Government Executive - Authors - Stacy Kaper

Lawmakers Attack Obama Administration’s Strategy in Iraq

Stacy Kaper, National Journal — Thu, 24 Jul 2014 16:34:07 -0400

In its second day of testimony on Capitol Hill, the Obama administration tried once again to prove it has a handle on the situation in Iraq, where a terrorist uprising has gained key strongholds and driven tens of thousands of refugees to flee across its crumbling borders.

At a heated hearing Thursday with officials from the State and Defense departments, Senate Foreign Relations Committee members took turns poking holes in the U.S. strategy, asking a litany of questions about the administration's assumptions and plans for handling the Islamic State of Iraq and Syria.

Committee Chairman Robert Menendez questioned why the administration has faith that Iraq will form an effective "functional federalist" state as the U.S. envisions, particularly if Prime Minister Nouri al-Maliki remains in power.

"Many say what is happening on the ground is accelerating towards a breakup of Iraq because too many Iraqi communities no longer trust the Maliki government, and the question is whether we can do anything to prevent it," the New Jersey Democrat said.

Brett McGurk, the deputy assistant secretary of State for Iraq and Iran, who just returned from Iraq, argued that there is an "emerging consensus" around this model of decentralizing power but keeping the state together, "in which you recognize a very substantial devolution of authorities to principles of local security control."

Administration officials argued Wednesday that U.S. interests are best served if Iraq does not break up into smaller ethnic factions.

But Menendez questioned whether such aspirations are realistic given the unstable security and political situation.

"Can you even get to a federalist model the way things are evolving in Iraq?" he asked. "If it ends up being the prime minister is Maliki, how do you think that you keep this nation together?... Isn't the likely outcome of that to be more possible to see a divided Iraq?"

McGurk stuck to his guns that the U.S. is not getting involved in whether Maliki should stay or go, but he acknowledged his continued leadership would present challenges. "It remains to be seen whether the existing prime minister could build such a consensus, but that remains very much a question," he said.

State and Defense officials said they have had the Islamic State on their radar for years but only picked up on the threat that Mosul would be taken days before it was stunningly seized without Iraqi Security Forces putting up a fight. Particularly in light of such a security collapse, Defense officials are reviewing assessments of Iraqi Security Forces and the situation on the ground with plans to update Obama soon on his military options.

But Menendez argued that the committee would be reluctant to approve any future arms sales to Iraq unless the assessments are shared with Congress and can demonstrate that the Iraqi Security Forces are competent, after watching U.S. weapons fall so easily into the hands of terrorists.

"Unless you are going to give us a sense of where the security forces are at, moving forward, this chair is not going to be willing to approve more arms sales so that they can be abandoned to go to the hands of those that we are seriously concerned about in terms of our own national security," he said.

Administration officials argued they are trying to address ISIS's advancement in Iraq as a regional conflict that threatens the broader area and are soliciting the assistance of allies in the region.

But several committee members criticized the administration's handling of the situation, particularly the lack of more proactive action to address the civil war in neighboring Syria, which has become a training camp for ISIS suicide bombers and a safe haven for terrorists.

"People on this committee have been saying for like a year and half that when the time was right—when we could have taken steps in Syria that could have prevented this—they weren't taken," said Republican Sen. Bob Corker of Tennessee, the panel's ranking member.

Corker added that he questions whether Obama's interest in sending $500 million to support Syrian rebels now amounts to too little too late.

"I now have gotten to the point where I question, I hate to say it, how effective that's going to be at this point," he said.

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Does the Next VA Secretary Face an Impossible Task?

Stacy Kaper and Jordain Carney, National Journal — Tue, 22 Jul 2014 16:51:59 -0400

As President Obama's pick to lead the embattled Veterans Affairs Department out of its current crisis, Robert McDonald faces a tall order from the senators who will decide his fate.

Members of the Senate Veterans' Affairs Committee insist that McDonald will need to overhaul the VA at once if he is confirmed. That includes everything from installing new leadership and transforming its culture to restoring accountability and ensuring that veterans receive prompt medical treatment.

"How does the VA—among other things—provide timely, quality health care?" committee Chairman Bernie Sanders of Vermont said in an interview just ahead of McDonald's confirmation hearing Tuesday. "How do we continue ... lowering the claims backlog? How do we make sure that the numbers that are coming out are accurate? How do we develop accountability at the VA? ... These are very difficult issues."

McDonald said that, if confirmed to oversee the department, he would take action on reforms during his first 90 days in office, telling lawmakers that he "will put the veteran at the center of everything we do."

The VA has been under fire in recent months after allegations of data manipulation at its medical facility in Phoenix that included reports of veterans dying while waiting for care.

Acting Secretary Sloan Gibson told lawmakers late last week that investigations into roughly 70 VA facilities are not expected to wrap up until mid-August.

Committee ranking member Richard Burr of North Carolina told McDonald that if he is confirmed, "it will be essential that you embrace the findings of these investigations."

The major hurdles McDonald faces are proving that the VA is being held accountable for its misdeeds and can turn itself around immediately by taking care of the millions of veterans under its charge, committee members stressed Tuesday.

"The biggest challenge is obviously getting the system nationally to be able to deliver much more rapid-response health care to our veterans," Democratic Sen. Mark Begich of Alaska said in an interview shortly before McDonald's hearing. "Second, I think he has a culture within the VA that he has to move kind of into this 21st century of how to respond to this very complicated health care delivery system that we have."

Begich added that McDonald faces not just a budget issue, but a recruitment challenge of hiring more doctors and other essential health care professionals.

"He has to kind of rebuild that image, rebuild that trust, and be able to deliver health care in a much more expedited way to veterans across the country."

Getting the American people—veterans in particular—to trust the VA must be his first order of business, some senators said. They added that this will require a significant housecleaning.

"First and foremost, making sure the information is accurate and truthful, getting good information" would be McDonald's top challenge, said Democratic Sen. Richard Blumenthal of Connecticut. "Second, changing the culture. Bringing tough standards to bear and making sure that they are met. And third, changing the people—making sure that there is new leadership and that they are part of the new culture."

Despite the laundry list of demands, McDonald is expected to have a smooth confirmation process. A handful of Republican senators--often tough critics of the VA--told McDonald that his confirmation is all but guaranteed. Lawmakers are hopeful that he can use the managerial skills he honed in the private sector—including during a stint as the CEO of Procter & Gamble—to whip the department into shape.

If confirmed, McDonald will replace Eric Shinseki, who stepped down as secretary in late May amid growing allegations of misconduct at VA offices across the country. Sloan Gibson has served as acting secretary since then.

But the scandal goes beyond the VA's health administration. On the other side of Capitol Hill, House Veterans' Affairs Committee members—led by Republican Rep. Jeff Miller of Florida—are looking into allegations that disability-claims workers cooked the books or destroyed information. Whistleblowers across the VA have come forward and testified before Congress about allegations of retaliation.

Linda Halliday, the assistant inspector general for audits and evaluations, told lawmakers last week that the VA's Office of Inspector General is investigating data-integrity complaints with VA claims at its offices in Baltimore, Philadelphia, Los Angeles, Oakland, Houston, and Little Rock, Ark.

And though lawmakers on both sides of the aisle have missed little opportunity to criticize the embattled department, legislation that would provide extra funding and allow veterans greater access to private health care is stuck in a conference committee, with no break in the logjam in sight.

In a bit of political football, Senate Majority Leader Harry Reid has blamed Republicans on the conference committee, saying they are unwilling to provide extra funding for veterans, despite supporting the recent wars.

But with the monthlong August recess looming, Sanders and Miller have said they were still hopeful an agreement could still be reached, despite the "tough negotiations."

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Are Budget Battles Slowing Health Care Reforms for Veterans?

Stacy Kaper, National Journal — Wed, 09 Jul 2014 10:11:22 -0400

As lawmakers scramble to push through legislation that aims to stop veterans from dying waiting for health care, veterans' groups hope funding squabbles over the cost of the reforms don't impede veterans' access to medical treatment.

The House and Senate are still struggling to push legislation over the finish line in response to reports raised back in April that veterans seeking health care have been left languishing for months on secret wait lists--or never even making it into the queue. Lawmakers were expected to send reform legislation to the president before the Fourth of July recess, but they failed to reach an agreement in time. They're now under pressure to show results before Congress breaks again at the end of the month.

Not wanting to let the momentum from the crisis wane, veterans service organizations are trying to: coax lawmakers to prioritize reforms, help them convince the Congressional Budget Office to lower its cost assumptions, and guarantee a funding stream is put in place.

The legislation the House and Senate conference committee is working to iron out would make it easier to remove incompetent officials at the Veterans Affairs Department and ensure veterans receive more timely care, even if it means going outside the VA.

The reform enjoys broad bipartisan support, but it's suffering from sticker shock over estimates by the non-partisan CBO that it could cost as much as $50 billion a year to implement.

Some veterans' groups fear that lawmakers could succumb to pressure to show fiscal restraint and rely on budget gimmicks that bring the legislation's cost estimates down, but that don't provide sufficient resources to ensure veterans' access to care will be met.

"Our biggest concern is the funding," said Joseph Violante, the national legislative director, with the Disabled American Veterans. "There is no clear path here that I can see that VA is going to get the funding they need. ... It's frustrating, because veterans are going to have high expectations of being able to get timely care, whether that's in the private sector or at the VA, and I don't know that VA is going to be able to fulfill that."

Other veterans' advocates are focusing on working with conference committee members and the CBO to ensure the key goals of the legislation are achieved while still keeping the costs down.

For example, a big part of the reason for the CBO's higher-than-expected cost estimate was its assumption that some 8 million additional veterans might flock to the VA, given the expected improved access to health care.

The bills under consideration would restrict the veterans who could seek care outside the VA to those who live more than 40 miles from a VA health center. But other restrictions that would keep costs down are under consideration, such as requiring that only veterans who were left waiting by the VA can go outside it for treatment.

"We've encouraged CBO to give Congress an estimate of just what it would cost to address the current veterans who are currently enrolled, who are existing on the backlog today, because that was what this legislation was originally designed to address," said Louis Celli, the legislative director with the American Legion. "If we had that estimate, I think everybody would be much more comfortable with the fact that this is an emergency piece of legislation specifically designed to address this backlog, and if we use it for that, the costs will be much more in line and in keeping with something reasonable to address this emergency."

Other veterans' organizations are so fed up with waiting for reforms to improve veterans' care that they are comfortable with lawmakers using a variety of budget tools to get the legislation signed into law. That's even if it means the VA will have to prove it's making progress in order to secure additional funds from Congress down the road to complete the reforms.

"There is a range of options to deal this from a budgetary perspective, and I think they are going to end up coming to an agreement on a way to move forward on the budget that recognizes the crisis aspect of this and that is also fiscally responsible," said Alex Nicholson, the legislative director of the Iraq and Afghanistan Veterans of America.

He predicted lawmakers would have to rely on a mix of using available resources at the VA, debt financing, and additional appropriations down the road, which he said was an acceptable solution.

"Our No. 1 priority is for them to get it done. It's concerning that it's stretched it out this far already," he said. "We don't want to see this delayed by posturing or fiscal tactics. The provisions that really expand and enhance the VA's capacity and flexibility to help people who are actually waiting right now and are not getting care and treatment—that should be the No. 1 priority."

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Remember the Veterans Health Care Crisis?

Stacy Kaper, National Journal — Mon, 07 Jul 2014 09:58:09 -0400

Having so far failed to complete reform legislation intended to ensure veterans don't die waiting for health care, lawmakers return facing significant unfinished business to show voters action before they go home to campaign in August.

The House and Senate are under the gun to show a response to reports that veterans have been left languishing for months on secret waiting lists for medical treatment, or never even getting onto such lists. Veterans are a popular constituency that neither party can afford to ignore, so the pressure is on to deliver something lawmakers can campaign on, before election season heats up.

But members serving on a joint House and Senate conference committee, tasked with hashing out veterans reform legislation, made little headway before recess.

The 28 committee members agreed they are committed to a bipartisan solution that will make it easier for veterans to receive the care they deserve. But several—particularly Republicans—remain hung up over concerns about estimates from the nonpartisan Congressional Budget Office that the reforms could cost as much as $50 billion a year.

The legislation would make it easier to remove incompetent Veterans Affairs Department leaders. It also aims to ensure veterans receive more timely care, including by letting veterans who live more than 40 miles from a VA health center seek care from private providers.

But lawmakers largely do not want to be seen doubling the government's cost of VA health care to achieve this goal.

Before recess, at the only public meeting of the conference committee, Sen. Richard Burr, R-N.C., who serves as the ranking member on the Senate Veterans Affairs Committee, blasted the CBO numbers, calling the agency's assumptions "ludicrous" and challenging it to back them up.

Since then members and staff have met behind closed doors with CBO officials, asking for a justification of its assumptions. CBO has argued that because the legislation aims to improve access to VA health care and minimize wait times, veterans are likely to increase the amount of care they receive from the VA. And veterans who do not currently rely on the VA are also more likely to enroll in it and seek out this benefit.

Currently about 8 million of roughly 21 million veterans are enrolled in VA health care; of those, about 6. 5 million take advantage of it. CBO estimated that another 8 million eligible veterans might seek access to VA health care because of the improvements to its access that would be made through the legislation.

But some conference committee members are balking, challenging these predictions. They are asking CBO and the VA to come up with new estimates of what the legislation would cost if additional restrictions or limitations were placed on the expanded access to health care in a final bill.

"The first order of business is for VA and CBO to produce information regarding certain costs and considerations associated with possible reform permutations," said a congressional aide familiar with the negotiations.

No additional formal meetings of the full roster of conferees have been set, but individual members and staff continue to discuss ways to whittle down the projected costs of the reform.

Lawmakers say they are committed to hashing out a compromise bill and getting it through both chambers and to the president's desk as quickly as possible. But sources tracking the negotiations argue the cost wrinkles could take a while to iron out, making the August recess the next big deadline for completion.

"What needs to happen is the conferees need to agree upon the size and scope and cost … as well as some of the other initiatives in the bill," said Robert Norton, a deputy director of government relations with the Military Officers Association of America. "Our biggest concern is that they need to get it done. They need to make sure that veterans get access and are not stuck on these waiting lists for months on end."

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Big Hurdle for the VA Bill Is Its Price Tag

Stacy Kaper, National Journal — Tue, 24 Jun 2014 12:49:24 -0400

The House and Senate have agreed it's time for reform of the Veterans Affairs Department. Now they have to agree how to pay for it—and they have to do it quickly.

More than two dozen House and Senate lawmakers meet Tuesday to formally begin negotiations aimed at merging the two chambers' VA reform bills into one. The measures have some minor discrepancies, but the big challenge is how much the reforms will cost and where the federal government will find the funding.

It was a question the chambers largely sidestepped as they rushed to pass reforms in the wake of the VA scandal, which revealed that veterans were being placed on "secret" waiting lists for treatment, and that some had died during the wait.

The Senate deemed the reforms imperative and authorized emergency funding to provide whatever resources necessary to carry them out. Cementing that sentiment, 75 senators voted to waive budget offsetting pay-as-you-go rules to protect that provision. The House bill would instead require that the reforms be funded by Congress's appropriations process.

The tension over payment has been heightened as the Congressional Budget Office has projected the measures to cost more than expected.

CBO has said the Senate bill could add as much as $35 billion in direct spending over 10 years, and ultimately cost the federal government an additional $50 billion a year as vets pursue additional health care options. The House bill—which seeks to slash health care wait times more expeditiously—is expected to entice more veterans into VA and private health care than the Senate bill would, costing the federal government a projected $54 billion per year.

"Their initial urge was to forget about funding altogether and get it past them, and now, of course, the whole process has slowed down, so now they are stuck with having to deal with budget reality. It's going to be difficult," said Joseph Antos, the Wilson H. Taylor Scholar in health care and retirement policy at the conservative American Enterprise Institute. "This is a problem for Republicans and Democrats alike."

But as Congress explores funding solutions, veterans groups will be watching carefully, pushing the lawmakers to provide specific, long-term funding for the reforms. Temporary funding or budget tricks, the groups say, could lead to a return to the status quo, where veterans continue to suffer from inadequate care.

"Congress and VA must not rely on budgetary gimmicks, such as unrealistic estimates of operational improvements, efficiencies, collections, carryovers, and contingencies. These undocumented 'savings' have rarely materialized and have contributed significantly to funding shortfalls that have plagued VA for more than a decade," the heads of more than a dozen veterans organization wrote to congressional leaders last week.

The groups fear that, given the political sensitivity of the issue and the coming Fourth of July recess, the groups will rush the bill through with an incomplete funding arrangement.

"They are not going back home for the July Fourth recess without having a bill on the president's desk. They all want something to go home and champion," said Louis Celli, the legislative director for the American Legion. "I think they have to with all the exposure on this.… The veterans need help, they need to be seen."

Analysts and congressional aides following the process expect lawmakers to pull out their fiscal tricks, including the use of arguably bogus funding sources or adoption of rose-colored assumptions about cost savings from certain programs. Alternatively, lawmakers could attempt cost-cutting by tightening restrictions on who would be eligible for care or limiting access by other means.

Most of the real wheeling and dealing is expected to take place behind closed doors, and negotiations among staffers have already begun.

Beyond funding woes, the lawmakers have a host of in-the-weeds details to hammer out before sending the bill to President Obama.

Both bills make it easier to fire incompetent senior VA leaders and aim to improve veterans' access to health care within and outside the VA.

But while the Senate bill would create an appeals process for fired VA leaders to contest their dismissal, the House bill lacks that provision. The Senate bill would also expand the GI bill's in-state tuition benefits further than separate House legislation would, including funding to the spouses of deceased veterans who would have qualified for the tuition break.

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Senate, House Expected to Name Conferees for VA Legislation Wednesday

Stacy Kaper, National Journal — Tue, 17 Jun 2014 17:33:57 -0400

Senate Veterans Affairs Committee Chairman Bernie Sanders made a plea Tuesday for continued support for legislation intended to stop a rash of preventable deaths of veterans waiting for health care.

Taking to the Senate floor, the Vermont independent parroted comments from Republican Sen. John McCain earlier in the day that if ever there was an emergency, the Veterans Affairs Department mess is it, and therefore is deserving of emergency funds to address it.

The House and Senate have each made the issue a priority and passed legislation last week intended to make it easier to fire incompetent leaders at the VA and expand health care services to vets beyond the VA, among other reforms. The chambers now need to work out differences to get a bill to President Obama and into law.

Sanders said he expects both chambers to appoint conferees Wednesday to serve on a conference committee to negotiate a compromise bill and said his staff has already begun preliminary conversations with staff for Republican House Veterans Affairs Committee Chairman Jeff Miller.

But one wrinkle is a nonpartisan Congressional Budget Office report. The CBO estimated that the Senate bill—which would skip budget offsetting, pay-as-you-go rules—could add as much as $35 billion in direct spending over 10 years and ultimately cost the federal government an additional $50 billion a year as vets pursue additional health care.

The cost estimate contributed to the loss of three Republican votes in the Senate and is adding complications to the more fiscally conservative House.

"In terms of balancing the budget, paying for things, figuring out where we're going ... clearly systemic reform and efficiency and effectiveness of operation is absolutely essential," House Minority Whip Steny Hoyer told reporters Tuesday, referencing the CBO score.

"What has happened in the VA and the impact it's had on our veterans is unacceptable, therefore we need to solve it. But that does not mean we need to not have any considerations for fiscal responsibility and sustainability over time, so yeah I think that will be part of the discussion," he added.

Seeking to shore up support, Sanders urged Senate colleagues to keep pushing to ensure reforms make their way into law quickly.

"My hope is that we can get this legislation onto the president's desk as soon as we possibly can," he said. "It is one thing to give heartfelt speeches about how much we love and respect veterans. It is another thing to act, and now is the time for action."

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Congress Could Almost Be Done With VA Reform for the Year

Stacy Kaper, National Journal — Thu, 12 Jun 2014 09:52:29 -0400

The Senate's passage Wednesday of legislation intended to stop veterans from dying waiting for health care is likely to be Congress's last major reform bill for the year to address failings in veterans' services or clean up the embattled Veterans Affairs Department.

The bill, which makes it easier to fire incompetent VA officials and expands veterans' access to health care, passed the Senate 93-3. The legislation still needs to be reconciled with similar legislation passed by the House before it can be sent to President Obama and implemented into law.

The reforms are being heralded on Capitol Hill as a significant step toward trying to cut down the long wait times for health care that have left veterans languishing in need of medical service for months on end—or unable to even get onto wait lists at all. But it doesn't come close to solving all of the problems facing veterans or the VA, such as the disability-claims backlog which has roughly 300,000 claims pending for 125 days or more and the total inventory of claims hovering just under 1.3 million. It also fails to address several shortcomings in benefits, planning for future veteran needs, and vulnerabilities in its funding structure.

"It's a huge concern," said Robert Norton, a deputy director of the Military Officers Association of America. "I would say we are worried that, assuming they pass the VA health care access and accountability, they probably will say, 'We are done for the summer.' They may come back and look at something in the fall, but more the likelihood is we may get kicked to the curb until after the elections and then we are into the lame duck."

Lawmakers themselves were mixed Wednesday on whether Congress would have the political will to come back to address any additional VA issues this year—or, frankly, whether additional veterans' legislation was necessary.

"I don't know what more legislatively [we need]," said Sen. John McCain, the Arizona Republican, who cosponsored the VA health care legislation. "But there are systemic problems, and this is a huge step in the right direction."

The House has passed a smorgasbord of bills to address a variety of VA issues, but the Senate was unable to pass an omnibus veterans' bill earlier this year from Senate Veterans Affairs Committee Chairman Bernie Sanders, largely because of Republicans' objections to its cost and offset.

With so much difficulty in getting bills through the Senate, once the chamber has tackled an issue, the sentiment is usually that the box has been checked. This is particularly true in an election year, where the window for legislating is condensed and the end of the year is typically left to play catch-up on expiring provisions and other must-pass measures that lawmakers were unable to finish—or unwilling to touch before November.

"I can guarantee there will be more issues," said Sen. Mike Johanns, a Nebraska Republican. "I think in terms of a major piece of legislation the answer is yes, this will probably be the last big reform bill on the VA this year, just simply because once legislation is passed, it does take some time for implementation just to see how it's working."

Both the House and Senate have primarily sought to use the power of the bully pulpit to put pressure on the VA to improve its backlog of disability claims. And there are a number of other veterans' benefits and advanced appropriation issues that veterans' groups want to see addressed, but they say they are worried they may have lost a golden opportunity for action.

"I'm hoping that the House and Senate and the administration do not ignore this issue," said Ronald Abrams, executive director with the National Veterans Legal Services Program, who works on veterans' claims issues. "Right now it burns brightly.... Once the outrage passes, stuff happens, and it goes to the back burner."

Joe Moore, an attorney and partner at Bergmann & Moore, a Bethesda-based law firm that handles Veterans' disability-claim appeals against VA, said Congress should do more to hold the VA's feet to the fire on processing disability claims and appeals.

"VA's inability to process disability claims in an accurate and timely manner would be improved significantly if VA shared accurate facts with Congress," he said.

"Congress should mandate that VA provide Congress frequent and transparent budgeting, staffing, training, accuracy, timeliness, and other pertinent facts, so VA can issue complete, accurate, and prompt disability-claim decisions for our veterans."

Louis Celli, legislative director at the American Legion, said the group would like to see the claims backlog issues addressed, an additional VA accountability measure from Maine Democrat Mike Michaud that would make the VA submit a 5-year plan, and urgent congressional pressure brought to bear on the VA's and Defense Department's plans to share health data.

"VA and DOD are bordering on contempt of Congress by not providing a comprehensive plan to fix the integrated health care records project, and the claims backlog," he said. "Every initial claim that is stalled represents a veteran who cannot access VA health care until they get their disability rating. Waiting for compensation aside, they need access to the VA."

The Military Officers Association of American and the Disabled American Veterans want to ensure that training available for home caregivers of disabled veterans is expanded beyond just Iraq and Afghanistan veterans to veterans of all conflicts.

These veteran' groups are also seeking to expand the VA accounts funded in advance, known as "advanced appropriations," to ensure that VA services are not vulnerable to gaps in coverage if there is another government shutdown.

Also on MOAA's wish list are provisions to expand survivor benefits to those who remarry as early as age 55 so that they are commensurate with other federal survivor benefits, and to allow career reservists eligible for pensions to be honored as veterans even if they never served on active duty.

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Senate Majority Leader Promises Immediate Action on VA Reforms

Stacy Kaper, National Journal — Mon, 09 Jun 2014 17:12:42 -0400

Senate Majority Leader Harry Reid vowed Monday to take action imminently on expected reforms to the Veterans Affairs Department.

The legislation, which was agreed to in principle last week, is still being drafted by Senate Veterans' Affairs Committee Chairman Bernie Sanders, I-Vt., and Arizona Republican John McCain.

But Reid promised Monday to bring the bill to the floor as soon as it's ready.

"I look forward to this legislation coming to the floor, and I would be happy to schedule a vote on it as quickly as possible," said the Nevada Democrat. "American veterans are depending on us completing this legislation, showing that our veterans are getting the care and resources they are promised by a grateful nation."

Reid praised the intention of the bill to reduce wait times for veterans' medical care, but noted that much of the specifics still need to be fleshed out.

"The details of the agreement are not in writing yet. At least they weren't a few minutes ago. They're being drafted.… Much will depend on the details of the final bill, but Senators Sanders and McCain put together an agreement, which is good for Americans and veterans in our country."

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4 Things Washington Could Do Right Now to Fix the VA

Stacy Kaper and Jordain Carney, National Journal — Fri, 23 May 2014 13:11:45 -0400

Part Three in a series on Veterans Affairs. Read Part One here and Part Two here.

The worst news: A government bureaucracy is standing between veterans and their health care, and veterans are dying because of it.

The bad news: Washington has already tried, and is now retrying, its typical responses to a crisis, and they're not working.

Money has been thrown at the problem and the problem is still there. An administrative head has rolled—and under a newly passed House bill, others would likely follow—and the problem is still there. And when politicians are done with their spastic grandstanding and finger-pointing, the problem will still be there.

There is no good news.

But there is hope of a silver lining: The veterans' deaths can be what galvanizes the government into fixing a system that has been far too broken for far too long. And if President Obama and Congress are willing to move past politicking to search for policy solutions, experts say there are steps that could be taken right now to better connect veterans with the care they need.

Here are four of them:

1. Congress could ask doctors—not veterans—to handle the paperwork.

Under the Veterans Affairs Administration's current system, veterans must fill out lengthy and complicated claims forms if they want reimbursement for their care, and those forms often arrive at the agency either incomplete or incorrect.

Compare that with the private insurance carried by most civilians, whose doctors typically submit reimbursement to the insurer. Were a similar process to be adopted by the VA, the agency would be receiving claims by legal professionals or military doctors who would be better trained and more accustomed to filling them out—and thus much more likely to file them accurately.

So what would it take to relieve veterans of the responsibility for filling out forms that most privately insured patients are free of?

An act of Congress, and a signature from Obama.

The VA claims process is set by statute, and so to change it lawmakers would have to pass new legislation allowing for changes. And there are other changes they might consider as well ...

2. Congress could require the VA to give more veterans the benefit of the doubt.

If Congress wanted to change the process to make life easier for veterans, they could also scratch the VA's policy of going through each and every claim filed. The IRS doesn't investigate every tax return. Medicare doesn't investigate every doctor bill. So why does the VA investigate each and every claim that veterans file?

Instead, the VA could mirror the private sector by generally approving the majority of claims that look accurate, and only auditing a sample or those that raise red flags, says Linda Bilmes of Harvard University's Kennedy School of Government.

"You should have the kind of process that you have at customs, where you don't check every bag. Because if you checked every bag of everyone stepping off the plane, you'd have a huge backlog," she said.

The VA expressed serious concerns about the proposal. According to a VA spokesperson, that system would "result in the majority of veterans getting monetary compensation for disabilities that cannot be determined to be due to service."

And while that may be true, at a time when Congress and Obama are declaring better care for veterans a national emergency, they should be ready to require the VA to err on the side of veterans.

3. The VA could start rewarding its employees for quality, not quantity.

For some reforms, the VA need not wait for Congress.

For example, the agency could immediately start developing new ways to evaluate its employees who process claims. The current system awards work credits to employees when they take a step on a claim—be it a denial or an acceptance. But that pushes an employee to focus on speed, and leaves few penalties for mistakes.

Take this hypothetical: An Iraq war veteran applied for a disability claim for post-traumatic stress in January and was erroneously denied in March. Then she tried again and was denied two more times in June and in November. Say, then, the veteran were to make a fourth attempt in December, and say the VA were to realize it had been wrong all along and award the compensation, the agency would claim credit for processing each attempt—without docking points for the fact that they had just wrongfully denied a veterans' claim three times, and kept her waiting for nine months.

"What has to change is the way the VA counts its work. As long as VA employees have an incentive to go fast and not process claims correctly they will do so. That is so obvious," said Ronald Abrams, the joint executive director with the National Veterans Legal Services Program, who has worked on VA claims for 40 years, including 14 at the agency.

Changing the incentive structure needs no act of Congress, or an executive order from Obama—though either would make it more likely to happen. Instead, the VA has the power to start making those changes the moment it decides to.

It's not, however, a fix without consequences. The trade-off between speed and accuracy leaves the VA in a bind, as both are going to be needed to resolve the backlog. But resolving the backlog is meaningless unless it means getting care to the veterans trapped in it. And as the wait time for claims has dropped, the number of appealed claims has risen. (For more on the appeals controversy, see Part One on Obama's efforts to eliminate the backlog.)

4. Congress can pressure the Pentagon and the VA to share electronic files.

The VA stands to benefit greatly from the Defense Department's information—and now there is a relatively easy way to share it: electronic health records. But for whatever reason, that isn't happening, and the VA's performance is suffering for it.

Claims routinely stall as the VA waits to get service records from the Pentagon, as VA staffers use those records to help determine if an injury is related to a veteran's time in the military.

Being able to share health records electronically has been a long-standing goal for the departments, dating all the way back to 1998. And under Obama, they planned to build a joint platform for records sharing. But the project was dropped in 2013 after costs ballooned into the billions. The Pentagon is now putting out a contract for a Defense Department-wide health record system, and the VA is among the bidders. The agency plans to build upon its current record system and see if the Pentagon will pick it.

But though integration still remains the end goal, the details on how to get there are unclear at best. The departments have yet to "disclose what the interoperable electronic health record will consist of, as well as how, when, and at what cost it will be achieved," according to a Government Accountability Office report released in February.

Congress has thus far been little help, setting arbitrary deadlines that don't get met. But the power of the pulpit pales in front of the power of the purse, and Congress has both. If lawmakers want to force both the Pentagon and the VA to better coordinate, that gives them plenty of pressure points: either by writing specific requirements into the budget or freezing bonuses and other fiscal goodies until the officials get the job done.

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The VA Is a Disgrace. Is Obama to Blame?

Stacy Kaper and Jordain Carney, National Journal — Tue, 20 May 2014 09:40:21 -0400

Part Two in a National Journal series on Veterans Affairs. Read Part One here.

Failure is an orphan—and there are few failures more toxic than those of the Department of Veterans Affairs.

The agency, ostensibly created to help veterans heal from the wounds of war, is plagued by a backlog of claims from soldiers seeking help, leaving them to wait months or even years for compensation.

There's consensus that the backlog is unacceptable, and President Obama's administration pledged to eliminate it by the end of 2015. But the agency—and the backlog—is getting new attention due to a spate of deaths at VA hospitals, and Republicans are attempting to pin the agency's failures squarely on the president.

Looking for a lone villain in the VA debacle, however, is a fool's errand. It's true that—despite holding the world's most powerful post for five years—Obama is yet to eliminate the long waiting times for veterans seeking help. Blaming him alone, however, is to ignore roots of the problem that stretch back decades before Obama took the Oval Office.

Instead, the sheen of shame over the VA's failures spreads across time and party affiliation. It stains the legacies of presidents as far back as John F. Kennedy and condemns past Congresses whose poor oversight allowed the problem to fester. The VA itself is also not without fault, as bureaucracy and intransigence let the agency deteriorate to the point the problem became nearly impossible to fix.

So who really broke the VA? In sum, it's a failure with many silent fathers.

President Obama

Obama's experience with the VA is a testament to the danger of big promises—and high expectations.

He pledged to end the claims backlog while simultaneously making a string of moves that summoned a flood of new claims to the agency.

The administration made it easier for veterans to get compensation for both post-traumatic stress disorder and exposure to Agent Orange—a Vietnam War-era defoliant now tied to a long list of neurological disorders. Those moves extended help to long-suffering veterans, but they weren't matched by the VA reforms needed to adequately address the new claims. Agent Orange alone took up 37 percent of the Veterans Benefits Administration's claims-processing resources nationally from October 2010 to March 2012, according to a Government Accountability Office report.

And as claims soared during Obama's first years in office, so did wait times. In 2009, there were about 423,000 claims at the VA, with 150,000 claims pending for more than four months (the official wait time it takes a claim to be considered "backlogged"). By 2012, claims had exploded to more than 883,000—and 586,540 of those sat on the agency's backlog list.

The administration did request—and get from Congress—additional funding for the agency. The agency's budget totaled $100 billion in 2009. In 2014, it was up to $154 billion. But that money doesn't instantly transfer into an expanded capacity to meet veterans' needs: It takes approximately two years to fully train a claims worker; the blame for the staff crunch doesn't rest on Obama's shoulders alone.

The influx of claims has since fallen, and the backlog is greatly diminished—though there is controversy over how the administration has dealt with the claims. (For more on the administration's struggle to fix the VA, seePart One.)

"As a candidate, Barack Obama promised veterans the moon, but in many cases he hasn't delivered as president," said GOP Rep. Jeff Miller of Florida, the chairman of the House Veterans Affairs Committee. "VA's disability claims backlog grew to historic levels on his watch. … Candidate Obama promised the most transparent administration in history, but his VA is a case study in how to stonewall the press, the public, and Congress."

Congress

Miller's own branch of government, however, cannot claim clean hands.

The VA could be overhauled to better address the needs of modern veterans, including reforms to the way it processes claims, assesses the performance of its employees, and measures its overall performance. But putting many of those reforms in place would require an act of Congress—and thus far those haven't happened.

Instead, Congress has taken a more reactive approach. When incidents—such as the recent hospital deaths—capture public attention, lawmakers hold hearings where they berate agency officials with juicy sound bites they can later play back for their constituents. It's good political theater, but it's unclear that the payoff is anything other than political.

"Congress has been totally exasperated by the VA's inability to get on top of the problem for a long time," said Linda Bilmes, a senior lecturer in public policy at Harvard University's Kennedy School. "But they haven't been willing to really contemplate anything other than throwing more money at the problem."

Congress is taking some legislative steps now: The House is slated to vote this week on a VA accountability bill to make it easier to fire senior executives, and the latest VA funding bill banned bonuses to agency executives. But neither measure contains changes on the structural level.

And even when Congress has passed legislation aimed at improving the agency, its record of efficacy is mixed at best—especially in terms of eliminating the claims backlog.

In 2000, lawmakers passed the Veterans Claims Assistance Act. The law was signed by President Clinton and was, by all accounts, a well-meaning attempt to make it easier for veterans to get VA claims approved.

The law required that the VA tell a veteran what to do to prove a claim, help the veteran obtain necessary records, and inform the veteran when the VA could not obtain the information it needed. The law required the VA to retrieve the veteran's service medical records and provide exams when the VA did not have sufficient evidence to substantiate a claim.

But the law was ambiguous and left much open to interpretation, which had to be fought out in the courts. It wound up adding several additional layers of bureaucracy to an already clunky VA claims process without appropriating additional funds or human resources to manage the increased workload.

"So the situation wasn't getting better; it just added another forum that made it harder to get things done," said Sherman Gillums, an associate executive director with Paralyzed Veterans of America. "We attribute a lot of the early trouble—not the current backlog, but early trouble—to this, because it created an institutional laziness or institutional inefficiency and made that a part of the culture at the VA. People just accepted claims sitting around a long time because they had to do all of this other stuff.

"So if there is a snowball in all of this, I would say that's the little tiny thing that would eventually become the avalanche," he said.

President George W. Bush

The Bush administration sent troops to Iraq and Afghanistan, but when those troops came home injured, the Defense Department failed to adequately communicate it to the agency tasked with helping them.

Early on, the department was publicly counting only about a third of the casualties stemming from the War on Terror. That was because the Department was only counting servicemen and women immediately targeted in the department's wounded-in-action statistics. That accounting method left out those who were not targeted but were wounded nonetheless, such as troops injured when they were riding two trucks back from one that was hit by a roadside bomb, or those hurt in training or transportation.

The underreporting made it more difficult for the VA to prepare for the coming influx of requests for help. The poor sharing of information—including medical records—between the two agencies has long been a bone of contention, and it remains a challenge (albeit one that is improving) to this day.

"It's not surprising, really, that the VA ended up being poorly prepared for what happened, given the way that they were planning," said Harvard Kennedy School's Bilmes. "There was absolutely a lack of planning, a lack of capacity for planning. ... They didn't know what hit them. They were completely overwhelmed."

Additionally, the VA's claims-processing time skyrocketed early in the Bush years. In 2002, it took the VA an average of 224 days to complete claims, as compared with 166 days in 1999.

VA leadership

While the agency was hampered by plenty of external factors, it is hardly an innocent victim. Agency leadership allowed its problems to fester and its infrastructure to crumble.

For example, the VA did not have a digital way to process claims nationwide until 2013, instead relying on an inefficient paper filing system. By comparison, the IRS rolled out its electronic filing system across the country—albeit with some problems—in 1990.

It's just one area where the agency was too slow to react to changes in the world around it.

Even by the mid-2000s, several years after 9/11, the VA was using out-of-date claims projections it had based on injury estimates that used assumptions from older wars. Due to medical advances, many service members who would have died from their injuries in past wars are now being saved. That means fewer deaths, but it also means more wounded veterans, a development the agency failed to anticipate and was slow to adapt to.

And agency leaders at times failed to request the funding needed to do their duty.

In 2005, under VA Secretary Jim Nicholson, after originally denying its fiscal predicament, it came out that the VA faced a $3 billion shortfall in funding for veterans health care. The situation required emergency supplemental funding from Congress.

"There was a leadership attitude that was not aggressive in pushing back against whatever administration, … or even quietly going to Congress and saying we need more people," said Gerald Manar, national veterans service deputy director at the Veterans of Foreign Wars and a former 30-year VA employee.

Kennedy to Nixon to George H.W. Bush—and every president in between

In many ways, the Obama administration is paying for the negligence of past administrations, dating all the way back to President John F. Kennedy, who authorized the decade-long use of Agent Orange in Vietnam.

But it wasn't just Kennedy. Under President Johnson, Agent Orange was the dominant chemical used during the war. President Nixon halted its use, but a long line of presidents either refused to acknowledge the damage done or failed to address it.

President Carter's VA created the Agent Orange registry, where veterans who were worried about potential side effects could be examined. But four years later, a GAO report found that 55 percent of respondents felt that the VA's Agent Orange examinations either weren't thorough or they received little or no information on what long-term health impacts exposure could cause.

And President Reagan's legacy includes a damning congressional report from 1990 that found: "The Reagan administration had adopted a legal strategy of refusing liability in military and civilian cases of contamination involving toxic chemicals and nuclear radiation. ... The Federal Government has suppressed or minimized findings of ill health effects among Vietnam veterans that could be linked to Agent Orange exposure."

Progress has been slow. Vietnam veterans won a major victory under President George H.W. Bush when Congress passed legislation allowing the VA secretary to make certain diseases, including Hodgkin's disease and non-Hodgkin's lymphoma, "presumptive" to Agent Orange exposure. This means that the VA automatically assumes the diseases are related to the defoliant that the veterans encountered during their military service, making it easier for them to collect disability payments.

The government's long-standing failure to address the damage done to veterans by Agent Orange mirrors the larger failure of the VA. It spans generations and party affiliations, and every effort to fix it comes with unintended consequences.

"This goes across party lines," said Ronald Abrams, the joint executive director with the National Veterans Legal Services Program, and a former VA official who has worked on veterans claims cases for 40 years. "Democrats and Republicans have allowed this festering sore to continue."

Coming Soon: What Would It Take to Really Fix the VA?

(Image via Flickr user qnr)

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Obama Has Every Reason to Fix the VA. Why Hasn't He?

Stacy Kaper and Jordain Carney, National Journal — Thu, 15 May 2014 09:41:49 -0400

Part One in a National Journal series on the Veterans Affairs Department.

The failure of the Veterans Affairs Department to quickly compensate veterans for their disabilities is a moral abomination: It leaves soldiers wounded by war waiting in long lines for payments they need and believe they have earned.

And VA failures are under new scrutiny amid reports of a string of preventable deaths among veterans and a growing political controversy around them—and many in Congress are pointing a finger in the White House's direction.

So why has President Obama failed to fix the backlog of veterans' disability claims after five years in office? More than 300,000 claims to the VA have been pending for 125 days or more, a time stamp that puts them in the agency's official definition of "backlogged."

And why did a long line of Obama's predecessors—Republican and Democratic alike—end their own tenures without fixing the problem?

In short, because fixing the VA backlog isn't just a question of putting the proper resources into an overwhelmed agency. Solving it would require not only untangling a Gordian knot of dysfunctional bureaucracy surrounding the VA claims system and decades of neglect, it would also mean overcoming a perfect storm of factors in the past few years that has made the problem much, much worse.

Surge in Claims

The VA received 1 million new claims during Obama's first year in office—the most it had ever received at one time—and the count climbed from there. Annual claims peaked in 2011 at 1.3 million, falling to 1.04 million claims received in 2013.

What's driving the surging number of claims? In short, a pair of wars that have created more veterans and new Obama administration rules that have made veterans from all wars eligible for more disability compensation.

The VA is dealing with a sudden influx of Afghanistan and Iraq veterans as the U.S. draws down its troop levels. Nearly 970,000 Iraq and Afghanistan war veterans deployed overseas since 9/11 have filed a disability claim, according to a Freedom of Information Act request released to Veterans for Common Sense this month by the Veterans Benefits Administration.

And due to medical advances, many service members who would have died from their injuries in past wars are now being saved, but they are returning home with more numerous and more complicated injuries. Vietnam veterans typically claimed three or four injuries. Now a single veteran from Iraq or Afghanistan routinely submits a claim with the number of injuries in the double digits.

Meanwhile, the Obama administration has also changed the rules to give more benefits to veterans. In 2010, the administration expanded coverage related to exposure to Agent Orange, a Vietnam War-era defoliant that has created a vast list of health problems. Veterans have long tied an assortment of illnesses to Agent Orange, and now more of those illnesses are covered.

Additionally, the administration made it easier for veterans to get coverage for posttraumatic-stress disorder, a disease less easily diagnosed and adjudicated than physical injuries. Since 2010, service members no longer have to provide documentation that supports their PTSD claims. Instead, a doctor performs an exam to determine that the veteran's symptoms are related to PTSD and that the cause of the PTSD, such as being under attack, is consistent with the veteran's military duties.

A Broken Agency

Not all of the VA's problems, however, come from external factors. The agency is haunted by its painfully slow embrace of technology: It did not have a digital way to process claims nationwide until 2013, and it long handled claims with a paper filing system. Victoria Dillon, a spokesperson for the VA, acknowledged that "these offices used to be stacks of papers everywhere," with claim files "18 inches thick on average."

By comparison, the IRS rolled out its electronic filing system across the country—albeit with some problems—in 1990.

The VA also uses a complicated regulatory code for dealing with claims that slows down the process. "The regulation dealing with [traumatic brain injury] is so complicated that some people call it the 'Da Vinci Code,' " Ronald Abrams, joint executive director for the National Veterans Legal Services Program, told lawmakers late last year.

The VA attempted to solve the problem by hiring more claims workers to handle the influx, but it takes approximately two years to fully train a claims worker to handle the complex process.

"Thousands of new PTSD and Agent Orange claims starting in 2010 overwhelmed an agency with a history of poor planning, chronic understaffing, and a lack of training," said Glenn R. Bergmann, a partner at Bergmann & Moore, a former VA litigator who represents veterans with VA disability-claim appeals.

The Scope of the Problem

In his first years in office, Obama's VA was a disaster, as a flood of new claims overwhelmed an antiquated process for handling them. In 2009, there were about 423,000 claims at the VA, and the official backlog of claims that had been pending for more than four months sat near 150,470. By 2012, claims had exploded to more than 883,000—and 586,540 of those sat in the agency's backlog list.

But in recent years, the administration has made progress in getting veterans more timely answers. The backlog list was cut to more than 300,000 as of May 10. If the VA maintains the current average monthly rate, the backlog could be cut by mid-2015. That would meet Veterans Affairs Secretary Eric Shinseki's 2010 pledge to eliminate the backlog by the end of next year.

Critics, however, say the shrinking backlog is something of a farce, the result of an administrative maneuver that has not delivered results for the veterans in the backlog, but has instead moved them into a different waiting line. When taking into consideration all VA claims, including those were the veterans died waiting for a decision, those stuck in appeals, and award adjustments—often adding a spouse or child—the VA's inventory of claims is much higher still hovering just under a whopping 1.3 million. (By comparison when Obama took office in January 2009, the inventory of claims was about half that amount: 631,000.)

As of May 10, the VA's number of appealed claims stood at 274,660, almost 100,000 more than the 174,891 appeals in late 2009. Between 2012 and 2013 the number of claims that ended up in appeal grew 5 percent, and between the end of 2013 and March 31 the number of appeals kept rising 2.7 percent. Once in the appeals process, veterans can wait in limbo for an average of two and a half years.

Critics contend that list is growing because, as the agency endeavored to quickly work through the claims, it has made more errors.

The VA rejects that charge, and says it accurately processes 91 percent of all claims.

But the Office of the Inspector General for the Veterans Affairs Department has issued several reports since 2009 that say VA regional offices where claims are processed need to improve policy guidance, oversight, management, training, and supervisory review to improve the timeliness and accuracy of disability claims processing.

Findings in the OIG reports are damning. For example, in 2013 the OIG inspected 20 field offices it had previously inspected, and 17 continued to be noncompliant with Veterans Benefits Administration policies. In December, the OIG reported to Congress that it found errors in 29 percent of the traumatic brain-injury claims and 49 percent of the claims for a full disability rating. But the OIG does hedge its criticisms, acknowledging in some of its 2013 field reports that it "sampled claims related to specific conditions that we consider at higher risk of processing errors," and so the errors it identifies "do not represent ... the overall processing accuracy rate" at a specific field office.

But veterans groups contend it's even worse.

"We've gone back, and I would say somewhere in the neighborhood of 40 percent to 50 percent of the cases we found either conflicts or errors as far as the way they were developed or just inaccurately rating claims," said Zachary Hearn, the deputy director of benefits for the Legion, which represents hundreds of thousands of veterans' claims cases.

The Human Cost of Failure

Whatever the backlog's size, it isn't a list of numbers. It's a line of former soldiers waiting for a verdict from the VA on whether they will get help.

Jason Ayala was stuck in that line for nearly two years. The 31-year-old Iraq War veteran served two tours with the Army. After his tours, he says he suffered from headaches, neck and back pain, as well as PTSD—a result of time spent under constant gunfire and at risk of improvised explosive devices.

But when he came to the VA for help, Ayala says he gave up the first time he tried, and only succeeded after he returned from his second tour.

"I started the process, you know; I went in there, and you're just sitting there.… All of the sudden you feel like you're being categorized as someone who is complaining or whining," Ayala said. "It just wasn't right. I did my time, I did my service."

Coming next: Who Broke the VA?

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Ryan Budget Calls for Return to Pre-Sequester Defense Spending

Stacy Kaper, National Journal — Tue, 01 Apr 2014 12:59:53 -0400

House Budget Committee Chairman Paul Ryan laid out a budget vision Tuesday that goes beyond President Obama's request by ramping up defense spending beyond the caps in 2016 and restoring them by 2017.

Ryan does this by taking from the nondefense side of the ledger and still reducing overall federal spending beyond what is contemplated under the total sequester caps.

"This budget rejects the president's cuts to national security.… It also keeps faith with the veterans who have served and protected the nation," declares the Ryan budget, which increases defense spending above what President Obama has called for by $273 billion over the 10-year budget window.

"The first job of the federal government is securing the safety and liberty of its citizens from threats at home and abroad," Ryan's budget proclaims, listing national defense at the top of its budget breakdown.

"This budget provides for the best equipment, training, and compensation for their continued success."

Unsurprisingly, the Wisconsin Republican's budget, like Obama's, sticks to the defense spending caps agreed to under last year's Bipartisan Budget Act of $521 billion for discretionary spending for fiscal 2015.

And it is important to note that for fiscal 2015, Obama technically is calling for more for defense, because his budget asks for an additional $28 billion for defense spending as part of a so-called opportunity fund that Congress would have to approve through a series of other policy changes, including tax increases that are unlikely to be adopted.

Although neither Obama nor Ryan sticks to the defense sequester caps in 2016 and beyond, starting in fiscal 2016 Ryan's budget starts increasing defense spending beyond what Obama calls for, every year through 2024.

For example, in fiscal 2017 Ryan's budget asks for $590 billion for defense discretionary spending, compared with the $569 billion total for defense discretionary spending that the president requests. The trend line continues, with Ryan requesting $696 billion for defense discretionary spending in 2024, compared with the $646 billion that Obama has reqeusted, after adjustments based on policy changes the White House is assuming in its budget.

Ryan does all this while still coming in under the total discretionary budget caps set by the sequester, ultimately shaving $308 billion from the overall federal budget caps. He does so by reducing nondefense discretionary spending by more than he is increasing defense spending. By 2024 Ryan is adding $483 billion to defense spending beyond what the sequester would allow and cutting $791 billion from nondefense discretionary spending sequester caps in order to achieve overall savings to the federal government.

Defense-budget analysts were quick to put the Ryan budget in context—it's a message piece that, like the president's budget, has next to no chance of becoming law.

"This is just another marker in the debate," said Todd Harrison, a senior fellow in defense-budget studies at the Center for Strategic and Budgetary Assessments.

Harrison said it is important to understand that Ryan's budget resolution might not pass the House, and has no chance of being reconciled with the Senate—which has said it is not putting out a budget proposal—and does not have the teeth of an appropriations bill.

"So all it is is a marker to give an indication of where the House thinks various spending levels ought to be. It does not mean that we will end up there in any way, shape, or form, even if they can get it to pass the House, which is not a given," Harrison added. "It doesn't mean too much, it's just an indication of the party's position."

Other budget analysts said the key takeaway is that both Obama and fiscal conservatives believe that the defense sequester cuts go too far in restricting funding for national defense.

"Ryan's budget—in following the president's—shows that there is bipartisan consensus that the defense sequester cuts remain too deep, which is a sensible belief because that part of the budget—like domestic discretionary—is not a driver of our long-term debt," said Shai Akabas, an associate director of economic policy with the Bipartisan Policy Center.

Whether this agreement will change the trajectory of defense spending is unclear. Democrats are unlikely to go along with Ryan's plan of sacrificing nondefense discretionary spending in order to increase defense spending.

The Ryan budget does not break down the national defense budget into specifics, such as how much would go to, say, the Defense Department versus the atomic energy defense activities of the Energy Department.

But for 2015 in total, his budget resolution calls for $528.9 billion in budget authority and $566.5 billion in outlays in fiscal 2015 for national defense. Of that, discretionary spending totals $521.3 billion in budget authority and $558.8 billion in outlays. Mandatory spending is $7.7 billion in outlays. The 10-year total for budget authority and outlays are $6.3 trillion and $6.2 trillion, respectively.

Ryan boasts that his budget sticks to the budget caps from last year's Bipartisan Budget Act approved by the House and Senate and signed into law by Obama in December.

"This is the amount provided for in the Bipartisan Budget Act," according to the budget document.

In the budget, Ryan criticizes the fact that over the last five years, DOD has repeatedly revised down its estimates of its budgetary resources necessary to meet the nation's security needs. He essentially admonishes the president for trying to cut defense spending, noting that in the president's 2014 budget, the request is approximately $184 billion lower than the Budget Control Act's pre-sequester caps.

Ryan's budget says that the defense program continues to be under-resourced and that the most recent Congressional Budget Office report found that last year's DOD defense program request was, on average, $33 billion short of providing for the full costs of the program estimated by CBO.

"Today in U.S. defense policy there are two big mismatches," the Ryan budget says. "First between the threats we face and the resources we've committed to meeting them, and second between our stated policy and the budget the president has requested."

It adds, "This budget seeks to resolve these contradictions by restoring defense budgets to to the levels dictated by the national security interests of the nation."

Ryan's budget says Obama's troop-reduction request is too severe and calls for additional resources for troops beyond what Obama requested, without providing specific details on costs.

Under last year's budget agreement between Ryan and Senate Budget Committee Chairwoman Patty Murray, Congress agreed to provide $9 billion in relief from the budget sequester for defense in fiscal 2015.

The sequester is one of the biggest budget challenges plaguing the Defense Department. A repercussion of the August 2011 debt-ceiling standoff, the sequester slashed $1.2 trillion in spending over 10 years and was established as a way to force Congress to come up with more targeted deficit-reduction plans. But Congress seems incapable of agreeing on a comprehensive replacement, and although they did lessen its impact for fiscal 2014 and 2015, they also extended the sequester another two years.

Last year, Ryan's budget took a similar tack with defense spending. It called for $560.2 billion in defense spending for fiscal 2014, which he called "consistent with our responsibilities."

The Ryan budget noted that the proposal was "significantly less than the levels in previous budget resolutions," but it boasted that it was roughly $500 billion more than will be available absent changes in the Budget Control Act.

"Our security is the federal government's top priority," said Ryan's fiscal 2014 budget. "The budget must reflect that fact."

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A Tale of Two Budget Wish Lists

Sara Sorcher, Stacy Kaper, and Jordain Carney, National Journal — Thu, 20 Mar 2014 15:49:00 -0400

Nobody in Washington is happy with the defense budget cuts coming next year. But the Pentagon and members of Congress each have their own ideas about how to spend any extra cash.

The Pentagon is hoping to minimize the full impact of the budget cuts with some extra financial padding. It has requested a budget of $496 billion for next year—which meets the budget caps Congress imposed—but the Pentagon has also submitted a hefty wish list of programs it wants if Congress can find an extra $26 billion.

However, not all of lawmakers’ pet projects are in the Pentagon’s base budget or even its wish list. Members of Congress are decrying the Pentagon’s proposed cuts to defense programs that could cause them political pain in their districts—and they desperately want to get them funded.

National Journal has outlined some of the key priorities the Pentagon and Congress have in their dueling wish lists—and what they would cost.

Of course, this extra cash is fictional, at least for now. There’s no room in the budget, and Congress may not change the law to give the Pentagon more money to spend. If members insist the Pentagon must fund their priorities anyway, the Pentagon would have to instead slash other programs in the main budget it considers crucial.

What's in Congress's Wish List?

Lawmakers want to ...

Keep the A-10

The Pentagon wants to retire the A-10 aircraft fleet to make room in its budget for other aircraft, such as the F-35 fighter jet. This would save $3.7 billion over five years. (The Defense Department could potentially save another $500 million if a wing-replacement program is also canceled.) Sen. Kelly Ayotte, a New Hampshire Republican whose husband was an A-10 pilot, and senators whose states are home to the A-10s, such as Republicans Saxby Chambliss, Johnny Isakson of Georgia and John McCain of Arizona, have all raised objections. They argue the replacement won’t be ready immediately and that the aircraft, which excels at close air-support missions, have been important for saving lives in Iraq and Afghanistan.

Reverse cuts to military pay and benefits

The Pentagon has been trying to rein in its growing personnel costs for a decade, but it has made little progress with a resistant Congress, which views cuts to military troops’ pay and benefits politically unpalatable. The Pentagon is proposing a slew of reforms that would slash its health care benefits, cap or freeze pay raises, and reduce the housing allowance and commissary benefits—for a net savings of $11.9 billion over five years. But lawmakers led by House Armed Services Committee Chairman Buck McKeon, R-Calif., are again dragging their heels, arguing Congress should await the results of a commission it set up, which is slated to come out with comprehensive recommendations next year to overhaul the military retirement and compensation system.

Avoid base closures

The Pentagon is calling for another round of base closures to begin in 2017. The U.S. is reducing the size of its military force as it ends an era of war in Iraq and Afghanistan, and the Pentagon wants to get rid of infrastructure it no longer wants or needs. The move is expected to cost $6 billion initially but then save $2 billion each year afterward. But no lawmakers want to see a base close in their districts. Among those screaming bloody murder about how the closures would affect jobs and the local economy are Ayotte and fellow Sen. Jeanne Shaheen of New Hampshire, along with Sens. Richard Blumenthal and Chris Murphy and Rep. Joe Courtney, all Connecticut Democrats.

Keep the LCS purchases intact

The Pentagon is scaling back its planned buy of Littoral Combat Ships from 52 ships down to 32. The controversial vessel is notorious for its historic delays and cost overruns, and the Pentagon has commissioned a force to determine whether it should build any more, modify them, or substitute another small surface combatant ship that might be better. Lawmakers like Reps. Bradley Byrne, R-Ala., and Reid Ribble, R-Wis., who represent regions where jobs are tied to the ships' building and contracts, are lobbying the White House directly not to cut the orders.

What’s in the Pentagon’s Wish List?

The Pentagon wants ...

Training

The Army wants an extra $1.8 billion to ramp up training in order to make sure troops are as prepared as possible for military operations.

Apache helicopters

The Army wants to buy 26 additional Apache helicopters, which have been used in the Afghanistan and Iraq conflicts. The cost to buy them would be $600 million.

Poseidon planes

The Pentagon is asking for $1.1 billion to buy eight P-8A Poseidon planes for the Navy. The maritime warfare aircraft can be used to hunt submarines, to gather intelligence, or—as they are currently doing—to try to find a missing plane.

Reaper drones

The Air Force wants 12 MQ-9 Reapers. These armed, unmanned aircraft are primarily used for intelligence gathering, but they are also designed for precision strikes. The additional planes would cost $200 million.

C-130 aircraft

The Air Force is asking for an additional $1.1 billion to buy 10 C-130 transport aircraft. The plane is frequently used for dropping troops and supplies into enemy territory.

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Senators Rekindle Debate After High-Profile Military Sexual-Assault Case

Stacy Kaper, National Journal — Tue, 18 Mar 2014 12:32:00 -0400

One court decision. Two polar-opposite conclusions.

That's the story on Capitol Hill on Monday after sexual-assault charges in a high-profile case against an Army general were thrown out in military court under a plea deal for lesser violations.

The case further fueled Democrats' intra-party fight over how to handle military sexual assault, a struggle that pits New York's Kirsten Gillibrand against Missouri's Claire McCaskill. Following the plea deal, both senators remained as dug in as ever.

Congressional reaction Monday to the dismissal of the charges was swift and divisive. It reinforced familiar battle lines over an ongoing political fight over the proper role for commanders in such cases.

McCaskill contends that the charges that Brig. Gen. Jeffrey Sinclair twice forced his former mistress, a captain, into sex acts and threatened to kill her and her family would never have come forward if not for the commander.

"As a former sex-crimes prosecutor, Claire knows how difficult these cases can be, and this case is obviously a complicated one," said McCaskill spokeswoman Sarah Feldman. "But one of its lessons highlights what we already know--that commanders are often more aggressive than prosecutors in pursuing prosecutions."

McCaskill has argued that commanders need to be held accountable and should keep this power, arguing that it is the best way to ensure sexual-assault prosecutions are brought forward. The senator's office argues that if the case had been handled by prosecutors alone, the rape charge would not have been brought forward. It points to reports in The New York Times that a prosecutor in the case resigned after trying to pressure a commander to drop the sexual-assault charges, according to defense lawyers.

"If this court-martial had been handled by prosecutors alone, it would not have gone to trial," said a background memo on the case from McCaskill's office, which was sent to reporters.

Meanwhile, on the other side of the divide, critics who have fought to strip commanders of the power to decide which sexual-assault cases move forward came out arguing the general's plea deal proves the system is broken.

Gillibrand, whose legislation to take the decision to prosecute out of the chain of command failed in the Senate earlier this month, said that the Sinclair case was an example of what's wrong with the system.

In an op-ed in the New York Daily News on Friday, Gillibrand said she was concerned about a report in USA Today that the judge had to temporarily halt the court-martial in the Sinclair case "over fears the commanding officer had rejected a plea deal on lesser charges for political reasons, despite concerns over the evidence."

Although she did not respond immediately to requests for reaction to the Sinclair developments Monday, Gillibrand said in her op-ed that she would continue to fight for the reform.

"We will work harder than ever in the coming year to strengthen our military by taking sexual assaults and other major crimes out of the chain of command—so that no victim is compelled to turn to his or her boss to ask for justice," she wrote. "We need every case to move forward based solely on the evidence and judged solely on the merits, not political pressure or other nonlegal considerations."

Others who share Gillibrand's stance on removing the chain of command spoke up as well.

"This is another example of why commanders shouldn't be deciding whether someone is prosecuted," said Rep. Jackie Speier, D-Calif., who has long sought legislation to create a joint military-civilian structure to oversee such cases. "Legal decisions should be made by legal experts, not commanders."

Speier added, "A justice system that is beholden to the whims of a commander is not credible. Even after pleading guilty to several sordid offenses, I am certain Sinclair will be sent home with a generous pension paid by taxpayers who expect their military leaders to serve honorably."

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Are Veterans Getting the Money They Deserve in Latest Budget?

Stacy Kaper, National Journal — Thu, 13 Mar 2014 09:58:00 -0400

Although budget requests are routinely dismissed as pie-in-the-sky wish lists doomed to be slashed, lawmakers fear that the Veterans Affairs Department actually might not be asking for enough money to meet its needs.

Lawmakers have a long list of concerns about the VA in the latest budget go-round, in which the department is asking for $163.9 billion—a 6.5 percent increase over the current fiscal year. They are faced with complaints back home of deficient veterans' health centers, long claims backlogs, and questionable treatment for Iraq and Afghanistan vets who are readily prescribed heaps of drugs to deal with serious post-traumatic stress disorder.

"It's very easy to beat up on the VA," said Senate Veterans Affairs Committee Chairman Bernie Sanders at a hearing Wednesday on its fiscal 2015 budget request.

Lawmakers from both parties took turns raising worries that the VA is not equipped to handle the veterans' needs back in their states, particularly when the wind-down of the Afghanistan war is sending a growing influx of servicemen and women into the VA system.

"As I understand it, the VA anticipates seeing an increase of approximately 100,000 new patients in the coming year," said Sanders, a Vermont independent. "But I am concerned whether the 3 percent increase in medical care that is in the budget will be sufficient to care for these new users, existing users, will span veterans services, and keep pace with all of the issues we have here. Is that enough money? It sounds to me like it's not."

VA Secretary Eric Shinseki, who was testifying before the panel, said the VA tried to ask for what it anticipates needing for 2015, but he admitted that the request was put together before the Defense Department announced its latest plans to reduce troop size.

"This budget request is prior to that plan being provided," Shinseki said. "We believe we have in this budget anticipated what our needs will be in 2015, but this again will depend on what the downsizing plan entails."

Congress has long been pushing the VA to work through its backlog of claims, and lawmakers continued to press the department Wednesday to ensure it is on track to clear through the backlog in 2015 as planned. Shinseki said it would.

But the concerns most lawmakers focused on were about the VA's capacity to provide adequate mental health services, and its ability to maintain and develop sufficient health care facilities.

Republican Sen. Mike Johanns of Nebraska complained about the VA's pace on capital improvement projects. Because an Omaha project was far down on the waiting list, he said it could take years for veterans to receive the access that they need.

"What I'm looking at, all these projects, a pretty rough estimate is that $23 billion is necessary to address what is on the waiting list," Johanns said. "How can we best put a process in place to address what you are dealing with and what we are dealing with? It's a lot of money; it would be very hard to come up with that."

Shinseki said that in the budget environment, the VA is trying to prioritize projects appropriately to provide for veterans' safety and security and maintain existing facilities. The VA has requested $561.8 million for major construction in its fiscal 2015 budget.

But Johanns questioned whether spending hundreds of millions of dollars to maintain old facilities was actually counterproductive.

"All these millions we are putting into these facilities across the country, I just hope we are not chasing good money with bad money," Johanns said.

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Democratic Senator Blames White House in Failure of Military Sexual-Assault Bill

Stacy Kaper, National Journal — Fri, 07 Mar 2014 10:36:00 -0500

Sen. Kirsten Gillibrand blamed the White House's lack of support for the failure of her sexual-assault bill in the Senate on Thursday, and she vowed to keep fighting to reform the military justice system.

"I made my greatest case, I advocated for this position, this reform, and the president has been very clear: He wants to end sexual assault in the military, he wants it to be further studied, and he wants to see progress and whether it's been accomplished in the next year," the New York Democrat said at a press conference after her bill went down.

When asked if she would have succeeded if President Obama had pushed for her bill and whether she was disappointed by the White House's lack of support, she quickly answered, "Yes, yes."

The legislation, which was fought mightily by the Pentagon and championed by victim-advocacy groups, would have stripped from commanders the power to decide which sexual-assault cases are prosecuted. It failed to attract the 60 votes necessary to overcome a procedural hurdle to pass the bill on a vote of 55 to 45.

Leading up to the vote, Gillibrand had said she had 55 supporters and was confident she would pick up more. Although she did indeed pick up two undecideds, Senate Minority Leader Mitch McConnell, R-Ky., and Republican Mike Enzi of Wyoming, she also lost two cosponsors: Tom Carper, D-Del., and Mark Kirk, R-Ill.

Carper voted against the bill because the president has asked the military to conduct a review of its efforts to combat sexual assault, which is due in December, according to an aide. In a statement ordering the review last year, Obama said that if current efforts do not work, then additional reforms should be considered, which was seen by many as squelching support for Gillibrand's reform.

Kirk said he believed Gillibrand's bill could make the military weaker.

"I co-sponsored Senator Gillibrand's legislation because I strongly believe that victims of sexual assault should always be protected, but ultimately supported the bipartisan McCaskill alternative because … [Gillibrand's] broad scope could jeopardize our readiness and our military stationed in the field."

Without a boost for the legislation in the Senate, it appears dead for now, particularly since similar legislation has languished in the House for so long.

A companion House bill to Gillibrand's from GOP Rep. Dan Benishek of Michigan has 71 cosponsors but has gone nowhere.

Another bill from Democratic Rep. Jackie Speier of California, which has stalled since it was first introduced in 2011, has 157 cosponsors. It would also remove commanders from the decision to prosecute sexual assaults but would go even further by taking such cases out of military courts.

Even though Gillibrand failed to pass her legislation, she did drum up more support than many thought possible, considering the broad opposition from the military's top brass and Armed Services Committee leaders.

Victim-advocacy groups who support the Gillibrand bill said that it was an important step to finally see a vote after so many fits and starts, but that the increased buzz on the issue still needs to be followed up with decisive legislative action.

"The attention has generated some helpful steps," said Susan Burke, an attorney who collaborates with Protect Our Defenders on sexual-assault cases. "The problem is that it is like building a house on a faulty foundation. It's a waste of time and money if you don't fix the structural problems."

Prominent fellow Democrat and former sexual-assault prosecutor Sen. Claire McCaskill of Missouri lobbied colleagues hard against the Gillibrand bill for months, arguing it could lead to fewer prosecutions, not more, by removing commanders' power.

She offered a noncontroversial alternative, building off reforms that were adopted last year in the defense authorization act, which is expected to sail through the Senate next week. The bill was moved ahead in a 100-0 procedural vote Thursday, but a vote on final passage was delayed for unrelated scheduling issues.

Gillibrand said she does not plan to change her bill to ease opposition, and she plans to press for its inclusion in the next defense authorization round, where she says she can continue to build support if the military fails to fix the problem.

"Many people said to me, 'Kirsten, I'm going to watch this; if it doesn't get better within the next six months, I'm with you next time,' " she said. "So for a number of people, an incremental step was more meaningful to them, and they wanted to see what happened. I think there will be many more senators who will side with us, because this is a huge problem."

For her part, McCaskill said she is hoping to fast track her reform package in the House, and if not, roll it into the next defense authorization.

Her bill would eliminate a soldier's good military character from being considered part of his defense. It would allow victim input in prosecutions, allow sexual-assault victims to challenge unfair discharge from the service, make it easier for prosecutors to recommend courts-martial for sexual-assault cases, increase commander accountability, and extend recently adopted reforms to military academies.

The debate has been full of drama and colored by butting egos. McCaskill said she did not enjoy being cast in the media as against victims, having attack ads run against her by victim groups, or battling her determined Democratic colleague.

"That's no fun," she said. "But because I was so confident that the policy was right, it is something that I couldn't have slept at night if I would have folded on this, because I really feel strongly that this is the right policy."

McCaskill said she plans to start focusing on boosting sexual-assault reporting and services on college campuses and wants to go back to working with Gillibrand to ensure sexual-assault reforms are implemented.

"It will be a relief to get back to Kirsten Gillibrand and I working lockstep to make sure that all these reforms are implemented in a way that protects victims and bring perpetrators to prison where they belong," she said.

Gillibrand said she is reviewing why convictions so often result in slaps on the wrist and is pressing the armed services for more data on how cases were handled.

Both Gillibrand and McCaskill said they also plan to focus efforts to address suicides and post-traumatic stress problems related to sexual assaults in the military, with an eye toward improving services and treatment offered.

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Gillibrand's Military Sexual-Assault Bill Fails in Senate

Stacy Kaper, National Journal — Thu, 06 Mar 2014 14:56:00 -0500

The Senate voted down a crucial motion to proceed on Sen. Kirsten Gillibrand's bill to combat sexual assault in the military, closing the door on the long-fought legislation for now.

The vote wraps up several months of fits and starts on the controversial legislation. Gillibrand's bill would strip commanders of the power to decide which sexual assault cases are prosecuted and is vehemently opposed by the Pentagon's top brass.

The New York Democrat, who argued passionately on the floor Thursday, has vowed to keep fighting for her legislation, which is championed by victim advocacy organizations.

The Senate was expected to easily pass a competing, non-controversial measure from Sen. Claire McCaskill, D-Mo., that would build on other reforms recently adopted in last year's defense authorization act.

Gilibrand's bill attracted 55 supporters but failed to overcome a procedural hurdle requiring 60 votes, with the Senate voting 55 to 45. Had the Senate approved the cloture vote, it would have cleared a path for a vote on final passage, which would have required only a simple majority.

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Military Groups Brace for Battle Against Higher Health Care Costs

Stacy Kaper, National Journal — Wed, 05 Mar 2014 10:38:00 -0500

The administration's push to shift more health care costs onto current military personnel and retirees met with resistance in Congress even before the details were revealed in the president's fiscal 2015 budget Tuesday.

Now the Pentagon's proposal to cut costs by consolidating its three health care options under Tricare into one, tack on new fees for those eligible for Medicare, and increase pharmacy co-pays is expected to receive an even chillier reception on Capitol Hill.

After all, it's an election year, and lawmakers from both parties have said repeatedly they want to wait until a commission they created comes up with a comprehensive plan before they overhaul compensation and benefits. The commission is not due to make recommendations until next year.

The force of the pushback on Capitol Hill is likely to mirror the strength of the opposition from military groups. Many raised initial concerns Tuesday but were looking for more specifics from the Pentagon before they launched their plans of attack.

Others came out swinging right away, arguing that any health care increases were nonnegotiable.

"The American Legion adamantly opposes any increases to Tricare, whether they be co-pays or additional fees of any kind," said Joseph Grassi, a deputy director with the American Legion. "The administration and Congress keeps going to Tricare as a way to save money, and it's the wrong answer."

Active-duty soldiers will push back, too, said Michael Hayden, legislative director with the Military Officers Association of America.

"The Pentagon's proposals will face a very tough road ahead. This is another attempt to shift significant costs onto beneficiaries, but with a twist. Not just retirees, but these proposals will impact the pockets of currently-serving members and their families," Hayden said.

Lawmakers just went through a hellish political mess, yielding to outrage from veterans' groups and reversing a measure to reduce military retiree pensions that was included in last year's budget agreement.

Now the Department of Defense is back at lawmakers' doorstep, asking for a series of sensitive cuts to shrink military benefits—including reducing commissary benefits, slashing housing allowances, and capping pay increases—which were detailed in a defense-budget sneak-peek last week.

On Tuesday, the Pentagon unveiled more details of its plan to tackle health care costs, which have long been a prime target for reform because they are the largest and fastest-rising of the personnel costs that threaten to overtake the department's budget.

"Internal savings initiatives are not enough to curb the expected increase in health care costs the department expects to experience in the coming years," said a defense budget overview from the office of the undersecretary of Defense.

"Therefore, DoD must pursue reasonable health benefit reform now as part of a balanced approach to cost containment."

The comptroller's defense-budget overview noted that health care costs accounted for only 4 percent of the department's base budget in 1990, compared with almost 10 percent in 2012.

The Pentagon contends that while health care costs have exploded, Congress has largely resisted efforts to allow beneficiaries to cover more of the cost—a trend that cannot continue.

The department argues that in 1996, a typical working-age military retiree's family that used civilian health care contributed on average roughly 27 percent of the total cost of its health care, while today that percentage has dropped to less than 11 percent. Health care costs, DoD says, have doubled or tripled during this time, but a family's out-of-pocket expenses, including enrollment fees, deductibles, and cost shares, has grown by only 30 to 40 percent.

The proposal would nearly triple pharmacy co-pays over the next decade. But it would also require all beneficiaries with long-term maintenance medications to fill their prescriptions by mail, which is significantly cheaper and is unlikely to be opposed by military and veterans' service organizations.

For an active-duty military member with three dependents who uses a mix of Tricare and civilian health care, the share of costs borne by the family would increase to 3.3 percent from 1.4 percent, or to $364 from $158, under the proposed consolidated Tricare plan, according to the Pentagon.

For a non-Medicare-eligible retiree under 65 with three dependents, the costs would go to $1,526 from $1,378, and raise the percent of the costs borne by the beneficiary to 10.8 percent from 9.3 percent.

Both the George W. Bush and Obama administrations have tried for the better part of a decade to rein in the soaring costs of Tricare, which provides coverage for both military personnel and retirees.

But in the face of massive pushback from military and veterans' service organizations, the Pentagon has made only modest inroads in this quest since 2005.

Last year, lawmakers rejected all of DoD's Tricare proposals, which called for raising annual fees by at least $1,000 for all military retirees, imposing means-testing of military health benefits, and significantly increasing pharmacy co-pays.

Because health costs have been a source of such long-standing tension, however, Congress has occasionally surrendered to the pressure and thrown DoD a bone.

In fiscal 2012, Congress allowed certain fee increases, enrollment rates to increase with inflation, and pharmacy co-pay increases. In fiscal 2013, Congress rejected most of the Pentagon's Tricare-reform requests to increase fees, establish new ones, impose means-testing for military retirees, and increase pharmacy co-pays. Instead, Congress agreed to require Medicare-eligible beneficiaries to fill long-term prescriptions by mail to reduce costs.

Military associations say that there are some proposals, like initiating fees for Medicare-eligible beneficiaries, that have been requested before and are bound to keep coming back until DoD succeeds.

In other cases, the department has taken into account some of the past criticisms of proposed cost increases and tried to lay out a set of reforms that conceivably stand a chance of approval on Capitol Hill.

"Some of these fees are actually more reasonable than what they have tried to put forward before. They are trying to work the art of the possible, I think. It's a sign that they want something to pass because they are under such budget pressures," said Joyce Raezer, the executive director of the National Military Family Association.

"But to comment more on some of the specifics, we have a lot of questions, and we are going to be looking for some answers and then we'll circle back and see what is the impact, especially for our active-duty families," Raezer said.

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The Politics of Process Plague Senate Vets Bill

Stacy Kaper and Michael Catalini, National Journal — Wed, 26 Feb 2014 10:02:00 -0500

Legislation to help veterans often wins bipartisan support, but a rift between Senate Democrats and Republicans over process—who gets to offer amendments and how many—is threatening an omnibus bill moving through the chamber.

Senate Republicans are emerging as skeptics of a Democratic bill sponsored by Veterans’ Affairs Committee Chairman Bernie Sanders of Vermont (I), arguing that an increasingly familiar script that has killed other bills may well repeat itself here.

Republican lawmakers describe a pattern in which Majority Leader Harry Reid, D-Nev., brings Democratic legislation to the floor and blocks the minority from offering amendments, and in response they block the measure from advancing to a simple-majority vote. The process has thus far stalled an extension of unemployment insurance.

“It’s pretty simple,” said Republican Sen. Chuck Grassley of Iowa. “We don’t understand why the Senate shouldn’t function as it historically has functioned. The right of a single senator to offer amendments is pretty important. It’s a matter of principle as much as it is about any of the specific pieces of legislation.”

The Senate voted Tuesday to proceed to the Sanders bill, which would reverse an unpopular cut to veterans’ pensions that was enacted as part of the budget deal, as well as expand veterans’ education and health care benefits.

Republicans are wary of Sanders’s plan to expand benefits, and they’re furious over what they say is strong-arming by Reid.

“If Senator Reid were willing to run a legislative process, I think you can move bills,” said Republican Sen. Mike Johanns of Nebraska, who sits on the Veterans’ Affairs Committee. “It’s like this unemployment [legislation]. I always thought the votes were there. I just never could understand why he didn’t let the process go forward.”

Republicans blame election-year politics.

Grassley said Reid may be limiting amendments to protect vulnerable Democrats.

“This I can’t answer, it’s just a supposition, but to what extent does Senator Reid not want the senate to function because he wants to protect his majority?” Grassley said.

For his part, Reid has said that he will green-light GOP amendments that are related to the veterans bill, but at the same time made it clear that he will draw a line beyond which Republicans cannot cross. Exactly where that line is set remains to be seen.

“This doesn’t mean that we’ll go on forever,” Reid said.

Though 99 senators got on board for Tuesday’s vote to move the measure a small step forward, it’s unclear whether that support will continue on future, more substantive votes to pass the bill.

One of the Republican amendments is a plan to replace the measure with an alternative from Sen. Richard Burr of North Carolina, the Veterans’ Affairs panel’s top Republican.

The GOP plan would change how to pay for the expanded spending, which under the Sanders bill relies on savings from the drawdown of the wars in Iraq and Afghanistan. Republicans say those savings are “false,” arguing they don’t actually save taxpayers money. Instead, Republicans want to pay for it by targeting a child tax credit used by undocumented immigrants.

If Republicans don’t get to vote on their amendments, and if its spending offset isn’t changed, they’re threatening to block the measure—even if that position leaves them at odds with most veterans groups.

“It would be very difficult for people to vote against a veterans bill,” said Republican Sen. James Inhofe of Oklahoma. “But if they do it with the [war-drawdown funding] offset there might be some of us who vote against it, and I might be one of them.”

Sen. John McCain, R-Ariz., took offense at the fact that Republicans were being blocked from amending such a massive bill for such a vital group. “I think I know as much about veterans as Mr. Sanders, with all due respect, yet I’m not allowed a single amendment to Mr. Sanders’s bill; that to me is an outrage and an insult,” he said.

Another Republican amendment would call for Iran sanctions, a sensitive area dividing some Democrats and the White House, which wants to see its diplomatic approach proceed.

Burr said that he could not abide a Democratic request that only amendments pertaining to veterans issues be offered.

“The chair made a plea that this be limited to VA issues,” Burr said. “That might be possible if the minority had the opportunity to amend legislation in this institution. It’s the only way we can get this to the floor because we’re denied any other attempt to do it.”

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Congress Extends Sequester to Pay for Veterans Benefits

Stacy Kaper, National Journal — Wed, 12 Feb 2014 16:02:00 -0500

The Senate overwhelmingly approved a House-passed bill 95 to 3 Wednesday that would unwind $6 billion in cuts to veterans benefits from last year's budget deal that proved to be a political fiasco for all involved.

The conclusion of the battle to unwind the cuts in Congress culminates several days of flip-flops from Democrats and Republicans. Lawmakers ultimately concluded it was shrewder to put to rest a rising political vulnerability with veterans than continue petty-looking squabbles over offsets that are lost on the public at large.

The takeaway message from the massive backlash over a relatively small-dollar provision included in last year's budget agreement engineered by Wisconsin Republican Rep. Paul Ryan is don't mess with vets, especially in an election year.

The legislation that now heads to President Obama's desk for his signature, would pay for restoring a 1 percent cost-of-living adjustment to military retirees' pensions by extending the mandatory sequester cuts an additional year.

Senate Democrats had spent much of Tuesday insisting that it was imperative to pass a "clean" bill without an offset ASAP, arguing that veterans had already "paid in full" their debt to society, even though none of the offsets being discussed would have touched other veterans benefits or even come out of the Department of Defense.

They were pushing a bill that was pending in the Senate from embattled Arkansas Democrat Mark Pryor that would have unwound the cuts without paying for them.

But between the House's undeniably overwhelming vote on its bill Tuesday of 326 to 90 including 120 Democrats, and the inability of Democrats and Republicans to agree on amendments to the Pryor bill, Democratic leadership abruptly changed course Tuesday scheduling a vote on the House bill.

A few hours ahead of the vote, Democrats appeared to be caught off guard.

Senate Armed Services Committee Chairman Carl Levin, D-Mich., said he didn't know if he would support the House payfor and needed to review the details including how he had voted on it previously.

"I don't know," he said. "There's a little uncertainty in my mind as to which particular extension this is."

Levin said that Democrats generally still preferred a bill without a payfor, and that his personal preference was one that would close off-shore tax havens.

"I think most Democrats want a clean bill. If our choice is a good payfor… I would clearly vote for that…. If it's a pure COLA restoration, I'm all in favor for that, but in terms of the other options I just have to withhold judgment until I know more about it."

The House payfor had received mixed reviews from Senate Republicans Tuesday with many continuing to push for a payfor from New Hampshire Republican Sen. Kelly Ayotte that would close the child tax credit to undocumented immigrants.

"I think sequestration was a terrible mistake to start with," said Arizona Republican Sen. John McCain Wednesday.

As Democrats had tested the waters with Republicans over the payfor fight, it had appeared last week that the GOP would balk at even debating a bill that didn't have a payfor. But Republicans reversed course on Monday joining with Democrats unanimously to take up the Pryor bill, which was left in the dust by Wednesday.

In the end, with a snowstorm threat pushing up a looming recess imminently, lawmakers gave up their payfor fights and just wanted to check the box, claim victory and go home.

"My inclination is I just want to solve this problem," said Maine Independent Angus King Wednesday, who had joined in a Democratic press conference decrying attempts to payfor the legislation the previous day.

"And the House has now recessed, so if we do something different, it gets delayed," he said. "Let's do it."

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Senate Republicans in a Box on Veterans Benefits

Stacy Kaper, National Journal — Wed, 12 Feb 2014 10:07:00 -0500

Senate Democrats are determined to get a bill reversing $6 billion in controversial cuts to veterans benefits through the chamber this week without offsetting the cost. Their message: Veterans have “paid in full” their debt to the nation and shouldn’t be used as budget pawns.

The effort is in sharp defiance of a majority of Republicans who argue that the cost of reversing the cuts in pension benefits should be offset in order to keep intact the bipartisan budget agreement reached last year.

Proving that a bipartisan pay-for is achievable, the House passed a bill Tuesday, 326-90, that would pay for repealing the cuts in veterans benefits by extending mandatory sequestration cuts an additional year. The measure has support from 120 Democrats.

But the House proposal was shot down immediately by Senate Majority Leader Harry Reid, D-Nev., and reaction was mixed among Senate Republicans, with some citing fears that pledges to make cuts later can easily be broken.

“That’s not an ideal pay-for, in part because it is so distant,” said Republican Sen. Pat Toomey of Pennsylvania. “The promise of distant future spending cuts is not at all optimal.”

Breaking from the now-infamous tradition of preventing Republicans from offering amendments, the Senate is expected to actually allow a vote on a pay-for favored by Senate Republicans, according to senators and aides involved. A vote on the pay-for from Republican Sen. Kelly Ayotte of New Hampshire that would close the child tax credit to undocumented immigrants could come as soon as Wednesday.

But without Democratic support, the measure is doomed to fail. Unless Democrats suddenly change their tune and strike a compromise on an offset, the building dynamic is to put Republicans in a box of having to either support unwinding the cuts outright—as the bill sponsored by Sen. Mark Pryor, D-Ark., would do—or being forced to vote against it over the lack of offset.

“I can’t vote for it” without a pay-for, said Sen. Lindsey Graham, R-S.C., a defense hawk. “That’s a false choice. I’m the guy that brought up the inequity of the pay-for,” he said about using the cost-of-living adjustment cuts in the budget deal. “That is a lousy way; we ought to go out and shoot the person who came up with this idea, but you don’t want to break the Budget Control Act, so let’s find another pay-for.... I’ve never been of the mind-set that in order to fix this you’ve got to break the budget agreement.”

The Senate majority’s clear goal is to undo the 1-percentage-point cut to COLA without an offset, claim victory, and go home to reap the political rewards over the Presidents Day recess. This was something Democrats made plain on Tuesday.

“This bill is very, very simple to me—it’s a veterans’ bill,” said Sen. Mark Begich, D‑Alaska, at a press conference with Pryor and several other Democrats sponsoring the bill. “You are for veterans or you are not. That’s the vote we will be taking. We made a promise we need to keep.... These veterans have already paid the price.”

Democratic Sen. Mary Landrieu of Louisiana echoed that sentiment, saying that getting hung up over an offset is essentially disrespectful to the troops.

“The 127 men and women [from Louisiana] who have already paid for this bill with their lives in Iraq and Afghanistan, and the thousands of veterans in Louisiana, are wondering why we are debating an offset,” she said.

“Whatever was owed they have already paid, and that is the issue in this bill.”

Senate Democrats could well get their way, given how politically untenable it is to take any vote that is equated with being against veterans, particularly in an election year.

Republicans last week had been expected to vote against even proceeding to a debate on the Pryor bill because it lacked a pay-for, but they abruptly changed course Monday and the chamber voted unanimously to proceed to the bill.

“I’m for fixing the COLA first and foremost,” said Sen. Johnny Isakson, R-Ga. “The pay-for is a secondary issue.”

Democrats are banking on that pressure to score them another win in the Senate, leaving the question of how to work out a resolution with the House for another day.

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House Votes to Repeal Cuts to Vets Benefits, Partially Extend Sequester

Stacy Kaper, National Journal — Tue, 11 Feb 2014 15:46:00 -0500

The House voted 326 to 90 Tuesday to reverse a controversial $6 billion cut in veterans' benefits included in last year's budget deal.

The House bill would offset the cost of the legislation by extending the budget sequester for mandatory spending cuts by an additional year.

The chamber is almost unanimous in its desire to reverse the cuts, but some Democrats voted against the bill because it would fund the veterans benefits, in part, through further cuts to mandatory domestic spending for social programs they favor.

Democrats on Monday had indicated to Republican leadership that they would not be able to deliver sufficient votes to pass the benefits bill if it was tied to the debt ceiling. The objections to the debt ceiling plan stemmed not from objections to restoring the benefits, but rather from Democrats' concern that they would set a precedent whereby Republicans could tie provisions—even legislation with broad bipartisan support—to a future debt ceiling increase.

In the end, 120 Democrats suppored the veterans measure Tuesday, while 71 voted against it.

The bill now heads to the Senate where it faces an uncertain future. Senate Democrats are arguing that veterans already paid their debt to society and that the legislation to reverse the cost of living adjustment cuts should pass without offsetting the legislation. And Senate Majority Leader Harry Reid, D-Nev., told reporters Tuesday that he would not support the House's sequester extension.

But Senate Republicans are still insisting that legislation to reverse in cuts contains provisions to prevent it from increasing the deficit.

A bill to reverse the vets COLA cuts from Arkansas Democrat Mark Pryor is pending in the Senate. Democrats say they hope to complete that bill this week, but the chamber might adjourn for its President's Day recess as soon as Wednesday because of an expected snow storm.

Sarah Mimms contributed to this article.

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Democrats Set Trap for Republicans on Veterans Benefits

Stacy Kaper and Jordain Carney, National Journal — Fri, 07 Feb 2014 14:15:00 -0500

The Senate fight over veterans benefits is about to begin in earnest, and it's about to get ugly.

The Senate on Monday will take an initial procedural vote on legislation from Democrat Mark Pryor of Arkansas that would restore $6 billion in funding to working-age military retirees. The benefits were cut as part of December's bipartisan budget deal, but the reductions sparked a massive political backlash, leaving lawmakers rushing to reverse them.

But while top Democrats are hoping to move Pryor's measure, they're assuming it will fail to get the 60 votes needed to clear cloture, according to a senior party aide. His bill measure lacks a way to offset the benefits cost, and for Senate Republicans, that's a fatal flaw.

Democrats, however, have an alternative option for when Pryor's proposal falls: a separate, broader bill from Bernie Sanders of Vermont that would not only reverse the $6 billion in benefits but also expand access to other veterans benefits, such as health care and education. Sanders's bill would cost $24 billion; the measure would offset $20 billion of that by taking money from the Overseas Contingency Operations Fund, a pool of money for the Afghan and Iraq wars that is exempt from Congress's self-imposed budget-cap laws. The other $4 billion, Sanders said, would come from other funds under the committee's jurisdiction.

But that mechanism won't pass muster with Republicans, either, who argue that it's an end-run around budget rules and does not represent real-life fiscal discipline. And so Sanders's bill faces long odds in the Senate and has virtually zero chance of passing the House.

"The pay-for has turned out to be more of a sticking point than I thought," said Sen. Roger Wicker, R-Miss. "Much as I would like to solve the COLA problem, I'm not willing to add to the national debt."

So why are Democrats teeing up a string of bills they know won't pass?

Obviously, they—like Republicans—want to undo the pension cuts, and these proposals represent their preferred method for doing it.

But Democrats are also interested in forcing the GOP to continually vote down veterans' funding, seeking to harness the maelstrom raised by the cuts and steer it toward their rivals.

Republicans, for their part, argue they're the ones who are sincere about repealing the cuts—they just won't sacrifice budget discipline to do it. "As I'm sure you know, Democrats are a little late to this effort. Republicans have multiple bills that would fix the COLA problem without adding to the deficit," said an aide to Minority Leader Mitch McConnell, R-Ky.

Sen. Kelly Ayotte wants to tie reversing the cuts to stopping what she views as tax fraud. The New Hampshire Republican's plan aims to bring in $20 billion by making it harder for some—namely, undocumented immigrants—to claim a child tax credit.

Sen. Richard Burr is pushing a broader veterans benefits package similar to Sanders's, but the North Carolina Republican's measure would likely use Ayotte's funding mechanism.

Democrats, meanwhile, have their own budget-neutral alternatives—albeit ones that Republicans will likely find unpalatable.

Sen. Jeanne Shaheen, D-N.H., and Rep. Dan Maffei, D-N.Y., have introduced legislation in their respective chambers to swap the roughly $6 billion in cuts with closing a tax loophole for offshore corporations.

In the middle is Sen. John McCain, R-Ariz., who is still eyeing the $550 billion National Defense Authorization Act as the most likely vehicle. Congress always manages to pass the yearly spending vehicle, which McCain sees as large enough to provide ample opportunities to offset the cost.

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Don't Be Fooled: Military Benefits Are on the Chopping Block

Sara Sorcher, Stacy Kaper, and Jordain Carney, National Journal — Wed, 29 Jan 2014 13:29:30 -0500

Score one for the veterans groups who demanded Congress go back on its plan to cut $6 billion out of military pensions.

The cuts, passed as part of December's budget deal between Sen. Patty Murray and Rep. Paul Ryan, sent members into a tailspin. As veterans groups mobilized en masse against the cuts, lawmakers have been tripping over each other to put their names on proposals to repeal the cuts.

And the repeal crowd was handed a boost Tuesday from Pentagon officials, who told the Senate Armed Services Committee that the provision in the budget deal was not the ideal way to reform military compensation. "We won," Sen. Lindsey Graham said, triumphantly, after the hearing.

The Pentagon suggested that Congress, at the very least, modify the cuts to exempt existing retirees and current service members who were already promised certain benefits. That message, the South Carolina Republican said, will guarantee Congress fixes the issue.

But Graham, and those upset about the recent cuts to military benefits, should not get too excited yet. They've yet to pass anything to repeal the cuts—and they're struggling to compromise on a way to do it without adding to the deficit. And even if they win this round, they have not yet won the impending war with the Pentagon over broader compensation reform.

Pentagon officials prefer Congress address personnel costs entirely after February 2015, so that members do not further interfere or influence the work of a commission set to recommend ways to overhaul the military's compensation and retirement system that would grandfather retirees and those currently serving. Members of Congress, however, are under political pressure. They want to get these cuts repealed now, even though they cannot agree on how to do it, to avoid appearing insensitive to veterans.

"Congress is supposed to get a say in this," said Senate Armed Services ranking member James Inhofe, an Oklahoma Republican. "This is a test to see who ends up being right on it."

The timing might seem like a relatively small detail. But the fact that there's so much momentum to reverse a relatively small cut now means a much larger battle over military compensation reform is looming on the horizon, when the commission report does eventually detail proposed reductions to what has historically proved a virtually off-limits part of the budget. In many ways, the $6 billion reduction in the budget deal became a de facto trial balloon. And Congress is, at least for now, shooting it down.

Members of Congress are caught in a tough place. Either they heed the calls from Pentagon leaders, including the usually-revered top uniformed generals, who say they urgently need compensation reform to keep the military ready and capable. Or they risk detonating a political land mine: Breaking faith with those who have served.

"If it were easy," said Republican Sen. Roger Wicker of Mississippi, "it would have been done long ago."

Sen. Richard Blumenthal said he was "doubtful" overarching reform "will be as easy as it sounds, even by 2015."

"This system is mind-bogglingly complex," the Connecticut Democrat said, "and the political forces will be challenging, so retirement reform is very far away from being a done deal."

But Pentagon officials insist that reform must take place. Due to increases in pay and benefits during more than a decade of war, inflation-adjusted pay and benefit costs are 40 percent higher than in 2001—even though the active-duty force today is only slightly larger, according to testimony at Tuesday's hearing from Christine Fox, acting deputy Defense secretary. Defense health care costs alone have grown from less than $20 billion in 2001 to nearly $50 billion in 2013; payments for housing costs have also increased faster than inflation.

"Given today's fiscal realities... we are unlikely to see defense budgets rise substantially for some time," Fox said. "So if this department is going to maintain a future force that is properly sized, modern, and ready, we clearly cannot maintain the last decade's rate of military compensation growth."

Put simply, the department cannot afford it.

The uniformed military leadership agrees. "Demanding at this point that our compensation not only remain at its currently high relative level, but that it continue to rise faster than that for the average American, would be irresponsible," testified Navy four-star Adm. James Winnefeld, vice chairman of the Joint Chiefs of Staff, "and is simply not sustainable at a time when our entire budget is under such great pressure."

Devil's in the Details

The $6 billion reduction to military pensions does have political—and financial—repercussions.

This "backroom deal," retired Navy Vice Adm. Norbert Ryan, chief of the Military Officers Association of America, said in a recent interview, means a sergeant first class or master sergeant retiring this year, with 20 years of service, would lose $83,000 compared to what he would have earned by the time he reaches age 62. It's unfair, Ryan argues, especially because compensation for military personnel has remained about one-third of the defense budget since 1980. Compensation costs are going up, as they are for say, weapons systems, he says, but "they're not out of proportion."

Square that with the Pentagon's call for a slower growth rate for pay, and higher health care fees and co-pays for retirees, since DoD personnel costs (including civilians) make up about half the department's budget. Without serious reform, officials have said, the military risks being well compensated—but poorly trained and equipped, limited in its abilities to fight and project power abroad.

So who's right? Both sides are downplaying the metric that appears to really matter: the costs per person.

Compensation grew—yes, along with the rest of the defense budget—but the number of service members has remained roughly the same, meaning that from 2001 to 2012, the average cost of basic pay and benefits per active-duty service member grew from $54,000 to $109,000 a year, according to analysis by Todd Harrison of the nonpartisan Center for Strategic and Budgetary Assessments. When you adjust for inflation, that's a whopping 56 percent increase, according to Harrison. If the costs keep growing at this rate—and the overall defense budget does not grow—these costs could gradually consume the entire defense budget by 2039.

High Stakes

For lawmakers, particularly those up for reelection this year, it's virtually impossible to support cuts in benefits for those who have served, says retired Marine Corps Maj. Gen. Arnold Punaro, a former staff director to the Senate Armed Services Committee. The issue is too complex to explain to the American public in a 30-second sound bite, or in a campaign ad, says Punaro, the chief executive of consulting firm The Punaro Group, even though the COLA cuts are minuscule compared to the reforms the military needs to confront in the future.

"The problem is the political cycle. If you are a congressman or a senator who is up for reelection, they"—the network of veterans groups—"use a bumper sticker against you," Punaro said. "The veterans groups are very powerful."

It's not just benefits that are hamstringing the Pentagon. Congress keeps putting restrictions on DoD to prevent it from making other reforms it wants. For instance, members are already working to prevent the Air Force from retiring the A-10 ground-attack aircraft to make room in the budget for newer planes. And Congress has rejected the Defense Department's request to reduce the number of bases it does not need.

The stakes are high: If the Pentagon is forced to downsize, it must make other sacrifices, with potentially more serious consequences for the military's ability to fight and equip its people. By refusing to cut compensation—and other political untouchables—the rest of the defense budget, from weapons programs to training for troops, will likely be slashed.

"If you can't go after infrastructure—your bases—and you can't go after force structure—the cost of your people—what that leaves is investment and operations," Eric Fanning, undersecretary of the Air Force, said in a recent interview. "So either you're not modernizing, buying the next generation of weapons, and/or not using them, not training. … We joke that there's not a caucus for readiness."

Even if the Pentagon cuts procurement and research and development accounts, budget-cutters "will have little choice but to cut the size of the force," Harrison said. "And if the cost-per-person continues to grow, they'll have to continue cutting people. So ultimately, we'll end up with a force too small to follow through on our global-security commitment."

Some members, like Senate Armed Services Chairman Carl Levin, D-Mich., understand this minefield. The Defense Department has made it clear, Levin said at the hearing, that it cannot meet the budget levels Congress has set without curtailing growth in the cost of military pay and benefits, and that failure to curb that growth "will necessarily result in drastic reductions to military force structure, readiness, and modernization accounts." Still, Levin opposes singling out the benefits of military retirees to reduce the deficit.

By the time the commission's work is over, however, Levin will have retired.

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Why Is Kirsten Gillibrand's Military Sexual-Assault Bill Stalled Out?

Stacy Kaper, National Journal — Mon, 13 Jan 2014 17:01:00 -0500

Senator Kirsten Gillibrand is running out of options in her bid to assemble the 60 votes she needs to win her high-profile battle to change the way the military handles sexual assault.

The New York Democrat has 53 supporters for her proposal, but that falls seven short of the tally likely needed to overcome the ever-present threat of a filibuster. And though Gillibrand insists she's still building support, the roster of undecided senators is looking less and less friendly.

In late November, Gillibrand's lobbying allies made a list of 25 who had not yet committed to the sentor's proposal but who—in the view of the advocates—had not explicitly ruled out joining her effort. The move to bring those 25 over, however, is foundering.

Of those 25 potential votes, nine have joined Gillibrand's opposition, and eight are indicating they are at least leaning against her.

Now, the list of undecideds includes only one Democrat—Montana's Max Baucus—and seven Republicans: Tom Coburn, Thad Cochran, Orrin Hatch, Mitch McConnell, Jerry Moran, Marco Rubio, and Pat Toomey.

So why is Gillibrand's bid stalling?

For one, several senators are opting to support a separate, less controversial military sexual-assault measure.

Missouri Democrat Claire McCaskill is proposing a package of more moderate reforms that would increase commander accountability, allow survivors to challenge unfair discharge from the service, and stop soldiers from using good military character as a defense. The plan is noncontroversial, enjoys broad bipartisan support, and is expected to be adopted easily whenever it comes up for a vote.

That measure, however, doesn't include one of the most highly sought-after reforms by victim advocates: stripping the chain of command of its power to decide whether-sexual assault cases are prosecuted. And that's the key switch Gillibrand is pushing for.

McCaskill isn't backing Gillibrand's bill—she actively opposes it—and the two Democrats' relationship has grown tense over the matter.

As well as McCaskill's alternative, several senators said they felt Congress had just made significant strides addressing the issue with reforms that were included in the National Defense Authorization Act that the Senate passed just before it adjourned for the year.

"I actually think that the result we ended up with in the defense authorization bill is probably the correct way to go," said Sen. Ron Johnson, a Wisconsin Republican who had been targeted as an undecided senator, but confirmed he plans to vote no on the Gillibrand bill.

Others did not realize the bill is pending on the calendar, or are dubious it will actually come up for a vote, which Senate aides say would be February at the earliest. With so much else, particularly fiscal matters, dominating the agenda, there is little driving attention on the Gillibrand bill, or the far less controversial, alternative from McCaskill and New Hampshire Republican Senator Kelly Ayotte, R-N.H., which would give Gillibrand opponents something to be "for."

"We'll see if they bring it up," said Wisconsin Republican John Barrasso, another senator recently considered undecided, who now says he is a no. "You want to leave the chain of command in charge. You need to do everything you can to lessen the amount of sexual assault. I think the National Defense Authorization Act has done a significant amount; it could go further. I think that the Ayotte-McCaskill bill addresses that."

McCaskill has argued that Gillibrand's measure would hurt rather than help the problem. She is backed by retiring Senate Armed Services Committee Chairman Carl Levin, D-Mich., and his heir apparent, Sen. Jack Reed, D-R.I.

Sen. Rob Portman, R-Ohio., is technically undeclared but said he's planning to support McCaskill and is probably a "no" on Gilllibrand, because of concerns he has heard from military leaders.

Sen. Sheldon Whitehouse, D-R.I., another senator who was recently considered undecided, said he is with McCaskill and Reed, the senior senator from his state.

"I've been with Claire McCaskill," Whitehouse said. When asked why he is against the Gillibrand bill, he said, "I'm supporting Jack Reed."

Other members—including a couple who remain in the undecided camp—add they are uncomfortable with the fact that the Gillibrand bill would change the protocol of the military-justice system beyond sexual crimes.

It would cover some other crimes, considered a felony in the civilian justice system, that are punishable by a year or more in confinement—including robbery, forgery, extortion and even murder.

"I still haven't taken a position on it," said Senator Marco Rubio, R-Fla. "I still have been talking to a lot of the military leaders including many in my own state to get a better indication of how it would work…. It is a major change in the way we prosecute crimes in the military. I just want to make sure it doesn't undermine the chain of command."

The issue of encompassing a broader class of crimes than just sexual assault has so far been a deal breaker for some potential supporters, but Senate aides say that Gillibrand is not looking to further limit the scope of her bill as she had flirted with last year.

"I thought it was too broad for pulling out non-sexual-assault cases.… There hadn't been a problem in that area," said Senator Tim Kaine, D-Va., who said he is a "no" for now. "What we ought to do now is implement those [reforms included in the NDAA] and see how they work and if we haven't done enough and we need to do more we can revisit it."

The procedure for the vote has not been worked out yet. It is technically possible that 60 votes would be required to take up Gillibrand's bill, but that it could then pass with a simple majority. But Gillibrand has said she expects approval will require 60 votes.

The last time the Gillibrand measure was slated to come up for a vote, the senator enjoyed a sudden surge of momentum. She won six additional supporters, including key members like Senate Majority Leader Harry Reid, D-Nev., and Senate Majority Whip Dick Durbin, D-Ill. They helped push her over the critical simple majority threshold to her current tally, in the lead up to an expected vote on her measure in the form of an amendment to the defense authorization bill late last year.

Advocates say they will need the pressure of lawmakers staring down a vote again to focus their attention and restart momentum.

"Keeping momentum, that is the challenge," said Greg Jacob, the Service Women's Action Network policy director and a former Marine.

Nancy Parrish, the president of Protect Our Defenders, said they will keep lobbying undecided and opposed senators to get 60 votes even if it takes multiple years.

"We're not going away," she said.

Gillibrand is continuing to work her colleagues. "The survivors' day on the Senate floor is coming and we will work as hard as we can until the gavel comes down to give them the justice system they deserve," she said.

"Nowhere in America does a boss get to decide whether or not a sexual assault occurred except the military. That needs to change."

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