[Congressional Record Volume 142, Number 40 (Thursday, March 21, 1996)]
[Extensions of Remarks]
[Page E403]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




          LEGISLATION TO IMPROVE SERVICE DELIVERY TO VETERANS

                                 ______


                      HON. G.V. (SONNY) MONTGOMERY

                             of mississippi

                    in the house of representatives

                       Wednesday, March 20, 1996

  Mr. MONTGOMERY. Mr. Speaker, I am introducing legislation to enable 
VA to provide health care to Medicare-eligible veterans who cannot now 
gain access to VA care.
  The VA's health care system serves a veteran population made up 
almost exclusively of veterans whose eligibility for care is based 
either on their income or on their service-incurred disability. Under 
tight budgets that for years have not fully kept pace with rising 
health-care delivery costs, most VA facilities have shut their doors to 
veterans with income exceeding VA's means test--approximately $21,000 
in the case of a veteran without dependents. While eligible for VA 
care, these veterans have neither an entitlement to care nor sufficient 
priority to assure them access. Many, however, are former VA patients, 
locked out of a system on which they once depended. VA now provides 
care to only a small number of these individuals. In all, only 2 
percent of VA's patients are higher income veterans.
  While large numbers of veterans who routinely receive VA care are 
also Medicare-eligible, VA is barred under existing law from receiving 
Medicare reimbursement for their care. Veterans' advocates have, 
understandably, long bristled at what appears to be VA subsidization of 
the Medicare trust fund. This has prompted calls for legislation to 
reimburse VA for care provided Medicare-eligible non-service-connected 
veterans.
  This bill provides for Medicare payments to VA only for higher 
income, Medicare-eligible veterans who are largely shut out of the VA 
system today. The bill would further limit the circumstances under 
which VA could receive Medicare payments--to covered veterans who 
enroll in a VA managed-care plan. My legislation would provide a long-
sought avenue for former VA patients to regain access to VA care. At 
the same time, it could actually lower Medicare costs, as proposed in 
pending Medicare reforms, by encouraging numbers of Medicare 
beneficiaries to abandon the traditional fee-for-service Medicare 
Program in favor of enrollment in a lower cost managed-care plan 
administered by VA.

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