President Biden’s Budget Fulfills Our Sacred Obligation to Care for Our Veterans and Their Families

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The President’s 2023 budget prioritizes caring for our veterans and their families and invests in key initiatives to improve their health and well-being. The budget provides $139 billion for the Department of Veterans Affairs (VA), a $22 billion or 19 percent increase above the 2022 budget request[1]. This funding includes $123 billion for VA medical care, a $21 billion or 21 percent above the 2022 budget, to deliver world-class, timely care to our veterans. The budget also focuses on critical areas such as suicide prevention and mental health care services, veteran homelessness, women veterans’ health care, environmental exposures during military service, and caregiver support. Furthermore, the budget invests in the President’s Unity Agenda to support veterans, improve mental health, beat the opioid epidemic, and accelerate progress against cancer.

Prioritizes Suicide Prevention and Mental Health Care Services

President Biden has made reducing veteran suicide and improving veterans’ mental health care services a priority. In 2021, approximately 1.84 million veterans, 30 percent of all veterans using VA health care, received mental health services from the Veterans Health Administration (VHA). Between 2006 and 2021, the number of veterans receiving mental health care from the VHA grew by an astounding 49 percent, far outpacing the 23 percent increase seen in overall VHA service use during that time period.

As demand for mental health care continues to surge, strengthening veteran mental health care services and suicide prevention must be a top clinical priority for VA. The President’s budget provides the resources necessary to meet these needs.

$13.9 billion to improve veterans’ mental health care services — This funding for mental health care services is an increase of $1.7 billion, or 14 percent, above the 2022 budget. This investment supports a comprehensive continuum of outpatient, residential, and inpatient mental health services for the full range of mental health conditions to meet the needs of veterans and family members involved in their care. These include proactive screening for symptoms of depression, post-traumatic stress disorder, problematic use of alcohol, experiences of military sexual trauma, suicide risk, and more. The budget also provides three outpatient mental health visits at zero cost for all enrolled veterans to expand access and lower out-of-pocket costs for mental health services.

$497 million to strengthen veteran suicide prevention initiatives — As a part of the overall mental health care services request, this investment supports the Veterans’ Crisis Line’s 988 expansion initiative, which creates a new national three‑digit emergency telephone number veterans and their families can use to reach crisis call centers across the country for suicide prevention. This funding supports more than 2,500 full-time equivalent personnel (FTE), an increase of more than 1,500 FTE over the 2021 level, to meet an estimated call volume increase of up to 154 percent as a result of the new 988 number. This funding also supports: the suicide prevention 2.0 program to grow public health efforts in communities; a lethal means safety campaign in partnership with other agencies; and the Staff Sergeant Parker Gordon Fox Suicide Prevention Grant Program to enhance community-based prevention strategies.

Invests $2.7 Billion to End Veteran Homelessness

VA is committed to ending veteran homelessness. The investments in the President’s Budget reflect an increase of $409 million, or 18 percent, above the 2022 budget for base homeless programs. This does not include $486 million provided by the American Rescue Plan Act (P.L. 117-2) to reduce veteran homelessness. The increased funding level supports VA’s efforts to ensure every veteran has permanent, sustainable housing with access to high‑quality health care and other supportive services to prevent and end veteran homelessness. This investment allows VA to hire 140 additional social workers to assist veterans experiencing homelessness enroll in health care; expand the Veteran Justice Outreach with approximately 440 staff; assist with design and development of housing partnerships for aging veterans; and provide grant funds for special needs for transitional housing in the Grant and Per Diem program.

Provides $9.8 Billion for Women Veterans’ Health Care, including $767 Million for Women-Specific Care

Since 2001, the number of women veterans using VA services has more than tripled from nearly 160,000 to more than 550,000 today. To meet this growing demand, the budget provides $9.8 billion for women veterans’ health care, an increase of $756 million, or about 8 percent, above the 2022 budget. This investment includes $767 million to support women-specific care and women’s health programs, an increase of $66 million, or 9 percent, above the 2022 budget. This funding includes $134 million for women veterans’ health care initiatives, a $28 million increase over the 2022 budget, to support gynecology, care coordination, maternity care, and staffing. The funding also supports comprehensive specialty medical and surgical services for women veterans, increased access to infertility counseling and assisted reproductive technology, and zero copayments for contraceptive coverage. The budget also improves the safety of women veterans by supporting implementation of the zero‑tolerance policy for sexual harassment and assault at VA facilities.

Supports Veterans Adversely Impacted by Environmental Exposures During Military Service

An estimated one in three veterans report an environmental exposure during military service and one in four report “persistent major health concerns due to deployment exposures.” Examples of military environmental exposures include Agent Orange in Vietnam and airborne hazards and open burn pits in the Southwest Asia Theater of Operations, which can result in short-term acute health outcomes and long-term chronic illnesses. The budget provides improved benefits for veterans exposed to toxic substances by approving new presumptive respiratory conditions and hiring additional claims processors to expedite processing of veterans’ disability compensation claims. The budget also supports veterans exposed to toxic substances by investing in medical research and advancing scientific understanding related to military toxic exposures.

$111 million to expedite processing of new presumptive disability compensation claims for veterans exposed to toxic substances — VA approved the establishment of three new presumptive respiratory conditions (rhinitis, sinusitis, and asthma) based on military service in Southwest Asia due to airborne hazard exposures. This funding supports hiring 795 FTEs to process claims for these new respiratory conditions in a timely manner. Also, as part of the newly funded 795 FTEs, the Veterans Benefits Administration will establish a new Military Exposures Team to provide resources and a dedicated focus on military environmental exposures. This initiative will expedite review and analysis of the types of conditions potentially eligible to meet the statutory threshold to pursue rulemaking as a presumptive disability.

$114 million to improve understanding of and support for adverse impacts from environmental exposures during military service — The budget invests $51 million, an increase of $20 million or 65 percent over the 2022 budget, to support medical research related to military toxic exposures. The budget also provides $63 million, a $32 million or 105 percent increase over the 2022 budget, for the Health Outcomes Military Exposures program. This program is dedicated to increasing scientific understanding of and clinical support for veterans and healthcare providers regarding the potential adverse impacts from environmental exposures during military service.  

Invests $1.8 Billion to Expand Caregiver Support

VA recognizes the important role of caregivers in supporting veterans. This funding for the Caregivers Support Program, a $433 million – or 31 percent – increase over the 2022 budget, supports a major program expansion to help empower family caregivers of eligible veterans. This investment supports both the Program of General Caregiver Support Services and the Program of Comprehensive Assistance for Family Caregivers (PCAFC), with resources for staffing, stipend payments, and many other supports and services for family caregivers of eligible veterans. The investment also enables continued processing of more than 109,000 applications received since the launch of the first phase of PCAFC expansion on October 1, 2020, to help caregivers of veterans who incurred or aggravated a serious injury in the line of duty on or before May 7, 1975. The investment also supports the second phase of PCAFC expansion on October 1, 2022, to caregivers of veterans who served between May 7, 1975 and September 11, 2001. This investment funds an additional 362 field-based positions to process an anticipated increase in volume of applications and it operationalizes VA’s response to the Beaudette ruling, which expanded appeal options outside the VHA Clinical Appeals process.

Targets Investments to Support the President’s Unity Agenda

The President’s Unity Agenda focuses on four key policy priorities: to support veterans, improve mental health, beat the opioid epidemic, and end cancer as we know it. In addition to fulfilling our commitment to provide timely, high-quality care and services to our veterans via the support described above, the VA budget provides targeted investments to combat veterans’ opioid use disorder and improve cancer research and care for veterans.

$663 million to combat veterans’ opioid use disorder — This investment to prevent and treat opioid use disorder constitutes a $16 million increase above the 2022 budget. It will support VA’s comprehensive strategy to ensure opioids are prescribed safely when needed, to treat opioid use disorder, and to prevent opioid overdose. This investment funds the Pain Management Program in Specialty Care Services expanded by the Jason Simcakoski Memorial and Promise Act (P.L. 114‑198, title XI) and allows for more targeted funding of pain management and opioid safety programs – primarily at the facility level – with national support to ensure successful implementation. The investment also funds continued growth and replenishment of VA’s Opioid Overdose Education and Naloxone Distribution, which provides naloxone and education to VA patients at risk for opioid overdose.

$248 million to improve cancer research and care for veterans — The budget invests $81 million in cancer research and $167 million in medical care funds for precision oncology to provide the best possible cancer care for veterans. The investment also supports the President’s Cancer Moonshot initiative to end cancer as we know it today. The $81 million investment in cancer research, an increase of $12 million or 17 percent above the 2022 budget, supports research and programs that address cancer care, rare cancers, and cancers in women, as well as genetic counseling and consultation that advance tele-oncology and precision oncology care. The $167 million investment in precision oncology, an increase of $67 million or 67 percent above the 2022 budget, improves the lives of veterans with cancer by ensuring they have access to cutting-edge cancer therapy using Precision Medicine, Telehealth, and a Learning Healthcare system that integrates research with clinical care. Precision oncology emphasizes treatment based on characteristics of the patient and the cancer, resulting in increased treatment success and decreased side effects compared with a one-size-fits-all approach.

Conclusion

President Biden’s State of the Union Address emphasized that, “Veterans are the backbone and the spine of this country. They’re the best of us. I’ve always believed that we have a sacred obligation to equip those we send to war and care for those and their family when they come home.” In accordance with the President’s key priority to support veterans, his budget puts veterans and their families first by expanding access to care and ensuring that they have timely access to the high‑quality services and benefits they deserve and have more than earned.