Small change, big impact: Creating a separate budget category for VA health care

President Biden recently recalled a pearl of wisdom from his father, who used to say, “show me your budget and I’ll tell you what you value.” Well, this year’s budget request shows once again how deeply this president — and our country — values veterans, their families, caregivers and survivors.

The president submits a budget proposal every year, but President Biden’s budget for FY 23 is special for two reasons. First, it seeks to invest the highest amount ever in our nation’s veterans — $301.4 billion for the world-class care and benefits vets so rightly deserve. Second, it asks that Congress separate out Department of Veterans Affairs health care as its own category of discretionary funding. That second piece may seem relatively inconsequential compared to the first, but it’s not. It’s a fantastic idea that — if adopted by Congress — will help ensure veterans get the health care they need when they need it.

Historically, the VA health care budget for veterans has been grouped together in one budget category with the budgets for other governmental agencies — meaning VA has had to compete with other non-defense departments and agencies for financial resources in the budgetary process. Under President Biden’s proposal, however, VA health care would be its own separate budget category. This change would send a clear message that VA health care should not be subject to competition with other funding needs — it is a sacred obligation we owe to those who serve, and we must fulfill that obligation each and every year.  

This budgetary change is particularly important now because the health care needs of veterans are becoming more complex, which means the cost of VA health care is rising. Since President Biden took office, VA has delivered more care to more veterans than ever before. Moreover, VA funding has more than doubled since 2013, and it will likely increase further in the coming years as President Biden delivers long-overdue presumptive benefits and care to vets who suffer from conditions related to military environmental exposures.

If we maintain the budgetary status quo amidst this continued growth, we will risk underfunding VA at a time when veterans need us most. Additionally, if we maintain the status quo, we will risk underinvesting in other non-defense agencies due to the growth of VA health care. This would be a bad outcome for all Americans — including veterans who often benefit directly from the federal programs that are currently competing against the VA for resources.

Just look at the Department of Health and Human Services, for example, which has saved countless veterans’ lives during the pandemic by leading the development of the COVID-19 vaccine; look at the Indian Health Service which helps care for tribal veterans every day; and look at the Department of Housing and Urban Development which is one of VA’s steadfast partners in our efforts to end veteran homelessness. These departments do fantastic work that benefits all Americans, and they need and deserve budgetary investments. But under the current budgetary structure investments in veterans’ health care accounts come at the expense of this important funding for other agencies which also provide opportunities for veterans and their families.

So, it’s time for a change.

Creating a separate budget category for VA health care would cement our country’s commitment to caring for veterans without cutting other non-defense discretionary investments. It would also mean greater scrutiny for VA, which we welcome.

At the end of the day, most veterans don’t know or care how many budget categories there are — they simply want to know they will get the world-class health care and benefits they’ve earned through their service. That’s what we as a nation owe them, and by adopting President Biden’s proposal for a new budgetary structure, we will be better positioned to fulfill that sacred obligation to Veterans for generations to come.

Denis McDonough is the 11th Secretary of Veterans Affairs.