Last week the Congressional Budget Office issued an updated budget score for lawmakers’ proposal (H.R. 3230) to expand veterans’ access to healthcare outside the VA for two years. CBO’s verdict: If the measure passes, VA would receive expanded authority and unlimited funds for two years to pay for health care from non-VA providers.

CBO’s 16-page report includes several factors for lawmakers to consider as they debate whether and how to pay for the measure in conference. Here are five:

  1. Direct Cost: $35 Billion. CBO estimates the cost of the additional mandatory or direct spending from the bill at $35 billion. This estimate is highly dependent on certain assumptions about how the law will affect veterans’ use of the expanded VA system.
  1. Use among enrolled veterans: 30 Percent, Rising to 55 Percent. On average, veterans enrolled in VA’s health care system obtain care from VA for only about 30 percent of their total healthcare use. CBO projects this would increase to 55 percent if H.R. 3230 becomes law.
  1. New Enrollees: 1.3 million. CBO estimates about 1.3 million additional eligible veterans would enroll in the VA system should H.R. 3230 become law: 400,000 veterans in 2015 and 900,000 in 2016. CBO also estimates these new enrollees would use the VA system for about half of their health care use.
  1. Potential Enrollees: 7 million. In 2013, 8.6 million veterans were enrolled in VA’s health care system. Of the remaining roughly 13 million veterans, CBO reports that about 7 million qualify to enroll in the VA system but have not done so.
  1. Non-VA veteran healthcare spending: $100 billion. The VA healthcare system is the sole source of coverage for only about one-fifth of enrolled veterans. CBO estimates that veteran healthcare spending exceeds the cost of the VA healthcare system by $100 billion.

Recent revelations about scandals at the VA have led Congress to consider reforms to improve accountability at the agency and to improve veterans’ access to care. Congress should take care to honor its responsibility to care for America’s veterans in a fiscally responsible manner.