[Congressional Record Volume 163, Number 102 (Thursday, June 15, 2017)]
[House]
[Pages H4925-H4929]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
{time} 1230
VETERANS EQUAL TREATMENT ENSURES RELIEF AND ACCESS NOW ACT
Mr. MARCHANT. Mr. Speaker, pursuant to House Resolution 379, I call
up the bill (H.R. 2372) to amend the Internal Revenue Code of 1986 to
clarify the rules relating to veteran health insurance and eligibility
for the premium tax credit, and ask for its immediate consideration.
The Clerk read the title of the bill.
The SPEAKER pro tempore (Mr. Murphy of Pennsylvania). Pursuant to
House Resolution 379, the amendment in the nature of a substitute
recommended by the Committee on Ways and Means, printed in the bill, is
adopted and the bill, as amended, is considered read.
The text of the bill, as amended, is as follows:
H.R. 2372
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Veterans Equal Treatment
Ensures Relief and Access Now Act'' or the ``VETERAN Act''.
SEC. 2. CLARIFICATION RELATING TO VETERAN HEALTH INSURANCE
AND ELIGIBILITY FOR PREMIUM TAX CREDIT.
(a) Amendment of Pre-2020 Credit.--
(1) In general.--Section 36B(c)(2)(B)(i) of the Internal
Revenue Code of 1986, prior to any amendment by section 214
of the American Health Care Act of 2017, is amended by adding
at the end the following: ``For purposes of the preceding
sentence, an individual shall not be treated as eligible for
coverage described in section 5000A(f)(1)(A)(v) unless such
individual is enrolled in such coverage.''.
(2) Effective date.--The amendment made by this subsection
shall apply to taxable years ending after December 31, 2013.
(b) Amendment of Post-2019 Credit.--
(1) In general.--Section 36B(d) of such Code, as amended by
section 214 of the American Health Care Act of 2017 and in
effect for months beginning after December 31, 2019, is
amended by adding at the end the following:
``For purposes of paragraph (2)(B), an individual shall not
be treated as eligible for coverage described in section
5000A(f)(1)(A)(v) unless such individual is enrolled in such
coverage.''.
(2) Effective date.--The amendment made by this subsection
is contingent upon the enactment of the American Health Care
Act of 2017 and shall apply (if at all) to months beginning
after December 31, 2019, in taxable years ending after such
date.
The SPEAKER pro tempore. The gentleman from Texas (Mr. Marchant) and
the gentleman from Massachusetts (Mr. Neal) each will control 30
minutes.
The Chair recognizes the gentleman from Texas.
General Leave
Mr. MARCHANT. Mr. Speaker, I ask unanimous consent that all Members
may have 5 legislative days within which to revise and extend their
remarks and to include in the Record any extraneous material on the
bill currently under consideration.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from Texas?
There was no objection.
Mr. MARCHANT. Mr. Speaker, I yield myself such time as I may consume.
I would first like to thank Chairman Brady for his strong support of
this bill, the Veterans Equal Treatment Ensures Relief and Access Now
Act, the VETERAN Act. This important legislation, which was reported
out of the Ways and Means Committee on a bipartisan basis, will ensure
all eligible veterans have access to quality, affordable private health
insurance.
Mr. Speaker, this Chamber cannot underscore enough the sacrifices of
our veterans and the sacrifices they have made to protect the freedom
and individual liberty of each American. In return for their faithful
service, these brave men and women are promised that, when they return
home, they will have access to affordable healthcare through the
Veterans Administration.
However, some veterans decide to forego their VA benefits and,
instead,
[[Page H4926]]
choose an alternative healthcare. Veterans should have the opportunity
to choose the best healthcare option available to fit their needs. It
is only right that our veterans are given the same opportunity as our
other citizens have and the citizens that they defend.
There have been conflicting reports about the eligibility of certain
veterans to receive tax credits for all health insurance under the
American Health Care Act. Make no mistake about it, no veteran would
see a change in their eligibility status as a result of the AHCA.
In fact, despite the Democrat's claims about veterans' eligibility
for tax credits under the AHCA, when they voted for and signed
ObamaCare into law, they failed to include this very same clarification
in statute. Rather, they left it to the Department of the Treasury to
issue a regulation clarifying that veterans are still eligible for a
credit unless they are enrolled in a VA healthcare benefit plan.
So today this legislation, authorized by my friend and a veteran, Mr.
Sam Johnson, should put into law current practice confirming that
veterans can, without question, get a tax credit to purchase health
insurance in the individual market if they choose not to enroll in VA
coverage.
It is important to note that AHCA initially proposed to put into law
this current practice, but that provision had to be removed due to
Senate guidance about their Chamber's unique reconciliation rules.
While I am disappointed that this happened, I am glad that this body is
acting on this item today.
I would note that this legislation has received the support of
several veterans' organizations, including the Paralyzed Veterans of
America, the Association of the United States Navy, and The Retired
Enlisted Association.
I think that something we can all agree on is that our veterans
should have the choice in where they receive their healthcare, just
like the American citizens they defended. In that spirit, this bill is
something we can all get behind.
To our veterans and their families, I thank them for their service.
To my friend Sam Johnson, I thank him for his leadership and the
authoring of this important bill.
I ask my colleagues for their support of the VETERAN Act.
Mr. Speaker, I reserve the balance of my time.
Mr. NEAL. I yield myself such time as I may consume.
Mr. Speaker, before I begin, I want to send my deepest thoughts and
prayers to our colleague Whip Scalise, the Capitol Police officers, and
the staff members that were injured in yesterday's shooting.
Although my Republican colleagues and I have robust policy
discussions, ultimately, we desire the same goals. Today is no
different, and our institution is based on the respect and thoughtful
debate that remain important pillars of our democracy.
Mr. Speaker, this discussion and debate that we are about to have
here is an honest disagreement. There is no suggestion here that there
is anybody on this side of the aisle that is any less enthusiastic or
less sincere in their support of what it is that our veterans need and
desire. This is an honest policy dispute.
And I must tell you, based on long service in this institution, this
is an unusual manner in which to proceed. We are actually being asked
today to amend a piece of legislation that a month ago left this
institution. I have not been witness to this, I believe, in the past;
and I hope that, as we go on for the next hour, we will have a chance
to connect the dots for our colleagues about why this underlying bill
is less than desirable.
Last month, the Republicans brought TrumpCare to the House floor and
every Democrat in this institution opposed it. This was the Republican
leadership's second attempt to pass the repeal, and it seems that their
first attempt was not harmful enough to the American people.
The measure, as passed, takes health insurance from millions of
Americans, raises premiums for working families, and places an age tax
on older Americans. Middle class Americans would end up on the losing
end, while millionaires would receive a handsome, nearly $1 trillion
tax cut.
Perhaps most concerning is that Members voted in favor of this
legislation without understanding its impact on the American people.
There were no hearings on TrumpCare. Amendments were rushed to the
floor without committee consideration, and the CBO score was not
available at the time the House considered it.
CBO, based on nonpartisan career professionals, provides important
context and independent advice for Members of Congress. It provides an
opportunity for us to look at the long-term results and ramifications
of policies we are considering.
Clearly, our Republican friends don't care about the jarring
consequences CBO foretold. The House has ignored certain procedures
when considering these important measures.
First, since the Republican repeal bill passed, the CBO confirmed
that the measure would leave 23 million Americans without health
insurance. It would cut Medicaid by $800 billion, discriminate against
individuals with preexisting conditions, and drastically raise premiums
for older Americans.
Earlier this week, the CMS actuary confirmed that out-of-pocket costs
will rise by 61 percent, and premiums will be 5 percent higher than
under current law. Simply put, TrumpCare would force Americans to pay
more for lower quality healthcare coverage.
Second, this bill is not appropriate to consider now because it
amends the TrumpCare bill, as I noted a moment ago, that has not passed
the Senate. And our Senate colleagues have stated they are rewriting a
House bill that the President called ``mean.''
Now I would like to turn to my substantive concerns with this bill.
H.R. 2372 would amend the AHCA to allow veterans not enrolled in
military-related coverage to receive tax credits. It does nothing to
fix the issues in the TrumpCare bill.
Whether or not you initially supported the wars in Iraq and
Afghanistan--and I was one of the few in this institution that voted
and spoke against the war in Iraq those years ago--these wars have
created 1 million more veterans, and we need to do what we can to
provide them with the support that we promised them.
Let me remind my colleagues that the TrumpCare bill would shift costs
onto veterans through per capita caps, roll back Medicaid expansion for
veterans, and erode essential health benefits and preexisting
conditions protections.
The Republican health plan would dramatically cut Medicaid, a program
that provides healthcare for nearly 2 million veterans. And the
President's recently released budget takes it a step further by cutting
veterans' programs, including disability benefits.
Even if this bill is incorporated into TrumpCare legislation, it
would not undo the terrible cuts in the bill: enormous coverage losses,
more than $800 billion worth of cuts to Medicaid, unravel important
consumer protections or cuts to programs designed to help address the
opioid addiction crisis in my State of Massachusetts and throughout the
Nation.
I am quite sure everyone in this institution at this moment and those
who are viewing know somebody close to them who is addicted to opioids.
In addition, Medicaid is now a program that many middle class
Americans rely on for long-term care. Thanks to Medicare and Medicaid,
your parents are not living in your attic.
This bill does nothing to fix the Republican healthcare plan and
could create new problems. If Republicans are serious about addressing
middle class American healthcare needs, they should go back to the
drawing board and start over and work with us.
This exercise is a distraction from the real issue, which is the harm
caused by the underlying TrumpCare bill. Instead, we should be
considering issues that help hardworking Americans and their families.
Mr. Speaker, I reserve the balance of my time.
Mr. MARCHANT. Mr. Speaker, I agree with Ranking Member Neal that this
is just a difference of opinion. It is a difference of policy opinion.
There is no animosity on either side of this debate.
Mr. Speaker, I yield such time as he may consume to the gentleman
from Tennessee (Mr. Roe), chairman of the Veterans' Affairs Committee.
[[Page H4927]]
Mr. ROE of Tennessee. Mr. Speaker, I rise today in support of H.R.
2372, the Veterans Equal Treatment Ensures Relief and Access Now, or
VETERAN, Act, which I am proud to sponsor along with Congressman Sam
Johnson from Texas and a number of our colleagues.
The VETERAN Act would codify an existing Internal Revenue Service
regulation, allowing a veteran who is eligible for but not enrolled in
the Department of Veterans Affairs healthcare system to use a tax
credit to purchase health insurance. Language that would have codified
that regulation in law was removed from a draft version of the American
Health Care Act in 2017 earlier this year to comply with Senate rules.
While the removal of that language from the version of the bill that
ultimately passed the House in no way changed existing regulation or a
veteran's eligibility to receive a tax credit pursuant to it, it did
form a basis for politically charged assertions that the American
Health Care Act would harm veterans.
First, congressional intent is clear. Second, I am confident that the
IRS would interpret the relevant language of the American Health Care
Act in the same manner as it did similar language in the Affordable
Care Act under the President Obama administration.
Nevertheless, I am glad that the passage of the VETERAN Act today
will, once and for all, put an end to posturing over this issue and
codify Congress' expectation that veterans who are eligible for but not
enrolled in the VA healthcare system may continue to receive applicable
tax credits to purchase health insurance.
Mr. Speaker, I urge all of my colleagues to support the passage of
the VETERAN Act today.
Mr. NEAL. Mr. Speaker, I yield 3 minutes to the gentleman from
Wisconsin (Mr. Kind).
Mr. KIND. Mr. Speaker, I thank my friend from Massachusetts for
yielding me this time.
Mr. Speaker, I rise in support of the VETERAN Act, the legislation
before us today, and I do so for a very simple reason: This merely
codifies what is already existing law under the Affordable Care Act, or
so-called ObamaCare, something that was done through rulemaking that I
presume has bipartisan support.
{time} 1245
Yes, it is important to protect the veterans, but the reason we are
on the floor today is another example of one of the greatest
legislative malpractice acts ever committed in Congress: trying to pass
a Republican healthcare bill with no oversight, with no hearing, no
public input, and no experts testifying to run the traps for us as far
as the intended and the unintended consequences.
The reason we are on the floor now 1 month after passage of that bill
is to try to correct just one of the deficiencies that exist in it.
I say it is a so-called healthcare bill because what it really is is
a $900 billion tax break to the most wealthy individuals in our
country, including insurance companies and drug companies, under the
guise of healthcare reform and asking 23 million Americans, including 2
million veterans, as my friend from Massachusetts just pointed out, in
Medicaid to give up their healthcare coverage to pay for that massive
tax cut.
It also will discriminate against older Americans in a rural
congressional district, such as mine in western and north central
Wisconsin, by allowing insurance companies to charge them higher
premiums. It will also allow insurance companies to once again
discriminate against individuals that have preexisting conditions.
It does absolutely nothing to control the costs of healthcare--which
have been rising--especially prescription drug costs that are affecting
all Americans, and it was done in a way to jam this Congress and jam
the American people about the consequences of this so-called healthcare
bill.
So, yes, let's fix and make sure that we are protecting veterans who
are getting their healthcare outside the VA medical center so that
they, too, qualify for premium tax credits, which this legislation
allows.
But let's do healthcare the right way by studying the implications of
what will affect one-fifth of the entire U.S. economy and almost one-
half of all Federal spending. Let's regroup and do it the right way,
through normal legislative process. That is having bipartisan
discussions, committee hearings, and talking to the experts--consumers
and patients alike--so we know what we are getting into when we are
trying to take a run at the importance of healthcare in our country.
One area that I think we can reach bipartisan agreement on or should
be focused on are further steps to reduce the cost of healthcare to
make it more affordable for all Americans. Again, we are missing that
opportunity because of the lack of hearings and because of how this
legislation was rushed through this Chamber just a month ago.
We on this side didn't even get to see the language of it until late
the night before it was on the House floor. That is no way to legislate
healthcare policy.
Mr. Speaker, let's fix it today with this one small piece of
legislation.
Mr. MARCHANT. Mr. Speaker, I reserve the balance of my time.
Mr. NEAL. Mr. Speaker, I yield 2\1/2\ minutes to the gentleman from
California (Mr. Takano), who is a well-known advocate for veterans.
Mr. TAKANO. Mr. Speaker, I want to begin my remarks by offering my
thoughts and prayers to Majority Whip Steve Scalise and his family, as
well as Special Agents David Bailey and Crystal Griner, and the two
other members of our community who were injured in yesterday's attack.
We are a family--from Members to staff, to the Capitol Police
officers who keep us safe. Families have disagreements and arguments,
but, in the end, we support each other. Speaker Ryan got it absolutely
right yesterday: an attack on one of us is an attack on all of us.
We owe it to the American people to hold a vigorous and public debate
of our ideas, but we also owe it to them and to each other to do so
without losing touch with our humanity.
With that in mind, Mr. Speaker, I rise in support of H.R. 2372, which
would protect access to tax credits for up to 7 million veterans on the
American Health Care Act. However, I am concerned by the process that
led to this legislation.
In testimony to the Rules Committee and on the House floor, I
described this loophole in the bill that jeopardizes access to tax
credits for veterans who are eligible but not enrolled in the VA.
Repeatedly, supporters of the AHCA told me that veterans' tax credits
would be protected by existing regulation. This bill is evidence that
the loophole is an issue and that the existing regulation would no
longer apply if the Affordable Care Act was repealed.
While I am glad we are making this fix, I am concerned that the
rushed process for considering the AHCA led to the House passing
disruptive healthcare legislation without fully understanding its
impact on millions of Americans, especially our Nation's veterans.
The tax credit issue is relatively easy to solve, but there are more
complicated issues for veterans under the AHCA that require more
comprehensive solutions.
The $834 billion cut to Medicaid could impact nearly 2 million
veterans. The potential for States to waive protections like essential
health benefits could lead many veterans without health coverage for
the invisible wounds of war. Indeed, military service could be
construed as a preexisting condition.
As someone who repeatedly called out this veterans loophole, I feel
compelled to support this fix, but my support is not an endorsement of
the AHCA or its impact on veterans and their families.
Mr. MARCHANT. Mr. Speaker, I yield such time as he may consume to the
gentleman from Florida (Mr. Bilirakis), a member of the Veterans'
Affairs Committee.
Mr. BILIRAKIS. Mr. Speaker, I rise today in support of the VETERAN
Act, H.R. 2372.
Our Nation's veterans must have access to affordable, quality
healthcare options. I know that is one thing, of course, everybody can
agree on, particularly when it comes to our veterans.
The VETERAN Act codifies an important protection for those who
served. Veterans who are not already enrolled in health insurance
through
[[Page H4928]]
the VA will continue to have the option to purchase coverage on the
individual insurance market.
Under the American Health Care Act, those veterans seeking coverage
on the individual market will be eligible for tax credits to purchase
the plan that is right for them. It is only right. This bill ensures
our veterans have more options and more control over their healthcare.
Mr. Speaker, again, this is something we can all agree on. I am proud
to be an original cosponsor of this legislation, and I urge passage.
Mr. NEAL. Mr. Speaker, I yield 2\1/2\ minutes to the gentlewoman from
New Hampshire (Ms. Kuster).
Ms. KUSTER of New Hampshire. Mr. Speaker, I rise to speak on H.R.
2372, the VETERAN Act. However, before I speak about this bill, I would
like to take a moment to thank my colleagues, General Bergman and Dr.
Wenstrup, both colleagues of ours on the very bipartisan Veterans'
Affairs Committee, for their bravery on the ball field yesterday.
Yesterday was a harrowing day for my colleagues, and their courage
under fire made this Congress and America proud. While Majority Whip
Scalise is still in critical condition, our colleagues, who both served
our country in uniform, gave Mr. Scalise a fighting chance. Please keep
Mr. Scalise, Matt Mika, Zack Barth, and U.S. Capitol Police Officers
Crystal Griner and David Bailey in your thoughts and prayers.
I rise before you today on the VETERAN Act to voice my concerns on
the underlying bill it seeks to fix: the American Health Care Act.
My colleagues and I criticized the AHCA a few weeks ago because it
did not give veterans access to, and choice for, affordable healthcare.
I am very glad to be here today now that my Republican colleagues have
realized this error and are seeking to help veterans gain access to tax
credits.
I renew my commitment to work in a bipartisan way to improve the
healthcare system in America. Our goal should be a system that provides
access to affordable healthcare to all Americans, including those who
have served in uniform.
But no one should be under the illusion that the AHCA, with or
without the VETERAN Act, will achieve these goals. The AHCA includes
significant negative changes to Medicaid. This Congress and the
American people should know that more than 2 million veterans rely upon
Medicaid for their healthcare, and millions more spouses and children
of veterans also rely on Medicaid. The AHCA would slash $834 billion in
Medicaid coverage.
When 40 percent of working-age veterans have no other coverage,
passing the AHCA will mean that these veterans and their families have
no access to lifesaving healthcare.
As co-chair of the bipartisan task force combating the opioid
epidemic, I urge my colleagues to consider that Medicaid provides vital
mental health and substance abuse treatment for many of these veterans
and their families that they will not receive otherwise. For our
veterans seeking treatment for combat wounds, PTSD, MST, and other
conditions, under the AHCA, military service to our country could be
considered a preexisting condition resulting in a denial of care.
Mr. MARCHANT. Mr. Speaker, I have no further speakers at this time,
and I reserve the balance of my time.
Mr. NEAL. Mr. Speaker, I yield myself the balance of my time.
Mr. Speaker, in closing, I want to make sure that the American people
understand the impact of the underlying bill that H.R. 2372 intends to
amend.
The bill purports to make a fix to the Republicans' harmful
healthcare bill, but the fix is inadequate for the harm the underlying
legislation would cause.
We have independent verification from both the CMS actuary and the
Congressional Budget Office to reinforce our position. The Republican
healthcare bill would cause millions to lose health insurance, face
higher premiums and out-of-pocket costs, and jeopardize the health
security that Americans with preexisting conditions have today.
We should be working to improve our healthcare system, not making it
more difficult and unaffordable for America's families. If this is such
a great policy, let's not tie it to a bill that is doomed in the
Senate. In fact, if anybody can find out where it is even being
discussed or authored in the Senate, they should inform us. It clearly
is not being done in the open. Let's not tie it to that simple
provision, and pass it as it stands alone today.
Middle class Americans can't afford this recipe. I urge my colleagues
to work over the next few months to educate the American people about
the Republican health plan and how harmful it is to our Nation's
health. Hospitals oppose it, doctors oppose it, and patient groups
oppose it. The bill needs to be scrapped. We should instead be helping
the middle class, not giving giant tax cuts to the wealthy.
Mr. Speaker, I yield back the balance of my time.
Mr. MARCHANT. Mr. Speaker, again, I would like to express my
gratitude to Ranking Member Neal and his hard work on the Ways and
Means Committee and his keeping the issue before us.
But the AHCA makes no changes to veterans' healthcare. Under this
bill, unless vets decide to enroll in VA coverage, they are eligible
for financial support. Veterans should have the opportunity to choose
the best healthcare option to meet their needs. It is only right that
our veterans are given the same opportunities as the citizens that they
defended.
Mr. Speaker, I urge my colleagues to support the VETERAN Act. I ask
for its passage, and I yield back the balance of my time.
Mr. SAM JOHNSON of Texas. Mr. Speaker, I'd first like to thank
Chairman Brady for his strong support of my bill, the veterans Equal
Treatment Ensures Relief and Access Now (VETERAN) Act. This important
legislation, which passed the Ways and Means Committee with bipartisan
support, seeks to ensure all eligible veterans have access to quality,
affordable private health insurance.
Mr. Speaker, I spent 29 years in the U.S. Air Force, so I understand
the sacrifices our veterans have made to protect the freedom and
individual liberties of each American. In return for their faithful
service, these brave men and women are promised that when they return
home, they will have access to affordable healthcare through the VA.
However, some some veterans decide to forgo VA coverage and instead
choose to enroll in other health coverage--as is their right. But
regardless of their eligibility for VA health coverage, veterans should
have the opportunity to choose the best health care option to meet
their needs. It is only fair that our veterans are given the same
opportunities as the citizens they defend.
With respect to the American Health Care Act, some folks have raised
concerns about the eligibility of certain veterans to receive tax
credits for health insurance. Specifically in question are veterans who
are eligible for, but not enrolled in, VA Health Coverage. Make no
mistake about it, we must ensure that these veterans have the same
access to the tax credits provided by The American Health Care Act as
any other American would.
That's where my bill, The Veteran Act, comes into play. My bill would
simply put into law a guarantee that veterans can indeed get these tax
credits to purchase health insurance in the individual market. Without
The Veteran Act, the eligibility of America's veterans for AHCA tax
credits would be left in the hands of IRS bureaucrats. That would be a
mistake. This is too important of an issue to leave in the hands of the
IRS. Bottom-line: this is a belt-and-suspenders approach to ensure
veterans have access to these tax credits.
It's important to note that the American Health Care Act initially
proposed to provide tax credits to veterans, but this language had to
be removed due to reconciliation rules. While I was disappointed that
this section was removed, I am glad we are doing the right thing today.
I would note that this legislation has received the support of
several veterans' organizations, including:
(1) The Paralyzed Veterans of America;
(2) The Association of the United States Navy; and
(3) The Retired Enlisted Association.
As I stated earlier, our veterans should have choice in where they
receive their healthcare, just like the American citizens they defend.
I think that's something we can all agree upon. And in that spirit, I
think this bill is something we can all get behind. I ask my colleagues
for their support of The Veteran Act.
To our veterans and their families, I thank you for your service. God
bless you, and God bless America. I salute you.
The SPEAKER pro tempore. All time for debate has expired.
Pursuant to House Resolution 379, the previous question is ordered on
the bill, as amended.
The question is on engrossment and third reading of the bill.
[[Page H4929]]
The bill was ordered to be engrossed and read a third time, was read
the third time, and passed.
____________________