[Congressional Record Volume 163, Number 59 (Wednesday, April 5, 2017)]
[House]
[Pages H2722-H2726]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
AMENDING THE VETERANS ACCESS, CHOICE, AND ACCOUNTABILITY ACT OF 2014
Mr. ROE of Tennessee. Mr. Speaker, I move to suspend the rules and
pass the bill (S. 544) to amend the Veterans Access, Choice, and
Accountability Act of 2014 to modify the termination date for the
Veterans Choice Program, and for other purposes.
The Clerk read the title of the bill.
The text of the bill is as follows:
S. 544
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
SECTION 1. MODIFICATION OF TERMINATION DATE FOR VETERANS
CHOICE PROGRAM.
Section 101(p)(2) of the Veterans Access, Choice, and
Accountability Act of 2014 (Public Law 113-146; 38 U.S.C.
1701 note) is amended by striking ``, or the date that is 3
years after the date of the enactment of this Act, whichever
occurs first''.
SEC. 2. ELIMINATION OF REQUIREMENT TO ACT AS SECONDARY PAYER
FOR CARE RELATING TO NON-SERVICE-CONNECTED
DISABILITIES AND RECOVERY OF COSTS FOR CERTAIN
CARE UNDER CHOICE PROGRAM.
(a) In General.--Section 101(e) of the Veterans Access,
Choice, and Accountability Act of 2014 (Public Law 113-146;
38 U.S.C. 1701 note) is amended--
(1) in the subsection heading, by striking ``Other Health-
care Plan'' and inserting ``Responsibility for Costs of
Certain Care'';
(2) in paragraph (1), in the paragraph heading, by striking
``to secretary'' and inserting ``on health-care plans'';
(3) by striking paragraphs (2) and (3);
(4) by redesignating paragraph (4) as paragraph (2); and
(5) by adding at the end the following new paragraph:
``(3) Recovery of costs for certain care.--
``(A) In general.--In any case in which an eligible veteran
is furnished hospital care or medical services under this
section for a non-service-connected disability described in
subsection (a)(2) of section 1729 of title 38, United States
Code, or for a condition for which recovery is authorized or
with respect to which the United States is deemed to be a
third party beneficiary under Public Law 87-693, commonly
known as the `Federal Medical Care Recovery Act' (42 U.S.C.
2651 et seq.), the Secretary shall recover or collect from a
third party (as defined in subsection (i) of such section
1729) reasonable charges for such care or services to the
extent that the veteran (or the provider of the care or
services) would be eligible to receive payment for such care
or services from such third party if the care or services had
not been furnished by a department or agency of the United
States.
``(B) Use of amounts.--Amounts collected by the Secretary
under subparagraph (A) shall be deposited in the Medical
Community Care account of the Department. Amounts so
deposited shall remain available until expended.''.
(b) Conforming Amendment.--Paragraph (1) of such section is
amended by striking ``paragraph (4)'' and inserting
``paragraph (2)''.
SEC. 3. AUTHORITY TO DISCLOSE CERTAIN MEDICAL RECORDS OF
VETERANS WHO RECEIVE NON-DEPARTMENT OF VETERANS
AFFAIRS HEALTH CARE.
Section 7332(b)(2) of title 38, United States Code, is
amended by adding at the end the following new subparagraph:
``(H)(i) To a non-Department entity (including private
entities and other Federal agencies) that provides hospital
care or medical services to veterans as authorized by the
Secretary.
``(ii) An entity to which a record is disclosed under this
subparagraph may not redisclose or use such record for a
purpose other than that for which the disclosure was made.''.
The SPEAKER pro tempore. Pursuant to the rule, the gentleman from
Tennessee (Mr. Roe) and the gentleman from Minnesota (Mr. Walz) each
will control 20 minutes.
The Chair recognizes the gentleman from Tennessee.
General Leave
Mr. ROE of Tennessee. Mr. Speaker, I ask unanimous consent that all
Members have 5 legislative days in which to revise and extend their
remarks and add extraneous material into the Record.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from Tennessee?
There was no objection.
Mr. ROE of Tennessee. Mr. Speaker, I yield myself such time as I may
consume.
I rise today in support of S. 544. Congress created the Choice
Program in 2014 to ensure that veterans waiting in line at the
Department of Veterans Affairs medical facilities across the country
had an option of seeking care in their communities. Though Choice is
far from perfect, 3 years later, more than a million veterans have used
it to get care they needed faster and closer to home.
Choice has also led to a nationwide conversation about the importance
of the VA healthcare system, the need for VA to be a better partner to
community providers and hospitals everywhere, and the actions we must
take to ensure that VA is well positioned to provide high-quality care
to veterans for generations to come. As chairman, I am wholeheartedly
committed to seeing that conversation through to a solution.
We are currently refining legislation that will provide a long-term
path to make the VA healthcare system and VA's care in the community
programs, including Choice, work better for veterans, for VA, for
community providers, and for taxpayers alike. Our goal is to have that
solution on the President's desk later this year.
However, Choice is expected to sunset just four short months from now
on August 7, 2017. And when it does, the VA expects to have anywhere
from $800 million to $1.2 billion left in the Choice fund.
Absent enactment of this bill or legislation like it, on August 8,
those funds will no longer be available to help veterans get the care
they need, with potentially tragic consequences.
During a full committee hearing last month, Secretary Shulkin
testified:
``Without congressional action, veterans will have to face longer
wait times for care.''
He went on to say that allowing Choice to sunset would be ``a
disaster for American veterans.''
With the passage of this bill today, we can get one step closer to
avoiding that disaster.
In anticipation of the program's expiration, VA has already started
halting referrals to Choice for services, like maternity care and
oncology care that typically require lengthy episodes of care. That
means that veterans with cancer or veterans who are pregnant can no
longer choose to take advantage of Choice care if they live far away
from a VA medical facility or have to wait more than 30 days for the
next VA appointment.
As if that wasn't bad enough, if Choice is not extended by the end of
April, VA will have to stop sending referrals to Choice for many other
services that veterans are relying on.
To prevent this, S. 544 would remove the August 7, 2017, sunset date
from the Choice program. This will allow the program to continue
working for veteran patients until all the money remaining in the
veterans Choice fund--the money that Congress provided 3 years ago for
this exact purpose--is fully expended.
It would also ensure that, as we move forward with ongoing efforts to
create an enduring solution to the problems VA is facing, veterans are
not cut off from potentially lifesaving or life-preserving care.
The bill would also eliminate the requirement for VA to act as the
secondary payor for nonservice-connected care provided under Choice.
This would bring Choice in line with VA's other care in the community
programs and remove a pain point that, while well-intentioned, has
impeded the provision of care for certain patients and challenged VA's
ability to issue reimbursements to community providers in a timely
consistent manner.
In addition, the bill would authorize VA to share medical record
information with community providers who are jointly treating veteran
patients. This would ensure that the clinicians caring for veterans,
both in VA and community medical facilities, have all the information
that they need to make well-informed treatment plans and provide the
highest quality care.
Subsequent redisclosure of medical records information would be
prohibited, meaning that personal patient information would be
safeguarded from inappropriate disclosures.
As chairman, as a veteran, and as a doctor, I cannot think of
anything more important that we can do today to help our Nation's
veterans and pass this legislation out of the House of Representatives
and swiftly deliver it to the President's desk for his signature.
[[Page H2723]]
I urge all of my colleagues to join me in doing that by supporting
this bill today.
I reserve the balance of my time.
{time} 1415
Mr. WALZ. Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, I, too, rise in strong support of S. 544 to eliminate
the sunset on the Veterans Choice Program.
This bill will basically allow the Department of Veterans Affairs to
continue spending previously appropriated resources in the Veterans
Choice Program to provide direct and timely patient care to veterans.
It allows the VA to charge a veteran's healthcare insurer for
nonservice-connected care so that veterans aren't sent expensive
medical bills, wasting time trying to figure out how to get them paid.
Finally, it allows the VA to share medical information with community
care providers so patient care is better coordinated.
This legislation is identical to H.R. 369, which passed unanimously
in our Committee on Veterans' Affairs. It includes amendments offered
by members of that committee.
I would like to take a moment, Mr. Speaker, to congratulate and thank
the chairman of the committee for the bipartisan way that he approached
this. The issue of veterans care is a passionate issue for all of us.
The issue of the Choice Program arose out of the crisis in Phoenix
and other places in 2014, and a sunset that needed to be addressed was
handled in a professional manner. It brought all parties together. I
think the chairman is going to get a unanimous vote. They have got one
in the Senate.
I can see that, under less steady hands, where this may have bogged
down, and I appreciate the chairman's sense of urgency in getting it to
this point. It puts us in a good place. So thank you for that.
It also gives us the time we need to come to a bipartisan fix for the
Choice Program. We know, under the Choice Program, veterans are still
waiting too long to receive care. As we said, in 2014, we all supported
the Choice Act because of the crisis. Throughout the country, veterans
were waiting, and in some cases dying, because they were waiting for
care. If we recall right, an honorable and decent man, the VA
Secretary, resigned over this crisis. So this was an important issue
that needed to be addressed. We passed the Choice Act so that veterans
could get that care.
The Choice Program was created as a temporary fix, designed to end
this summer or when the VA spent the $10 billion. As the chairman said,
there is about $1 billion left in Choice. With veterans still in need
of care, we cannot possibly allow that to go back without addressing
where it needs to go. It would be a waste of money, a waste of time,
and it would make veterans' wait times even higher.
The bill gives us time to rewrite the Choice Program. The bill will
give us time to address all of the problems with Choice so that
veterans' care is managed and coordinated with VA and community care
providers and so that veterans do not have wait times. It will also
make sure the money will continue to be spent on veterans' health care.
I look forward to working with the chairman. As I said earlier, his
steady hand and visionary leadership has gotten us to this point. It
will ensure that we can figure out what the next iteration of
community-based care looks like, and we can come together, bring that
to the floor, and get it passed.
For this reason, I would urge my colleagues to support this
legislation so veterans can receive their care now while Congress
continues to work to improve upon that.
Mr. Speaker, I reserve the balance of my time.
Mr. ROE of Tennessee. Mr. Speaker, I thank my friend, Ranking Member
Walz, for his kind words and his hard work on this legislation also.
I yield 2 minutes to the gentleman from Florida (Mr. Bilirakis), the
vice chair of the Veterans' Affairs Committee.
Mr. BILIRAKIS. Mr. Speaker, while the Veterans Choice Program is by
no means perfect--the chairman said this, as well as the ranking
member--many of our men and women who wore our Nation's uniform rely on
it for increased access to quality health care.
I strongly support S. 544 because veterans should have certainty that
their care will continue, and I am optimistic that our efforts to
reform and build upon the Choice Program will yield positive results
going forward. The intentions and goals of the Choice Program are good,
giving our true American heroes more choices and more focused care;
but, clearly, some areas of the program need improvement. I hear that
from my veterans.
We have already taken some solid steps to make the program work
better for veterans, but not enough. We will have the opportunity to
fix this in a bipartisan fashion; for example, one positive step: The
eligibility rules initially stated that a veteran had to live 40 miles
as the crow flies from the nearest VA facility. We changed it to 40
miles driving distance. That is just common sense; isn't it? I think it
is. We have also made reforms to increase the number of non-VA
providers who are allowed to participate in the program and expand
eligibility to all enrolled veterans.
There is much work to be done, there is no question. The only way we
can continue improving the Veterans Choice Program and ensure that
veterans see no interruption to their health care is to eliminate the
sunset date.
Mr. Speaker, I urge passage of S. 544.
Mr. WALZ. Mr. Speaker, I yield 2 minutes to the gentlewoman from New
Hampshire (Ms. Kuster), my good friend and a friend of all veterans,
our ranking member on the Oversight and Investigations Subcommittee.
Ms. KUSTER of New Hampshire. Mr. Speaker, I, too, want to commend our
chairman, Mr. Roe, and ranking member, Mr. Walz, for their bipartisan
efforts.
I rise to speak on S. 544, the bill that will eliminate the sunset on
the Veterans Choice Program.
The Veterans Choice Program was a bipartisan effort to quickly help
our veterans in need by ensuring they had access to quality health care
after the crisis in Phoenix. However, it was a temporary program. It
was not intended to last longer than a few years until Congress could
have developed the future of VA community care. As many of my
colleagues note, the Choice Program needs an update. This bill
represents the first step of that process.
It is expected that the Veterans Choice fund will still have funding
by August 2017, as noted, when the Choice Program is scheduled to
sunset. This bill will ensure that our veterans will be able to use
those resources, and it will ensure those who have long-term care
through the Choice Program will not suddenly find themselves without
care.
But, as we design a new program to replace the Choice Program, we
must ensure that it is an effective and efficient system of care that
follows the very best practices of American health care. Part of that
is ensuring that these healthcare practitioners do not discriminate on
the basis of race, sex, gender, or sexual orientation.
The current Choice Program eliminated those protections to facilitate
faster implementation, and while I am concerned of the regulatory
burden these antidiscrimination measures could provide, I am committed
to working with my colleagues across the aisle on a commonsense and
reasonable compromise. We can make a program that not only provides
effective and accessible care for our veterans, but also prevents
discrimination in the workplace and upholds the finest ideals of the
United States of America.
Mr. ROE of Tennessee. Mr. Speaker, I yield 2 minutes to the gentleman
from Colorado (Mr. Coffman), my good friend, a veteran of both the
Marine Corps and the Army, twice deployed to Iraq, and a very active
member of the committee.
Mr. COFFMAN. Mr. Speaker, I stand today in support of legislation to
remove the sunset date on the Veterans Choice Program and, in turn,
bring continuity to our Nation's veterans currently receiving their
health care in the community through the Choice Program. Although the
program is not perfect, it did provide our Nation's veterans with an
unprecedented choice in where they seek their health care and assisted
the VA in reducing the appointment wait times backlog.
[[Page H2724]]
While my colleagues and I on the House Veterans' Affairs Committee
work to streamline and reform the VA's in-community care programs, it
is critical that we pass S. 544 to extend the Veterans Choice Program
beyond the August 7 sunset date. This will provide help to veterans
seeking long-term care through the Choice Program and help meet our
Nation's obligations to our veterans who have sacrificed so much in
defense of our freedom.
Mr. Speaker, I thank Chairman Roe for his leadership on this matter.
Mr. WALZ. Mr. Speaker, at this time it is my privilege to yield 3
minutes to the gentleman from California (Mr. Takano), my good friend
and also a good friend of veterans, the vice ranking member of the full
Committee on Veterans' Affairs,
Mr. TAKANO. Mr. Speaker, I thank the ranking member, the gentleman
from Minnesota, for yielding.
Mr. Speaker, I rise today in support of S. 544. This legislation
ensures that the approximately $1 billion left in Choice funding is
spent on the critical mission of providing veterans timely access to
care.
It would be an abdication of our responsibility to veterans if we
allowed this money to go back to the Treasury instead of going to those
who need and deserve our support.
I appreciate the efforts from my colleagues on both sides of the
aisle for advancing this legislation.
The Choice Act was designed as a rapid response to the veteran wait
time crisis, but its framework and implementation has been deeply
flawed. Objective analyses found that it is not meaningfully reducing
veterans' wait times, and its arbitrary standards have added a layer of
confusion for both patients and providers.
There is bipartisan consensus that these concerns must be addressed
when the Choice Act sunsets and the funding expires. We can and must do
a better job of prioritizing and streamlining veterans' access to care
in the community. We can and must do better than the existing Choice
Act.
Now, the Choice Act was a temporary emergency measure to address an
unacceptable crisis. Unfortunately, it contained language that
undermined protections against workplace discrimination for Federal
contractors. The next iteration of this law cannot subvert the rights
of those who treat and serve our veterans.
The Office of Federal Contract Compliance Programs continues to be a
vital tool for ensuring fairness and equality in the workplace. It
should apply to everyone that does business with the Federal Government
because the Federal Government cannot endorse discrimination of any
kind.
I will fight to ensure that this committee and this Congress restores
their commitment to equality and fairness as we develop a more
streamlined and thoughtful method for connecting veterans with
community care.
Mr. Speaker, I include in the Record a letter echoing these concerns
from the Human Rights Campaign, the National Women's Law Center, The
Leadership Conference on Civil and Human Rights, and the National
Partnership for Women & Families.
April 5, 2017.
Dear Representative: We write to express our serious
concerns about H.R. 369/S. 544, which would eliminate the
sunset of the Veterans Choice Program. The Veterans Choice
Program currently includes a provision exempting it from
oversight by the Office of Federal Contract Compliance
Programs (OFCCP). This has diminished civil rights
protections when the Department of Veterans Affairs (VA)
enters into federal contracts for veterans' health care
services. The Veterans Choice Program was always intended to
be a temporary solution to ease the health care access crisis
faced by the veterans receiving care through the VA. We fear
that removing the sunset will open the door to extension of
the program, including extending the provision that strips
critical equal employment opportunity protections from the
men and women serving our nation's veterans. OFCCP must have
full jurisdiction to protect against employment
discrimination and promote equal employment opportunities.
The antidiscrimination rules enforced by OFCCP ensure that
federal contract dollars further equal employment opportunity
and are not used to subsidize unlawful discrimination. OFCCP
plays a unique and vital role in combating unlawful
employment discrimination by federal contractors on the basis
of sex, race, national origin, religion, color, sexual
orientation, gender identity, and disability. It also
enforces the Vietnam Era Veterans Readjustment Assistance
Act, or VEVRAA, which requires nondiscrimination and
affirmative action for special and disabled veterans of any
war, campaign, or expedition in which a campaign badge has
been authorized. In addition, OFCCP guides contractors and
subcontractors on affirmatively promoting equal opportunity
in the workplace and promotes fair and nondiscriminatory
federal contractor workplaces. Many of its regulations
require contractors to take affirmative steps to expand the
pool of individuals from which it recruits, and evaluate
their own practices to identify and address conduct that
limits equal employment opportunities for protected classes
of workers. By conducting compliance audits and systemic
investigations, through its data collection and investigative
authority, OFCCP can aid contractors in identifying and
resolving practices that limit equal employment
opportunities, without relying solely on individuals who are
willing to risk retaliation to challenge unfair employment
practices. OFCCP's historic and current role in ensuring
artificial barriers do not restrict employment based on sex,
race, color, national origin, religion, sexual orientation,
gender identity, disability, or veteran status has improved
opportunities for a wide range of workers across the country
and has ensured that federal tax dollars do not subsidize
discrimination.
Carving out the VA provider agreements from these
antidiscrimination protections, affirmative action rules, and
data reporting requirements has the effect of narrowing
employment opportunities for women, people of color, people
with disabilities, veterans, and LGBT individuals and removes
critical tools for ending employment discrimination and
harassment. Extending the provision that weakens these
protections ultimately threatens harm not only to workers,
but to those who depend on them for care.
There is no appreciable administrative burden that
justifies continuing to suspend these protections and
requirements. Federal contractors and subcontractors with
less than 50 employees and $50,000 in contracts or
subcontracts are not covered by OFCCP's affirmative action
requirements. More than 94 percent of health care and social
assistance firms had fewer than 50 employees in 2009. The
larger providers, those with 50 or more employees and $50,000
or more in federal contracts, should be well-equipped to meet
the minimal administrative obligations associated with
maintaining an affirmative action plan.
The carve-out of VA contractors from the employment
discrimination rules applicable to federal contractors not
only has a detrimental impact on the workforces affected, but
sends a disturbing message that ensuring fair treatment for
women, people of color, LGBT people, veterans, and people
with disabilities is unnecessary and inconsequential. It sets
a precedent for future carve-outs and represents a step
backward from equal opportunity. Any continuation of the
Veterans Choice Program must ensure OFCCP jurisdiction to
enforce the antidiscrimination rules and other equal
employment opportunity protections for these providers.
For further information, please contact the Human Rights
Campaign, the National Women's Law Center, the Leadership
Conference on Civil and Human Rights, or the National
Partnership for Women and Families.
Sincerely,
National Women's Law Center.
Leadership Conference on Civil and Human Rights.
National Partnership for Women & Families.
Human Rights Campaign.
Mr. ROE of Tennessee. Mr. Speaker, I yield myself such time as I may
consume.
I look forward to working with Ranking Member Walz and our fellow
committee members to strike the appropriate balance between ensuring
protections that are in place to provide provider agreement authority
from being unfairly utilized and reducing administrative burdens on
small providers.
However, absent passage of this legislation today, veterans with
serious need will not be able to get the care they need. Already,
veterans who are pregnant or who have been diagnosed with cancer have
been unable to take advantage of the increased access to care that the
Choice Program provides.
I would also note that, since Choice granted VA provider agreement
authority in the Choice Act 3 years ago, the committee has not heard a
single instance where that authority has been improperly utilized or
resulted in unfair labor practices.
Furthermore, the exclusion afforded in the Choice Act is no more
generous than providers under Medicare or in TRICARE currently enjoy,
and there is no reason why providers accepting veteran patients should
have to deal with more administrative burdens than providers under
Medicare and TRICARE. I can assure you, as a Medicare provider and a
TRICARE provider, that is enough burden.
[[Page H2725]]
Mr. Speaker, I yield 2 minutes to the gentleman from New Jersey (Mr.
Lance), my good friend and fellow classmate.
Mr. LANCE. Mr. Speaker, I certainly commend the chairman of the
committee, Dr. Roe, for his leadership on this issue, as well as the
ranking member for his leadership.
I rise in strong support of S. 544, which will extend the Veterans
Access, Choice, Accountability and Transparency Act. This is an
important bill. I have heard from constituents in the congressional
district I serve that the Choice Program is working and Congress should
extend its authorization and its funding.
The Choice Program was the first step in a long road to true
transformation of the Veterans Administration. Veterans should get to
choose the care and the facility serving them best. No veteran should
ever been forced into waiting lines and other limitations.
Many Veterans Administration healthcare facilities do tremendous
work, like the Lyons VA Hospital in Bernards Township, Somerset County,
New Jersey, in the district I serve. But care through the VA should not
be limited to VA facilities.
The extension of the Choice Program should be a down payment on other
reforms. We should be expanding choice and eliminating geographic
limitations, and I hope to work with Chairman Roe and his committee to
do so.
Too many of our Nation's heroes have lost confidence in a desperately
broken bureaucracy, and we have begun to reform that in 2014, and we
continue today. Legislation like this bill is another step in restoring
that trust and faith.
The brave men and women who have stepped forward to serve our Nation
deserve our continued dedication to fixing the VA and ensuring they
receive the services they have earned in our defense.
{time} 1430
Mr. WALZ. Mr. Speaker, I yield 2 minutes to the gentlewoman from
California (Ms. Brownley), the ranking member of our Health
Subcommittee.
Ms. BROWNLEY of California. Mr. Speaker, I thank the gentleman from
Minnesota, our ranking member, for yielding me time and for his
tireless advocacy on behalf of our Nation's veterans.
As the ranking member of the House Veterans' Affairs Subcommittee on
Health, it has been my privilege to work with the ranking member and my
fellow committee members to establish and conduct rigorous oversight of
the Choice Program.
We enacted the Choice Act in a time of crisis. Those of us who served
on the committee during that time remember all too well the horrific
stories that came to light that moved Congress to enact this law.
Congress passed the Choice Act to ensure that all veterans receive
timely access to quality care. It is clear, however, that, in the rush
to set up the Choice Program, many veterans were still forced to wait
too long and bureaucratic headaches continue to delay needed care.
We need to get Choice 2.0 right and balance the obvious need for care
in the community while protecting the top quality care that the VA
provides. We must also make sure that Choice 2.0 protects the civil
rights of veterans as well as VA employees, contractors, and community
providers caring for our veterans.
Today's bill will allow the VA to continue spending the remaining
funds in the Veterans Choice Program fund. It will also allow the VA to
reimburse community providers faster and improve the sharing of medical
records. It gives us time to continue our bipartisan work to fix the
Choice Program.
Each Member of this body, on both sides of the aisle, agrees that our
veterans have earned the very best care available. Mr. Speaker, I urge
my colleagues to support this legislation so that veterans can receive
care now while Congress uses this opportunity to get this right.
Mr. ROE of Tennessee. Mr. Speaker, I yield 2 minutes to the gentleman
from Pennsylvania (Mr. Costello), a former member and a very active
member of our committee.
Mr. COSTELLO of Pennsylvania. Mr. Speaker, I thank the chairman for
his leadership.
Mr. Speaker, I rise today in support of the Veterans Choice Program
Improvement Act.
This legislation protects access to health care for our Nation's
veterans by maintaining the VA Choice Program and ensuring that funds
already allocated for veterans health care remain dedicated to that
purpose.
Veterans across my district have utilized the program to access
treatment from community healthcare providers. And while they
appreciate the flexibility this program provides, I often hear of a
need to make improvements and remove hurdles that prevent this program
from realizing its full potential.
I am pleased this legislation takes several steps to reduce red tape.
Now, what do I mean by that?
First, we are going to speed up reimbursements to community
providers. We are going to strengthen medical record sharing between
the VA and community providers and reduce out-of-pocket costs for
veterans--all very important steps to improving the VA Choice Program.
These are commonsense, bipartisan improvements.
I want to thank Chairman Roe for his leadership.
Mr. Speaker, I urge my colleagues to support this bill.
Mr. WALZ. Mr. Speaker, I yield 3 minutes to the gentleman from Texas
(Mr. O'Rourke), my good friend, the ranking member of our Economic
Opportunity Subcommittee.
Mr. O'ROURKE. Mr. Speaker, I would like to begin by thanking the
chairman of the full committee, and I join the ranking member of the
full committee in honoring the work of Chairman Roe, his staff, and his
ensuring that we do the right thing for every single one of the
veterans in this country that we are here to serve.
It would be easy just to criticize the Choice Program which has not
worked fully as intended. Too many of the veterans that we represent
are still getting bills when their provider in the community, the VA,
and the third-party administrator can't resolve their differences.
Too many veterans are having too hard of a time in getting an
appointment in a timely fashion. And as we learned recently, the VA
still is not fully measuring the true wait time for the more than 3
million appointments that have been made through the Choice Program
right now. We don't have the kind of accountability that we must have.
All the same, the Choice Program is bridging care for veterans who
need it in millions of instances. To simply allow the sunset to take
place without having the time necessary to work on some of the
necessary fixes would be irresponsible. So thanks to the chairman and
the ranking member, we are able to do that today.
We also ensure that the VA becomes the primary payer, which is going
to reduce some of the billing headaches that veterans have
unnecessarily been subjected to.
Mr. Speaker, I also want to point out that the bill contains the Vet
Connect Act, which I was able to author with Congressman Benishek, a
bipartisan bill, last session, re-introduced this session.
It is bicameral, as well, in the Senate. We have Senators Tester,
Isakson, and Manchin, who authored this bill that ensures that
veterans' private medical information follows them from the VA to their
provider in the community and then back to the VA, ensuring that every
appointment, every provider, and every doctor can make informed medical
decisions on behalf of those veterans. Right now, at the current rate
of inclusion of veterans' personal medical information, it would take
60 years to get all the data into the hands of the doctors who need to
make that care.
This brings the VA and the veterans under the VA's care into modern
medical record keeping and sharing. It honors all of the HIPAA
regulations; ensures privacy of veterans' medical records; but, most
importantly, ensures that they are going to get better, more informed
quality care, better outcomes, better treatment. It is what the
veterans that we serve have earned and deserve.
I am very proud to join my colleagues in this to work for its
passage. I hope that the other Members of this body will join us in
supporting this unanimously.
[[Page H2726]]
Mr. ROE of Tennessee. Mr. Speaker, I have no further speakers, and I
reserve the balance of my time.
Mr. WALZ. Mr. Speaker, may I inquire how much time I have remaining?
I have two speakers to go.
The SPEAKER pro tempore (Mr. Woodall). The gentleman from Minnesota
has 7\1/2\ minutes remaining.
Mr. WALZ. Mr. Speaker, I yield 2 minutes to the gentleman from
California (Mr. Correa), a good friend, a new member of the Veterans'
Affairs Committee, someone who came to the House of Representatives and
asked to serve veterans and be on the committee.
Mr. CORREA. Mr. Speaker, I thank Chairman Roe and our ranking member,
Mr. Walz, for all the good work for all of our veterans.
Mr. Speaker, I rise also in support of the Choice Act and urge my
colleagues to also protect our veterans' access to health care.
Our veterans all gave some, and many, many made the ultimate
sacrifice for our Nation. Providing our vets with the best health care
our Nation can deliver on a timely basis is the least we can do for our
veterans.
Sadly, as all of us know, in 2014, the average wait time at a VA
medical center was 115 days. The Choice Program has provided vets with
the opportunity of obtaining health care in their community on a timely
basis.
The VA, of course, is an excellent institution that takes care of
many, many of our veterans. Yet, when the VA is not available, the
Choice Program can be the best option for our heroes.
No one--no one--should have to wait 3 months to see their doctor,
especially our vets, our heroes. We must meet our commitment one way or
another. I urge my colleagues to support this bill. Let's, all of us,
keep the promise this country has made to every one of our veterans.
Mr. ROE of Tennessee. Mr. Speaker, I reserve the balance of my time.
Mr. WALZ. Mr. Speaker, I yield 1 minute to the gentleman from Nevada
(Mr. Kihuen), who has taken a keen interest in veterans' issues. I am
grateful that he is here today.
Mr. KIHUEN. Mr. Speaker, I thank Chairman Roe and Ranking Member Walz
for their bipartisan work on this issue on behalf of our veterans and
our country. It is very refreshing to see bipartisanship here in this
body.
Mr. Speaker, veterans have made the incredible sacrifice for our
country. The Department of Veterans Affairs has the obligation to
ensure that they have access to high-quality and affordable health
care.
I support the aim of S. 544 to make key improvements to the Choice
Program as Congress continues to work on longer term solutions.
While I am hopeful that this bill will help eliminate the problems
and delays that veterans have experienced with the Choice Program, this
program should be the option of last resort for veterans.
In Ely, Nevada, a rural community in my district, the VA is
considering not renewing its contract with the Ely Community Clinic,
forcing veterans to rely solely on the Choice Program for access to
care. Just this week, hundreds of veterans turned out at a forum in Ely
to voice their opposition to using the Choice Program.
Closing the VA clinic in Ely will be burdensome for many veterans in
northern Nevada and central Nevada and could force them to travel
hundreds of miles to get healthcare services that they rely on. These
veterans have already fought for their country. They shouldn't have to
fight to keep their VA clinic in Ely open.
Mr. Speaker, I support this bill, but it is not enough. We owe it to
our veterans not to use the Choice Program as a crutch, but to make the
proper investments in the health care our veterans deserve.
Mr. ROE of Tennessee. Mr. Speaker, I reserve the balance of my time.
Mr. WALZ. Mr. Speaker, once again, I would like to thank the
chairman, the staff, and everyone who has been here.
I think, of all the committees that are modeling the behavior of
democracy, bipartisanship, and what our government stands for, the
Veterans' Affairs Committee is one that takes that responsibility
seriously. The chairman always models it. I think this is a case of
that.
You heard the speakers come here. This is a big issue. There may be
some differences in how the delivery, long term, looks, but there is no
division on getting the best and most timely care to our veterans.
With that, I encourage my colleagues to support S. 544.
Mr. Speaker, I yield back the balance of my time.
Mr. ROE of Tennessee. Mr. Speaker, I yield myself the balance of my
time.
I want to thank the majority and the minority staff that worked on
this bill, and certainly the Senate, Senators Tester and Isakson, and
the committee on the Senate side for getting this over here in a timely
way. We needed to do this now so that we could continue care for
patients that would go past August 7. We have people right now who are
getting care that is going to be long term, and they would be cut off
or couldn't use the Choice program.
We have heard a lot of the problems with Choice here, but it has also
helped a lot of veterans. What we feel like we want the opportunity to
do now is be given a little bit of time, in a bipartisan way, to work
out the problems with this.
I think this goes for everyone on our committee: At the end of the
day, our purpose, our goal is to provide access and the best quality of
care for veterans that this country can deliver. That is the goal of
our committee in a bipartisan way.
With that, once again, I encourage all of my Members to support this
legislation.
Mr. Speaker, I yield back the balance of my time.
The SPEAKER pro tempore. The question is on the motion offered by the
gentleman from Tennessee (Mr. Roe) that the House suspend the rules and
pass the bill, S. 544.
The question was taken; and (two-thirds being in the affirmative) the
rules were suspended and the bill was passed.
A motion to reconsider was laid on the table.
____________________