Dr. David Shulkin, the new secretary of the Department of Veterans Affairs, said Tuesday that he expects increases in the VA's $180 billion budget to come out President Donald Trump's proposals to slash domestic spending to pay for a military buildup.
"This looks like an increase in resources for us," Shulkin said to a small group of reporters after addressing the American Legion in Washington, D.C. He did not give figures but said, "I'm confident this budget is going to reflect the president's commitment to his ability to deliver on his promises to make veterans care better and stronger."
On Monday, Mick Mulvaney, the new director of the White House Office of Management and Budget, said Trump's budget plan would result in "increasing defense by $54 billion, or 10 percent." The military buildup would be offset by cutting domestic programs and foreign aid, which would likely be opposed by most Democrats in Congress and some Republicans.
Trump was to outline his agenda in an address to a joint session of Congress on Tuesday night. In a preview, Trump told Fox News on Monday morning, "I will talk about the military. I will talk about the border."
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Shulkin said he is confident that Trump's agenda will spare the VA from the cuts. He said he expects the fiscal 2018 budget proposal for the VA to exceed the FY17 numbers. It is his understanding after consultations with the White House that "we're being given the resources to get the job done," Shulkin said.
Along those lines, Shulkin said he plans to press ahead with tens of thousands of public safety and health exemptions for the VA from Trump's 90-day, across-the-board hiring freeze for federal agencies.
The VA is seeking 37,000 exemptions for 45,000 job vacancies, Shulkin said. "We have asked for it," and "we've received the full 37,000" from the White House.
In addition, Shulkin said he also will seek to fill jobs for claims processing at the Veterans Benefits Administration that would not qualify for public safety or health exemptions. He did not have a number for the jobs to be filled at VBA but said it is "probably in the hundreds."
The logic is simple, he said: "If vets can't sign up for benefits, they can't access services."
In his remarks to the American Legion, Shulkin also expanded on his proposed changes to the Veterans Choice Program, which he outlined in an address to the Disabled American Veterans on Sunday in his first public address since taking over the VA two weeks ago.
Shulkin's proposals -- dubbed "Choice 2.0" -- on allowing veterans more options for private care would eliminate the so-called "40 mile, 30 day rule," which allows veterans to go outside the VA for health care if they had to wait more than 30 days for an appointment or drive more than 40 miles to a VA facility.
Shulkin called the rule "extremely complex and bureaucratic" and said he would ask Congress to scrap it, although critics fear that it would be a step toward the full privatization of VA health care.
During his Senate confirmation hearing, Shulkin said he is not opposed to more options for private care, but pledged that full privatization would not happen "under my watch" at VA.
The choice program was enacted by Congress as a temporary measure in 2014 after it was discovered that veterans were suffering long waits for health care at some VA facilities. It was funded with $10 billion and given an expiration date of Aug. 7, 2017.
Shulkin said his first priority on choice is to get Congress to enact an extension of the program and then to propose reforms in its implementation this fall.
Sen. John McCain, an Arizona Republican and chairman of the Senate Armed Services Committee, and Rep. Phil Roe, a Tennessee Republican and chairman of the House Veterans Affairs Committee, both introduced legislation last month to do away with the expiration date on the choice program.
McCain and Roe, who also addressed the Legion on Monday morning, both estimated that the choice program would have about $1 billion left when its expiration date hits in August.
"You should have the choice to go where you want to" for care, Roe told the Legion audience, but "I'm not sitting up here talking about privatizing the VA." His goal is to make the VA more efficient, he said.
"No one should be on a waitlist for days or weeks or months -- no one," said McCain, who received a distinguished public service award from the VA.
Partly out of fear that Trump might choose a VA secretary who would advocate for full privatization, the Legion was among a number of veterans service organizations that urged the president to consider retaining former VA Secretary Bob McDonald.
Instead, Trump chose Shulkin, who was already at VA as under secretary for health. Shulkin became the only holdover from the Obama administration to hold cabinet rank under Trump.
In his opening remarks at the event, American Legion National Commander Charles E. Schmidt played down the usual blanket criticisms of the VA over wait times, claims backlogs and poor care.
"We think the VA is already pretty good but, as the president would say, 'Let's make the VA great again,' " Schmidt said. "That isn't to say that there aren't some serious problems to address," but he has confidence that Shulkin "does agree that it is a system worth saving."
On the choice program, Schmidt said, "We are not against the concept of health care choices for veterans. Realistically, not all veterans would find it convenient to use the VA."
However, "we are against the current mess that is called the Choice Program," he said. "Delays, non-reimbursement for services and bureaucratic entanglements are constant experiences for many who have attempted to use the program."
Schmidt said the Legion shares Shulkin's goal of making the "VA so great that veterans would overwhelmingly choose VA over the private sector."
-- Richard Sisk can be reached at Richard.Sisk@Military.com.