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The Agenda

NRO’s domestic-policy blog, by Reihan Salam.

Today’s Policy Agenda: The VA Is Doing a Lot More Private Referrals



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The budget deficit is 24 percent lower, for now.

In the Wall Street Journal, Eric Morath reports on theTreasury Department’s monthly statement, which said that the total deficit incurred from October to July is 24 percent less that it was  2013 levels. Deficit spending for the month of July came in at around $94 billion, about $2 billion lower than economists expected and 3 percent lower than in July 2013.

The annual deficit peaked in 2009 at $1.4 trillion and has been trending down since — the year-to-date deficit in July was the smallest since the recession began in 2008. Economist think the deficit will shrink again in 2015, but it is expected to begin growing again in 2016:


According to the CBO, health-care spending, Medicare and Social Security benefits for the Baby Boomers, and rising interest rates will drive the deficit increases.

The VA is referring more patients to private providers.

The Associated Press’s Adrain Sainz reports that in the last two months, the Veterans Health Administration referred 25 percent more patients to private providers than during the same period in 2013. Robert McDonald, the new VA secretary, said the system will refer more veterans to private providers until their facilities are able to offer veterans timely care:

“Until we get systems up to capacity, we’re expanding our use of private care and other non-VA health care to improve access for veterans experiencing excessive wait times,” McDonald said. “And we’re monitoring non-VA care to ensure veterans receive the best that they deserve.”

This surge of private provider referrals comes after reports of life threatening wait times and poor quality of care at some VA facilities. Last Thursday, Obama signed a $16 billion dollar VA bill that appropriated specific funds to pay for some veterans to get care in non-VA facilities — there’s an existing Non-VA Care system that will essentially be formalized and expanded.

Obama launches new $250 million dollar pre-K initiative with competitive grants.

Alyson Klein discusses Obama’s new preschool development-grant competition in Education Week. Here’s what government preschool enrollment across the country looked like in 2014:

There will be two separate grant competitions — one to help states without pre-K programs build one and another for states who already have pre-K programs to expand them. Like the Obama administration’s earlier Race to the Top competition for elementary and secondary education, states will compete for funding using a points system based on indicators like levels of teacher training and number of low-income children served.

President Obama proposed a $75 billion dollar “Preschool for All” initiative in his Fiscal Year 2014 budget, which was almost unanimously rejected by both bodies of Congress. This small initiative is intended to spur states to expand pre-K coverage for poorer kids at a much lower cost to the federal government.



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