Department of Veterans Affairs FY2022 Appropriations

Department of Veterans Affairs FY2022
June 28, 2022
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 Biden submitted his formal budget proposal for FY2022 on May 28, 2021. The
Heather M. Salazar
Administration requested $268.41 billion for VA. This amount included $155.44 billion in
Analyst in Veterans Policy
mandatory funding and $112.97 billion in discretionary funding—a 10.38% increase compared

with the $243.16 billion enacted in FY2021 (excluding FY2021 funding provided in the
American Rescue Plan Act of 2021, P.L. 117-2). The President’s budget also proposed using a

Recurring Expenses Transformational Fund, established by the Consolidated Appropriations Act
of 2016 (P.L. 114-113), to transfer $820 million of unobligated balances at the end of FY2021 to supplement the
discretionary budget request for FY2022. In addition, the budget request included an advance appropriation request of
$267.87 billion for FY2023 to fund the seven advance appropriations accounts: compensation and pensions, readjustment
benefits, insurance and indemnities, medical services, medical community care, medical support and compliance, and
medical facilities.
On July 29, 2021, the House passed H.R. 4502, consisting of seven appropriations bills. Division F of H.R. 4502 (H.Rept.
117-81) included the Military Construction, Veterans Affairs, and Related Agencies (MILCON-VA) appropriations bill for
FY2022. The House-passed bill provided $268.59 billion for VA, including $155.44 billion in mandatory spending and
$113.15 billion in discretionary spending. On August 4, 2021, the Senate Appropriations Committee reported its version of
the MILCON-VA bill for FY2022 (S. 2604; S.Rept. 117-35). The Senate Appropriations Committee-reported bill
recommended $268.37 billion for VA for FY2022, including $155.44 billion in mandatory spending and $112.93 billion in
discretionary spending. Both the House-passed and Senate-reported versions of the MILCON-VA bill for FY2022 include
$267.87 billion in advance appropriations for FY2023. On March 15, 2022, the Consolidated Appropriations Act, 2022 (P.L.
117-103), was signed into law. The act provides $269.26 billion for VA for FY2022, including $157.05 in mandatory
spending and $112.22 billion in discretionary spending. The act also includes $272.32 billion in advance appropriations for
FY2023. Comparative funding levels for FY2021 (excluding FY2021 funding provided in the American Rescue Plan Act of
2021, P.L. 117-2) and FY2022 are as follows (component amounts may not sum to totals due to rounding):
FY2022 Senate
FY2022
Appropriations
House-Passed
Committee
FY2021 Enacted
H.R. 4502
S. 2604
FY2022 Enacted

(P.L. 116-260)
FY2022 Request
(H.Rept. 117-81)
(S.Rept. 117-35)
(P.L. 117-103)
Veterans Benefits
$142.10 bil ion
$159.09 bil ion
$159.09 bil ion
$159.16 bil ion
$160.73 bil ion
Administration
(VBA, including
General Operating
Expenses)
Veterans Health
$90.64 bil ion
$98.33 bil ion
$98.46 bil ion
$98.33 bil ion
$97.93 bil ion
Administration
(VHA)
National Cemetery
$352.0 mil ion
$394.0 mil ion
$392.0 mil ion
$394.0 mil ion
$394.0 mil ion
Administration
(NCA)
Departmental
$10.06 bil ion
$10.59 bil ion
$10.65 bil ion
$10.48 bil ion
$10.28 bil ion
Administration

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Contents
Introduction ..................................................................................................................................... 1
Scope and Limitations of This Report ....................................................................................... 1
The Department of Veterans Affairs Budget ................................................................................... 2
Advance Appropriations ............................................................................................................ 2
Historical Perspective ................................................................................................................ 3
FY2021 Budget Summary ............................................................................................................... 4
American Rescue Plan Act of 2021 (P.L. 117-2)....................................................................... 6
Budget Request for FY2022 and Congressional Action ................................................................. 8
President’s Request ................................................................................................................... 8
House Action ............................................................................................................................. 9
Senate Action .......................................................................................................................... 10
Continuing Appropriations ...................................................................................................... 10
Consolidated Appropriations Act, 2022 (H.R. 2471; P.L. 117-103) ......................................... 11
Mandatory Programs Funding ................................................................................................. 12
Compensation and Pensions ............................................................................................. 12
Readjustment Benefits ...................................................................................................... 13
Veterans Insurance and Indemnities (VI&I) ..................................................................... 14
Medical Care and Medical Research Discretionary Programs Funding ................................. 15
Background ....................................................................................................................... 15
The Veteran Patient Population ......................................................................................... 17
President’s Request and Congressional Action ................................................................. 17

Nonmedical Discretionary Programs Funding ........................................................................ 22
National Cemetery Administration (NCA) ....................................................................... 22
VBA, General Operating Expenses .................................................................................. 23
Board of Veterans’ Appeals ............................................................................................... 25
Information Technology .................................................................................................... 25
Electronic Health Record Modernization (EHRM) .......................................................... 26
Construction ...................................................................................................................... 28
Asset and Infrastructure Review ....................................................................................... 30

Figures
Figure 1. VA Appropriations, FY1995-FY2021 .............................................................................. 4
Figure 2. FY2021 VA-Enacted Appropriations ............................................................................... 5
Figure 3. American Rescue Plan Act of 2021 Funding ................................................................... 6
Figure 4. FY2022 Budget Request .................................................................................................. 9
Figure 5. Summary of AIR Act Process ........................................................................................ 31

Tables
Table 1. American Rescue Plan Act (P.L. 117-2) Allocations ......................................................... 7
Table 2. FY2021-FY2022 Appropriations and FY2023 Advance Appropriations ........................ 32

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Table A-1. Veteran Population, VA Enrollees, and VA Patients, FY2000-FY2022 ....................... 36
Table B-1. VA Appropriations FY1995-FY1999 ........................................................................... 37
Table B-2. VA Appropriations FY2000-FY2004 ........................................................................... 39
Table B-3. VA Appropriations FY2005-FY2009 ........................................................................... 41
Table B-4. VA Appropriations FY2010-FY2014 ........................................................................... 43
Table B-5. VA Appropriations FY2016-FY2020 ........................................................................... 45
Table B-6. VA Appropriations FY2020-FY2024 ........................................................................... 48

Appendixes
Appendix A. Veteran Population, VA Enrollees, and VA Patients, FY2000-FY2022 ................... 36
Appendix B. VA Appropriations FY1995-FY2021 ....................................................................... 37

Contacts
Author Information ........................................................................................................................ 51


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Introduction
The Department of Veterans Affairs (VA) provides a range of benefits and services to veterans
who meet certain eligibility criteria. These benefits and services include, among other things,
hospital and medical care;1 disability compensation and pensions;2 education;3 vocational
rehabilitation and employment services;4 assistance to homeless veterans;5 home loan
guarantees;6 administration of life insurance, as well as traumatic injury protection insurance for
servicemembers; and death benefits that cover burial expenses.7
The department carries out its programs nationwide through three administrations and the Board
of Veterans Appeals (BVA). The Veterans Health Administration (VHA) is responsible for health
care services and medical and prosthetic research programs. The Veterans Benefits
Administration (VBA) is responsible for, among other things, providing compensation, pensions,
and education assistance. The National Cemetery Administration (NCA)8 is responsible for
maintaining national veterans cemeteries; providing grants to states for establishing, expanding,
and improving state veterans cemeteries; and providing headstones and markers for the graves of
eligible persons, among other things. The BVA reviews all appeals made by veterans or their
representatives for entitlement to veterans’ benefits, including claims for service connection,
increased disability ratings, pensions, insurance benefits, and educational benefits, among other
things.
Scope and Limitations of This Report
This report provides an overview of the FY2022 President’s request for VA and subsequent
congressional action. It begins with a discussion of various appropriations and funds that
constitute VA’s budget, followed by a brief overview of the FY2021 congressional appropriations
process and enacted amounts for FY2021, including American Rescue Plan (ARP) Act (P.L. 117-
2) funding. It then discusses the President’s request for FY2022 for care, benefits, and services
for veterans and administration of the department, followed by congressional action on the
FY2022 request. The report provides funding levels for the accounts as presented in the Military
Construction, Veterans Affairs, and Related Agencies (MILCON-VA) appropriations bill; it does
not provide funding levels at the subaccount, program, or activity levels. Generally, VA accounts
are purpose specific rather than program specific. For example, VHA’s supply chain
modernization program could include funding from the medical support and compliance account
and the information technology account. Appendix B lists appropriations to VA from FY1995 to
FY2021. Funding amounts shown in the appendices of this report may include transfers in and

1 For more information on programs, see CRS Report R42747, Health Care for Veterans: Answers to Frequently Asked
Questions
.
2 For more information on programs, see CRS Report R44837, Benefits for Service-Disabled Veterans; and CRS Report
RS22804, Veterans’ Benefits: Pension Benefit Programs.
3 For a discussion of education benefits, see CRS Report R42755, The Post-9/11 GI Bill: A Primer.
4 For details on VA’s vocational rehabilitation and employment, see CRS Report RL34627, Veterans’ Benefits: The
Veteran Readiness and Employment Program
.
5 For detailed information on homeless veterans programs, see CRS In Focus IF10167, Veterans and Homelessness.
6 For details on the home loan guarantee program, see CRS Report R42504, VA Housing: Guaranteed Loans, Direct
Loans, and Specially Adapted Housing Grants
.
7 For more information on burial benefits, see CRS Report R41386, Veterans’ Benefits: Burial Benefits and National
Cemeteries
.
8 Established by the National Cemeteries Act of 1973 (P.L. 93-43).
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out of accounts as calculated by VA; therefore, those amounts may be different from those shown
in Table 2 which presents budget authority from the MILCON-VA appropriations bills and
accompanying committee reports. Table 2 is included at the end of discussion on the FY2022
budget request and congressional action.
The Department of Veterans Affairs Budget
VA’s budget includes both mandatory9 and discretionary funding.10 Mandatory accounts fund
disability compensation for veterans, the survivor’s Dependency and Indemnity Compensation
(DIC) program, pensions, vocational rehabilitation and employment, education, life insurance,
housing, clothing allowances, and burial benefits (such as burial allowances, grave liners, outer
burial receptacles, and headstones and markers), among other benefits and services. Discretionary
accounts fund medical care, medical research, construction programs, information technology, the
Office of Inspector General, BVA, and general operating expenses, among other things. These
accounts are further supplemented by revolving funds, such as the Canteen Service Revolving
Fund and the Pershing Hall Revolving Fund; trust funds, such as the Department of Veterans
Affairs Cemetery Gift Fund and the General Post Fund; and special funds, such as the Medical
Care Collections Fund and the Capital Asset Fund.11
Advance Appropriations12
VA has advance appropriation authority for specified medical care and benefits accounts. In 2009,
Congress enacted the Veterans Health Care Budget Reform and Transparency Act of 2009 (P.L.
111-81), authorizing advance appropriations for three of the four VHA accounts: medical
services, medical support and compliance, and medical facilities.13 In 2014, Congress passed the
Consolidated and Further Continuing Appropriations Act, 2015 (H.R. 83; P.L. 113-235), which
amended 38 U.S.C. §117 and included three more accounts to the advance appropriations list of
accounts. This act authorized advance appropriations for three mandatory VA benefits programs
within the Veterans Benefits Administration: compensation and pensions, readjustment benefits,
and veterans insurance and indemnities. Beginning with the FY2016 Military Construction and
Veterans Affairs, and Related Agencies Appropriations Act (MILCON- VA; P.L. 114-113), those

9 Mandatory programs funded through the annual appropriations process are commonly referred to as appropriated
entitlements
. In general, appropriators have little control over the amounts provided for appropriated entitlements;
rather, the authorizing statute establishes the program parameters (e.g., eligibility rules, benefit levels) that entitle
certain recipients to payments. If Congress does not appropriate the money necessary to meet these commitments,
entitled recipients (e.g., individuals, states, or other entities) may have legal recourse. For an overview of mandatory
spending, see CRS Report R44641, Trends in Mandatory Spending: In Brief.
10 Funding for discretionary programs is provided and controlled through the annual appropriations process. For more
information, see CRS Report R41726, Discretionary Budget Authority by Subfunction: An Overview.
11 For more details about these funds, see Department of Veterans Affairs, FY2016 Congressional Budget Submission,
Supplemental Information and Appendices, vol. 1 of 4, February 2015, pp. Appendix 117-Appendix 126. (This is the
last edition in which this information was published.) For definitions about “revolving funds,” “trust funds,” and
“special funds,” see Executive Office of the President, Office of Management and Budget (OMB), OMB Circular No.
A–11, Section 20- Terms and Concepts, available at https://www.whitehouse.gov/wp-content/uploads/2018/06/a11.pdf.
12 In general, advance appropriations refer to budget authority provided in an appropriations act that becomes available
for obligation one or more fiscal years after the year covered by the act. For a detailed discussion of advance
appropriations, see CRS Report R43482, Advance Appropriations, Forward Funding, and Advance Funding: Concepts,
Practice, and Budget Process Considerations
.
13 Codified at 38 U.S.C. §117.
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accounts received advance appropriations for the first time in FY2017, in addition to the three
VHA accounts already authorized to receive advance appropriations.
Section 4003 of the Surface Transportation and Veterans Health Care Choice Improvement Act of
2015 (P.L. 114-41) required the establishment of a separate new account for medical community
care beginning with the FY2017 appropriations cycle. The Jeff Miller and Richard Blumenthal
Veterans Health Care and Benefits Improvement Act of 2016 (P.L. 114-315) authorized advance
appropriations for the medical community care account.
Congress had authorized (through P.L. 111-81, P.L. 113-235, and P.L. 114-315) advance
appropriations of new budget authority for the aforementioned VBA and VHA accounts to
prevent potential delays in the delivery of care and benefits to veterans that may have arisen in
the event of a funding lapse.
Under present budget scoring guidelines, advance appropriations are scored as new budget
authority in the fiscal year in which they become available for obligation, not in the fiscal year the
appropriations are enacted and are required to be accommodated within the statutory spending
caps for that year.14 Therefore, throughout the funding tables in this report, advance
appropriations numbers are displayed by the label “memorandum” and in the corresponding fiscal
year column.
Historical Perspective
Figure 1
provides funding trends for mandatory, discretionary, and total VA-enacted
appropriations from FY1995 through FY2021. Between FY1995 and FY2021, total mandatory
appropriations grew from $19.45 billion to $154.15 billion in nominal dollars, a compound
annual growth rate (CAGR) of 8.29%.15 During this same period, discretionary appropriations
grew from $18.02 billion to $104.43 billion, a CAGR of 6.99%. The total VA appropriations from
FY1995 through FY2021 grew from $37.47 billion to $258.58 billion, a CAGR of 7.71%.

14 Executive Office of the President, Office of Management and Budget (OMB), OMB Circular No. A–11, Section 20-
Terms and Concepts
, available at https://www.whitehouse.gov/wp-content/uploads/2018/06/s20.pdf; also see OMB
Circular No. A–11, Appendix A -Scorekeeping Guidelines, available at https://www.whitehouse.gov/wp-content/
uploads/2018/06/a11.pdf.
15 CAGR is annualized average rate of growth between two given years, calculated as CAGR; year FY1995 to year
FY2021 = [(value in year 2021/value in year 1995) ^ (1/26)-1].
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Figure 1. VA Appropriations, FY1995-FY2021

Source: Figure prepared by CRS based on figures from the Department of Veterans Affairs, Office of
Management, Office of Budget (see Appendix B).
Notes: Amounts in nominal, or noninflation-adjusted, dol ars, and discretionary funding excludes offsetting
col ections deposited in the Medical Care Col ections Fund (MCCF).
FY2009: American Recovery and Reinvestment Act (P.L. 111-5) provided supplemental funding, VHA received
$1.0 bil ion for the medical facilities account, and the $700 mil ion was for the economic recovery payments. The
supplemental $700 mil ion is not included in the discretionary subtotal but included in overall VA total.
FY2014: Amounts include $15 bil ion in mandatory funding provided in the Veterans Choice Act (P.L. 113-146).
FY2021: Amounts include American Rescue Plan (ARP) Act (P.L. 117-2) funding.
FY2021 Budget Summary16
President Donald Trump submitted his budget proposal for FY2021 on February 10, 2020. The
President’s budget requested $240.25 billion for VA. This amount included $135.43 billion in
mandatory benefits funding and $104.81billion in discretionary funding.
On July 9, 2020, the House Appropriations Committee held a markup of the FY2021 MILCON-
VA appropriations bill, and the bill was ordered reported to the full House on July 13 (H.R. 7609;
H.Rept. 116-445). Subsequently, the text of H.R. 7609 was included in a four-bill appropriations
package (H.R. 7608, the State, Foreign Operations, Agriculture, Rural Development, Interior,
Environment, Military Construction, and Veterans Affairs Appropriations bill 2021) and passed
by the full House on July 24. The House-passed measure (Division D of H.R. 7608) provided a
total of $240.21 billion for VA, which included $135.43 billion in mandatory funding and
$104.78 billion in discretionary funding.
On November 10, 2020, the chair of the Senate Committee on Appropriations, Senator Richard
Shelby, released drafts of all 12 annual appropriations bills along with draft accompanying
explanatory statements, including the FY2021 MILCON-VA appropriations bill.17 The release of

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

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

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

Source: Figure prepared by CRS based on Department of Veterans Affairs, FY2022 Budget Submission,
Supplemental Information and Appendices
, vol. 1of 4, May 28, 2021, p. Supplemental Information – 11.
Note: Allocations are estimates and subject to change, based on FY2021 actual spending and changes
throughout FY2022 and FY2023.
A summary of VA provisions follows, and Table 1 provides VA’s estimated allocations by
account level. Final FY2022 and FY2023 funding allocations are subject to change based on
FY2021 actual spending and changes throughout FY2022 and FY2023.
 Section 8001 provided $272 million for VBA, general operating expenses
account, and the Board of Veterans Appeals, to remain available until September
30, 2023, for processing disability claims and appeals for entitlement to veterans’
benefits.
 Section 8002 provided $14.48 billion to remain available until September 30,
2023, for allocation to VA medical care accounts. VA established the Veterans
Medical Care and Health Fund to execute Section 8002 of P.L. 117-2.
 Section 8003 provided $100 million to remain available until September 30,
2022, for the supply chain modernization initiative.
 Section 8004 provided $250 million for a one-time only obligation and
expenditure to existing state extended care facilities for payment of per diem
payments during March 11, 2021, through September 30, 2022. This section also
provided $500 million to remain available until expended for grants to assist
states to acquire, construct, remodel, modify, or alter state extended care
facilities.

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

Medical Services
9,020,443
Medical Community Care
1,901,196
Medical Support and Compliance
978,433
Medical Facilities
2,572,928
Medical and Prosthetic Research
9,000
Section 8002 Subtotal
14,482,000
Information Technology
100,000
Section 8003 Subtotal
100,000
Medical Community Care
250,000
Grants for Construction of State Extended Care Facilities
500,000
Section 8004 Subtotal
750,000
Office of Inspector General
10,000
Section 8005 Subtotal
10,000
Veterans Benefits Administration (VBA) General Operating Expenses (GOE)- Veteran Rapid
386,000
Retraining Assistance Program
Section 8006 Subtotal
386,000
Medical Services
627,900
Medical Community Care
72,100
Medical Care Col ections Fund
300,000
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Estimated
Account
Allocation
Section 8007 Subtotal
1,000,000
Emergency Department of Veterans Affairs Employee Leave Fund
80,000
Section 8008 Subtotal
80,000
Total TITLE VIII of American Rescue Plan Act (P.L. 117-2)
$17,080,000
Source: Table prepared by CRS based on Department of Veterans Affairs, FY2022 Budget Submission,
Supplemental Information and Appendices, vol. 1of 4, May 28, 2021, p. Supplemental Information – 11; Department
of Veterans Affairs, FY2022 Budget Submission, Medical Programs and Information Technology Programs, vol. 2 of 4,
May 28, 2021; and information from VA Office of Management, Office of Budget.
Note: VA established the Veterans Medical Care and Health Fund (VMCHF) to execute Section 8002 and
Section 8007, with the estimated allocation of funding for copayments not col ected.
The VA Transparency & Trust Act of 2021(P.L. 117-63) required the VA Secretary to submit to
the Senate and House Veterans Affairs Committees detailed plans for obligating and expending
funds provided in the American Rescue Plan (ARP) Act (P.L. 117-2), the Coronavirus Aid, Relief
and Economic Security (CARES) Act (P.L. 116-136), and the Families First Coronavirus
Response Act (P.L. 116-127). Additionally, P.L. 117-63 requires biweekly reports to the
committees detailing the obligations, expenditures, and the planned uses for funds provided by
P.L. 116-127, P.L. 116-136, and P.L. 117-2.
Budget Request for FY2022 and
Congressional Action

President’s Request
On April 9, 2021, President Biden submitted his discretionary funding request for FY2022.20 The
formal budget request for FY2022 was submitted on May 28. The President’s budget requested
$268.41 billion for VA. This amount included $155.44 billion in mandatory funding and $112.97
billion in discretionary appropriations. In addition, the Administration proposed to use $820
million from the Recurring Expenses Transformational Fund to supplement the discretionary
budget request. The Recurring Expenses Transformational Fund was established by the
Consolidated Appropriations Act, 2016 (P.L. 114-113, Division J, Title II, Section 243). The law
allows unobligated balances of expired discretionary appropriations, in FY2016 or any
succeeding fiscal year, to be transferred from the General Fund of the Treasury to VA and
deposited in the Recurring Expenses Transformational Fund at the end of the fifth fiscal year after
the last fiscal year for which such funds were available. The law stipulates that amounts deposited
in the fund may be available for facility infrastructure improvements, including nonrecurring
maintenance, at existing VA hospitals and clinics, and information technology systems
improvements and sustainment, subject to approval by the Office of Management and Budget
(OMB) and House and Senate Appropriations Committees.21

20 Office of Management and Budget (OMB), “Office of Management and Budget Releases the President’s Fiscal Year
2022 Discretionary Funding Request,” press release, April 9, 2021, https://www.whitehouse.gov/wp-content/uploads/
2021/04/FY2022-Discretionary-Request-Press-Release.pdf.
21 38 U.S.C. §313 note.
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The President’s budget request for FY2022 included $159.09 billion for VBA, including general
operating expenses; $98.33 billion for VHA; $394 million for NCA; and $10.59 billion for
departmental administration, which includes the following accounts: general administration,
BVA, and information technology systems (IT systems); veterans electronic health record
modernization (EHRM), Office of Inspector General, construction major and minor accounts, and
grants for construction of state extended care facilities; and grants for the construction of veterans
cemeteries (see Figure 4).
The President’s budget also requested $156.59 billion in advance appropriations for FY2023 for
VBA mandatory accounts and $111.29 billion in advance appropriations for FY2023 for VHA
discretionary accounts.
Figure 4. FY2022 Budget Request

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

22 The Subcommittee on Military Construction, Veterans Affairs, and Related Agencies did not hold a planned
subcommittee markup on August 2, 2021.
23 U.S. Congress, Senate Committee on Appropriations, Military Construction, Veterans Affairs, and Related Agencies
Appropriations Bill, 2022
, report to accompany S. 2604, 117th Cong., 1st sess., August 4, 2021, S.Rept. 117-35, p. 67.
24 The FY2021 rate of operations does not apply to transfer authorities of unobligated balances from title X of Division
B of the Coronavirus Aid, Relief, and Economic Security Act (P.L. 116-136), provided in Division J of the
Consolidated Appropriations Act, 2021 (H.R. 133, P.L. 116-260).
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Veterans Affairs, and Related Agencies Appropriations Act, 2021 (Division J of P.L. 116-260),
these accounts were not affected by the CR.
However, Section 151 of Division A of the Extending Government Funding and Delivering
Emergency Assistance Act provided VA with transfer authority to transfer up to $193.5 million of
FY2021 unobligated balances from the medical services account to the following three accounts,
specifying that
 up to $178 million may be transferred to the VBA general operating expenses
account,
 up to $5.8 million may be transferred to BVA, and
 up to $9.7 million may be transferred to the information technology systems
account.
These transferred amounts were to be used for expenses related to the processing of disability
claims for asthma, rhinitis, and sinusitis on a presumptive basis due to presumed exposure to
particulate matter (such as burn pit emissions) during servicemembers’ deployment to countries in
Southwest Asia and certain other countries.25
Additional CRs—Further Extending Government Funding Act (P.L. 117-70), Further Additional
Extending Government Funding Act (P.L. 117-86), Extension of Continuing Appropriations Act,
2022 (P.L. 117-95)—extended funding until the Consolidated Appropriations Act, 2022, was
enacted.
Consolidated Appropriations Act, 2022 (H.R. 2471; P.L. 117-103)26
March 9, 2022, the House passed H.R. 2471, consisting of all 12 FY2022 appropriations bills.
The Senate passed the measure on March 10. President Biden signed the measure into law as P.L.
117-103 on March 15. Division J of the Consolidated Appropriations Act, 2022, included the
Military Construction, Veterans Affairs, and Related Agencies Appropriations Act, 2022. The act
provides $269.26 billion for VA for FY2022. This includes $157.05 billion in mandatory funding
and $112.22 billion in discretionary funding (see Table 2). The act also provides $272.32 billion
in advance appropriations for FY2023. This is $4.45 billion above the advance appropriations
request of $267.87 billion for FY2023. This revised advance appropriations amount is for the
compensation and pension account of VBA. Furthermore, Division J of the Consolidated
Appropriations Act, 2022, includes Section 253, rescinding and reappropriating funds from the
Recurring Expenses Transformational Fund in support of the Administration’s proposal to use the
Recurring Expenses Transformational Fund to supplement VA’s discretionary budget amount.
Nonrecurring maintenance projects (NRM) under the medical facilities account would receive
$150 million, and the information technology account would receive $670 million (these amounts

25 For more information, see CRS Insight IN11724, VA Now Processing Gulf War Veterans’ Disability Claims for New
Respiratory Presumptive Conditions
. Also see Department of Veterans Affairs, “Interim Final Rule-Presumptive
Service Connection for Respiratory Conditions Due to Exposure to Particulate Matter,” 86 Federal Register 42724-
42733, August 5, 2021.
26 A joint explanatory statement accompanying H.R. 2471 was published in the Congressional Record. The explanatory
statement accompanying Division J-the Military Construction, Veterans Affairs, and Related Agencies Appropriations
Act, 2022, can be found in “Explanatory Statement Submitted By Ms. Delauro, Chair of the House Committee on
Appropriations, Regarding the House Amendment to the Senate Amendment to H.R. 2471, Consolidated
Appropriations Act, 2022” Congressional Record, daily edition, vol. 168, no. 42—Book IV (March 9, 2022), pp.
H2944-H2991.
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are not included in the medical facilities account and information technology account in Table 2
since they are reallocation of funds).
The next sections discuss account-level details of the President’s FY2022 request and
congressional action on regular VA appropriations. Comparisons to FY2021-enacted funding
amounts do not include funding from the American Rescue Plan Act (P.L. 117-2).
Mandatory Programs Funding
Major mandatory program funding includes compensation and pensions (VA’s disability
compensation program; pensions to low-income veterans, their surviving spouses, and dependent
children); readjustment benefits (education and vocational rehabilitation assistance); and veterans
insurance and indemnities (the provision of life insurance).
Compensation and Pensions
The Compensation and Pensions category includes payments for benefits such as disability
compensation; dependency and indemnity compensation (DIC); pension benefits for low-income
disabled or elderly wartime veterans and their survivors; burial benefits (allowances, flags,
headstones, etc.); and a clothing allowance for certain disabled veterans.
For FY2022, VA requested $137.58 billion for the Compensation and Pensions account, an
increase of $13.22 billion over the FY2021-enacted level of funding and $7.3 billion over the
FY2022 advanced appropriations amount (see Table 2).27 The largest portion of the budget
request was disability compensation, and VA estimated that $133.8 billion in compensation
payments would go to an estimated 5.5 million veterans, 475,146 survivors, and 1,281 children in
FY2022. Pension payments were estimated to be $4.8 billion to approximately 209,355 veterans
and 147,472 survivors. Finally, an estimated $418.0 million was allocated for burial benefits.28
The funding request increase included $3.0 billion in obligations during FY2022 for the three
new Agent Orange presumptive conditions identified in P.L. 116-283: Parkinson’s-like symptoms,
bladder cancer, and hypothyroidism. VA estimated that these new conditions qualifying for
disability compensation included approximately $2.2 billion in retroactive benefits.29 In general,
the average payments for benefits, including disability compensation, pension, and survivor
benefits, was expected to increase due to the annual cost-of-living adjustment (COLA).
Division F of H.R. 4502 recommended for FY2022 an appropriation of $137.58 billion for VA’s
Compensation and Pensions account, which was the exact amount VA requested (see Table 2).30
The House Appropriations Committee, in its report (H.Rept. 117-81), highlighted various areas of
interest and directive actions. The committee encouraged VA to continue implementing GAO’s
recommendations to improve regional office processing of claims, increase communication with
Veterans Service Organizations (VSOs), and discuss the feasibility of locating satellite
congressional offices within VA Medical Centers. In addition, the committee remained concerned

27 U.S. Department of Veterans Affairs, FY2022 Budget Submission, Benefits and Burial Programs and Departmental
Administration
, vol. 3 of 4, May 2021, p. VBA-52.
28 U.S. Department of Veterans Affairs, FY2022 Budget Submission, Benefits and Burial Programs and Departmental
Administration
, vol. 3 of 4, May 2021, pp. VBA-52-53.
29 U.S. Department of Veterans Affairs, FY2022 Budget Submission, Benefits and Burial Programs and Departmental
Administration
, vol. 3 of 4, May 2021, p. VBA-53.
30 U.S. Congress, House Committee on Appropriations, Military Construction, Veterans Affairs, and Related Agencies
Appropriations Bill, 2022
, report to accompany H.R. 4355, 117th Cong., 1st sess., July 2, 2021, H.Rept. 117-81, p. 29.
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with the backlog of disability claims and the processing of dependency and indemnity
compensation (DIC) claims when the cause of death is listed as COVID-19. The committee
directed VA to provide additional guidance on how a survivor can request a medical opinion to
determine if a service-connected illness or disability contributed to the veteran’s death, and
directed VA to continue providing quarterly reports on the disability backlog.31
In S. 2604, the Senate Appropriations Committee recommended providing $7.35 billion in
additional funding to the $130.23 billion provided in advanced appropriations for FY2022. This
amount provided VA with a total budget of $137.58 billion, equal to VA’s FY2022 request (see
Table 2).32 The committee’s report, S.Rept. 117-35, explained that the increase in appropriations
reflected the increased obligations VA faces with disability compensation payments, the
implementation of new laws, and the requirement to adjudicate disability claims for Blue Water
Navy veterans.33
Title II of Division J in the Consolidated Appropriations Act, 2022 (P.L. 117-103), provides
$139.18 billion for VA’s FY2022 Compensation and Pension account (see Table 2). This amount
is $14.82 billion over FY2021’s enacted amount, $8.96 billion over FY2022 advanced
appropriations, and $1.61 billion over VA’s requested amount. The increase in funding is to
provide for the expansion of benefits with the new presumption of service connection claims VA
is adjudicating for exposure to environmental hazards.
Readjustment Benefits
The Readjustment Benefits category reflects several benefits related to the transition of
servicemembers from active duty status to veteran status, as well as benefits for disabled veterans.
Some of these programs include education benefits for veterans, survivors, and dependents;
vocational rehabilitation and employment training for service-connected disabled veterans; and
helping individual veterans purchase and/or rehabilitate homes.
For FY2022, VA requested appropriations of $14.95 billion to provide funding for Readjustment
Benefits, which was approximately $2.37 billion more than the amount enacted in FY2021 (see
Table 2). In addition to the appropriated funds, VA combined $174.3 million in offsetting
collections from the Department of Defense (DOD), and an estimated unobligated balance of $3.7
billion from FY2021 to sufficiently provide the benefits required. The increase in readjustment
benefits funding was due, in part, to two legislative directives. First, P.L. 116-140, the Student
Veteran Coronavirus Response Act of 2020, changed education and VR&E benefits due to the
pandemic and required the continuation of benefits paid that otherwise may have stopped due to
educational institutions closing or the shift to a virtual learning environment.34 Second, P.L. 116-

31 U.S. Congress, House Committee on Appropriations, Military Construction, Veterans Affairs, and Related Agencies
Appropriations Bill, 2022
, report to accompany H.R. 4355, 117th Cong., 1st sess., July 2, 2021, H.Rept. 117-81, pp. 30-
31.
32 U.S. Congress, Senate Committee on Appropriations, Military Construction, Veterans Affairs, and Related Agencies
Appropriation Bill, 2022
, report to accompany S. 2604, 117th Cong., 1st sess., August 4, 2021, S.Rept. 117-35, pp. 33-
34.
33 U.S. Congress, Senate Committee on Appropriations, Military Construction, Veterans Affairs, and Related Agencies
Appropriation Bill, 2022
, report to accompany S. 2604, 117th Cong., 1st sess., August 4, 2021,<LISRef number="35"
congress="117" title="*" type="senateReport" url="http://www.congress.gov/cgi-
lis/cpquery/R?cp117:FLD010:@1(sr35):" id="3753990749" /> p. 34. For background on disability compensation
benefits to veterans exposed to herbicide agents while serving on U.S. Navy or Coast Guard vessels off the coast of
Vietnam, see CRS In Focus IF11368, Expansion of Benefits to Blue Water Navy Vietnam Veterans.
34 U.S. Department of Veterans Affairs, FY2022 Budget Submission, Benefits and Burial Programs and Departmental
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315, the Johnny Isakson and David P. Roe, M.D. Veterans Health Care and Benefits Improvement
Act of 2020, enhanced and expanded the eligibility for the Edith Nourse Rogers STEM
Scholarship and the Fry Scholarship.35
Division F of H.R. 4502 provided $14.95 billion for Readjustment Benefits in FY2022, the exact
amount requested by VA.36 The House Appropriations Committee, in its report (H.Rept. 117-81),
highlighted several VA efforts to help veterans transition to civilian life and requested that VA
continue and enhance those efforts. The committee believed that VA should increase coordination
with the Departments of Defense, Education, and Labor to ensure that veterans can successfully
transition into jobs, receive employment training, and understand options available for repayment
or forgiveness of student loans. The committee also requested that VA explore possible options to
continue the payment of benefits after December 21, 2021, with the possibility of educational
institutions continuing with virtual or hybrid programs.
In the same manner as the House Appropriations Committee, the Senate Appropriations
Committee recommended $14.95 billion for Readjustment Benefits in FY2022, the exact amount
requested by VA in S. 2604.37 The committee report, S.Rept. 117-35, addressed one program
within VA’s Readjustment Benefits, the Veteran Employment Through Technology Education
Courses (VET TEC) Program. The committee supported this program and called on VA to
consider expanding the program to address increased demand.38
Title II of Division J in the Consolidated Appropriations Act, 2022 (P.L. 117-103), provides
$14.95 billion for VA’s FY2022 Readjustment benefits account (Table 2). This is $2.34 billion
over FY2021’s enacted amount and is equal to VA’s requested amount. The funding will enable
VA to continue to pay education and VR&E benefits to veterans whose programs were disrupted
by the COVID-19 pandemic. It will also fund the expansion of VA’s educational scholarship
programs.
Veterans Insurance and Indemnities (VI&I)
The Veterans Insurance and Indemnities account is the mandatory funding mechanism for several
government life insurance programs for veterans. In addition to direct payments made to insured
veterans and their beneficiaries, this category includes supplemental funding for National Service

Administration, vol. 3 of 4, May 2021, p. VBA-78.
35 The Edith Nourse Rogers STEM Scholarship is a program for eligible veterans and dependents who are enrolled in
an undergraduate STEM program or who have earned a post-secondary graduate degree and are working toward a
certification or are in a clinical training program. The scholarship would allow all beneficiaries to extend their Post-
9/11 Bill or Fry Scholarship benefits. The Fry Scholarship is a scholarship for children and spouses of certain veterans
who died in the line of duty on or after September 11, 2001, or a member of the Selected Reserve who died from a
service-connected disability.
36 U.S. Congress, House Committee on Appropriations, Military Construction, Veterans Affairs, and Related Agencies
Appropriations Bill, 2022
, report to accompany H.R. 4355, 117th Cong., 1st sess., July 2, 2021, H.Rept. 117-81, p. 31.
37 U.S. Congress, Senate Committee on Appropriations, Military Construction, Veterans Affairs, and Related Agencies
Appropriation Bill, 2022
, report to accompany S. 2604, 117th Cong., 1st sess., August 4, 2021, S.Rept. 117-35, p. 34.
38 U.S. Congress, Senate Committee on Appropriations, Military Construction, Veterans Affairs, and Related Agencies
Appropriation Bill, 2022
, report to accompany S. 2604, 117th Cong., 1st sess., August 4, 2021, p. 34.
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Life Insurance (NSLI),39 Service-Disabled Veterans Insurance (S-DVI),40 and Veterans Mortgage
Life Insurance (VMLI).41
For FY2022, VA estimated that this account required $136.95 million, approximately $5.58
million more than the FY2021-enacted funding.42 This funding will help provide life insurance to
5.6 million veterans, servicemembers, and dependents. Provided appropriations for FY2022
enabled VA to transfer $20,000 to the NSLI program, $32.3 million to the VMLI program, and
$104.7 million to the S-DVI program. In addition, VA will have an estimated $6.0 million in
collections from premiums, interest on investments, and extra hazard payments from military
service branches. VA also requested $109.87 million in advance appropriations for FY2023.43
In H.R. 4502 and S. 2604, both the House and Senate Appropriations Committees recommended
appropriating $136.95 million to VA’s insurance and indemnity account, which was the amount
VA requested.44 Title II of Division J in the Consolidated Appropriations Act, 2022 (P.L. 117-
103), provides $136.95 million VA’s FY2022 Insurance and Indemnities account (see Table 2).
This is $7.73 million over FY2021’s enacted amount and equal to VA’s requested amount.
Medical Care and Medical Research Discretionary
Programs Funding

Background
The Veterans Health Administration operates one of the nation’s largest integrated direct health
care delivery systems.45 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

39 The National Service Life Insurance (NSLI) program was created on October 8, 1940, to handle insurance needs of
World War II veterans. These policies were issued until April 24, 1951, and provided a maximum of $10,000 in
coverage. See https://www.benefits.va.gov/insurance/nsli.asp.
40 The Service-Disabled Veterans Insurance (S-DVI) program was established on April 25, 1951, and remains open for
new policies to service-connected disabled veterans who separated under other than dishonorable conditions. S-DVI
provides up to $10,000 in coverage for which premium relief is available to certain insured veterans. Up to an
additional $30,000 in supplemental coverage may be granted without a waiver of premiums. See https://www.va.gov/
life-insurance/options-eligibility/s-dvi/.
41 The Veterans Mortgage Life Insurance (NSLI) program provides veterans who meet certain requirements, including
having received a grant for specially adapted housing with up to $200,000 of mortgage protection life insurance. This
program pays the benefit directly to the bank or lender of the veteran’s mortgage. See https://www.va.gov/life-
insurance/options-eligibility/vmli/.
42 U.S. Department of Veterans Affairs, FY2022 Budget Submission, Budget in Brief, May 2021, p. BiB-28.
43 U.S. Department of Veterans Affairs, FY2022 Budget Submission, Benefits and Burial Programs and Departmental
Administration
, vol. 3 of 4, May 2021, pp. VBA-129, 131.
44 U.S. Congress, House Committee on Appropriations, Military Construction, Veterans Affairs, and Related Agencies
Appropriations Bill, 2022
, report to accompany H.R. 4355, 117th Cong., 1st sess., July 2, 2021, H.Rept. 117-81, p. 33;
and U.S. Congress, Senate Committee on Appropriations, Military Construction, Veterans Affairs, and Related
Agencies Appropriation Bill, 2022
, report to accompany S. 2604, 117th Cong., 1st sess., August 4, 2021, S.Rept. 117-35,
p. 35.
45 U.S. Department of Veterans Affairs, FY 2009 Performance and Accountability Report, Washington, DC, November
16, 2009, p. I-42. Established on January 3, 1946, as the Department of Medicine and Surgery by P.L. 79-293,
succeeded in 1989 by the Veterans Health Services and Research Administration, and renamed the Veterans Health
Administration in 1991.
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system could be categorized as a veterans-specific national health care system, in the sense that
the federal government owns the medical facilities and employs the health care providers.46
The VA’s health care system is organized into 18 geographically defined Veterans Integrated
Service Networks (VISNs). Although policies and guidelines are developed at VA headquarters to
be applied throughout the VA health care system, management authority for basic decisionmaking
and budgetary responsibilities is delegated to the VISNs.47 As of September 30, 2020, the VHA
operated 146 hospitals, 134 nursing homes, 775 community-based outpatient clinics (CBOCs),48
and 300 Readjustment Counseling Centers (Vet Centers).49 In 2009, VA began a pilot Mobile Vet
Center (MVC) program to improve access to services for veterans in rural areas, and the
department has deployed 83 MVCs to date.50
Although VHA provides most health care services to eligible veterans through its integrated
network of facilities, it does pay for care in the community under certain circumstances. The
Veterans Community Care Program (VCCP) applies eligibility for care in the community broadly
to all enrolled veterans based on specific criteria.51 VA is authorized to provide care in the
community through individual agreements with community providers, called veterans care
agreements
. VA is also authorized to reimburse for emergency care visits if specific criteria are
met.52 Inpatient and outpatient care is provided in the private sector to eligible dependents of
veterans under the Civilian Health and Medical Program of the Department of Veterans Affairs
(CHAMPVA).53 In addition, VHA provides grants for construction of state-owned nursing homes
and domiciliary facilities54 and collaborates with the Department of Defense in sharing health
care resources and services.
Apart from providing direct patient care to veterans,55 VHA’s other statutory missions are to
conduct medical research,56 serve as a contingency backup to the DOD medical system during a

46 Adam Oliver, “The Veterans Health Administration: An American Success Story?” The Milbank Quarterly, vol. 85,
no. 1 (March 2007), pp. 5-35.
47 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.
48 For more information on CBOCs, see CRS Report R41044, Veterans Health Administration: Community-Based
Outpatient Clinics
(archived).
49 Department of Veterans Affairs, FY2022 Budget Submission, Medical Programs and Information Technology
Programs
, vol. 2 of 4, May 28, 2021, p. VHA-443. Vet Centers are a nationwide system of community-based programs
separate from VA medical centers (VAMCs). Client services provided by Vet Centers include psychological
counseling and psychotherapy (individual and group), screening for and treatment of mental health issues, substance
abuse screening and counseling, employment/educational counseling, and bereavement counseling, among other
services.
50 Department of Veterans Affairs, FY2022 Budget Submission, Medical Programs and Information Technology
Programs
, vol. 2 of 4, May 28, 2021, p. VHA-443.
51 For more information on the VCCP and the eligibility criteria, see CRS Report R45390, VA Maintaining Internal
Systems and Strengthening Integrated Outside Networks Act of 2018 (VA MISSION Act; P.L.115-182)
.
52 For more information, see CRS Report R42747, Health Care for Veterans: Answers to Frequently Asked Questions.
53 For details on CHAMPVA, see CRS Report RS22483, Health Care for Dependents and Survivors of Veterans.
54 Under the grant program, VA may fund up to 65% of the cost of these state-owned facilities. States must fund the
remaining 35%. The law requires that 75% of the residents in a state extended care facility must be veterans (38 U.S.C.
§§8131-8138.) All nonveteran residents must be spouses of veterans or parents of children who died while serving in
the U.S. Armed Forces. VA is prohibited by law from exercising any supervision or control over the operation of a
state veterans nursing home, including setting admission criteria. Admission requirements are determined exclusively
by the state. Also see CRS In Focus IF11656, State Veterans Homes.
55 38 U.S.C. §7301(b).
56 38 U.S.C. §7303.
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national security emergency,57 provide support to the National Disaster Medical System and the
Department of Health and Human Services as necessary,58 and train health care professionals to
provide an adequate supply of health personnel for VA and the nation.59
The Veteran Patient Population60
In FY2021, approximately 9.2 million of the 19.5 million total veterans were enrolled in VA’s
health care system.61 VA estimates that in FY2022, enrollment will grow by approximately 5,000.
In FY2021, of the total number of enrolled veterans, VA anticipated treating approximately 7.0
million unique veteran and nonveteran patients.62 For FY2022, VHA estimates that it will treat
about 7.2 million unique veteran patients, or 1.0% over the FY2021 estimate (see Table A-1 for
veteran population, VA enrollees, and VA patients from FY2000 to FY2022).
In addition, VHA estimates that outpatient visits will increase from 114.72 million visits in
FY2021 to 118.99 million visits in FY2022, an increase of 4.27 million, or 3.7%. VHA
anticipates a decrease in the total number of inpatients treated in all inpatient facilities from 1.05
million patients in FY2021 to 1.03 million patients in FY2022, a decrease of 1.9%.63
President’s Request and Congressional Action
The VA’s annual appropriations for the medical services, medical community care, medical
support and compliance, and medical facilities accounts include advance appropriations that
become available one fiscal year after the fiscal year for which the appropriations act was
enacted. Therefore, funding levels for FY2022 for these four accounts were provided by the
Consolidated Appropriations Act, 2021 (Div. J; P.L. 116-260). However, in any given year the
Administration could submit a revised budget request based on projected budget requirements for
the upcoming fiscal year and Congress could revise previously enacted advance appropriation
amounts through the annual appropriations process. Across all four accounts, the President’s
budget increased by $3.27 billion over the enacted advance appropriation amounts for FY2022.64
This increase from the FY2022 request was driven by readjusted actuarial estimates for the
medical community care account. In total, the FY2022 budget request for VHA is $101.72 billion,
including medical care collections (see Table 2).65 The medical and prosthetic research account
does not receive advance appropriation and is funded through regular annual appropriations.

57 38 U.S.C. §8111A.
58 38 U.S.C. §8117(e).
59 38 U.S.C. §7302.
60 Department of Veterans Affairs, FY2022 Budget Submission, Medical Programs and Information Technology
Programs
, vol. 2 of 4, May 28, 2021, p. VHA-38.
61 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
.
62 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.
63 Department of Veterans Affairs, FY2022 Budget Submission, Medical Programs and Information Technology
Programs
, vol. 2 of 4, May 28, 2021, p. VHA-40.
64 Department of Veterans Affairs, FY2022 Budget Submission, Medical Programs and Information Technology
Programs
, vol. 2 of 4, May 28, 2021, p. VHA-11.
65 The committees on appropriations include medical care cost recovery collections when considering funding for the
VHA. Congress has provided VHA the authority to bill some veterans and most health care insurers for nonservice-
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As required by the Veterans Health Care Budget Reform and Transparency Act of 2009 (P.L. 111-
81), the President’s budget requested $111.29 billion in advance appropriations for the four
medical care appropriations (medical services, medical community care, medical support and
compliance, and medical facilities) for FY2023, an increase of approximately 14.2% over the
FY2022-requested amount of $97.45 billion for the same four accounts. In FY2023, the
Administration’s budget request would provide $70.32 billion for the medical services account,
$24.16 billion for medical community care, $9.67 billion for the medical support and compliance
account, and $7.13 billion for the medical facilities account (see Table 2).
The House-passed version of the MILCON-VA appropriations bill (Division F of H.R. 4502;
H.Rept. 117-81) provided a higher VHA appropriation than the President’s request for FY2022
($123 million higher), while the Senate Appropriations Committee MILCON-VA bill for FY2022
(S. 2604; S.Rept. 117-35) recommended the same amount as the President’s request.
The Consolidated Appropriations Act, 2022 (Division J of P.L. 117-103), provides $101.32 billion
in total for VHA in FY2022. This is $400 million less than the President’s request and is due to
rescissions in the Medical Services and Medical Community Care accounts ($200 million each).66
The act provides $111.29 billion in advance appropriations for FY2023, the same amount as the
President’s request.
The sections below detail the amounts requested for each VHA account for FY2022, the funds
provided in the House-passed bill and recommended in the Senate Appropriations Committee bill
for each account, and the final amount provided by the Consolidated Appropriations Act, 2022.
Medical Services
The medical services account covers expenses for furnishing inpatient and outpatient care and
treatment of veterans and certain dependents, including care and treatment in non-VA facilities;
outpatient care on a fee basis; medical supplies and equipment; salaries and expenses of
employees hired under Title 38, United States Code (U.S.C.); cost of hospital food service
operations;67 grants for adaptive sports programs for disabled veterans and members of the Armed
Forces, beneficiary travel, prosthetics, Long-Term Services and Supports (LTSS), aid to state
veterans’ homes; and assistance and support services for family caregivers, and costs associated

connected care provided to veterans enrolled in the VA health care system, to help defray the cost of delivering medical
services to veterans. Funds collected from first- and third-party (copayments and insurance) bills are retained by the
VA health care facility that provided the care for the veteran. The Consolidated Omnibus Budget Reconciliation Act of
1985 (P.L. 99-272), enacted into law in 1986, established means testing for veterans seeking care for nonservice-
connected conditions. The Balanced Budget Act of 1997 (P.L. 105-33) established the Department of Veterans Affairs
Medical Care Collections Fund (MCCF) and gave the VHA the authority to retain these funds in the MCCF. Instead of
returning the funds to the Treasury, VA can use them, without fiscal year limitations, for medical services for veterans.
In FY2004, the Administration’s budget requested consolidating several existing medical collections accounts into one
MCCF. The conferees of the Consolidated Appropriations Act of 2004 (H.Rept. 108-401) recommended that
collections that would otherwise be deposited in the Health Services Improvement Fund (former name), Veterans
Extended Care Revolving Fund (former name), Special Therapeutic and Rehabilitation Activities Fund (former name),
Medical Facilities Revolving Fund (former name), and the Parking Revolving Fund (former name) should be deposited
in MCCF. The Consolidated Appropriations Act of 2005 (P.L. 108-447, H.Rept. 108-792) provided the VA with
permanent authority to deposit funds from these five accounts into the MCCF.
66 Division J Section 255 of P.L. 117-103.
67 In its FY2008 budget request to Congress, VA requested the transfer of food service operations costs from the
medical facilities appropriations to the medical services appropriations. The House and Senate Appropriations
Committees concurred with this request. The cost of food service operations supports hospital food service workers,
provisions, and supplies related to the direct care of patients.
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with activation of newly constructed or leased VA medical care facilities, among other distinct
activities.68
For FY2022, the President’s budget requested $58.90 billion for the medical services account.
This amount is equal to the FY2022 advance appropriated amount. According to VA, when
combined with $9.6 billion of unobligated balances from funding provided in the American
Rescue Plan Act, this amount fully funds all needs.
The House-passed version of the MILCON-VA appropriations bill (Division F of H.R. 4502;
H.Rept. 117-81) provided $106 million over the FY2022 President’s request. The Senate
Appropriations Committee MILCON-VA bill recommendation for FY2022 was the same as the
President’s request. Both the House-passed bill and the Senate Appropriations Committee bill
provided FY2023 advance appropriations equal to the President’s request of $70.32 billion (see
Table 2).
The Consolidated Appropriations Act, 2022 (Division J of P.L. 117-103), provides $58.7 billion in
FY2022. This is $200 million less than the President’s request. The act provides $70.32 billion in
advance appropriations for FY2023, the same amount as the President’s request.
The act provides for a vast array of specific initiatives funding through Medical Services. This
includes $1.4 billion for the VA’s caregiver programs and $3.3 million for the Office of Rural
Health and the Rural Health Initiative.69
Medical Community Care
Section 4003 of the Surface Transportation and Veterans Health Care Choice Improvement Act of
2015 (P.L. 114-41) required the establishment of a separate new account for medical community
care, beginning with the FY2017 appropriations cycle. The Jeff Miller and Richard Blumenthal
Veterans Health Care and Benefits Improvement Act of 2016 (P.L. 114-315) authorized advance
appropriations for the medical community care account. The account is intended to consolidate all
community care programs under a single appropriation, and it is the funding source for care that
VHA provides to eligible veterans through community health care providers. These programs
include the Veterans Community Care Program (VCCP), the Camp Lejeune Family Member
Program (CLFMP), CHAMPVA, the Foreign Medical Program (FMP), the Spina Bifida Health
Care Program, the Children of Women Vietnam Veterans Health Care Benefits Program
(CWVV), and the Indian Health Service (IHS)/Tribal Health Programs (THP) Reimbursement
Agreements Program.
Some expenses related to the community care program are funded through the medical support
and compliance account and the Information Technology account. These expenses include
administrative expenses related to claims processing performed by the Third Party Administrators
(TPAs) and VHA, and software required for information technology (IT) systems related to the
community care program.70

68 Department of Veterans Affairs, FY2022 Budget Submission, Medical Programs and Information Technology
Programs
, vol. 2 of 4, May 28, 2021, p. VHA-306.
69 “Explanatory Statement Submitted By Ms. Delauro, Chair of the House Committee on Appropriations, Regarding the
House Amendment to the Senate Amendment to H.R. 2471, Consolidated Appropriations Act, 2022” Congressional
Record
, daily edition, vol. 168, no. 42—Book IV (March 9, 2022), p. H2945.
70 Department of Veterans Affairs, FY2022 Budget Submission, Medical Programs and Information Technology
Programs
, vol. 2 of 4, May 28, 2021, p. VHA-334.
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The President’s budget requested $23.42 billion for the medical community care account. This
amount was $3.27 billion over the FY2022 advance appropriated amount of $20.15 billion. This
requested increase was largely driven by readjusted actuarial estimates for the medical
community care account.71
The House-passed version of the MILCON-VA appropriations bill (Division F of H.R. 4502;
H.Rept. 117-81) provided $3.26 million more than the FY2022 advance appropriation amount.
This was $5 million less than the FY2022 request. The Senate Appropriations Committee bill
recommended the same amount as the FY2022 request. Both bills provided FY2023 advance
appropriation amounts equivalent to the President’s request (see Table 2).
The Consolidated Appropriations Act, 2022 (Division J of P.L. 117-103), provides $23.22 billion
in FY2022. This is $200 million less than the President’s request. The act provides $24.16 billion
in advance appropriations for FY2023, the same amount as the President’s request.
The committees remain focused on preventing disruption of care—specifying that the VA is
encouraged to sustain continuity of care for rural veterans and that care is not disrupted for
dialysis patients.72
Medical Support and Compliance
This account provides for expenses related to the management, security, and administration of
VA’s health care system through the operation of VA medical centers (VAMCs) and other medical
facilities, such as community-based outpatient clinics (CBOCs) and Vet Centers. This includes
among other things, VMAC leadership teams (Director, Chief of Staff, Chief Medical Officer, and
Chief Nurse) and VAMC support functions, such as “quality of care oversight, security services,
legal services, billing and coding activities, acquisition, procurement, and logistics activities,
human resource management, logistics and supply chain management, and financial
management.”73 This account also funds 18 Veterans Integrated Service Network (VISN)74
offices, which include network management activities such as the following network leadership
teams within each VISN: Network Director, Deputy Network Director, Chief Financial Officer,
Chief Medical Officer, and Chief Information Officer.75 This account also provides for expenses
related to VHA Central Office (VHACO) operating units, such as offices of the Assistant Under
Secretary for Community Care and Deputy Assistant Under Secretary for Community Care, the
Office of the Assistant Under Secretary for Health for Clinical Services and the Chief Medical
Officer (AUSH/CS), and the Office of Discovery, Education, and Affiliate Networks (DEAN),
among other offices and suboffices.

71 Department of Veterans Affairs, FY2022 Budget Submission, Medical Programs and Information Technology
Programs
, vol. 2 of 4, May 28, 2021, p. VHA-11.
72 “Explanatory Statement Submitted By Ms. Delauro, Chair of the House Committee on Appropriations, Regarding the
House Amendment to the Senate Amendment to H.R. 2471, Consolidated Appropriations Act, 2022” Congressional
Record
, daily edition, vol. 168, No. 42—Book IV (March 9, 2022), p. H2947.
73 Department of Veterans Affairs, FY2022 Budget Submission, Medical Programs and Information Technology
Programs
, vol. 2 of 4, May 28, 2021, p. VHA- 351.
74 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.
75 Department of Veterans Affairs, FY2022 Budget Submission, Medical Programs and Information Technology
Programs
, vol. 2 of 4, May 28, 2021, p. VHA- 352.
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The President’s budget requested $8.40 billion for the medical support and compliance account.
This amount is equivalent to the FY2022 advance appropriated amount.76
Both the House-passed version of the MILCON-VA appropriations bill (Division F of H.R. 4502;
H.Rept. 117-81) and the Senate Appropriations Committee bill provided the same amount as the
President’s request (see Table 2).
The Consolidated Appropriations Act, 2022 (Division J of P.L. 117-103), provides $23.22 billion
in FY2022. This is equivalent to the President’s request. The act provides $9.67 billion in
advance appropriations for FY2023, the same amount as the President’s request.
Medical Facilities
The medical facilities account funds expenses pertaining to the operations and maintenance of
VHA’s capital infrastructure. These expenses include utilities and administrative expenses related
to planning, designing, and executing construction or renovation projects at VHA facilities. It also
funds medical facility leases, including clinical space in CBOCs, engineering and environmental
management, grounds maintenance, fire protection, nonrecurring maintenance, recurring
maintenance and repairs, textile care processing and maintenance, and operating equipment
maintenance and repairs, among others.
The President’s budget requested $6.73 billion for the medical facilities account. This amount is
equivalent to the FY2022 advance appropriated amount.77
Both the House-passed version of the MILCON-VA appropriations bill (Division F of H.R. 4502;
H.Rept. 117-81) and the Senate Appropriations Committee bill provided the same amount as the
President’s request (see Table 2).
The Consolidated Appropriations Act, 2022 (Division J of P.L. 117-103), provides $6.73 billion in
FY2022. This is equivalent to the President’s request. The act provides $7.13 billion in advance
appropriations for FY2023, the same amount as the President’s request.
Medical and Prosthetic Research
As required by law, the medical and prosthetic research program (medical research) focuses on
research into the special health care needs of veterans. This account provides funding for many
types of research, such as investigator-initiated research; mentored research; large-scale, multisite
clinical trials; and centers of excellence. VA researchers receive funding not only through this
account but also from DOD, the National Institutes of Health (NIH), and private sources. The
medical services, medical support and compliance, and medical facilities accounts also provide
funds for additional expenses required for VAMCs supporting research activities.
In general, VA’s research program is intramural; VA investigators conduct research at VA
facilities and in approved off-site space occupied by VA under a legal agreement. Unlike other
federal agencies, such as NIH and DOD, VA does not have the statutory authority to make
research grants to colleges and universities, cities and states, or any other non-VA entities.

76 Department of Veterans Affairs, FY2022 Budget Submission, Medical Programs and Information Technology
Programs
, vol. 2 of 4, May 28, 2021, p. VHA-19.
77 Department of Veterans Affairs, FY2022 Budget Submission, Medical Programs and Information Technology
Programs
, vol. 2 of 4, May 28, 2021, p. VHA-19.
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The President’s budget requested $882 million for the medical and prosthetic research account, an
increase of $87 million, or 10.9%, above the FY2021-enacted amount of $795 million. The
VHA’s major research priorities in FY2022 include, among others, traumatic brain injury (TBI),
military exposures, and Coronavirus-related research and impact, cloud computing and storage,
data security/counterintelligence, precision oncology, and collaboration with Department of
Energy.78
The House-passed version of the MILCON-VA appropriations bill (Division F of H.R. 4502;
H.Rept. 117-81) provided $22 million more than the FY2022 request. The amount recommended
by the Senate Appropriations Committee bill for FY2022 was the same as the request (see Table
2
)
. The Consolidated Appropriations Act, 2022 (Division J of P.L. 117-103), provides $882
million in FY2022.
Nonmedical Discretionary Programs Funding
National Cemetery Administration (NCA)
The majority of NCA’s discretionary funding falls into the Operations and Maintenance category.
VA requested a total of $394 million in FY2022 for this account (see Table 2)—a $42 million, or
12%, increase for NCA’s operations and maintenance expenses over the FY2021-enacted
amount. The requested funding will provide for an estimated 136,000 interments, perpetual care
of 4 million gravesites, and the operations and maintenance of 158 national cemeteries and 34
additional sites.79 The request also included funding to support hiring an additional 97 full-time
equivalents (FTEs), bringing the total number of FTEs from 2,120 in FY2021 to 2,217 in
FY2022.80
As VA works toward its goal of providing 95% of veterans with access to a cemetery within 75
miles of their homes, VA’s request included $7.6 million for the continued activation of the rural
cemeteries in Fargo, ND; Cheyenne, WY; and Northwoods, WI; along with the initial activation
of the New York and Indianapolis columbarium-only cemeteries and the Cedar City, UT, rural
cemetery. With the addition of these new cemeteries and the increased workload anticipated
during FY2022, VA requested $7.7 million and 35 new FTEs to address these needs.81
Within the Operations and Maintenance appropriations category, VA requested funds to support
the agency’s programs and initiatives to memorialize the veterans in the cemeteries. The funds
will be used to continue developing the Veterans Legacy Memorial (VLM) and to incorporate
millions of veterans’ records from non-VA national cemeteries. To complement NCA’s digital
efforts, NCA will continue to develop onsite interpretive signs, exhibits, and publications to
increase the public’s knowledge of NCA’s history. To commemorate its 50th anniversary, NCA is
to produce a book that would be the “first comprehensive history of NCA highlighting its
establishment and transformation to the present.”82

78 Department of Veterans Affairs, FY2022 Budget Submission, Medical Programs and Information Technology
Programs
, vol. 2 of 4, May 28, 2021, p. VHA-544.
79 U.S. Department of Veterans Affairs, FY2022 Budget Submission, Budget in Brief, May 2021, pp. BiB-32-33.
80 U.S. Department of Veterans Affairs, FY2022 Budget Submission, Budget in Brief, May 2021, p. BiB-33.
81 U.S. Department of Veterans Affairs, FY2022 Budget Submission, Benefits and Burial Programs and Departmental
Administration
, vol. 3 of 4, May 2021, pp. NCA-23-24.
82 U.S. Department of Veterans Affairs, FY2022 Budget Submission, Benefits and Burial Programs and Departmental
Administration
, vol. 3 of 4, May 2021, p. NCA-25.
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Division F of H.R. 4502 provided $392 million for NCA expenses in FY2022, which is $2
million less than the requested amount but $40 million over the FY2021-enacted amount (see
Table 2).83 The House Appropriations Committee, in its report (H.Rept. 117-81), explained that
NCA should prioritize two key goals: (1) maintaining the current level of services at existing
cemeteries and (2) activating new cemeteries to increase burial access. In addition, the committee
highlighted two items it would like to see more action on: (1) completing the replacement of the
headstones of prisoners of war that have a German insignia on them and (2) pursing efforts to
expand and ensure burial access to veterans in rural communities.84
In comparison, the Senate Appropriations Committee, in S. 2604, recommended $394 million for
NCA expenses in FY2022, which is equivalent to the requested amount and $42 million over the
FY2021-enacted amount.85 The committee report, S.Rept. 117-35, addressed three ongoing NCA
projects. First, the committee directed VA to establish a pilot program to partially or fully enclose
committal shelters at national cemeteries located in various climates. Second, the committee was
pleased with the progress toward completion of the Western New York National Cemetery and
requested a timeline for completion within 60 days after enactment of the act. Finally, the
committee supported additional infrastructure at rural cemeteries, but requested that VA consider
any necessary water, sewer, and electric utilities needed for these projects.86
Title II of Division J in the Consolidated Appropriations Act, 2022 (P.L. 117-103), provides $394
million for VA’s FY2022 National Cemetery Administration account (see Table 2). This is $42
million over FY2021’s enacted amount and equal to VA’s requested amount.
VBA, General Operating Expenses
VA requested $3.423 billion in funding for VBA general operating expenses for FY2022. This
amount was an estimated $243 million, or 7.6%, increase over the enacted FY2021 budget and
will support 25,303 FTEs, an increase of 560 over FY2021 (see Table 2).87 In addition, VA’s two
key priorities for FY2022 are benefits delivery and suicide prevention.88 To address these
priorities, VA requested $81.5 million to modernize the Education Service platform to improve
claims processing, collaboration with stakeholders, and communications through an online
platform. In addition, VA requested $3.6 million to develop and implement a pilot program that
would provide employment opportunities to veterans and servicemembers with service-connected
disabilities, and to use this program to learn more about ways to assist disabled veterans.89

83 U.S. Congress, House Committee on Appropriations, Military Construction, Veterans Affairs, and Related Agencies
Appropriations Bill, 2022
, report to accompany H.R. 4355, 117th Cong., 1st sess., July 2, 2021, H.Rept. 117-81, p. 72.
84 U.S. Congress, House Committee on Appropriations, Military Construction, Veterans Affairs, and Related Agencies
Appropriations Bill, 2022
, report to accompany H.R. 4355, 117th Cong., 1st sess., July 2, 2021, H.Rept. 117-81, p. 73.
In March 2022, VA completed the removal and replacement of the three controversial headstones. For more
information, see CRS In Focus IF11587, Removal of Nazi Symbols and Inscriptions on Headstones of Prisoners of War
in VA National Cemeteries
.
85 U.S. Congress, Senate Committee on Appropriations, Military Construction, Veterans Affairs, and Related Agencies
Appropriation Bill, 2022
, report to accompany S. 2604, 117th Cong., 1st sess., August 4, 2021, S.Rept. 117-35, pp. 65-
66.
86 U.S. Congress, Senate Committee on Appropriations, Military Construction, Veterans Affairs, and Related Agencies
Appropriation Bill, 2022
, Report to accompany S. 2604, 117th Cong., 1st sess., August 4, 2021, p. 66.
87 U.S. Department of Veterans Affairs, FY2022 Budget Submission, Benefits and Burial Programs and Departmental
Administration
, vol. 3 of 4, May 2021, p. VBA-147.
88 U.S. Department of Veterans Affairs, FY2022 Budget Submission, Budget in Brief, May 2021, p. BiB-28.
89 U.S. Department of Veterans Affairs, FY2022 Budget Submission, Benefits and Burial Programs and Departmental
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Division F of H.R. 4502 provided $3.417 billion for VBA General Operating Expenses in
FY2022, which is $5.6 million less than the requested amount but $237.4 million over the
FY2021-enacted amount (see Table 2).90 The committee stated that “VBA should prioritize use of
these funds to process claims, including claims related to new Agent Orange presumptive
conditions, and reduce the claims backlog.”91 In addition, the committee identified several areas
that it wanted VA to address. The committee encouraged VA to create a transparent and evidence-
based framework to expeditiously establish new presumptions for illnesses and disability
associated with toxic exposures. It also directed VA to partner with DOD, TRICARE, private
sector health providers, and the Centers for Medicare & Medicaid Services (CMS) to complete a
report that examines the total number of veterans who have filed claims for disability
compensation related to burn pits, along with the demographic information, medical diagnoses,
location of burn pits, and the approval and denial rates and rationale for denials.92
In comparison, the Senate Appropriations Committee, in S. 2604, recommended $3.486 billion
for VBA general operating expenses in FY2022. This funding is $63 million above VA’s
requested amount and $306 million over the FY2021-enacted amount.93 The committee report,
S.Rept. 117-35, addressed several issues, such as, but not limited to, compensation and pension
exams, digitization of military records, and a national training curriculum. The committee
expressed its concern about VBA’s increased reliance on contract examiners for compensation
and pension exams and urged VA to make these exams available at VA facilities “with the
capability to conduct them in a safe and thorough manner.”94 The committee also requested that
VA work in coordination with the Archivist of the United States to provide an update, in the form
of a report, on the progress made by the National Personnel Records Center on improving
veterans’ access to military records and on the effort to digitize outstanding personnel records for
the year 1990 and earlier. Finally, the committee encouraged VA to improve its training of
disability claim processors to ensure they are correctly adjudicating claims of veterans suffering
from posttraumatic stress disorder (PTSD).95
Title II of Division J in the Consolidated Appropriations Act, 2022 (P.L. 117-103), provides $3.45
billion for VBA’s FY2022 General Operating Expenses account (see Table 2). This is $273.81
million over FY2021’s enacted amount and $30.81 million over VA’s requested amount. The
increase in funding is intended to help VA process new benefits claims and lower the claims
backlog.96

Administration, vol. 3 of 4, May 2021, p. VBA-150.
90 U.S. Congress, House Committee on Appropriations, Military Construction, Veterans Affairs, and Related Agencies
Appropriations Bill, 2022
, report to accompany H.R. 4355, 117th Cong., 1st sess., July 2, 2021, H.Rept. 117-81, p. 35.
91 U.S. Congress, House Committee on Appropriations, Military Construction, Veterans Affairs, and Related Agencies
Appropriations Bill, 2022
, report to accompany H.R. 4355, 117th Cong., 1st sess., July 2, 2021 p. 35.
92 U.S. Congress, House Committee on Appropriations, Military Construction, Veterans Affairs, and Related Agencies
Appropriations Bill, 2022
, report to accompany H.R. 4355, 117th Cong., 1st sess., July 2, 2021, H.Rept. 117-81, pp. 36-
37.
93 U.S. Congress, Senate Committee on Appropriations, Military Construction, Veterans Affairs, and Related Agencies
Appropriation Bill, 2022
, report to accompany S. 2604, 117th Cong., 1st sess., August 4, 2021, S.Rept. 117-35, p. 37.
94 U.S. Congress, Senate Committee on Appropriations, Military Construction, Veterans Affairs, and Related Agencies
Appropriation Bill, 2022
, report to accompany S. 2604, 117th Cong., 1st sess., August 4, 2021, S.Rept. 117-35, p. 37.
95 U.S. Congress, Senate Committee on Appropriations, Military Construction, Veterans Affairs, and Related Agencies
Appropriation Bill, 2022
, report to accompany S. 2604, 117th Cong., 1st sess., August 4, 2021, S.Rept. 117-35, pp. 38-
39.
96 U.S. Congress, Senate Committee on Appropriations, Division J: Military Construction, Veterans Affairs, and
Related Agencies Appropriation Bill, 2022
, joint explanatory statement to accompany Senate Amendment to H.R. 2471
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Board of Veterans’ Appeals
The Board of Veterans’ Appeals is an agency within VA established in 1933.97 The BVA’s role is
to conduct hearings and make final decisions on behalf of the VA Secretary regarding appeals for
veterans’ benefits and services from VBA, VHA, and NCA, as well as the Office of General
Counsel (OGC), that are presented to BVA for appellate review.98
The VA’s FY2022 request for BVA was $228 million, a $32 million increase over the FY2021-
enacted amount of $196 million (see Table 2). This amount would support 129 new full time
equivalent (FTE) staff, including 35 additional Veteran Law Judges (VLJs).
The House-passed version of the MILCON-VA appropriations bill (Division F of H.R. 4502;
H.Rept. 117-81) provided $228 million as requested, along with authority to carry over 10% of
this funding into FY2023.
The Senate Committee version MILCON-VA bill for FY2022 (S. 2604; S.Rept. 117-35), similar
to the House-passed bill, recommended the same amount as the President’s request. The
committee report, while acknowledging the current appeals backlog, stated: “[the] Department is
currently experiencing a backlog of disability claims, which has only been exacerbated by the
COVID–19 pandemic. The Committee recognized veterans’ expectations regarding timely and
accurate appeals processing, and supports full funding of the [BVA] to increase personnel, reduce
the backlog of claims and get veterans the timely answers they deserve.”99
Title II of Division J in the Consolidated Appropriations Act, 2022 (P.L. 117-103), provides $228
million for VA’s FY2022 Board of Veterans Appeals account (see Table 2). This is $32 million
over FY2021’s enacted amount and equal to VA’s requested amount.
Information Technology
The information technology (IT) account provides funding for department-wide IT activities such
as IT and telecommunications support, management of data systems, and acquisition of IT
systems and department-wide cybersecurity efforts, among other things.
The President’s FY2022 IT budget request was $4.843 billion, a decrease of $31.7 million below
the 2021-enacted budget (see Table 2). Of this amount, $297 million would have been for IT
development, such as building new software applications; $3.13 billion would have been for
operations and maintenance (O&M); and $1.414 billion would have been for staffing and
administrative support services. The Administration’s budget proposed to supplement the IT
budget request with $670 million from the Recurring Expenses Transformational Fund in
FY2022.100 The budget proposed to use the Transformational Fund to support IT infrastructure

117th Cong., 1st sess., March 9, 2022, p. 12.
97 38 U.S.C. §§7101-7113.
98 Department of Veterans Affairs, Board of Veterans’ Appeals Annual Report, Fiscal Year (FY) 2020, December 2020,
p. 5.
99 U.S. Congress, Senate Committee on Appropriations, Military Construction, Veterans Affairs, and Related Agencies
Appropriation Bill, 2022
, report to accompany S. 2604, 117th Cong., 1st sess., August 4, 2021, S.Rept. 117-35, p. 69.
100 The Recurring Expenses Transformational Fund was established by the Consolidated Appropriations Act, 2016
(P.L. 114-113, Division J, Title II, Section 243). The law allows unobligated balances of expired discretionary
appropriations, in FY2016 or any succeeding fiscal year, to be transferred from the General Fund of the Treasury to VA
and deposited in the Recurring Expenses Transformational Fund at the end of the fifth fiscal year after the last fiscal
year for which such funds were available. The law stipulates that amounts deposited in the fund may be available for
facility infrastructure improvements, including nonrecurring maintenance, at existing VA hospitals and clinics, and
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readiness, Financial Management Business Transformation (FMBT),101 and modernizing human
resources systems.102
The House-passed bill (Division F of H.R. 4502) provided approximately $4.842 billion for the
IT systems account for FY2022, which was approximately $1 million less than the request (see
Table 2). Within this total, the House-passed measure allocated $297 million for IT development,
such as building new software applications; $3.13 billion for operations and maintenance (O&M);
and $1.413 billion for staffing and administrative support services. H.Rept. 117-81 directed the
Office of Information Technology (OIT), in coordination with VHA and Office of Electronic
Health Records Modernization (OEHRM), to develop end-to-end encrypted communication for
telehealth, and to develop a centralized data system to catalog sexual harassment and assault
complaint data as part of a comprehensive policy to end sexual assault, including sexual
harassment and gender-based harassment, throughout VA.103
The Senate Appropriations Committee-reported FY2022 MILCON-VA appropriations bill (S.
2604: S.Rept. 117-35) recommended approximately $4.843 billion for the IT systems account, the
same as the Administration’s request (see Table 2). Of this amount, the Senate version of the
MILCON-VA appropriations bill recommended $297 million for IT development, $3.13 billion
for operations and maintenance (O&M), and $1.414 billion for staffing and administrative
support services, the same as the President’s budget request. The committee also supported the
Administration’s proposal to allocate Recurring Expenses Transformational Fund funds to
supplement funds for IT programs delineated in the Administration’s budget proposal for
FY2022.104
The Consolidated Appropriations Act, 2022, provides $4.843 billion for the IT systems account
(see Table 2), and of this amount, $1.414 billion is for staffing and administrative support
services, $3.13 billion is for O&M, and $297 million is for systems development. Furthermore,
the act includes a provision to allocate $670 million of the Recurring Expenses Transformational
Fund balances to support IT programs.
Electronic Health Record Modernization (EHRM)105
On May 17, 2018, VA signed a contract with Cerner Corporation to modernize its electronic
health care record system. This account provides funding for activities required to plan and

information technology systems improvements and sustainment, subject to approval by the Office of Management and
Budget (OMB) and House and Senate Appropriations Committees.
101 In 2016, VA embarked on a new financial management modernization program known as the Financial
Management Business Transformation (FMBT) program. Funding for the FMBT is derived from multiple accounts.
These include the IT appropriation account, general administration appropriation account, and the Franchise Fund
appropriation account. For more information on FMBT, see U.S. Government Accountability Office, Veterans Affairs:
Ongoing Financial Management System Modernization Program Would Benefit from Improved Cost and Schedule
Estimating
, GAO-21-227, April 20, 2021.
102 Department of Veterans Affairs, FY2022 Budget Submission, Medical Programs and Information Technology
Programs
, vol. 2 of 4, May 28, 2021, p. OIT–643.
103 The Deborah Sampson Act of 2020 (Johnny Isakson and David P. Roe, M.D. Veterans Health Care and Benefits
Improvement Act of 2020; P.L. 116-315; 134 STAT. 5022) required the Secretary to establish a comprehensive anti-
harassment and anti-sexual assault policy at VA. U.S. Congress, House Committee on Appropriations, Military
Construction, Veterans Affairs, and Related Agencies Appropriations Bill, 2022
, report to accompany H.R. 4355, 117th
Cong., 1st sess., July 2, 2021, H.Rept. 117-81, p. 78.
104 U.S. Congress, Senate Committee on Appropriations, Military Construction, Veterans Affairs, And Related Agencies
Appropriations Bill, 2022
, report to accompany S. 2604, 117th Cong., 1st sess., August 4, 2021, S.Rept. 117-35, p. 70.
105 P.L. 115-407, Title V, §503, 132 Stat. 5376 defines ‘‘Electronic Health Record Modernization Program’’ as “any
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deploy the Cerner Millennium electronic health care record system at VA medical facilities. This
includes the Electronic Health Record (EHR) contract costs, infrastructure readiness, and
expenses related to the Project Management Office (PMO). Beginning with the Military
Construction, Veterans Affairs, and Related Agencies Appropriations Act for FY2018 (P.L. 115-
141), Congress established this new account, which is “intended to be the single source of
funding within VA for the electronic health record effort” (H.Rept. 115-673). The Office of the
Deputy Secretary is the only office responsible for administering the funds in this account.
On October 24, 2020, VA began initial deployment of the Cerner Millennium EHR at the Mann-
Grandstaff VAMC in Spokane, WA, and the West Consolidated Patient Account Center. Due to
various implementation challenges, and potential patient safety issues encountered during
transition to the new EHR system, as highlighted by the Government Accountability Office
(GAO), VA OIG, and medical center staff, on March 19, 2021, Secretary Denis McDonough
announced a strategic review of the EHRM program.106 The results of this review were released
in July 2021.107 Considering the results of the strategic review, VA altered the deployment
schedule for Cerner Millennium EHR, based on assessing and ensuring readiness at each
deployment site.108 Previously, the deployment schedule was tied to a synchronized DOD and VA
regional schedule.
The President requested $2.66 billion for the EHR account for FY2022 (see Table 2). The request
was further separated into three subaccounts: approximately $1.43 billion allocated for the Cerner
EHR Millennium solution, approximately $951.8 million allocated for infrastructure readiness,
and approximately $285.7 million allocated for program support.109
The House-passed measure (Division F of H.R. 4502) provided approximately $2.64 billion for
the EHR account, which was $26 million less than the Administration’s request (see Table 2).
Furthermore, the bill stipulated that 25% of funding would not be available until July 1, 2022, and
that the release of funds would be based on the certification by the Secretary regarding any
changes to the EHRM deployment schedule. The House Committee report (H.Rept. 117-81)
further delineated EHR funding at the subaccount level, including approximately $1.42 billion
allocated for the electronic health record contract, approximately $276.71 million allocated for
program management, and approximately $943.79 allocated for infrastructure support.110 In
addition, “due to the uncertainty of the timing of obligations,” funds in this account would have
been available for three fiscal years.111

activities by the Department of Veterans Affairs to procure or implement an electronic health or medical record system
to replace any or all of the Veterans Information Systems and Technology Architecture, the Computerized Patient
Record System, the Joint Legacy Viewer, or the Enterprise Health Management Platform; and any contracts or
agreements entered into by the Secretary of Veterans Affairs to carry out, support, or analyze the activities under the
[Electronic Health Record Modernization Program].”
106 Department of Veterans Affairs, “VA announces strategic review of Electronic Health Record Modernization
program,” press release, March 19, 2021, https://www.va.gov/opa/pressrel/pressrelease.cfm?id=5647.
107 Department of Veterans Affairs, Electronic Health Record Modernization: Comprehensive Lessons Learned Report,
July 2021.
108 U.S. Congress, Senate Committee on Veterans’ Affairs, VA Electronic Health Records: Modernization and the Path
Ahead,
Statement of the Honorable Denis McDonough, 117th Cong., 1st sess., July 14, 2021,
https://www.veterans.senate.gov/hearings/va-electronic-health-records-modernization-and-the-path-ahead-07-14-21
109 Department of Veterans Affairs, FY2022 Budget Submission, Medical Programs and Information Technology
Programs
, vol. 2 of 4, May 28, 2021, pp. EHRM – 609-EHRM – 610.
110 U.S. Congress, House Committee on Appropriations, Military Construction, Veterans Affairs, and Related Agencies
Appropriations Bill, 2022
, report to accompany H.R. 4355, 117th Cong., 1st sess., July 2, 2021, H.Rept. 117-81, p. 78.
111 U.S. Congress, House Committee on Appropriations, Military Construction, Veterans Affairs, and Related Agencies
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The Senate Appropriations Committee-reported version of the FY2022 MILCON-VA
appropriations bill (S. 2604; S.Rept. 117-35) recommended $2.5 billion for the EHR account,
which was $163 million below the Administration’s request (see Table 2). The committee
expressed its displeasure with VA’s EHR deployment: “while the Committee remains supportive
of replacing VA’s current EHR with the same system being acquired by DoD, frustrations
continue with the delays in execution, as well as with the Department’s poor communication.”112
Furthermore, similar to the House-passed measure, the bill stipulates that 25% of funding would
not be available until July 1, 2022, and that the release of funds would be based on the Secretary
providing a plan to the committees regarding “benchmarks and measureable metrics for
deployment, and a plan for addressing all required infrastructure upgrades.”113 Moreover, VA was
advised to consult with the Indian Health Service, as the IHS modernizes the Indian Health
Service Electronic Health Record system, in order to ensure interoperability between VA and the
IHS EHR systems.114
Division J of the Consolidated Appropriations Act, 2022 (P.L. 117-103), provides $2.3 billion for
EHRM activities related to the development and rollout of the EHR system. Furthermore, the act
stipulates that 25% of these funds will not be available until July 1, 2022, and are contingent upon
VA providing a plan to the House and Senate Committees on Appropriations “with benchmarks
and measurable metrics for deployment, and a plan for addressing all required infrastructure
upgrades” no later than 30 days prior July 1, 2022. According to the joint explanatory statement
accompanying this act, “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.”115
Construction
Construction accounts include major construction, minor construction, and construction and
renovation grants for state extended care facilities, as well as grants for state veterans cemeteries.
The major construction account provides funds for capital projects costing $20 million or more
that are intended to design, build, alter, extend, or improve a VHA facility. Projects identified
through the Strategic Capital Investment Planning (SCIP) process are submitted for congressional
authorization. Congress reviews, approves, and funds major construction on a project-by-project
basis. Typical major construction projects are replacements of hospital buildings, the addition of
large ambulatory care centers, and new hospitals or nursing homes.
The minor construction account provides funds for capital projects costing less than $20 million
that are intended to design, build, alter, extend, or improve a VHA facility. The total cost of a
minor construction project cannot be greater than this statutory threshold. Minor construction
projects are approved by the Office of Capital Asset Management and Support at the VA Central
Office through the SCIP process. The grants to the state extended care facilities account provide
grants to states for construction or acquisition of state home facilities, including funds to remodel,

Appropriations Bill, 2022, report to accompany H.R. 4355, 117th Cong., 1st sess., July 2, 2021, H.Rept. 117-81, p. 78.
112 U.S. Congress, Senate Committee on Appropriations, Military Construction, Veterans Affairs, And Related Agencies
Appropriations Bill, 2022
, report to accompany S. 2604, 117th Cong., 1st sess., August 4, 2021, S.Rept. 117-35, p. 72.
113 U.S. Congress, Senate Committee on Appropriations, Military Construction, Veterans Affairs, And Related Agencies
Appropriations Bill, 2022
, report to accompanyS. 2604, 117th Cong., 1st sess., August 4, 2021, S.Rept. 117-35, p. 72.
114 U.S. Congress, Senate Committee on Appropriations, Military Construction, Veterans Affairs, And Related Agencies
Appropriations Bill, 2022
, report to accompany S. 2604, 117th Cong., 1st sess., August 4, 2021, S.Rept. 117-35, p. 73.
115 “Explanatory Statement Submitted By Ms. Delauro, Chair of the House Committee on Appropriations, Regarding
the House Amendment to the Senate Amendment to H.R. 2471, Consolidated Appropriations Act, 2022”
Congressional Record, daily edition, vol. 168, no. 42—Book IV (March 9, 2022), p. H2948.
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modify, or alter existing buildings used for furnishing domiciliary, nursing home, or hospital care
to veterans. A grant may not exceed 65% of the total cost of the project. Lastly, the grants for
construction of the veterans cemeteries account provide grants to states, territories, and federally
recognized tribal governments for the establishment, expansion, or improvement of state and
tribal veterans cemeteries.
The President’s FY2022 budget request for construction and construction grants is approximately
$2.21 billion. This amount included $1.61 billion for the major construction account, $553
million for the minor construction account, and $45 million for grants for construction of veterans
cemeteries (see Table 2). In addition, the budget request proposed $150 million from the
Recurring Expenses Transformational Fund to supplement the minor construction account in
FY2022.116 The Administration did not request any funding for grants for state extended care
facilities. The department estimated that it would carry over $596 million into FY2022 from prior
year appropriations and American Rescue Plan (ARP) Act (P.L. 117-2) funding.117
The House-passed bill (Division F of H.R. 4502) provided approximately $2.30 billion for
construction and construction grants accounts for FY2022, approximately $92.1 million above the
request. This included the requested amounts for the construction major and minor accounts, and
$90 million for funding for grants for state extended care facilities (see Table 2). According to
House Committee report (H.Rept. 117-81): “supporting grants for construction of state extended
care facilities has been and will continue to be a priority of the Committee. As such, in order to
ensure that VA has the resources required to address priority project applications submitted in
April 2021, the bill maintains level funding of $90 million for fiscal year 2022.”118 Lastly, the
House-passed MILCON-VA appropriations bill provided $47.1 million for grants for construction
of veterans cemeteries.
The Senate Appropriations Committee-reported version of the FY2022 MILCON-VA
appropriations bill (S. 2604; S.Rept. 117-35) recommended approximately $2.26 billion for
construction and construction grants, approximately $55 million above the President’s FY2022
request (see Table 2). This included the requested amounts for the construction major and minor
accounts. S. 2604 also included a provision to include $150 million from the Recurring Expenses
Transformational Fund to supplement minor construction account. The committee
recommendation included $50 million for grants for state extended care facilities, and noted “that
additional projects are needed around the country to support the needs of our Nation’s veterans,
and VA receives new applications each year. Therefore, the Committee recommends funding in
fiscal year 2022 to address applications for additional Priority 1 projects.”119 S. 2604 also
recommended $50 million for grants for construction of state veterans cemeteries, which is $5
million above the request.

116 The Recurring Expenses Transformational Fund was established by the Consolidated Appropriations Act, 2016
(P.L. 114-113, Division J, Title II, Section 243). The law allows unobligated balances of expired discretionary
appropriations, in FY2016 or any succeeding fiscal year, to be transferred from the General Fund of the Treasury to VA
and deposited in the Recurring Expenses Transformational Fund at the end of the fifth fiscal year after the last fiscal
year for which such funds were available. The law stipulates that amounts deposited in the fund may be available for
facility infrastructure improvements, including nonrecurring maintenance, at existing VA hospitals and clinics, and
information technology systems improvements and sustainment, subject to approval by the Office of Management and
Budget (OMB) and House and Senate Appropriations Committees.
117 Department of Veterans Affairs, FY2022 Budget Submission, Medical Programs and Information Technology
Programs
, vol. 2 of 4, May 28, 2021, p. VHA – 505.
118 U.S. Congress, House Committee on Appropriations, Military Construction, Veterans Affairs, and Related Agencies
Appropriations Bill, 2022
, report to accompany H.R. 4355, 117th Cong., 1st sess., July 2, 2021, H.Rept. 117-81, p. 83.
119 U.S. Congress, Senate Committee on Appropriations, Military Construction, Veterans Affairs, And Related Agencies
Appropriation Bill, 2022
, report to accompany S. 2604, 117th Cong., 1st sess., August 4, 2021, S.Rept. 117-35, p. 76.
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The Consolidated Appropriations Act, 2022 (Division J of P.L. 117-103), provides $2.27 billion
for construction and construction grant accounts for FY2022, and $53.50 million above the
President’s request (see Table 2). The act provides $50 million for grants for state extended care
facilities and recommended $48.5 million for grants for construction of state veterans cemeteries.
The act does not include $150 million from the Recurring Expenses Transformational Fund to
supplement minor construction account, but rather includes a provision to allocate $150 million
from the Recurring Expenses Transformational Fund to supplement for facilities infrastructure
improvements, including nonrecurring maintenance (NRM), at existing VHA hospitals and clinics
under the medical facilities account.
Asset and Infrastructure Review
Title II of the VA MISSION Act (P.L. 115-182) included the VA Asset and Infrastructure Review
(AIR) Act of 2018. The AIR Act establishes a process for realigning and modernizing VHA
facilities. Under this process, VA is to develop criteria for selecting VHA facilities to dispose of,
modernize, or acquire, so as to better meet the health care needs of veterans.120 VA must then
create a list of recommendations based on those criteria and submit it to a newly created Asset
and Infrastructure Review Commission (the Commission). This nine-member commission
reviews the VA’s recommendations but may not alter them, unless it determines that one or more
recommendations are inconsistent with the criteria. The Commission submits the list of
recommendations to the President, who either approves the list in its entirety or sends it back to
the Commission with the reasons for disapproval. The Commission shall take into account the
reasons for disapproval and submit a second report to the President with recommendations for
realignment and modernization of VHA facilities. The President may approve or disapprove the
revised list. If the President approves the original or revised list, then VA must begin
implementation of the recommendations within three years, unless Congress passes a joint
resolution of disapproval, in which case the process terminates.121
As required by the AIR Act, VA conducted its market assessments and publicly released the
department’s recommendations on March 14, 2022.122 On March 10 and 21, 2022, President
Biden submitted nominees to the AIR Commission to the Senate.123 The AIR Commission is to
submit its recommendations to the President for review and approval, prior to sending to
Congress for review and approval in 2023.124 Figure 5 provides a summary of the process as
prepared by VA.

120 Department of Veterans Affairs, “Draft Criteria for Section 203 of the MISSION Act,” 86 Federal Register 7921,
February 2, 2021; and final selection criteria published in Department of Veterans Affairs, “Asset and Infrastructure
Review Commission Foreword and Criteria,” 86 Federal Register 28932-28935, May 28, 2021.
121 For a section-by-section summary of AIR Act provisions, see CRS Report R45390, VA Maintaining Internal
Systems and Strengthening Integrated Outside Networks Act of 2018 (VA MISSION Act; P.L.115-182)
.
122 Department of Veterans Affairs, “Recommendations for Modernization or Realignment of Veterans Health
Administration (VHA) Facilities,” 87 Federal Register 14328-14329, March 14, 2022. The full recommendations are
available at https://www.va.gov/aircommissionreport/. Department of Veterans Affairs, “VA releases Asset and
Infrastructure Review report,” press release, March 14, 2022, https://www.va.gov/opa/pressrel/pressrelease.cfm?id=
5774.
123 The White House, “Nominations Sent to the Senate,” press release, March 10, 2022, https://www.whitehouse.gov/
briefing-room/statements-releases/2022/03/10/press-release-nominations-sent-to-the-senate-9/, and The White House,
“Nominations Sent to the Senate,” press release, March 21, 2022, https://www.whitehouse.gov/briefing-room/
statements-releases/2022/03/21/press-release-nominations-sent-to-the-senate-11/.
124 For a timeline of the review process, see CRS Report R46992, Veterans Affairs Asset and Infrastructure Review Act:
Timeline and Funding
.
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Figure 5. Summary of AIR Act Process

Source: Department of Veterans Affairs. Adopted from VA briefing documents titled “VA’s Recommendations
to the AIR Commission: Summary of Process and Outcomes,” March 2022.
For the first time, the Administration’s request for FY2022 included $5 million in funding for a
new Asset and Infrastructure Review account (see Table 2). This funding would provide for
support staff and necessary day-to-day operational expenses related to the AIR Commission
activities, which would be conducted in calendar years 2022 and 2023.125 The versions of the
FY2022 MILCON-VA appropriations bill passed by the House and reported by the Senate
Appropriations Committee provided $5 million as requested. The Consolidated Appropriations
Act, 2022 (Division J of P.L. 117-103), provides $5 million as requested for FY2022, which will
remain available until September 30, 2023.
On June 27, 2022, Senate Veterans’ Affairs Committee Chairman Jon Tester and several other
Senators issued a statement stating that the AIR Commission process would not move forward.
According to the press release, “Without the Senate’s approval of the nominees, no Commission
will be established and the process as outlined by the VA MISSION Act will not move
forward.”126


125 Department of Veterans Affairs, FY2022 Budget Submission, Construction, Long Range Capital Plan and Appendix,
vol. 4 of 4, May 28, 2021, p. 6.3-2.
126 Senator Jon Tester, “Tester, Manchin, Rounds, Colleagues Statement on Bipartisan Opposition to the Asset and
Infrastructure Review Commission Process,” press release, June 27, 2022, https://www.tester.senate.gov/?p=
press_release&id=9185, and https://www.veterans.senate.gov/2022/6/tester-manchin-rounds-colleagues-statement-on-
bipartisan-opposition-to-the-asset-and-infrastructure-review-commission-process. Also see House Committee on
Veterans Affairs, “Ranking Members Bost, Moran Statement on Senators’ Refusal to Move Forward with VA Asset
and Infrastructure Review,” press release, June 27, 2022, https://republicans-veterans.house.gov/news/
documentsingle.aspx?DocumentID=6026.
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Table 2. FY2021-FY2022 Appropriations and FY2023 Advance Appropriations
($ in Thousands)
Consolidated
Appropriations
Consolidated
Act, 2022
Appropriations Act, 2021
House
Senate Committee
(H.R. 2471,

(Div. J; P.L. 116-260)
President’s Request
(Division F; H.R. 4502)
(S. 2604; S.Rept. 117-35)
P.L. 117-103)
Program
FY2021
FY2022
FY2022
FY2023
FY2022
FY2023
FY2022
FY2023
FY2022
Compensation and Pensions
$118,246,975

$130,227,650

$130,227,650

$130,227,650

$130,227,650
Over FY2021 Enacted Advance
6,110,252








Appropriations
Over FY2022 Enacted Advance


7,347,837

7,347,837

7,347,837

8,955,364
Appropriations
Subtotal Compensation and Pensions
124,357,227

137,575,487

137,575,487

137,575,487

139,183,014
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
Over FY2021 Enacted Advance
2,148








Appropriations
Subtotal Insurance and Indemnities
131,372

136,950

136,950

136,950

136,950
Housing Benefit Program Fund Credit
1,663,000

2,781,000

2,781,000

2,781,000

2,781,000
Subsidy
Housing Benefit Program Fund
204,400

229,500

229,500

229,500

229,500
Administrative Expenses
Vocational Rehabilitation Loan Program
34

3

3

3

3
Vocational Rehabilitation Loan Program
424

429

429

429

429
Administrative Expenses
Native American Housing Loan
1,186

1,186

1,400

1,300

1,400
Program
General Operating Expenses (VBA)
3,180,000

3,423,000

3,417,400

3,486,000

3,453,813
P.L. 116-260 rescission (§254)
-16,000








Total, Veterans Benefits
142,100,608

159,094,173

159,090,787

159,157,287

160,732,727
Administration (VBA)
Medical Services
56,158,015

58,897,219

58,897,219

58,897,219

58,897,219
CRS-32


Consolidated
Appropriations
Consolidated
Act, 2022
Appropriations Act, 2021
House
Senate Committee
(H.R. 2471,

(Div. J; P.L. 116-260)
President’s Request
(Division F; H.R. 4502)
(S. 2604; S.Rept. 117-35)
P.L. 117-103)
Program
FY2021
FY2022
FY2022
FY2023
FY2022
FY2023
FY2022
FY2023
FY2022
Over FY2021 Enacted Advance
497,468







58,897,219
Appropriations
Over FY2022 Enacted Advance




106,000




Appropriations
P.L. 116-260 rescission (§254)
-100,000








P.L. 117-103 rescission (§255)








-200,000
Subtotal Medical Services
56,555,483

58,897,219

59,003,219

58,897,219

58,697,219
Medical Community Care
17,131,179

20,148,244

20,148,244

20,148,244

20,148,244
Over FY2021 Enacted Advance
1,380,800








Appropriations
Over FY2022 Enacted Advance


3,269,000

3,264,000

3,269,000

3,269,000
Appropriations









-200,000
Subtotal Medical Community Care
18,511,979

23,417,244

23,412,244

23,417,244

23,217,244
Medical Support and Compliance
7,914,191

8,403,117

8,403,117

8,403,117

8,403,117
Over FY2021 Enacted Advance
300,000








Appropriations
P.L. 116-260 rescission (§254)
-15,000








Subtotal Medical Support and Compliance
8,199,191

8,403,117

8,403,117

8,403,117

8,403,117
Medical Facilities
6,433,265

6,734,680

6,734,680

6,734,680

6,734,680
Over FY2021 Enacted Advance
150,000








Appropriations
Subtotal Medical Facilities
6,583,265

6,734,680

6,734,680

6,734,680

6,734,680
Medical and Prosthetic Research
815,000

882,000

904,000

882,000

882,000
P.L. 116-260 rescission (§254)
-20,000








Subtotal Medical and Prosthetic Research
795,000

882,000

904,000

882,000

882,000
Medical Care Col ection Fund (MCCF)









CRS-33


Consolidated
Appropriations
Consolidated
Act, 2022
Appropriations Act, 2021
House
Senate Committee
(H.R. 2471,

(Div. J; P.L. 116-260)
President’s Request
(Division F; H.R. 4502)
(S. 2604; S.Rept. 117-35)
P.L. 117-103)
Program
FY2021
FY2022
FY2022
FY2023
FY2022
FY2023
FY2022
FY2023
FY2022
(Offsetting Receipts)
4,403,000

3,386,000

3,386,000

3,386,000

3,386,000
(Appropriations – indefinite)
-4,403,000

-3,386,000

-3,386,000

-3,386,000

-3,386,000
Total, Veterans Health
90,644,918

98,334,260

98,457,260

98,334,260

97,934,260
Administration (VHA)
Total VHA with MCCF

95,047,918

101,720,260

101,843,260

101,720,260

101,320,260
National Cemetery Administration
352,000

394,000

392,000

394,000

394,000
(NCA)
Total, NCA
352,000

394,000

392,000

394,000

394,000
General Administration (including P.L.
353,911

401,200

396,911

401,200

401,200
116-260 rescission [§254])
Board of Veterans Appeals
196,000

228,000

228,000

228,000

228,000
Information Technology (including P.L.
4,874,500

4,842,800

4,841,800

4,842,800

4,842,800
116-260 rescission [§254])
Electronic Health Record
2,607,000

2,663,000

2,637,000

2,500,000

2,300,000
Modernization (EHRM) (including P.L.
116-260 rescission [§254])
Inspector General
228,000

239,000

239,000

239,000

239,000
Construction, major projects
1,316,000

1,611,000

1,611,000

1,611,000

1,611,000
Construction, minor projects (including
354,300

553,000

553,000

553,000

553,000
P.L. 116-260 rescission [§254])
Grants for State Extended Care
90,000



90,000

50,000

50,000
Facilities
Grants for State Veterans Cemeteries
45,000

45,000

47,097

50,000

48,500
Total Construction
1,805,300

2,209,000

2,301,097

2,453,000

2,262,500
Asset and Infrastructure Review (AIR)


5,000

5,000

5,000

5,000
Commission
Total, Departmental
10,064,711

10,588,000

10,648,808

10,480,000

10,278,500
Administration
CRS-34


Consolidated
Appropriations
Consolidated
Act, 2022
Appropriations Act, 2021
House
Senate Committee
(H.R. 2471,

(Div. J; P.L. 116-260)
President’s Request
(Division F; H.R. 4502)
(S. 2604; S.Rept. 117-35)
P.L. 117-103)
Program
FY2021
FY2022
FY2022
FY2023
FY2022
FY2023
FY2022
FY2023
FY2022
P.L. 117-103 rescission (§256)








-76,105
Total, Department of Veterans
$243,162,237

$268,410,433

$268,586,855

$268,365,547

$269,263,382
Affairs (without MCCF)
Total Mandatory
$138,730,564

$155,440,055

$155,440,055

$155,440,055

$157,047,582
Total Discretionary
$104,431,673

$112,970,378

$113,146,800

$112,925,492

$112,215,800
Memorandum: Advance Appropriations

Compensation and Pensions

$130,227,650

$147,569,474

$147,569,474

$147,569,474
$152,016,542
Readjustment Benefits

14,946,618

8,906,851

8,906,851

8,906,851
8,906,851
Veterans Insurance and Indemnities

136,950

109,865

109,865

109,865
109,865
Subtotal

145,311,218

156,586,190

156,586,190

156,586,190
161,033,258
Medical Services

58,897,219

70,323,116

70,323,116

70,323,116
70,323,116
Medical Community Care

20,148,244

24,156,659

24,156,659

24,156,659
24,156,659
Medical Support and Compliance

8,403,117

9,673,409

9,673,409

9,673,409
9,673,409
Medical facilities

6,734,680

7,133,816

7,133,816

7,133,816
7,133,816
Subtotal

94,183,260

111,287,000

111,287,000

111,287,000
111,287,000
Total Advance Appropriations

$239,494,478

$267,873,190

$267,873,190

$267,873,190
$272,320,258
Source: Table prepared by CRS based on U.S. Congress, House Committee on Appropriations, Consolidated Appropriations Act, 2021, committee print, prepared by
House Committee on Appropriations, H.R. 133/P.L. 116-260 [Legislative Text and Explanatory Statement] Book 2 of 2 Divisions G–L, 116th Cong., 2nd sess., March 2021
(Washington: GPO, 2021), pp. 1885-1903; U.S. Congress, House Committee on Appropriations, Military Construction, Veterans Affairs, and Related Agencies Appropriations
Bill, 2022
, report to accompany H.R. 4355, 117th Cong., 1st sess., July 2, 2021, H.Rept. 117-81. Division F of H.R. 4502—Labor, Health and Human Services, Education,
Agriculture, Rural Development, Energy and Water Development, Financial Services and General Government, Interior, Environment, Military Construction, Veterans
Affairs, Transportation, and Housing and Urban Development G-655Appropriations Act, 2022; U.S. Congress, Senate Committee on Appropriations, Military Construction,
Veterans Affairs, And Related Agencies Appropriation Bill, 2022
, report to accompany S. 2604, 117th Cong., 1st sess., August 4, 2021, S.Rept. 117-35; and U.S. Congress,
committee print, prepared by House Committee on Appropriations Consolidated Appropriations Act, 2022 (H.R. 2471; P.L. 117-103) [Legislative Text and Explanatory
Statement Book 2 of 2 Divisions G–L,],117th Cong., 2nd sess., April 2022 (Washington: GPO, 2022), pp. 2209-2221.
Notes: FY2021-enacted amounts exclude American Rescue Plan Supplemental Appropriations (P.L. 117-2).
CRS-35

Department of Veterans Affairs FY2022 Appropriations

Appendix A. Veteran Population, VA Enrollees, and
VA Patients, FY2000-FY2022

Table A-1. Veteran Population, VA Enrollees, and VA Patients, FY2000-FY2022
Patients Using VA Health Care During the Year
Total Veteran
VA-Enrolled
Year
Population
Veterans
Veterans
Nonveterans
Total Patients
FY2000
26,745,368
4,936,259
3,462,082
355,191
3,817,273
FY2001
26,092,046
6,073,264
3,890,871
356,333
4,247,204
FY2002
25,627,596
6,882,488
4,246,084
380,320
4,671,037
FY2003
25,217,342
7,186,643
4,504,508
417,023
4,961,453
FY2004
24,862,857
7,419,851
4,713,583
453,250
5,166,833
FY2005
24,521,247
7,746,201
4,862,992
445,322
5,308,314
FY2006
24,179,183
7,872,438
5,030,582
435,488
5,466,070
FY2007
23,816,018
7,833,445
5,015,689
463,240
5,478,929
FY2008
23,442,489
7,834,763
5,078,269
498,420
5,576,689
FY2009
23,066,965
8,048,560
5,221,583
523,110
5,744,693
FY2010
23,031,892
8,343,117
5,441,059
559,051
6,000,110
FY2011
22,676,149
8,574,198
5,582,171
584,020
6,166,191
FY2012
22,328,279
8,762,548
5,680,374
652,717
6,333,091
FY2013
21,972,964
8,926,546
5,803,890
680,774
6,484,664
FY2014
21,999,108
9,078,615
5,955,725
677,010
6,632,735
FY2015
21,680,534
8,965,923
6,047,750
694,120
6,741,870
FY2016
21,368,156
9,124,712
6,168,606
705,743
6,874,349
FY2017
21,065,561
9,247,803
6,277,360
715,928
6,993,288
FY2018
20,333,894
9,178,149
6,170,756
744,740
6,915,496
FY2019
19,928,795
9,237,638
6,271,019
764,777
7,035,796
FY2020
19,541,961
9,190,143
6,211,825
764,006
6,975,831
FY2021
19,162,515
9,210,599
6,265,880
771,698
7,037,578
FY2022
18,792,191
9,216,025
6,317,059
812,674
7,129,733
Source: Total Veteran Population numbers are from VetPop2018 (FY2018-FY2022), available at
https://www.va.gov/vetdata/docs/Demographics/New_Vetpop_Model/1L_VetPop2018_National.xlsx., and an
archived copy of an earlier version no longer available on the website (FY2000-FY2017). “VA-Enrol ed Veterans”
numbers and “Patients Using VA Health Care During the Year” numbers were obtained from the Department of
Veterans Affairs (VA) and/or the VA budget submissions to Congress for FY2002-FY2021; the number for each
fiscal year is taken from the budget submission two years later (e.g., the FY2000 number is from the FY2002
budget submission).
Note: FY2022 total veteran population projected as of September 30, 2020. FY2021 and FY2022 veteran
enrol ee and patient data are estimates.

Congressional Research Service

36

Department of Veterans Affairs FY2022 Appropriations

Appendix B. VA Appropriations FY1995-FY2021
Table B-1. VA Appropriations FY1995-FY1999
($ in Thousands)
FY1995
FY1996
FY1997
FY1998
FY1999

Enacted
Enacted
Enacted
Enacted
Enacted
Veterans Benefits Administration (VBA)
Compensation and Pensions
$17,626,892
$18,331,561
$18,671,259
$19,932,997
$21,857,058
Supplemental

$100,000
$928,000
$550,000

Readjustment Benefits
$1,286,600
$1,345,300
$1,377,000
$1,366,000
$1,175,000
Veterans Insurance and
$24,760
$24,890
$38,970
$51,360
$46,450
Indemnities
Education Loan Program
$196
$196
$196
$201
$207
Account
Loan Guaranty Program
$78,035
$75,088
$47,901


Account
Guaranty & Indemnity Program
$428,120
$569,348
$263,869


Account
Direct Loan Program
$1,042
$487
$110


Veterans Housing Benefit



$192,447
$263,587
Program Fund
Veterans Housing Benefit



$160,437
$159,121
Program Fund Administrative
Expenses
Vocational Rehabilitation Loan
$54
$54
$49
$44
$55
Program
Vocational Rehabilitation Loan
$767
$377
$377
$388
$400
Program Administrative
Expenses
Native American Veterans
$218
$205
$205
$515
$515
Housing Loan Program
Administrative Expenses
Subtotal VBA
$19,446,684
$20,447,506
$21,327,936
$22,254,389
$23,502,393
Veterans Health Administration (VHA)
Medical Care
$16,232,756
$16,564,000
$17,013,447
$17,057,396
$17,306,000
Rescission
-$84,762
-$21,250


-$35,373
Medical Administration and
$69,808
$63,602
$61,207
$59,860
$63,000
Miscellaneous Operating
Expenses (MAMOE)
Rescission
-$44
-$86


-$67
Health Professional Scholarships
$10,386




Medical and Prosthetic Research
$252,000
$257,000
$262,000
$272,000
$316,000
Rescission
-$574
-$322


-$348
Congressional Research Service

37

Department of Veterans Affairs FY2022 Appropriations

FY1995
FY1996
FY1997
FY1998
FY1999

Enacted
Enacted
Enacted
Enacted
Enacted
Medical Care Col ections Fund



$666,579
$587,000
(MCCF)
Subtotal VHA
$16,479,570
$16,862,944
$17,336,654
$18,055,835
$18,236,212
National Cemetery
$72,663
$72,604
$76,864
$84,183
$92,006
Administration (NCA)
Rescission
-$128
-$97


-$122
Subtotal NCA
$72,535
$72,507
$76,864
$84,183
$91,884
Departmental Administration
General Operating Expenses
$890,600
$848,143
$827,584
$786,135
$855,661
Rescission
-$879
-$1,127


-$1,558
Office of Inspector General
$31,819
$30,900
$30,900
$31,013
$36,000
Rescission
-$32
-$42


-$43
Construction, Major Projects
$355,612
$136,155
$250,858
$175,000
$142,300
Rescission
-$32,337
-$186
-$32,100

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


-$16
Supplemental



$32,100

Parking Fund
$16,300

$12,300


Rescission




-$23
Grants to Republic of the
$500




Philippines
Grants for State Extended Care
$47,397
$47,397
$47,397
$80,000
$90,000
Facilities
Grants for State Veterans
$5,378
$1,000
$1,000
$10,000
$10,000
Cemeteries
Subtotal Departmental
$1,467,264
$1,251,980
$1,312,939
$1,292,148
$1,307,308
Administration
Total Department of
$37,466,053
$38,634,937
$40,054,393
$41,686,555
$43,137,797
Veterans Affairs with MCCF
Total Department of
$37,466,053
$38,634,937
$40,054,393
$41,019,976
$42,550,797
Veterans Affairs without
MCCF

Total Mandatory
$19,445,449
$20,446,674
$21,327,109
$22,092,804
$23,342,095
Total Discretionary with
$18,020,604
$18,188,263
$18,727,284
$19,593,751
$19,795,702
MCCF
Total Discretionary without
$18,020,604
$18,188,263
$18,727,284
$18,927,172
$19,208,702
MCCF
Congressional Research Service

38

Department of Veterans Affairs FY2022 Appropriations

Table B-2. VA Appropriations FY2000-FY2004
($ in Thousands)
FY2000
FY2001
FY2002
FY2003
FY2004

Enacted
Enacted
Enacted
Enacted
Enacted
Veterans Benefits Administration (VBA)
Compensation and Pensions
$21,568,364
$22,766,276
$24,944,288
$28,949,000
$29,845,127
Supplemental

$589,413
$1,100,000


Readjustment Benefits
$1,469,000
$1,634,000
$2,135,000
$2,264,808
$2,529,734
Supplemental

$347,000



Veterans Insurance and
$28,670
$19,850
$26,200
$27,530
$29,017
Indemnities
Education Loan Program
$215
$221
$65
$71
$71
Account
Guaranteed Transitional
$48,250




Housing for Homeless
Veterans
Veterans Housing Benefit
$282,342
$165,740
$203,278
$437,522
$305,834
Program Fund
Veterans Housing Benefit
$156,958
$162,000
$164,497
$168,207
$154,850
Program Fund Administrative
Expenses
Rescission

-$356
-$123
-$1,093
-$914
Vocational Rehabilitation Loan
$57
$52
$72
$54
$52
Program
Vocational Rehabilitation Loan
$415
$432
$274
$289
$300
Program Administrative
Expenses
Rescission

-$1

-$2
-$2
Native American Veterans
$520
$532
$544
$558
$571
Housing Loan Program
Administrative Expenses
Rescission

-$1

-$4
-$3
Subtotal VBA
$23,554,791
$25,685,156
$28,574,095
$31,846,939
$32,864,636
Veterans Health Administration (VHA)
Medical Care
$19,006,000
$20,281,587
$21,331,164
$23,889,304

Supplemental


$142,000


Rescission
-$79,519
-$46,234
-$16,084


Medical Administration and
$59,703
$62,000
$66,731
$74,716

Miscellaneous Operating
Expenses (MAMOE)
Rescission

-$136
-$50
-$486

Medical Services




$17,867,220
Rescission




-$103,823
Congressional Research Service

39

Department of Veterans Affairs FY2022 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

40

Department of Veterans Affairs FY2022 Appropriations

FY2000
FY2001
FY2002
FY2003
FY2004

Enacted
Enacted
Enacted
Enacted
Enacted
Total Department of
$44,255,165
$47,897,527
52,361,833
$58,198,431
$62,116,757
Veterans Affairs without
MCCF

Total Mandatory
$23,348,376
$25,522,279
$28,408,766
$31,678,860
$32,709,712
Total Discretionary with
$21,470,544
$23,142,935
$25,086,281
$27,994,287
$31,115,071
MCCF
Total Discretionary
$20,906,789
$22,375,248
$23,953,067
$26,519,571
$29,407,045
without MCCF

Table B-3. VA Appropriations FY2005-FY2009
($ in Thousands)
FY2005
FY2006
FY2007
FY2008
FY2009

Enacted
Enacted
Enacted
Enacted
Enacted
Veterans Benefits Administration (VBA)
Compensation and Pensions
$32,607,688
$33,897,787
$38,172,360
$41,236,322
$43,111,681
Supplemental




$700,000
Readjustment Benefits
$2,556,232
$3,309,234
$3,262,006
$3,300,289
$3,832,944
Veterans Insurance and
$44,380
$45,907
$49,850
$41,250
$42,300
Indemnities
Veterans Housing Benefit
$43,784
$64,586
$66,234
$17,389
$2,000
Program Fund
Credit Subsidy



-$108,000

Veterans Housing Benefit
$154,075
$153,575
$154,284
$154,562
$157,210
Program Fund Administrative
Expenses
Rescission
-$1,233




Vocational Rehabilitation Loan
$47
$53
$53
$71
$61
Program
Vocational Rehabilitation Loan
$311
$305
$306
$311
$320
Program Administrative
Expenses
Rescission
-$2.865




Native American Veterans
$571
$580
$584
$628
$646
Housing Loan Program
Administrative Expenses
Rescission
-$4.569




Subtotal VBA
$35,405,848
$37,472,027
$41,705,677
$44,642,822
$47,847,162
Medical Services
$19,472,777
$21,322,141
$25,518,254
$29,104,220
$30,969,903
Budget Supplemental
$1,500,000
$1,225,000
$466,800


Hurricane Supplemental
$38,783
$198,265



Pandemic Influenza

$27,000



Supplemental
Congressional Research Service

41

Department of Veterans Affairs FY2022 Appropriations

FY2005
FY2006
FY2007
FY2008
FY2009

Enacted
Enacted
Enacted
Enacted
Enacted
Rescission
-$155,782




Total Medical Services
$20,855,778
$22,772,406
$25,985,054
$29,104,220
$30,969,903
Medical Administration
$4,705,000
$2,858,442
$3,177,968
$3,517,000
$4,450,000
Supplemental
$1,940

$250,000


Rescission
-$37,640




Medical Facilities
$3,745,000
$3,297,669
$3,569,533
$4,100,000
$5,029,000
Supplemental
$46,909
—-
$595,000

$1,000,000
Rescission
-$29,960




Medical and Prosthetic
$405,593
$412,000
$413,980
$480,000
$510,000
Research
Supplemental


$32,500


Rescission
-$3,245




Medical Care Col ections Fund
$1,953,020
$2,170,000
$2,198,154
$2,414,000
$2,544,000
(MCCF)
Subtotal VHA
$31,642,395
$31,510,517
$36,222,190
$39,615,220
$44,502,903
National Cemetery
$148,925
$156,447
$160,747
$195,000
$230,000
Administration (NCA)
Rescission
-$1,191



$50,000
Supplemental
$50
$200



Subtotal NCA
$147,784
$156,647
$160,747
$195,000
$280,000
General Operating Expenses
$1,324,753
$1,410,520
$1,481,472
$1,605,000
$1,801,867
Rescission
-$10,598




Supplemental
$545
$24,871
$83,200
$100,000
$157,100
Filipino Veterans Equity




$198,000
Compensation Fund
Office of Inspector General
$69,711
$70,174
$70,641
$80,500
$87,818
Rescission
-$558



$1,000
Information Technology

$1,213,820
$1,213,820
$1,966,465
$2,489,391
Supplemental


$35,100
$20,000
$50,100
Construction, Major Projects
$458,800
$607,100
$399,000
$1,069,100
$923,382
Rescission
-$3,670




Supplemental

$953,419

$396,377

Construction, Minor Projects
$230,779
$198,937
$198,937
$630,535
$741,534
Rescission
-$1,846




Supplemental
$36,343
$1,800
$326,000


Grants for State Extended
$105,163
$85,000
$85,000
$165,000
$175,000
Care Facilities
Rescission
-$841



$150,000
Grants for State Veterans
$32,000
$32,000
$32,000
$39,500
$42,000
Cemeteries
Rescission
-$256




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42

Department of Veterans Affairs FY2022 Appropriations

FY2005
FY2006
FY2007
FY2008
FY2009

Enacted
Enacted
Enacted
Enacted
Enacted
Subtotal Departmental
$2,240,324
$4,597,641
$3,925,171
$6,072,477
$6,817,192
Administration
Total Department of

$69,436,351
$73,736,832
$82,013,784
$90,525,519
$99,670,165
Veterans Affairs with
MCCF
Total Department of

$67,483,331
$71,566,832
$79,815,630
$88,111,519
$96,903,257
Veterans Affairs without
MCCF
Total Mandatory

$35,252,084
$37,317,514
$41,550,450
$44,487,250
$46,988,925
Total Discretionary with
$34,184,267
$36,419,318
$40,463,334
$46,038,269
$51,981,240
MCCF
Total Discretionary

$32,231,247
$34,249,318
$38,265,180
$43,624,269
$49,214,332
without MCCF
Table B-4. VA Appropriations FY2010-FY2014
($ in Thousands)
FY2010
FY2011
FY2012
FY2013
FY2014
Enacted
Enacted
Enacted
Enacted
Enacted

Veterans Benefits Administration (VBA)

Compensation and Pensions
$47,396,106
$53,978,000
$51,237,567
$60,599,855
$71,476,104
Readjustment Benefits
$9,232,369
$10,396,245
$12,108,488
$12,023,458
$13,135,898
Veterans Insurance and
$49,288
$77,589
$100,252
$104,600
$77,567
Indemnities
Veterans Housing Benefit
$23,553
$19,078
$318,612
$184,859

Program Fund
Veterans Housing Benefit

$165,082
$154,698
$157,605
$158,430
Program Fund Administrative
Expenses
Rescission
$165,082
-$330



Vocational Rehabilitation Loan

$29
$19
$19
$5
Program
Rescission
$29
-$1



Vocational Rehabilitation Loan
$328
$337
$343
$346
$354
Program Administrative
Expenses
Rescission

-$10



Native American Veterans
$664
$707
$1,116
$1,087
$1,109
Housing Program
Administrative Expenses
Rescission

-$44



Subtotal VBA
$56,867,419
$64,636,683
$63,921,095
$73,071,830
$86,886,074
Veterans Health Administration (VHA)
Medical Services
$34,707,500
$37,136,000
$39,649,985
$41,509,000
$43,557,000
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43

Department of Veterans Affairs FY2022 Appropriations

FY2010
FY2011
FY2012
FY2013
FY2014
Enacted
Enacted
Enacted
Enacted
Enacted

Budget Supplemental



— $40,000
Hurricane Supplemental



$21,000

Rescission

-$74,272

-$14,937
-$179,000
Total Medical Services
$34,707,500
$37,061,728
$39,649,985
$41,515,063
$43,418,000
Medical Administration
$4,930,000
$5,307,000
$5,535,000
$5,746,000
$6,033,000
Rescission

-$44,546

-$2,039
-$50,000
Medical Facilities
$4,859,000
$5,740,000
$5,426,000
$5,441,000
$4,872,000
Supplemental



$6,000
$85,000
Rescission

-$26,450

-$1,991

Medical and Prosthetic Research
$581,000
$590,000
$581,000
$581,905
$585,664
Rescission

-$10,162



Medical Care Col ections Fund
$2,847,565
$2,775,214
$2,830,302
$2,903,092

(MCCF)
Subtotal VHA
$47,925,065
$51,392,784
$54,022,287
$56,189,031
$58,031,656
National Cemetery
$250,000
$250,000
$250,934
$258,284
$250,000
Administration (NCA)
Rescission

-$500

-$341
-$1,000
Supplemental



$2,100

Subtotal NCA
$250,000
$249,500
$250,934
$260,043
$249,000
Departmental Administration
VBA—General Operating

$2,622,110
$2,018,764
$2,164,074
$2,465,490
Expenses
Rescission
$250,000
-$87,834

-$2,856

General Administration


$416,737
$424,737
$415,885
Rescission



-$561
-$2,000
Office of Inspector General
$109,000
$109,367
$112,391
$114,848
121,411
Rescission

-$585



Information Technology
$3,307,000
$3,307,000
$3,111,376
$3,323,053
$3,703,344
Rescission





Supplemental
$1,194,000
-$166,396



Construction, Major Projects

$1,151,036
$589,604
$531,767
$342,130
Rescission

-$2,302



Construction, Minor Projects
$703,000
$467,700
$482,386
$606,728
$714,870
Rescission

-$935



Supplemental




511,200
Grants for State Extended Care
$100,000
$85,000
$85,000
$84,888
$85,000
Facilities
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44

Department of Veterans Affairs FY2022 Appropriations

FY2010
FY2011
FY2012
FY2013
FY2014
Enacted
Enacted
Enacted
Enacted
Enacted

Rescission

-$170



Grants for State Veterans
$46,000
$46,000
$46,000
$45,939
$46,000
Cemeteries
Rescission

-$92



Subtotal Departmental
$7,539,607
$7,529,899
$6,862,258
$6,871,298
$8,403,330
Administration
Total Department of
$112,582,091 $123,733,866 $125,056,574 $137,020,522 $168,570,058
Veterans Affairs with MCCF
Total Department of
$109,734,526 $120,958,652 $122,226,272 $134,117,429 $165,482,068
Veterans Affairs without
MCCF

Total Mandatory
$56,701,316
$64,470,912
$63,764,919
$72,912,772 $101,726,176
Total Discretionary with
$55,880,775
$59,262,954
$61,291,655
$64,107,750
$66,843,882
MCCF
Total Discretionary without
$53,033,210
$56,487,740
$58,461,353
$61,204,657
$63,755,892
MCCF

Table B-5. VA Appropriations FY2016-FY2020
($ in Thousands)
FY2015
FY2016
FY2017
FY2018
FY2019
Enacted
Enacted
Enacted
Enacted
Enacted

Veterans Benefits Administration (VBA)

Compensation and Pensions
$79,071,000
$76,865,545
$86,083,128
$90,119,449
$95,768,462
Budget Supplemental




$2,994,366
Readjustment Benefits
$14,997,136
$14,313,357
$16,340,828
$13,708,648
$11,832,175
Veterans Insurance and
$63,257
$77,160
$108,525
$120,338
$109,090
Indemnities
Budget Supplemental





Veterans Housing Benefit

$509,008



Program Fund
Veterans Housing Benefit
$160,881
$164,558
$198,856
$178,626
$200,612
Program Fund Administrative
Expenses
Rescission





Vocational Rehabilitation
$10
$31
$36
$30
$39
Loan Program
Rescission





Vocational Rehabilitation
$361
$367
$389
$395
$396
Loan Program Administrative
Expenses
Rescission





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Department of Veterans Affairs FY2022 Appropriations

FY2015
FY2016
FY2017
FY2018
FY2019
Enacted
Enacted
Enacted
Enacted
Enacted

Native American Veterans
$1,130
$1,114
$1,163
$1,163
$1,163
Housing Program
Administrative Expenses
Rescission





Subtotal VBA
$94,753,582
$91,931,140 $102,732,905 $104,128,649 $110,906,303
Veterans Health Administration (VHA)
Medical Services
$45,015,527
$47,603,202
$51,673,000
$44,886,554
$49,161,165
Budget Supplemental
209,189
$2,369,158
1,078,993
$1,962,984
$750,000
Hurricane Supplemental



$11,075

P.L. 115-31, (Opioid


$50,000


Supplemental)
Families First





Coronavirus Response
Act (P.L. 116-127)
CARES Act (P.L. 116-





136)
Rescission
-28,829.839

-$7,380,181
-$751,000

Total Medical Services
$45,195,886.1
$49,972,360
$45,421,812
$46,109,613
$49,911,165
61
Medical Community Care



$9,409,118
$8,384,704
Budget Supplemental


7,246,181
$419,176
$1,000,000
Families First





Coronavirus Response
Act (P.L. 116-127)
CARES Act (P.L. 116-136)





Total Medical Community


$7,246,181
$9,828,294
$9,384,704
Care
Medical Administration
$5,879,700
$6,144,000
$6,524,000
$6,654,480
$7,239,156
Budget Supplemental



$100,000

Hurricane Supplemental



$3,209

Rescission
-5,609.461

-$26,000

-$211,000
CARES Act (P.L. 116-





136)
Total Medical

$6,144,000
$6,498,000
$6,757,689
$7,028,156
Administration
Medical Facilities
$4,739,000
$4,915,000
$5,074,000
$5,434,880
$5,914,288
Supplemental

$105,312
$247,668
$1,707,000
$890,180
Hurricane Supplemental



$75,108
$3,000
Rescission
-1,999.835

-$9,000


CARES Act (P.L. 116-





136)
Total Medical Facilities

$5,020,312
$5,312,668
$7,216,988
$6,807,468
Congressional Research Service

46

Department of Veterans Affairs FY2022 Appropriations

FY2015
FY2016
FY2017
FY2018
FY2019
Enacted
Enacted
Enacted
Enacted
Enacted

Medical and Prosthetic
$588,922
$630,735
$675,366
$722,262
$779,000
Research
Rescission
-409.359

-$2,000


Total Medical and

$630,735
$673,366
$722,262
$779,000
Prosthetic Research
Medical Care Col ections

$3,503,146
$3,561,642
$3,515,635
$3,915,045
Fund (MCCF)
Subtotal VHA
$59,619,422
$62,270,373
$68,713,669
$74,150,481
$77,825,538
Veterans Choice Act


$2,100,000
$7,300,000

Mandatory Funds
National Cemetery
$256,800
$271,220
$286,193
$306,193
$315,836
Administration (NCA)
Rescission
-169.500




Supplemental





Subtotal NCA
$256,631
$271,220
$286,193
$306,193
$315,836
Departmental Administration
VBA—General Operating
$2,534,254
$2,707,734
$2,856,160
$2,910,000
$2,956,316
Expenses
Rescission
-2,355.482

-$12,000


General Administration
$321,591
$336,659
$345,391
$335,891
$355,897
Rescission
-446.436




Board of Veterans Appeals

$109,884
$156,096
$161,048
$174,748
Rescission


-$500


Office of Inspector General
$126,411
$136,766
$160,106
$164,000
$192,000
Rescission


-$500


Information Technology
$3,903,344
$4,133,363
$4,278,259
$4,055,500
$4,103,000
Rescission
-1,066

-$8,000


CARES Act (P.L. 116-





136)
Electronic Health Records



$782,000
$1,107,000
Modernization (EHRM)
Construction, Major Projects
$561,800
$1,243,800
$325,812
$1,442,750
$2,503,786
Rescission


-$20,322
-$420,000

Construction, Minor Projects
$495,200
$406,200
$372,069
$767,570
$799,514
Supplemental



$4,088

Grants for State Extended
$90,000
$120,000
$90,000
$685,000
$150,000
Care Facilities
Grants for State Veterans
$46,000
$46,000
$45,000
$45,000
$45,000
Cemeteries
Subtotal Departmental
$8,173,912
$9,240,406
$8,587,571
$10,932,847
$12,387,261
Administration
Congressional Research Service

47

Department of Veterans Affairs FY2022 Appropriations

FY2015
FY2016
FY2017
FY2018
FY2019
Enacted
Enacted
Enacted
Enacted
Enacted

Total Department of

$162,803,546 $166,713,139 $182,420,358 $196,818,170 $201,434,938
Veterans Affairs with
MCCF
Total Department of

$159,579,614 $163,209,993 $178,858,716 $193,302,535 $197,519,893
Veterans Affairs without
MCCF

Total Mandatory
$94,591,200
$91,765,070 $104,632,481 $111,248,435 $110,704,093
Total Discretionary with
$68,212,346
$74,948,069
$77,787,876
$85,569,735
$90,730,845
MCCF
Total Discretionary

$64,988,414
$71,444,923
$74,226,235
$82,054,100
$86,815,800
without MCCF
Table B-6. VA Appropriations FY2020-FY2024
($ in Thousands)
FY2020
FY2021
FY2022
FY2023
FY2024
Enacted
Enacted
Enacted
Enacted
Enacted

Veterans Benefits






Administration (VBA)
Compensation and Pensions
$109,017,152
$118,246,975



Budget Supplemental
$1,439,931
$6,110,252



Readjustment Benefits
$14,065,282
$12,578,965



ARPA (P.L. 117-2)

$386,000



Veterans Insurance and
$111,340
$129,224



Indemnities
Budget Supplemental
$17,620
$2,148



Veterans Housing Benefit





Program Fund
Veterans Housing Benefit
200,377
$204,400



Program Fund Administrative
Expenses
Vocational Rehabilitation
$58
$34



Loan Program
Vocational Rehabilitation
$402
$424



Loan Program Administrative
Expenses
Native American Veterans
$1,186
$1,186



Housing Program
Administrative Expenses
Subtotal VBA
$138,918,630
$150,238,573



Medical Services
$51,411,165
$56,158,015



Budget Supplemental

$497,468



Hurricane Supplemental





Congressional Research Service

48

Department of Veterans Affairs FY2022 Appropriations

FY2020
FY2021
FY2022
FY2023
FY2024
Enacted
Enacted
Enacted
Enacted
Enacted

P.L. 115-31, (Opioid





Supplemental)
Families First
$30,000




Coronavirus Response
Act (P.L. 116-127)
CARES Act (P.L. 116-
$14,432,000




136)
ARPA (P.L. 117-2)

$627,900



Rescission
-$350,000
-$100,000



Total Medical Services
$65,523,165
$57,183,383



Medical Community Care
$10,758,399
$17,131,179



Budget Supplemental
$3,906,400
$1,380,800



Families First
$30,000




Coronavirus Response
Act (P.L. 116-127)
CARES Act (P.L. 116-
$2,100,000




136)
ARPA (P.L. 117-2)

$322,100



Total Medical Community
$16,794,799
$18,834,079



Care
Medical Administration
$7,239,156
$7,914,191



Budget Supplemental
$98,800
$300,000



CARES Act (P.L. 116-
$100,000




136)
Rescission
-$10,000
-$15,000



Total Medical
$7,427,956
$8,199,191



Administration
Medical Facilities
$6,141,880
$6,433,265



Budget Supplemental

$150,000



CARES Act (P.L. 116-
$606,000




136)
Total Medical Facilities
$6,747,880
$6,583,265



Medical and Prosthetic
$3,429,116
$815,000



Research
Rescission
-$50,000
-$20,000



Total Medical and
$750,000
$795,000



Prosthetic Research
Medical Care Col ections
$3,429,116
$2,965,445



Fund (MCCF)
ARPA (P.L. 117-2)

$300,000



ARPA (P.L. 117-2)

$14,482,000



Congressional Research Service

49

Department of Veterans Affairs FY2022 Appropriations

FY2020
FY2021
FY2022
FY2023
FY2024
Enacted
Enacted
Enacted
Enacted
Enacted

ARPA (P.L. 117-2)

$80,000



Subtotal VHA
$100,672,916
$109,422,363



National Cemetery
$329,000
$352,000



Administration (NCA)
Rescission
-$1,000




Subtotal NCA
$328,000
$352,000



VBA—General Operating
$3,125,000
$3,180,000



Expenses
Rescission
-$258
-$16,000



CARES Act (P.L. 116-
13,000




136)
ARPA (P.L. 117-2)

$262,000



General Administration
$355,911
$365,911



Rescission
$6,000
-$12,000



CARES Act (P.L. 116-
$182,000




136)
Board of Veterans Appeals
$182,000
$196,000



Rescission
-$8,000




ARPA (P.L. 117-2)

$10,000



Office of Inspector General
$210,000
$228,000



CARES Act (P.L. 116-
$12,500




136)
ARPA (P.L. 117-2)

$10,000



Information Technology
$4,371,615
$4,912,000



Rescission

-$37,500



CARES Act (P.L. 116-
$2,150,000




136)
ARPA (P.L. 117-2)

$100,000



Electronic Health Records
$1,500,000
$2,627,000



Modernization (EHRM)
Rescission
-70,000
-$20,000



Construction, Major Projects
$1,270,200
$1,316,000



Construction, Minor Projects
$398,800
$390,000



Rescission

-$35,700



Grants for State Extended
$90,000
$90,000



Care Facilities
CARES Act (P.L. 116-
$150,000




136)
ARPA (P.L. 117-2)

$500,000



Congressional Research Service

50

Department of Veterans Affairs FY2022 Appropriations

FY2020
FY2021
FY2022
FY2023
FY2024
Enacted
Enacted
Enacted
Enacted
Enacted

Grants for State Veterans
$45,000
$45,000



Cemeteries
Subtotal Departmental
$13,801,768
$14,110,711



Administration
Total Department of
$239,656,032
$261,544,682



Veterans Affairs with
MCCF

Total Department of
$236,226,916
$258,579,237



Veterans Affairs without
MCCF

Total Mandatory
$124,651,325
$154,147,564



Total Discretionary with
$115,004,707
$107,397,118



MCCF
Total Discretionary
$111,575,591
$104,431,673



without MCCF



Author Information

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


Jared S. Sussman

Analyst in Health Policy


Acknowledgments
Isaac A. Nicchitta and John H. Gorman, CRS Research Assistants in the Domestic Social Policy Division,
provided invaluable assistance with this report.
Congressional Research Service

51

Department of Veterans Affairs FY2022 Appropriations



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Congressional Research Service
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