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Office of Management

Department of

and Budget

Veterans Affairs

July 16, 2018
The Honorable Richard Shelby

The Honorable Rodney Frelinghuysen

Chairman

Chairman

Committee on Appropriations
United States Senate

Committee on Appropriations
U.S. House of Representatives

Washington, D.C. 20510

Washington, D.C. 20515

The Honorable Patrick Leahy

The Honorable Nita Lowey

Vice Chairman

Ranking Member

Committee on Appropriations

Committee on Appropriations

United States Senate

U.S. House of Representatives

Washington, D.C. 20510

Washington, D.C. 20515

Dear Conferees:
The Administration appreciates Congress's strong support for the Department of Veterans

Affairs (VA) and the funding levels provided so far in the FY 2019 appropriations process, and
is committed to securing full funding for the VA MISSION Act of 2018 (MISSION Act). This
funding can and should be provided within the existing non-Defense discretionary spending cap,
and the Administration opposes efforts to increase or adjust the cap. Given Congress's recent
approval of a $67 billion increase in the non-Defense discretionary spending cap for FY 2019,
the Administration is confident that the current cap level is more than sufficient to fully fund the

additional needs created by the MISSION Act.
The FY 2019 President's Budget supports a new, consolidated community care program for
veterans and all ofVA healthcare within the discretionary caps already in place. The
Administration worked closely with Congress to make this proposal a reality through the
MISSION Act, and has engaged with Congress to communicate the funding necessary to operate
the traditional community care program until the new, consolidated program is established.
We have a responsibility to provide our veterans with the care they deserve, while also being
good stewards of the taxpayer dollar. The best way to serve our veterans is by ensuring
congressional oversight in the same way other programs are subjected to oversight, including by
asking the Congress to make difficult tradeoffs between competing priorities within the statutory
spending limits that the Congress itself sets. Such oversight justifies every taxpayer .dollar spent
and encourages the program to serve veterans with innovative, streamlined, and efficient quality
of care.

 The FY 2019 Budget includes $73.1 billion to provide healthcare services to veterans and
eligible beneficiaries. The Budget enhances and expands veterans' access to high quality care
by consolidating multiple community care programs, including the Veterans Choice Program,
into one unified program. Unifying funding for the new veterans community care program by
using discretionary resources would increase transparency and accountability.
Enacting the MISSION Act is an historic achievement for the Trump Administration and the
115th Congress, and the Administration looks forward to continuing its cooperation with the
Congress to enact FY 2019 appropriations to support the MISSION Act and to address its future year requirements through the regular budget process.

^&1 ^
Sincerely,

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Peter O'Rourke Mick Mulvaney

Acting Secretary Director
Department of Veterans Affairs Office of Management and Budget

ec:

The Honorable Lamar Alexander
The Honorable John Boozman
The Honorable Steve Daines
The Honorable James Lankford
The Honorable Dianne Feinstein
The Honorable Brian Schatz

The Honorable Chris Murphy
The Honorable Mike Simpson
The Honorable John Carter
The Honorable Ken Calvert
The Honorable Jeff Fortenberry
The Honorable Charles Fleischmann
The Honorable Jaime Herrera Beutler
The Honorable Scott Taylor
The Honorable Marcy Kaptur
The Honorable Peter Visclosky
The Honorable Tim Ryan
The Honorable Debbie Wasserman Schultz