Independent THE Budget

1 THE. THE. Independent Budget Fiscal Years 2023 and 2024 for the Department of Veterans Affairs Budget RECOMMENDATIONS. Independent THE. Budget Fiscal Years 2023 and 2024 for the Department of Veterans Affairs A Comprehensive Budget Created by Veterans for Veterans Table of Contents Summary Table of IB Budget Veterans Health Administration Medical General Operating Expenses Veterans Benefits 11. Department Administration and Misc. Construction 1 The Independent Budget Budget for Fiscal Years 2023 24. Introduction T. he Independent Budget (IB) is a decades-long part- Aid, Relief, and Economic Security Act (CARES) Act ( nership among DAV (Disabled American Veterans), 116-136) and the American Rescue Plan (ARP) Act ( Paralyzed Veterans of America (PVA) and the Veter- 117-2) make it extremely difficult to establish an accu- ans of Foreign Wars of the United States (VFW) for the rate FY 2022 baseline Budget .

2 Purpose of providing annual Budget and appropriations recommendations for the Department of Veterans Af- Moreover, ongoing and future policy changes could dra- fairs (VA) and its many programs, services, and benefits. matically alter VA's future funding needs. For example, This report provides funding and related recommenda- the Asset and Infrastructure Review (AIR) mandated by tions for VA's fiscal year (FY) 2023 Budget and FY 2024 the VA MISSION Act will determine how and where VA. advance appropriations for VA medical care programs.

3 Plans to deliver health care to enrolled veterans over the next decade and what VA facilities will be required At the beginning of 2022, the COVID pandemic contin- to assure timely and convenient access. Congress is also ues to significantly impact every aspect of American considering major legislation that could change how and life, with no clear indication of when it will subside. As when VA recognizes injuries, illnesses, and disabilities the virus continues to spread and new variants emerge, associated with military toxic exposures; which would the disruption to the economy and health care systems significantly increase the number of veterans eligible for continues with no clear end.

4 In this environment, there VA health care and benefits. is great uncertainty about the assumptions of Budget In this environment, the IB veterans service organiza- tions (IBVSOs) made cautious assumptions for the FY. Congress and the 2023 Budget recommendations based on historical Administration must regularly trends. Our recommendations primarily indicate where additional funding will be needed in FY 2023 and FY. review and be prepared to adjust 2024 for existing programs, services, and initiatives, as funding levels whenever necessary well as requirements to establish new programs to meet veterans' emerging needs.

5 Given the uncertainty sur- to ensure VA has sufficient rounding VA's future resource needs, Congress and the resources to care for our nation's Administration must regularly review and be prepared to adjust funding levels whenever necessary to ensure ill and injured veterans. VA has sufficient resources to care for our nation's ill and injured veterans. In this volatile fiscal and political envi- projections, such as future year health care enrollment, ronment, it is imperative that Congress and VA work in utilization, and reliance, as well as broad economic fac- good faith with each other, and with veterans service tors such as inflation and unemployment.

6 Furthermore, organizations (VSOs) and other veteran stakeholders, to the failure of Congress and the Administration to enact ensure that every man and woman who has served, is a full-year FY 2022 appropriation and the historic emer- serving and will serve this nation, receives the benefits gency funding provided to VA through the Coronavirus and health care they earned.. 2 The Independent Budget Budget for Fiscal Years 2023 24. IB Recommendations for FY 2023 and FY 2024 Advance (in thousands). FY 2022 FY 2023 FY 2023 FY 2024. Appropriation Adv.

7 Approp. Appropriation Adv. Approp. Veterans Health Administration (VHA) Admin. Request Admin. Request IB Recommend IB Recommend Medical Services 58,897,219 70,323,000 78,312,000 82,603,000. Medical Support and Compliance 8,403,117 9,673,000 9,761,000 10,098,000. Medical Facilities 6,734,680 7,134,000 6,950,000 7,153,000. Medical Care Collections (VA Medical Care) 3,461,624 3,508,000 . Subtotal, VA Medical Care 77,496,640 90,638,000 95,023,000 99,854,000. Medical Community Care 23,417,000 24,157,000 26,149,000 27,339,000. Medical Care Collections (Community Care) 623,328 657,000.

8 Subtotal, Medical Community Care 24,040,328 24,814,000 26,149,000 27,339,000. Total, Medical Care 101,536,968 115,452,000 121,172,000 127,193,000. Medical and Prosthetic Research 882,000 980,000. Total, Veterans Health Administration 102,418,968 122,152,000. General Operating Expenses Veterans Benefits Administration 3,423,000 3,935,00. General Administration 401,000 439,000. Board of Veterans Appeals 228,000 251,000. Total, General Operating Expenses 4,052,000 4,625,000. Department Admin and Misc. Programs Information Technology 4,843,000 5,458,000.

9 EHRM (Cerner) 2,663,000 2,600,000. National Cemetery Administration 394,000 456,000. Office of Inspector General 239,000 248,000. Total, Dept. Admin and Misc. Programs 8,139,000 8,762,000. Construction Programs Major Construction 1,611,000 2,925,000. Minor Construction 553,000 830,000. Grants for State Extended Care Facilities 0 500,000. Grants for State Vets Cemeteries 45,000 111,000. Total, Construction Programs 2,209,000 4,366,000. Other Discretionary Programs 231,232 240,000. Total, Budget Authority 117,049,968 140,145,000. 3 The Independent Budget Budget for Fiscal Years 2023 24.

10 Veterans Health Administration Total Medical Care FY 2023 IB Recommendation $ Billion FY 2023 Advance Appropriation Request $ Billion FY 2023 Estimated Medical Care Collections $ Billion Total, FY 2023 Advance Appropriation Request $ Billion FY 2022 Appropriation Request $ Billion FY 2022 Estimated Medical Care Collections $ Billion Total, FY 2022 Appropriation Request $ Billion FY 2024 IB Advance Appropriation Recommendation $ Billion After almost two years of the COVID pandemic, veter- For FY 2023, the IBVSOs recommend approximately ans like all Americans are ready for a return to nor- $ billion in total medical care funding and ap- malcy in all aspects of their lives, including their use of proximately $ billion for FY 2024.