[Congressional Record Volume 149, Number 88 (Monday, June 16, 2003)]
[Extensions of Remarks]
[Pages E1266-E1267]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




          H.R. 2475--THE VETERANS HEALTH CARE FULL FUNDING ACT

                                 ______
                                 

                       HON. CHRISTOPHER H. SMITH

                             of new jersey

                    in the house of representatives

                         Monday, June 16, 2003

  Mr. SMITH of New Jersey. Mr. Speaker, today, along with 
Representative Rob Simmons of Connecticut, Chairman of the Veterans' 
Affairs Subcommittee on Health, and three dozen other cosponsors, I am 
introducing H.R. 2475, the Veterans Health Care Full Funding Act, 
legislation to ensure full funding for the Department of Veterans 
Affairs' health care system.-
  This bill would fulfill the central recommendation of the President's 
Task Force To Improve Delivery of Health Care for Our Nation's 
Veterans, which reported an alarming mismatch between demand for 
services and available resources that threatened the quality of VA 
health care. The Task Force recommended that the veterans' health care 
funding process should be overhauled in order to achieve full funding.
  As early as 1993, national veterans organizations were calling for 
guaranteed funding for VA health care. Last year I introduced H.R. 
5250, legislation to achieve that goal by funding VA health care 
through a permanently fixed formula, one possible approach recommended 
by the President's Task Force.
  The legislation we are introducing today takes the other major 
approach identified by the Task Force, establishing an independent 
board of experts on health care economics, with an independent budget 
and staff, to determine the annual funding levels necessary for 
veterans' medical care and to be included in the Administration's 
budget.
  Under our legislation, a three-member Funding Review Board would be 
appointed by the Secretary of Veterans Affairs for staggered 15-year 
terms. The Board would have full access to VA's economic, actuarial and 
other data relevant to determining health care funding, as well as the 
Office of Management and Budget's (OMB) economic and forecasting 
analysis, but would be independent of both.
  The Board would produce an annual budget request and a budget 
forecast for funding necessary to provide full health care benefits in 
a timely and cost-efficient fashion to all enrolled veterans in 
Priority Groups 1-7, primarily those injured or disabled while serving 
their nation, or with low income levels. The amount calculated by the 
Board for the next fiscal year would become the President's budget 
request submitted to Congress. From that point forward, the 
congressional budget and appropriations process would remain unchanged.
  To ensure that veterans are receiving timely care, the legislation 
would require VA to provide care in a timely manner; if VA is unable to 
furnish care to veterans who need it within reasonable timeframes, it 
would be obligated to contract for that care with private sector health 
care providers.
  In order to promote fiscal discipline within VA health care, the 
Board would be required to identify areas where VA program efficiencies 
and savings can be achieved, as well as be required to consider 
recommendations from OMB.
  Mr. Speaker, for at least the past five years, veterans' usage of VA 
health care services has surpassed every Administration estimate--
Republican and Democrat. The continuing rise in demand for VA health 
care services has been driven by many factors, including VA's 
establishment of over 650 new and more convenient VA community-based 
outpatient clinics for primary care, improved safety and quality of 
care, and the availability of VA prescription drug benefits. VA has 
become an increasingly important supplier of prescription drugs to 
veterans, particularly senior veterans who lack a drug benefit from the 
Medicare program.
  Further evidence of the urgent funding needs of VA health care comes 
from a report issued last year measuring the amount of time veterans 
are waiting for medical services. According to VA's report, there were 
nearly 300,000 veterans waiting for initial medical appointments, half 
of whom were waiting 6 months or more; and the other half having no 
appointment at all. While the VA has indicated progress is being made 
to reduce this waiting list, the Secretary's decision to halt 
enrollment of Priority 8 veterans for the remainder of this year is 
another clear indicator that VA is not properly equipped to handle the 
current demand for medical services because it lacks the funding to do 
so.
  The President's Task Force (PTF) was established in May, 2001 to 
improve collaboration and resource sharing between the Departments of 
Defense and Veterans Affairs health care systems. Within months of the 
start of its deliberations, the Task Force discovered that a mismatch 
between demand for VA health care services and available resources 
prevented VA and DOD from achieving the full advantages of sharing and 
threatened the quality of VA health care. The PTF recommended in its 
report that the current budget and appropriations process be reformed. 
Let me quote from the report:

       The Federal Government should provide full funding to 
     ensure that enrolled veterans in Priority Groups 1 through 7 
     (new) are provided the current comprehensive benefit in 
     accordance with VA's established access standards. Full 
     funding should occur through modifications to the current 
     budget and appropriations process, by using a mandatory 
     funding mechanism, or by some other changes in the process 
     that achieve the desired goal.

  The PTF identified two possible approaches to addressing current 
problems with the funding process: make veterans health care funding a 
mandatory budgetary item, or create an independent Board of experts, 
actuaries, or other outside officials to dispassionately review needs 
and determine funding levels. Both approaches would have the same goal: 
to achieve full funding to meet demand in a timely manner.
  Mr. Speaker, the Veterans Health Care Full Funding Act would 
accomplish this goal by establishing a funding process similar to one 
already used by the Department of Defense. Our legislation is modeled 
on a provision in the 2001 Floyd Spence Defense Authorization Act, 
Public Law 106-398, popularly known as ``TRICARE for Life.'' Under this 
legislation, an outside panel of experts and actuaries was established 
to determine future funding levels to meet health care needs of 
military retirees and their families in the TRICARE program. Our 
legislation is modeled on this successful program.
  In addition, our legislation would codify standards for veterans' 
access to health care. Without a requirement that VA meet reasonable 
access standards, veterans could continue to be denied access to care 
regardless of any funding. I would like to recognize and thank my 
colleague on the Veterans' Affairs Committee, Representative Ginny 
Brown-Waite, who has introduced separate legislation, H.R. 2357, to 
achieve this very goal. The standards established in the Brown-Waite 
bill are incorporated in the legislation we are introducing today.
  The VA budget for fiscal year 2003 contained a record $2.6 billion 
increase in the funding of medical care for our Nation's veterans and 
this year, based upon our Committee's recommendations, the House 
approved another record veterans budget, increasing overall veterans 
spending by $6.2 billion, including about a $3 billion increase for 
medical care. But even with these historic increases,

[[Page E1267]]

VA may not be able to meet demand for medical services.
  Mr. Speaker, with the introduction of the Veterans Health Care Full 
Funding Act, H.R. 2475, we hope to move beyond debate and discussion 
and finally get on the fast track to legislative action. It's time to 
fix the funding system for veterans' health care. I urge all my 
colleagues to carefully review and consider supporting the Veterans 
Health Care Full Funding Act, H.R. 2475, to provide dependable, stable 
and sustained funding to meet the health care needs of veterans of our 
armed forces. They deserve no less from a grateful nation.

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