H.R. 5562, a bill to amend title 38, United States Code, to expand eligibility for hospital care, medical services, and nursing home care from the Department of Veterans Affairs to include veterans of World War II

Congressional Budget Office

Cost Estimate

January 10, 2022

H.R. 5562, a bill to amend title 38, United States Code, to expand eligibility for hospital care, medical services, and nursing home care from the Department of Veterans Affairs to include veterans of World War II

As ordered reported by the House Committee on Veterans' Affairs on November 4, 2021

	By Fiscal Year, Millions of Dollars	2022			2022-2026				2022-2031
	Direct Spending (Outlays)	0			0				0
	Revenues	0			0				0
	Increase or Decrease (-)
	0			0				0
	in the Deficit
	Spending Subject to				17							185				not estimated
	Appropriation (Outlays)
	Statutory pay-as-you-go			No							Mandate Effects
	procedures apply?
							Contains intergovernmental mandate?		No
	Increases on-budget deficits in any			No
	of the four consecutive 10-year
	periods beginning in 2032?							Contains private-sector mandate?		No

Under current law, World War II (WWII) veterans with service-connected disabilities or with incomes below certain thresholds are eligible to enroll in the health care system of the Department of Veterans Affairs (VA). H.R. 5562 would make all WWII veterans eligible for hospital care, medical services, and nursing home care from VA. Veterans who are currently eligible for care solely because of low incomes also would be eligible for care at a higher priority level than they currently receive. They also would be eligible for reduced copayments for care.

CBO expects that most WWII veterans are eligible for Medicare and will continue to rely on that coverage for a significant portion of their health care needs. However, CBO expects that some of those veterans may use VA for some of their health care because of lower copayments for prescription drugs or because they are not satisfied with their current provider.

CBO estimates that in 2022, about 40,000 WWII veterans would be newly eligible or eligible for care at a higher priority and lower copayments under the bill. By 2031, that number would decline to 16,000 veterans because of mortality. On the basis of information from VA, CBO estimates that those veterans would receive an average of $1,730 in additional health care from VA each year. In total, implementing H.R. 5562 would cost $185 million over the

See also CBO's Cost Estimates Explained,www.cbo.gov/publication/54437;

How CBO Prepares Cost Estimates, www.cbo.gov/publication/53519; and Glossary, www.cbo.gov/publication/42904.

CBO Cost Estimate	Page 2
H.R. 5562, as ordered reported by the House Committee on Veterans' Affairs

2022-2026 period, after accounting for the gradual enrollment of newly eligible veterans. Such spending would be subject to the availability of appropriated funds.

The costs of the legislation, detailed in Table 1, fall within budget function 700 (veterans benefits and services).

Table 1.

Estimated Increases in Spending Subject to Appropriation Under S. 1040

		By Fiscal Year, Millions of Dollars
	2022	2023	2024	2025	2026	2022-2026
Health Care
Estimated Authorization	19	33	43	50	47	192
Estimated Outlays	17	31	41	49	47	185

On January 6, 2022, CBO transmitted a cost estimate for S. 1040, a bill to amend title 38, United States Code, to expand eligibility for hospital care, medical services, and nursing home care from the Department of Veterans Affairs to include veterans of World War II, as order reported by the Senate Committee on Veterans' Affairs on July 28, 2021. The two bills are similar, and CBO's estimates of the cost of implementing them are the same.

The CBO staff contact for this estimate is Etaf Khan. The estimate was reviewed by Leo Lex, Deputy Director of Budget Analysis.