[House Document 109-46]
[From the U.S. Government Publishing Office]




 
109th Congress, 1st Session                    House Document 109-46


                 REQUEST FOR FY 2006 BUDGET AMENDMENTS

                               __________

                             COMMUNICATION

                                  from

                   THE PRESIDENT OF THE UNITED STATES

                              transmitting

A REQUEST FOR A FY 2006 BUDGET AMENDMENT FOR THE DEPARTMENT OF VETERANS 
                                AFFAIRS




July 18, 2005.--Referred to the Committee on Appropriations and ordered 
                             to be printed
                                            The White House
                                         Washington, July 14, 2005.
Hon. J. Dennis Hastert,
Speaker of the House of Representatives,
Washington, DC.
    Dear Mr. Speaker: My Administration is committed to 
ensuring that our Nation's veterans continue to receive timely 
and high-quality health care. To this end, I ask the Congress 
to consider the enclosed $1.977 billion FY 2006 budget 
amendment for the Department of Veterans Affairs (VA). I am 
requesting these resources to cover the expected increased 
costs in FY 2006 that VA will experience in its medical care 
budget.
    The details of this proposal are set forth in the enclosed 
letter from the Director of the Office of Management and 
Budget.
            Sincerely,
                                                    George W. Bush.
                [Estimate No. 8, 109th Cong., 1st Sess.]

                 Executive Office of the President,
                           Office of Management and Budget,
                                     Washington, DC, July 14, 2005.
The President
The White House.
    Submitted for your consideration is a request for a $1.977 
billion FY 2006 budget amendment for the Department of Veterans 
Affairs (VA) medical care budget. The discretionary budget 
authority proposed in your FY 2006 Budget would be increased by 
this amount. With this amendment, discretionary spending 
proposed in your Budget would grow by 2.3 percent, less than 
the expected rate of inflation, and non-security discretionary 
spending would be held below the FY 2005 level.
    The VA has recently determined that due to unanticipated 
growth in the number of patients using the VA health care 
system and the increased cost per patient of providing this 
care, the FY 2005 enacted budget and the FY 2006 proposed 
budget include insufficient funding. On June 28, 2005, 
Secretary Nicholson informed the Congress of additional needs 
for the VA medical care system. On June 30, 2005, you submitted 
a $975 million supplemental request to Congress to address FY 
2005 needs. In that supplemental request you indicated that the 
Administrtion would be submitting a budget amendment for FY 
2006.
     The details of this FY 2006 request and how the request 
rlates to the FY 2005 supplemental funding request that was 
transmitted to the Congress on June 30,2005, are described 
below.
FY 2005 supplemental I
    The FY 2005 supplemental for VA medical care proposed a 
$975 million increase for VA to cover a 2.9 percent unexpected 
increase in the number of patients in 2005. VA predicted a 2.3 
percent increase in patients and now predicts that number to be 
5.2 percent.
FY 2006 budget amendment
    The components of the amendment are:
    An additional $300 million to meet FY 2005 needs. The 
supplemental covered the increased cost for the additional 
number of new patients. However, new VA data indicate that the 
average cost per patient in the entire system has increased by 
one percent because of the increasing number of visits per 
patient and the complexity of their conditions. The President's 
original budget assumed that VA would carry over funding from 
FY 2005 to meet FY 2006 needs, but now $300 million of that 
expected carryover will be used for the re-estimated FY 2005 
needs. The FY 2006 budget amendment will cover the loss ofthis 
expected carryover.
    A $677 million increase for VA to cover an estimated 2.0 
percent increase in the number of patients expected to seek 
care in FY 2006. The President's Budget assumed 5.2 million 
patients in FY 2006 and VA now predicts this number to be 5.3 
million patients.
    A $400 million increase to recognize that the average cost 
per patient in the entire system will continue to grow in FY 
2006 to 1.2 percent more than expected.
    A $600 million upward revision to correct for the estimated 
cost of long-term care.
Recommendation
    I have carefully reviewed this proposal and am satisfied 
that this is necessary at this time. Therefore, I join the 
Secretary of the Department of Veterans Affairs in recommending 
that you transmit this amendment to the Congress.
    Sincerely,
                                         Joshua B. Bolten, Director
    Enclosures
                        FY 2006 Budget Amendment


                     DEPARTMENT OF VETERANS AFFAIRS


                            Medical Programs


                            MEDICAL SERVICES

FY 2006 Budget Appendix Pages: 893-897
FY 2006 Pending Request: $22,377,141,000 (includes two 
        legislative fee proposals)
Proposed Amendment: $1,977,000,000
Revised Request: $24,354,141,000
    (In the appropriations language under the above heading, 
delete ``$19,789,141,000'' and substitute 
``$21,766,141,000''.)$22,377,141,000 (includes two legislative 
fee proposals)
    This amendment would increase the resources available to 
the Medical Services Fund to address an increase in the demand 
and cost for VA medical care that began in FY 2005 and will 
continue through FY 2006.
    The request would increase FY 2006 outlays by 
$1,810,338,900.

                                
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