OMB COST ESTIMATE
FOR PAY-AS-YOU-GO CALCULATIONS

Report No: 497
Date: 01/03/00

1. LAW NUMBER: P.L.106-117 (H.R. 2116)
2. BILL TITLE: Veterans Millennium Health Care and Benefits Act
3. BILL PURPOSE: (1) Makes a variety of changes to the Department of Veterans Affairs' medical care program; (2) revises and extends veterans programs affecting housing, education, and compensation benefits; and (3) authorizes several new medical facility construction projects and leases.
4. OMB ESTIMATE:

	(Fiscal years; in millions of dollars)
	1999	2000	2001	2002	2003	2004
Net costs.....................	0	10	12	28	15	31

P.L. 106-117 expands several veterans' disability and education benefits, extends Selected Reservists' eligibility for VA housing loans, and provides special borrowing authority for the American Battle Monuments Commission to spend on establishing the World War II memorial in the District of Columbia. These provisions will cost a total of $96 million over the 2000 through 2004 period.

5. CBO ESTIMATE:

	(Fiscal years; in millions of dollars)
	1999	2000	2001	2002	2003	2004
Net costs....................	0	-4	289	343	414	137

6. EXPLANATION OF DIFFERENCES BETWEEN OMB AND CBO ESTIMATES:

CBO scores costs of $1,179 million over the five-year period, which is $1,083 million higher than the OMB estimate. The difference is predominantly due to different interpretations of a requirement providing nursing home care to certain veterans. CBO interprets the requirement as providing certain veterans with an entitlement to nursing home care. OMB and VA interpret the requirement as directing VA to give a higher priority for nursing home care to these veterans. Accordingly, VA's general counsel advises that nursing home care costs are to be funded from VA's medical care account, which is subject to annual appropriations.

7. CUMULATIVE EFFECT OF DIRECT SPENDING AND REVENUE LEGISLATION ENACTED TO DATE:

	(Fiscal years; in millions of dollars)
	1999	2000	2001	2002	2003	2004
Outlay effect..............	53	725	967	609	815	-57
Receipt effect............	-5	3,659	1,779	769	1,985	37
Net costs....................	58	-2,934	-812	-160	-1,170	-94