[Congressional Record Volume 164, Number 84 (Tuesday, May 22, 2018)]
[Senate]
[Pages S2815-S2827]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
VETERANS CEMETERY BENEFIT CORRECTION ACT
The PRESIDING OFFICER. Cloture having been invoked, the clerk will
report the House message to accompany S. 2372.
The senior assistant legislative clerk read as follows:
House message to accompany S. 2372, a bill to amend title
38, United States Code, to provide outer burial receptacles
for remains buried in National Parks, and for other purposes.
Pending:
McConnell motion to concur in the amendment of the House to
the bill.
McConnell motion to concur in the amendment of the House to
the bill, with McConnell amendment No. 2246 (to the House
amendment to the bill), to change the enactment date.
McConnell amendment No. 2247 (to amendment No. 2246), of a
perfecting nature.
McConnell motion to refer the message of the House on the
bill to the Committee on Veterans Affairs', with
instructions, McConnell amendment No. 2248, to change the
enactment date.
McConnell amendment No. 2249 (to (the instructions)
amendment No. 2248), of a perfecting nature.
[[Page S2816]]
McConnell amendment No. 2250 (to amendment No. 2249), of a
perfecting nature.
The PRESIDING OFFICER. The Senator from Montana.
Mr. DAINES. Mr. President, we have all seen the headlines across the
Nation about the VA Choice Program and how it has failed our veterans.
I wish to share some of those headlines from my home State of Montana.
From Montana Public Radio, the headline was: ``Montana Hospitals: New
VA Program Fails To Pay.''
From NBC Montana, the headline was: ``New problems for Veterans
Choice in Montana.''
From the Billings Gazette, the headline read: ``Painful truth about
Montana VA.''
As I travel around the State, as I hear from veterans who come back
to Washington, DC, I personally have heard from them, from countless
healthcare professionals, from our hospitals regarding payment delays,
long waiting times, and elusive runaround on the most basic services.
Under the Choice Program, our veterans did not receive the healthcare
they deserved. However, the bipartisan MISSION Act will follow through
on the promises that were made to our veterans. Rural veterans will get
greater, easier, quicker access to the care they need. Whether a
veteran lives 20, 30, or 40 miles from a VA clinic, they can go
elsewhere if the VA does provide them with the services they need. It
brings VA care into the 21st century by encouraging telemedicine and
strengthens oversight of opioid prescriptions. Veterans will have more
access to doctors because there will be measures holding companies
accountable--companies like Health Net--for how they manage the new
program. It provides scholarships to encourage medical and dental
students to serve in the VA, and it creates a new loan repayment
program for medical students who are training in specialties that are
currently lacking in the VA.
This is one of the big problems we have. We can't fill the slots with
medical professionals in the VA. It is about time we take meaningful
steps toward fully delivering on the promises we have made to our
veterans.
On this Memorial Day week, I wish to share that we have passed my
bill to name VA clinics in Missoula and Billings after Montana veterans
David Thatcher, Dr. Joseph Medicine Crow, and Benjamin Steele. My bill
has been sent to President Trump's desk for his signature. With the
passage of the MISSION Act, these three clinics will be delivering new
and improved care and will also display the names of three Montana
World War II heroes. I urge my colleagues in the Senate to join me in
supporting the VA MISSION Act.
I yield back my time.
The PRESIDING OFFICER. The Senator from Washington.
Mrs. MURRAY. Mr. President, I come to the floor today to bring
attention to a particular provision of the bill now before the Senate--
a provision that would do so much to help our country fulfill its
promise to our veterans--and that is to expand and strengthen the VA's
caregiver program.
This program may not be well known outside of military family
circles, but, make no mistake, the caregiver program could be a game
changer for the estimated 5.5 million people across this country who
put their lives on hold to care for a loved one who returned from
service with illness or injury.
I met one of those caregivers not too long ago in my home State of
Washington. Tiffany Smiley wears many hats. She is a mother, a wife, a
nurse, and a veteran caregiver. She and her husband Scotty first met
back in junior high, and years later they were married. He signed up to
serve our country and Tiffany became a military spouse. Then, in 2005,
she got the call every military family fears. Scotty had been severely
injured in a suicide bombing in Iraq. He was alive, but he lost his
eyesight permanently.
As Tiffany describes it, her world was shaken to its core, and their
lives were never the same again. But Tiffany, like so many other
military spouses, didn't think twice about whether she would care for
her husband and their growing family. It was just a matter of how she
could do it. To this day, Tiffany is an amazing advocate for the
caregiver program and what it has meant to her and to her family.
She describes both the good days and the bad days, so those of us not
in her shoes can understand some of the challenges they face. She does
it because she knows she is not alone. She knows that sharing her
experience is making a difference to educate the rest of the country
about what it means to be a veteran's caregiver.
It is so true. I heard from countless people who, when their loved
one came home from service with an injury or illness, made big life
changes by quitting a job, scaling back their hours, or taking leave
from college. They put big purchases, retirements, and dream vacations
on hold or they took on more parenting responsibilities. You name it.
They sprang into action and did what they needed to do, because that is
just what you do when it is someone you love.
We know that the care military caregivers provide comes at a cost.
Several years ago, the Dole Foundation commissioned the largest ever
study of its kind to examine the sacrifice of military caregivers. It
showed that some caregivers spend more than 40 hours a week caring for
veterans. That is the equivalent of a full-time job, and that takes a
toll. The study showed that caregivers have significantly worse health
than noncaregivers. They run a higher risk of depression because they
put their own physical and mental well-being on hold. The stress of
providing care can strain relationships and increase divorce rates. So
caregivers--or, as they are often called, our hidden heroes--don't
necessarily wear a uniform or go overseas, but they sacrifice a whole
lot and they serve our country in ways most people find unimaginable.
That is why expanding the caregiver program to veterans of all eras
is so important, because the program provides resources and support,
including training and counseling, a stipend, access to healthcare,
respite, and more.
This bill expands the support services for caregivers to address
their still unmet needs. That includes offering financial and legal
advice to deal with the many complex and difficult challenges that
arise that are unique to being a caregiver.
Not only does the caregiver program recognize the sacrifice of
caregivers, but it also puts decisions about care into the hands of the
veterans and their loved ones. They can decide to be at home with
onsite care or on their own terms and as independent as possible. That
is really important. The fact that we are so close to getting this
program expansion across the finish line goes to show how far we have
moved this conversation. That is also why we have to keep pushing it
forward--so veterans and military caregivers never feel like they have
to face these problems alone, because the reality is that if a
servicemember is hurt while fighting for our country, the
responsibility of care should never fall to only one family. It is the
responsibility and the duty of our entire Nation to have their backs
and give them what they need.
We can't stop until we get this done. We can't stop until every
veteran and military caregiver knows that their country is there for
them on their terms, no matter what. I am so proud that the caregivers
program expansion is front and center in the VA MISSION Act now before
the Senate. On behalf of Tiffany and Scotty and all of the other
military families out there, I urge my colleagues to express their
support for this critically important program.
I yield the floor.
I suggest the absence of a quorum.
The PRESIDING OFFICER. The clerk will call the roll.
The senior assistant legislative clerk proceeded to call the roll.
Mr. SULLIVAN. Mr. President, I ask unanimous consent that the order
for the quorum call be rescinded.
The PRESIDING OFFICER. Without objection, it is so ordered.
Cloture having been invoked, the motion to refer and the amendments
pending thereto fall.
The PRESIDING OFFICER (Mr. Hoeven). The Senator from Alaska.
Tribute to Rich Owens
Mr. SULLIVAN. Mr. President, as my colleagues know, one of the best
times of the week for me is when I get to come down to the floor and
talk about some of my great constituents back home in Alaska, somebody
or a group of Alaskans I refer to as the ``Alaskan of the Week.''
[[Page S2817]]
We all think we come from great States, but what I really enjoy about
talking about the Alaskan of the week is not just talking about Alaska
and how beautiful and big and majestic it is but also about the people
who make it such a great place. In this ``Alaskan of the Week''
presentation, I want to talk about not just Rich Owens, whom I am going
to talk a lot about this afternoon, but also small businesses in
Alaska--in this case, in Anchorage, my hometown. As you know, the
owners of these businesses really make a positive impact on communities
like Anchorage or States like Alaska or really the whole country.
When you think of Alaska, you think of food. Particularly right now,
as spring is in full swing, you think of our delicious salmon. I have
good news for all the salmon lovers out there: Copper River salmon
season opened last week. It is some of the best wild salmon on the
planet. You might also think about our halibut and black cod, king
crab, shrimp, and oysters. We actually serve that to our fellow
Senators here when we have lunch. I know the Presiding Officer loves
Alaskan seafood.
I want people to actually realize that some of our food is ice cream.
I know that sounds strange--ice cream in Alaska. In fact, it is said
that Alaskans consume more ice cream per capita than any other State in
the country. Go figure on that one. That doesn't surprise Rich Owens,
our Alaskan of the week, who is the owner of the bustling Tastee Freez
on the corner of Jewel Lake and Raspberry Road in Anchorage. That
Tastee Freez, which opened in Anchorage at a slightly different
location 60 years ago, is one of the oldest Tastee Freezes in the
country, and it sells more ice cream than any other Tastee Freez in
America. That is remarkable. Rich also claims the largest menu of any
Tastee Freez in the United States.
Like so many of our great small businesses, it is much more than just
an ice cream store. To those who live in Anchorage and many who live
across the State, Rich's Tastee Freez is an institution. It is a
bulwark for the community, thanks largely to Rich's ownership. Since he
bought the business in 1994, he has made giving back to his community
his top priority in so many different ways beyond running that great
small business.
Rich was raised in a small town in Montana. His father was a
pharmacist, and his parents owned a drugstore. Giving back to the
community was something he saw his parents do every single day. ``It
was not the exception,'' Rich said, ``it was the rule.''
Rich came to Alaska in the 1980s to work at what is now the
Millennium Hotel--another great business in Alaska. In 1994, he bought
the Tastee Freez. Since that time, Rich has donated his time and energy
and, importantly, his philanthropy to our great State and our
community. Let me provide a few examples.
Rich is a huge champion for our schools. That can mean delivering up
to 400 sundaes to elementary schools when they have a family reading or
math night. He helps fund school trips for students who need help.
Every year, each elementary school that he works with stages a Tastee
Freez takeover. School staff members work shifts behind the counter,
and Tastee Freez employees wear school T-shirts. Those takeovers are
widely advertised and popular, and Tastee Freez donates a portion of
that day's take to the school. He is very focused on community.
Rich has also formed a work-study partnership with high schools. He
guesses that the average age of his 28 employees is 17 years old--about
the age of our pages right here listening so intently. For so many
Alaskans, it was their first and some say their best job ever, working
in that Tastee Freez Rich owns. He has donated his time, energy, and
talents to successful summer camps that teach young Alaskans about the
outdoors and important values. One of his assistant managers began to
work at the shop when she was 15 years old. She is 31 years old, and
she met her husband at the shop. This is a great community small
business.
Rich is also a huge supporter of our military, our veterans, and the
National Guard. As we are approaching Memorial Day weekend and as we
are literally debating a very important Veterans Affairs' bill on the
Senate floor right now, it is important to remember the thousands of
Alaskans and the literally millions of Americans who are veterans and
those like Rich, who are supporting our veterans day in and day out.
For example, Rich has been part of the Alaska National Guard's
Operation Santa Claus each Christmas holiday, which flies Santa Claus
and a bag of presents, toys, school supplies, and fresh fruit to some
of the most remote, far-flung Alaska villages each year during the
holidays. These kids and these communities love it. Of course, Santa
and his helpers also bring Rich's ice cream. Thanks to Rich, the kids
get ice cream in the winter. Every year, he serves thousands of 5-ounce
sundaes to these young kids in our villages--some who have never seen
sprinkles or caramel toppings on their ice cream. For his efforts, Rich
is known in my State as the commander of the Alaska National Guard Ice
Cream Support Squadron.
Just a few weeks ago, the Tastee Freez in Anchorage--Rich's great
small business--celebrated 60 years of service to the community. In
case you want to know whether this is a popular small business in our
community, over 1,000 people showed up at this celebration. They served
1,644 small ice cream cones, not including the dipped cones and sundaes
that day--all free of charge.
I was there for that great celebration. Senator Murkowski was there.
Congressman Young was there. Our Governor was there. Tastee Freez
corporate officers from the lower 48 flew up to Alaska for this big
event. They had never seen anything like it. This is the No. 1 Tastee
Freez in the country. But what most excited Rich that day was all the
people there he had served throughout the years, including the hundreds
of people who used to work at the shop, who met their spouses at Tastee
Freez and then had children, and those children now go there, and some
even work there.
That is what a small business with heart can do for a community. It
can provide young people with their first real job. It can bring us
together. It can provide a sense of community. It can serve the
community. And, of course, it can be a delicious place of memories for
families. That is what the Tastee Freez in Anchorage has done, and that
is why we want to congratulate Rich on being our Alaskan of the week
and thank him again for all the great things he has done for our State
and community.
I yield the floor.
I suggest the absence of a quorum.
The PRESIDING OFFICER. The clerk will call the roll.
The legislative clerk proceeded to call the roll.
Mr. MORAN. Mr. President, I ask unanimous consent that the order for
the quorum call be rescinded.
The PRESIDING OFFICER. Without objection, it is so ordered.
Mr. MORAN. Mr. President, I am pleased to be back on the Senate floor
this afternoon in support of the VA MISSION Act. I was here last
Thursday, and, in part, I paid tribute to Senator McCain. We greatly
miss him here on the Senate floor. I personally--and I know my
colleagues also--wish he were here to help us determine a path forward
and to find the solutions to problems. Senator McCain is an expert in
caring for those who have served us in the military and taking care of
our military retirees and our veterans. So, again, I use this moment on
the Senate floor to pay tribute to my colleague Senator McCain and to
thank him for his service to our Nation and his willingness to work
side by side with me as we develop legislation that deals with the
issue of community care for veterans across the country.
I highlighted last Thursday that challenges at the VA have caused
Congress to respond, and that response involves Choice, legislation
that now exists in which, under certain circumstances, veterans have
the ability to find and be provided care within their communities. They
can see their hometown physician and be admitted to their hometown
hospital under certain circumstances.
The Choice Program has worked well for many veterans, just as the VA
itself internally works well for many veterans. But I know from my own
experience as a Member of the U.S. Senate
[[Page S2818]]
that Kansans have experienced significant challenges with VA programs,
especially with the Choice Program, in which the bureaucracy seems to
inhibit the ability of the VA to provide the care that veterans across
Kansas are seeking.
I indicated last week that currently within our office, we have 80
cases in which we are dealing with veterans who are facing challenges
from something they need from the VA and are not receiving. I looked at
the numbers prior to that since I have been a Member of the U.S.
Senate. There have been 2,650 occasions in which a veteran sought help
from their U.S. Senator for something we would expect them to be
entitled to based upon their service to our Nation. We are grateful to
those veterans, and we want to make sure they are honored and esteemed.
At the same time, we want to make sure the promises that were made to
those who have served our Nation are kept.
The legislation before us that has been approved by the House of
Representatives and is now in front of the Senate has been entitled the
VA MISSION Act. We were actually successful in honoring Senator McCain
by including his name in the title. Again, I appreciate his willingness
to help create the Choice Program and now to reform and extend it.
One of the challenges I have taken upon myself is to make certain we
don't simply--nothing is simple around here--just extend the current
Choice Program. We have worked to reform it and improve it and make it
more likely that the challenges of those 80 veterans who are seeking
help from my staff or those 2,650 who have sought help from my staff
are a lot less.
So I judge the efforts in this legislation with this challenge: What
are we doing to reduce the problems veterans encounter in seeking the
help they are entitled to? In a conversation with my staff, I asked
them to give me the top 10 reasons why this legislation is a good
thing; tell me what are the top 10 reasons a Member of the U.S. Senate
should vote for this legislation.
Incidentally, when we pass it, it will be forwarded to the President.
President Trump has indicated his strong support for this legislation,
so there is every indication the President will, of course, since he
supports the legislation, sign it into law and will do so prior to
Memorial Day, a time in which we again pay respect to those who have
served our Nation.
My top 10 list became 12, and I would guess that if given more time
and greater ability to spend time on the floor, that list of 12 could
be expanded to a much longer list, but let me share with my colleagues
reasons that I think it is important for this legislation to be
approved and to be sent to the President.
Again, I was a skeptic early on. I wanted to make certain that we did
something significant and not just extend the Choice Program into the
future but make significant changes. The challenge has been trying to
make certain the VA does things we want them to do, that they follow
the letter of the law of legislation we pass, and they follow the
intent of Members of Congress. In regard to the Choice Act that passed
now 3 years or so ago, it was hard sometimes to see that the VA was
implementing that legislation the way it was written or the way it was
intended.
No. 1 of the top 12 reasons this legislation should be approved is
that this legislation makes certain the VA executes the law consistent
with the intent of Congress. It mandates coordination with Congress as
it develops rules and regulations under this new legislation.
The goal I expect to be successful in achieving is to prevent the
VA's ability to narrow or limit the program's opportunity to serve
veterans as was intended by this law and, more importantly, as they
deserve.
No. 2, this legislation consolidates community care programs. There
are seven different community care programs within the VA in which a
veteran can access care away from the hospital--the big brick buildings
that most of us have in our States; usually in the most populated areas
of our States--and those seven community care programs are consolidated
into one community care. That will reduce the bureaucracy at the VA but
will also make it more understandable for our veterans and for the
providers, including doctors, hospitals, and others who provide care to
veterans today, in those community care programs--one program, not
seven.
No. 3, we want to improve care coordination. By that we mean the
quality of the relationship that a veteran has with the VA and what
that relationship means in terms of them accessing care today and
tomorrow and care related to their circumstances. This legislation
requires the VA to provide a coordinator of care for veterans utilizing
care in the community to ensure continuity of care and service in a
timely manner. This will make it an easier task for a veteran to
receive what they need, and it ensures it is done in a timely way. It
also prevents lapses in care by increasing the communications between
the veteran and the VA community provider.
No. 4, the legislation reforms eligibility. This is an important one.
They are all important, but this one is especially important to me.
Under the Choice Act under which we operate today, the VA was
instructed to allow a veteran who lives more than 40 miles from a VA
facility or it takes more than 30 days for that veteran to receive his
or her care at the VA--to provide, under Veterans Choice, that care in
a community setting. Eligibility was defined by a narrow circumstance.
However, having said that, it was never clear whether a veteran would
qualify.
That 30-day, 40-mile criteria empowered the VA to make decisions that
often left a veteran who seemingly should be eligible, ineligible for
care in the community. This legislation removes the 30-day, 40-mile
requirement and replaces it with the criteria of what is in the best
interest of the veteran. That is pretty important and pretty basic. One
would expect that always to be the circumstance, but the criteria is
changed now to what is in the best interest of the veteran, and the VA
must meet clearly defined, routinely reviewed criteria as to whether
that veteran is eligible to have community care if he or she desires
it. So we are reducing the discretion. The decision is still made
between the veteran and the VA, but we have narrowed the amount of
discretion the Department of Veterans Affairs has and left the
opportunity for the veteran, when it is in his or her best interest,
access to care in the community.
So it is clearly defined, and the criteria is routinely reviewed to
make sure access is available and that quality standards are met.
No. 5, if it turns out that the veteran disagrees with the decision
made by the Department of Veterans Affairs as to whether he or she is
eligible for care in the community--whether or not it is in his or her
best interest--then there is an appeal to the hospital director in that
person's area. In Kansas, this would be an appeal to the hospital
director at the Colmery-O'Neil Hospital, at the Dwight Eisenhower
Hospital in Leavenworth, or the Dole VA Hospital in Wichita.
Today, when a veteran is denied access to care in a community, their
only recourse is to call their Congressman or to call their U.S.
Senator to complain and have us go to bat. While we are all willing and
we welcome the opportunity to serve those who have served us, the
reality is, no one--and certainly no veteran--should have to call their
U.S. Senator in order to get the VA to provide care that is in their
best interests.
So this now gives a different route and hopefully a much more
convenient route for veterans. We wouldn't have had the 2,650 cases if
we had this provision. The veteran could have the opportunity to have
their decision about their care--what is in their best interests--
determined by the VA at home. So there is recourse for a veteran who is
dissatisfied with the outcome.
No. 6, this provides full access for episodes of care. What our
veterans have faced in using the Choice Act to date is, they will get a
referral to a physician, but then the physician decides the veteran
needs lab work or an x-ray. Unfortunately, that meant the veteran had
to return to the VA to seek additional approval for the lab work and
additional approval for the x-ray.
So we have redefined what it is the referral involves, which is they
are referred for an episode of care. That means the lab work and the
entire episode of care is treated in completion in
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the community. No longer is the veteran required to re-call, re-request
the VA to give them additional reauthorization.
No. 7, the legislation also mandates regular market assessments to
determine what care is available in the community and where the
Department of Veterans Affairs excels. We know the Department of
Veterans Affairs has many medical programs, care, and treatments that
veterans want and need, in which they excel. This gives us a better
understanding--the veteran, the Department of Veterans Affairs, and us
as Members of Congress in our oversight responsibilities--to know what
is available within the VA and what is available in the community, and
that lends itself to the determination of what is in the best interests
of the veteran.
No. 8 of the list of 12 is something that is important to us as
Members of Congress who have veterans who come from rural areas. We
have 127 hospitals in Kansas; 88 of them are designed as critical
access hospitals. It is a designation under Medicare, and it provides a
cost-based reimbursement for that healthcare provider. It means our
smallest hospitals in our smallest communities have a Medicare
reimbursement rate that is designed to keep them in business, to keep
their doors open.
Unfortunately, the Choice Act, in its current form, only requires the
VA to reimburse at Medicare rates. That Medicare rate was never
interpreted by the VA to be the rate that hospital received for
Medicare patients, only a more standard Medicare rate. This legislation
requires that the care be paid for at that critical access hospital
designation rate. The same, I hope, is true for our rural health
clinics, so physicians and hospitals receive the amount of money they
would receive if they were treating a Medicare patient.
Why is this important? It is important because it encourages our
hospitals to accept veterans into the community care program. The
amount of reimbursement they would receive would be the same or similar
to what they receive in caring for a Medicare patient, and our
hospitals, in that circumstance, are hanging on financially by a thread
anyway. It is a challenge to keep hospital doors open in our smallest
communities. This gives them a reimbursement rate that increases the
chance that the revenue is sufficient to cover the cost. It will
encourage more hospitals to accept Choice community care patients, and
it will increase the chance of those patients being alive and well into
the future.
No. 9, this bill allows for access to walk-in care. Something that is
changing in our delivery healthcare system is the ability to go to a
pharmacy and have your blood pressure taken or get an inoculation, a
vaccine. So access to walk-in care is becoming more common across our
State and around the country. This allows our veterans to receive,
under this community care program, care from local walk-in clinics,
convenient care clinics, and federally funded health centers, giving
veterans the same access to nonemergent convenience care that people
other than veterans now receive.
Allowing walk-in care at your local clinic is a much more convenient
and a much more cost-effective way of addressing the issue of access to
care across the State of Kansas and around the country.
No. 10, this legislation provides additional funds to maintain the
Veterans Choice Program during its development and implementation. One
of the challenges we faced is the inability of the Department of
Veterans Affairs to determine actually how much money is required to
keep the Choice Program going. This legislation keeps the program in
place while we transition.
I serve as a member of the Appropriations Committee, and I have
chaired the subcommittee that funds the Department of Veterans Affairs.
We have been worried that every time there is a shortfall in the money
available for Choice, we will see the VA reduce the number of veterans
who qualify for care and therefore starve the program, and the networks
that have been built up with healthcare providers in the community will
disappear. So this is stabilizing. It is a process issue, but it is
important because it allows for care to continue during the interim as
we move to this new legislation.
No. 11, it increases access to telemedicine. The VA is known as a
high-quality provider of telemedicine, but this is an opportunity to
expand that, especially for rural veterans or specialty care, where it
is expensive for that care to be provided--and we don't have providers
in every VA setting--or if where a veteran lives is so remote that
getting to the Department of Veterans Affairs hospital is a challenge.
The State of Kansas has lots of rural communities and long distances--
it can be a 4- or 5-hour drive.
I have been joined on the floor by the Senator from Montana, the
ranking member on the Veterans' Affairs Committee on which I serve. The
Senator from Montana understands very well the challenges rural
veterans face in getting access to care when it is a distance away.
Finally, No. 12, we are going to work hard to foster innovation
within the Department of Veterans Affairs. This legislation creates the
VA Center for Innovation for Care and Payment, allowing the VA to more
efficiently develop and carry out pilot programs to test and check out
innovative solutions and approaches to improving the care for veterans,
improving access to care, improving the cost associated with that care,
and trying to find ways we can better assist our veterans in a more
cost-effective way.
I again reiterate my support for the VA MISSION Act and honor Senator
McCain, for whom this legislation is named. I look forward to its
passage. I am encouraged by the vote that occurred as we moved forward
with this bill. I think there were 94 Senators who voted in favor of
it. It has broad support.
It was my pleasure to work with my colleagues on the Veterans'
Affairs Committee.
I now yield the floor to the Senator from Montana, Mr. Tester.
The PRESIDING OFFICER. The Senator from Montana.
Mr. TESTER. Mr. President, I thank Senator Moran for his kind
comments.
I want to begin my comments by acknowledging the chairman of the
Senate Veterans' Affairs Committee. We would not be here today taking
up the VA MISSION Act without the leadership of Senator Johnny Isakson
of the majority. He is a fierce advocate for veterans, and he has been
an incredible pleasure for me to work with. The bipartisanship and
collaboration on our Senate Veterans' Affairs Committee happens because
we leave politics at the door. That is possible because of Johnny's
personality and leadership style, as well as his commitment to the
veterans of this Nation.
I would also like to thank the many veterans service organizations
that have weighed in and provided positive feedback on the VA MISSION
Act. Thirty-eight veterans organizations representing millions of
veterans and service men and women nationwide support the VA MISSION
Act. They have been asking for Choice reform and responsible investment
in the VA, and this bill gets it done.
I also thank the House Veterans' Affairs Committee for working with
us in getting a bill drafted that we can all be proud of.
At the beginning of this Congress, we set out to draft a bill that
reforms community care and also strengthens the VA. As Senator Moran
pointed out, coming from a State like Montana--a rural State, 147,000
square miles--I know we cannot have a VA clinic in every community, but
veterans cannot always drive 2 hours to the nearest VA clinic, and they
certainly can't afford to wait months for an appointment. That is why
we need private healthcare to fill in the gaps when the VA cannot
deliver that healthcare.
I also know how much veterans need the services they get from a VA
clinic. In my dozens and dozens of face-to-face listening sessions with
veterans, they have told me that the kind of care they get from the VA
is important. They are surrounded by their peers, many of whom have
experienced the mental and physical implications of being in combat. VA
doctors and nurses know how to treat PTSD, toxic exposure, and other
wounds unique to their service.
The best defense against any effort to privatize the VA or send
veterans wholesale to the private sector is to make sure the VA is
living up to our promise to veterans. The VA MISSION Act recognizes
that there is a balance
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between VA care and community care and invests in medical and clinical
staff to serve veterans at the VA. It builds capacity within the VA,
and it uses the private sector to fill in the gaps where the VA falls
short.
It takes the bill that Johnny and I wrote, the Caring for Our
Veterans Act, and adds a few things, but the foundation of this
legislation is something Senator Isakson and I have written over the
course of the last year with veterans groups. So I am incredibly proud
to be standing here today to hopefully push this bill to the
President's desk.
The Choice Program was created with an important mission: to make it
easier and faster for veterans to get healthcare. It hasn't worked like
that for many veterans--veterans like Tom, a retired U.S. Navy
commander of the Vietnam war, a Montanan. In his 24 years as a Navy
pilot, Tom spent a lot of time yelling to be heard over the roar of an
engine. That took a toll on his ability to hear. Three years ago, he
began the process of getting hearing aids from the VA. He got his
hearing test done, but when it came time to order the hearing aids, Tom
was told that he wasn't authorized.
The nearest VA facility to Tom was almost 3 hours away, so he and his
wife decided to drive to the closest civilian clinic, which was about
45 miles away in Sandpoint, ID, just across the line from his home in
Noxon, MT. There, he hit another snag. After weeks of back-and-forth
visits, the authorization was again denied because he was not a
resident of Idaho. So he returned to square one. He drove 5 hours to
Fort Harrison in Helena, 250 miles away.
With assistance from my office, he got the authorization for those
hearing aids. Tom had to drive two 5-hour roundtrips to a Choice
provider in Kalispell, but a few months later, he finally received his
hearing aids.
All in all, Tom drove nearly 20 hours to get those hearing aids, and
I am here to tell you that it shouldn't be that hard for a veteran to
get the healthcare they have earned from the VA. Do you know what the
worst part is? There was an audiologist in Tom's hometown the entire
time who could have helped him if the VA had just realized how
important it was to access that audiologist instead of driving 20 hours
down the road.
Unfortunately, Tom is not the only veteran with a story like this. I
could tell you about a veteran in Lake County who had several
appointments scheduled through the Choice Program, and then he was told
he wasn't eligible for Choice at all--after his appointment. When he
caught pneumonia, my office stepped in and got him the care he needed
through the Choice Program. I could tell you about Bruce, a veteran in
Billings who couldn't get a followup appointment through the Choice
Program after his hip surgery. He was told he wouldn't wait more than 5
days, and then he couldn't get anybody on the phone. We were able to
help him get the followup care he needed. Terry, in Butte, got a
procedure done through the Choice Program. It was approved, completed,
and then he was told he didn't qualify for the Choice Program. Again,
this U.S. Senator had to step in so Terry didn't have to foot the bill
for his healthcare.
I could go on and on. Veterans across the State of Montana have
called my office for help since the Choice Program was started. Their
frustrations over issues like scheduling, reimbursements, or traveling
long distances for care are a sorry way to say thank you to those folks
who have served this country.
It shouldn't take a Senate office stepping in to make sure the
government lives up to its promises to America's veterans, so Chairman
Isakson and I wrote a bill that reforms the entire system. We
negotiated with the House, the White House, veterans, and advocates to
move our bill forward.
The Caring for Our Veterans Act was a giant step forward. Thanks to
the leadership of the House Veterans Affairs Committee and our effort,
the Caring for Our Veterans Act is included in the VA MISSION Act.
Our bill gets rid of seven different community care programs,
including Choice, and replaces them with one community healthcare
system with a streamlined set of rules for veterans, local providers,
and VA staff. It will be much easier to understand.
Under the MISSION Act, if a veteran wants to get care in their
community, they can have a discussion with their doctor and decide what
is best. VA doctors and nurses won't have to spend time figuring out
which program to refer a veteran to.
Local providers who see veterans won't be waiting months for payments
from the VA. A new, streamlined payment system will make sure they are
getting paid in a timely manner.
Our bill holds the VA accountable and requires them to create a
business plan to tell us exactly how the agency will spend taxpayer
dollars if and when they ask for additional funding.
Our bill brings more providers to work at the VA, especially in rural
and Tribal areas and vet centers.
The bill breaks down barriers along State lines that prevent veterans
from accessing mental health care closer to home.
The bill expands the VA Caregiver Support Program to veterans of all
eras and their caregivers. This was a provision Senator Murray worked
on very hard. It was the right thing to do, and Senator Isakson made it
a priority of his.
The VA and community care are equally important parts of the VA
healthcare system. It will either starve the VA to death and empower
rural community hospitals or, as this bill does, strike a balance--the
right balance--between investing in the VA's ability to provide care
for our veterans and cutting the bureaucracy when it makes sense for a
veteran to go to a local doctor.
The VA MISSION Act is a bold, bipartisan product of working together
that puts healthcare decisions in the hands of veterans and breaks down
barriers to healthcare wherever it makes the most sense for a veteran
to get the care they need.
This Nation owes our veterans much more than a thank-you. Veterans
deserve a healthcare system that works for them regardless of where
they live, what medical condition they are struggling with, or their
means. Our bill gets rid of a one-size-fits-all system and creates a
more efficient and easier to navigate system for veterans.
I urge the Senate to pass the VA MISSION Act to send the message that
saying thank you isn't enough for those who put their lives on the line
for our Nation. We are going to deliver them a healthcare system that
is worthy of their service.
Mr. President, I turn the floor over to Senator Johnny Isakson,
chairman of the Senate Veterans' Affairs Committee.
The PRESIDING OFFICER. The Senator from Georgia.
Mr. ISAKSON. Mr. President, before the Senator from Montana leaves, I
wish to thank him for 3 years of dedicated service and the last 2 in
particular as we put together the pieces of shrapnel--which was the
original attempt to make Choice work--to be a streamlined program that
is going to work for all of our veterans.
Jon Tester has been a magnificent ranking member and a magnificent
leader. I appreciate very much the kind things he had to say about me,
and I say ditto to you.
I also thank Chairman Phil Roe, of Tennessee, in the House of
Representatives. He has been a stalwart.
The reason we are able to act today and tomorrow--as the House did
last week--and pass a bill before Memorial Day is because both bodies
have worked together, and the votes have been overwhelming. Our motion
to invoke cloture this morning was 91 to 4. The House passed this 3 to
1 when they passed it in final passage. So obviously there was a lot of
unanimity, but that should not be a disguise for the effort it took. It
took a lot of effort to get to where we are and a lot of people doing
that effort--a lot of Republicans, a lot of Democrats, a lot of staff.
There was a tremendous amount of staff time. We went from doing the art
of the impossible to making the art of the possible, with everybody
working together, leaving our political weapons at the door, and
putting our good heads together to make the Veterans' Administration
system better for our veterans.
My speech is not going to be long because Senator Moran and Senator
Tester have covered the types of examples the new Choice Program brings
for all our veterans--a real choice, a real opportunity to make the
private
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sector a force multiplier for access to healthcare for our veterans but
also make our healthcare system for our veterans accountable--
accountable to the most important people of all, and that is our
veterans.
It does a few other things too. It creates a caregiver program for
the Vietnam-era veterans. That hasn't been talked about much on the
floor, but Patty Murray on our committee and Susan Collins from the
Republican caucus in the Senate have for years tried to get caregiver
benefits for Vietnam-era veterans and veterans of other wars which were
not covered previously. With the passage of this bill, they will be
covered for those basic essentials of life and necessities. They will
have that covered for them, and we will get it done.
Those veterans who came home from a terrible war in Vietnam with many
injuries we had never seen people survive before also need care we
never thought we would have to pay for before, but we are doing it now
with caregivers for that generation, which is my generation. I am proud
to say that we are finally looking after them and are seeing to it that
they are included and are working hard on doing so.
We have also made Choice accountable to the veterans, working for our
veterans and making our VA better at a lower cost to the taxpayers than
it would have been otherwise, were we providing that service solely by
the VA. You get choices, you get quality, you get better service, and
you get a better VA for our veterans.
There have been a lot of people who have made this happen. Senator
John McCain originally introduced the idea of Choice 4 years ago. He
founded it, and that is why his name is a part of the title of this
bill. We could not have done this without John. He is a great American
hero, a great colleague, and through our prayers and our blessings, we
wish for him to recover as he is in Arizona.
I want to thank Joan Carr, my chief of staff; Trey Kilpatrick, my
deputy chief; Jay Sulzman; Amanda Maddox; Ryan Evans; Sal Ortega; and
Kristine Nichols. My staff has been phenomenal. They have done a great
job. They put up with a lot. They have worked hard, and we got here
because of them.
Also, I thank the other unsung heroes of the Committee on Veterans'
Affairs who have helped Jon Tester and me and all our members to see to
it that we covered every item, dotted every i, and crossed every t: Bob
Henke, our staff director; Adam Reece, who deserves a special shout-out
and who, the last couple of weeks, has done double duty and done a
great job to get us to where we are today; Leslie Campbell; Maureen
O'Neill; Jillian Workman; David Shearman; Camlin Moore; Thomas Coleman;
John Ashley; Mitchell Sylvest; Heather Vachon; and Pauline Schmitt. We
could not have done our job as elected officials were it not for those
people who tirelessly worked long hours to see to it that we got it
done.
Here we are in the U.S. Senate. I am speaking with my First Amendment
rights. You are gathered in the Gallery today and watching this at home
on C-SPAN because of the First Amendment, gathering because of the
amendment that allows us to freely assemble without fear of retribution
by the government. Our Bill of Rights are the rights we operate under,
and we wouldn't have them at all were it not for our veterans.
Next Monday we will celebrate Memorial Day. We will give thanks for
every veteran who sacrificed their life and gave the ultimate sacrifice
for you and for me. It is not unreasonable to think back and say: You
know, had our soldiers not done what they did in World War I and World
War II, we might be speaking German or Japanese today rather than
English. Because they fought for us in the two great World Wars, they
secured and preserved our liberty and freedom, and we speak today as
free Americans, and we enjoy the freedom that only democracy could
give. That is what we owe our veterans. We owe them everything. Without
them, we wouldn't have the protections we have today.
As Memorial Day approaches, I love to tell my favorite story about
the great reminder I have of what Memorial Day is all about. It is all
about a veteran, Roy C. Irwin, from the State of New Jersey. I have
never met Roy; I never knew him. When I was in Margraten in the
Netherlands at the U.S. cemetery where over 8,000 Americans are buried
from the Battle of the Bulge, my wife and I spent an afternoon paying
tribute and respect at the graves of our veterans and our soldiers. We
walked down the road to look at the Stars of David and the crosses,
paused for a minute at each headstone, and gave a prayer of thanks for
the veterans who had sacrificed everything so that we could be there.
Then something happened to me that I have never forgotten, and it
could happen to any one of you if you ever go to one of those
cemeteries and visit. I came upon a headstone, a cross, and I stopped
and read it. It said: Roy C. Irwin, New Jersey, private, died, killed
in action 12/28/44. I froze in place; 12/28/44 was not just the day
that Roy C. Irwin died in the Battle of the Bulge fighting for us. It
was the day I was given birth by my mother in Piedmont Atlanta Hospital
in GA.
There I was, standing at the foot of someone who had died on the day
I was born. He gave his life so that I could enjoy mine.
Since that time, I have had 73\1/2\ years in which I have been able
to be a free citizen of the United States of America, all because of
lots of things but nothing more important than Roy C. Irwin and
thousands like him who volunteered to fight for our country, to call on
the forces of evil wherever they might be. They won our freedom,
maintained our independence, and saw to it that you and I could be here
today. I have always stopped to give thanks every Memorial Day for all
of those who pledged and gave the ultimate sacrifice so that I could be
here to make a sacrifice for you.
I look at our pages in the room today, and I think about my children
and my grandchildren. I am so happy they had the opportunity to grow up
in the United States of America and so happy you have the ability to
serve here today in the United States of America. Remember this: You
and I are both here because of one thing. This is a country full of
brave volunteers who, when the bell tolls, answer the bell and go fight
for America, fight for our freedom, fight for our peace, and fight for
our liberty.
So strike one for liberty when we vote on the final passage of the VA
MISSION Act. Vote for better healthcare for our veterans, the choices
of our veterans, caregivers for our veterans who haven't had them in
the past. Give thanks. And with your vote for that bill here, we will
have to continue to pay our debt to those who sacrificed or offered to
sacrifice the maximum sacrifice for us.
This is a great country for lots of reasons. You will never find
anyone trying to break out of the United States of America. You always
find them trying to break in. There is one big difference over any
other; that is, those who have fought and died so that we could be free
and American citizens forever.
May God bless our soldiers, may God bless our country, and may God
bless the United States of America.
I yield back my time.
The PRESIDING OFFICER (Mr. Flake). The Senator from Connecticut.
Gun Violence
Mr. MURPHY. Mr. President, 2 days before the tragic shooting in Santa
Fe, which has rightly dominated the news for the last several days,
Texas experienced another mass shooting when a man killed his three
children, his ex-wife's boyfriend, and himself. Mass shootings are
generally characterized as incidents where four or more people are shot
at one time. It is a catastrophic event for a community to have four
people shot in one instance. That shooting 2 days before the Santa Fe
school shooting was the 100th mass shooting in the United States of
America in 2018. We average about a mass shooting every single day in
this country.
In the 3 days following the Santa Fe High School shooting, there were
around 88 gun deaths and 222 gun injuries in this country. That is a
big number. It is the most in any 72-hour span so far in 2018.
Rightly, our attention has been directed toward the community of
Santa Fe as they try to recover from the unrecoverable--another
targeting of children in a school in this country. It is important to
remind ourselves that no
[[Page S2822]]
matter whether the shooting happens on a street corner, in a school, in
a movie theater, or in one's home, the devastation for those who lose
their brother or their sister or their husband or their wife is no less
or no greater, whatever the circumstances may be.
In the 3 days after Santa Fe, as the country could have been deluded
into thinking that was the only shooting of any consequence in the
country, 88 people lost their lives from guns, and 222 others were shot
and survived--part of the 33,000 a year, 2,800 a month, and 93 on
average a day who are killed by guns in this country. It is a mix of
suicides and accidental shootings, domestic violence incidents, mass
shootings, and homicides, but there is no other country in the world in
which the number is this big.
There have been 5,531 deaths from gun violence in 2018 alone. That is
according to Gun Violence Archive. Twelve hundred kids have been killed
or injured, and we are not even halfway through the year.
Our rate of gun violence in this country is 20 times higher than that
of all our other competitor OECD nations. It is not because our schools
are less safe. It is not because we have more instances of mental
illness. It is not because we have more troubled young men. It is not
because we spend less money on law enforcement. You control all of the
other factors that people claim to be the reason for these crimes, and
it cannot--it does not--explain why this epidemic is happening here and
nowhere else.
What is different about the United States is that we have the
loosest, laxest gun laws of the OECD nations. What is different about
the United States is that in shooting after shooting, killing after
killing, we do nothing. We do nothing of substance or significance to
condemn or change this trajectory of violence.
I argue to you that would-be shooters who are contemplating acts of
mass violence--who clearly have had something go wrong in their mind to
consider such a thing--see our silence as a green light. Of course, we
don't mean it that way, but when we refuse to do anything other than
make minor tweaks to Federal gun laws year after year, young men who
are contemplating doing something like this, seeing no substantial
condemnation or change in law, pervert that silence into permission.
I think that is what is happening today. That is why I argue that we
have become complicit in these murders, whether we think we are or not.
We are grieving hard for Santa Fe, but we are grieving hard for all of
the other victims.
I sat with the President at the White House a few months ago as he
told us he was going to fix this problem. He was lying. He wasn't
telling the truth. He had no intention of fixing the problem. The
President had the gun lobby in the next day, and all of a sudden the
discussion evaporated. He talked a lot in that meeting about school
safety and arming teachers, but it is important to note that Santa Fe
High had adopted really aggressive measures to prevent a school
shooting. They had resource officers who were armed, two of them. They
had approved a plan to arm teachers, though they had not started to do
so. They had gone through a very successful lockdown. They had won an
award for that response. In this school they thought they were ready,
and they weren't.
This has to be about a conversation rooted in data. The data will
tell you that more guns will not solve this problem and that for every
time a gun you own is used in self-defense, there are four times that a
privately owned gun is used in an unintentional shooting, seven times
that a privately owned gun is used in an assault or murder, and 11
times that a gun is used in a suicide. The data doesn't back up the
fact that more guns are going to solve this problem.
Beyond the data, there are these faces, there are these people, there
are these lives that were cut short. I want to spend the remaining few
minutes telling you a few of their stories. I have tried to do that
over the years--to come and put a hole in the data and let you know who
these people are whom we have lost.
On average, psychiatrists and mental health professionals tell us
that when one person is killed by a gun, there are 20 other people who
experience trauma or some level of trauma.
In Santa Fe, we think a lot today about Cynthia Tisdale. She was 63.
She was a substitute teacher for children with special needs. She got
married when she was 17 years old, and she took care of her ailing
husband. He was very sick for 47 years. He said:
She was a good woman. She watched out for me.
Her son said:
She loved to help children. She didn't have to do it. She
did it because she loved it.
Cynthia Tisdale is gone at 63.
Sabika Sheikh was 17 years old. Unlike the others who were killed in
that school, she didn't have any family in the United States. Santa Fe
was her adopted community. She was staying with a family. The family
she left behind, her adoptive family in Texas, said: ``We loved her and
she loved us,'' adding that the ``root of our issues is love because
when people love each other, these kinds of things don't
happen.'' Sabika dreamed one day of being a diplomat and working to
empower women. She died at age 17.
Christopher Jake Stone was 17 as well. He was the youngest of three
siblings in Santa Fe. He and his siblings were known as the ``three
Stones.'' His sister said:
Being a brother was his best job. He was always there if
someone needed someone to listen to or some cheering up.
Definitely the life of the party, and one of the most
understanding, open-minded kids I know.
She said in a Facebook message: ``He had a lot of heart.''
Two days later, to give you a sense of the scope of this, Kimberly
Phillips was in a parking lot at a Shell gas station in Chattanooga,
TN, when her ex-husband found her, shot her, and then killed himself
afterward. It was a murder-suicide, one of the thousands partner-on-
partner incidents of domestic violence that happen in this country.
One of her coworkers at the senior living community where she worked
said:
Today I lost one of the most caring, loving caregivers I
have ever had on my team. . . . She loved her residents and
took their care very seriously.
She was 48 years old.
The day before that, Sherrell Wheatley was walking home from feeding
one of her neighbor's dogs in Dayton, OH. Her neighbor said that she
did this all the time. She cooked a lot, and she would cook all the
scraps and take them to feed the neighbor's dog. She was walking home,
and she was shot as a bystander in a driveby shooting. She was a mom,
grandma, aunt, an active member of her local community, a volunteer in
the local elementary school, and a pillar of kindness.
Her son, a quadriplegic who relied on her care, said:
That was my mom--
She was helping people, even at the moment she died.
I loved her. She was my angel, she was my everything, and
somebody snatched that away from me.
Those are just 5 of the victims who died over a 2- or 3-day period of
time--32,000 a year, 2,200 a month, 93 a day--and we are doing nothing.
I appreciate some of my colleagues working on a minor adjustment to
our background check laws earlier this year. I am not saying that is
totally inconsequential, but it doesn't match up to the moment.
What is wild is, we are the only ones who don't think we should do
anything. Americans have woken up to what is happening, and they are
desperate for us to change the laws. In fact, 97 percent of Americans
think we should pass universal background checks. By a 2-to-1 margin,
people think we should get these assault weapons and military-style
killing machines off the streets. People support things like what we
did in Connecticut, requiring people to get local police permits for
carrying a handgun. These are not controversial outside of the U.S.
Senate.
Increasingly, Americans have come to realize that no one is safe. In
that heartbreaking video, a young woman, I think just hours after the
shooting, was asked by a newscaster whether she found it hard to fathom
that the school shooting had happened at her school. To paraphrase her
answer, she said: No, I wasn't surprised. It happens everywhere, and I
just figured it was a matter of time before it happened here.
Nicole Hockley, who lost her son at Sandy Hook, says all the time
that she
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never, ever expected to be one of these parents grieving the loss of a
child. She reminds everyone she talks to that you don't imagine you
will be in that situation either, but if you don't do something about
it, if you don't stand up and speak truth to power, it might be you
too.
I will continue to come to the floor and tell these stories--these
voices of the victims who have been silenced through gun violence.
Hopefully, at some point, we will wake up to the need for change.
I yield the floor.
I suggest the absence of a quorum.
The PRESIDING OFFICER. The clerk will call the roll.
The senior assistant legislative clerk proceeded to call the roll.
Mr. THUNE. Madam President, I ask unanimous consent that the order
for the quorum call be rescinded.
The PRESIDING OFFICER (Mrs. Hyde-Smith). Without objection, it is so
ordered.
Tax Reform
Mr. THUNE. Madam President, tax reform is working. The results of two
surveys released last week show that tax reform is doing exactly what
it is supposed to be doing for American workers.
Our goal with tax reform was simple: make life better for American
workers. So we took action to put more money into Americans' pockets
right away. We cut tax rates across the board, nearly doubled the
standard deduction, and doubled the child tax credit. Americans are
already seeing this relief in their paychecks.
We knew that tax cuts, as essential as they were, were not enough. In
order to make life better for American workers, we also needed to make
sure Americans had access to good jobs, good wages, and good
opportunities, the kinds of jobs and opportunities that would set them
up for security and prosperity in the long term. Since jobs and
opportunities are created by businesses, that meant reforming our Tax
Code to improve the playing field for businesses so that they could
improve the playing field for workers, and that is what we did.
I am proud to report that it is working. Last week, the National
Association of Manufacturers released the results of its recent tax
reform survey, and here is what the survey showed: 77 percent of
manufacturers planned increased hiring as a result of tax reform, 72
percent planned to increase wages or benefits, and 86 percent report
they plan to increase investments, which means new jobs and
opportunities for workers. These are tremendous results, and they are
exactly what we were looking for with tax reform.
Government can make sure it isn't taking too much out of Americans'
pockets, but it can't create the jobs and opportunities Americans need
for long-term economic security and prosperity. Only businesses can do
that. But government can make sure that businesses are free to create
jobs by making sure they are not weighed down with burdensome taxes and
regulations, and that is exactly what we set out to do with tax reform.
Before the Tax Cuts and Jobs Act, the government was not helping
businesses to create jobs. In fact, it was doing the opposite. That had
real consequences for American workers. A small business owner
struggling to afford the hefty annual tax bill for her business was
highly unlikely to be able to hire a new worker or to raise wages. A
larger business struggling to stay competitive in the global
marketplace while paying a substantially higher tax rate than its
foreign competitors too often had limited funds to expand or increase
investment in the United States.
When it came time for tax reform, we set out to improve the playing
field for American workers by improving the playing field for
businesses as well. To accomplish that, we lowered tax rates across the
board for owners of small and medium-sized businesses, farms, and
ranches. We lowered our Nation's massive corporate tax rate, which up
until January 1 was the highest corporate tax rate in the developed
world. We expanded business owners' ability to recover investments that
they make in their businesses, which frees up cash that they can
reinvest in their operations and their workers. We brought the U.S.
international tax system into the 21st century by replacing our
outdated worldwide system with a modernized territorial tax system so
that American businesses are not operating at a disadvantage next to
their foreign competitors.
Now we are seeing the results. I will say it again. Seventy-seven
percent of manufacturers are planning to increase hiring, 72 percent
are planning to increase wages or benefits, and 86 percent are planning
to increase investments, which creates new jobs and new opportunities
for American workers.
I haven't even mentioned last week's other survey on small
businesses. The National Federation of Independent Business released a
survey last week that shows that 75 percent of small business owners
think that the Tax Cuts and Jobs Act will have a positive effect on
their business. The survey also showed that among small business owners
who expect to pay less in taxes next year, 44 percent plan to increase
employee compensation, and more than a quarter plan to hire new
employees.
Those numbers may get even better. As the survey shows, small
businesses are just starting to explore all the benefits of the new tax
law since small businesses, unlike large businesses, don't have full-
time tax departments to plan for and take into account the new tax
changes. Most small businesses spend the first part of each year
focused on preparing and filing their taxes from the prior year, not to
mention running their businesses, which means, with tax day now behind
them, they are just now having the chance to explore the benefits of
the Tax Cuts and Jobs Act. In addition, their tax advisers--many of
whom are often small businesses themselves--have also wrapped up most
of their filing season responsibilities, so now they can help their
small business clients with factoring the new tax changes into their
business plans.
American workers had a tough time during the last administration.
Wages stagnated, and jobs and opportunities were often few and far
between. But thanks to the Tax Cuts and Jobs Act and other Republican
initiatives, our economy is turning around. Unemployment is at its
lowest level in more than 17 years. Economists have upped their
projections for economic growth. And the good news for American workers
just keeps piling up--more jobs, more opportunities, higher wages, and
better benefits. The American dream is roaring back, and the future is
looking bright.
I yield the floor.
I suggest the absence of a quorum.
The PRESIDING OFFICER. The clerk will call the roll.
The senior assistant legislative clerk proceeded to call the roll.
Mr. MANCHIN. Madam President, I ask unanimous consent that the order
for the quorum call be rescinded.
The PRESIDING OFFICER. Without objection, it is so ordered.
Unanimous Consent Request--S. 2906
Mr. MANCHIN. Madam President, I ask unanimous consent that
notwithstanding rule XXII, the Senate proceed to the immediate
consideration of S. 2906, which is at the desk; that the bill be read a
third time and passed, and the motion to reconsider be considered made
and laid upon the table with no intervening action or debate.
The PRESIDING OFFICER. Is there objection?
The Senator from North Carolina.
Mr. TILLIS. Madam President, reserving the right to object, I want to
thank my friend Senator Manchin. He and I serve on the VA Committee. I
know he is absolutely committed to trying to do the best we possibly
can for our veterans. We may have a disagreement on what he has in mind
for this particular unanimous consent request, but I don't think there
is any daylight between us in terms of what we are trying to do for
veterans.
I look forward to working with the chair to get to a good place and
to address in the Senate committee some of the concerns he has. For
that reason, I object.
The PRESIDING OFFICER. Objection is heard.
Mr. MANCHIN. Madam President, I would like the right to proceed.
I thank my good friend from North Carolina, Senator Tillis. He is
always willing to work in a bipartisan way. I thank him very much.
We have concerns about the VA and all of our veterans. He is in a
State that has a tremendous population, and
[[Page S2824]]
I am in a State with a tremendous population of veterans. I am
disappointed there is an objection to my bill.
I rise to speak to my frustration that the Asset and Infrastructure
Review, or the so-called AIR Act, provision is being included in what
is otherwise a very good package. I thank Chairman Isakson, Ranking
Member Tester, and Senator Tillis for all their hard work on the
overall MISSION Act.
The MISSION Act is going to do so many good things. It is going to
streamline how we provide non-VA care. It is finally expanding
caregivers for veterans of all eras, and it will make it easier for the
VA to hire high-quality providers.
I am against adding the AIR, which is the Asset and Infrastructure
Review Act, or I like to call it the VA BRAC. This bill could be
detrimental to rural veterans.
The AIR Act provision was supposedly added by House Republicans to
the MISSION Act because the Senate insisted the caregivers bill be
included. I am a proud cosponsor of the caregivers bill because it does
not make sense to give a benefit to one era of veterans and not give it
to them all.
I thank my colleague Senator Murray for the year she has dedicated to
the caregivers issue. The AIR Act was never voted on or discussed in
the Senate Veterans' Affairs Committee. The House Caregivers companion
bill is bipartisan and has 90 cosponsors. We could pass this bill
without the AIR Act in a heartbeat.
While I am generally supportive of efforts to cut waste, the AIR Act
will not come close to paying for this bill. Instead, it puts rural
hospitals and facilities like those in West Virginia in the crosshairs
of the VA bureaucrats and technocrats who do not know my veterans and
what they need.
The last time there was an asset review--the CARES Commission--was in
the early 2000s. It recommended closing the acute inpatient hospital
beds and contracting for acute care in the community for the Beckley VA
Medical Center. Only after stakeholders yelled and screamed did the
Secretary not follow their recommendations.
Today, those 25 acute care beds and 5 ICU beds are vitally important,
not just to our Southern West Virginia veteran community but the entire
community. Administrators at the surrounding hospitals have told me
they could not absorb the Beckley VA patient load. We were lucky then
to have vocal stakeholders holler and scream and a Secretary who
listened, but will we be so lucky in the future? Furthermore, should
veterans have to endure the uncertainty their VA hospital or CBOC may
not always be there for them?
My veteran population is nearly 40 percent Vietnam veterans. In the
last 10 years, there was a nearly 20-percent decrease in my veteran
population because our World War II and Korean veterans are dying, and
our Vietnam veterans are not getting any younger.
If we send this Commission in and they do the analysis, my fear is,
resources and funding will be realigned away from our patriotic West
Virginia veterans--Phoenix gets picked over Clarksburg; Los Angeles
over Beckley; Washington, DC, over Martinsburg; and Orlando over
Huntington.
I feel sure the VA will follow the law, hold their public hearings,
and read statements put in the Federal Register, but they will still
have the power to close or downsize West Virginia facilities. Just
because you are a veteran living in a rural area does not mean you
don't deserve the same quality and access of care that you would
receive in an urban area.
Is this truly about taking evaluation of waste or is this the slow
filing away of the VA infrastructure as we know it?
I am aware the MISSION Act just passed out of the House 347 to 70. I
have a lot of good friends on both sides of the aisle who want the
overall bill. It has the support of the national veterans service
organizations, and the effects of this bill will not likely come into
being until 2025. I will not be serving in the Senate then. Yet, for
the sake of the veteran population in West Virginia, I have to say
something publicly.
The AIR Act could have detrimental second and third order effects in
our communities. If this bill passes with the AIR Act in it, the powers
that wish to downsize the level of care we give to veterans will see it
as a victory, but they should be prepared for robust and exhaustive
oversight by me and my colleagues on the committee. If we don't have
the market assessments, access to other population data, and if the
central office doesn't start filling some of the healthcare provider
vacancies in West Virginia VA medical centers, I will reluctantly put a
hold on some nominees for this Commission. I am going to encourage my
colleagues from rural States who represent rural areas to do the same.
Thank you.
The PRESIDING OFFICER. The Senator from North Carolina.
Mr. TILLIS. Madam President, there are a million reasons why I love
North Carolina, but one of them is, it is a State of 10 million people.
Half those people live in urban areas. The other half live in rural
areas. One in ten people in the State are veterans--a State that
proudly claims having one of the fastest growing veteran populations in
the country.
When I go into the VA Committee and I look at what we have to do, I
don't look at it as coming from an urban State. I don't look at it as
coming from a rural State. In many respects, I think North Carolina is
a microcosm of the Nation as a whole.
When we look at some of the changes we want to make, what I hope we
get out of this review is what to do with the 430 empty buildings that
are as much as 90 years old that are owned by the VA. We may have to do
basic maintenance on them, but they are properties that may have a
historic value. Maybe we can convey them to the States and sell them
and use the resources to plow back into quality care for the veterans.
I can tell my friend from West Virginia that we share a mountain
range together. We share a lot of cultures out in the western part of
our State with West Virginia. There is no way on Earth that I would
allow the VA to move forward on something I felt was going further away
from providing quality care to any veterans anywhere in West Virginia,
North Carolina, or any other rural area.
On the one hand, we continue to say we don't have enough money for
veterans. On the other hand, we say we have to find some of those
additional resources by taking steps to make the VA more efficient and
shed the assets that are no longer providing value to the veterans. I,
for one, believe we can do it on a balanced basis.
As this process goes through, it is actually an authority the VA has
today. They haven't acted on it. We are trying to put more pressure on
them to make some concise decisions. The Senator from West Virginia has
my commitment that any instance where we see a decision being made by
the VA that is something that is going to take veterans further away
from care, I will be the first one to join him in making sure we don't
allow that to happen.
Thank you.
The PRESIDING OFFICER. The Senator from West Virginia.
Mr. MANCHIN. I agree with my colleague from North Carolina.
We don't want to continue if there are areas and assets that can be
done away with for efficiencies. I understand that can be done without
this.
I don't know the underlying reasons for it. The AIR Act was never
even discussed in our committee. We never had the bill in front of us
at all. That is all I was saying. How did this all of a sudden get
thrown in?
I understand--because of what we put in, the expansion of how we were
going to take care of caregivers to all populations of veterans--they
were upset on the House side. This was put in retribution to that. I
objected to how it was put in being what the intent was.
I believe the VA can dispose of excess properties that have been
closed, vacant, and not in utilization. I am concerned they are going
to come back and say: In the rural areas, we are going to close this
CBOC and consolidate. We have more need right now and a greater need
with some of our population base, especially with the conflicts we have
around the world now.
I never talked to a veteran who did not want veterans care if there
was any way they could get to a veterans hospital or clinic. They were
the people who knew them best and knew how to take care of their
concerns. That is all I am trying to preserve.
I don't know what the intentions are of this. That is why I wanted to
have
[[Page S2825]]
that removed, and maybe we can discuss it in our Senate VA Committee
and have a better way of reviewing the excess properties and properties
not being utilized.
Thank you.
I yield the floor.
The PRESIDING OFFICER. The Senator from South Dakota.
Mr. ROUNDS. Madam President, I rise today to discuss the legislation
before us, known as the VA MISSION Act of 2018--a significant change
for the healthcare delivery system at the Department of Veterans
Affairs.
The VA MISSION Act passed the House of Representatives last week and
is scheduled to be voted on in the Senate in the coming days. The bill
is a result of months of negotiations and discussions between
stakeholders, the administration, and the House and Senate Veterans'
Affairs Committees, of which I am a member.
While I appreciate the hard work of those involved, unfortunately,
the final legislation is not something that I am able to support.
Before I get into my concerns about the bill and what I believe to be
its fatal flaws, I want to acknowledge that there is a host of good
provisions in here that I do support.
The one on the forefront of many minds is the caregivers program
expansion. The caregivers program, a program that gives support and
assistance to certain veterans so they can receive home healthcare by a
family member, has always been limited to post-9/11 veterans. However,
there are many pre-9/11 veterans' family members who do the same work
as a caregiver recipient but are not compensated for that work. This
program is more cost effective over the long term than an alternative
long-term care accommodation. It is due time for this expansion to
occur for all families.
I also support section 101, paragraph (a), which expands extended
care services, such as nursing home care, through the community care
program. It is similar to a bill I introduced with the senior Senator
from North Dakota, the Veterans Access to Long Term Care and Health
Services Act. This provision will allow long-term care services to more
easily work with the VA in serving veterans.
Further, section 101, paragraph (k) of the VA MISSION Act establishes
in law that a veteran shall not pay a greater amount for receiving care
or services outside of the VA, compared to receiving care at a VA
facility. It is similar to the Veterans Equal Cost for Care Act, which
I introduced in Congress last year. This section makes certain that
veterans will know that VA policy will not change in this regard and
that the VA will not place additional financial barriers for veterans
to access care outside of the VA at a private provider in an effort to
incentivize in-house VA care.
Last, section 101, paragraph (d)(1)(D) of this bill, along with
section 104, requires the VA to develop appropriate access standards
when seeking healthcare. However, I remain concerned that the VA will
not implement it properly.
If the VA implements access standards similar to TRICARE, which is
the health program at the Department of Defense, then, these sections
could be good for veterans.
Let me get into my concerns with the bill. This bill makes
significant changes to the 40-mile rule under the Choice Program, and I
am concerned that it puts our rural veterans in jeopardy.
The Choice Act, which Congress passed in 2014, before I took office,
allowed all veterans who live 40 or more miles from a VA facility to
receive care at a local, private hospital or clinic. Under the VA
MISSION Act, this provision will end for all veterans except those in
the top five rural States after 2 years.
When the Choice Act was first enacted, giving rural veterans the
option to receive care in their communities, rather than at a VA
facility, they overwhelmingly chose to stay close to home and receive
private care. They voted with their feet.
Because of the law, many are getting better local, private care. I
believe veterans who use this type of eligibility successfully today
ought to be able to use this program in the future, no matter which
State he or she is from.
In fact, these concerns were addressed when the original legislation
was crafted in the Senate Veterans' Affairs Committee, and all veterans
who use the Choice Program today were grandfathered into being able to
use the 40-mile rule in perpetuity. Unfortunately, the proposal agreed
to in committee is not the one in front of us today.
I understand that the number crunchers did the math and concluded
that the bill discussed in committee was too expensive and they didn't
want to pay this much for the care of our veterans. So the provision I
offered was cut down significantly to be limited to the top five rural
States, including my own State of South Dakota.
While South Dakota was fortunate to be a part of the top five States,
this country has many rural States and many rural veterans who rely on
the Choice Program's 40-mile eligibility to get their healthcare.
There are roughly 750,000 eligible 40-mile veterans across the United
States. Of this portion, a little less than half, or 330,000 veterans,
have used this eligibility to receive healthcare.
In just 2 years, many of these veterans will no longer be eligible to
receive care outside the VA system based on the 40-mile rule alone, as
they do today. Instead, more veterans will have to work through more
gatekeepers and review processes to get their community care request
granted, if it is granted at all.
Just as important is the way in which 40-mile-eligible veterans
receive community care. Currently, when a rural, 40-mile veteran wants
community care, they get community care. There are little, if any,
barriers to access community care today. The VA can't decide for the
veteran where he or she should get the care. The veteran is in total
control of their care. There are no reviews, gatekeepers, or
consultations. The veteran just goes.
Under the VA MISSION Act, as it stands today, a VA clinician acts as
a gatekeeper for the veteran. Section 101, paragraph (d)(2) states that
a VA employee must consider certain criteria, some of which are
peculiar to a rural veteran, when consulting with a veteran on where
the veteran should go for healthcare. ``Consider'' is not a very tough
or obligatory word, and it leaves a lot of leeway for our Washington
bureaucrats to write rules in a way that may not put the care of our
veterans above all else.
My concern here is that when this bill is signed into law, rules are
going to start to be written, and the number crunchers are going to
influence every rule to meet the bare minimum of the required language.
Just in case anyone is interested in an example, let me briefly
remind the Chamber that the original Choice Act intended to provide
community care to veterans who live 40 miles or more from a VA
facility. How was that rule initially written? Community care was based
on 40 miles as the crow flies. That is right--as the crow flies. It
took intense pressure from the veterans organizations and Congress to
amend that rule to be based on driving distance, or better known as the
way almost every veteran travels to a VA facility.
Why was that rule written to determine community care as the crow
flies? Cost. Cost and nothing more. The VA wrote the rule in a manner
that complied with the bare minimum requirements of the law but not
with the spirit of the law. The VA did not write the rule in a way that
was in line with the way a normal veteran would access community care.
By writing the rule this way, the VA was able to restrict community
care access to veterans to control cost.
With so much ambiguity in the language as it is currently written, my
fear is that the same cost-first mentality will be used once this bill
is signed into law. We believe veterans should be in full control of
their healthcare, not a bureaucrat.
Additionally, under the Choice Act, the access standards have been
clear when it comes to the 30-day rule. It states that if you wait
longer than 30 days, you can use a private provider, period. Under the
VA MISSION Act, the standards are fluid, and the cut-and-dry 30-day
standard goes away. We know that this has been a widely used metric for
veterans' eligibility to receive care outside the VA. In fact, since
the Choice Act began in November of 2014, there has been roughly 1.4
[[Page S2826]]
million instances in which a veteran has been authorized for care
outside of the VA based on the 30-day rule.
Under the VA MISSION Act, there will be a new review process for
veterans who request to receive care outside the VA system, based on
meeting an access standard which has yet to be written. Again, if the
VA implements these access standards like TRICARE, this could be good
for veterans. But whether that happens is subject to rulemaking and
cost constraints.
Finally, I am concerned about title II of this bill, which is the
asset and infrastructure review provision that paves the way for what
is essentially a VA BRAC that could close out some of our most
vulnerable VA facilities, particularly in rural areas. I know that my
friend and colleague from West Virginia was just expressing some of the
same concerns. Of particular concern is a provision that would seek to
neutralize appropriations language that prohibits the VA from reducing
services in the Veterans Integrated Services Network 23 unless a series
of important criteria are made.
For years, the VA has incrementally sought to close the Hot Springs
campus in my home State of South Dakota. The VA has not conducted its
due diligence in deliberating over the future of the Hot Springs
campus, which provides veterans from three States and Indian Country
healthcare. This is a pocket of rural America where few healthcare
options exist.
This VA BRAC provision puts VA facilities like the one we have in Hot
Springs in jeopardy. The Hot Springs VA facility has consistently been
named one of the top VA facilities in the entire United States. If we
are truly putting the care of our veterans before all else, we should
be propping up facilities that have a track record of delivering
timely, high-quality care to our veterans.
With the asset and infrastructure review provision in this bill, I
worry about the future of rural VA facilities such as Hot Springs. More
importantly, I am concerned about our rural veterans' access to
adequate care, including mental health services, should these vital
facilities be closed in the future.
Some have been saying that even though the provision is in there, the
VA has provided assurances that places like Hot Springs are not in
jeopardy, despite the law allowing the agency to review and eventually
close facilities across the Nation if it determines it is necessary.
While the VA has some great employees, including its leadership, I am
reluctant to consent to the BRAC process because the appropriations
language requirements are what I view as due diligence by the VA before
any decision is made on the closing of campuses like those in Hot
Springs. In this particular case, the asset and infrastructure review
language intends to neutralize that appropriations language, and I will
not support that path forward.
At the end of the day, all we can count on is what we have enacted
through legislation, and this bill clearly allows for the VA BRAC to
occur.
My decision to oppose the VA MISSION Act is not one that I have made
lightly. I recognize the many good provisions in this bill that would
go a long way toward improving care for our Nation's veterans. I also
want to recognize the hard work that went into the final package. I
particularly want to thank Chairman Isakson, our Senate Veterans'
Affairs chairman, for making a truly honest effort to address the ideas
and concerns of all the committee members, including my concerns, which
were reflected when we passed our bill out of committee earlier this
year. Unfortunately, those concerns were not included in the final
package. That said, the fight is not over.
Even though we expect the VA MISSION Act to pass the Senate and be
signed into law before Memorial Day, there will be plenty of work to do
as the law is being implemented. I will continue working with my
colleagues, the administration, veterans groups across the State, and
other stakeholders to keep a close watch on the VA's implementation of
the VA MISSION Act to make certain the agency is putting the proper
care of our veterans above all else.
Now, this is something that you never hear in this body, but this is
an instance in which I would be happy to be wrong in my assessment. In
fact, I challenge the VA to prove me wrong. We were close to having a
really good bill with the VA MISSION Act by expanding the caregivers
program to pre-9/11 veterans, by expanding community care to include
community services, and in providing payment protections to rural vets
so they will not pay a greater amount for using community care than
they would for care at a VA facility, just to name a few.
I would have happily voted for any of these provisions as separate
measures, and I am grateful that our veterans will greatly benefit from
them.
I had hoped to get a place in the final bill where my concerns would
be able to be fixed, but at the end of the day, my concerns outweigh
the good, and I have to vote no.
I have the privilege of serving on both the Senate Veterans' Affairs
Committee and the Senate Armed Services Committee, and I cannot tell my
colleagues what an honor it is to fight every day to make sure that our
servicemembers and veterans receive the tools and the care they so
clearly deserve. They make incredible sacrifices so that we can be
free. We have a responsibility to take care of them when their service
is complete. I look forward to continuing to work to fulfill that
responsibility.
Thank you, Madam President.
I yield the floor.
Mr. WYDEN. Madam President, with Memorial Day coming up this weekend,
I want to offer a few thoughts on this package of legislative reforms
for the Department of Veterans Affairs, known as the VA MISSION Act of
2018, being considered by the U.S. Senate.
I want to start by commending Senator Jon Tester of Montana, the
senior Democrat on the Senate Veterans' Affairs Committee, for
negotiating based on what I call principled bipartisanship: taking
ideas from both parties without sacrificing core values.
Montanans have every reason to be proud of Senator Tester for
spending months at the negotiating table with Chairman Isakson, the
House of Representatives, and the White House.
Make no mistake, the bill before the Senate will make some important
reforms to the way the VA does business.
It will consolidate the VA's multiple community care programs,
including the Veterans Choice program, into one permanent framework to
allow veterans to seek care in their communities. Streamlining these
programs was something sought by the Obama administration as well and
will help make it easier for veterans to understand their options and
access the care they need.
It will also expand a VA program that provides benefits to in-home
caregivers, an effort I have supported for years. The program is
currently open to veterans wounded after the terrorist attacks of
September 11, 2001. The VA MISSION Act will open the program to
veterans from all eras.
It will provide more incentives and inducements to help attract
medical providers to the VA and keep them there. In particular, the
bill will provide more recruitment, retention, and relocation bonuses,
it will raise the cap on student loan reimbursement, and it will
establish a new loan repayment program for specialties where the VA is
experiencing a shortage.
As important as these provisions are, I want to express my
reservations about the VA MISSION Act as well.
I voted for the Choice Act in 2014 because I said it was unacceptable
for veterans in Oregon and across the country to be waiting months or
driving long hours for a VA appointment. I will be the first to say the
same thing today, but I fear this bill will give broad authority to VA
leadership to send more veterans out of the VA system.
Given the relentless push by special interest groups to send an ever
greater number of veterans into the private sector, I am concerned
about the Trump administration giving into those folks and turning the
VA over to ideologues or privatization partisans.
I am also disappointed to see the asset review provisions included in
this bill. If the VA has unnecessary infrastructure, it should be able
to make the case to Congress to close or consolidate those facilities
just like any other agency without being required to set up a whole new
bureaucracy.
[[Page S2827]]
Taken together, these provisions strike me as essentially asking
Senators to put more trust in VA leadership and Donald J. Trump, the
same Donald Trump who publicly attacked the parents of a Muslim soldier
killed in action and the same Donald Trump who nominated his wholly
unqualified personal physician to run the VA. Unfortunately, this
administration has already proven it can't be trusted to take care of
our veterans.
I had hoped Senators would be given an opportunity to debate this
bill and offer amendments that might have addressed the bill's
shortcomings. The Senate majority has prevented that from happening.
So the choice before me and every other Senator this week is to
oppose this bill and the good it will do or to support it with
significant reservations.
After hearing from many Oregonians and from the 38 veterans and
military service organizations and seven former VA Secretaries who
support this bill, I have chosen the second option and will support the
bill despite my concerns.
Mark my words: The ultimate success or failure of this bill will
depend on whether Donald Trump and his team at the VA choose to work
with Congress and put our veterans first or whether they sell out to
the privatization partisans.
I hope my fears about this bill prove to be unwarranted, but as the
saying goes, hope is not a strategy, After Donald Trump signs this bill
into law, I will redouble my efforts to work with Senator Tester and
others to support and sustain a robust VA worthy of the millions of
veterans it serves.
If the Trump administration implements any of these provisions in a
way that threatens to privatize or undermine the VA as a healthcare
system, I will pull out all the stops and fight it like hell.
Mr. SANDERS. Madam President, there are parts of the VA MISSION Act
that I strongly support. The expansion of the Caregivers program to
veterans of all generations will help support family members who have
made enormous sacrifices for their loved ones wounded in war. Raising
the limits on the Education Debt Reduction Program, an effort that I
helped lead, will make it easier for the VA to attract the doctors and
other medical personnel they need.
I am concerned, however, that despite some very good provisions in
this bill, it continues a trend toward the slow, steady privatization
of the VA. No one disagrees that veterans should be able to seek
private care in cases where the VA cannot provide the specialized care
they require or when wait times for appointments are too long or when
veterans might have to travel long distances for that care.
The way to reduce wait times is not to direct resources outside the
VA, as this bill does, but to strengthen the VA by recruiting and
retaining the best healthcare professionals to care for the brave women
and men who rely on VA healthcare. The way to reduce wait times is to
make sure that the VA is able to fill the more than 30,000 vacancies it
currently has. This bill provides $5 billion for the Choice program. It
provides nothing to fill the vacancies at the VA. That is wrong. My
fear is that this bill will open the door to the draining, year after
year, of much needed resources from the VA.
Further, I am disappointed that the legislative process did not allow
for votes on amendments that could have made this a stronger bill. The
amendments I filed, but was prevented from offering, would have
provided equal funding for the Veterans Health Administration and the
Choice program, provided real money and a meaningful expansion of the
Caregivers program, and established a pilot program for VA dental care
in rural areas. In addition, I authored an amendment that would have
struck the AIR Act provisions that could result in the closure of VA
facilities and language clarifying that veterans may not be held
financially liable for errors made by the VA.
It is my sincere belief that these amendments would have gone a long
way to addressing the deficiencies in the bill and providing the care
and benefits our veterans have earned and deserved. I hope that my
colleagues on the Senate Veterans Affairs Committee will work with me
to make these necessary improvements in future legislation. We must do
a better job in standing together against the effort to privatize the
VA.
I acknowledge the work done by some of my colleagues to improve this
bill, but I believe it moves us too far in the direction of
privatization. That is why I will vote against it.
Mr. ROUNDS. I suggest the absence of a quorum.
The PRESIDING OFFICER. The clerk will call the roll.
The legislative clerk proceeded to call the roll.
Mr. RUBIO. Madam President, I ask unanimous consent that the order
for the quorum call be rescinded.
The PRESIDING OFFICER. Without objection, it is so ordered.
____________________