By Tom Philpott: CNJ columnist
More than a month after a new fiscal year began Oct. 1, the House and Senate are still pressing to pass a group of bills to improve veterans’ benefits and health programs, rolling them together in “omnibus” legislative packets.
The omnibus bills can then be shaped by final compromises between the two chambers and passed relatively quickly, often by voice vote, so lawmakers can move on to other late, more politically sensitive business.
Standing athwart those plans this month, however, is Sen. Tom Coburn, R-Okla., a family physician whose top goal as a lawmaker has been to slow the rising tide of debt caused, he says, by colleagues who are willing to pass or spend whatever is necessary to assure their re-election.
Coburn frequently uses his prerogative of a senator to put a hold on bills, in this case a $3.7 billion packet of health care initiatives, the Caregivers and Veterans Omnibus Health Services Act of 2009 (S. 1963).
The bill’s centerpiece is unprecedented support for family caregivers of severely wounded veterans, those injured since 9-11. They would be paid a stipend based on hours and level of care. VA would ensure caregivers are properly trained and have their own medical coverage to include stress counseling if needed. VA also would pay for replacement caregivers when family members seek respite from their care obligations.
The idea is to give more very severely wounded veterans an option other than institutional care.
“This legislation forges a new paradigm of long-term care for our severely wounded warriors, one that acknowledges and fully supports the vital role of the family caregiver” in successful rehabilitation, said leaders of 21 veterans’ groups in an Oct. 21 letter urging passage of the bill.
But Coburn has refused to allow it to come to a floor vote. His spokesman, John Hart, said the senator’s biggest concern is that the Senate doesn’t intend to pay for the bill with an offset of current spending or higher taxes, so its passage will add to annual budget deficits and the national debt.
Coburn “believes strongly if we don’t start paying for things we’re not going to have a country left to defend,” Hart said. “He says we are waterboarding the next generation with debt and somebody has to stand up and say, ‘Let’s cut it out.’ ”
The Senate Veterans Affairs Committee acknowledges that money hasn’t been found to cover at least $2.8 billion of the bill’s $3.7 billion projected cost over the next five years, including money for the caregiver provisions, which would total $1.7 billion through fiscal 2014.
But Sen. Daniel K. Akaka, D-Hawaii, chairman of the committee, argues that the Iraq and Afghanistan wars also haven’t been “paid for” and proper care of wounded veterans is just another very necessary cost of war.
Another reason Coburn blocks the bill, Hart said, is that it isn’t fair to extend caregiver benefits to wounded from Iraq and Afghanistan but not to those severely injured in the Persian Gulf War, Vietnam or earlier conflicts.
Finally, Coburn believes VA isn’t “making smart use of existing benefits and therefore avoiding duplication,” Hart said. “This is legislation very popular for politicians to put forward for Veterans Day. But we need to produce a higher quality of care rather than press releases.”
He said Coburn will introduce alternative legislation because he supports the goals of the bill.