[Congressional Record Volume 144, Number 143 (Sunday, October 11, 1998)]
[Extensions of Remarks]
[Page E2071]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




 MEDICARE HOME HEALTH AND VETERANS HEALTH CARE IMPROVEMENTS ACT OF 1998

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                               speech of

                            HON. LANE EVANS

                              of illinois

                    in the house of representatives

                        Friday, October 9, 1998

  Mr. EVANS. Mr. Speaker, I rise today in support of the bill, H.R. 
4567, although I do so with some reservations. The Committee on 
Veterans' Affairs has a long tradition of bipartisanship in developing 
constructive policy to meet the needs of veterans. Under the leadership 
of Chairman Bob Stump, our Committee considered, perfected and 
approved, H.R. 1362, the Veterans Medicare Reimbursement Act of 1997. I 
continue to believe H.R. 1362 better addresses the needs of veterans 
and VA while simultaneously providing Medicare savings. These Medicare 
savings would result from authorizing VA to charge the Health Care 
Financing Administration for certain care provided by VA to certain 
Medicare-eligible veterans using a discounted Medicare fee schedule or 
capitated payment rate. H.R. 1362 was approved by the Veterans' Affairs 
Committee with the support of the Administration and all of the major 
veterans' services organizations. Working with the Senate Committee on 
Veterans' Affairs, the Senate Finance Committee included a provision 
similar to H.R. 1362 in its version of the Balanced Budget Act of 1997. 
Unfortunately, this provision was not included in the conference 
agreement. I hope that future negotiations with the Senate will yield a 
measure more like H.R. 1362--a more thoughtful and cautious approach 
than the measure we are considering today.
  My support for the measure before us today is due to VA's desperate 
need for funding from non-appropriated sources on which the 
Administration is depending. Since it received authority to retain 
medical care cost recovery funds, VA collections have actually 
declined. VA intended to use both Medicare reimbursement and medical 
care cost recovery funds to provide 10-percent of its funding from non-
appropriated sources. VA's inability to collect the levels of funds it 
anticipated from these sources has resulted in a serious unanticipated 
budget shortfall.
  Now VA faces a new challenge--the Under Secretary for Health has 
committed to ``take all comers'' into its health care system and 
provide them with specified health care benefits. Since VA has already 
committed to enrolling both veterans who bring payment for services to 
the door with them and veterans without such funding, VA will have no 
additional incentive to treat those in higher-income groups. I am 
uncertain what the consequences of Dr. Kizer's decision to enroll all 
veterans will be for VA, but I know that additional resources will 
better ensure its ability to honor this commitment without limiting 
access to care to other veterans with a higher priority to care.
  I commend the gentleman from California, Mr. Thomas, for his work on 
behalf of VA-Medicare Subvention. However, I believe we need to re-
assess VA's health care funding sources and end the funding ``shell 
game'' which has subjected VA to an uncertain revenue stream for the 
last three years. It hasn't worked. If VA is to be a high-quality 
health care system, Congress must be committed to funding the VA with 
adequate appropriated resources for the next fiscal year and years to 
come.

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