technology (OIT), in coordination with VHA and Office of Electronic Health
Records Modernization (OEHRM), to develop end-to-end encrypted communication for
telehealth, and to develop a centralized data system to catalog sexual harassment and assault
complaint data as part of a comprehensive policy to end sexual assault, including sexual
harassment and gender-based harassment, throughout VA.98
The Senate Appropriations Committee-reported FY2022 MILCON-VA appropriations bill (S.
2604: S.Rept. 117-35) recommends approximately $4.843 billion for the IT systems account, the
same as the Administration’s request (see Table 2). Of this amount, the Senate version of the
MILCON-VA appropriations bill recommends $297 million for IT development, $3.13 billion for
operations and maintenance (O&M), and $1.414 billion for staffing and administrative support
services, the same as the President’s budget request. The committee also supports the
Administration’s proposal to allocate Recurring Expenses Transformational Fund funds to
supplement funds for IT programs delineated in the Administration’s budget proposal for
FY2022.99
Electronic Health Record Modernization (EHRM)100
On May 17, 2018, 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. This
includes the Electronic Health Record (EHR) contract costs, infrastructure readiness, and
expenses related to the Project Management Office (PMO). Beginning with the Military

96 In 2016, VA embarked on a new financial management modernization program known as the Financial Management
Business Transformation (FMBT) program. Funding for the FMBT is derived from multiple accounts. These include
the IT appropriation account, general administration appropriation account, and the Franchise Fund appropriation
account. For more information on FMBT, see U.S. Government Accountability Office, Veterans Affairs: Ongoing
Financial Management System Modernization Program Would Benefit from Improved Cost and Schedule Estimating,
GAO-21-227, April 20, 2021.
97 Department of Veterans Affairs, FY2022 Budget Submission, Medical Programs and Information Technology
Programs, vol. 2 of 4, May 28, 2021, p. OIT–643.
98 The Deborah Sampson Act of 2020 (Johnny Isakson and David P. Roe, M.D. Veterans Health Care and Benefits
Improvement Act of 2020; P.L. 116-315; 134 STAT. 5022) required the Secretary to establish a comprehensive anti-
harassment and anti-sexual assault policy at VA. U.S. Congress, House Committee on Appropriations, Military
Construction, Veterans Affairs, and Related Agencies Appropriations Bill, 2022, report to accompany H.R. 4355, 117th
Cong., 1st sess., July 2, 2021, H.Rept. 117-81, p. 78.
99 U.S. Congress, Senate Committee on Appropriations, Military Construction, Veterans Affairs, And Related Agencies
Appropriations Bill, 2022, report to accompany S. 2604, 117th Cong., 1st sess., August 4, 2021, S.Rept. 117-35, p.70.
100 P.L. 115-407, Title V, § 503, 132 Stat. 5376 defines ‘‘Electronic Health Record Modernization Program’’ as “any
activities by the Department of Veterans Affairs to procure or implement an electronic health or medical record system
to replace any or all of the Veterans Information Systems and Technology Architecture, the Computerized Patient
Record System, the Joint Legacy Viewer, or the Enterprise Health Management Platform; and any contracts or
agreements entered into by the Secretary of Veterans Affairs to carry out, support, or analyze the activities under the
[Electronic Health Record Modernization Program].”
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Construction, Veterans Affairs, and Related Agencies Appropriations Act for FY2018 (P.L. 115-
141), Congress established this new account, which is “intended to be the single source of
funding within VA for the electronic health record effort” (H.Rept. 115-673). The Office of the
Deputy Secretary is the only office responsible for administering the funds in this account.
On October 24, 2020, VA began initial deployment of the Cerner Millennium EHR at the Mann-
Grandstaff VAMC in Spokane, WA, and the West Consolidated Patient Account Center. Due to
various implementation challenges, and potential patient safety issues encountered during
transition to the new EHR system, as highlighted by the Government Accountability Office
(GAO), VA OIG, and medical center staff, on March 19, 2021, Secretary Denis McDonough
announced a strategic review of the EHRM program.101 The results of this review were released
in July 2021.102 Based on the results of the strategic review, VA altered the deployment schedule
for Cerner Millennium EHR, based on assessing and ensuring readiness at each deployment
site.103 Previously, the deployment schedule was based on a synchronized DOD and VA regional
schedule.
The President’s request for the EHR account for FY2022 is $2.66 billion (see Table 2). The
request is further separated into three subaccounts: approximately $1.43 billion allocated for the
Cerner EHR Millennium solution, approximately $951.8 million allocated for infrastructure
readiness, and approximately $285.7 million allocated for program support.104
The House-passed measure (Division F of H.R. 4502) provides approximately $2.64 billion for
the EHR account, which is $26 million less than the Administration’s request (see Table 2).
Furthermore, the bill stipulates that 25% of funding would not be available until July 1, 2022, and
that the release of funds would be based on the certification by the Secretary regarding any
changes to the EHRM deployment schedule. The House Committee report (H.Rept. 117-81)
further delineates EHR funding at the subaccount level, including approximately $1.42 billion
allocated for the electronic health record contract, approximately $276.71 million allocated for
program management, and approximately $943.79 allocated for infrastructure support.105 In
addition, “due to the uncertainty of the timing of obligations,” funds in this account would be
available for three fiscal years.106
The Senate Appropriations Committee-reported version of the FY2022 MILCON-VA
appropriations bill (S. 2604; S.Rept. 117-35) recommends $2.5 billion for the EHR account,
which is $163 million below the Administration’s request (see Table 2). The committee expresses
its displeasure with VA’s EHR deployment: “while the Committee remains supportive of
replacing VA’s current EHR with the same system being acquired by DoD, frustrations continue

101 Department of Veterans Affairs, “VA announces strategic review of Electronic Health Record Modernization
program,” press release, March 19, 2021, https://www.va.gov/opa/pressrel/pressrelease.cfm?id=5647.
102 Department of Veterans Affairs, Electronic Health Record Modernization: Comprehensive Lessons Learned Report,
July 2021.
103 U.S. Congress, Senate Committee on Veterans’ Affairs, VA Electronic Health Records: Modernization and the Path
Ahead, Statement of the Honorable Denis McDonough, 117th Cong., 1st sess., July 14, 2021,
https://www.veterans.senate.gov/hearings/va-electronic-health-records-modernization-and-the-path-ahead-07-14-21
104 Department of Veterans Affairs, FY2022 Budget Submission, Medical Programs and Information Technology
Programs, vol. 2 of 4, May 28, 2021, p. EHRM – 609-EHRM – 610.
105 U.S. Congress, House Committee on Appropriations, Military Construction, Veterans Affairs, and Related Agencies
Appropriations Bill, 2022, report to accompany H.R. 4355, 117th Cong., 1st sess., July 2, 2021, H.Rept. 117-81, p. 78.
106 U.S. Congress, House Committee on Appropriations, Military Construction, Veterans Affairs, and Related Agencies
Appropriations Bill, 2022, report to accompanyH.R. 4355, 117th Cong., 1st sess., July 2, 2021, H.Rept. 117-81 H.Rept.
117-81, p. 78.
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with the delays in execution, as well as with the Department’s poor communication.”107
Furthermore, similar to the House-passed measure, the bill stipulates that 25% of funding would
not be available until July 1, 2022, and that the release of funds would be based on the Secretary
providing a plan to the committees regarding “benchmarks and measureable metrics for
deployment, and a plan for addressing all required infrastructure upgrades.”108 Moreover, VA is
advised to consult with the Indian Health Service, as the IHS modernizes the Indian Health
Service Electronic Health Record system, in order to ensure interoperability between VA and the
IHS EHR systems.109
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 the state extended care facilities account provide
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 the veterans cemeteries account provide grants to states, territories, and federally
recognized tribal governments for the establishment, expansion, or improvement of state and
tribal veterans cemeteries.
The President’s FY2022 budget request for construction and construction grants is approximately
$2.21 billion. This amount includes $1.61 billion for the major construction account, $553 million
for the minor construction account, and $45 million for grants for construction of veterans
cemeteries (see Table 2). In addition, the budget request proposes $150 million from the
Recurring Expenses Transformational Fund to supplement the minor construction account in
FY2022.110 The Administration does not request any funding for grants for state extended care

107 U.S. Congress, Senate Committee on Appropriations, Military Construction, Veterans Affairs, And Related Agencies
Appropriations Bill, 2022, report to accompany S. 2604, 117th Cong., 1st sess., August 4, 2021, S.Rept. 117-35, p. 72.
108 U.S. Congress, Senate Committee on Appropriations, Military Construction, Veterans Affairs, And Related Agencies
Appropriations Bill, 2022, report to accompanyS. 2604, 117th Cong., 1st sess., August 4, 2021, S.Rept. 117-35, p. 72.
109 U.S. Congress, Senate Committee on Appropriations, Military Construction, Veterans Affairs, And Related Agencies
Appropriations Bill, 2022, report to accompany S. 2604, 117th Cong., 1st sess., August 4, 2021, S.Rept. 117-35, p.73.
110 The Recurring Expenses Transformational Fund was established by the Consolidated Appropriations Act, 2016
(P.L. 114-113, Division J, Title II, Section 243). The law allows unobligated balances of expired discretionary
appropriations, in FY2016 or any succeeding fiscal year, to be transferred from the General Fund of the Treasury to VA
and deposited in the Recurring Expenses Transformational Fund at the end of the fifth fiscal year after the last fiscal
year for which such funds were available. The law stipulates that amounts deposited in the fund may be available for
facility infrastructure improvements, including nonrecurring maintenance, at existing VA hospitals and clinics, and
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facilities. The department is estimating that it would carry over $596 million into FY2022 from
prior year appropriations and American Rescue Plan (ARP) Act (P.L. 117-2) funding.111
The House-passed bill (Division F of H.R. 4502) provides approximately $2.30 billion for
construction and construction grants accounts for FY2022, approximately $92.1 million above the
request. This includes the requested amounts for the construction major and minor accounts, and
$90 million for funding for grants for state extended care facilities (see Table 2). According to
House Committee report (H.Rept. 117-81): “[s]upporting grants for construction of state extended
care facilities has been and will continue to be a priority of the Committee. As such, in order to
ensure that VA has the resources required to address priority project applications submitted in
April 2021, the bill maintains level funding of $90 million for fiscal year 2022.”112 Lastly, the
House-passed MILCON-VA appropriations bill provides $47.1 million for grants for construction
of veterans cemeteries.
The Senate Appropriations Committee-reported version of the FY2022 MILCON-VA
appropriations bill (S. 2604; S.Rept. 117-35) recommends approximately $2.26 billion for
construction and construction grants, approximately $55 million above the President’s FY2022
request (see Table 2). This includes the requested amounts for the construction major and minor
accounts. S. 2604 also includes a provision to include $150 million from the Recurring Expenses
Transformational Fund to supplement minor construction account. The committee
recommendation includes $50 million for grants for state extended care facilities, and notes “that
additional projects are needed around the country to support the needs of our Nation’s veterans,
and VA receives new applications each year. Therefore, the Committee recommends funding in
fiscal year 2022 to address applications for additional Priority 1 projects.”113 S. 2604 also
recommends $50 million for grants for construction of state veterans cemeteries, which is $5
million above the request.
Asset and Infrastructure Review
Title II of the VA MISSION Act (P.L. 115-182) included the VA Asset and Infrastructure Review
(AIR) Act of 2018. The AIR Act establishes a process for realigning and modernizing VHA
facilities. Under this process, VA is to develop criteria for selecting VHA facilities to dispose of,
modernize, or acquire, so as to better meet the health care needs of veterans.114 VA must then
create a list of recommendations based on those criteria and submit it to a newly created Asset
and Infrastructure Review Commission (the Commission). This nine-member commission
reviews the VA’s recommendations but may not alter them, unless it determines that one or more
recommendations are inconsistent with the criteria. The Commission submits the list of
recommendations to the President, who either approves the list in its entirety or sends it back to
the Commission with the reasons for disapproval. The Commission shall take into account the

information technology systems improvements and sustainment, subject to approval by the Office of Management and
Budget (OMB) and House and Senate Appropriations Committees.
111 Department of Veterans Affairs, FY2022 Budget Submission, Medical Programs and Information Technology
Programs, vol. 2 of 4, May 28, 2021, p. VHA – 505.
112 U.S. Congress, House Committee on Appropriations, Military Construction, Veterans Affairs, and Related Agencies
Appropriations Bill, 2022, report to accompany H.R. 4355, 117th Cong., 1st sess., July 2, 2021, H.Rept. 117-81, p. 83.
113 U.S. Congress, Senate Committee on Appropriations, Military Construction, Veterans Affairs, And Related Agencies
Appropriations Bill, 2022, report to accompany S. 2604, 117th Cong., 1st sess., August 4, 2021, S.Rept. 117-35, p. 76.
114 Department of Veterans Affairs, “Draft Criteria for Section 203 of the MISSION Act,” 86 Federal Register 7921,
February 2, 2021; and final selection criteria published in Department of Veterans Affairs, “Asset and Infrastructure
Review Commission Foreword and Criteria,” 86 Federal Register 28932-28935, May 28, 2021.
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reasons for disapproval and submit a second report to the President with recommendations for
realignment and modernization of VHA facilities. The President may approve or disapprove the
revised list. If the President approves the original or revised list, then VA must begin
implementation of the recommendations within three years, unless Congress passes a joint
resolution of disapproval, in which case the process terminates.115
As required by the AIR Act, VA is conducting market assessments to develop high-performing
networks to improve access to care. The market assessment uses information regarding market
geography and demographics, current and future market demand, access to care, quality of care,
facility conditions, and health care resources that exist in the broader health care market (e.g.,
DOD, Federally Qualified Health Centers, academic partners, and private community
providers).116 The market assessments would receive input from local VA medical facilities staff.
Recommendations from the market assessments are to be finalized and submitted by the VA
Secretary to the presidentially appointed AIR Commission for consideration. The AIR
Commission’s authorized start date is January 1, 2022. The AIR Commission is to submit its
recommendations to the President for review and approval, prior to sending to Congress for
review and approval in 2023.
For the first time, the Administration’s request for FY2022 is requesting $5 million in funding for
a new Asset and Infrastructure Review account (see Table 2). This funding would provide for
support staff and necessary day-to-day operational expenses related to the AIR Commission
activities, which would be conducted in calendar years 2022 and 2023.117 The versions of the
FY2022 MILCON-VA appropriations bill passed by the House and reported by the Senate
Appropriations Committee provide $5 million as requested.
Table 2. FY2021-FY2022 Appropriations and FY2023 Advance Appropriations
($ in Thousands)
Consolidated
Appropriations Act, 2021
House
Senate Committee
(Div. J; P.L. 116-260)
President’s Request
(Division F; H.R. 4502)
(S. 2604; S.Rept. 117-35)
Program
FY2021
FY2022
FY2022
FY2023
FY2022
FY2023
FY2022
FY2023
Compensation and Pensions $118,246,975
—
$130,227,650
—
$130,227,650
—
$130,227,650
—
Over FY2021 Enacted
6,110,252
—
—
—
—
—
—
—
Advance Appropriations
Over FY2022 Enacted
—
—
7,347,837
—
7,347,837
—
7,347,837
—
Advance Appropriations
Subtotal Compensation and
124,357,227
—
137,575,487
—
137,575,487
—
137,575,487
—
Pensions
Readjustment Benefits
12,578,965
—
14,946,618
—
14,946,618
—
14,946,618
—
Insurance and Indemnities
129,224
—
136,950
—
136,950
—
136,950
—
Over FY2021 Enacted
2,148
—
—
—
—
—
—
—
Advance Appropriations

115 For a section-by-section summary of AIR Act provisions, see CRS Report R45390, VA Maintaining Internal
Systems and Strengthening Integrated Outside Networks Act of 2018 (VA MISSION Act; P.L.115-182).
116 Department of Veterans Affairs, “Draft Criteria for Section 203 of the MISSION Act,” 86 Federal Register 7921,
February 2, 2021.
117 Department of Veterans Affairs, FY2022 Budget Submission, Construction, Long Range Capital Plan and Appendix,
vol. 4 of 4, May 28, 2021, p. 6.3-2.
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Consolidated
Appropriations Act, 2021
House
Senate Committee
(Div. J; P.L. 116-260)
President’s Request
(Division F; H.R. 4502)
(S. 2604; S.Rept. 117-35)
Program
FY2021
FY2022
FY2022
FY2023
FY2022
FY2023
FY2022
FY2023
Subtotal Insurance and
131,372
—
136,950
—
136,950
—
136,950
—
Indemnities
Housing Benefit Program
1,663,000
—
2,781,000
—
2,781,000
—
2,781,000
—
Fund Credit Subsidy
Housing Benefit Program
204,400
—
229,500
—
229,500
—
229,500
—
Fund Administrative
Expenses
Vocational Rehabilitation
34
—
3
—
3
—
3
—
Loan Program
Vocational Rehabilitation
424
—
429
—
429
—
429
—
Loan Program
Administrative Expenses
Native American Housing
1,186
—
1,186
—
1,400
—
1,300
—
Loan Program
General Operating
3,180,000
—
3,423,000
—
3,417,400
—
3,486,000
—
Expenses (VBA)
P.L. 116-260 rescission
-16,000
—
—
—
—
—
—
—
(§254)
Total, Veterans Benefits 142,100,608
—
159,094,173
—
159,090,787
—
159,157,287
—
Administration (VBA)
Medical Services
56,158,015
—
58,897,219
—
58,897,219
—
58,897,219
—
Over FY2021 Enacted
497,468
—
—
—
—
—
—
—
Advance Appropriations
Over FY2022 Enacted
—
—
—
—
106,000
—
—
—
Advance Appropriations
P.L. 116-260 rescission
-100,000
—
—
—
—
—
—
—
(§254)
Subtotal Medical Services
56,555,483
—
58,897,219
—
59,003,219
—
58,897,219
—
Medical Community Care
17,131,179
—
20,148,244
—
20,148,244
—
20,148,244
—
Over FY2021 Enacted
1,380,800
—
—
—
—
—
—
—
Advance Appropriations
Over FY2022 Enacted
—
—
3,269,000
—
3,264,000
—
3,269,000
—
Advance Appropriations
Subtotal Medical Community
18,511,979
—
23,417,244
—
23,412,244
—
23,417,244
—
Care
Medical Support and
7,914,191
—
8,403,117
—
8,403,117
—
8,403,117
—
Compliance
Over FY2021 Enacted
300,000
—
—
—
—
—
—
—
Advance Appropriations
P.L. 116-260 rescission
-15,000
—
—
—
—
—
—
—
(§254)
Subtotal Medical Support and
8,199,191
—
8,403,117
—
8,403,117
—
8,403,117
—
Compliance
Medical Facilities
6,433,265
—
6,734,680
—
6,734,680
—
6,734,680
—
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Department of Veterans Affairs FY2022 Appropriations

Consolidated
Appropriations Act, 2021
House
Senate Committee
(Div. J; P.L. 116-260)
President’s Request
(Division F; H.R. 4502)
(S. 2604; S.Rept. 117-35)
Program
FY2021
FY2022
FY2022
FY2023
FY2022
FY2023
FY2022
FY2023
Over FY2021 Enacted
150,000
—
—
—
—
—

—
Advance Appropriations
Subtotal Medical Facilities
6,583,265
—
6,734,680
—
6,734,680
—
6,734,680
—
Medical and Prosthetic
815,000
—
882,000
—
904,000
—
882,000
—
Research
P.L. 116-260 rescission
-20,000
—
—
—
—
—
—
—
(§254)
Subtotal Medical and
795,000
—
882,000
—
904,000
—
882,000
—
Prosthetic Research
Medical Care Col ection

—
Fund (MCCF)
(Offsetting Receipts)
4,403,000
—
3,386,000
—
3,386,000
—
3,386,000
—
(Appropriations –
-4,403,000
—
-3,386,000
—
-3,386,000
—
-3,386,000
—
indefinite)
Total, Veterans Health
90,644,918
—
98,334,260
—
98,457,260
—
98,334,260
—
Administration (VHA)
Total VHA with MCCF
95,047,918
—
101,720,260
—
101,843,260
—
101,720,260
—
NCA
352,000
—
394,000
—
392,000
—
394,000
—
Total, NCA
352,000
—
394,000
—
392,000
—
394,000
—
General Administration
353,911
—
401,200
—
396,911
—
401,200
—
(including P.L. 116-260
rescission [§254])
Board of Veterans Appeals
196,000
—
228,000
—
228,000
—
228,000
—
Information Technology
4,874,500
—
4,842,800
—
4,841,800
—
4,842,800
—
(including P.L. 116-260
rescission [§254])
Electronic Health Record
2,607,000
—
2,663,000
—
2,637,000
—
2,500,000
—
Modernization (EHRM)
(including P.L. 116-260
rescission [§254])
Inspector General
228,000
—
239,000
—
239,000
—
239,000
—
Construction, major
1,316,000
—
1,611,000
—
1,611,000
—
1,611,000
—
projects
Construction, minor
354,300
—
553,000
—
553,000
—
553,000
—
projects (including P.L. 116-
260 rescission [§254])
Grants for State Extended
90,000
—
—
—
90,000
—
50,000
—
Care Facilities
Grants for State Veterans
45,000
—
45,000
—
47,097
—
50,000
—
Cemeteries
Total Construction
1,805,300
—
2,209,000
—
2,301,097
—
2,453,000
—
Asset and Infrastructure
—
—
5,000
—
5,000
—
5,000
—
Review (AIR) Commission
Total, Departmental
10,064,711
—
10,588,000
—
10,648,808
—
10,480,000
—
Administration
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Department of Veterans Affairs FY2022 Appropriations

Consolidated
Appropriations Act, 2021
House
Senate Committee
(Div. J; P.L. 116-260)
President’s Request
(Division F; H.R. 4502)
(S. 2604; S.Rept. 117-35)
Program
FY2021
FY2022
FY2022
FY2023
FY2022
FY2023
FY2022
FY2023
Total, Department of
$243,162,237
—
$268,410,433
—
$268,586,855
—
$268,365,547
—
Veterans Affairs
(without MCCF)
Total Mandatory
$138,730,564
—
$155,440,055
—
$155,440,055
—
$155,440,055
—
Total Discretionary
$104,431,673
—
$112,970,378
—
$113,146,800
—
$112,925,492
—
Memorandum: Advance Appropriations
Compensation and Pensions
—
$130,227,650
—
$147,569,474
—
$147,569,474
—
$147,569,474
Readjustment Benefits
—
14,946,618
—
8,906,851
—
8,906,851
—
8,906,851
Veterans Insurance and
—
136,950
—
109,865
—
109,865
—
109,865
Indemnities
Subtotal
—
145,311,218
—
156,586,190
—
156,586,190
—
156,586,190
Medical Services
—
58,897,219
—
70,323,116
—
70,323,116
—
70,323,116
Medical Community Care
—
20,148,244
—
24,156,659
—
24,156,659
—
24,156,659
Medical Support and
—
8,403,117
—
9,673,409
—
9,673,409
—
9,673,409
Compliance
Medical facilities
—
6,734,680
—
7,133,816
—
7,133,816
—
7,133,816
Subtotal
—
94,183,260

111,287,000

111,287,000

111,287,000
Total Advance
—
$239,494,478
—
$267,873,190
—
$267,873,190
—
$267,873,190
Appropriations
Source: Table prepared by CRS based on U.S. Congress, House Committee on Appropriations, Consolidated
Appropriations Act, 2021, committee print, prepared by House Committee on Appropriations, H.R. 133/P.L. 116-
260 [Legislative Text and Explanatory Statement] Book 2 of 2 Divisions G–L, 116th Cong., 2nd sess., March 2021
(Washington: GPO, 2021), pp. 1885-1903; U.S. Congress, House Committee on Appropriations, Military
Construction, Veterans Affairs, and Related Agencies Appropriations Bill, 2022, report to accompany H.R. 4355, 117th
Cong., 1st sess., July 2, 2021, H.Rept. 117-81. Division F of H.R. 4502—Labor, Health and Human Services,
Education, Agriculture, Rural Development, Energy and Water Development, Financial Services and General
Government, Interior, Environment, Military Construction, Veterans Affairs, Transportation, and Housing and
Urban Development Appropriations Act, 2022, and U.S. Congress, Senate Committee on Appropriations,
Military Construction, Veterans Affairs, And Related Agencies Appropriations Bill, 2022, report to accompany S. 2604,
117th Cong., 1st sess., August 4, 2021, S.Rept. 117-35.
Notes: FY2021-enacted amounts exclude American Rescue Plan Supplemental Appropriations (P.L. 117-2).

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Appendix A. Veteran Population, VA Enrollees, and
VA Patients, FY2000-FY2022
Table A-1. Veteran Population, VA Enrollees, and VA Patients, FY2000-FY2022
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
9,190,143
6,211,825
764,006
6,975,831
FY2021
19,162,515
9,210,599
6,265,880
771,698
7,037,578
FY2022
18,792,191
9,216,025
6,317,059
812,674
7,129,733
Source: Total Veteran Population numbers are from VetPop2018 (FY2018-FY2022), available at
https://www.va.gov/vetdata/docs/Demographics/New_Vetpop_Model/1L_VetPop2018_National.xlsx., 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).
Note: FY2022 total veteran population projected as of September 30, 2020. FY2021 and FY2022 veteran
enrol ee and patient data are estimates.

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Appendix B. VA Appropriations FY1995-FY2021
Table B-1. VA Appropriations FY1995-FY1999
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
Rescission
-$574
-$322
—
—
-$348
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Department of Veterans Affairs FY2022 Appropriations

FY1995
FY1996
FY1997
FY1998
FY1999

Enacted
Enacted
Enacted
Enacted
Enacted
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
Congressional Research Service

34

Department of Veterans Affairs FY2022 Appropriations

Table B-2. VA Appropriations FY2000-FY2004
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
Medical Administration
—
—
—
—
$5,000,000
Congressional Research Service

35

Department of Veterans Affairs FY2022 Appropriations

FY2000
FY2001
FY2002
FY2003
FY2004

Enacted
Enacted
Enacted
Enacted
Enacted
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

36

Department of Veterans Affairs FY2022 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

Table B-3. VA Appropriations FY2005-FY2010
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
Rescission
-$4.569
—
—
—
—
—
Subtotal VBA
$35,405,848 $37,472,027
$41,705,677 $44,642,822
$47,847,162
$56,867,419
Congressional Research Service

37

Department of Veterans Affairs FY2022 Appropriations

FY2005
FY2006
FY2007
FY2008
FY2009
FY2010

Enacted
Enacted
Enacted
Enacted
Enacted
Enacted
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
—
Filipino Veterans
—
—
—
—
$198,000
—
Equity
Compensation Fund
Office of Inspector
$69,711
$70,174
$70,641
$80,500
$87,818
$109,000
General
Congressional Research Service

38

Department of Veterans Affairs FY2022 Appropriations

FY2005
FY2006
FY2007
FY2008
FY2009
FY2010

Enacted
Enacted
Enacted
Enacted
Enacted
Enacted
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
$99,670,165 $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
$46,988,925
$56,701,316
Total
$34,184,267 $36,419,318
$40,463,334 $46,038,269
$51,981,240
$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
Congressional Research Service

39

Department of Veterans Affairs FY2022 Appropriations

Table B-4. VA Appropriations FY2011-FY2015
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
$77,589
$100,252
$104,600
$77,567
$63,257
and 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
$5,307,000
$5,535,000
$5,746,000
$6,033,000
$5,879,700
Administration
Rescission
-$44,546
—
-$2,039
-$50,000
-5,609.461
Congressional Research Service

40

Department of Veterans Affairs FY2022 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
$58,031,656
$59,619,422
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
$256,631
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

41

Department of Veterans Affairs FY2022 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
$8,173,912
Departmental
Administration
Total Department
$123,733,866
$125,056,574
$137,020,522
$168,570,058
$162,803,546
of Veterans Affairs
with MCCF
Total Department
$120,958,652
$122,226,272
$134,117,429
$165,482,068
$159,579,614
of Veterans Affairs
without MCCF
Total Mandatory
$64,470,912
$63,764,919
$72,912,772
$101,726,176
$94,591,200
Total Discretionary
$59,262,954
$61,291,655
$64,107,750
$66,843,882
$68,212,346
with MCCF
Total Discretionary
$56,487,740
$58,461,353
$61,204,657
$63,755,892
$64,988,414
without MCCF

Table B-5. VA Appropriations FY2016-FY2020
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
$95,768,462
$109,017,152
Pensions
Budget
—
—
—
$2,994,366
$1,439,931
Supplemental
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
$111,340
Indemnities
Budget
—
—
—
—
$17,620
Supplemental
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
Congressional Research Service

42

Department of Veterans Affairs FY2022 Appropriations

FY2016
FY2017
FY2018
FY2019
FY2020
Enacted
Enacted
Enacted
Enacted
Enacted

Program Administrative
Expenses
Rescission
—
—
—
—
—
Native American
$1,114
$1,163
$1,163
$1,163
$1,186
Veterans Housing
Program Administrative
Expenses
Rescission
—
—
—
—
—
Subtotal VBA
$91,931,140
$102,732,905
$104,128,649
$110,906,303
$124,853,348
Veterans Health Administration (VHA)
Medical Services
$47,603,202
$51,673,000
$44,886,554
$49,161,165
$51,411,165
Budget
$2,369,158
1,078,993
$1,962,984
$750,000
—
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
$46,109,613
$49,911,165
$65,523,165
Services
Medical Community
—
—
$9,409,118
$8,384,704
$10,758,399
Care
Budget
—
7,246,181
$419,176
$1,000,000
$3,906,400
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
$16,794,799
Community Care
Medical Administration
$6,144,000
$6,524,000
$6,654,480
$7,239,156
$7,239,156
Budget
—
—
$100,000
—
$98,800
Supplemental
Hurricane
—
—
$3,209
—
—
Supplemental
Rescission
—
-$26,000
—
-$211,000
-$10,000
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Department of Veterans Affairs FY2022 Appropriations

FY2016
FY2017
FY2018
FY2019
FY2020
Enacted
Enacted
Enacted
Enacted
Enacted

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
$5,914,288
$6,141,880
Supplemental
$105,312
$247,668
$1,707,000
$890,180
—
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
$3,429,116
Col ections Fund
(MCCF)
Subtotal VHA
$62,270,373
$68,713,669
$74,150,481
$77,825,538
$100,672,916
Veterans Choice Act
—
$2,100,000
$7,300,000
—
—
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 Administration
$336,659
$345,391
$335,891
$355,897
$355,911
Rescission
—
—
—
—
—
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
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Department of Veterans Affairs FY2022 Appropriations

FY2016
FY2017
FY2018
FY2019
FY2020
Enacted
Enacted
Enacted
Enacted
Enacted

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 Technology
$4,133,363
$4,278,259
$4,055,500
$4,103,000
$4,371,615
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
$325,812
$1,442,750
$2,503,786
$1,270,200
Projects
Rescission
—
-$20,322
-$420,000

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
$8,587,571
$10,932,847
$12,387,261
$13,801,768
Departmental
Administration
Total Department of
$166,713,139
$182,420,358
$196,818,170
$201,434,938
$239,656,032
Veterans Affairs with
MCCF
Total Department of
$163,209,993
$178,858,716
$193,302,535
$197,519,893
$236,226,916
Veterans Affairs
without MCCF
Total Mandatory
$91,765,070
$104,632,481
$111,248,435
$110,704,093
$124,651,325
Total Discretionary
$74,948,069
$77,787,876
$85,569,735
$90,730,845
$115,004,707
with MCCF
Total Discretionary
$71,444,923
$74,226,235
$82,054,100
$86,815,800
$111,575,591
without MCCF
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Department of Veterans Affairs FY2022 Appropriations

Table B-6. VA Appropriations FY2021-FY2025
FY2021
FY2022
FY2023
FY2024
FY2025
Enacted
Enacted
Enacted
Enacted
Enacted

Veterans Benefits Administration (VBA)
Compensation and
$118,246,975
—
—
—
—
Pensions
Budget
$6,110,252
—
—
—
—
Supplemental
Readjustment Benefits
$12,578,965
—
—
—
—
ARPA (P.L. 117-2)
$386,000
—
—
—
—
Veterans Insurance and
$129,224
—
—
—
—
Indemnities
Budget
$2,148
—
—
—
—
Supplemental
Veterans Housing
—
—
—
—
—
Benefit Program Fund
Veterans Housing
$204,400
—
—
—
—
Benefit Program Fund
Administrative Expenses
Rescission
—
—
—
—
—
Vocational
$34
—
—
—
—
Rehabilitation Loan
Program
Rescission
—
—
—
—
—
Vocational
$424
—
—
—
—
Rehabilitation Loan
Program Administrative
Expenses
Rescission
—
—
—
—
—
Native American
$1,186
—
—
—
—
Veterans Housing
Program Administrative
Expenses
Rescission
—
—
—
—
—
Subtotal VBA
$137,659,608
—
—
—
—
Veterans Health Administration (VHA)
Medical Services
$56,158,015
—
—
—
—
Budget
$497,468
—
—
—
—
Supplemental
Hurricane
—
—
—
—
—
Supplemental
P.L. 115-31,
—
—
—
—
—
(Opioid
Supplemental)
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46

Department of Veterans Affairs FY2022 Appropriations

FY2021
FY2022
FY2023
FY2024
FY2025
Enacted
Enacted
Enacted
Enacted
Enacted

Families First
—
—
—
—
—
Coronavirus
Response Act (P.L.
116-127)
CARES Act (P.L.
—
—
—
—
—
116-136)
ARPA (P.L. 117-2)
$627,900
—
—
—
—
Rescission
$100,000
—
—
—
—
Total Medical
$57,183,383
—
—
—
—
Services
Medical Community
$17,131,179
—
—
—
—
Care
Budget
$1,380,800
—
—
—
—
Supplemental
Families First
—
—
—
—
—
Coronavirus
Response Act (P.L.
116-127)
CARES Act (P.L.
—
—
—
—
—
116-136)
ARPA (P.L. 117-2)
$322,100
—
—
—
—
Total Medical
$18,834,079
—
—
—
—
Community Care
Medical Administration
$7,914,191
—
—
—
—
Budget
$300,000
—
—
—
—
Supplemental
Hurricane
—
—
—
—
—
Supplemental
Rescission
-$15,000
—
—
—
—
CARES Act (P.L.
—
—
—
—
—
116-136)
Total Medical
$8,199,191
—
—
—
—
Administration
Medical Facilities
$6,433,265
—
—
—
—
Supplemental
$150,000
—
—
—
—
P.L. 115-141,
—
—
—
—
—
Section 255
Hurricane
—
—
—
—
—
Supplemental
Rescission
—
—
—
—
—
CARES Act (P.L.
—
—
—
—
—
116-136)
Total Medical
$6,583,265
—
—
—
—
Facilities
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Department of Veterans Affairs FY2022 Appropriations

FY2021
FY2022
FY2023
FY2024
FY2025
Enacted
Enacted
Enacted
Enacted
Enacted

Medical and Prosthetic
$815,000
—
—
—
—
Research
Rescission
-$20,000
—
—
—
—
Total Medical and
$795,000
—
—
—
—
Prosthetic Research
Medical Care
$2,965,445
—
—
—
—
Col ections Fund
(MCCF)
ARPA (P.L. 117-2)
$300,000
—
—
—
—
Veterans Medical Care
—
—
—
—
—
and Health Fund
ARPA (P.L. 117-2)
$14,482,000
—
—
—
—
Emergency Employee
—
—
—
—
—
Leave Fund
ARPA (P.L. 117-2)
$80,000
—
—
—
—
Subtotal VHA
$109,422,363
—
—
—
—
Veterans Choice Act
—
—
—
—
—
Mandatory Funds
National Cemetery
$352,000
—
—
—
—
Administration
(NCA)
Rescission
—
—
—
—
—
Supplemental
—
—
—
—
—
Subtotal NCA
$352,000
—
—
—
—
Departmental Administration
VBA—General
$3,180,000
—
—
—
—
Operating Expenses
Rescission
-$16,000
—
—
—
—
CARES Act (P.L.
—
—
—
—
—
116-136)
ARPA (P.L. 117-2)
$262,000
—
—
—
—
General Administration
$365,911
—
—
—
—
Rescission
-$12,000
—
—
—
—
CARES Act (P.L.
—
—
—
—
—
116-136)
Board of Veterans
$196,000
—
—
—
—
Appeals
Rescission
—
—
—
—
—
ARPA (P.L. 117-2)
$10,000
—
—
—
—
Office of Inspector
$228,000
—
—
—
—
General
Congressional Research Service

48

Department of Veterans Affairs FY2022 Appropriations

FY2021
FY2022
FY2023
FY2024
FY2025
Enacted
Enacted
Enacted
Enacted
Enacted

ARPA (P.L. 117-2)
$10,000
—
—
—
—
Rescission
—
—
—
—
—
CARES Act (P.L.
—
—
—
—
—
116-136)
Information Technology
$4,912,000
—
—
—
—
Rescission
-$37,500
—
—
—
—
ARPA (P.L. 117-2)
$100,000
—
—
—
—
CARES Act (P.L.
—
—
—
—
—
116-136)
Electronic Health
$2,627,000
—
—
—
—
Records Modernization
(EHRM)
Rescission
-$20,000
—
—
—
—
Construction, Major
$1,316,000
—
—
—
—
Projects
Rescission
—
—
—
—
—
Construction, Minor
$390,000
—
—
—
—
Projects
Rescission
-$35,700
—
—
—
—
Supplemental
—
—
—
—
—
Grants for State
$90,000
—
—
—
—
Extended Care Facilities
Rescission
—
—
—
—
—
ARPA (P.L. 117-2)
$500,000
—
—
—
—
CARES Act (P.L.
—
—
—
—
—
116-136)
Grants for State
$45,000
—
—
—
—
Veterans Cemeteries
Rescission
—
—
—
—
—
Subtotal
$14,110,711
—
—
—
—
Departmental
Administration
Total Department of
$261,544,682
—
—
—
—
Veterans Affairs with
MCCF
Total Department of
$258,579,237
—
—
—
—
Veterans Affairs
without MCCF
Total Mandatory
$154,147,564
—
—
—
—
Total Discretionary
$107,397,118
—
—
—
—
with MCCF
Congressional Research Service

49

Department of Veterans Affairs FY2022 Appropriations

Total Discretionary
$104,431,673
—
—
—
—
without MCCF

Author Information

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

Jared S. Sussman

Analyst in Health Policy

Acknowledgments
Isaac A. Nicchitta, CRS Research Assistant in the Domestic Social Policy Division, provided invaluable
assistance with this report.

Disclaimer
This document was prepared by the Congressional Research Service (CRS). CRS serves as nonpartisan
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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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