Department of Veterans Affairs FY2021 Appropriations

July 21, 2020 – June 30, 2021 R46459

Department of Veterans Affairs
June 30, 2021
FY2021 Appropriations
Sidath Viranga Panangala
The Department of Veterans Affairs (VA) administers numerous programs that provide benefits
Specialist in Veterans
and services to eligible veterans and their families. These benefits include medical care; disability
Policy
compensation and pensions; education; vocational rehabilitation and employment services;

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

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

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

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

FY2020 Enacted
FY2021 Request
H.R. 7608)
Majority Draft
P.L. 116-260)
Veterans Benefits
$128.7 bil ion
$138.8 bil ion
$138.8 bil ion
$142.1bil ion
$142.1 bil ion
Administration
(VBA, including
General Operating
Expenses)
Veterans Health
$97.9 bil ion
$90.8 bil ion
$90.8 bil ion
$90.8 bil ion
$90.6 bil ion
Administration
(VHA)
National Cemetery
$328 mil ion
$360 mil ion
$349 mil ion
$352 mil ion
$352 mil ion
Administration
(NCA)
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Department of Veterans Affairs FY2021 Appropriations

FY2021 House-
FY2021 Senate
Consolidated
passed
Appropriations
Appropriations
(Division D of
Committee
Act, 2021 (Div. J;

FY2020 Enacted
FY2021 Request
H.R. 7608)
Majority Draft
P.L. 116-260)
Departmental
$10.6 bil ion
$10.3 bil ion
$10.2 bil ion
$10.2 bil ion
$10.1 bil ion
Administration

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Table B-1. Department of Veterans Affairs Enacted Appropriations, FY1995-FY1999 ............. 34
Table B-2. Department of Veterans Affairs Enacted Appropriations, FY2000- FY2004 ............ 36
Table B-3. Department of Veterans Affairs Enacted Appropriations, FY2005-FY2010 ............. 38
Table B-4. Department of Veterans Affairs Enacted Appropriations, FY2011-FY2015 ............. 41
Table B-5 Department of Veterans Affairs Enacted Appropriations, FY2016-FY2020 .............. 43

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

Contacts
Author Information ....................................................................................................... 47

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

1 For more information on programs, see CRS Report R42747, Health Care for Veterans: Answers to Frequently Asked
Questions.
2 For more information on programs, see CRS Report R44837, Benefits for Service-Disabled Veterans; and CRS Report
RS22804, Veterans’ Benefits: Pension Benefit Program s.
3 For a discussion of education benefits, see CRS Report R42755, The Post-9/11 GI Bill: A Primer.
4 For details on VA’s vocational rehabilitation and employment, see CRS Report RL34627, Veterans’ Benefits: The
Vocational Rehabilitation and Em ploym ent 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
Cem eteries.
8 Established by the National Cemeteries Act of 1973 (P.L. 93-43).
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shown in Table 1, which is based on budget authority amounts shown in the MILCON-VA
appropriations bil s, accompanying committee reports, and explanatory statements.
The Department of Veterans Affairs Budget
The VA budget includes both mandatory9 and discretionary funding.10 Mandatory accounts fund
disability compensation for veterans, the survivor’s Dependency and Indemnity Compensation
(DIC) program, pensions, vocational rehabilitation and employment, education, life insurance,
housing, clothing al owances, and burial benefits (such as burial al owances, 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 Hal Revolving Fund; trust funds, such as the Department of Veterans
Affairs Cemetery Gift Fund and the General Post Fund; and special funds, such as the Medical
Care Collections Fund and the Capital Asset Fund.11
Advance Appropriations12
The VA has advance appropriation authority for specified medical care and benefits accounts. In
2009, Congress enacted the Veterans Health Care Budget Reform and Transparency Act of 2009
(P.L. 111-81), authorizing advance appropriations for three of the four VHA accounts: medical
services, medical support and compliance, and medical facilities.13 In 2014, Congress passed the
Consolidated and Further Continuing Appropriations Act, 2015 (H.R. 83; P.L. 113-235), which
amended 38 U.S.C. §117 and included three more accounts to the advance appropriations list of
accounts. This act authorized advance appropriations for three mandatory VA benefits programs
within the Veterans Benefits Administration: compensation and pensions, readjustment benefits,
and veterans insurance and indemnities. Beginning with the FY2016 Military Construction and
Veterans Affairs, and Related Agencies Appropriations Act (MILCON- VA; P.L. 114-113), those
accounts received advance appropriations for the first time in FY2017, in addition to the three
VHA accounts already authorized to receive advance appropriations.
Section 4003 of the Surface Transportation and Veterans Health Care Choice Improvement Act of
2015 (P.L. 114-41) required the establishment of a separate new account for medical community

9 Mandatory programs funded through the annual appropriations process are commonly referred to as appropriated
entitlem ents. 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- Term s and Concepts, available at https://www.whitehouse.gov/wp-content/uploads/2018/06/s20.pdf.
12 For a detailed discussion of advance appropriations, see CRS Report R43482, Advance Appropriations, Forward
Funding, and Advance Funding: Concepts, Practice, and Budget Process Considerations.
13 Codified at 38 U.S.C. §117.
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care, beginning with the FY2017 appropriations cycle. The Jeff Mil er 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 has authorized (through P.L. 111-81, P.L. 113-235, and P.L. 114-315) advance
appropriations of new budget authority for these VBA and VHA accounts to prevent potential
delays in the delivery of care and benefits to veterans that may arise in the event of a funding
lapse.
Under present budget scoring guidelines, advance appropriations are scored as new budget
authority in the fiscal year in which they become available for obligation, not in the fiscal year the
appropriations are enacted and required to be accommodated within the statutory spending caps
for that year.14 Therefore, throughout the funding tables in this report, advance appropriations
numbers are noted by the label “memorandum” and in the corresponding fiscal year column.
Historical Perspective
Figure 1 provides funding trends for mandatory, discretionary, and total VA-enacted
appropriations from FY1995 through FY2020. Between FY1995 and FY2020, total mandatory
appropriations grew from $19.5 bil ion to $124.7 bil ion in nominal dollars, a compound annual
growth rate (CAGR) of 7.7%.15 During this same period, discretionary appropriations grew from
$18.0 bil ion to $112.1 bil ion, a CAGR of 7.6%. The total VA appropriations from FY1995
through FY2020 grew from $37.5 bil ion to $236.8 bil ion, a CAGR of 7.7%.

14 Executive Office of the President, Office of Management and Budget (OMB), OMB Circular No. A–11, Section 20-
Term s and Concepts, 2017, p. 16, available at https://www.whitehouse.gov/sites/whitehouse.gov/files/omb/assets/
a11_current_year/a11_2017/s20.pdf; also see OMB Circular No. A–11, Appendix A -Scorekeeping Guidelines, 2017, p.
2, available at https://www.whitehouse.gov/sites/whitehouse.gov/files/omb/assets/a11_current_year/a11_2017/
app_a.pdf.
15 CAGR is annualized average rate of growth between two given years, calculated as CAGR, year FY1995 to year
FY2020 = [(value in year 2020/value in year 1995) ^ (1/25) -1].
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Figure 1. VA Appropriations, FY1995-FY2020

Source: Figure prepared by CRS based on figures from the Department of Veterans Affairs, Office of
Management, Office of Budget (see, Appendix B).
Notes: Amounts in in nominal, or noninflation-adjusted, dol ars, and discretionary funding excludes offsetting
col ections deposited in the Medical Care Col ections Fund (MCCF).
FY2020 Budget Summary
President Trump submitted his FY2020 budget request for the VA on March 11, 2019. The
Administration requested a total $216.1 bil ion for the VA. This amount included $123.2 bil ion in
mandatory appropriations and $92.9 bil ion in discretionary funding. The President’s request also
included advance appropriations for FY2021 for specific medical care and mandatory veterans’
benefit programs. For medical care accounts, the budget request included $87.6 bil ion in
discretionary advance appropriations and $129.5 bil ion in advance appropriations for mandatory
benefits.
On May 9, 2019, the House Appropriations Committee approved the FY2020 Military
Construction, Veterans Affairs, and Related Agencies (MILCON-VA) bil (H.R. 2745; H.Rept.
116-63). The Senate Appropriations Committee did not mark up or report its version of the
FY2020 MILCON-VA bil . After the passage of several continuing resolutions (CRs), on
December 20, 2019, the President signed the Further Consolidated Appropriations Act, 2020
(H.R. 1865; P.L. 116-94), providing regular appropriations for FY2020. Division F of this act
contained the Military Construction, Veterans Affairs, and Related Agencies Appropriations
(MILCON-VA) Act, 2020.16 The act provides $217.9 bil ion for the VA. This amount includes
$125.4 bil ion in mandatory appropriations and $92.5 bil ion in discretionary funding. P.L. 116-94
provided advance appropriations for FY2021 totaling $87.6 bil ion for medical care accounts
(medical services, medical community care, medical support and compliance, and medical
facilities) and $131 bil ion for mandatory veterans benefits (compensation and pensions,

16 T he full legislative text and the explanatory statement of P.L. 116-94 is contained in the House Committee Print
Further Consolidated Appropriations Act, 2020, at https://www.govinfo.gov/content/pkg/CPRT -116HPRT38679/pdf/
CPRT -116HPRT 38679.pdf.
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readjustment benefits, and veterans insurance and indemnities). Al amounts are prior to the
enactment of COVID-19 supplemental funding. Table 1 provides total funding levels that include
the regular appropriations provided in P.L. 116-94 and the supplemental appropriations discussed
below. Figure 2 provides an overview of FY2020-enacted mandatory and discretionary
appropriations.
COVID-19 Pandemic FY2020 Supplemental Appropriations17
In response to the rapidly evolving COVID-19 pandemic, Congress provided supplemental
funding for FY2020 for several VA accounts. The total amount of supplemental funding for
FY2020 is $19.63 bil ion. This amount includes $60.0 million provided in the Families First
Coronavirus Response Act (P.L. 116-127) and $19.6 bil ion provided in the Coronavirus Aid,
Relief, and Economic Security Act, “CARES Act” (P.L. 116-136).
Families First Coronavirus Response Act (P.L. 116-127)
On March 18, 2020, the President signed into law the Families First Coronavirus Response Act
(P.L. 116-127). The act provides $30 mil ion for VHA’s medical services account to fund health
services and related items pertaining to COVID-19, and $30 mil ion for VHA’s medical
community care account (see Table 1). These funds are designated as emergency spending and
are to remain available until September 30, 2022.
Coronavirus Aid, Relief, and Economic Security Act, "CARES Act" (P.L. 116-
136)
On March 27, the President signed into law the CARES Act (P.L. 116-136). Division B of this act
included an emergency supplemental appropriations measure. Title X of Division B provides
supplemental appropriations for FY2020, designated as emergency spending, for certain VA
accounts totaling $19.6 bil ion. Unless otherwise noted below, funds remain available until
September 30, 2021. Funding provided in the CARES Act is broken down as follows (see Table
1):18
 VHA, medical services account, $14.4 bil ion, for increased telehealth services;
purchasing of additional medical equipment and supplies, testing kits, and
personal protective equipment; and to provide additional support to homeless
veterans, among other things.
 VA, information technology systems account, $2.2 bil ion, for increased telework
capacity, purchasing additional laptops for telework and telehealth-enabled
laptops for VHA providers to work from home, and to increase bandwidth and IT
infrastructure needs, among other things.
 VHA, medical community care account, $2.1 bil ion, for increased emergency
room and urgent care usage in the community.
 VHA, medical facilities account, $606 mil ion, for the procurement of mobile
treatment facilities, improvements in security, and nonrecurring maintenance
projects.

17 For more details on the VA’s and Congress’s response to the COVID-19 pandemic, see CRS Report R46340,
Federal Response to COVID-19: Departm ent of Veterans Affairs.
18 Based on Senate Appropriations Committee, Coronavirus Supplemental Appropriations Summary, available at
https://www.appropriations.senate.gov/download/coronavirus-emergency-supplemental-appropriations-summary.
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 VA, grants for construction of state extended care facilities account, $150.0
mil ion, to help state homes renovate, alter, or repair facilities to respond to
COVID-19.
 VHA, medical support and compliance account, $100 mil ion, for the provision
of 24-hour emergency management coordination overtime payments, and for
costs associated with travel and transport of materials.
 VBA, general operating expenses account, $13.0 mil ion, for enhancing telework
support for VBA staff and for additional cleaning contracts.
 VA, Office of Inspector General account, $12.5 mil ion, for increased oversight
of the VA’s preparation and response to COVID-19 (funds remain available until
September 30, 2022).
 VA, general administration account, $6.0 million, for maintaining 24-hour
operations of crisis response and continuity of operations plans at VA facilities,
among other things.
Figure 2. Enacted Appropriations, FY2020, by Major Program and
Spending Category

Source: Figure prepared by CRS based on based on the Further Consolidated Appropriations Act, 2020 (P.L.
116-94); the Families First Coronavirus Response Act (P.L. 116-127); the Coronavirus Aid, Relief, and Economic
Security Act (P.L. 116-136) and U.S. Congress, House Committee on Appropriations, Military Construction,
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Veterans Affairs, and Related Agencies Appropriations Bil , 2021, report to accompany H.R. 7609, 116th Cong., 2nd
sess., July 13, 2020, H.Rept. 116-445, pp. 131-141.
Notes: Total budget authority excludes offsetting col ections deposited in the Medical Care Col ections Fund
(MCCF). Percentages may not add up due to rounding.
Budget Request for FY2021 and
Congressional Action
President Trump submitted his budget proposal for FY2021 on February 10, 2020. The
President’s budget requested $240.2 bil ion for VA. This amount included $135.4 bil ion in
mandatory benefits funding and $104.8 bil ion in discretionary funding. When compared with the
FY2020-enacted amount for VA of $237.5 bil ion—which included regular appropriations
provided by the Further Consolidated Appropriations Act, 2020 (P.L. 116-94), and supplemental
funding provided by the Families First Coronavirus Response Act (P.L. 116-127) and the
Coronavirus Aid, Relief, and Economic Security Act (P.L. 116-136)—this was an increase of
$2.752 bil ion. Additional y, the Administration’s budget request included an advance
appropriation request of $239.5 bil ion for FY2022 to fund the seven advance appropriations
accounts—compensation and pensions, readjustment benefits, insurance and indemnities, medical
services, medical community care, medical support and compliance, and medical facilities.
Figure 3 provides the FY2021 President’s requested mandatory and discretionary appropriations
by major program.
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Figure 3. Budget Request, FY2021, by Major Program and Spending Category

Source: Figure prepared by CRS based on U.S. Congress, House Committee on Appropriations, Military
Construction, Veterans Affairs, and Related Agencies Appropriations Bil , 2021, report to accompany H.R. 7609, 116th
Cong., 2nd sess., July 13, 2020, H.Rept. 116-445, pp. 131-141.
Notes: Total budget authority excludes offsetting col ections deposited in the Medical Care Col ections Fund
(MCCF). Percentages may not add up due to rounding.
On July 6, 2020, the House Committee on Appropriations, Subcommittee on Military
Construction, Veterans Affairs, and Related Agencies held a markup of the FY2021 Military
Construction, Veterans Affairs, and Related Agencies (MILCON-VA) appropriations bil , and the
draft bil was approved. On July 9, the House Appropriations Committee held a markup of the
FY2021 MILCON-VA appropriations bil and the bil 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-bil appropriations package (H.R. 7608, the State, Foreign Operations, Agriculture, Rural
Development, Interior, Environment, Military Construction, and Veterans Affairs Appropriations
bil 2021) and passed by the full House on July 24. The House-passed measure (Division D of
H.R. 7608) provided a total of $240.2 bil ion for VA, which included $135.4 bil ion in mandatory
funding and $104.8 bil ion in discretionary funding. Within the overal total of $104.8 bil ion in
discretionary funding, $12.5 bil ion is designated as emergency funding.
On November 10, 2020, the chair of the Senate Committee on Appropriations, Senator Richard
Shelby, released drafts of al 12 annual appropriations bil s along with draft accompanying
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explanatory statements including the FY2021 MILCON-VA appropriations bil .19 The release of
the draft bil s was intended to further negotiations on annual appropriations between the House
and the Senate.20 The majority draft FY2021 MILCON-VA appropriations bil recommended
$243.1 bil ion for VA, including $138.7 bil ion in mandatory spending and $104.4 bil ion in
discretionary spending. Similar to the House-passed measure, the Senate majority draft version of
the MILCON-VA appropriations bil has designated $12.5 bil ion as emergency spending within
the recommended $104.4 bil ion discretionary spending level.
Continuing Appropriations (P.L. 116-159; P.L. 116-215; P.L. 116-225;
P.L. 116-226; P.L. 116-246)21
Since none of the regular appropriations bil s were enacted at the beginning of the fiscal year on
October 1, Congress passed five continuing resolutions (CRs) to continue funding at FY2020
levels. Since seven accounts (compensation and pensions, readjustment benefits, insurance and
indemnities, medical services, medical community care, medical support and compliance, and
medical facilities) received advance appropriations budget authority for FY2021 in P.L. 116-94,
these accounts were not affected by the CRs. However, the first CR (Division A of P.L. 116-159)
provided exceptions to specific accounts, or programs below.
Section 161—Compensation and Pensions
Section 161 made a technical correction to the Military Construction, Veterans Affairs, and
Related Agencies Appropriations Act, 2020 (Division F of P.L. 116-94), related to the Department
of Veterans Affairs’ (VA’s) “Compensation and Pensions” account. This provision authorized
advance appropriations for the “Compensation and Pensions” account provided in P.L. 116-94
that became available on October 1, 2020, to remain available until expended. This change
al owed unobligated carryover appropriations and funds in this account to remain available
beyond FY2021.
Section 162—Veterans Electronic Health Record
Section 162 provides authority to the VA to apportion funds up to the rate of operations necessary
for activities related to the implementation, preparation, development, management, rollout, and
maintenance of the veterans Electronic Health Record (EHR) system, including salaries and
expenses of VA employees associated with the development and deployment of the EHR system.
Section 163—Canteen Service Revolving Fund
Section 163 provides authority to the VA during FY2021 to transfer up to $140 mil ion of
unobligated balances provided by the CARES Act (P.L. 116-136) for the Medical Services
account to the Canteen Service Revolving Fund. Operations of the Canteen Service Revolving
Fund are general y financed by collections from the sale of meals, merchandise, and services at

19 T he 12 draft bills and explanatory statements are on the committee’s website linked to the majority press release at
https://www.appropriations.senate.gov/news/committee-releases-fy21-bills-in-effort-to-advance-process-produce-
bipartisan-results.
20 Ibid. See also the statement from the Senate Appropriations Committee Vice Chair, Senator Patrick Leahy, at
https://www.appropriations.senate.gov/news/minority/senate-approps-vice-chair-leahy-statement-on-the-release-of-the-
fy-2021-senate-appropriations-bills-.
21 For more details on the continuing resolution, see CRS Report R46582, Overview of Continuing Appropriations for
FY2021 (P.L. 116-159).
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VA medical facilities. However, due to a decline in collections as a result of the COVID-19
pandemic, the Administration requested this transfer authority to offset these losses.
Consolidated Appropriations Act, 2021 (P.L. 116-260)
Based on negotiations between the House and Senate Appropriations Committees, the then-
Chairwoman of the House Committee on Appropriations, Representative Nita Lowey, offered a
House amendment to the Senate amendment to H.R. 133. On December 21, 2020, both the House
and Senate agreed to the measure, and President Trump signed the legislation on December 27,
2020, as the Consolidated Appropriations Act, 2021 (H.R. 133, P.L. 116-260). Division J of this
act contained the FY2021 Military Construction, Veterans Affairs, and Related Agencies
(MILCON-VA) Appropriations Act. The act provides $243.2 bil ion for VA for FY2021, which
includes $104.4 bil ion in discretionary funding and $138.7 bil ion in mandatory funding (Table
1). In March 2021, the American Rescue Plan Act (P.L. 117-2) was enacted and provided
approximately $17.1 bil ion in mandatory funding in addition to amount enacted in P.L. 116-260
(see text box below).
American Rescue Plan Act of 2021 (P.L. 117-2)
On March 11, 2021, President Biden signed into law the American Rescue Plan Act of 2021. This legislation was
crafted by authorizing committees, instead of appropriations committees, using the budget reconciliation process.
The Veterans’ Affairs Committee provisions (TITLE VIII of 117-2) provides approximately $17.1 bil ion for VA
programs and activities. Since it is unclear how funding wil be al ocated by VA to various accounts, this report
does not include any discussion of funding in either the narrative or tables of this report. For example, authority
to expend funds in support of medical care, information technology, and medical facility requirements are
clustered together in the act. Therefore, it is not clear how the department would al ocate funding among the
accounts that comprise those categories. In addition, VA has not publicly released a state-by-state breakdown of
American Rescue Plan Act of 2021 funding provided to VA. A summary of key provisions in the act fol ows:

$272 mil ion for benefit claims and appeals processing.

$14.5 bil ion for medical care and health needs.

$100 mil ion for supply chain modernization.

$750 mil ion for state veteran homes.

$10 mil ion for the Office of Inspector General.

$386 mil ion for COVID-19 veteran rapid retraining assistance program.

$1 bil ion for expenses related to prohibition on col ecting any copayments or other cost sharing
requirements from veterans during the COVID-19 emergency.

$80 mil ion for the VA Employee Leave Fund.
Mandatory Programs Funding
Major mandatory program funding includes VA’s disability compensation program; pensions to
low-income veterans, their surviving spouses, and dependent children; education and vocational
rehabilitation assistance; and the provision of life insurance.
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 (al owances, flags,
headstones, etc.); and a clothing al owance for certain disabled veterans.
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For FY2021, VA requested $121.1 bil ion for the Compensation and Pensions account, an
increase of $2.8 bil ion over the FY2021 advance appropriations. The largest portion of this
budget item is disability compensation, which VA estimated would be $115.8 bil ion in
compensation payments to an estimated 5.3 mil ion veterans, 456,000 survivors, and 1,266
children. Pension payments were estimated to be $4.9 bil ion to approximately 231,100 veterans
and 161,300 survivors. Final y, an estimated $355 mil ion would be al ocated for burial benefits.
An increase in disability compensation obligations most significantly comes from the expansion
of benefits under the Blue Water Navy Vietnam Veterans Act of 2019 (P.L. 116-23).22 In general,
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).
The Consolidated Appropriations Act, 2021 (H.R. 133, P.L. 116-260) provides $124.4 bil ion for
VA’s FY2021 Compensation and Pension account. This is $13.9 bil ion over the FY2020-enacted
amount, $6.1 bil ion over the FY2021 advance appropriations, and $3.3 bil ion over VA’s
requested amount for FY2021 (see Table 1). These increases reflect the increased number of
disability compensation claims that wil be granted and paid out on a monthly basis. These funds
wil also continue to support VA programs to address root causes of veterans’ financial hardships
and to improve communications with Veterans Service Organizations (VSOs).23 The explanatory
statement raises concerns about VA’s accounting measures for this account and directs VA to
submit a plan to both the Senate and House Appropriations Committees addressing required
accounting adjustments and reconciliation of FY2020 funds. The committees requested this plan
to be submitted no later than 60 days after the FY2021 MILCON-VA appropriations bil is
enacted.24 The explanatory statement also expresses concern about the high denial rate for Gulf
War veterans disability claims and directs VA to submit a report on its efforts to improve the
claim approval rate and the feasibility of eliminating the deadline for filing presumptive claims
for Gulf War veterans. The committees request this report no later than 180 days after FY2021
MILCON-VA appropriations bil is enacted.25
Readjustment Benefits
The Readjustment Benefits category reflects several benefits related to the transition of
servicemembers from active duty status to veteran status, as wel benefits for disabled veterans.
Some of these programs include education benefits for veterans, survivors, and dependents;
vocational rehabilitation and employment training for service-connected disabled veterans; and
financial assistance for adaptive automobiles, equipment, and housing grants for disabled
veterans.
For FY2021, VA requested appropriations of $12.6 bil ion to provide sufficient mandatory
funding for Readjustment Benefits, approximately $1.5 bil ion less than the amount enacted in
FY2020. The decrease in readjustment benefits funding between FY2020 and FY2021 is largely

22 For more information, see CRS In Focus IF11368, Expansion of Benefits to Blue Water Navy Vietnam Veterans.
23 U.S. Congress, House Committee on Appropriations, Military Construction, Veterans Affairs, and Related Agencies
Appropriations Bill, 2021, report to accompany H.R. 7609, 116th Cong., 2nd sess., July 13, 2020, H.Rept. 116-445, pp.
36-37.
24 U.S. Congress, House Committee on Appropriations, Committee Print of the Committee on Appropriations U.S.
House of Representatives on H.R. 133/P.L. 116-260, committee print, 117th Cong., 1st sess., March 2021, pp. 1853-
1854, at https://www.govinfo.gov/content/pkg/CPRT -117HPRT43750/pdf/CPRT -117HPRT43750.pdf.
25 U.S. Congress, House Committee on Appropriations, Committee Print of the Committee on Appropriations U.S.
House of Representatives on H.R. 133/P.L. 116-260, committee print, 117th Cong., 1st sess., March 2021, p. 1854, at
https://www.govinfo.gov/content/pkg/CPRT -117HPRT43750/pdf/CPRT -117HPRT43750.pdf.
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due to the carryover of $2.9 bil ion in unobligated benefits from prior years and $191.2 mil ion in
offsetting collections from the Department of Defense (DOD).26
P.L. 116-260 provides $12.6 bil ion for FY2021, the same as VA’s requested amount, for the
Readjustment Benefits account (see Table 1). In the explanatory statement, the committees direct
VA to submit a report on the feasibility and advisability of, and a cost estimate for, granting
eligible disabled veterans with an additional adaptive automobile grant if at least 10 years have
passed since their initial grant or assistance. The Committees on Appropriations request the report
within 270 days of the enactment of this act.27
Veterans Insurance and Indemnities (VI&I)
The Veterans Insurance and Indemnities (VI&I) account is the mandatory funding mechanism for
several government life insurance programs for veterans. In addition to direct payments made to
insured veterans and their beneficiaries, this category includes supplemental funding for National
Service Life Insurance (NSLI),28 Service-Disabled Veterans Insurance (S-DVI),29 and Veterans
Mortgage Life Insurance (VMLI).30
For FY2021, VA estimates $6.3 mil ion in collections from premiums, interest on investments,
and extra hazard payments from military service branches. In addition, VA has $2.1 mil ion in
previously appropriated funds to use until expended. In addition to the advance appropriated
funds, VA requested $129.2 mil ion, bringing the total amount to $131.4 mil ion, an estimated
$2.4 mil ion increase from the FY2020-enacted budget. This increase would enable VA to transfer
$40,000 to the NSLI, program, $43 mil ion to the VMLI program, and $96.6 mil ion to the S-DVI
program.31 P.L. 116-260 provides the same amount for the Insurance and Indemnities account for
FY2021 as requested in the Administration’s budget request (see Table 1).32

26 U.S. Department of Veterans Affairs, FY2021 Budget Submission, Benefits and Burial Programs and Departmental
Adm inistration, vol. 3 of 4, February 2020, pp. VBA-74, 75.
27 U.S. Congress, House Committee on Appropriations, Committee Print of the Committee on Appropriations U.S.
House of Representatives on H.R. 133/P.L. 116-260, committee print, 117th Cong., 1st sess., March 2021, p. 1854 at
https://www.govinfo.gov/content/pkg/CPRT -117HPRT43750/pdf/CPRT -117HPRT43750.pdf.
28 T he National Service Life Insurance (NSLI) program was created on October 8, 1940, to handle insurance needs of
World War II veterans. T hese 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.
29 T he 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/.
30 T he 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. T his
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/.
31 U.S. Department of Veterans Affairs, FY2021 Budget Submission, Benefits and Burial Programs and Departmental
Adm inistration, vol. 3 of 4, February 2020, pp. VBA-131, 133.
32 U.S. Congress, House Committee on Appropriations, Military Construction, Veterans Affairs, and Related Agencies
Appropriations Bill, 2021, report to accompany H.R. 7609, 116th Cong., 2nd sess., July 13, 2020, H.Rept. 116-445, p.
40.
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Medical Care and Medical Research Discretionary
Programs Funding
Background
The Veterans Health Administration (VHA) operates one of the nation’s largest integrated direct
health care delivery systems.33 Although Medicare, Medicaid, and the Children’s Health
Insurance Program (CHIP) are also publicly funded programs, most health care services under
these programs are delivered by private providers in private facilities. In contrast, the VA health
care system could be categorized as a veteran-specific national health care system, in the sense
that the federal government owns the medical facilities and employs the health care providers.34
The VA’s health care system is organized into 18 geographical y defined Veterans Integrated
Service Networks (VISNs). Although policies and guidelines are developed at VA headquarters to
be applied throughout the VA health care system, management authority for basic decisionmaking
and budgetary responsibilities is delegated to the VISNs.35 As of FY2020, the VHA operates 148
hospitals, 135 nursing homes, 765 community-based outpatient clinics (CBOCs),36 and 300
Readjustment Counseling Centers (Vet Centers).37 In 2009, the VA began a pilot Mobile Vet
Center (MVC) program to improve access to services for veterans in rural areas, and the
department has deployed 80 MVCs, to date.38
Although the VHA provides most health care services to eligible veterans through its integrated
network of facilities, it does pay for care in the community under certain circumstances. The
Veterans Community Care Program (VCCP) applies eligibility for care in the community broadly
to al enrolled veterans based on specific criteria.39 The VA is authorized to provide care in the
community through individual agreements with community providers, cal ed veterans care
agreements. The VA is also authorized to reimburse for emergency care visits if specific criteria
are met.40 Inpatient and outpatient care are provided in the private sector to eligible dependents of
veterans under the Civilian Health and Medical Program of the Department of Veterans Affairs
(CHAMPVA).41 In addition, the VHA provides grants for construction of state-owned nursing

33 U.S. Department of Veterans Affairs, FY 2009 Performance and Accountability Report, Washington, DC, November
16, 2009, p. I-42. Established on January 3, 1946, as the Department of Medicine and Surgery by P.L. 79 -293,
succeeded in 1989 by the Veterans Health Services and Research Administration, renamed the Veterans Health
Administration in 1991.
34 Adam Oliver, “T he Veterans Health Administration: An American Success Story?” The Milbank Quarterly, vol. 85,
no. 1 (March 2007), pp. 5-35.
35 Kenneth Kizer, John Demakis, and John Feussner, “Reinventing VA health care: Systematizing Quality
Improvement and Quality Innovation,” Medical Care, vol. 38, no. 6 (June 2000), Suppl. 1:17-116.
36 For more information on CBOCs, see CRS Report R41044, Veterans Health Administration: Community-Based
Outpatient Clinics (archived).
37 Vet Centers are a nationwide system of community-based programs separate from VA medical centers (VAMCs).
Client services provided by Vet Cent ers 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 service s.
38 U.S. Department of Veterans Affairs, FY2021 Budget Submission, Medical Programs and Information Technology
Program s, vol. 2 of 4, February 2020, p. VHA-333.
39 For more information on the VCCP and the eligibility criteria, see CRS Report R45390, VA Maintaining Internal
System s and Strengthening Integrated Outside Networks Act of 2018 (VA MISSION Act; P.L.115 -182).
40 For more information, see CRS Report R42747, Health Care for Veterans: Answers to Frequently Asked Questions.
41 For details on CHAMPVA, see CRS Report RS22483, Health Care for Dependents and Survivors of Veterans.
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homes and domiciliary facilities42 and collaborates with DOD in sharing health care resources and
services.
Apart from providing direct patient care to veterans,43 the VHA’s other statutory missions are to
conduct medical research,44 serve as a contingency backup to the DOD medical system during a
national security emergency,45 provide support to the National Disaster Medical System and the
Department of Health and Human Services as necessary,46 and train health care professionals to
provide an adequate supply of health personnel for the VA and the nation.47
The Veteran Patient Population48
In FY2020, approximately 9.3 mil ion of the 19.5 mil ion total veterans were enrolled in the VA
health care system.49 The VA estimates that in FY2021, enrollment wil grow by 33 thousand. Of
the total number of enrolled veterans in FY2020, the VA anticipated treating approximately 7.1
mil ion unique veteran and nonveteran patients.50 For FY2021, the VHA estimates that it wil
treat about 7.2 mil ion unique veteran patients, or 1.0% over the FY2020 estimate (see Appendix
A for veteran population, VA enrollees, and VA patients from FY2000-FY2021).
The VHA also estimates that outpatient visits wil increase from 123.8 mil ion in FY2020 to
126.5 mil ion in FY2021, an increase of 2.7 mil ion, or 2.2%. It also anticipates an increase in
inpatients treated from 928,552 in FY2020 to 936,639 in FY2021, an increase of 8,087, or 0.9%.
President’s Request and Congressional Action
The VA’s annual appropriations for the medical services, medical community care, medical
support and compliance, and medical facilities accounts include advance appropriations that
become available one fiscal year after the fiscal year for which the appropriations act was
enacted. Therefore, funding levels for FY2021 for these four accounts were provided by the
Further Consolidated Appropriations Act, 2020 (P.L. 116-94). However, in any given year the

42 Under the grant program, the VA may fund up to 65% of the cost of these state-owned facilities. States must fund the
remaining 35%. T he law requires that 75% of the residents in a state-extended care facility must be veterans (38 U.S.C.
§§8131-8138.) All nonveteran residents must be spouses of veterans or parents of children who died while serving in
the U.S. Armed Forces. T he VA is prohibited by law from exercising any supervision or control over the operation of a
state veterans nursing home, including setting admission criteria. Admission requirements are determined exclusively
by the state. Also see CRS In Focus IF11656, State Veterans Hom es.
43 38 U.S.C. §7301(b).
44 38 U.S.C. §7303.
45 38 U.S.C. §8111A.
46 38 U.S.C. §8117(e).
47 38 U.S.C. §7302.
48 Data in this section adapted from Office of Management and Budget (OMB), Appendix, Budget of the United States
Governm ent Fiscal Year 2021, Washington, DC, February 10, 2020, pp. 1045 -1055, and Department of Veterans
Affairs, FY2021 Budget Subm ission, Medical Program s and Inform ation Technology Programs, vol. 2 of 4, February
2020, p. VHA-19. Population estimates were made before the COVID-19 pandemic. T he VA response to the pandemic
has the potential to alter the estimated veteran population, enrollees, and patients in both FY2020 and FY2021.
49 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.
50 A unique veteran patient means each patient is counted only once in each fiscal year. However, there could be
multiple visits (clinical encounters) per unique veteran patient in a given fiscal year.
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Administration could request additional funding for the upcoming fiscal year and Congress could
revise these amounts through the annual appropriations process. Across al four accounts, the
President’s budget increased by $2.3 bil ion over the advance appropriations amount in
FY2021.51 The VA attributed the increase largely to revised actuarial trends based on recent data.
In total, the FY2021 budget request for VHA was $95.2 bil ion, including medical care
collections (see Table 1).52
As required by the Veterans Health Care Budget Reform and Transparency Act of 2009 (P.L. 111-
81), the President’s budget requested $94.2 bil ion in advance appropriations for the four medical
care appropriations (medical services, medical community care, medical support and compliance,
and medical facilities) for FY2022, an increase of approximately 3.85% over the FY2021-
requested amount of $90.8 bil ion for the same four accounts. In FY2022, the Administration’s
budget request would have provided $58.9 bil ion for the medical services account, $20.1 bil ion
for medical community care, $8.4 bil ion for the medical support and compliance account, and
$6.7 bil ion for the medical facilities account (see Table 1).
Both the House-passed version of the MILCON-VA appropriations bil (H.R. 7608; H.Rept. 116-
445) and the Senate Appropriations Committee majority draft bil provided FY2021 VHA
appropriations higher than the President’s request ($67.5 mil ion and $13 mil ion higher,
respectively). The Consolidated Appropriations Act, 2021 (P.L. 116-260), provides VHA
appropriations of $90.6 bil ion ($160 mil ion less than the request) for FY2021. Amounts
requested for each VHA account for FY2021 in both the House-passed bil and the Senate
Appropriations Committee majority draft bil recommended amounts, as wel as the final amounts
provided by the Consolidated Appropriations Act, 2021, for each account are detailed in
subsequent sections.
Medical Services
The medical services account covers expenses for furnishing inpatient and outpatient care and
treatment of veterans and certain dependents, including care and treatment in non-VA facilities;
outpatient care on a fee basis; medical supplies and equipment; salaries and expenses of
employees hired under Title 38, United States Code (U.S.C.); cost of hospital food service

51 U.S. Department of Veterans Affairs, FY2021 Budget Submission, Medical Programs and Information Technology
Program s, vol. 2 of 4, February 2020, p. VHA-9.
52 T he committees on appropriations include medical care cost recovery collections when considering funding for the
VHA. Congress has provided VHA the authority to bill some veterans and most health care insurers for nonservice-
connected care provided to veterans enrolled in the VA health care system, to help defray the cost of delivering medical
services to veterans. Funds collected from first - and third-party (copayments and insurance) bills are retained by the
VA health care facility that provided the care for the veteran. The Consolidated Omnibus Budget Reconciliation Act of
1985 (P.L. 99-272), enacted into law in 1986, established means testing for veterans seeking care for nonservice -
connected conditions. T he Balanced Budget Act of 1997 ( P.L. 105-33) established the Department of Veterans Affairs
Medical Care Collections Fund (MCCF) and gave the VHA the authority to retain these funds in the MCCF. Instead of
returning the funds to the T reasury, the VA can use them, without fiscal year limit ations, for medical services for
veterans. In FY2004, the Administration’s budget requested consolidating several existing medical collections accounts
into one MCCF. T he conferees of the Consolidated Appropriations Act of 2004 ( H.Rept. 108-401) recommended that
collections that would otherwise be deposited in the Health Services Improvement Fund (former name), Veterans
Extended Care Revolving Fund (former name), Special T herapeutic and Rehabilitation Activities Fund (former name),
Medical Facilities Revolving Fund (former name), and the Parking Revolving Fund (former name) should be deposited
in MCCF. T he Consolidated Appropriations Act of 2005 ( P.L. 108-447, H.Rept. 108-792) provided the VA with
permanent authority to deposit funds from these five accounts into the MCCF.
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operations;53 aid to state veterans’ homes; and assistance and support services for family
caregivers.
For FY2021, the President’s budget requested $56.7 bil ion for the medical services account. This
amount is $497.5 mil ion over the FY2021 advance appropriated amount of $56.2 bil ion.
According to the VA, this increase reflects implementation of the Precision Oncology initiative,
as wel as increased staff and funding for pain management and suicide prevention efforts.54
The House-passed version of the MILCON-VA appropriations bil (H.R. 7608; H.Rept. 116-445)
amount for FY2021 was $514 mil ion over the FY2021 advance appropriation amount. This was
$16.5 mil ion more than the President’s request while the FY2022 advance appropriation amount
for the medical services account was the same as the President’s request. The Senate
Appropriations Committee majority draft bil recommended amount for FY2021 and for the
FY2022 advance appropriations was the same as the President’s request (see Table 1).
Within the total amount for medical services in the House-passed bil for FY2021, which is $56.7
bil ion, the committee provided the following:55
 for mental health care, an additional $40 mil ion, for a total of $10.3 bil ion;
 for homelessness initiatives, an additional $40 mil ion, for a total of $1.9 bil ion;
 for rural health, an additional $30 mil ion, for a total of $300 mil ion;
 for gender-specific care for women, an additional $35 mil ion, for a total of
$660.7 mil ion;
 for Whole Health initiatives, an additional $20 mil ion, for a total of $83.6
mil ion;
 for suicide prevention efforts, an additional $85.1 mil ion, for a total of $312.6
mil ion;
 for a new Precision Oncology initiative, $75 mil ion; and
 for opioid prevention and treatment, an additional $64.7 mil ion, for a total of
$503.7 mil ion;
Within the total amount for medical services in the Senate Appropriations Committee majority
draft bil for FY2021, which is $56.7 bil ion, the committee provided the following:
 for mental health care, an additional $40 mil ion, for a total of $10.3 bil ion;
 for homelessness initiatives, an additional $40 mil ion, for a total of $1.9 bil ion;
 for telehealth, a total of $1.3 mil ion, equivalent to the request; and
 for suicide prevention efforts, an additional $85.1 mil ion, for a total of $312.6
mil ion.

53 In its FY2008 budget request to Congress, the VA requested the transfer of food service operations costs from the
medical facilities appropriations to the medical services appropriations. T he House and Senate Appropriations
Committees concurred with this request. T he cost of food service operations supports hospital food service workers,
provisions, and supplies related to the direct care of patients.
54 T he Precision Oncology initiative seeks to improve cancer treatment outcomes and decrease side effects by selecting
treatments based on characteristics of the patient and the cancer. In total, the President’s budget includes $75 million to
support implementation in FY2021.
55 U.S. Congress, House Committee on Appropriations, Military Construction, Veterans Affairs, and Related Agencies
Appropriations Bill, 2021, report to accompany H.R. 7609, 116th Cong., 2nd sess., July 13, 2020, H.Rept. 116-445, p.
45.
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In addition, the House-passed bil included new authorizing language that would permanently
authorize the use of medical services appropriations for assisted reproductive technology
treatment and adoption reimbursement for certain veterans with service-connected disabilities that
results in being unable to procreate without in vitro fertilization (IVF) treatment or other forms of
assisted reproductive technology services.56 The Senate Appropriations Committee majority draft
bil temporarily would have authorized the use of medical services appropriations for the same
services.57
The Consolidated Appropriations Act, 2021 (P.L. 116-260), provides $56.6 bil ion for the Medical
Services Account in FY2021 and $58.9 bil ion in advance appropriations for FY2022. The
explanatory statement accompanying the act included a number of initiatives funded through the
Medical Services account.58 Some are highlighted below:
 for caregiver support, a total of $1.2 bil ion to fund a recent expansion of the
program;
 for mental health and suicide prevention, a total of $10.3 bil ion, with language
encouraging the VA to use machine-learning software to prevent suicide, add
functionality to the veterans crisis line, and utilize a specified pilot program;
 for homelessness initiatives, a total of $1.9 bil ion;
 for rural health care, a total of $300 mil ion;
 for telehealth, a total of $1.3 bil ion; and
 for gender-specific care for women, a total of $661 mil ion.
Medical Community Care
Section 4003 of the Surface Transportation and Veterans Health Care Choice Improvement Act of
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 Mil er 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 al

56 U.S. Congress, House Committee on Appropriations, Military Construction, Veterans Affairs, and Related Agencies
Appropriations Bill, 2021, report to accompany H.R. 7609, 116th Cong., 2nd sess., July 13, 2020, H.Rept. 116-445, p.
104. For more information on In Vitro Fertilization (I VF) services for certain veterans see, CRS In Focus IF11082,
Veterans Health Adm inistration: Gender-Specific Health Care Services for Wom en Veterans.
57 T his policy has been authorized in appropriations acts since FY2017. Section 260 of the Continuing Appropriations
and Military Construction, Veterans Affairs, and Related Agencies Appropriations Act, 2017, and the Zika Response
and Preparedness Act (P.L. 114-223) permitted the VA to use funds from the Medical Services account for this purpose
for FY2017. Section 236 of Division J of the Military Construction, Veterans Affairs, and Related Agencies
Appropriations Act, 2018 (P.L. 115-141), continued this policy for FY2018 and FY2019. Section 235 of the Energy
and Water, Legislative Branch, and Military Construction and Veterans Affairs Appropriations Act, 2019 (P.L. 115-
244), continued this policy for FY2019 and FY2020. Section 235 of the Military Construction, Veterans Affairs, and
Related Agencies Appropriations Act, 2020 (Division F of the Further Consolidated Appropriations Act, 2020; P.L.
116-94), allows the VHA to use FY2020 appropriations and FY2021 advance appropriations to continue providing IVF
services to certain veterans and their spouses.
58 U.S. Congress, House Committee on Appropriations, Committee Print of the Committee on Appropriations U.S.
House of Representatives on H.R. 133/P.L. 116-260, committee print, 117th Cong., 1st sess., March 2021, p. 1858, at
https://www.govinfo.gov/content/pkg/CPRT -117HPRT43750/pdf/CPRT -117HPRT43750.pdf.

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community care programs under a single appropriation, and it is the funding source for care that
the VHA provides to eligible veterans through community health care providers.
The President’s budget requested $18.5 bil ion for the medical community care account. This
amount is $1.381 bil ion over the FY2021 advance appropriated amount of $17.1 bil ion. This
increase was largely driven by more recent projections for community care and the cost of
establishing a community care network.59
The House-passed version of the MILCON-VA appropriations bil (H.R. 7608; H.Rept. 116-445)
amount for FY2021 was $1.377 bil ion over the FY2021 advance appropriation amount. This was
$4.0 mil ion less than the FY2021 request, while the FY2022 advance appropriation amount was
the same as the request. The Senate Appropriations Committee majority draft bil recommended
amount for FY2021 and the FY2020 advance appropriation was the same as the President’s
request. The Consolidated Appropriations Act, 2021 (P.L. 116-260), provides $18.5 bil ion for the
Medical Community Care account in FY2021 and $20.1 bil ion in advance appropriations for
FY2022, the same as the President’s request (see Table 1).
Medical Support and Compliance
This account provides for expenses related to the management, security, and administration of the
VA health care system through the operation of VA medical centers and other medical facilities,
such as community-based outpatient clinics (CBOCs) and Vet Centers.60 The account also funds
21 Veterans Integrated Service Network (VISN)61 offices and facility director offices; chief of
staff operations; public health and environmental hazard programs; quality and performance
management programs; medical inspection; human research oversight; training programs and
continuing education; security; volunteer operations; and human resources management.
The President’s budget requested $8.2 bil ion for the medical support and compliance account.
This amount is $300 mil ion over the FY2021 advance appropriated amount of $7.9 bil ion.62
The House-passed version of the MILCON-VA appropriations bil (H.R. 7608; H.Rept. 116-445)
provided $282 mil ion over the FY2021 advance appropriation of $7.9 bil ion, a decrease of $18
mil ion from the request, while the FY2022 advance appropriation amount was the same as the
request. The Senate Appropriations Committee majority draft bil recommended amount for
FY2021 and the FY2020 advance appropriation was the same as the President’s request. The
Consolidated Appropriations Act, 2021 (P.L. 116-260), provides $8.2 bil ion for medical support
and compliance in FY2021 and $8.4 bil ion in advance appropriations for FY2022 (see Table 1).

59 U.S. Department of Veterans Affairs, FY2021 Budget Submission, Medical Programs and Information Technology
Program s, vol. 2 of 4, February 2020, p. VHA-9.
60 Vet Centers are community-based counseling centers that provide a wide range of social and psychological services,
such as professional readjustment counseling to veterans who have served in a combat zone, military sexual trauma
(MST ) counseling, bereavement counseling for families who experience an active duty death, substance abuse
assessments and referral, medical referral, veterans’ benefits explanation and referral, and employment counseling,
among other services.
61 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.
62 U.S. Department of Veterans Affairs, FY2021 Budget Submission, Medical Programs and Information Technology
Program s, vol. 2 of 4, February 2020, p. VHA-9.
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Medical Facilities
The medical facilities account funds expenses pertaining to the operations and maintenance of the
VHA’s capital infrastructure. These expenses include utilities and administrative expenses related
to planning, designing, and executing construction or renovation projects at VHA facilities. It also
funds leases, laundry services, grounds maintenance, trash removal, housekeeping, fire
protection, pest management, and property disposition and acquisition.
The President’s budget requested $6.6 bil ion for the medical facilities account. This amount is
$150 mil ion over the FY2021 advance appropriated amount of $6.4 bil ion. This increase was
largely driven by infrastructure improvements to ensure compatibility for the Electronic Health
Record Modernization (EHRM) project.63
The House-passed version of the MILCON-VA appropriations bil (H.R. 7608; H.Rept. 116-445)
provided $170 mil ion over the FY2021 advance appropriation of $6.4 bil ion, an increase of $20
mil ion from the request, while the FY2022 advance appropriation amount was the same as the
request. The Senate Appropriations Committee majority draft bil recommended amount for
FY2021 and the FY2020 advance appropriation was the same as the President’s request. The
Consolidated Appropriations Act, 2021 (P.L. 116-260), provides $6.4 bil ion for Medical
Facilities in FY2021 and $6.7 bil ion in advance appropriations for FY2022, the same as the
President’s request (see Table 1).
Medical and Prosthetic Research
As required by law, the medical and prosthetic research program (medical research) focuses on
research into the special health care needs of veterans. This account provides funding for many
types of research, such as investigator-initiated research; mentored research; large-scale, multisite
clinical trials; and centers of excel ence. VA researchers receive funding not only through this
account but also from DOD, the National Institutes of Health (NIH), and private sources.
In general, VA’s research program is intramural; that is, research is performed by VA
investigators at VA facilities and approved off-site locations. Unlike other federal agencies, such
as NIH and DOD, the VA does not have the statutory authority to make research grants to
colleges and universities, cities and states, or any other non-VA entities.
The President’s budget requested approximately $787 mil ion for the medical and prosthetic
research account, an increase of $37 mil ion, or 5%, above the FY2020-enacted amount of $750
mil ion. The VHA’s major research priorities in FY2021 include, among others, suicide
prevention, opioid safety and pain management, post-traumatic stress disorder (PTSD), traumatic
brain injury (TBI), mental health, and Gulf War il ness.64
The House-passed version of the MILCON-VA appropriations bil (H.R. 7608; H.Rept. 116-445)
provided $840 mil ion for FY2021 for the medical and prosthetic research account, an increase of
$53 mil ion from the request. The Senate Appropriations Committee majority draft bil
recommended amount for FY2021 is $800 mil ion, an increase of $13 mil ion from the
President’s request. The Consolidated Appropriations Act, 2021 (P.L. 116-260), provides $795
mil ion for Medical and Prosthetic Research in FY2021 (see Table 1).

63 Ibid.
64 U.S. Office of Management and Budget (OMB), Appendix, Budget of the United States Government Fiscal Year
2021, Washington, DC, February 10, 2020, p. 1052.
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Nonmedical Discretionary Programs Funding
National Cemetery Administration (NCA)
The majority of NCA’s discretionary funding fal s into the Operations and Maintenance category.
VA requested a total of $360 mil ion in FY2021 for this account. This is a $32 mil ion, or 9.8%,
increase for NCA’s operations and maintenance expenses over the FY2020 enacted amount and
would have provided for hiring an additional 77 full-time equivalents (FTEs).65 In addition, the
increase would have supported the costs encountered with opening four new cemeteries in New
York, Indiana, Wyoming, and Utah during 2021. There are also associated expenses for an
additional 11 cemeteries transferred from the Department of the Army bringing the total number
of national cemeteries to 156. Final y, VA anticipated a 2.1% increase in the number of interments
during FY2021 compared with FY2020.66
Within the Operations and Maintenance appropriations category, VA requested funds to support
extending its historical knowledge and public outreach programs. NCA plans to implement these
efforts by continuing its digital memorial platform, which wil preserve the 3.5 mil ion veterans
interred and in future phases wil al ow the public to post memories and photographs of each
veteran. To complement NCA’s digital efforts, they wil continue to develop onsite interpretive
signs, exhibits, and publications to increase the public’s knowledge of NCA’s history.
P.L. 116-260 provides $352 mil ion for NCA expenses for FY2021, $8 mil ion less than VA’s
requested amount, but $23 mil ion more than the FY2020-enacted amount 67 (see Table 1). The
explanatory statement accompanying the bil explains that committee believes that these funds
wil adequately address the needs of NCA to meet its increased workload and burial expansions,
but stresses that NCA should prioritize services at existing cemeteries and opening new
cemeteries for increased burial access.68 An area of ongoing concern is the way VA is addressing
the Prisoner of War headstones with German inscriptions and emblems on them and how VA
plans to provide historical context for the headstones of prisoners of war.69 The committee would
like NCA to continue providing reports to Congress on this matter.
The explanatory statement also recognizes the advancement NCA has achieved in expanding
burial spaces to underserved populations in rural communities; however, the committee remains
concerned about limited infrastructure at these sites that could detract from cemetery operations
and committal services. Therefore, the committees direct VA to assess the potential for permanent
infrastructure enhancements at each Rural Initiative national cemetery and to submit a report to
the Committees on Appropriations no later than 180 days after enactment of this act.70

65 U.S. Department of Veterans Affairs, FY2021 Budget Submission, Budget in Brief, February 2020, p. BiB-26-27.
66 U.S. Department of Veterans Affairs, FY2021 Budget Submission, Benefits and Burial Programs and Departmental
Adm inistration, vol. 3 of 4, February 2020, pp. NCA-18, 19.
67 U.S. Congress, House Committee on Appropriations, Committee Print of the Committee on Appropriations U.S.
House of Representatives on H.R. 133/P.L. 116-260, committee print, 117th Cong., 1st sess., March 2021, pp. 1870-
1871, at https://www.govinfo.gov/content/pkg/CPRT -117HPRT43750/pdf/CPRT -117HPRT43750.pdf.
68 U.S. Congress, House Committee on Appropriations, Committee Print of the Committee on Appropriations U.S.
House of Representatives on H.R. 133/P.L. 116-260, committee print, 117th Cong., 1st sess., March 2021, pp. 1870-
1871, at https://www.govinfo.gov/content/pkg/CPRT -117HPRT43750/pdf/CPRT -117HPRT43750.pdf.
69 For more information on this issue, see CRS In Focus IF11587, Removal of Nazi Symbols and Inscriptions on
Headstones of Prisoners of War in VA Nationa l Cem eteries.
70 U.S. Congress, House Committee on Appropriations, Committee Print of the Committee on Appropriations U.S.
House of Representatives on H.R. 133/P.L. 116-260, committee print, 117th Cong., 1st sess., March 2021, p. 1871, at
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VBA, General Operating Expenses
VA requested $3.21 bil ion in funding for VBA general operating expenses for FY2021. This was
an estimated $69 mil ion increase over the enacted FY2020 budget. The largest portion of this
funding request, approximately $2.5 bil ion, was for the general operating expenses associated
with the compensation and pension (including burial benefits) categories.71
Within the compensation service category, an estimated $1.9 bil ion of VBA’s request was for
FTE salaries and benefits. This amount would have provided for an additional 691 FTEs in
support of the processing and adjudication of Blue Water Navy claims. With this increase, VBA
projected having 16,682 FTEs supporting the delivery of veterans’ compensation benefits,
equating to 72% of the program’s operating expenses.72 In addition to staffing, processing, and IT
investments to implement the Blue Water Navy Act (P.L. 116-23), funding al ocations would have
gone toward implementing the Forever GI Bil (P.L. 115-48); supporting economic development
initiatives along with transition assistance programs; and funding mission-critical agency
operations.73
The Consolidated Appropriations Act provides $3.19 bil ion for VBA operating expenses for
FY2021, $27 mil ion less than VA’s request (see Table 1).74 The committee report stresses the
importance of timely processing of claims, including those associated with the Blue Water Navy
Act (P.L. 116-23). The committee did highlight a few items it would like to see VBA improve
upon during FY2021, including ways to improve the accessibility of benefits to veterans.
These areas include efforts to mitigate veteran underemployment; studying the feasibility of
funding a veteran benefit counselor position within states’ VA departments; expanding the Solid
Start program for transitioning servicemembers; and expanding awareness and use of GI Bil
apprenticeships and on-the-job training. In addition, the committee requests a report from VA to
both Appropriations Committees on Open Air Burn Pit claims within 180 days of the enactment
of the act. The report is to include a list of conditions for which veterans filed benefits, the
locations veterans are claiming exposure, and the reasons for the denial of claims. Final y, the
accompanying report directs VA to assess the feasibility to expand eligibility for VA benefits to
individuals who served honorably in Laotian and Hmong Special Gueril a Units and other
irregular forces supporting the U.S. during the Vietnam War. This report should include a cost
estimate and is to be submitted to the Committees on Appropriations no later than a year after
enactment of this act.75

https://www.govinfo.gov/content/pkg/CPRT -117HPRT43750/pdf/CPRT -117HPRT43750.pdf.
71 U.S. Department of Veterans Affairs, FY2021 Budget Submission, Supplemental Information and Appendices, vol. 1
of 4, February 2020, p. Appendix-100.
72 U.S. Department of Vet erans Affairs, FY2021 Budget Submission, Benefits and Burial Programs and Departmental
Adm inistration, vol. 3 of 4, February 2020, p. VBA-169.
73 U.S. Department of Veterans Affairs, FY2021 Budget Submission, Benefits and Burial Programs and Departmental
Adm inistration, vol. 3 of 4, February 2020, pp. VBA-145, 146.
74 U.S. Congress, House Committee on Appropriations, Military Construction, Veterans Affairs, and Related Agencies
Appropriations Bill, 2021, report to accompany H.R. 7609, 116th Cong., 2nd sess., July 13, 2020, H.Rept. 116-445, p.
42.
75 U.S. Congress, House Committee on Appropriations, Committee Print of the Committee on Appropriations U.S.
House of Representatives on H.R. 133/P.L. 116-260, committee print, 117th Cong., 1st sess., March 2021, pp. 1855-
1856, at https://www.govinfo.gov/content/pkg/CPRT -117HPRT43750/pdf/CPRT -117HPRT43750.pdf.
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Information Technology
The information technology (IT) account provides funding for department-wide IT activities such
as IT and telecommunications support, management of data systems, and acquisition of IT
systems and department-wide cybersecurity efforts, among other things.
For FY2021, the Administration requested $4.9 bil ion for the information technology budget.
This amount would have funded IT activities across the VA, including modernizing Veterans
Benefits Management to automate Blue Water Navy veterans’ claims, implementing the VA
MISSION Act, implementing a new health care logistics information system, and improving
cybersecurity among other things.
The House-passed bil (Division D of H.R. 7608) provided approximately $4.9 bil ion for the IT
systems account, $8.5 mil ion less than the President’s request (see Table 1). This level of
funding would have provided for developing clinical applications, maintaining and improving
health management platforms, IT systems associated with veterans’ benefits and memorial affairs,
cybersecurity and information infrastructure, among others.76 Furthermore, the committee
(H.Rept. 116-445) provided funding within the $4.9 bil ion for a digital protection initiative to
protect veterans, and Congressional y Chartered VSOs “from both foreign and domestic threats
across the digital landscape attempting to steal money, pilfer personal information or peddle
foreign influence via social media or other online campaigns.”77
The Senate Appropriations Committee majority draft bil recommended $4.9 bil ion for IT
systems, and this amount was equal to the President’s request. To provide better oversight on how
IT funds are executed by the VA, the Senate Appropriations Committee majority draft explanatory
statement provided funding for the IT systems account as three subaccounts: $1.2 bil ion for
salaries and expenses, $3.2 bil ion for operation and maintenance of existing IT systems, and
$495.5 mil ion for IT program development.78
The Consolidated Appropriations Act, 2021 (P.L. 116-260), provides $4.9 bil ion for the IT
systems account (see Table 1). This amount includes a $37.5 mil ion rescission as required by
Section 254 of the MILCON-VA Appropriations Act, 2021 (Division J of P.L. 116-260). The
explanatory statement to accompany the Consolidated Appropriations Act, 2021, includes $1.2
bil ion for staff salaries and expenses, $3.2 bil ion for operation and maintenance of existing IT
systems, and $495.5 mil ion for IT program development.79 Within this account, $111.1 mil ion is
provided for the Financial Management Business Transformation (FMBT) program.80

76 U.S. Congress, House Committee on Appropriations, Military Construction, Veterans Affairs, and Related Agencies
Appropriations Bill, 2021, report to accompany H.R. 7609, 116th Cong., 2nd sess., July 13, 2020, H.Rept. 116-445, p.
92.
77 U.S. Congress, House Committee on Appropriations, Military Construction, Veterans Affairs, and Related Agencies
Appropriations Bill, 2021, report to accompany H.R. 7609, 116th Cong., 2nd sess., July 13, 2020, H.Rept. 116-445, pp.
93-94.
78 Senate Appropriations Committee, “Majority Draft Military Construction, Veterans Affairs, and Related Agencies,
2021 Explanatory Statement,” p. 65, at https://www.appropriations.senate.gov/download/fy21-mcva-report.
79 U.S. Congress, House Committee on Appropriations, Consolidated Appropriations Act, 2021 , committee print,
prepared by House Committee on Appropriations, H.R. 133/P.L. 116-260 [Legislative T ext and Explanatory Statement]
Book 2 of 2 Divisions G–L, 116th Cong., 2nd sess., March 2021 (Washington: GPO, 2021), p. 1816.
80 In 2016, the VA embarked on a new financial management modernization program known as the Financial
Management Business T ransformation (FMBT ) program. T he program in general would, among other things,
standardize and streamline budgeting, procurement, accounting, resource management, and financial reporting.
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Electronic Health Record Modernization
On May 17, 2018, the VA signed a contract with Cerner Corporation to modernize its electronic
health care record system. This account provides funding for activities required to plan and
deploy the Cerner Mil ennium electronic health care record system at VA medical facilities.
Beginning with the Military Construction, Veterans Affairs, and Related Agencies Appropriations
Act for FY2018 (P.L. 115-141), Congress established this new account, “intended to be the single
source of funding within VA for the electronic health record effort” (H.Rept. 115-673).
The President’s budget proposal requested $2.6 bil ion for activities related to the development
and rollout of VA’s Electronic Health Record Modernization (EHRM) initiative, including
interoperability with the DOD electronic health record.
The House-passed MILCON-VA Appropriations bil for FY2021 (Division D of H.R. 7608;
H.Rept. 116-445) provided the same amount as the President’s budget request (see Table 1).
Funding provided for this account is available until September 30, 2023, “due to the uncertainty
of the timing” of the EHRM initiative.81 The committee report accompanying the MILCON-VA
Appropriations bil went on to state that “[the] VA transition to a commercial-based EHR system
continues to be chal enging, and it is uncertain if this capability wil be delivered across the
enterprise by 2027.”82
The Senate Appropriations Committee majority draft MILCON-VA Appropriations bil for
FY2021 recommended the same amount as the budget request. Additional y, the majority draft
bil included an administrative provision that makes 25% of funding based on certification by the
Secretary regarding any changes to the EHRM deployment schedule.83
The Consolidated Appropriations Act, 2021 provides $2.6 bil ion for the EHRM program (see
Table 1). This amount includes a $20 mil ion rescission as required by Section 254 of the
MILCON-VA Appropriations Act, 2021(Division J of P.L. 116-260). The explanatory statement
to accompany P.L. 116-260 requires VA to provide regular status updates to the Senate and House
Appropriations Committees on the progress of the EHRM program including spending and
oversight of the program.
While the Committees remain supportive of the EHRM initiative, as with any acquisition
of this size and magnitude, there are implementation concerns, including maintaining
budget, scope, implementation and deployment schedules, security, reporting, and
interoperability. As such, the agreement directs the Secretary to continue to provide
quarterly reporting of obligations, expenditures, and deployment implementation by
facility. Additionally, the agreement directs the Department to provide updates on plans
and efforts to integrate community care providers into the system. Such updates should be
submitted concurrently with the quarterly reports. Moreover, the agreement directs the
Department to continue quarterly briefings on performance milestones, costs, and progress
towards or changes to implementation and management plans, and directs the Department
to provide an accurate up-to-date deployment schedule with each quarterly briefing. Should

81 U.S. Congress, House Committee on Appropriations, Military Construction, Veterans Affairs, and Related Agencies
Appropriations Bill, 2021, report to accompany H.R. 7609, 116th Cong., 2nd sess., July 13, 2020, H.Rept. 116-445, p.
94.
82U.S. Congress, House Committee on Appropriations, Military Construction, Veterans Affairs, and Related Agencies
Appropriations Bill, 2021, report to accompany H.R. 7609, 116th Cong., 2nd sess., July 13, 2020, H.Rept. 116-445, p.
96.
83 VA is required to notify Congress and get approval on revisions to EHRM deployment timeline. For example,
because of the COVID-19 pandemic impacts, VA revised the EHRM deploymen t schedule that was included in VA’s
FY2021 congressional budget submission. Congress approved the revised timeline in August 2020.
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there be any deviation from the deployment schedule, the agreement directs the Department
to formally submit in writing a proposed updated deployment schedule within seven days
of notification of any potential change, and prior to implementation of the updated
deployment schedule, to the Committees. The Secretary is not provided transfer authority
and is directed to continue using this account as the sole source of funding within the
Department for EHRM. Further, the agreement continues to direct the Secretary to manage
EHRM at the headquarters level in the Office of the Deputy Secretary. 84
Construction
Construction accounts include major construction, minor construction, and construction and
renovation grants for state extended care facilities, as wel as grants for state veterans cemeteries.
The major construction account provides funds for capital projects costing $20 mil ion 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 mil ion
that are intended to design, build, alter, extend, or improve a VHA facility. The total cost of a
minor construction project cannot be greater than this statutory threshold. Minor construction
projects are approved by the Office of Capital Asset Management and Support at the VA Central
Office through the SCIP process. The grants to state-extended care facilities account provides
grants to states for construction or acquisition of state home facilities, including funds to remodel,
modify or alter existing buildings used for furnishing domiciliary, nursing home or hospital care
to veterans. A grant may not exceed 65% of the total cost of the project. Lastly, the grants for
construction of veterans cemeteries account provides grants to states, territories, and federal y
recognized tribal governments for the establishment, expansion, or improvement of state and
tribal veterans cemeteries.
For FY2021, the President’s budget requested $1.9 bil ion for the VA’s total construction
program. This amount included $1.77 bil ion for the VA’s major and minor construction
programs, $90 mil ion for construction and renovation grants for state-extended care facilities,
and $45 mil ion for grants for state veterans cemeteries.
The House-passed bil (Division D of H.R. 7608; H.Rept. 116-445) provided approximately $1.9
bil ion for the department’s total construction program for FY2021. Al amounts recommended
for the VA’s major and minor construction programs, and grants for construction of veterans’
cemeteries accounts, were the same as the President’s request for FY2021 (see Table 1).
However, for grants for construction of state extended care facilities the measure provided $93
mil ion—$3 mil ion more than the Administration’s request.
The Senate Appropriations Committee majority draft bil recommended approximately $1.8
bil ion for the department’s total construction program for FY2021, which is $67 mil ion below
budget request. For the major construction projects the committee recommendation was $57
mil ion below the requested amount of $1.37 bil ion, and for minor construction projects the

84 U.S. Congress, House Committee on Appropriations, Consolidated Appropriations Act, 2021 , committee print,
prepared by House Committee on Appropriations, H.R. 133/P.L. 116-260 [Legislative T ext and Explanatory Statement]
Book 2 of 2 Divisions G–L, 116th Cong., 2nd sess., March 2021 (Washington: GPO, 2021), p. 1875.
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majority draft bil recommendation was $10 mil ion below the President’s request of $400 mil ion
(see Table 1).
The Consolidated Appropriations Act, 2021, provides approximately $1.8 bil ion for the total
construction program. This includes $1.3 bil ion for the major construction program and $354.3
mil ion for the construction minor program, which includes $35.7 million rescission as required
by Section 254 of the MILCON-VA Appropriations Act, 2021(Division J of P.L. 116-260), $90
mil ion for construction and renovation grants for state-extended care facilities, and $45 mil ion
for grants for state veterans cemeteries (see Table 1).

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

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

1,663,000

1,663,000
—
1,663,000
—
1,663,000
—
Credit Subsidy
Housing Benefit Program Fund
200,377
—
204,400
—
204,400
—
204,400
—
204,400
—
Administrative Expenses
Vocational Rehabilitation Loan
58
—
34
—
34
—
34
—
34
—
Program
Vocational Rehabilitation Loan
402
—
424
—
424
—
424
—
424
—
Program Administrative
Expenses
Native American Housing Loan
1,186
—
1,163
—
1,186
—
1,163
—
1,186
—
Program
CRS-26

link to page 37
Enacted (P.L. 116-94;
Consolidated
P.L. 116-127;
President’s
House-Passed
Senate Appropriations
Appropriations Act, 2021
P.L. 116-136)
Request
(Div. D- H.R. 7608)
Committee Majority Draft
(Div. J; P.L. 116-260)
Program
FY2020
FY2021
FY2021
FY2022
FY2021
FY2022
FY2021
FY2022
FY2021
FY2022
Transfer from Veterans Choice
615,000
—
—
—
—
—
—
—
—
—
Fund (VCF) to Community Care
(P.L. 116-94)a
Families First Coronavirus
30,000
—
—
—
—
—
—
—
—
—
Response Act
(P.L. 116-127)
CARES Act
2,100,000
—
—
—
—
—
—
—
—
—
(P.L. 116-136)
Rescission §252
—
—
—
—
—
—
-2,466,380
—
—
—
Subtotal Medical Community Care
17,409,799
—
18,511,979
—
18,507,979
—
18,511,979
—
18,511,979
—
Medical Support and
7,239,156
—
7,914,191
—
7,914,191
—
7,914,191
—
7,914,191
—
Compliance
Over FY2020 Enacted Advance
98,800
—
—
—
—
—

—
—
—
Appropriations
Over FY2021 Enacted Advance
—
—
300,000
—
$281,880
—
886,235
—
300,000
—
Appropriations
P.L. 116-94 rescission (§253)
-10,000
—
—
—
—
—
—
—
—
—
CARES Act
100,000
—
—
—
—
—
—
—
—
—
(P.L. 116-136)
Rescission §252
—
—
—
—
—
—
-586,235
—
—
—
P.L.116-260 rescission (§254)
—
—
—
—
—
—
—
—
-15,000
—
Subtotal Medical Support and
7,427,956
—
8,214,191
—
8,196,071
—
8,214,191
—
8,199,191
—
Compliance
Medical Facilities
6,141,880
—
6,433,265
—
6,433,265
—
6,433,265
—
6,433,265
—
CARES Act
606,000
—
—
—
—
—
—
—
—
—
(P.L. 116-136)
Over FY2021 Enacted Advance
—
—
150,000
—
170,120
—
441,385
—
150,000
—
Appropriations
Rescission §252
—
—
—
—
—
—
-291,385
—
—

CRS-28

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

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

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

General Administration
355,911
—
413,000
—
346,111
—
365,911
—
365,911
—
CARES Act
6,000
—
—
—
—
—
—
—
—
—
(P.L. 116-136)
P.L.116-260 rescission (§254)

-12,000

Subtotal General Administration
361,911
—
413,000
—
346,111
—
365,911
—
353,911
—
Board of Veterans Appeals
182,000
—
198,000
—
198,000
—
190,000
—
196,000
—
Rescission
-8,000
—
—
—
—
—
—
—
—
—
(P.L. 116-94)
Subtotal Board of Veterans Appeals
174,000
—
198,000
—
198,000
—
190,000
—
196,000
—
Information Technology
4,371,615
—
4,912,000
—
4,903,500
—
4,912,000
—
4,912,000
—
CRS-29

Enacted (P.L. 116-94;
Consolidated
P.L. 116-127;
President’s
House-Passed
Senate Appropriations
Appropriations Act, 2021
P.L. 116-136)
Request
(Div. D- H.R. 7608)
Committee Majority Draft
(Div. J; P.L. 116-260)
Program
FY2020
FY2021
FY2021
FY2022
FY2021
FY2022
FY2021
FY2022
FY2021
FY2022
CARES Act
2,150,000
—
—
—
—
—
—
—
—
—
(P.L. 116-136)
P.L.116-260 rescission (§254)
—
—
—
—
—
—
—
—
-37,500

Subtotal Information Technology
6,521,615
—
4,912,000
—
4,903,500
—
4,912,000
—
4,874,500
—
Electronic Health Record
1,500,000
—
2,627,000
—
2,627,000
—
2,627,000
—
2,627,000
—
Modernization (EHRM)
Rescission
-70,000
—
—
—
—
—
—
—
—
—
(P.L. 116-94)
P.L.116-260 rescission (§254)
—
—
—
—
—
—
—
—
-20,000

Subtotal EHRM
1,430,000
—
2,627,000
—
2,627,000
—
2,627,000
—
2,607,000
—
Inspector General
210,000
—
228,000
—
229,300
—
228,000
—
228,000
—
CARES Act
12,500
—
—
—
—
—
—
—
—
—
(P.L. 116-136)
Subtotal Inspector General
222,500
—
228,000
—
229,300
—
228,000
—
228,000
—
Construction, major projects
1,235,200
—
1,373,000
—
1,373,000
—
1,316,000
—
1,316,000
—
Construction, minor projects
398,800
—
400,000
—
400,000
—
390,000
—
390,000
—
P.L.116-260 rescission (§254)
—
—
—
—
—
—
—
—
-35,700

Subtotal Construction, minor
398,800
—
400,000
—
400,000
390,000
354,300

projects

—
—
Grants for State Extended Care
90,000
—
90,000
—
93,000
—
90,000
—
90,000
—
Facilities
CARES Act
150,000
—
—
—
—
—
—
—
—
—
(P.L. 116-136)
Subtotal grants for state extended
240,000
—
90,000
—
93,000
—
90,000
—
90,000
—
care facilities
Grants for State Veterans
45,000
—
45,000
—
45,000
—
45,000
—
45,000
—
Cemeteries
CRS-30

Enacted (P.L. 116-94;
Consolidated
P.L. 116-127;
President’s
House-Passed
Senate Appropriations
Appropriations Act, 2021
P.L. 116-136)
Request
(Div. D- H.R. 7608)
Committee Majority Draft
(Div. J; P.L. 116-260)
Program
FY2020
FY2021
FY2021
FY2022
FY2021
FY2022
FY2021
FY2022
FY2021
FY2022
Total, Departmental
10,629,026
—
10,286,000
—
10,214,911
—
10,163,911
—
10,064,711
—
Administration
Administrative Rescission
-15,949
—
—
—
—
—
—
—
—
—
(P.L. 116-94)
Administrative Provisions (§253)
—
—
—
—
—
—
-257,462
—
—
—
Total, Department of
$237,492,225
—
$240,245,173
—
$240,209,607
—
$243,119,952
—
$243,162,237
—
Veterans Affairs (without
MCCF)
Total Mandatory
$125,352,325
—
$135,434,234
—
$104,775,373
—
$104,389,388
—
$104,431,673
—
Total Discretionary
$112,139,900
—
$104,810,939
—
$135,434,234
—
$138,730,564
—
$138,730,564
—
Memorandum: Advance Appropriations

Compensation and Pensions
—
$118,246,975
—
$130,227,650
—
$130,227,650
—
$130,227,650
—
$130,227,650
Readjustment Benefits
—
12,578,965
—
14,946,618
—
14,946,618
—
14,946,618
—
14,946,618
Insurance and Indemnities
—
129,224
—
136,950
—
136,950
—
136,950
—
136,950
Subtotal, Benefits Programs
—
130,955,164
—
145,311,218
—
145,311,218
—
145,311,218
—
145,311,218
Medical Services
—
56,158,015
—
58,897,219
—
58,897,219
—
58,897,219
—
58,897,219
Medical Community Care
—
17,131,179
—
20,148,244
—
20,148,244
—
20,148,244
—
20,148,244
Medical Support and
—
7,914,191
—
8,403,117
—
8,403,117
8,403,117
8,403,117
Compliance
—
—
Medical Facilities
—
6,433,265
—
6,734,680
—
6,734,680
—
6,734,680
—
6,734,680
Subtotal Medical Care
—
87,636,650
—
94,183,260
—
94,183,260
—
94,183,260
—
94,183,260
Total Advance
—
$218,591,814
—
$239,494,478
—
$239,494,478
$239,494,478
$239,494,478
Appropriation
—
—
Source: Table prepared by CRS based on the Further Consolidated Appropriations Act, 2020 (P.L. 116-94); the Families First Coronavirus Response Act (P.L. 116-127);
the Coronavirus Aid, Relief, and Economic Security Act (P.L. 116-136); U.S. Congress, House Committee on Appropriations, Military Construction, Veterans Affairs, and
Related Agencies Appropriations Bil , 2021, report to accompany H.R. 7609, 116th Cong., 2nd sess., July 13, 2020, H.Rept. 116-445, pp. 131-141; Division D of H.R. 7608;
Senate Appropriations Committee majority draft explanatory statement released on November 10, 2020, pp.98-108; and U.S. Congress, House Committee on
CRS-31

Appropriations, Consolidated Appropriations Act, 2021, committee print, prepared by House Committee on Appropriations, H.R. 133/Public Law 116–260 [Legislative Text
and Explanatory Statement] Book 2 of 2 Divisions G–L, 116th Cong., 2nd sess., March 2021 (Washington: GPO, 2021), pp. 1885-1903.
a. The Further Consolidated Appropriations Act, 2020 (P.L. 116-94), authorized a mandatory balance transfer of $615 mil ion from the Veterans Choice Fund (VCF)
established by §802(c)(4) of the Veterans Access, Choice, and Accountability Act of 2014, as amended (38 U.S.C. §1701 note) to the medical community care
account.

CRS-32

Department of Veterans Affairs FY2021 Appropriations

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

33

Department of Veterans Affairs FY2021 Appropriations

Appendix B. Department of Veterans Affairs,
Enacted Appropriations FY1995-FY2020
Table B-1. Department of Veterans Affairs Enacted Appropriations, FY1995-FY1999
($ in Thousands)
FY1995
FY1996
FY1997
FY1998
FY1999

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

34

Department of Veterans Affairs FY2021 Appropriations

FY1995
FY1996
FY1997
FY1998
FY1999

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

35

Department of Veterans Affairs FY2021 Appropriations

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

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

36

Department of Veterans Affairs FY2021 Appropriations

FY2000
FY2001
FY2002
FY2003
FY2004

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

37

Department of Veterans Affairs FY2021 Appropriations

FY2000
FY2001
FY2002
FY2003
FY2004

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

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

38

Department of Veterans Affairs FY2021 Appropriations

FY2005
FY2006
FY2007
FY2008
FY2009
FY2010

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

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

39

Department of Veterans Affairs FY2021 Appropriations

FY2005
FY2006
FY2007
FY2008
FY2009
FY2010

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

40

Department of Veterans Affairs FY2021 Appropriations

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

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

41

Department of Veterans Affairs FY2021 Appropriations

FY2011
FY2012
FY2013
FY2014
FY2015
Enacted
Enacted
Enacted
Enacted
Enacted

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

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

511,200

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

42

Department of Veterans Affairs FY2021 Appropriations

FY2011
FY2012
FY2013
FY2014
FY2015
Enacted
Enacted
Enacted
Enacted
Enacted

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

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

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

43

Department of Veterans Affairs FY2021 Appropriations

FY2016
FY2017
FY2018
FY2019
FY2020
Enacted
Enacted
Enacted
Enacted
Enacted

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

44

Department of Veterans Affairs FY2021 Appropriations

FY2016
FY2017
FY2018
FY2019
FY2020
Enacted
Enacted
Enacted
Enacted
Enacted

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

-$1,000
Supplemental
—
—
—

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

Departmental

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

45

Department of Veterans Affairs FY2021 Appropriations

FY2016
FY2017
FY2018
FY2019
FY2020
Enacted
Enacted
Enacted
Enacted
Enacted

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

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

46

Department of Veterans Affairs FY2021 Appropriations

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

Author Information

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

Jared S. Sussman

Analyst in Health Policy

Disclaimer
This document was prepared by the Congressional Research Service (CRS). CRS serves as nonpartisan
shared staff to congressional committees and Members of Congress. It operates solely at the behest of and
under the direction of Congress. Information in a CRS Report should n ot be relied upon for purposes other
than public understanding of information that has been provided by CRS to Members of Congress in
connection with CRS’s institutional role. CRS Reports, as a work of the United States Government, are not
subject to copyright protection in the United States. Any CRS Report may be reproduced and distributed in
its entirety without permission from CRS. However, as a CRS Report may include copyrighted images or
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R46459 · VERSION 4 · UPDATED
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