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The New York Times
February 7, 2005
Bush Budget Raises Prescription Prices for Many Veterans
By ROBERT PEAR and CARL HULSE

WASHINGTON, Feb. 6 - President Bush's budget would more than double the 
co-payment charged to many veterans for prescription drugs and would 
require some to pay a new fee of $250 a year for the privilege of using 
government health care, administration officials said Sunday.

The proposals, they said, are in the $2.5 trillion budget that Mr. Bush 
plans to unveil on Monday. White House officials said the budget 
advanced his goal of cutting the deficit, which hit a record last year.

"We are being tight," Vice President Dick Cheney said on "Fox News 
Sunday." "This is the tightest budget that has been submitted since we 
got here."

The proposals to increase charges to veterans face stiff opposition from 
veterans organizations, Democratic members of Congress and some Republicans.

Mr. Cheney said the White House had judiciously identified scores of 
domestic programs to be cut or eliminated. "It's not something we've 
done with a meat ax, nor are we suddenly turning our backs on the most 
needy people in our society."

The proposals could provoke months of furious debate on Capitol Hill. 
Democrats have already indicated that they are poised to pounce on any 
sign that the Bush administration is stinting on veterans' benefits.

Over all, the president is seeking $70.8 billion for the Department of 
Veterans Affairs in the fiscal year that begins Oct. 1, say 
Congressional aides who have seen budget documents from the agency.

The total consists of $33.4 billion in discretionary spending, which is 
subject to annual appropriation by Congress, and $37.4 billion for 
entitlements, like disability compensation, survivor benefits and 
pensions, which are authorized under prior laws.

Health care accounts for almost all of the agency's discretionary 
spending. Mr. Bush is seeking an increase of 2.7 percent, or $880 
million, in such spending.

The president would increase the co-payment for a month's supply of a 
prescription drug to $15, from the current $7. The administration says 
the co-payment and the $250 "user fee" would apply mainly to veterans in 
lower-priority categories, who have higher incomes and do not have 
service-related disabilities.

The government had no immediate estimate of how many veterans would be 
affected if the user fee and co-payment proposals were adopted. But 
veterans' groups said that hundreds of thousands of people would end up 
paying more and that many would be affected by both changes.

Veterans groups attacked the proposals. Richard B. Fuller, legislative 
director of the Paralyzed Veterans of America, said: "The proposed 
increase in health spending is not sufficient at a time when the number 
of patients is increasing and there has been a huge increase in health 
care costs. It will not cover the need. The enrollment fee is a health 
care tax, designed to raise revenue and to discourage people from 
enrolling."

Mr. Fuller added that the budget would force veterans hospitals and 
clinics to limit services. "We are already seeing an increase in waiting 
lists, even for some Iraq veterans," he said.

In Michigan, for example, thousands of veterans are on waiting lists for 
medical services, and some reservists returning from Iraq say they have 
been unable to obtain the care they were promised. A veterans clinic in 
Pontiac, Mich., put a limit on new enrollment. Cutbacks at a veterans 
hospital in Altoona, Pa., are forcing some veterans to seek treatment 
elsewhere.

But Cynthia R. Church, a spokeswoman for the Department of Veterans 
Affairs, defended the administration's record. "Our budget increase from 
2001 to 2005 for health care alone has been more than 40 percent," Ms. 
Church said. "President Bush has kept his commitment to veterans."

The department expects to care for five million people at its hospitals 
and clinics this year. Under the new budget, the agency will focus on 
what officials describe as their "core constituency," including veterans 
with service-related disabilities or low incomes.

The budget also advances previously announced plans to close or scale 
back some veterans hospitals. Money spent on underused buildings and 
excess land could be better spent providing care to veterans, the agency 
said.

Veterans groups want a $3.5 billion increase in the department's health 
care budget next year, but Congressional aides said the request was 
unrealistic.

Other budget details came to light over the weekend as well. Sifting 
through documents, Tobin L. Smith, a policy analyst at the Association 
of American Universities, which represents 60 large research 
universities, found a shift in priorities at the Pentagon.

"In the budget request for 2006," Mr. Smith said, "Defense Department 
spending for science and technology is significantly reduced, while the 
budget for development, testing and evaluation of major weapons systems 
increases."

The Pentagon budget provides $10.5 billion for science and technology in 
2006, a reduction of $2.5 billion from this year's level, he said.

"We are concerned about that change because it means the Defense 
Department will be providing less support for university research," Mr. 
Smith said. "Engineering and computer science will be particularly hard 
hit."

The new budget will not show the costs of the president's top domestic 
priority, revamping Social Security to let people divert some of their 
payroll taxes to individual investment accounts.

To finance the change, Mr. Cheney said, the federal government would 
need to borrow $750 billion in the next 10 years and "trillions more 
after that." But, he said, "the personal accounts will themselves 
provide a significant return for those who hold them, so that they'll 
get a better deal."

Any effort to restrain spending on veterans programs is sure to provoke 
strong criticism from Democrats, who contend that the Republican-led 
Congress and the Bush administration have already shortchanged current 
and former members of the military.

In recent years, Democrats have been trying to emphasize their support 
of veterans programs, taking aim at a constituency that has been seen as 
reliably Republican. The administration's effort has caused some 
discomfort for Republicans.

In early January, House leaders ousted the chairman of the Veterans 
Affairs Committee, Representative Christopher H. Smith, Republican of 
New Jersey, who was seen as a strong advocate of veterans programs and 
higher spending. Mr. Smith was replaced by Representative Steve Buyer, 
Republican of Indiana.

Jim Nicholson, the new secretary of veterans affairs, heard many 
concerns about veterans' health care when he had his confirmation 
hearing before a Senate committee last month.

Senator Larry E. Craig, Republican of Idaho, chairman of the panel, the 
Committee on Veterans Affairs, told Mr. Nicholson, "The fiscal 
environment that you inherit will be considerably less friendly than the 
relatively flush times the V.A. has enjoyed over the last four years."

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