[Congressional Record Volume 168, Number 13 (Thursday, January 20, 2022)]
[House]
[Pages H257-H270]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                ENSURING VETERANS' SMOOTH TRANSITION ACT

  Mr. TAKANO. Mr. Speaker, pursuant to House Resolution 860, I call up 
the bill (H.R. 4673) to amend title 38, United States Code, to provide 
for the automatic enrollment of eligible veterans in patient enrollment 
system of Department of Veterans Affairs, and for other purposes, and 
ask for its immediate consideration in the House.
  The Clerk read the title of the bill.
  The SPEAKER pro tempore. Pursuant to House Resolution 860, an 
amendment in the nature of a substitute consisting of the text of Rules 
Committee Print 117-26 is adopted, and the bill, as amended, is 
considered read.
  The text of the bill, as amended, is as follows:

                               H.R. 4673

       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 ``Ensuring Veterans' Smooth 
     Transition Act'' or the ``EVEST Act''.

     SEC. 2. AUTOMATIC ENROLLMENT OF ELIGIBLE VETERANS IN PATIENT 
                   ENROLLMENT SYSTEM OF DEPARTMENT OF VETERANS 
                   AFFAIRS.

       (a) In General.--Section 1705 of title 38, United States 
     Code, is amended by adding at the end the following new 
     subsection:
       ``(d)(1) The Secretary shall enroll each veteran described 
     in subsection (a) in the patient enrollment system under this 
     section by not later than 60 days after receiving the 
     information described in paragraph (3) with respect to the 
     veteran.
       ``(2) Not later than 60 days after enrolling a veteran 
     under paragraph (1), the Secretary shall provide to the 
     veteran--
       ``(A) notice of the veteran's enrollment; and
       ``(B) instructions for how the veteran may opt out of such 
     enrollment, at the election of the veteran.
       ``(3) The information described in this paragraph is the 
     appropriate information concerning eligibility for enrollment 
     in the patient enrollment system under this section, as 
     provided by the Defense Manpower Data Center of the 
     Department of Defense, or such successor entity of the 
     Department.''.
       (b) Applicability.--Subsection (d) of section 1705 of title 
     38, United States Code, as added by subsection (a), shall 
     apply to a veteran with respect to whom the Secretary 
     receives the information described in paragraph (3) of such 
     subsection on or after the date of the enactment of this Act.
       (c) Electronic Certificates of Eligibility for Department 
     of Veterans Affairs Patient Enrollment System.--Not later 
     than August 1, 2022, the Secretary of Veterans Affairs shall 
     ensure that any veteran who is eligible for automatic 
     enrollment in the patient enrollment system under subsection 
     (d) of section 1705 of title 38, United States Code, as added 
     by subsection (a), is able to access--
       (1) an electronic version of the certificate of eligibility 
     showing the veteran's eligibility for such enrollment; and
       (2) an electronic mechanism by which the veteran may opt 
     out of such enrollment.

  The SPEAKER pro tempore. The bill, as amended, is debatable for 1 
hour equally divided and controlled by the chair and ranking minority 
member of the Committee on Veterans' Affairs or their respective 
designees.
  The gentleman from California (Mr. Takano) and the gentleman from 
Illinois (Mr. Bost) each will control 30 minutes.
  The Chair recognizes the gentleman from California.


                             General Leave

  Mr. TAKANO. Mr. Speaker, I ask unanimous consent that all Members may 
have 5 legislative days in which to revise and extend their remarks and 
to insert extraneous material on H.R. 4673, as amended.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from California?
  There was no objection.
  Mr. TAKANO. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I rise today in support of H.R. 4673, as amended, my 
bill, the Ensuring Veterans' Smooth Transition, or EVEST Act.
  I have made suicide prevention a top priority for the House Veterans' 
Affairs Committee. Last Congress, we passed bipartisan, bicameral 
mental health legislative packages, including the Commander John Scott 
Hannon Veterans Mental Health Improvement Act and the Veterans COMPACT 
Act. This Congress, we continued this work by passing the Sergeant 
Ketchum Rural Veterans Mental Health Act into law, but there is always 
more to do.
  EVEST builds on our work and finally closes one of the most glaring 
gaps for veterans being able to successfully access high-quality VA 
health services, the enrollment process. We shouldn't be trying to hide 
VA care from those who earned it.
  We know that the months following transition out of the military can 
be very stressful and particularly risky for new veterans in terms of 
mental health. With the EVEST Act, servicemembers will be automatically 
enrolled in VA care during their transition out of the military, with 
the choice to opt out. This helps simplify the process and prevents 
veterans from potentially missing out on lifesaving care. It also keeps 
veterans from having to opt into VA care later and attempt to navigate 
a new bureaucracy all on their own.
  The symptoms of PTSD can be significantly improved in veterans who 
receive prompt mental healthcare. A 2014 study led by researchers at 
the San Francisco VA Medical Center looked at nearly 40,000 Iraq and 
Afghanistan veterans who received VA mental

[[Page H258]]

healthcare between 2001 and 2011 and had a post-deployment diagnosis of 
PTSD. They found that veterans who sought and received care soon after 
the end of their service had lower levels of PTSD upon follow-up a year 
after they initiated care. Each year that a veteran waited to initiate 
treatment, there was about a 5 percent increase in the odds of their 
PTSD either not improving or getting worse.
  Mr. Speaker, I include in the Record the study from the San Francisco 
VA Medical Center.

                 [From Psychiatric Services, Dec. 2014]

 Timing of Mental Health Treatment and PTSD Symptom Improvement Among 
                     Iraq and Afghanistan Veterans

 (By Shira Maguen, Ph.D.; Erin Madden, M.P.H.; Thomas C. Neylan, M.D.; 
Beth E. Cohen, M.D., M.A.S.; Daniel Bertenthal, M.P.H.; Karen H. Seal, 
                             M.D., M.P.H.)


                               Objective

       This study examined demographic, military, temporal, and 
     logistic variables associated with improvement of 
     posttraumatic stress disorder (PTSD) among Iraq and 
     Afghanistan veterans who received mental health outpatient 
     treatment from the U.S. Department of Veterans Affairs (VA) 
     health care system. The authors sought to determine whether 
     time between last deployment and initiating mental health 
     treatment was associated with a lack of improvement in PTSD 
     symptoms.


                                Methods

       The authors conducted a retrospective analysis of existing 
     medical records of Iraq and Afghanistan veterans who enrolled 
     in VA health care, received a postdeployment PTSD diagnosis, 
     and initiated treatment for one or more mental health 
     problems between October 1, 2007, and December 31, 2011, and 
     whose records contained results of PTSD screening at the 
     start of treatment and approximately one year later 
     (N=39,690).


                                Results

       At the start of treatment, 75% of veterans diagnosed as 
     having PTSD had a positive PTSD screen. At follow-up, 27% of 
     those with a positive screen at baseline had improved, and 
     43% of those with a negative screen at baseline remained 
     negative. A negative PTSD screen at follow-up was associated 
     with female gender, older age, white race, having never 
     married, officer rank, non-Army service, closer proximity to 
     the nearest VA facility, and earlier initiation of treatment 
     after the end of the last deployment.


                              Conclusions

       Interventions to reduce delays in initiating mental health 
     treatment may improve veterans' treatment response. Further 
     studies are needed to test interventions for particular 
     veteran subgroups who were less likely than others to improve 
     with treatment. (Psychiatric Services 65:1414-1419, 2014; 
     doi: 10.1176/appi.ps.201300453)
       Posttraumatic stress disorder (PTSD) is one of the most 
     common mental disorders among veterans returning from recent 
     deployments. Yet, despite the availability of evidence-based 
     treatments, there are multiple barriers to initiating mental 
     health treatment. Many military personnel and veterans who 
     report barriers to mental health care do not seek treatment 
     or postpone seeking it.
       Among veterans who do seek mental health care, the time lag 
     is quite significant. In a previous study, we found that 
     recently returning veterans with psychiatric diagnoses had 
     delayed initiating mental health care at the U.S. Department 
     of Veterans Affairs (VA) by a median of over two years after 
     their last deployment ended. Delays in care can translate 
     into delays in symptom and functional improvement, hindering 
     readjustment to civilian life, family, and community.
       Some studies have examined predictors of PTSD symptom 
     worsening, but outside of randomized treatment trials, only a 
     few studies have examined variables that are associated with 
     PTSD symptom improvement. In other words, few studies have 
     examined variables that are associated with PTSD symptom 
     improvement in a naturalistic fashion, by allowing treatment 
     initiation or engagement to vary among participants. 
     Furthermore, even fewer studies have examined these questions 
     among military personnel or veterans, particularly among 
     those who have served in Iraq and Afghanistan. Existing 
     studies have found a few variables that were associated with 
     PTSD symptom improvement. For example, service members 
     serving in multiple deployments demonstrated greater symptom 
     improvement than those serving in a single deployment. For 
     other demographic variables, the association with improvement 
     is unclear. For example, although we know that female gender 
     may be associated with the development of PTSD, it is not 
     clear how gender is related to PTSD symptom improvement.
       If we can better understand why some individuals improve, 
     we can better understand the course and trajectories of PTSD 
     and how to best contribute to individuals' recovery. This 
     study evaluated demographic, military, temporal, and logistic 
     variables that may be associated with PTSD symptom 
     improvement. We were particularly interested in whether 
     seeking mental health treatment sooner was associated with 
     improvement in PTSD symptoms.


                                Methods

     Data source and extraction
       We conducted a retrospective analysis of existing medical 
     records from the VA's Operation Enduring Freedom (OEF)/
     Operation Iraqi Freedom (OIF)/Operation New Dawn (OND) 
     roster, a national database of veterans who have separated 
     from OEF/OIF/OND military service and who have enrolled in VA 
     health care. Veterans of OEF served predominantly in 
     Afghanistan, and veterans of OIF and OND served predominantly 
     in Iraq. We linked the OEF/OIF/OND roster database, which 
     contains veterans' demographic and military service 
     information, to the Decision Support System's National Data 
     Extract of pharmacy data and the VA National Patient Care 
     Database, which provides VA visit dates and associated 
     diagnostic codes from the International Classification of 
     Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). 
     These data are derived from electronic medical records 
     generated during clinical visits. Visits to mental health 
     outpatient and primary care services are categorized by 
     clinic stop codes. Mental health outpatient services include 
     visits to integrated care clinics providing primary care and 
     mental health care. Fee basis codes designate care that is 
     rendered at non-VA facilities and reimbursed by the VA but do 
     not capture all non-VA care, such as care reimbursed by 
     private insurance. The results of PTSD screening were 
     extracted from the VA Corporate Data Warehouse.
       All analyses were restricted to OEF/OIF/OND veterans who 
     had received a diagnosis of PTSD (ICD-9-CM code 309.81) 
     during two or more clinical encounters that occurred after 
     the end of their last deployment and before December 31, 
     2012; had utilized mental health outpatient care between 
     October 1, 2007 (beginning of nationwide primary care 
     screenings), and December 31, 2012, and had not made any 
     prior use of VA care; and had received PTSD screenings at 
     both the start of treatment (up to three months before and 
     one month after the first mental health visit) and on at 
     least one other occasion occurring at least one year later 
     (N=39,690). Of veterans who newly entered mental health 
     treatment, 83% had a baseline screen for PTSD, and of those 
     with a baseline screen, 50% had a follow-up screen during the 
     period beginning one year later. The follow-up screen that 
     was closest in proximity to the one-year follow-up date was 
     utilized.
     Measures
       PTSD symptoms were assessed by using the Primary Care PTSD 
     Screen (PC-PTSD), the PTSD Checklist (PCL), or both. Both 
     measures were included in order to capture the most 
     representative sample, given that the PC-PTSD screen is 
     mainly used in VA primary care settings and other non-mental 
     health settings and the PCL is used primarily in VA mental 
     health settings. The PC-PTSD, a brief four-item screen given 
     annually and after each deployment, is designed to detect 
     possible PTSD symptoms. The screen yields binary responses 
     (yes or no) for each of four PTSD symptom clusters: 
     reexperiencing, avoidance, emotional numbing, and 
     hyperarousal; a score of 3 designates a positive PTSD screen 
     for veterans.
       The PCL is a 17-item measure, with each item rating the 
     presence of a different symptom over the past month on a 5-
     point Likert scale, from not at all to a little bit, 
     moderately, quite a bit, and extremely. The PCL has been 
     shown to have very good internal consistency, and it 
     correlates strongly with other measures of PTSD symptoms. The 
     PCL also demonstrates high diagnostic efficiency (.90). 
     Within the VA, the PCL is mainly administered at the 
     discretion of treating clinicians, typically to track patient 
     progress during the course of mental health treatment. For 
     the purposes of this study, symptoms rated as moderately or 
     above on the PCL were considered present. PTSD symptoms from 
     the PCL were combined in order to create indicators that 
     paralleled each of the four symptom cluster proxies from the 
     PC-PTSD. The validity of the mapping of PCL questions onto 
     PC-PTSD items was tested by examining concordance between the 
     two screens given at the VA on the same date. For the 
     purposes of validation, all OEF/OIF/OND veterans who were 
     administered the PCL and the PC-PTSD on the same date (not 
     restricted to our study sample) were included (N=53,756), 
     with a total of 57,889 instances in which a given veteran had 
     both a PC-PTSD and PCL administered on the same day. [A table 
     describing the mapping of the PCL to the PC-PTSD and 
     agreement between the two instruments is available online as 
     a data supplement to this article.]
       We created a composite variable, referred to as the PTSD 
     screen result; endorsing three or more symptoms on either 
     measure constituted a positive screen for PTSD.
     Dependent variable
       The binary dependent variable, a negative (versus positive) 
     PTSD screen result, was defined as a score of <3 at follow-up 
     on the PTSD screen. This outcome comprised PTSD screen 
     results that had improved or had remained negative compared 
     with baseline results (versus having worsened or remained 
     positive).
     Independent variables
       The main independent variable was time until initiation of 
     mental health outpatient treatment, which was defined for 
     each person as the time (in years) from the end of the last 
     deployment until the first mental health

[[Page H259]]

     outpatient visit. Other independent variables included date 
     of birth, gender, race-ethnicity, marital status, and 
     military characteristics. Details about each person's 
     military characteristics (armed forces branch [Army, Marines, 
     Navy or Coast Guard, or Air Force], rank, component type 
     [National Guard and reserves or active duty], and number of 
     deployments [one or multiple deployments]) were extracted 
     from the OEF/OIF/OND roster. Information about the type of 
     VA facility nearest to the individual and the distance to 
     the closest facility was derived from the OEF/OIF/OND 
     roster by the VA planning and system support group.
       The following independent variables were treated as 
     potential confounders because each could account for change 
     in PTSD symptoms: mental health outpatient treatment 
     utilization, defined as the number of mental health clinic 
     visits between the start of mental health treatment and the 
     follow-up screen; regular use of primary care services, 
     defined as a mean interval between visits of six months or 
     fewer; and use of a selective serotonin reuptake inhibitor 
     (SSRI) for 12 consecutive weeks or more, as encoded in VA 
     outpatient pharmacy data.
     Analysis
       We used logistic regression analysis to examine the 
     association of independent predictor variables with a 
     negative PTSD screen result. In separate logistic regression 
     models, we examined predictors of PTSD screen results for 
     each of the four PTSD symptom clusters (reexperiencing, 
     avoidance, emotional numbing, and hyperarousal). The main 
     predictors of interest included time from the end of the last 
     deployment to initiation of mental health outpatient 
     treatment, gender, age, race-ethnicity, marital status, 
     military component, rank, branch, number of deployments, and 
     distance to and type of nearest VA facility. The multi-
     variable analysis adjusted for potential confounders of the 
     association between changes in PTSD symptoms and predictors. 
     Potential confounders included baseline PTSD screen result, 
     timing of follow-up screen, regular utilization of primary 
     care services, total mental health outpatient treatment 
     utilization, and SSRI use. Primary care and mental health 
     service utilization and antidepressant use were included only 
     for adjustment purposes because of potential biases due to 
     confounding by indication. More specifically, persons who are 
     more symptomatic are more likely to utilize health services 
     and antidepressant medications.
       We tested interactions of demographic and military 
     predictors with each other and, separately, with time to 
     initiation of mental health outpatient treatment. As 
     mentioned above, the study combined results for veterans 
     whose PTSD screen result had improved from baseline with 
     those for veterans whose screen result had remained negative. 
     To determine whether it was valid to combine these scores, we 
     tested interactions of baseline screen results with 
     demographic and military factors and, separately, with time 
     from the end of the last deployment to initiation of mental 
     health outpatient treatment. All tests were two-tailed. 
     Analyses were performed by using SAS, version 9.3. The study 
     was approved by the Committee on Human Research, University 
     of California, San Francisco, and the San Francisco VA 
     Medical Center.


                                RESULTS

       The sample was 90% male, with a meanSD age of 
     30.58.16; 57% were white, 11% were black, 11% 
     were Hispanic, and 21% were of other or unknown race-
     ethnicity. At the time of initiation of mental health 
     outpatient treatment, 75% of the veterans screened positive 
     for PTSD, having endorsed at least three of the four PTSD 
     symptom clusters on the PTSD screen (Table 1). After at least 
     one year (mean follow-up=2.37.93 years), 27% 
     (N=7,908) of those with a positive screen at baseline had 
     improved, and 43% (N=4,329) of those with a negative screen 
     at baseline continued to screen negative.
       Multivariable logistic regression analysis showed that the 
     following characteristics were associated with a negative 
     PTSD screen result: women compared with men, older versus 
     younger age at first mental health outpatient visit, officer 
     rank compared with enlisted rank, service in branches of the 
     military other than the Army, and negative PTSD screen at 
     baseline (Table 2).
       Blacks were less likely than whites to have a negative 
     screen result (Table 2), and this difference persisted after 
     adjustment for time from the end of the last deployment to 
     mental health outpatient treatment. Similar to findings of 
     previous studies, the median interval between the end of the 
     last deployment and the use of services was about three 
     months longer for blacks than for whites (p<.001; data not 
     shown). The reduced likelihood among blacks versus whites of 
     a negative PTSD screen result was partly driven by the 7% 
     greater probability that blacks would screen positive for 
     PTSD at follow-up after having screened negative at baseline 
     (p<.001; results not shown).
       Veterans who were married were slightly less likely than 
     those who were never married to have a negative PTSD screen 
     result. Veterans who lived more than ten miles away from the 
     nearest VA facility were less likely than veterans who lived 
     closer to have a negative screen result. Veterans who lived 
     closer to a community-based outpatient clinic than to a VA 
     medical center were also less likely to have a negative 
     screen result.
       Notably, veterans who waited longer to initiate mental 
     health outpatient treatment were less likely to have a 
     negative screen result. Figure 1 illustrates the decreasing 
     probability of a negative screen result with each year that 
     passed after the end of the last deployment.
       Logistic regression analyses found similar patterns of 
     association between predictor variables and PTSD screen 
     results for each of the four PTSD symptom clusters (results 
     not shown).


                               DISCUSSION

       A number of demographic, military, temporal, and logistic 
     variables were associated with symptom improvement or with 
     continuing to score below the threshold for a positive PTSD 
     screen. Although temporal variables are rarely examined, we 
     found that greater time to mental health outpatient treatment 
     engagement was negatively associated with PTSD symptom 
     improvement. More specifically, veterans who waited longer to 
     get mental health treatment were less likely than veterans 
     who sought treatment sooner to experience PTSD symptom 
     improvement during the study period. This finding sheds light 
     on the importance of continuing to better understand barriers 
     to mental health treatment, particularly given that less than 
     half of veterans with mental health problems seek care and 
     those who seek care do so after significant delays.
       Outreach efforts to help veterans engage in treatment in a 
     timely manner are critical and may, in turn, help with PTSD 
     symptom improvement over time. Intervening early when mental 
     health problems are first detected should be a priority. 
     Given that integrated primary and mental health care is now 
     becoming available at many VA health care facilities, this 
     ``one-stop shop'' model provides an optimal way to decrease 
     time to seeking mental health care. Veterans in primary 
     care who screen positive for any mental health problems 
     can receive immediate mental health assistance within an 
     integrated care model, which may assist with the stigma of 
     receiving care in a mental health setting. Indeed, 
     veterans who received integrated primary care were more 
     likely to receive a mental health evaluation or care 
     within a month.
       We also found that female gender was associated with 
     greater PTSD symptom improvement compared with male gender. 
     Although civilian studies found that females are at greater 
     risk of PTSD, findings in military samples have been mixed, 
     with some studies finding no gender differences. In addition, 
     we recently found that although both genders experienced a 
     delay in engaging in minimally adequate mental health care 
     (eight mental health outpatient visits within a year), female 
     veterans received minimally adequate mental health care about 
     two years sooner than male veterans, which may explain why 
     they achieved greater symptom improvement.
       Black veterans were less likely, but only modestly so, to 
     demonstrate PTSD symptom improvement, compared with their 
     white counterparts, and this difference was not explained by 
     longer time from the end of the last deployment to mental 
     health outpatient treatment initiation. That is not 
     surprising, given that studies have consistently found that 
     unmet treatment needs are greatest in underserved groups, 
     including racial-ethnic minority groups). It may be that 
     veterans from racial-ethnic minority groups face particular 
     barriers to treatment that are important to acknowledge, and 
     more research is needed in this area in order to optimize 
     outcomes. Furthermore, other variables, such as differential 
     rates of traumatic stressors and preexisting conditions, are 
     important to further explore and may explain some of these 
     differences.
       Officers were more likely than enlisted personnel to 
     experience PTSD symptom improvement. One possible explanation 
     is that officer status may be a proxy for higher education; 
     research has shown that lower levels of education are 
     associated with chronic trajectories of PTSD. However, other 
     variables that we were not able to measure, such as social 
     support in the aftermath of trauma, may also explain some of 
     these findings.
       A number of limitations should be considered when 
     interpreting these findings. First, this study was conducted 
     with a population of treatment-seeking veterans who had at 
     least one visit to a VA health care facility. Therefore, our 
     results should not be generalized to all OEF/OIF/OND military 
     personnel or veterans. Second, we selected a population of 
     veterans who served in support of OEF/OIF/OND, and, 
     therefore, these results should not be generalized to 
     veterans of other eras or to veterans from other countries. 
     Third, ICD-9-CM diagnoses were acquired from administrative 
     health records and were not verified with standardized 
     diagnostic measures. A related concern is the combined use of 
     two separate validated tools, the PCL and the PC-PTSD. We 
     used both the PCL and the PC-PTSD in order to obtain the most 
     representative sample and because they are the measures used 
     by the VA system. Furthermore, we found that the method we 
     used was statistically reliable. Nonetheless, combining two 
     separate validated tools may have resulted in variations in 
     these data. Future studies should continue to examine the 
     validity and reliability of this method.
       Fourth, because of the ways in which data appear in the VA 
     administrative database, we were not able to distinguish 
     between the types of mental health treatments that veterans 
     were receiving, such as evidence-based treatment for PTSD or 
     other mental health

[[Page H260]]

     problems versus supportive therapy; rather, we could account 
     only for number of visits. We hope to have better indicators 
     of evidence-based treatment for PTSD in the future so that 
     the particular types of care that veterans receive can be 
     examined more closely in relation to symptom improvement. 
     Fifth, because we used administrative data, we were not able 
     to examine third variables that may be associated with our 
     outcome, including severe avoidance symptoms, interpersonal 
     difficulties, and poor attachment, among others. Finally, we 
     were able to include only veterans whose PTSD symptoms were 
     measured during at least two occasions; those who dropped out 
     after one visit are not as well represented.


                              Conclusions

       Veterans who waited longer to get mental health treatment 
     were less likely to experience PTSD symptom improvement 
     during the study period. Furthermore, improving barriers for 
     black, male, younger, rural, lower-ranking, and possibly less 
     well educated veterans is an important priority, given our 
     findings. Models that integrate primary care and mental 
     health care may be an optimal way to help expedite veteran 
     treatment engagement.


                    Acknowledgments and disclosures

       This research was supported by VA Health Services Research 
     and Development Service (HSR&D) Career Development Award (RCD 
     06-042) to Dr. Maguen, an HSR&D Service Directed Research 
     Award (SDR-08-408) to Dr. Seal, and a Department of Defense 
     Mental Health Research Infrastructure Award (W81XWH-11-2-
     0189) to Dr. Neylan. The authors thank Julie Dinh, B.A., for 
     assistance.
       Dr. Neylan has received study medication for a study funded 
     by the Department of Defense and study medication for a study 
     funded by the VA. The other authors report no competing 
     interests.

  Mr. TAKANO. A smooth care transition from DOD to VA can help support 
veterans as they adjust to the next phase of their lives and provide 
easy access to healthcare should any challenges arise.
  Everyday Americans find it difficult and frustrating to sign up for 
healthcare. Now, imagine that you have just come off Active-Duty 
military service where, for years you were told when and where to show 
up for your healthcare. You probably heard something about VA services 
during your transition assistance program but, frankly, you were 
focused on everything you had to do to finalize your separation from 
the military and possibly looking for new employment and relocating 
your family.
  Now, after having separated from the military, you are a veteran, and 
maybe for the first time you have to figure out how to check your 
eligibility for VA healthcare and navigate the system while potentially 
also facing some new stress in your personal and family life. This is 
completely avoidable with EVEST, which simply enrolls you in the VA 
healthcare for which you are already eligible, ensuring that when you 
need VA, there aren't any unnecessary roadblocks to seeing a doctor.
  Now, let me say that again. This legislation has nothing to do with a 
veteran's eligibility, nor does it change VA standards or who is 
eligible. It only connects eligible veterans to VA care faster and 
easier.
  We know that veterans are much more likely to use VA services and 
care when the process to enroll is simple, and we know that VA care is 
world class. EVEST is a straightforward tool that will allow us to 
simplify the transition process and take steps toward preventing 
veteran suicide.
  Automatic enrollment is something policymakers and veterans service 
organizations and stakeholders have been trying to advance for years, 
and with EVEST it will finally become a reality.
  Paralyzed Veterans of America and Disabled American Veterans have 
formally endorsed this legislation. The Nurses Organization of Veterans 
Affairs, the American Federation of Government Employees, the Veterans 
Healthcare Policy Institute, and the American Psychological Association 
also support EVEST.
  Again, Mr. Speaker, I include in the Record letters of support from 
the Nurses Organization of Veterans Affairs and the Veterans Healthcare 
Policy Institute.
                                            Nurses Organization of


                                             Veterans Affairs,

                                                 January 14, 2021.
     Chairman Mark Takano,
     Committee on Veterans' Affairs,
     Washington, DC.
       Dear Chairman Takano: On behalf of the nearly 3,000 members 
     of the Nurses Organization of Veterans Affairs (NOVA) we 
     would like to offer our strong support for your bill, H.R. 
     4673, Ensuring Veterans' Smooth Transition Act (EVEST).
       As nurses, caring for Veterans is our number one priority. 
     Your bill will provide Veterans with the option of enrolling 
     in VA healthcare during the critical months following their 
     transition to civilian life and ensure servicemembers 
     separating from active duty receive the critical health care 
     to which they are eligible.
       Your bill will also help eliminate barriers to care--
     including those who may not know they are even eligible to 
     receive care at VA. It will also help to assure the Veteran 
     that they are not alone in seeking care for any physical or 
     mental health condition acquired during their military 
     service.
       Offering automatic enrollment with an opt out will help to 
     lessen the burden of navigating the VA healthcare system at a 
     time when they are dealing with many challenges as they 
     transition to civilian life.
       NOVA believes that most Veterans will find care provided 
     them within the VA is suited to their individual and complex 
     needs and cannot be matched in the private sector. Many 
     providers at the VA are Veterans themselves so they 
     understand what it means to serve and are trained to provide 
     a Whole Health approach to the Veteran patients' health and 
     well-being.
       Thank you for your leadership on this issue and your 
     continued support for Veterans and the healthcare 
     professionals who care for them.
           Sincerely,
     Taryn-Janae Wilcox-Olson, MHS, RN,
       President, Nurses Organization of Veterans Affairs (NOVA).
                                  ____

                                               Veterans Healthcare


                                      Policy Institute (VHPI),

                                                 January 19, 2022.
     Endorsement of the ``Ensuring Veterans' Smooth Transition 
         Act''
       The Veterans Healthcare Policy Institute (VHPI) is pleased 
     to formally endorse House bill H.R. 4673, the ``Ensuring 
     Veterans' Smooth Transition Act'' or ``EVEST Act.'' The EVEST 
     Act creates a process to automatically enroll Veterans who 
     are eligible, upon their discharge from the military, into 
     the VA for medical care, with an opportunity to opt out. Many 
     Veterans do not receive the health care they have earned 
     through their service because they are unaware of their 
     eligibility or are too overwhelmed during the complex period 
     of transitioning from active duty. By automatically enrolling 
     Veterans into the VA system, many more eligible veterans will 
     be able to utilize valuable VA health care benefits. Many 
     lives will be saved.
       This is one of the most important bills in many years, and 
     we are pleased to support its passage.

  Mr. TAKANO. Mr. Speaker, I wish to thank Speaker Pelosi and Leader 
Hoyer for considering this legislation today, and I urge the rest of my 
colleagues to support this vital legislation to increase access to care 
and ensure a smooth transition to civilian life for veterans.
  Mr. Speaker, I reserve the balance of my time.
  Mr. BOST. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I rise today in opposition to H.R. 4673, the Ensuring 
Veterans' Smooth Transition, or EVEST Act.
  This bill would require VA to automatically enroll every eligible 
separating servicemember into the VA healthcare system. As a veteran, I 
know firsthand that the transition from military to civilian life can 
be hard. One of the goals is to remove barriers to care for veterans, 
whether they left the military decades ago or just last week.
  I believe the intention of the EVEST Act is to further that goal by 
connecting more at-risk servicemembers with the VA as they leave the 
service. I support the intention. I know many other Members do as well, 
which is why I expect the bill to pass the House, and probably on a 
bipartisan basis.
  However, as the ranking member of the Veterans' Affairs Committee, I 
have a different perspective on this bill than many of my colleagues. I 
have taken a long, hard look at this legislation, and what I have seen 
is a bill that may be well intended but has several potential problems.
  To start with, the EVEST Act enrolls separating servicemembers into 
the VA healthcare system without their knowledge or consent. Only after 
they have been enrolled does the bill require VA to inform the veterans 
of their enrollment, the status of their enrollment, and how to opt out 
by disenrolling themselves.
  We shouldn't be signing veterans up for a government program they 
aren't asking for and may never need without at least letting them know 
first. And

[[Page H261]]

we shouldn't be telling them that if they don't like it, they can 
figure out how to disenroll themselves. That is backwards.
  Veterans deserve better than that. Veterans also deserve better than 
a bill that has been rushed through Congress without due diligence. 
There has never been a single hearing on the EVEST Act in this 
Congress.
  You may hear the chairman say that there has been a hearing on this 
bill last Congress. That is true. But last Congress and this Congress 
are very different. We had a different administration last Congress; we 
had a different VA Secretary last Congress. I believe more than 70 
Members are new this Congress. More than half of the membership of the 
Veterans' Affairs Committee is new as well. And, regardless, VA did not 
provide testimony at the hearing last Congress.
  We have no idea if VA can implement the bill without disrupting 
service to the veterans already in the VA health system, further 
burdening VA's already overworked staff, or increasing the strain on 
VA's already overfull facilities. Every Member of the House hears from 
veterans in our districts who are waiting too long for care they need, 
stuck in crowded VA facilities, and being treated by VA staff who are 
struggling and overwhelmed. I am concerned that this bill could make 
each of those things worse.
  I am not the only one who thinks so. Last week, right before this 
bill was considered by the Rules Committee, the Biden administration 
issued a Statement of Administration Policy on the EVEST Act. The 
statement reads, ``There may be challenges implementing this bill as 
drafted, and the administration looks forward to working with Congress. 
. . .'' In other words, even the President recognizes that this bill 
needs more work.
  Mr. Speaker, I include in the Record the Statement of Administration 
Policy.

                   Statement of Administration Policy


H.R. 1836--Guard and Reserve GI Bill Parity Act of 2021--Rep. Levin, D-
                    California, and nine cosponsors

   H.R. 4673--Ensuring Veterans' Smooth Transition (EVEST) Act--Rep. 
                          Takano, D-California

       The Biden-Harris Administration supports efforts that 
     ensure veterans receive timely access to high-quality 
     benefits and services that they have earned.
       The Administration supports H.R. 1836, which would expand 
     eligibility criteria for certain education benefits. Current 
     law defines the term ``active duty'' as those individuals who 
     are on full-time duty in the active military service of the 
     United States, including full-time training duty, annual 
     training duty, and attendance, while in the active military 
     service, at a school designated as a service school by law or 
     by the Secretary of the military department concerned. H.R. 
     1836 would expand eligibility criteria to include those 
     training in full-time National Guard duty, which includes the 
     National Guard, the Army National Guard, and the Air National 
     Guard, as well as those same members when performing active 
     duty.
       The Administration supports the EVEST Act's goal of 
     seamless enrollment in health care coverage. As currently 
     written, H.R. 4673 would require the Department of Veterans 
     Affairs (VA) to automatically enroll new veterans into VA 
     health care, and notify veterans of their enrollment and 
     instructions on how to un-enroll, if desired. There may be 
     challenges implementing this bill as drafted, and the 
     Administration looks forward to working with Congress on how 
     best to operationalize its objective.

  Mr. BOST. Mr. Speaker, to be clear, the Veterans' Affairs Committee 
had numerous opportunities in the last year to do that work that I had 
just discussed, and I don't know why the chairman chose not to. I have 
heard him say over the last week that it is okay we didn't have a 
hearing on the EVEST Act in this Congress because the bill has been in 
the public domain.
  Now, I am not sure what that statement really means because there 
have been almost 400 bills introduced in this Congress that have been 
referred to the Veterans' Affairs Committee. I guess that each of those 
are in the public domain. But I don't think any of them are ready for a 
vote here on the House floor.
  It is not too much to ask that we seek the input from stakeholders 
before voting on a bill to become law. That is actually the least we 
can do. I don't think our constituents sent us here to do anything less 
than that.
  During last week's Rules Committee, Congresswoman Torres, a member of 
Chairman Takano's own party, seemed to agree with me by lamenting the 
lack of process this bill has received this Congress. With all due 
respect to the Congresswoman, I doubt that we agree on much, but we do 
agree on this, though. Having this bill go through a much more robust 
process this Congress could have resulted in a much better product for 
our veterans.

                              {time}  0930

  Finally, I want to note that the bill will also cost taxpayers $3.1 
billion in new discretionary spending. Not a penny of that $3.1 billion 
is offset.
  Implementing this bill will certainly require additional funding 
above the nearly $100 billion already appropriated for the VA 
healthcare system.
  We cannot keep saddling our children and grandchildren with billions 
of dollars more debt. We have to do better than this.
  Mr. Speaker, I reiterate that I understand why my colleagues will 
likely vote for this bill. I wish I could vote for this bill, as well.
  Leaving the military was not easy. It can leave new veterans feeling 
adrift and alone. I have been there. But that is why I supported 
efforts during the Trump administration to improve the Transition 
Assistance Program and increase the VA's outreach to separating 
servicemembers during their first year out of uniform.
  I want separating servicemembers who need additional support to be 
able to get it and the help they need in a seamless manner. And I am 
not at all confident that this bill will accomplish that goal without 
harming services to other veterans and adding to the national debt. As 
a result, I must oppose this bill today.
  Mr. Speaker, I reserve the balance of my time.
  Mr. TAKANO. Mr. Speaker, I yield myself such time as I may consume.
  I reiterate that we should not be hiding the care that our veterans 
have earned. Let me quickly say that this bill has been in the public 
domain for 2 years. It was reintroduced last summer, and the minority 
had over 6 months to talk with us and the VA about it.
  Furthermore, the committee has held six hearings on suicide 
prevention and transition since 2019. The common sense of this bill 
shines through.
  And let me also add that regarding the capacity of VA--and I am glad 
that the ranking member has entered the statement of administrative 
support into the Record; that statement clearly says and declares the 
administration's support and its willingness to work with the 
administration.
  Data shows that VA enrollment has been going down in recent years, 
and while new enrollment hovers around 400,000 per year, it used to be 
double that, around one million per year, and using current 
assumptions, VA projects veteran enrollment in VHA to remain relatively 
steady from 2019 to 2029.
  I am very confident about VA's ability to absorb the additional 
veterans that will take advantage of VA's world-class healthcare.
  Mr. Speaker, I yield 5 minutes to the gentleman from Indiana (Mr. 
Mrvan), my good friend and a member of the House Committee on Veterans 
Affairs and the chairman of the Subcommittee on Technology 
Modernization.
  Mr. MRVAN. Mr. Speaker, I thank Mr. Takano for yielding me the time.
  It is my honor today to rise in support of H.R. 4673, the Ensuring 
Veterans' Smooth Transition Act.
  I appreciate the leadership of Chairman Takano to advance this 
critical legislation that will require the VA to automatically enroll 
individuals who are separating from the military into the VA system.
  Our brave members of the military put their lives and health on the 
line every day to keep our Nation safe, defend our democracy, and 
protect our freedoms.
  We have a responsibility to make it as easy as possible for them to 
transition from military service to civilian life, and I am pleased 
that this legislation does just that.
  My life experiences have afforded me the opportunity as a former 
township trustee in northwest Indiana to work every day with the 
veterans community. I was able to initiate a veterans services 
roundtable and bring together veteran organizations to discuss, 
coordinate, and streamline much-needed resources to our veterans.

[[Page H262]]

  In many instances, it was not that the resources or the benefit was 
unavailable, but rather, the individual was unaware of the existing 
benefit, or unable to access, for whatever reason, the very resource 
they needed.
  Today, I am thinking of those countless discussions and individuals 
as I will vote to support the EVEST Act. It is an effective proposal to 
help ensure that veterans access the valuable healthcare services 
available to them during this transition process from active to veteran 
status.
  Today, I want to make sure we meet our veterans' mental health needs 
and increase veterans' access to healthcare. I again thank Chairman 
Takano and my fellow members of the Veterans' Affairs Committee for 
your commitment to supporting veterans and bringing this measure to the 
floor today.
  I urge my colleagues to support this measure.
  Mr. TAKANO. Mr. Speaker, I reserve the balance of my time.
  Mr. BOST. Mr. Speaker, I yield myself such time as I may consume.
  In response to the EVEST Act has been in the public domain, I think 
it is very important to note, as I mentioned earlier, the last Congress 
is not the same as this Congress. We have more than 70 Members who are 
new Members of Congress, half of the Veterans' Affairs Committee is 
new, we have a different President, and we have a different secretary.
  Introducing a bill is not the same as conducting a hearing. You can't 
get input from the stakeholders. You can't engage in meaningful debate 
in the public domain. This reflects zero input from the VA, meaning we 
have no idea whether it is flexible, whether it is workable, whether it 
is disruptive to the VA system. We don't know.
  And even the Biden administration agrees that more work is needed 
before this bill should become law.
  And the previous speaker, Mr. Speaker, spoke about the person that 
didn't know what was available to them through the VA. If you were my 
age as a veteran it is true that you could not know because you got a 
quick class and the TAP program. And I have mentioned on this floor 
before that that is a tap on the back and see you later.
  But today's TAP program is a course that you take, and you are bound 
to understand separation from your active service and what VA benefits 
are available to you.
  And not only that, the Trump administration in 2018 put an 
administrative order out that you are then contacted after separation 
at 90, 180, and 360 days out to be notified of what benefits are 
available to you in the VA. We are doing that.
  This instead enrolls members without their consent, and then they are 
enrolled. And the only option they have is to be notified later how 
maybe they can get out of being enrolled.
  Mr. Speaker, I reserve the balance of my time.
  Mr. TAKANO. Mr. Speaker, I yield myself such time as I may consume.
  I want to add that, in response to the esteemed ranking member, VA 
formally supports this legislation and has been discussing auto 
enrollment for years.
  VA has already been working to make transition into VA healthcare 
smoother with Solid Start and will soon have data showing that warm 
handoffs have a positive impact on veteran outcomes without 
overwhelming the VA system.
  In response to the criticism that VSOs have not had input, I want to 
point out that VSOs, including Paralyzed Veterans of America and 
Disabled American Veterans, have already formally endorsed EVEST. Why? 
Because the common sense of this legislation shines through.
  All VSOs have had a chance to weigh in, and many did. The Nurses 
Organization of Veterans Affairs, the American Federation of Government 
Employees, the Veterans Health Policy Institute, and the American 
Psychological Association also support this legislation.
  Mr. Speaker, I yield 3 minutes to the gentleman from California (Mr. 
Correa), my good friend and a former member of the House Veterans' 
Affairs Committee who now serves on the Agriculture Committee, Homeland 
Security Committee, and House Judiciary Committee.
  Mr. CORREA. Mr. Speaker, today I rise in strong support of the EVEST 
Act.
  All gave some, and many made the ultimate sacrifice. America has made 
a promise to our veterans that we will take care of them when they 
return home.
  I represent Orange County, California, and many of my constituents 
have served their country proudly. One of my constituents, Billy Hall, 
from the city of Orange, enlisted at the age of 15, served from 1941 to 
1945 in World War II, and again from 1948 to 1967 in the Korean and 
Vietnam wars.
  Every servicemember deserves our respect and gratitude, and most of 
all, all the benefits and care that we promised them when they would 
return home.
  This bill is very simple but very important. It automatically enrolls 
veterans in the healthcare system. It provides veterans healthcare 
without the red tape.
  I urge my colleagues to vote ``yes'' on the EVEST Act and pass this 
simple and important commonsense legislation for our veterans.
  Mr. TAKANO. Mr. Speaker, I reserve the balance of my time.
  Mr. BOST. Mr. Speaker, I yield myself such time as I may consume.
  In my debate and the things that I brought up here today, I never 
said that VSOs didn't have input. I did say the VA did not come to the 
committee, and we did not have the proper hearings. If the VA is in 
support of this bill, I would request that the VA send the 
documentation saying how they are in support of this bill. Their input 
would be vitally important.
  Whether it is a Republican or Democrat administration, the VA is 
vitally important to make sure they provide services to our 
constituents and to our veterans.
  No one on this floor cares more about veterans than the people who 
serve on this committee--I can guarantee you that--whether it is the 
chairman or myself.
  But we have to make sure what we are providing does what it is we are 
trying to do. It was mentioned earlier that they believe that this 
would help reduce suicide among transitioning servicemembers. I care 
deeply about this. This is something that both I and the chairman have 
worked on and will continue to work on.
  The majority of veterans who die of suicide have not had meaningful 
engagement with the VA. They may have been enrolled in the VA, but they 
haven't gotten the VA care that they need.
  This bill would add names of eligible separating servicemembers from 
the VA and put them on the rolls, but it doesn't do the outreach that 
is necessary to possibly prevent them from that ultimate decision to 
end their lives.
  Those are the type of things we are working on and will continue to 
work on. This is not the answer to that. There are a lot of other 
concerns that I have expressed and will continue to express.
  Mr. Speaker, I reserve the balance of my time.
  Mr. TAKANO. Mr. Speaker, I yield myself such time as I may consume.
  Let me say that the amendments that we are considering to this bill 
today, which I consider friendly, will address many of the ranking 
member's concerns about the reaching out.
  I yield 3 minutes to the gentleman from Connecticut (Mr. Himes), my 
good friend who serves on the Financial Services Committee and the 
Permanent Select Committee on Intelligence.
  Mr. HIMES. Mr. Speaker, I thank Chairman Takano for moving this very 
important legislation.
  In this polarized and angry time, one of the lights of this 
institution is that we have always come together to better serve our 
veterans, to better serve those men and women who took the ultimate 
risk and were prepared to make the ultimate sacrifice on behalf of all 
of us and the system that this room embodies.
  And this is a real problem. As I go around my district and I talk to 
young veterans, they face any number of transitional issues; with 
housing, with healthcare. And let's face it, the change from being on 
active duty to being a veteran is a challenging one, one that all too 
often results in the kind of tragedy that we have acknowledged here in 
this Chamber today.

[[Page H263]]

  And so I rise in strong support of the EVEST Act. It is consistent 
with something that I am very proud to have accomplished many years ago 
when we passed the SERVE Act, which made it easier for veterans to show 
that they had an income so that they could get the housing which they 
were entitled to. It was a small thing, but it just eased the passage 
for those young men and women who have so well served this country.
  This is important, and it is not a big deal, but it is going to 
affect tens of thousands of veterans. My Republican friends know that I 
respect and value their input and their objections to our ideas. It 
makes us better when you pose objections to our ideas. But I am a 
little puzzled by the objections that I am hearing today.
  I have heard sitting here that this is not paid for. Okay. It is $3 
billion that I think is well spent on perhaps the most valuable 
population that we have. But the notion that it is not paid for, let's 
remember it was just a couple years ago that my friends on the 
Republican side passed $2 trillion in tax cuts, 83 percent of which 
benefited the top 1 percent of this country's citizens. I have to 
believe that if we can do $2 trillion in tax cuts that largely benefits 
the richest Americans, that we can find $3 billion to ease the passage 
for our veterans.

                              {time}  0945

  I have heard the ranking member say that the VA maybe can't handle 
it. Let's remember that the VA supports this idea and that we are just 
asking them to do a little bit more of what they already do. This is 
not some new and fanciful program. No, it is making a program that is 
well-established available to more.
  Mr. Speaker, this is a good bill. I am particularly proud of my 
friend and neighbor--  Joe Courtney will talk about this shortly--that 
my neighbor, Jahana Hayes, is proposing an amendment that will increase 
the notification that goes to veterans about what is available to them.
  This bill needs to pass because, at the end of the day, we are 
answering the question: Do we want more veterans to have access to what 
we have promised them, or do we want fewer veterans to have access to 
what we have promised them? That is what is at stake here.
  Mr. Speaker, I thank the ranking member and urge him to rethink his 
objections to this bill because this will be a proud moment when this 
bill passes.
  Mr. BOST. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I mentioned that the Committee on Veterans' Affairs did 
not do our job on this bill. We did not consider this bill in a 
legislative hearing. We did not seek input from stakeholders or the VA. 
We did not make certain that automatically enrolling newly separated 
servicemembers into the VA healthcare system would not impede access 
for existing employees or cause funding crises. And those things are 
very, very real.
  Even the Biden OMB has admitted that there are going to be challenges 
with implementing this bill. If you look at the numbers--and I am going 
to add this into what should be mentioned--19.1 million veterans is 
what we have; 9 million veterans are enrolled; 7 million have used 
access to the VA. If we start and do it this way without letting 
veterans make decisions on their own, it can overwhelm the VA. That is 
what has been mentioned by OMB.
  Veterans are already facing tough challenges. So is the VA health 
system that they can go to. But we don't need to add any more to their 
plates without at least hearing how it is going to affect the services 
that are already being provided to our veterans.
  That is why, just so you know, I am offering a motion to recommit 
this morning. My motion to recommit, if adopted, would send this bill 
back to the Committee on Veterans' Affairs to consider an amendment to 
H.R. 4673 that would delay implementation until 30 days after the VA 
has certified that it can implement, without disruption, services to 
veterans or requiring additional funds.
  Mr. Speaker, I don't see how those who support this bill, despite its 
problems and the Biden administration's recognition that it may cause 
challenges, can object to this amendment. The very least we can do for 
the millions of veterans who are already enrolled in VA care and 
counting on VA services is to ensure--before this bill goes into 
effect--that it won't cause undue harm to them. I have already drafted 
an amendment that would accomplish that goal.
  Mr. Speaker, I ask unanimous consent to insert the text of my 
amendment in the Record immediately prior to the vote on the motion to 
recommit.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Illinois?
  There was no objection.
  Mr. BOST. Mr. Speaker, I urge my colleagues to support my motion to 
recommit, and I yield back the balance of my time.
  Mr. TAKANO. Mr. Speaker, I yield myself the balance of my time.
  Mr. Speaker, let me just say, in response to my friend, the esteemed 
ranking member, that his MTR, which would delay implementation in order 
to avoid harm to our veterans, dare I say that the harm is in the 
delay.
  I am reminded of a quote from the VFW's Pat Murray that we had at 
yesterday's roundtable on toxic exposure: Our pay-for for this bill and 
our pay-for, frankly, for all that we do for veterans was the ticket 
that we sent servicemembers overseas to serve. I repeat: Our pay-for 
was the ticket we sent servicemembers overseas to serve.
  And a little further discussion on the pay-for issue: The 
Congressional Budget Office does not estimate that this bill will 
increase mandatory spending and does not require an offset. These are 
the rules we play by.
  Again, we are not creating new eligibility here. The only cost of 
this bill is veterans seeking care that they are already eligible for. 
We are all better off when veterans are seeking the care that they 
need, and we should not be hiding that care for which they are 
eligible.
  Automatic enrollment in VA healthcare for eligible veterans is a 
long-needed suicide prevention tool. We cannot put a price tag on 
protecting the health and safety of our veterans. Many of these 
veterans would go on to use VA healthcare even if they are not 
automatically enrolled, and the minority does not give a compelling 
reason why we should hinder or make that process more difficult for our 
veterans.
  Again, I repeat, we should not be hiding the care for which our 
veterans are already eligible.
  Mr. Speaker, I ask that all my colleagues join me in passing H.R. 
4673, as amended, and I anticipate we will see a big bipartisan vote 
today.
  Mr. Speaker, I yield back the balance of my time.
  Ms. JACKSON LEE. Mr. Speaker, I stand here in strong support of H.R. 
1836, the Ensuring Veterans' Smooth Transition Act (EVEST), which 
provides automatic enrollment in the VA for all transitioning service 
members, and veterans who don't want to obtain its services have the 
easy choice of opting out.


 =========================== NOTE =========================== 

  
  January 20, 2022, on page H263, in the third column, the 
following appeared: Mrs JACKSON LEE. Mr. Speaker, I stand here in 
strong support of H.R. 1836, the Ensuring Veterans' Smooth 
Transition Act
  
  The online version has been corrected to read: Ms. JACKSON LEE. 
Mr. Speaker, I stand here in strong support of H.R. 1836, the 
Ensuring Veterans' Smooth Transition Act


 ========================= END NOTE ========================= 


  Specifically, this bill would:
  Automatically enroll new veterans into VA Health Care;
  Provide VA with information about transitioning service members;
  Require the VA to reach out to veterans about the scope of, and 
access to, benefits.
  Assuring future cohorts of veterans--including those struggling with 
the Taliban triumph in Afghanistan--don't go without health care during 
their transition from military to civilian life is the worthy goal of 
this bill.
  After attempting suicide while serving on active duty in Iraq, 
Kristofer Goldsmith was given a general discharge by the Army and 
little else.
  The overwhelmed 21-year-old returned to his hometown on Long Island, 
N.Y., totally unaware that he was eligible for care from the Veterans 
Health Administration (VA).
  ``I had just lost my income, my support network, my identity, and 
almost my life. I was in a total mental health crisis,'' Goldsmith 
said.
  During the critical months following his transition to civilian life, 
he went without desperately needed services.
  If his mother hadn't forced him to go to the VA, Goldsmith, who 
credits the VA with helping him rebuild his life, doesn't know what 
would have happened to him.
  Of this, however, he is certain, ``If I had heard from my local VA 
informing me of what benefits I had and that I'd been enrolled in the 
system, it would have changed my life drastically.''
  This bill would help thousands of veterans who need services for the 
multitude of conditions acquired or exacerbated by military service but 
are confused about how to access them.

[[Page H264]]

  These ailments include everything from respiratory problems caused by 
burn-pit toxic exposure to signature combat conditions such as 
Traumatic Brain Injury (TBI) and Post-Traumatic Stress Disorder (PTSD).
  For all these problems, prompt attention means everything.
  For example, according to research conducted by the VA, veterans who 
received care soon after the end of their service ``had lower levels of 
PTSD upon follow-up a year after they initiated care.
  According to the study, for each year that a veteran waited to 
initiate treatment, there was about a 5 percent increase in the odds of 
their PTSD either not improving or worsening.
  In 2018, the National Academies of Sciences, Engineering and Medicine 
found that post-9/11 veterans who had not sought VA mental health care 
didn't know how to apply for benefits--or were unsure whether they were 
even eligible.
  Some didn't know what services the VA offered or felt that they 
didn't deserve care even if they could get it.
  Some women veterans are similarly unsure whether VA services are even 
available to their gender.
  This legislation will not only be key to eliminating these barriers 
but also to reducing the veteran suicide crisis.
  A disproportionate number of veterans die by suicide during the 
initial months and years following separation from military service.
  Veterans ages 18 to 34 have the highest rate of suicide.
  Automatic pre-enrollment could be lifesaving during a crisis when 
speed is of the essence.
  Smoother access to VA health care has never been more important than 
it is today.
  The tumultuous end of the war in Afghanistan is intensifying mental 
health symptoms within the veteran population.
  I am proud to support this legislation in order to better serve 
veterans and reduce veteran suicide.
  This bill, in which we further the benefits and recognition that our 
servicemen and women deserve, also reminds us that we have an 
overriding duty to protect the health and dignity of those serving 
today.
  For this reason, I would like to discuss the crisis that our National 
Guardsmen and Guardswomen have been thrust into at the Texas Governor's 
direction on our Southern Border.
  In March 2021, the Texas Governor launched the ill-fated and 
ineffective Operation Lone Star which he claimed was necessary to stem 
a so-called invasion of migrants at Texas' southern border.
  As of November 2021, more than 10,000 Texas National Guardsmen have 
been deployed to the southern border in pursuit of this folly.
  According to published media accounts, National Guard members who 
have been activated for Operation Lone Star are experiencing habitual 
pay delays and poor working conditions during the border mission, 
including being exposed to COVID-19, and many are missing the equipment 
necessary for safety and mission success.
  In addition, the National Guard has faced austere conditions and 
limited resources, leading to unsanitary conditions such as the lack of 
portable restrooms.
  Rather than addressing these conditions, just last week the Texas 
Governor filed a frivolous lawsuit in federal court challenging the 
authority of President Biden, the Commander-in-Chief of the Armed 
Forces to require that members of the National Guard be vaccinated 
against COVID-19.
  There is no merit to this nuisance law suit as demonstrated by the 
summary rejection of similar arguments raised by neighboring Oklahoma 
Governor Stitt.
  The Texas Governor's failure to comply with the policies intended to 
reduce the spread of COVID-19 among the Armed Forces will mean that 
there will be less military personnel available national disasters that 
have struck Texas in recent years, such as the winter freeze of last 
year.
  This will also mean that there are fewer personnel to respond to any 
attacks on the homeland.
  Encouraged by the Texas Governor's obstinacy, about 40% of the 
members of the Texas Army National Guard are refusing to get 
vaccinated, which puts at risk their colleagues and the persons they 
are sworn to defend and protect.
  National Guardsmen and Guardswomen deployed in this disastrous 
mission at the Texas Governor's insistence face the deadly spread of 
COVID-19, unsanitary conditions, lack of pay, and a lack of a certain 
future.
  These uniformed men and women deserve better, and some of them, 
seeing no alternative to their present reality, have decided to end it 
all.
  Five National guard soldiers have shot and killed themselves in the 
past three months, and one more survived a suicide attempt.
  One of these men, private first class Joshua R. Cortez, was preparing 
to accept a ``lifetime job'' with one of the nation's biggest health 
insurance companies in late October last year, but the Texas National 
Guard had other ideas.
  Operation Lone Star required involuntary activations to meet the 
Texas Governor's troop quotas, and Cortez was one of the soldiers 
tapped to go on state active duty orders--with no idea how long the 
mission would last.
  In November, the 21-year-old mechanic requested a hardship release 
from the mission: ``I've been waiting for this job and I'm on my way to 
getting hired . . . I missed my first opportunity in September when I 
had to go on the flood mission in Louisiana. . . . I can not miss this 
opportunity because it is my last opportunity for this lifetime job.''
  Cortez's company commander recommended approval. But his battalion 
commander and brigade commander disapproved.
  Within 36 hours of his request being denied, Cortez drove to a 
parking lot in northwest San Antonio and shot himself in the head.
  Three other soldiers tied to Operation lone Star have died by 
suicide, including:
  Sgt. Jose L. De Hoyos was found dead in Laredo, Texas, on Oct. 26. He 
was a member of the 949th Brigade Support Battalion's headquarters 
company.
  1st Sgt. John ``Kenny'' Crutcher died Nov. 12, as time ran out on his 
temporary hardship waiver. He was the top NCO for B Company, 3rd 
Battalion, 144th Infantry.
  1st Lt. Charles Williams, a platoon leader in Crutcher's company, 
died at home overnight Dec. 17 while on pass.
  The string of suicides raises urgent questions about the mission's 
conditions and purpose, as well as the way it's organized and manned 
through indefinite involuntary call-ups.
  This is an excellent and common-sense bill that will enhance the 
benefits of our servicemen and women.
  We must also act to ensure that our servicemen and women are 
protected from COVID-19, both for their own safety and the safety of 
our nation.
  Although we cannot bring back the lives lost due to the Texas 
Governor's misguided actions, we can remember the names of those we 
have lost and work to ensure that we treat all members of our military 
equally and with dignity and respect.
  The SPEAKER pro tempore. All time for debate has expired.
  Each further amendment printed in part B of House Resolution 117-225, 
not earlier considered as part of amendments en bloc pursuant to 
section 5 of House Resolution 860, shall be considered only in the 
order printed in the report, may be offered only by a Member designated 
in the report, shall be considered as read, shall be debatable for the 
time specified in the report equally divided and controlled by the 
proponent and an opponent, may be withdrawn by the proponent at any 
time before the question is put thereon, shall not be subject to 
amendment, and shall not be subject to a demand for division of the 
question.
  It shall be in order at any time for the chair of the Committee on 
Veterans' Affairs or his designee to offer amendments en bloc 
consisting of further amendments printed in part B of House Report 117-
225 not earlier disposed of. Amendments en bloc shall be considered as 
read, shall be debatable for 20 minutes equally divided and controlled 
by the chair and ranking minority member of the Committee on Veterans' 
Affairs or their respective designees, shall not be subject to 
amendment, and shall not be subject to a demand for a division of the 
question.


         Amendments En Bloc Offered by Mr. Takano of California

  Mr. TAKANO. Mr. Speaker, pursuant to section 5 of House Resolution 
860, I rise to offer the four amendments en bloc to H.R. 4673.
  The SPEAKER pro tempore. The Clerk will designate the amendments en 
bloc.
  Amendments en bloc consisting of amendment Nos. 1, 2, 4, and 5, 
printed in part B of House Report 117-225, offered by Mr. Takano of 
California:


           amendment no. 1 offered by mr. delgado of new york

       Page 1, line 15, insert ``(A)'' before ``Not later''.
       Page 1, line 18, strike ``(A)'' and insert ``(i)''.
       Page 2, line 1, strike ``(B)'' and insert ``(ii)''.
       Page 2, after line 3, insert the following:
       ``(B) In carrying out subparagraph (A), the Secretary shall 
     consider using, to the extent practical, mass texting 
     capabilities through mobile telephones.''.


           amendment no. 2 offered by mr. delgado of new york

       At the end of the bill, add the following:

     SEC. 3. GAO REPORT ON NOTICE OF AUTOMATIC ENROLLMENT IN 
                   PATIENT ENROLLMENT SYSTEM OF DEPARTMENT OF 
                   VETERANS AFFAIRS.

       Not later than 180 days after the date of the enactment of 
     this Act, the Comptroller

[[Page H265]]

     General of the United States shall submit to Congress a 
     report containing the results of a study to determine the 
     best methods for the Secretary of Veterans Affairs to provide 
     notice under paragraph (2) of subsection (d) of section 1705 
     of title 38, United States Code, as added by section 2. In 
     making such determination, the Comptroller General shall 
     consider needs of veterans based on--
       (1) age;
       (2) residence in urban areas; and
       (3) residence in rural areas.


          amendment no. 4 offered by mrs. hayes of connecticut

       Page 1, line 15, insert ``(A)'' before ``Not later''.
       Page 1, line 18, strike ``(A)'' and insert ``(i)''.
       Page 1, line 18, strike ``and''.
       Page 2, line 1, strike ``(B)'' and insert ``(ii)''.
       Page 2, line 3, strike the period and insert ``; and''.
       Page 2, after line 3, insert the following:
       ``(iii) instructions for how the veteran may elect to 
     enroll at a later date.
       ``(B) Any notice or instructions required to be provided 
     under this paragraph shall be provided in the form of a 
     physical copy delivered by mail and, to the extent practical, 
     in the form of an electronic copy delivered by electronic 
     mail.''.
       Page 3, after line 5, insert the following:
       (d) Provision of Notice and Information.--The notice and 
     instructions required to be provided under subsection (d)(2) 
     of section 1705 of title 38, United States Code, as added by 
     subsection (a), shall be provided in accordance with the 
     established procedures of the Department of Veterans Affairs 
     with respect to the provision of similar types of notices and 
     instructions.


            amendment no. 5 offered by ms. tlaib of michigan

       Add at the end the following:
       (d) Report on Automatic Enrollment.--
       (1) In general.--Not later than one year after the first 
     veteran is enrolled in the patient enrollment system of the 
     Department of Veterans Affairs under subsection (d) of 
     section 1705 of title 38, United States Code, as added by 
     subsection (a), the Secretary shall submit to Congress a 
     report on the enrollment process under such subsection. Such 
     report shall include each of the following:
       (A) A discussion of any anticipated challenges that 
     occurred in implementing such subsection, the strategies used 
     to address such challenges, and the effectiveness of such 
     strategies.
       (B) A discussion of any unanticipated challenges that 
     occurred in implementing such subsection, the strategies used 
     to address such challenges, and the effectiveness of such 
     strategies.
       (C) Any additional information the Secretary determines 
     appropriate, including information that may be useful to 
     other Federal departments and agencies considering the 
     implementation of similar automatic enrollment programs.
       (2) Form of report.--The report required under paragraph 
     (1) shall be submitted in unclassified form, but may include 
     a classified annex.

  The SPEAKER pro tempore. Pursuant to House Resolution 860, the 
gentleman from California (Mr. Takano) and the gentleman from Illinois 
(Mr. Bost) each will control 10 minutes.
  The Chair recognizes the gentleman from California.
  Mr. TAKANO. Mr. Speaker, I rise today in support of these en bloc 
amendments. Seamlessly connecting veterans with the benefits and care 
they earned through their service is paramount to the transition 
process.
  The Delgado amendment No. 1 makes sure that VA can easily notify 
veterans regarding care and services through mass texting. As 
technology and communication methods improve, so should how VA uses 
those capabilities to easily inform veterans of their benefits. Texting 
eligible veterans to tell them they have been auto-enrolled in VA 
healthcare is an effective, simple way to increase awareness of the 
care available to them.
  The Delgado amendment No. 2 requires GAO to submit a report to 
determine the best methods to notify veterans regarding their automatic 
enrollment in VA healthcare. This amendment will strengthen the 
underlying bill and inform best practices for how VA can ensure 
veterans have the information they need regarding their access to care 
and services.
  Getting information to veterans in an effective manner is crucial to 
their transition into civilian life, and the Delgado amendment No. 2 
will help improve how VA communicates an eligible veteran's enrollment 
in VA healthcare so they can easily access the care they need.
  The Hayes amendment requires that VA notify veterans who opt out of 
automatic enrollment that they may elect to enroll at a later date. We 
understand there will be some veterans who opt out for auto-enrollment 
for a variety of reasons, but it is our duty that they know that the VA 
will be waiting for them if their future needs change.
  Ensuring VA adopts and scales best practices related to auto-
enrollment while also learning from any issues that arise during its 
rollout is important to the long-term effectiveness of the aims of H.R. 
4673.
  The Tlaib amendment requires the VA to submit a report a year after 
the first veteran is auto-enrolled in VA healthcare to preserve lessons 
learned from the rollout. This report will help improve auto-enrollment 
for both the VA administrators implementing the program and veteran 
users alike.
  Mr. Speaker, I urge my colleagues to support the en bloc amendments, 
and I reserve the balance of my time.
  Mr. BOST. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, the four en bloc amendments are offered by Congressman 
Delgado, Congresswoman Hayes, and Congresswoman Tlaib. I thank them for 
their work. I remain opposed to the underlying bill, and I explained 
why in detail over the last debate.
  One of the reasons I was opposed to it is because the Committee on 
Veterans' Affairs did not do our job before bringing this bill to the 
floor. We did not hold hearings on the bill or seek input from 
stakeholders. And importantly, we did not get assurance from the VA 
that the bill could be implemented without negative impact to services.
  In fact, shortly before this bill hit the Rules Committee, the Biden 
administration did release the statement that we talked about earlier. 
That statement, remember, says that there are challenges in 
implementing this bill.
  Now, I wish we could have done that work in the VA Committee before 
considering the bill on the floor. If there are challenges, we need to 
know about them, and we need to be able to address them to make sure 
that no veteran is harmed by this bill.
  Nevertheless, here we are. These en bloc amendments will help get 
some of the information we should have gotten before passing the bill. 
They will help us stay informed on how the bill is working and the 
impact it is having on veterans and on the VA healthcare system after 
the fact.
  For example, one of Congressman Delgado's amendments would require 
GAO to study the best methods for VA to notify newly separated 
servicemembers of their enrollment status. His second amendment would 
require VA to consider texting newly separated servicemembers to inform 
them of their enrollment status and their ability to disenroll. If a 
veteran chooses to disenroll, Congresswoman Hayes' amendment would 
require VA to provide them with information on how to enroll at a later 
date if they change their mind down the line.
  Finally, Congresswoman Tlaib's amendment would require VA to report 
to Congress on the implementation of this bill not later than 1 year 
after enactment. That would allow us to course-correct, as needed, if 
the bill is causing problems at least 1 year out.
  Now, I feel like a broken record, but this is information we should 
have had already. Nevertheless, it is better late than never. That is 
why I will be in support of that amendment alongside the amendments for 
Delgado and Hayes.
  Mr. Speaker, I urge my colleagues to do the same, and I yield back 
the balance of my time.
  Mr. TAKANO. Mr. Speaker, may I inquire how much time is remaining.
  The SPEAKER pro tempore. The gentleman from California has 7\1/2\ 
minutes remaining.
  Mr. TAKANO. Mr. Speaker, I yield 2 minutes to the gentleman from 
Connecticut (Mr. Courtney), my good friend who serves on the House 
Committee on Armed Services as chairman of the Subcommittee on Seapower 
and Projection Forces and the Committee on Education and Labor.

                              {time}  1000

  Mr. COURTNEY. Mr. Speaker, I thank Mr. Takano and Ranking Member Bost 
for supporting the en bloc.
  Mr. Speaker, it is my honor today to speak on behalf of the Hayes 
amendment offered by my friend and neighbor from Connecticut, 
Congresswoman Jahana Hayes, who unfortunately could not be here today 
because she is

[[Page H266]]

quarantining. Her amendment is a commonsense proposal to improve an 
already outstanding bill that will connect more veterans to benefits 
they have earned by volunteering to wear the uniform of this country.
  Mr. Speaker, last year, at the outset of the VA's highly successful 
COVID vaccination program, Congresswoman Hayes and I both toured the VA 
hospital in West Haven, Connecticut, which is the flagship of our VA 
healthcare system. I had a chance to personally observe her authentic, 
well-informed advocacy for veteran patients and their family members, 
asking questions about ways Congress can improve the system, 
particularly about communicating the full extent of their benefits.
  She described casework from the veterans seeking care, about the 
burdens they faced when navigating a complicated system where not only 
veterans, but family members struggle to stay current with changing 
rules and programs. It is particularly troublesome to hear cases of 
veterans who lose eligibility for help because of late claims caused by 
poor communication, oftentimes at the time of discharge from military 
service.
  Mr. Speaker, that is why it is so important for the House to pass the 
EVEST Act which will provide automatic enrollment in the VA system for 
all transitioning servicemembers.
  Mrs. Hayes' friendly amendment wisely requires the VA to go the extra 
mile and inform veterans who opt out of automatic enrollment through 
multiple methods, including not only email but also paper mail, that 
they can reenroll as they transition out of the military. Her measure 
is a commonsense insurance that veterans are informed of the EVEST so 
that they know from day one all of the options and rights that they 
have to get help.
  Mr. Speaker, I want to again thank Chair Takano and Ranking Member 
Bost.
  And I will close by simply noting that my district in eastern 
Connecticut is home to the largest military installation in New 
England, with 9,000 sailors and officers who work every day to protect 
our Nation. The transition from military to civilian life happens on a 
rolling, nonstop basis. Too often we work with veterans who experience 
gaps in benefits caused by a failure to enroll or late enrollment, 
which this excellent bill will fix.
  The SPEAKER pro tempore. The gentleman's time has expired.
  Mr. TAKANO. Mr. Speaker, I yield an additional 30 seconds to the 
gentleman from Connecticut (Mr. Courtney).
  Mr. COURTNEY. Mr. Speaker, I urge my colleagues to support the Hayes 
amendment in the en bloc and the underlying bill.
  Mr. TAKANO. Mr. Speaker, I yield 2\1/2\ minutes to the gentlewoman 
from Michigan (Ms. Tlaib), my good friend and author of this amendment. 
She serves on the Financial Services Committee, the Natural Resources 
Committee and the Oversight and Reform Committee.
  Ms. TLAIB. Mr. Speaker, I thank Chairman Takano and the committee 
staff for working with me on this important amendment and for their 
leadership on this bill. I can't thank him enough and look forward to 
him one day coming to my district for a visit to our VA hospital that 
we love and cherish.
  Mr. Speaker, the transition of being on Active Duty to being a 
veteran is not easy. The EVEST Act helps with that transition and makes 
life easier for those who served our Nation.
  This act is also a great opportunity to review the automatic 
enrollment programs and learn what works and what doesn't, because 
ensuring effective implementation is critical to its success.
  Mr. Speaker, I am a social worker at heart, and we have to ensure 
that our veterans' lives are changing for the better with this bill. My 
amendment ensures the lessons learned during implementation of the 
program are preserved for other agencies, as well as to learn, again, 
what to do and what not to do.
  Mr. Speaker, I appreciate the committee for working with me on this 
and look forward to my colleagues' support of this amendment. I also 
look forward to working with the committee on a number of other issues 
impacting our veterans, especially veteran suicide and access to mental 
health services.
  Mr. TAKANO. Mr. Speaker, I yield 2\1/2\ minutes to the gentleman from 
Texas (Mr. Green), my good friend and member of the Financial Services 
Committee where he is chairman of the Subcommittee on Oversight and 
Investigations.
  Mr. GREEN of Texas. Mr. Speaker, by way of further introduction, I am 
the same Al Green who lives across the street from the DeBakey VA 
hospital; the same Al Green who fought in this Congress to secure a 
Congressional Gold Medal for Dr. Michael E. DeBakey; the same Al Green 
who has 800 flags outside of his office presently to be distributed 
over at the DeBakey VA hospital; the same Al Green that goes there 
annually and speaks to veterans, who talks to them about their needs on 
an annual basis; the same Al Green who has had veterans who tell me the 
difficulties associated with enrollment; the same Al Green who has 
veterans who say they are so pleased that somebody would come by to be 
of service to them.
  Mr. Speaker, this Al Green announces here and now that I will support 
the underlying bill. I support it because it is necessary. I support it 
because I believe the veterans that I have spoken to will support it. 
They need it, and they will enjoy knowing that we came to this floor to 
bring this to fruition.
  Mr. Speaker, finally, if the VA hospital is not properly funded and 
this creates some funding issues, I am prepared to vote to fund the VA 
hospital sufficiently so that our veterans can be taken care of. Anyone 
who is willing to go to a distant place, who may not return the same 
way they left, who may have issues for the rest of their lives, and 
they do it because they want to protect this country, I am going to do 
all that I can to protect them. This is the least a grateful Nation can 
do.
  Mr. TAKANO. Mr. Speaker, I have no further speakers. I am prepared to 
close. I ask all my colleagues to support me in supporting these four 
amendments.
  Mr. Speaker, I yield back the balance of my time.
  The SPEAKER pro tempore. Pursuant to House Resolution 860, the 
previous question is ordered on the amendments en bloc offered by the 
gentleman from California (Mr. Takano).
  The question is on the amendments en bloc.
  The en bloc amendments were agreed to.
  A motion to reconsider was laid on the table.


                 Amendment No. 3 offered by Ms. Escobar

  The SPEAKER pro tempore. It is now in order to consider amendment No. 
3 printed in part B of House Report 117-225.
  Ms. ESCOBAR. Mr. Speaker, I have an amendment at the desk.
  The SPEAKER pro tempore. The Clerk will designate the amendment.
  The text of the amendment is as follows:

       Page 2, line 12, insert after ``a veteran'' the following: 
     ``who is discharged or separated from the Armed Forces on or 
     after the date that is 90 days before the date of the 
     enactment of this Act and''.

  The SPEAKER pro tempore. Pursuant to House Resolution 860, the 
gentlewoman from Texas (Ms. Escobar) and a Member opposed each will 
control 5 minutes.
  The Chair recognizes the gentlewoman from Texas.
  Ms. ESCOBAR. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I thank Chairman Takano for his continued, strong, 
unwavering leadership on behalf of our veterans.
  I am proud to represent a district that is home to a strong and 
growing veteran community, and proud to represent Fort Bliss in 
Congress, where thousands of our servicemembers transition to civilian 
life.
  One of my top priorities in Congress has been to protect our veterans 
and their families in the same way they have served and defended our 
country. Today, I am honored to stand in support of this critical 
legislation for our Nation's veterans and to present my amendment.
  Mr. Speaker, H.R. 4673, the Ensuring Veterans' Smooth Transition Act, 
provides automatic enrollment in the VA for all transitioning 
servicemembers. This bill is vital in that it expedites

[[Page H267]]

the use of healthcare benefits that veterans have already earned. My 
amendment seeks to ensure that servicemembers who were discharged up to 
90 days before the enactment of this legislation can also reap its 
benefits.
  Servicemembers transitioning to civilian life already face a 
multitude of hurdles, from adjusting to everyday life, dealing with 
unemployment issues, housing and security, and poor mental and physical 
health, among other things.
  Mr. Speaker, our veterans deserve that we eliminate these and any 
other barriers. Thousands of veterans leave the service without knowing 
about the VA, whether they are eligible, and what benefits they are 
entitled to receive.
  Veterans who returned to civilian life during the pandemic faced even 
more challenges to access and overall engagement with the VA due to 
closures and the VA's limited operational capacity at the height of the 
pandemic. We cannot leave these veterans behind.
  Already, more than half of eligible veterans don't use VA health 
benefits, many of which are due to confusion on eligibility and 
benefits and lack of access to information. The pandemic only 
exacerbated this. Our withdrawal from Afghanistan this past year 
similarly impacted millions of veterans who now need that care more 
than ever.
  Mr. Speaker, my amendment is not adding any new entitlements. It is 
simply extending them to those who are equally in need. With my 
amendment to this bill, we can ensure that newly transitioned veterans 
do not miss the opportunity to access VA benefits they deserve and are 
entitled to.
  As our chairman has said, when it comes to supporting our veterans, 
the true heroes of our country, there is always more work to be done. 
This bill is truly transformative and assures future cohorts of 
veterans receive the expeditious access to the healthcare they need.
  Mr. Speaker, I urge a ``yes'' vote on my amendment. I reserve the 
balance of my time.
  Mr. BOST. Mr. Speaker, I claim time in opposition to the amendment.
  The SPEAKER pro tempore. Without objection, the gentleman is 
recognized.
  There was no objection.
  Mr. BOST. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, Congresswoman Escobar's amendment would expand automatic 
enrollment to servicemembers who left the military 90 days before this 
bill is enacted. There are already many existing mechanisms for 
separating servicemembers to connect with the VA if that is something 
they need and want.
  As I explained during the general debate, I have a number of serious 
concerns with the underlying bill. The Biden administration agrees that 
there are challenges. I think that is an understatement. Regardless, we 
should not be further complicating an already difficult implementation 
by expanding it even more.
  Mr. Speaker, I oppose the amendment, and I yield back the balance of 
my time.
  Ms. ESCOBAR. Mr. Speaker, I yield 2 minutes to the gentleman from 
California (Mr. Takano).
  Mr. TAKANO. Mr. Speaker, I rise in support of the Escobar amendment 
to H.R. 4673.
  Mr. Speaker, seamlessly connecting veterans with the benefits and 
care they have earned through their service is paramount to the 
transition process. The Escobar amendment extends the automatic 
enrollment in VA healthcare to eligible veterans discharged within 90 
days before enactment of the underlying bill.
  Mr. Speaker, many of the 175,000 veterans who served in Operation 
Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn are 
unaware of their eligibility for 5 years of VA healthcare upon 
separation. Automatically enrolling recently separated eligible 
veterans into VA healthcare will support our aim to prevent veteran 
suicides and improve their access to care during their transition to 
civilian life.
  Mr. Speaker, I urge my colleagues to support the Escobar amendment.
  Ms. ESCOBAR. Mr. Speaker, I yield back the balance of my time.
  The SPEAKER pro tempore. Pursuant to House Resolution 860, the 
previous question is ordered on the amendment offered by the 
gentlewoman from Texas (Ms. Escobar).
  The question is on the amendment offered by the gentlewoman from 
Texas (Ms. Escobar).
  The question was taken; and the Speaker pro tempore announced that 
the ayes appear to have it.
  Mr. BOST. Mr. Speaker, on that I demand the yeas and nays.
  The SPEAKER pro tempore. Pursuant to section 3(s) of House Resolution 
8, the yeas and nays are ordered.
  The vote was taken by electronic device, and there were--yeas 228, 
nays 198, not voting 7, as follows:

                             [Roll No. 12]

                               YEAS--228

     Adams
     Aguilar
     Allred
     Auchincloss
     Axne
     Barragan
     Bass
     Beatty
     Bera
     Beyer
     Bishop (GA)
     Blumenauer
     Blunt Rochester
     Bonamici
     Bourdeaux
     Bowman
     Boyle, Brendan F.
     Brown (MD)
     Brown (OH)
     Brownley
     Bush
     Bustos
     Butterfield
     Carbajal
     Cardenas
     Carson
     Carter (LA)
     Cartwright
     Case
     Casten
     Castor (FL)
     Castro (TX)
     Cherfilus-McCormick
     Chu
     Cicilline
     Clark (MA)
     Clarke (NY)
     Cleaver
     Clyburn
     Cohen
     Connolly
     Cooper
     Correa
     Costa
     Courtney
     Craig
     Crist
     Crow
     Cuellar
     Davids (KS)
     Davis, Danny K.
     Dean
     DeFazio
     DeGette
     DeLauro
     DelBene
     Delgado
     Demings
     DeSaulnier
     Deutch
     Dingell
     Doggett
     Doyle, Michael F.
     Escobar
     Eshoo
     Espaillat
     Evans
     Fitzpatrick
     Fletcher
     Foster
     Frankel, Lois
     Gallego
     Garamendi
     Garcia (IL)
     Garcia (TX)
     Golden
     Gomez
     Gonzalez, Vicente
     Gottheimer
     Green, Al (TX)
     Grijalva
     Harder (CA)
     Hayes
     Higgins (NY)
     Himes
     Horsford
     Houlahan
     Hoyer
     Huffman
     Jackson Lee
     Jacobs (CA)
     Jayapal
     Jeffries
     Johnson (TX)
     Jones
     Kahele
     Kaptur
     Katko
     Keating
     Kelly (IL)
     Khanna
     Kildee
     Kilmer
     Kim (NJ)
     Kind
     Kirkpatrick
     Krishnamoorthi
     Kuster
     Lamb
     Langevin
     Larsen (WA)
     Larson (CT)
     Lawrence
     Lawson (FL)
     Lee (CA)
     Lee (NV)
     Leger Fernandez
     Levin (CA)
     Levin (MI)
     Lieu
     Lofgren
     Lowenthal
     Luria
     Lynch
     Malinowski
     Maloney, Carolyn B.
     Maloney, Sean
     Manning
     Mast
     Matsui
     McBath
     McCollum
     McEachin
     McGovern
     McNerney
     Meeks
     Meijer
     Meng
     Mfume
     Moore (WI)
     Morelle
     Moulton
     Mrvan
     Murphy (FL)
     Nadler
     Napolitano
     Neal
     Neguse
     Newman
     Norcross
     O'Halleran
     Ocasio-Cortez
     Omar
     Pallone
     Panetta
     Pappas
     Pascrell
     Payne
     Perlmutter
     Peters
     Phillips
     Pingree
     Pocan
     Porter
     Pressley
     Price (NC)
     Quigley
     Raskin
     Rice (NY)
     Ross
     Roybal-Allard
     Ruiz
     Ruppersberger
     Rush
     Ryan
     Sanchez
     Sarbanes
     Scanlon
     Schakowsky
     Schiff
     Schneider
     Schrader
     Schrier
     Scott (VA)
     Scott, David
     Sewell
     Sherman
     Sherrill
     Sires
     Slotkin
     Smith (NJ)
     Smith (WA)
     Soto
     Spanberger
     Speier
     Stansbury
     Stanton
     Stevens
     Strickland
     Suozzi
     Swalwell
     Takano
     Thompson (CA)
     Thompson (MS)
     Thompson (PA)
     Titus
     Tlaib
     Tonko
     Torres (CA)
     Torres (NY)
     Trahan
     Trone
     Underwood
     Valadao
     Vargas
     Veasey
     Vela
     Velazquez
     Wasserman Schultz
     Waters
     Watson Coleman
     Welch
     Wexton
     Wild
     Williams (GA)
     Wilson (FL)
     Wittman
     Yarmuth

                               NAYS--198

     Aderholt
     Allen
     Amodei
     Armstrong
     Arrington
     Babin
     Bacon
     Baird
     Balderson
     Banks
     Barr
     Bentz
     Bergman
     Bice (OK)
     Bilirakis
     Bishop (NC)
     Boebert
     Bost
     Brady
     Brooks
     Buchanan
     Buck
     Bucshon
     Budd
     Burchett
     Burgess
     Calvert
     Cammack
     Carey
     Carl
     Carter (GA)
     Carter (TX)
     Cawthorn
     Chabot
     Cheney
     Cline
     Cloud
     Clyde
     Cole
     Comer
     Crawford
     Crenshaw
     Curtis
     Davidson
     Davis, Rodney
     DesJarlais
     Diaz-Balart
     Donalds
     Dunn
     Ellzey
     Emmer
     Estes
     Fallon
     Feenstra
     Ferguson
     Fischbach
     Fitzgerald
     Fleischmann
     Fortenberry
     Foxx
     Franklin, C. Scott
     Fulcher
     Gaetz
     Gallagher
     Garbarino
     Garcia (CA)
     Gibbs
     Gimenez
     Gohmert
     Gonzales, Tony
     Gonzalez (OH)
     Good (VA)
     Gooden (TX)
     Gosar
     Granger
     Graves (LA)
     Graves (MO)
     Green (TN)
     Greene (GA)
     Griffith
     Grothman
     Guest
     Guthrie
     Hagedorn
     Harris
     Harshbarger
     Hartzler
     Hern
     Herrell
     Herrera Beutler
     Hice (GA)
     Higgins (LA)
     Hill
     Hinson
     Hudson
     Huizenga
     Issa
     Jackson
     Jacobs (NY)
     Johnson (LA)
     Johnson (OH)
     Johnson (SD)
     Jordan
     Joyce (OH)
     Joyce (PA)
     Keller
     Kelly (MS)
     Kelly (PA)
     Kim (CA)
     Kinzinger
     Kustoff
     LaHood
     LaMalfa
     Lamborn
     Latta
     LaTurner
     Lesko
     Letlow
     Long
     Loudermilk
     Lucas
     Luetkemeyer
     Mace
     Malliotakis
     Mann
     McCarthy
     McCaul
     McClain
     McKinley
     Meuser
     Miller (IL)
     Miller (WV)
     Miller-Meeks
     Moolenaar

[[Page H268]]


     Mooney
     Moore (AL)
     Moore (UT)
     Mullin
     Murphy (NC)
     Nehls
     Newhouse
     Norman
     Obernolte
     Owens
     Palazzo
     Palmer
     Pence
     Perry
     Pfluger
     Posey
     Reed
     Reschenthaler
     Rice (SC)
     Rodgers (WA)
     Rogers (AL)
     Rogers (KY)
     Rose
     Rosendale
     Rouzer
     Roy
     Rutherford
     Salazar
     Scalise
     Schweikert
     Scott, Austin
     Sessions
     Simpson
     Smith (MO)
     Smith (NE)
     Smucker
     Spartz
     Stauber
     Steel
     Stefanik
     Steil
     Steube
     Stewart
     Taylor
     Tenney
     Tiffany
     Timmons
     Turner
     Upton
     Van Drew
     Van Duyne
     Wagner
     Walberg
     Walorski
     Waltz
     Weber (TX)
     Webster (FL)
     Wenstrup
     Westerman
     Williams (TX)
     Wilson (SC)
     Womack
     Young
     Zeldin

                             NOT VOTING--7

     Biggs
     Duncan
     Hollingsworth
     Johnson (GA)
     Massie
     McClintock
     McHenry

                              {time}  1050

  Messrs. COMER, BURGESS, JOYCE of Pennsylvania, and GONZALEZ of Ohio 
changed their vote from ``yea'' to ``nay.''
  Messrs. WITTMAN, VALADAO, and MEEKS changed their vote from ``nay'' 
to ``yea.''
  So the amendment was agreed to.
  The result of the vote was announced as above recorded.


    Members Recorded Pursuant to House Resolution 8, 117th Congress

     Adams (Brown (MD))
     Bass (Cicilline)
     Beatty (Kuster)
     Blumenauer (Beyer)
     Boyle, Brendan F. (Gallego)
     Brown (OH) (Kaptur)
     Brownley (Kuster)
     Bush (Bowman)
     Butterfield (Panetta)
     Carter (LA) (Jeffries)
     Cawthorn (Nehls)
     Chu (Clark (MA))
     Cleaver (Davids (KS))
     Clyburn (Panetta)
     Cohen (Beyer)
     Costa (Correa)
     Crawford (Stewart)
     Crist (Soto)
     Cuellar (Correa)
     Davis, Danny K. (Garcia (IL))
     DeFazio (Brown (MD))
     DeGette (Blunt Rochester)
     Demings (Soto)
     DeSaulnier (Beyer)
     Doggett (Raskin)
     Doyle, Michael F. (Connolly)
     Evans (Mfume)
     Fallon (Gooden)
     Fletcher (Allred)
     Fortenberry (Moolenaar)
     Frankel, Lois (Clark (MA))
     Garamendi (Sherman)
     Gohmert (Weber (TX))
     Gonzalez, Vicente (Correa)
     Gottheimer (Panetta)
     Granger (Calvert)
     Grijalva (Garcia (IL))
     Hagedorn (Carl)
     Hayes (Clark (MA))
     Higgins (NY) (Bowman)
     Jayapal (Raskin)
     Keating (Clark (MA))
     Kelly (IL) (Kuster)
     Kildee (Panetta)
     Kilmer (Bera)
     Kinzinger (Meijer)
     Kirkpatrick (Pallone)
     Krishnamoorthi (Bera)
     Lawrence (Stevens)
     Lawson (FL) (Soto)
     Lee (CA) (Khanna)
     Lofgren (Jeffries)
     Loudermilk (Fleischmann)
     Lowenthal (Beyer)
     Lynch (Trahan)
     Maloney, Carolyn B. (Wasserman Schultz)
     McBath (Allred)
     McCollum (Blunt Rochester)
     McEachin (Wexton)
     Meng (Kuster)
     Moore (UT) (Meijer)
     Moore (WI) (Beyer)
     Moulton (Clark (MA))
     Nadler (Pallone)
     Napolitano (Correa)
     Neguse (Perlmutter)
     Newman (Clark (MA))
     Norman (Wilson (SC))
     Ocasio-Cortez (Garcia (IL))
     Pascrell (Pallone)
     Payne (Pallone)
     Pingree (Cicilline)
     Pocan (Raskin)
     Porter (Wexton)
     Reed (Kelly (PA))
     Rogers (KY)
     (Reschenthaler)
     Roybal-Allard
     (Levin (CA))
     Ruiz
     (Correa)
     Ruppersberger (Raskin)
     Rush (Kaptur)
     Schneider (Connolly)
     Schrier (Spanberger)
     Scott, David (Jeffries)
     Sires (Pallone)
     Swalwell (Gomez)
     Timmons (Armstrong)
     Titus (Connolly)
     Trone (Brown (MD))
     Van Drew
     (Reschenthaler)
     Vargas (Correa)
     Vela (Correa)
     Velazquez (Clark (MA))
     Waters (Takano)
     Watson Coleman (Pallone)
     Welch (Raskin)
     Wilson (FL) (Cicilline)

  The SPEAKER pro tempore. The previous question is ordered on the 
bill, as amended.
  The question is on engrossment and third reading of the bill.
  The bill was ordered to be engrossed and read a third time, and was 
read the third time.


                           Motion to Recommit

  Mr. BOST. Mr. Speaker, I have a motion to recommit at the desk.
  The SPEAKER pro tempore. The Clerk will report the motion to 
recommit.
  The Clerk read as follows:

                           Motion to Recommit

       Mr. Bost of Illinois moves to recommit the bill H.R. 4673 
     to the Committee on Veterans' Affairs.

  The material previously referred to by Mr. Bost is as follows:
       In section 2(b), strike ``the date of the enactment of this 
     Act'' and insert ``the effective date of this Act''.
       In section 2(c), strike ``Not later than August 1, 2022'' 
     and insert ``Subject to subsection (d), not later than August 
     1, 2022''
       At the end, add the following:
       (d) Delayed Effective Date; Readiness Certification.--This 
     Act, including the amendments made by this Act, shall not 
     take effect until 30 days after the date on which the 
     Secretary of Veterans Affairs submits to the Committees on 
     Veterans' Affairs of the House of Representatives and the 
     Senate a certification that the requirements of this Act may 
     be carried out without requiring additional resources or 
     disrupting services for veterans currently enrolled in the 
     patient enrollment system under section 1705 of title 38, 
     United States Code.

  The SPEAKER pro tempore. Pursuant to clause 2(b) of rule XIX, the 
previous question is ordered on the motion to recommit.
  The question is on the motion to recommit.
  The question was taken; and the Speaker pro tempore announced that 
the noes appeared to have it.
  Mr. BOST. Mr. Speaker, on that I demand the yeas and nays.
  The SPEAKER pro tempore. Pursuant to section 3(s) of House Resolution 
8, the yeas and nays are ordered.
  The vote was taken by electronic device, and there were--yeas 206, 
nays 221, not voting 6, as follows:

                             [Roll No. 13]

                               YEAS--206

     Aderholt
     Allen
     Amodei
     Armstrong
     Arrington
     Babin
     Bacon
     Baird
     Balderson
     Banks
     Barr
     Bentz
     Bergman
     Bice (OK)
     Bilirakis
     Bishop (NC)
     Boebert
     Bost
     Brady
     Brooks
     Buchanan
     Buck
     Bucshon
     Budd
     Burchett
     Burgess
     Calvert
     Cammack
     Carey
     Carl
     Carter (GA)
     Carter (TX)
     Cawthorn
     Chabot
     Cheney
     Cline
     Clyde
     Cole
     Comer
     Crawford
     Crenshaw
     Curtis
     Davidson
     Davis, Rodney
     DesJarlais
     Diaz-Balart
     Donalds
     Duncan
     Dunn
     Ellzey
     Emmer
     Estes
     Fallon
     Feenstra
     Ferguson
     Fischbach
     Fitzgerald
     Fitzpatrick
     Fleischmann
     Fortenberry
     Foxx
     Franklin, C. Scott
     Fulcher
     Gaetz
     Gallagher
     Garbarino
     Garcia (CA)
     Gibbs
     Gimenez
     Gohmert
     Gonzales, Tony
     Gonzalez (OH)
     Good (VA)
     Gooden (TX)
     Gosar
     Granger
     Graves (LA)
     Graves (MO)
     Green (TN)
     Greene (GA)
     Griffith
     Grothman
     Guest
     Guthrie
     Hagedorn
     Harris
     Harshbarger
     Hartzler
     Hern
     Herrell
     Herrera Beutler
     Hice (GA)
     Higgins (LA)
     Hill
     Hinson
     Hudson
     Huizenga
     Issa
     Jackson
     Jacobs (NY)
     Johnson (LA)
     Johnson (OH)
     Johnson (SD)
     Jordan
     Joyce (OH)
     Joyce (PA)
     Katko
     Keller
     Kelly (MS)
     Kelly (PA)
     Kim (CA)
     Kinzinger
     Kustoff
     LaHood
     LaMalfa
     Lamborn
     Latta
     LaTurner
     Lesko
     Letlow
     Long
     Loudermilk
     Lucas
     Luetkemeyer
     Mace
     Malliotakis
     Mann
     Mast
     McCarthy
     McCaul
     McClain
     McHenry
     McKinley
     Meijer
     Meuser
     Miller (IL)
     Miller (WV)
     Miller-Meeks
     Moolenaar
     Mooney
     Moore (AL)
     Moore (UT)
     Mullin
     Murphy (NC)
     Nehls
     Newhouse
     Norman
     Obernolte
     Owens
     Palazzo
     Palmer
     Pence
     Perry
     Pfluger
     Posey
     Reed
     Reschenthaler
     Rice (SC)
     Rogers (AL)
     Rogers (KY)
     Rose
     Rosendale
     Rouzer
     Roy
     Rutherford
     Salazar
     Scalise
     Schweikert
     Scott, Austin
     Sessions
     Simpson
     Smith (MO)
     Smith (NE)
     Smith (NJ)
     Smucker
     Spartz
     Stauber
     Steel
     Stefanik
     Steil
     Steube
     Stewart
     Taylor
     Tenney
     Thompson (PA)
     Tiffany
     Timmons
     Turner
     Upton
     Valadao
     Van Drew
     Van Duyne
     Wagner
     Walberg
     Walorski
     Waltz
     Weber (TX)
     Webster (FL)
     Wenstrup
     Westerman
     Williams (TX)
     Wilson (SC)
     Wittman
     Womack
     Young
     Zeldin

                               NAYS--221

     Adams
     Aguilar
     Allred
     Auchincloss
     Axne
     Barragan
     Bass
     Beatty
     Bera
     Beyer
     Bishop (GA)
     Blumenauer
     Blunt Rochester
     Bonamici
     Bourdeaux
     Bowman
     Boyle, Brendan F.
     Brown (MD)
     Brown (OH)
     Brownley
     Bush
     Bustos
     Butterfield
     Carbajal
     Cardenas
     Carson
     Carter (LA)
     Cartwright
     Case
     Casten
     Castor (FL)
     Castro (TX)
     Cherfilus-McCormick
     Chu
     Cicilline
     Clark (MA)
     Clarke (NY)
     Cleaver
     Clyburn
     Cohen
     Connolly
     Cooper
     Correa
     Costa
     Courtney
     Craig
     Crist
     Crow
     Cuellar
     Davids (KS)
     Davis, Danny K.
     Dean
     DeFazio
     DeGette
     DeLauro
     DelBene
     Delgado
     Demings
     DeSaulnier
     Deutch
     Dingell
     Doggett
     Doyle, Michael F.
     Escobar
     Eshoo
     Espaillat
     Evans
     Fletcher
     Foster
     Frankel, Lois
     Gallego
     Garamendi
     Garcia (IL)
     Garcia (TX)
     Golden
     Gomez
     Gonzalez, Vicente
     Gottheimer
     Green, Al (TX)
     Grijalva
     Harder (CA)
     Hayes
     Higgins (NY)
     Himes
     Horsford
     Houlahan
     Hoyer
     Huffman
     Jackson Lee
     Jacobs (CA)
     Jayapal
     Jeffries
     Johnson (GA)
     Johnson (TX)
     Jones
     Kahele
     Kaptur
     Keating
     Kelly (IL)
     Khanna
     Kildee
     Kilmer
     Kim (NJ)
     Kind
     Kirkpatrick
     Krishnamoorthi
     Kuster
     Lamb
     Langevin
     Larsen (WA)
     Larson (CT)
     Lawrence
     Lawson (FL)
     Lee (CA)
     Lee (NV)
     Leger Fernandez
     Levin (CA)
     Levin (MI)
     Lieu
     Lofgren
     Lowenthal
     Luria
     Lynch
     Malinowski
     Maloney, Carolyn B.
     Maloney, Sean
     Manning
     Matsui
     McBath
     McCollum
     McEachin
     McGovern
     McNerney
     Meeks
     Meng
     Mfume
     Moore (WI)
     Morelle
     Moulton

[[Page H269]]


     Mrvan
     Murphy (FL)
     Nadler
     Napolitano
     Neal
     Neguse
     Newman
     Norcross
     O'Halleran
     Ocasio-Cortez
     Omar
     Pallone
     Panetta
     Pappas
     Pascrell
     Payne
     Perlmutter
     Peters
     Phillips
     Pingree
     Pocan
     Porter
     Pressley
     Price (NC)
     Quigley
     Raskin
     Rice (NY)
     Ross
     Roybal-Allard
     Ruiz
     Ruppersberger
     Rush
     Ryan
     Sanchez
     Sarbanes
     Scanlon
     Schakowsky
     Schiff
     Schneider
     Schrader
     Schrier
     Scott (VA)
     Scott, David
     Sewell
     Sherman
     Sherrill
     Sires
     Slotkin
     Smith (WA)
     Soto
     Spanberger
     Speier
     Stansbury
     Stanton
     Stevens
     Strickland
     Suozzi
     Swalwell
     Takano
     Thompson (CA)
     Thompson (MS)
     Titus
     Tlaib
     Tonko
     Torres (CA)
     Torres (NY)
     Trahan
     Trone
     Underwood
     Vargas
     Veasey
     Vela
     Velazquez
     Wasserman Schultz
     Waters
     Watson Coleman
     Welch
     Wexton
     Wild
     Williams (GA)
     Wilson (FL)
     Yarmuth

                             NOT VOTING--6

     Biggs
     Cloud
     Hollingsworth
     Massie
     McClintock
     Rodgers (WA)

                              {time}  1115

  So the motion to recommit was rejected.
  The result of the vote was announced as above recorded.


    Members Recorded Pursuant to House Resolution 8, 117th Congress

     Adams (Brown (MD))
     Bass (Cicilline)
     Beatty (Kuster)
     Blumenauer (Beyer)
     Boyle, Brendan F. (Gallego)
     Brown (OH) (Kaptur)
     Brownley (Kuster)
     Bush (Bowman)
     Butterfield (Panetta)
     Carter (LA) (Jeffries)
     Cawthorn (Nehls)
     Chu (Clark (MA))
     Cleaver (Davids (KS))
     Clyburn (Panetta)
     Cohen (Beyer)
     Costa (Correa)
     Crawford (Stewart)
     Crist (Soto)
     Cuellar (Correa)
     Davis, Danny K. (Garcia (IL))
     DeFazio (Brown (MD))
     DeGette (Blunt Rochester)
     Demings (Soto)
     DeSaulnier (Beyer)
     Doggett (Raskin)
     Doyle, Michael F. (Connolly)
     Duncan (Rice (SC))
     Evans (Mfume)
     Fallon (Gooden)
     Fletcher (Allred)
     Fortenberry (Moolenaar)
     Frankel, Lois (Clark (MA))
     Garamendi (Sherman)
     Gohmert (Weber (TX))
     Gonzalez, Vicente (Correa)
     Gottheimer (Panetta)
     Granger (Calvert)
     Grijalva (Garcia (IL))
     Hagedorn (Carl)
     Hayes (Clark (MA))
     Higgins (NY) (Bowman)
     Jayapal (Raskin)
     Keating (Clark (MA))
     Kelly (IL) (Kuster)
     Kildee (Panetta)
     Kilmer (Bera)
     Kinzinger (Meijer)
     Kirkpatrick (Pallone)
     Krishnamoorthi (Bera)
     Lawrence (Stevens)
     Lawson (FL) (Soto)
     Lee (CA) (Khanna)
     Lofgren (Jeffries)
     Loudermilk (Fleischmann)
     Lowenthal (Beyer)
     Lynch (Trahan)
     Maloney, Carolyn B. (Wasserman Schultz)
     McBath (Allred)
     McCollum (Blunt Rochester)
     McEachin (Wexton)
     Meng (Kuster)
     Moore (UT) (Meijer)
     Moore (WI) (Beyer)
     Moulton (Clark (MA))
     Nadler (Pallone)
     Napolitano (Correa)
     Neguse (Perlmutter)
     Newman (Clark (MA))
     Norman (Wilson (SC))
     Ocasio-Cortez (Garcia (IL))
     Pascrell (Pallone)
     Payne (Pallone)
     Pingree (Cicilline)
     Pocan (Raskin)
     Porter (Wexton)
     Reed (Kelly (PA))
     Rogers (KY)
     (Reschenthaler)
     Roybal-Allard (Levin (CA))
     Ruiz (Correa)
     Ruppersberger (Raskin)
     Rush (Kaptur)
     Schneider (Connolly)
     Schrier (Spanberger)
     Scott, David (Jeffries)
     Sires (Pallone)
     Swalwell (Gomez)
     Timmons (Armstrong)
     Titus (Connolly)
     Trone (Brown (MD))
     Van Drew
     (Reschenthaler)
     Vargas (Correa)
     Vela (Correa)
     Velazquez (Clark (MA))
     Waters (Takano)
     Watson Coleman (Pallone)
     Welch (Raskin)
     Wilson (FL) (Cicilline)

  The SPEAKER pro tempore (Ms. Scanlon). The question is on the passage 
of the bill.
  The question was taken; and the Speaker pro tempore announced that 
the ayes appeared to have it.
  Mr. BOST. Madam Speaker, on that I demand the yeas and nays.
  The SPEAKER pro tempore. Pursuant to section 3(s) of House Resolution 
8, the yeas and nays are ordered.
  The vote was taken by electronic device, and there were--yeas 265, 
nays 163, not voting 5, as follows:

                             [Roll No. 14]

                               YEAS--265

     Adams
     Aguilar
     Allred
     Amodei
     Auchincloss
     Axne
     Barragan
     Bass
     Beatty
     Bera
     Beyer
     Bilirakis
     Bishop (GA)
     Blumenauer
     Blunt Rochester
     Bonamici
     Bourdeaux
     Bowman
     Boyle, Brendan F.
     Brown (MD)
     Brown (OH)
     Brownley
     Bush
     Bustos
     Butterfield
     Calvert
     Carbajal
     Cardenas
     Carson
     Carter (LA)
     Cartwright
     Case
     Casten
     Castor (FL)
     Castro (TX)
     Cherfilus-McCormick
     Chu
     Cicilline
     Clark (MA)
     Clarke (NY)
     Cleaver
     Clyburn
     Cohen
     Cole
     Connolly
     Cooper
     Correa
     Costa
     Courtney
     Craig
     Crist
     Crow
     Cuellar
     Curtis
     Davids (KS)
     Davis, Danny K.
     Dean
     DeFazio
     DeGette
     DeLauro
     DelBene
     Delgado
     Demings
     DeSaulnier
     DesJarlais
     Deutch
     Dingell
     Doggett
     Doyle, Michael F.
     Escobar
     Eshoo
     Espaillat
     Evans
     Fitzpatrick
     Fletcher
     Fortenberry
     Foster
     Frankel, Lois
     Gaetz
     Gallego
     Garamendi
     Garbarino
     Garcia (CA)
     Garcia (IL)
     Garcia (TX)
     Golden
     Gomez
     Gonzalez (OH)
     Gonzalez, Vicente
     Gottheimer
     Green, Al (TX)
     Grijalva
     Harder (CA)
     Hartzler
     Hayes
     Herrera Beutler
     Higgins (NY)
     Himes
     Horsford
     Houlahan
     Hoyer
     Huffman
     Issa
     Jackson Lee
     Jacobs (CA)
     Jacobs (NY)
     Jayapal
     Jeffries
     Johnson (GA)
     Johnson (TX)
     Jones
     Joyce (OH)
     Joyce (PA)
     Kahele
     Kaptur
     Katko
     Keating
     Keller
     Kelly (IL)
     Kelly (PA)
     Khanna
     Kildee
     Kilmer
     Kim (CA)
     Kim (NJ)
     Kind
     Kinzinger
     Kirkpatrick
     Krishnamoorthi
     Kuster
     Lamb
     Langevin
     Larsen (WA)
     Larson (CT)
     Lawrence
     Lawson (FL)
     Lee (CA)
     Lee (NV)
     Leger Fernandez
     Levin (CA)
     Levin (MI)
     Lieu
     Lofgren
     Long
     Lowenthal
     Luria
     Lynch
     Malinowski
     Malliotakis
     Maloney, Carolyn B.
     Maloney, Sean
     Manning
     Mast
     Matsui
     McBath
     McCaul
     McCollum
     McEachin
     McGovern
     McKinley
     McNerney
     Meeks
     Meijer
     Meng
     Mfume
     Miller-Meeks
     Moore (WI)
     Morelle
     Moulton
     Mrvan
     Murphy (FL)
     Nadler
     Napolitano
     Neal
     Neguse
     Newman
     Norcross
     O'Halleran
     Obernolte
     Ocasio-Cortez
     Omar
     Pallone
     Panetta
     Pappas
     Pascrell
     Payne
     Pence
     Perlmutter
     Peters
     Phillips
     Pingree
     Pocan
     Porter
     Posey
     Pressley
     Price (NC)
     Quigley
     Raskin
     Reed
     Reschenthaler
     Rice (NY)
     Ross
     Roybal-Allard
     Ruiz
     Ruppersberger
     Rush
     Ryan
     Sanchez
     Sarbanes
     Scanlon
     Schakowsky
     Schiff
     Schneider
     Schrader
     Schrier
     Scott (VA)
     Scott, David
     Sewell
     Sherman
     Sherrill
     Sires
     Slotkin
     Smith (NJ)
     Smith (WA)
     Soto
     Spanberger
     Speier
     Stansbury
     Stanton
     Steel
     Stevens
     Strickland
     Suozzi
     Swalwell
     Takano
     Thompson (CA)
     Thompson (MS)
     Thompson (PA)
     Titus
     Tlaib
     Tonko
     Torres (CA)
     Torres (NY)
     Trahan
     Trone
     Underwood
     Upton
     Valadao
     Vargas
     Veasey
     Vela
     Velazquez
     Walorski
     Wasserman Schultz
     Waters
     Watson Coleman
     Welch
     Wexton
     Wild
     Williams (GA)
     Wilson (FL)
     Wittman
     Yarmuth
     Young
     Zeldin

                               NAYS--163

     Aderholt
     Allen
     Armstrong
     Arrington
     Babin
     Bacon
     Baird
     Balderson
     Banks
     Barr
     Bentz
     Bergman
     Bice (OK)
     Bishop (NC)
     Boebert
     Bost
     Brady
     Brooks
     Buchanan
     Buck
     Bucshon
     Budd
     Burchett
     Burgess
     Cammack
     Carey
     Carl
     Carter (GA)
     Carter (TX)
     Cawthorn
     Chabot
     Cheney
     Cline
     Cloud
     Clyde
     Comer
     Crawford
     Crenshaw
     Davidson
     Davis, Rodney
     Diaz-Balart
     Donalds
     Duncan
     Dunn
     Ellzey
     Emmer
     Estes
     Fallon
     Feenstra
     Ferguson
     Fischbach
     Fitzgerald
     Fleischmann
     Foxx
     Franklin, C. Scott
     Fulcher
     Gallagher
     Gibbs
     Gimenez
     Gohmert
     Gonzales, Tony
     Good (VA)
     Gooden (TX)
     Gosar
     Granger
     Graves (LA)
     Graves (MO)
     Green (TN)
     Greene (GA)
     Griffith
     Grothman
     Guest
     Guthrie
     Hagedorn
     Harris
     Harshbarger
     Hern
     Herrell
     Hice (GA)
     Higgins (LA)
     Hill
     Hinson
     Hudson
     Huizenga
     Jackson
     Johnson (LA)
     Johnson (OH)
     Johnson (SD)
     Jordan
     Kelly (MS)
     Kustoff
     LaHood
     LaMalfa
     Lamborn
     Latta
     LaTurner
     Lesko
     Letlow
     Loudermilk
     Lucas
     Luetkemeyer
     Mace
     Mann
     McCarthy
     McClain
     McHenry
     Meuser
     Miller (IL)
     Miller (WV)
     Moolenaar
     Mooney
     Moore (AL)
     Moore (UT)
     Mullin
     Murphy (NC)
     Nehls
     Newhouse
     Owens
     Palazzo
     Palmer
     Perry
     Pfluger
     Rice (SC)
     Rodgers (WA)
     Rogers (AL)
     Rogers (KY)
     Rose
     Rosendale
     Rouzer
     Roy
     Rutherford
     Salazar
     Scalise
     Schweikert
     Scott, Austin
     Sessions
     Simpson
     Smith (MO)
     Smith (NE)
     Smucker
     Spartz
     Stauber
     Stefanik
     Steil
     Steube
     Stewart
     Taylor
     Tenney
     Tiffany
     Timmons
     Turner
     Van Drew
     Van Duyne
     Wagner
     Walberg
     Waltz
     Weber (TX)
     Webster (FL)
     Wenstrup
     Westerman
     Williams (TX)
     Wilson (SC)
     Womack

                             NOT VOTING--5

     Biggs
     Hollingsworth
     Massie
     McClintock
     Norman

                              {time}  1135

  Ms. GRANGER changed her vote from ``yea'' to ``nay.''
  So the bill was passed.
  The result of the vote was announced as above recorded.
  A motion to reconsider was laid on the table.


    Members Recorded Pursuant to House Resolution 8, 117th Congress

     Adams (Brown (MD))
     Bass (Cicilline)
     Beatty (Kuster)
     Blumenauer (Beyer)
     Boyle, Brendan F. (Gallego)
     Brown (OH) (Kaptur)
     Brownley (Kuster)
     Bush (Bowman)
     Butterfield (Panetta)
     Carter (LA) (Jeffries)
     Cawthorn (Nehls)
     Chu (Clark (MA))
     Cleaver (Davids (KS))
     Clyburn (Panetta)
     Cohen (Beyer)
     Costa (Correa)
     Crawford (Stewart)
     Crist (Soto)
     Cuellar (Correa)
     Davis, Danny K. (Garcia (IL))

[[Page H270]]


     DeFazio (Brown (MD))
     DeGette (Blunt Rochester)
     Demings (Soto)
     DeSaulnier (Beyer)
     Doggett (Raskin)
     Doyle, Michael F. (Connolly)
     Duncan (Rice (SC))
     Evans (Mfume)
     Fallon (Gooden)
     Fletcher (Allred)
     Fortenberry (Moolenaar)
     Frankel, Lois (Clark (MA))
     Garamendi (Sherman)
     Gohmert (Weber (TX))
     Gonzalez, Vicente (Correa)
     Gottheimer (Panetta)
     Granger (Calvert)
     Grijalva (Garcia (IL))
     Hagedorn (Carl)
     Hayes (Clark (MA))
     Higgins (NY) (Bowman)
     Jayapal (Raskin)
     Keating (Clark (MA))
     Kelly (IL) (Kuster)
     Kildee (Panetta)
     Kilmer (Bera)
     Kinzinger (Meijer)
     Kirkpatrick (Pallone)
     Krishnamoorthi (Bera)
     Lawrence (Stevens)
     Lawson (FL) (Soto)
     Lee (CA) (Khanna)
     Lofgren (Jeffries)
     Loudermilk (Fleischmann)
     Lowenthal (Beyer)
     Lynch (Trahan)
     Maloney, Carolyn B. (Wasserman Schultz)
     McBath (Allred)
     McCollum (Blunt Rochester)
     McEachin (Wexton)
     Meng (Kuster)
     Moore (UT) (Meijer)
     Moore (WI) (Beyer)
     Moulton (Clark (MA))
     Nadler (Pallone)
     Napolitano (Correa)
     Neguse (Perlmutter)
     Newman (Clark (MA))
     Ocasio-Cortez (Garcia (IL))
     Pascrell (Pallone)
     Payne (Pallone)
     Pingree (Cicilline)
     Pocan (Raskin)
     Porter (Wexton)
     Reed (Kelly (PA))
     Rogers (KY)
      (Reschenthaler)
     Roybal-Allard (Levin (CA))
     Ruiz (Correa)
     Ruppersberger (Raskin)
     Rush (Kaptur)
     Schneider (Connolly)
     Schrier (Spanberger)
     Scott, David (Jeffries)
     Sires (Pallone)
     Swalwell (Gomez)
     Timmons (Armstrong)
     Titus (Connolly)
     Trone (Brown (MD))
     Van Drew
      (Reschenthaler)
     Vargas (Correa)
     Vela (Correa)
     Velazquez (Clark (MA))
     Waters (Takano)
     Watson Coleman (Pallone)
     Welch (Raskin)
     Wilson (FL) (Cicilline)

                          ____________________