WASHINGTON — Veterans Affairs Secretary David Shulkin has promised a host of changes at his department, and now he's also pledging to do it on a tight budget.
"I'm planting the flag that we are not going to be able to go back to Congress and ask for these types of large (budget) increases year after year," he told reporters after a Senate Appropriations Committee hearing on Thursday. "It's going to mean a different way of doing business, but that is our primary objective."
The comments came after senators questioned whether a host of planned program moves at the department — including an ambitious revamp of outside medical care programs — can be done without a significant increase in VA's budget, or without sacrificing other programs.
Shulkin insisted it's a reasonable goal.
"We understand that there are limits to the amount of resources we can and should be asking for," he said.
"We do seek this redesigned system to meet veterans needs better by taking our resources and putting them more into clinical care and less into administrative (costs). We will do this within the president's budget."
President Trump has already proposed a 6 percent boost in VA discretionary spending next year, "so that VA can continue to meet the ever-growing demand for health care services while building an integrated system of care that strengthens services within VA and makes effective use of community services," according to White House documents.
The full federal budget, with specifics on how that money will be spent, is due out in the next two weeks.
Since fiscal 2001, Congress has approved an increase in the department's budget every year, even as other government agencies saw their funding stalled or drawn back. Seven times those funding boosts have topped 10 percent of the previous year's budget. Only twice was the increase less than two percent.
Trump’s budget plan for fiscal 2018 would likely push the total VA budget over $180 billion, almost twice the budget total when President Barack Obama took office in fiscal 2009 ($93.7 billion) and almost four times the total when the war in Afghanistan began ($48.7 billion).
But that sizable increase has drawn concerns on Capitol Hill, especially given continued problems with medical care access and benefits processing at the 360,000-plus employee department.
In recent weeks, Shulkin has promised to expand access to mental health care for veterans with other-than-honorable discharges and change eligibility rules for the VA caregiver stipend program, within the current budget restraints.
His plans for massive changes to programs for veterans seeking health care outside the VA system will follow the same general financial limits, he said Thursday. The department is also looking for ways to cut administrative costs and outsourcing some services.
"We can’t be in the business of doing things that can be done better by the private sector," he said, while simultaneously promising he’s not in favor of "privatizing" the department.
At least some of the cost savings will come from a renewed VA effort to close underused and vacant department-owned buildings. Officials have identified more than 1,100 such facilities in recent years, some dating back to before the Civil War.
"I worry about the sustainability of a system that is continually asking for larger increases than what the private sector is planning," he said. "I understand that is going to require tougher choices, it’s going to require us to modernize our systems so that we’re not continuing to throw good money after bad."
VA’s 6 percent planned budget increase is much more generous than most other non-defense agencies in Trump’s budget. Several, including the State Department and Environmental Protection Agency, face sizable cuts under the White House’s initial plans.
Lawmakers will offer their views on the fiscal 2018 budget in coming weeks. While some conservatives have questioned the size of the VA budget increases in recent years, few have offered significant resistance to the idea.
Leo Shane III covers Congress, Veterans Affairs and the White House for Military Times. He can be reached at firstname.lastname@example.org.