VA Aid and Attendance Benefits

Pursuant to a congressional request, GAO provided information on the: (1) historical purpose of the Department of Veterans Affairs' (VA) aid and attendance (A&A) benefits and the policies affecting the use of these benefits; (2) medical, demographic, and economic characteristics of veterans who receive these benefits; and (3) impact of the Health Care Financing Administration's (HCFA) 1994 A&A policy decision on state veterans nursing homes, including federal and state expenditures for the care of veterans in these homes. GAO did not independently verify the data received from VA or the state veterans nursing homes.

GAO noted that: (1) A&A benefits have historically been a means of providing additional disability benefits to veterans requiring assistance with activities of everyday living; (2) veterans receiving these benefits are generally among the oldest, poorest, and most disabled veterans; (3) HCFA's current A&A policy has increased state and federal Medicaid payments for the care of veterans in state veterans nursing homes; (4) while the increases potentially could be as much as $30 million annually, GAO estimated that the current financial impact is significantly less because of such factors as the relatively small number of Medicaid-eligible veterans residing in state nursing homes and the fact that many states have not yet implemented the current HCFA policy; and (5) HCFA's policy may also create an inequity by allowing Medicaid-eligible veterans in state homes to keep their A&A benefits, while non-Medicaid eligible veterans in these homes are required to use these benefits to pay for the cost of care.