[House Document 109-39]
[From the U.S. Government Publishing Office]




109th Congress, 1st Session - - - - - - - - - - - - - House Document 109-39


                 REQUEST FOR FY 2005 BUDGET AMENDMENTS

                               __________

                             COMMUNICATION

                                  from

                     THEPRESIDENTOFTHEUNITEDSTATES

                              transmitting

 
A REQUEST FOR FY 2005 SUPPLEMENTAL APPROPRIATIONS FOR THE DEPARTMENT OF 
                            VETERANS AFFAIRS




June 30, 2005.--Referred to the Committee on Appropriations and ordered 
                             to be printed


                                           The White House,
                                     Washington, DC, June 30, 2005.

Hon. J. Dennis Hastert,
Speaker of the House of Representatives,
Washington, DC.

    Dear Mr. Speaker: I ask the Congress to consider 
expeditiously the enclosed request in the amount of $975 
million for a supplemental appropriation for the Department of 
Veterans Affairs (VA).
    I am requesting these resources to cover the increased 
costs in FY 2005 that the VA is experiencing in its medical 
care system.
    As Secretary Nicholson informed the Congress on June 28th, 
additional needs in the VA medical care system have also been 
identified for FY 2006. Details on specific FY 2006 
requirements are under review and will be transmitted 
separately. My Administration is committed to ensuring that our 
Nation's veterans continue to receive timely and high-quality 
health care.
    The details of the FY 2005 request are set forth in the 
enclosed letter from the Director of the Office of Management 
and Budget.

            Sincerely,
                                                    George W. Bush.



               [Estimate No. 7, 109th Congr., 1st Sess.]

                 Executive Office of the President,
                           Office of Management and Budget,
                                     Washington, DC, June 30, 2005.

The President,
The White House.


    Submitted for your consideration is a request for an FY 
2005 supplemental appropriation in the amount of $975 million 
to fund the Medical Services account within the Department of 
Veterans Affairs (VA) Medical Care budget. This request is in 
addition to the $28.0 billion already appropriated for FY 2005 
medical care costs.
    As Secretary Nicholson testified on June 28, 2005, the 
actuarial model used by the Administration forecasted 2.3 
percent annual growth in health care demand in FY 2005. The 
Administration recently discovered that growth had accelerated 
through April 2005 to 5.2 percent above FY 2004, which is 
almost 3 percent above the Administration's annual projection.
    A significant, but not the predominant component of this 
growth, is the increase in the number of veterans, including an 
increased number of reservists, who are entitled to receive 
medical care from the VA as a result of their combat service in 
the Global War on Terror. While VA's estimate of those 
returning from Iraq and Afghanistan in FY 2005 has increased 
from its initial projection, these individuals are generally in 
good health and most do not need intensive health care. Many of 
them are being treated for dental care only--an area in which 
VA has seen considerable cost growth. A relatively small 
percentage of these veterans treated by VA in 2005 who have 
returned from the current combat theatres are traumatically 
disabled. The majority of the increased cost is due to higher 
utilization of services by veterans from prior combat eras.
    The Department had been planning to defer $600 million from 
anticipated capital items (equipment and non-emergency, non-
recurring maintenance) as well as to expend $375 million in 
planned carryover into FY 2006, on VA medical care costs. This 
supplemental will ensure VA has the funds it needs to continue 
scheduled maintenance and capital improvements, as well as to 
replenish the $375 million projected carryover into FY 2006.
    I have carefully reviewed this proposal and am satisfied 
that it is necessary at this time. Therefore, I join the 
Secretary of Veterans Affairs in recommending you transmit the 
proposal to the Congress.
    Details on specific FY 2006 requirements are under review 
and will be transmitted separately. Your Administration remains 
committed to ensuring that our Nation's veterans continue to 
receive timely and high-quality health care.

            Sincerely,
                                          Joshua B. Bolten,
                                                          Director.
    Enclosure.



                     DEPARTMENT OF VETERANS AFFAIRS

                     Veterans Health Administration

                            MEDICAL SERVICES

    For an additional amount for ``Medical Services,'' 
$975,000,000 to remain available until--expended.
    At the beginning of FY 2005, the VA medical care system was 
expecting an increase in patients over FY 2004 of 2.3 percent, 
but is now estimating an increase of 5.2 percent resulting in 
an increased need of $975 million.

                                  
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