MILITARY UPDATE: Bill would pay for wounded care

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 measures.

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 health care initiative, the Caregivers and Veterans Omnibus Health Services Act of 2009.

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 the hours they spend hours and the level of care they provide. The Department of Veterans Affairs 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.

The idea is to give 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 by cutting expenses elsewhere or raising taxes.
Coburn “believes strongly if we don’t start paying for things we’re not going to have a country left to defend,” Hart said.

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 cost of war.

Another reason Coburn is blocking the bill, Hart said, is it isn’t fair to extend caregiver benefits to wounded from Iraq and Afghanistan but not to those severely injured in earlier conflicts.

Finally, Coburn believes the 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 the bill on the Senate calendar which could mean up to 60 hours of debate during which Coburn can make his points publicly.

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.”