Senator puts hold on wounded vets’ caregiver bill

By Tom Philpott

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 reelection.

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.

A senator can’t delay action on a bill indefinitely.  It’s effective only when leadership seeks passage of popular bills by unanimous consent rather by scheduling time-consuming floor debate.  So to get around Coburn’s hold, Sen. Harry Reid (D-Nev.), majority leader, has placed S. 1963 on the Senate calendar which could mean up to 60 hours of debate during which Coburn can make his points publicly and often to colleagues and C-Span cameras.

Hart said protests from veterans and their organizations, by e-mail and phone, are pouring in but they don’t influence the senator.

“He’s done the same thing on hundreds of bills,” Hart said.  “He held up a breast cancer research bill because it duplicated existing breast cancer research, and all the breast cancer groups were upset.   His mindset is let’s make the hard choices so the next generation can enjoy the same freedoms we enjoy.  He’s willing to endure the wrath of any group to advance that.”

CORRECTION – Last week’s column on the Survivor Benefit Plan used analysis from the think-tank CNA as presented in a September memo to the deputy commandat of the Marine Corps.   After several readers questioned those figures on SBP costs and benefit, CNA analyst Anita Hattiangadi reviewed the material and found two significant errors.

First, in the example of a typical 40-year-old military retiree who dies at age 65, he will have paid a total of $47,703 in SBP premiums, not $62,000.  What the $62,000 actually represents is the most premiums the retiree would have to pay regardless of when he dies, said Hattiangadi.

Also, the $401,897 figure given for total payments that a retiree’s widow would receive if she were to live just seven years past his death, until age 70, was wrong.  The correct amount is $241,000.  The larger figure should have been labeled by CNA as total SBP paid to the 63-year-old surviving spouse if she lived to age 85, her normal life expectancy.

Hattiangadi said her “main point still holds: SBP is a great deal for service members and their families.”   She referred to a more thorough cost-benefit analysis of SBP and its relative value prepared by the Defense Department’s Office of the Actuary.  The link to that online is: http://actuary.defense.gov/program/sbpsubsidy09.xls

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