[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)
____________________