[Congressional Record Volume 143, Number 112 (Friday, August 1, 1997)]
[Extensions of Remarks]
[Pages E1614-E1615]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




      CONFERENCE REPORT ON H.R. 2015, BALANCED BUDGET ACT OF 1997

                                 ______
                                 

                               speech of

                             HON. BOB STUMP

                               of arizona

                    in the house of representatives

                        Wednesday, July 30, 1997

  Mr. STUMP. Mr. Speaker, as chairman of the Veterans' Affairs 
Committee, I am committed to ensuring that the VA health care system 
has adequate funds to meet the health care needs of our veterans. 
Adequate funding for VA has long been an issue. As chairman and 
earlier, as ranking member, I have long advocated legislation to give 
VA new mechanisms to supplement the funding provided through the 
appropriations process.
  My goals in this regard have included legislation to allow VA to 
retain money collected from third-party payers and legislation to allow 
VA to be reimbursed by Medicare when it provides care to certain 
Medicare-covered veterans. We have achieved success on the former, but 
more work needs to be done to give VA the opportunity to demonstrate 
that it can save dollars for the Medicare Program.
  Current law permits VA to retain only the cost of its medical care 
collections. The remainder, constituting several hundred million 
dollars annually, must be deposited in the Treasury, in accordance with 
existing law. That policy fails to compensate VA facilities for the 
cost of care, and necessarily provides little incentive for achieving 
full recoveries or efficient collection efforts.
  Our budget reconciliation bill effects a historic change in law by 
permitting the VA to retain money it collects from third parties. This 
important new provision differs markedly from the collections-retention 
proposal sent to Congress by the administration earlier this year. 
First, it specifically establishes a policy that all moneys collected 
will stay at the network level. With this provision, we create a 
powerful incentive for individual facilities to collect as much as 
possible with the knowledge that the funds will be used locally.
  Notwithstanding the incentive associated with this new authority, 
however, many have expressed well-founded concerns that, for reasons 
beyond VA's control, collections could fall short of target levels. 
Such a shortfall could materially diminish VA's ability to meet 
veterans' health care needs. Mr. Speaker, these concerns prompted our 
committee to develop a contingency funding mechanism, which would be in 
effect for fiscal year 1998. In essence, the measure establishes a 
mechanism that would trigger what would amount to an automatic 
supplemental appropriation if VA collections fall short of 
Congressional Budget Office projections by more than $25 million. These 
and other changes to the original administration proposal provide 
greater assurance that the new policy will foster veterans' interests, 
rather than place them in jeopardy.

  I continue to believe that VA's medical care cost recoveries should 
supplement, rather than substitute for, appropriated funds. All in all, 
however, I believe that the third-party retention language passed by 
the House will help the VA to more effectively care for our veterans, 
and am extremely pleased that this measure is well on its way to 
becoming law.
  I wish the same could be said for the straightforward legislation our 
committee developed earlier this session to demonstrate

[[Page E1615]]

that VA could save money for the Medicare Program while expanding 
access to care for many of our veterans. A seemingly fair-minded and 
straightforward proposal to permit higher income, non-service-connected 
veterans to use their Medicare benefits at VA health care facilities, 
was dropped from this bill. This legislation was favorably reported by 
our committee, had the strong support of all major veterans 
organizations, had 110 cosponsors, and was adopted by the Senate in a 
slightly modified form.
  I very strongly believe that this legislation--H.R. 1362--is at the 
very least cost neutral and would likely save Medicare money. I regret 
that the administration did not make more of an effort to signal its 
strong support for this legislation and failed to counter the 
misinformed view that VA is not prepared to mount such a demonstration 
project.
  VA should be given the opportunity to establish a demonstration which 
can not only expand veterans' access to care but potentially save 
significant sums for Medicare. In that regard, it is ironic, and 
troubling, to learn from the recent testimony of the HHS Inspector 
General that the Medicare Program may pay out considerably more in 
improper payments than the entire VA medical care budget of $17 
billion.
  What some refer to as ``VA-Medicare subvention'' is not simply a 
veterans' issue. It can prove beneficial to the Medicare Program as 
well. We veterans' advocates will, nevertheless, have to redouble our 
efforts to highlight that veterans who cannot now gain access to VA 
health care deserve to be able to use their Medicare benefits at VA 
facilities. I believe that, as more Members come to understand this 
issue and realize the positive effect it could have on tens of 
thousands of veterans nationwide, passage can be achieved.
  Mr. Speaker, we've taken an important step in our efforts to provide 
new revenue streams to fund veterans' health care. New and innovative 
funding mechanisms should be encouraged, studied and implemented. I am 
confident that, with congressional support, the VA can thrive as it 
provides needed care to veterans well into the 21st century.

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