[Congressional Record Volume 166, Number 164 (Tuesday, September 22, 2020)]
[House]
[Pages H4678-H4679]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




       NATIVE AMERICAN VETERAN PARITY IN ACCESS TO CARE TODAY ACT

  Mr. TAKANO. Madam Speaker, I move to suspend the rules and pass the 
bill (H.R. 4908) to amend title 38, United States Code, to prohibit the 
collection of a health care copayment by the Secretary of Veterans 
Affairs from a veteran who is a member of an Indian tribe, as amended.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                               H.R. 4908

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Native American Veteran 
     Parity in Access to Care Today Act'' or ``Native American 
     PACT Act''.

     SEC. 2. PROHIBITION ON COLLECTION OF A HEALTH CARE COPAYMENT 
                   BY THE SECRETARY OF VETERANS AFFAIRS FROM A 
                   VETERAN WHO IS A MEMBER OF AN INDIAN TRIBE.

       (a) In General.--Section 1730A of title 38, United States 
     Code, is amended--
       (1) in the heading, by striking ``catastrophically 
     disabled'' and inserting ``certain'';
       (2) by inserting ``(a) Prohibition.--'' before 
     ``Notwithstanding'';
       (3) by striking ``a veteran who is catastrophically 
     disabled, as defined by the Secretary,'' and inserting ``a 
     covered veteran''; and
       (4) by adding at the end the following new subsection:
       ``(b) Covered Veteran Defined.--In this section, the term 
     `covered veteran' means a veteran who--
       ``(1) is catastrophically disabled, as defined by the 
     Secretary; or
       ``(2) is an Indian or urban Indian, as those terms are 
     defined in section 4 of the Indian Health Care Improvement 
     Act (Public Law 94-437; 25 U.S.C. 1603).''.
       (b) Technical Amendment.--The table of sections at the 
     beginning of chapter 17 of such title is amended by striking 
     the item relating to section 1730A and inserting the 
     following:

``1730A. Prohibition on collection of copayments from certain 
              veterans.''.

       (c) Delayed Effective Date.--The amendments made by this 
     section shall take effect on the day that is one year after 
     the date of the enactment of this Act.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
California (Mr. Takano) and the gentleman from Tennessee (Mr. David P. 
Roe) each will control 20 minutes.
  The Chair recognizes the gentleman from California.


                             General Leave

  Mr. TAKANO. Madam Speaker, I ask unanimous consent that all Members 
have 5 legislative days in which to revise and extend their remarks and 
insert extraneous material on H.R. 3908, as amended.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from California?
  There was no objection.
  Mr. TAKANO. Madam Speaker, I yield myself such time as I may consume.
  Madam Speaker, I rise in support of H.R. 4908, as amended, the Native 
American PACT Act.
  The Federal Government has a legal and moral obligation to uphold its 
treaty obligations to Tribal nations, which include the provision of 
healthcare. Our responsibility to ensure care is compounded when 
American Indians and Alaska Natives serve this country in uniform.
  While largely provided by the Indian Health Service and Tribal Health 
Programs, the healthcare obligations of the United States do not start 
and stop

[[Page H4679]]

with one agency. For decades, VA has not recognized the unique status 
of Native veterans and has charged them copays for care provided at VA.
  For far too many Native Americans, particularly those in rural areas, 
the copay burden is a barrier to care. These veterans, who may be 
unable to access specialty care from their Tribal health systems, are 
then unable to access VA due to cost.
  Eliminating the copay burden is a step toward upholding the treaties 
between the United States and Tribal nations while also bringing 
immediate relief to veterans unable to access care during these 
distressing times.
  Madam Speaker, I want to thank Congressman Gallego for his steadfast 
leadership on this issue. I encourage all of my colleagues to support 
H.R. 4908, as amended, and I reserve the balance of my time.
  Mr. DAVID P. ROE of Tennessee. Madam Speaker, I yield myself such 
time as I may consume.
  Madam Speaker, I rise today in support of H.R. 4908, the Native 
American Veteran Parity in Access to Care Today Act, or PACT Act.
  The care that the Department of Veterans Affairs provides to veterans 
for conditions that are related to military service are always provided 
at no cost to the veteran. Veterans being cared for by VA for 
conditions that are unrelated to their military service may be charged 
a copayment to offset the cost of care and encourage appropriate use of 
the VA healthcare system.
  According to the Government Accountability Office and the National 
Council of American Indians, approximately one-third of American Indian 
and Alaska Native veterans were charged copayments from VA in fiscal 
year 2017. Those copayments averaged just under $300 per veteran.
  However, almost a century ago, Congress passed the Snyder Act, which 
guaranteed healthcare to Native Americans free of charge. In 
recognition of that, the Native American PACT Act would prohibit VA 
from charging copayments to Native American veterans regardless of 
whether the care they receive from the VA is for a service-connected 
condition or not.
  There is no ethnic group that volunteers to defend the United States 
in uniform at a higher rate than Native Americans whose history of 
service to this country dates back to the Revolutionary War. This bill 
would increase access to care for those brave veterans and create 
parity between the care provided to them through the VA, the Centers 
for Medicare and Medicaid Services, and the Indian Health Service. It 
would also uphold the United States Government's longstanding trust and 
treaty responsibilities to the Native American community.
  The Native American PACT Act is sponsored by my colleague and fellow 
veteran, Congressman Ruben Gallego from Arizona. I am glad to stand 
with him in support of its passage today.
  Madam Speaker, I encourage all of my colleagues to support this bill, 
and I yield back the balance of my time.
  Mr. TAKANO. Madam Speaker, I too ask all of my colleagues to join me 
in passing H.R. 4908, as amended, and I yield back the balance of my 
time.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentleman from California (Mr. Takano) that the House suspend the rules 
and pass the bill, H.R. 4908, as amended.
  The question was taken; and (two-thirds being in the affirmative) the 
rules were suspended and the bill, as amended, was passed.
  A motion to reconsider was laid on the table.

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