Letter to the Hon. Keith Hall, Director of the Congressional Budget Office - Veterans' Affairs Committee Democrats Send Letter to CBO Regarding AHCA

Letter

Dear Director Hall:

As the Congressional Budget Office (CBO) works to complete its analysis of H.R. 1628, the American Health Care Act, we ask that you include a thorough evaluation of the impact the legislation would have on healthcare affordability and coverage for our nation's veterans, their spouses, and dependent children. These men and women have served our nation bravely, and it is essential that Congress and the American people know and understand the impact of the proposed legislation on veterans.

As Members of the House Committee on Veterans' Affairs, we are particularly concerned about the applicability of tax credits for veterans who are eligible for, but not enrolled in, VA care. The pending legislation denies tax credits to individuals who are eligible for certain types of health coverage, including Medicare, Tricare, and others. We are concerned that this prohibition also applies to veterans eligible for VA care, even if they are not enrolled. As first published by the Rules Committee, H.R. 1628 included a special rule for these veterans. Page 97, line 21, laid out the special rule by affirmatively guaranteeing that veterans who are eligible for, but not enrolled in, VA care would still be eligible for tax credits to help them afford coverage.[1] The subsequent Walden-Brady Amendment #4 replaced the section on refundable tax credits with new language that omitted the clear protection for veterans.[3]

It is a common misconception that all veterans receive their health care through the VA. In fact, of the more than 20 million veterans, only 9 million are enrolled in VA care. The Commission on Care, a bipartisan, independent commission, estimated that 7 million veterans are eligible for, but not enrolled in, VA care.[3] A 2014 CBO report found that number could be closer to 8 million.[4] If these veterans are prevented from receiving tax credits to help them afford coverage, it could create an incentive for them to enroll in VA care. A sudden influx of this magnitude would severely hamper the VA's ability to provide timely care and have significant impacts on the agency's budget needs.

Additionally, in the first two years following the Affordable Care Act's implementation, the uninsured rate among veterans dropped by 40 percent. More than 400,000 veterans gained health insurance coverage, many through the Medicaid expansion.[5] We ask that you include analysis of the legislation's impact on these veterans and families, particularly the provisions impacting Medicaid expansion and reductions in federal Medicaid funding in the bill.

Thank you for your attention to this matter and your thoughtful, balanced review of this legislation. Should you need additional information, please contact Amanda Eaton in Congressman Takano's office at Amanda.eaton@mail.house.gov or 202-225-2305.

Sincerely,

Mark Takano
Vice Ranking Member
House Committee on Veterans' Affairs

Tim Walz
Ranking Member
House Committee on Veterans' Affairs

Julia Brownley
Ranking Member
Health Subcommittee

Ann McLane Kuster
Ranking Member
Oversight and Investigations Subcommittee

Beto O'Rourke
Ranking Member
Economic Opportunity Subcommittee

Kathleen M. Rice
Member of Congress

J. Luis Correa
Member of Congress

Gregorio Kilili Camacho Sablan
Member of Congress

Elizabeth H. Esty
Ranking Member
Disability Assistance & Memorial Affairs Subcommittee

Scott Peters
Member of Congress