Pursuant to clause (3)(c)(3) of rule XIII of the Rules of the House of Representatives, the following is the cost estimate for H.R. 2137, as amended, provided by the Congressional Budget Office (CBO) pursuant to section 402 of the Congressional Budget Act of 1974:
The bill would: Make several changes to the processes for adjudicating claims for Department of Veterans Affairs (VA) benefits, thus requiring updates to information technology systems Authorize the Board of Veterans' Appeals to aggregate certain appeals for veterans' benefits Prohibit VA from denying a claim for veterans' benefits solely because a veteran does not report for a medical examination Require several reports and studies Expand the jurisdiction of the Court of Appeals for Veterans Claims Extend the reduction of pensions that VA pays to veterans and survivors residing in Medicaid nursing homes Estimated budgetary effects would mainly stem from: Updating information technology systems Increasing VA's workload Updating information technology systems Providing the required reports and studies Reducing VA pension payments Bill summary: H.R. 2137 would make several changes to the processes for adjudicating claims for Department of Veterans Affairs (VA) benefits. The bill would authorize the Board of Veterans' Appeals (BVA) to aggregate certain appeals for veterans' benefits and prohibit the VA from denying a claim for benefits solely because a veteran does not report for a medical examination. The bill also would expand the jurisdiction of the Court of Appeals for Veterans Claims (CAVC) and extend the reduction of pension payments for veterans and survivors who reside in Medicaid nursing homes. Estimated Federal cost: The estimated budgetary effects of H.R. 2137 are shown in Table 1. The costs of the legislation fall within budget functions 550 (health) and 700 (veterans benefits and services).
Estimated Budget authority 11 1 2 2 3 3 -37 -45 -43 -5 19 -108 Estimated Outlays 8 3 3 2 3 3 -37 -45 -43 -5 19 -108
INCREASES IN SPENDING SUBJECT TO APPROPRIATION
Basis of estimate: For this estimate, CBO assumes that H.R. 2137 will be enacted near the beginning of fiscal year 2026 and that outlays will follow historical spending patterns for affected programs. Provisions that affect spending subject to appropriation and direct spending: Several provisions of H.R. 2137 would make changes to the process for adjudicating claims for VA benefits. In total, CBO estimates that those changes would cost $144 million over the 2026-2035 period. Spending subject to appropriation would increase by $107 million and direct spending would increase by $37 million over the 2026-2035 period. Those changes would affect spending subject to appropriation as well as direct spending because CBO expects that some of the costs of those changes would be paid from the Toxic Exposures Fund (TEF) established by Public Law 117-168, the Honoring our PACT Act. The TEF is a mandatory appropriation that VA uses to pay for health care, disability claims processing, medical research, and information technology (IT) modernization that benefit veterans who were exposed to environmental hazards. Additional spending from the TEF would occur if legislation increases the costs of similar activities that benefit veterans with such exposure. Thus, in addition to increasing spending subject to appropriation, enacting the bill would increase amounts paid from the TEF, which are classified as direct spending. CBO projects that the proportion of costs paid by the TEF will grow over time based on the amount of formerly discretionary appropriations that CBO expects will be provided through the mandatory appropriation as specified in the Honoring our PACT Act.\1\ --------------------------------------------------------------------------- \1\For additional information about estimated spending from the TEF, see Congressional Budget Office, ``Toxic Exposures Fund--January 2025 Baseline'' (January 2025), https://tinyurl.com/3xjr6d3h. --------------------------------------------------------------------------- Information Technology. CBO expects that BVA would require additional IT resources to implement several provisions of H.R. 2137. BVA is a component of VA that hears appeals on matters affecting veterans' benefits. The agency would need to update its case management system to aggregate appeals, to notify employees of errors that delay consideration of appeals, and to manage various requirements for reporting data and tracking appeals. Using information from BVA and data about similar IT changes, CBO estimates that updating BVA's systems would cost $67 million over the 2026-2035 period. Of that amount, $50 million would be spending subject to appropriation and $17 million would be direct spending. Claims Aggregation. Section 3 of the bill would authorize BVA to aggregate appeals with similar issues to address them with a single decision, rather than considering each appeal individually. Because the section would not change the facts or evidence presented, CBO expects that aggregating appeals would not significantly change the outcomes of those appeals and thus would not significantly affect the rates at which veterans' benefits are granted or denied. To aggregate claims, BVA attorneys would need to review all appeals that are filed to identify similarities among them. On the basis of information from VA, CBO estimates that reviewing the roughly 200,000 appeals that are filed each year would increase BVA's workload by the equivalent of 20 attorneys. Each attorney would receive an average total compensation of $250,000 per year; thus, CBO estimates that aggregating claims would cost $50 million over the 2026-2035 period. Of that amount, $38 million would be spending subject to appropriation and $12 million would be direct spending. Medical Examinations. Section 2 would prohibit VA from denying a claim for veterans' benefits solely because a veteran fails to report for a required medical examination. Under current law, VA may require an applicant to undergo a medical examination to determine their eligibility for disability compensation or veterans' pensions; if that applicant does not report for the examination, VA denies their claim. Section 2 would require VA to determine eligibility by reviewing the information presented in a veteran's application rather than denying the claim for failure to undergo the medical exam. CBO expects that VA would continue to deny most claims for which a veteran misses their examination because, without that examination, their application could lack the evidence needed to support their claim. Thus, the prohibition would not significantly increase mandatory spending for disability compensation or pensions. Under the bill, VA would need additional resources to review claims that would no longer be automatically denied. Using information from VA, CBO estimates that reviewing those claims that would have been summarily denied would increase the agency's workload by the equivalent of nine full-time claims processors each year. Each employee would receive an average total compensation of $180,000 per year. In total, CBO estimates that the provision would cost $15 million over the 2026-2035 period. Of that amount, $10 million would be spending subject to appropriation and $5 million would be direct spending. Reports and Studies. Several provisions of H.R. 2137 would require studies or reports. The bill would direct VA to contract with a federally funded research and development center to study common questions of law considered by BVA and to assess BVA's processes for aggregating claims. Using information from BVA and data about the cost of similar reports and studies, CBO estimates that those requirements would cost $12 million over the 2026-2035 period. Of that amount, $9 million would be spending subject to appropriation and $3 million would be direct spending. Direct spending: In addition to the $37 million increase in direct spending from the TEF that was discussed under ``Provisions that Affect Spending Subject to Appropriation and Direct Spending,'' enacting H.R. 2137 would reduce direct spending by extending a statutory limitation on VA pension payments. In total, enacting the bill would decrease net direct spending by $108 million over the 2026-2035 period (see Table 2). Under current law, VA reduces pension payments to veterans and survivors who reside in Medicaid nursing homes to $90 per month. That required reduction expires November 30, 2031. Section 6 would extend that reduction for 37 months, through December 31, 2034. CBO estimates that extending that requirement would reduce VA benefits by about $10 million per month. (Those benefits are paid from mandatory appropriations and are therefore considered direct spending.) As a result of that reduction in beneficiaries' income, Medicaid would pay more of the cost of their care, increasing spending for that program by about $6 million per month. Thus, enacting section 6 would reduce net direct spending by $145 million over the 2026- 2035 period.
Spending subject to appropriation: In addition to the $107 million increase in discretionary costs described under ``Provisions that Affect Spending Subject to Appropriation and Direct Spending,'' section 3 of the bill would increase costs by granting the Court of Appeals for Veterans Claims jurisdiction over certain appeals that have been made to VA or to BVA, regardless of whether they have been appealed to CAVC. In total, implementing the bill would cost $136 million over the 2026-2035 period, CBO estimates (see Table 3). Such spending would be subject to the availability of appropriated funds. Expanding CVAC's jurisdiction would increase the court's workload. Using information about CAVC's resources and current workload, CBO estimates the additional effort would be equivalent to the time of 10 attorneys. Each attorney would receive an average total compensation of $250,000, at a cost of $25 million over the 2026-2035 period. In addition to those personnel, CBO expects that CAVC would require IT upgrades to manage its expanded authority. Using information about the cost of similar IT upgrades CBO estimates those upgrades would cost $4 million. Altogether, expanding CAVC's jurisdiction would cost $29 million over the 2026-2035 period, CBO estimates. (Because expanding CAVC's jurisdiction would not alter the information presented in appeals, CBO anticipates that the change would not affect the outcome of those appeals. Thus, the provision would not significantly increase mandatory spending on veterans' benefits CBO estimates.)
Uncertainty: For this estimate, CBO incorporated the assumption that BVA would use the authority provided by the bill to aggregate claims. If the agency does not aggregate claims, or only uses the authority in limited instances, costs could be less than estimated. Pay-As-You-Go considerations: The Statutory Pay-As-You-Go Act of 2010 establishes budget-reporting and enforcement procedures for legislation affecting direct spending or revenues. The net changes in outlays that are subject to those pay-as-you-go procedures are shown in Table 2. Increase in long-term net direct spending and deficits: CBO estimates that enacting H.R. 2137 would not increase net direct spending by more than $2.5 billion in any of the four consecutive 10-year periods beginning in 2036. CBO estimates that enacting H.R. 2137 would not increase on-budget deficits by more than $5 billion in any of the four consecutive 10-year periods beginning in 2036. Mandates: The bill contains no intergovernmental or private-sector mandates as defined in the Unfunded Mandates Reform Act. Estimate prepared by: Federal costs: Logan Smith; Mandates: Brandon Lever. Estimate reviewed by: David Newman, Chief, Defense, International Affairs, and Veterans' Affairs Cost Estimates Unit; Kathleen FitzGerald, Chief, Public and Private Mandates Unit; Christina Hawley Anthony, Deputy Director of Budget Analysis. Estimate approved by: Phillip L. Swagel, Director, Congressional Budget Office.