A technical dispute over how to account for spending on veterans' healthcare in an otherwise popular bipartisan bill has blown up into a high-profile, politicized controversy thanks to the unhelpful intervention of Jon Stewart.
The comedian has gone on the warpath against Senate Republicans, in particular Sens. Ted Cruz (R–Texas) and Pat Toomey (R–Pa.), for successfully stalling the passage of the Honoring our Promise to Address Comprehensive Toxics Act (PACT) Act last week.
The bill would expand Veterans Affairs (V.A.) benefits for Iraq and Afghanistan veterans who have developed a long list of conditions linked to exposure to toxic burn pits.
Veteran advocacy groups say the current system makes it too hard for servicemembers to get health coverage for burn pit–related conditions. Fiscal hawks have criticized the bill for expanding entitlement spending without paying for it. Some conservative wonks argue the eligibility criteria in the bill would have taxpayers covering government veterans' health conditions that aren't linked to their service.
The bill is "not going to seriously study what conditions might be caused or exacerbated by burn pits, it's not trying to measure the extent to which any service member was exposed to burn bits," says David Ditch, a policy analyst at the Heritage Foundation. "It's just saying that if you were an Iraq or Afghanistan veteran and you have a broad array of medical problems, it is presumed to have been caused by burn pits."
Senate Republicans mostly support the bill's substantive provisions. Their objections instead rest on more technical concerns that the PACT Act's conversion of existing discretionary veterans' spending to mandatory entitlement spending would open the door to additional federal largesse unrelated to veterans' healthcare.
"The PACT Act as written includes a budget gimmick that would allow $400 billion of current law spending to be moved from the discretionary to the mandatory spending category," said Toomey last week. "This provision is completely unnecessary to achieve the PACT Act's stated goal of expanding health care and other benefits for veterans." (He's offered an amendment to address these concerns.)
Stewart, a longtime advocate of the bill, said outside the Capitol last week after Republicans stalled the bill, "I'm used to the lies, I'm used to the hypocrisy. … But I am not used to cruelty."
"The difference between mandatory and discretionary is… that's just a word salad that [Cruz is]spewing into his coffee cup on his way to God knows where as veterans sit in Washington, D.C., and the sweltering heat, demanding that they pass this legislation that they have been fighting for, for 15 years," Stewart said to Chuck Todd on Meet the Press over the weekend.
"[Senate Republicans'] critique is absolutely accurate," Marc Goldwein, senior policy director at the nonpartisan Committee for a Responsible Federal Budget, tells Reason. "This bill could cause up to $400 billion of increased discretionary spending on anything and everything. We don't know how much this is going to cost."
Currently, the V.A. health system offers coverage to veterans for a range of conditions and health problems related to their military service. The bill would expand health benefits to automatically cover conditions 23 conditions—including several types of cancer, leukemia, and bronchitis—for veterans who were stationed in 17 countries during particular times, including in Iraq during the Gulf Wars and in Afghanistan following 9/11.
The bill would treat new spending on this coverage as mandatory spending, meaning that it's not subject to the yearly appropriations bills that Congress passes. The new spending would be on autopilot, like Social Security and Medicare. Importantly, it would also convert a lot of existing, discretionary veterans' health spending into mandatory, entitlement spending.
A June analysis from the nonpartisan Congressional Budget Office (CBO) found that the bill would raise overall spending by $277 billion over ten years and convert an additional $390 billion of existing, discretionary spending into mandatory spending over the same time period.
The upshot of making more spending on such benefits mandatory is that Congress doesn't have to find the money for them when it's writing up annual spending bills. But by relieving Congress of the need to find $40 billion to spend on benefits for veterans each year, they'll have more room to spend that $40 billion on other discretionary programs without increasing overall discretionary spending at all.
Stewart and others have dismissed this by noting that there's nothing in the PACT Act that would spend money on things other than healthcare for veterans.
That's true. But it also misses the point.
"We don't know how appropriators are going to react," Goldwein says. "I think we can surmise that if their spending needs are lower because $40 billion a year, on average, has been removed from something they need to fund, they're going to feel like they have more wiggle room to spend on other things."
Some Democrats have already said as much. Sen. Jon Tester (D–Mont.) told Roll Call that the PACT Act's shift to mandatory spending makes budget writers' jobs much easier by relieving them of the need to find money for the new benefits in the annual appropriations process.
Another criticism offered by Stewart is that many of the Republicans opposing the PACT Act as written also voted for a substantively identical one in June, when the bill passed the Senate on an 84-14 vote.
"It's always been mandatory spending. No gimmick, no trick, been there the whole fucking time," he said in a Friday video monologue.
— Jon Stewart (@jonstewart) July 29, 2022
Manhattan Institute scholar Brian Riedl says many Senate Republicans voted to move the PACT Act forward in June on the belief that they'd have a chance to offer amendments addressing the discretionary vs. mandatory spending issues later in the process.
But that didn't happen in the House. Then this past week, Senate Democrats tried to move the bill forward without allowing consideration of amendments.
Riedl attributes Democrats' unwillingness to accept the Toomey amendment, which would keep $400 billion in current veterans' healthcare spending as discretionary, as pure political gamesmanship.
"They could fix this problem easily and pass the bill," he says. "But by not fixing it and not allowing any amendments to fix it, they were able to spend the weekend generating headlines that Republicans hate veterans."
"I don't think this was an intentional effort, at first, to backfill the discretionary budget," says Goldwein, contra Riedl. "I think this was a complicated budget issue they are trying to work through."
Stewart's moralizing antics over what is essentially a bookkeeping issue haven't helped.
His supposed value add as a political commentator and comedian was always that he could cut through the made-for-television partisan fights designed to conceal how Democrats and Republicans were essentially in agreement on some misguided policy.
But with the PACT Act, he's done the exact opposite. Stewart has inflamed a minor and largely technical dispute about a flawed bill with massive bipartisan support into a life-or-death struggle between greedy Republicans and sick veterans. At best, that's presented an inaccurate picture of the debate over the bill. At worst, it's obscured the fact that both Republicans and Democrats support a major, unfunded expansion of veteran healthcare benefits for conditions that, in many cases, aren't plausibly connected to their service.
The Senate will likely hold another vote on the bill early this week.