[Congressional Record Volume 170, Number 114 (Wednesday, July 10, 2024)]
[Senate]
[Pages S4325-S4326]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]



                          Veterans Healthcare

  Mr. MORAN. Madam President, it was just a few weeks ago that I stood 
in this position on this floor and raised concern about how the Biden 
administration was undermining the law and restricting the ability of 
veterans nationwide to get healthcare closer to home.
  Since then, 19 of my Republican colleagues have joined me in calling 
on the Biden administration to quickly reverse course and to lift these 
restrictions on community care that they have put in place, to the 
detriment of many of America's veterans.
  One of those veterans, in my home State of Kansas, is Myca. Myca is 
an Air Force veteran and a single mother and a community leader. She 
does not have health insurance, and she relies upon the VA to help her 
manage her autoimmune disorder and many other health issues.
  Myca lives about an hour from the closest VA clinic, which is small 
and has a limited amount of services, and she lives more than 3 hours 
from the nearest VA medical center.
  In her own words, she said:

       I don't know what my health would be like or where I would 
     be if I did not have my VA healthcare benefits in the 
     community.

  Congress passed and President Trump signed the MISSION Act 6 years 
ago to expand and protect the right of veterans to seek community care. 
Community care offers veterans across the country--and is particularly 
useful in States like many of ours that are so rural, certainly in 
States like mine--a much needed lifeline.
  Often, it is the distance that causes a veteran to choose that he 
needs or she needs care in the community. Sometimes, it is expertise 
and specialty. However, in all instances, the Department of Veterans 
Affairs is making it harder for veterans like Myca to get the care they 
are entitled to under the law in the community.
  In President Biden's administration, community care has come under 
attack, and veterans--many of them--are paying the price. In January, 
the Department's Under Secretary for Health commissioned an outside 
panel to examine community care spending. After being provided with 
select data and briefings, the panel recommended that VA save money by, 
among other things, reducing community care referrals for veterans 
seeking emergency, oncology, and mental health care.
  There is not enough mental health care anyplace in the country. How 
could we restrict--why would we restrict, why would the VA restrict--
access to mental health care in the community? These veterans are among 
our most vulnerable and high-risk veterans in the VA patient 
populations.
  Since those recommendations were issued in the spring, veterans have 
been reaching out to me. As I have indicated on the floor before, many 
of the things I know about what is going on in veterans' lives come by 
the conversations I have with veterans or my staff has with veterans or 
phone calls, emails--the suggestion that something is not right in the 
way the VA is caring for a veteran. It often ends up in casework, and 
we try to solve the individual problem for the individual veteran.

  We also ought to solve the system problems, and this is one that is 
now systematic. It is not the circumstance that an individual veteran 
is uniquely being denied care in the community. It has become a 
systemwide effort to reduce the opportunities veterans have to access 
care in the community.
  I am sure my colleagues--Republicans and Democrats--if they talk to 
their caseworkers, our staff, people who deal with veterans' issues, 
you will see the same thing is happening in your community with your 
veterans.
  Most recently, I spoke about this on the floor when it turned out the 
VA had denied a cancer patient the last two cancer treatments where he 
has received the first 58 but was told he had to return to the VA--more 
than an hour away, to the VA hospital--to receive the 59th and 60th 
cancer treatment.
  And, most recently, I think if you would check with the folks in your 
offices who know these things--and I would guess many of my colleagues 
have heard this themselves--time and time again, someone who has had 
chiropractic care in the community is being denied the opportunity to 
continue to see their chiropractor and told: No, if you are going to 
have chiropractic care, you must have it at the VA hospital.
  We are also hearing, beyond our own constituents, from whistleblowers 
within the VA, people who work at VA medical facilities, and they are 
telling us--they are telling me--that they are facing increasing 
pressures from the VA leaders to keep veterans in VA medical 
facilities, whatever the choice is of the veteran.
  Incidentally, at the same time, the VA has actively indicated they 
are going to reduce the number of employees at the Department of 
Veterans Affairs, working in VA medical centers, by 10,000.
  I am grateful to my colleagues who join me in opposing these 
policies, and I appreciate that effort.
  Let me take this step with just a little bit of history. At a point 
in time, not too many years ago, we had veterans dying within the VA 
system because they couldn't access the care. Phoenix comes to mind. 
And, as a result, Congress responded and passed the Choice Act.
  The Choice Act said: If you live a certain number of miles away from 
a VA hospital--a VA facility--you can access care at home with your own 
physician, your own hospital.
  The VA was very reluctant, very reticent, and very difficult in the 
implementation of the law passed by Congress and signed by the 
President. And so we tried it again with the MISSION Act, a few years 
later. And one of the main provisions of the MISSION Act says that if 
it is in the interest of a veteran, he or she can have care where they 
choose to have it. And the best care of the veteran is defined not by 
the VA. Let me say that more clearly. The best interest of the veteran 
is not defined by the Department of Veterans Affairs but by the veteran 
and his or her healthcare provider.
  So the choice under the law rests with the veteran, not with the VA, 
and yet the VA is once again undermining the law and trying to make 
certain that those choices that a veteran, he or she, can make are not 
made by the veteran but made by the Department of Veterans Affairs.
  The veteran who wants chiropractic care at home, who has seen the 
same

[[Page S4326]]

chiropractor for years, is told: No, we don't care what you want; we 
want to do it our way.
  These policies are very damaging and could put us back in the same 
position in which the life and well-being of veterans across the 
country are impacted, are affected, and damaged.
  I would again ask, along with my colleagues--which I hope is much 
broader than just a Republican set of colleagues; I hope my Democratic 
colleagues and my Republican colleagues--I hope all of us will insist 
that the Biden administration follow the law.
  It used to be that Republicans and Democrats came together when an 
executive branch decision was made that intruded upon the legislative 
branches' lawmaking authority.
  We need to get back to the days that, whether it is a Republican 
administration or a Democratic administration, if they are not 
following the law, they are not following what Congress has told them 
do, and we ought to all object. And we certainly ought to object to 
what the Biden administration is doing at the Department of Veterans 
Affairs to restrict the capabilities of people who are making choices--
those who served our country who are making choices that this is in 
their best interest. And we don't need the Department overruling a 
choice about that decision.
  I hope we will work together. I hope the Department of Veterans 
Affairs will change its ways. In the meantime, I am worried about 
veterans across Kansas and across the country whose decisions about 
their own well-being are undermined by those who decide something 
better is for them.
  Let's let our veterans, who served our country, make a choice in 
consultation with their healthcare provider about what makes the most 
sense. Sometimes it is miles. Sometimes it is quality of care. But that 
choice, regardless, ought to be made by the veteran.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from North Dakota.