[Congressional Record (Bound Edition), Volume 148 (2002), Part 11]
[EXTENSIO]
[Pages 15257-15258]
[From the U.S. Government Publishing Office, www.gpo.gov]




           VETERANS HEALTH CARE FUNDING GUARANTEE ACT OF 2002

                                 ______
                                 

                       HON. CHRISTOPHER H. SMITH

                             of new jersey

                    in the house of representatives

                         Friday, July 26, 2002

  Mr. SMITH of New Jersey. Mr. Speaker, on behalf of America's 25 
million veterans, I am introducing H.R. 5250, the Veterans Health Care 
Funding Guarantee Act of 2002, along with my friend and the Ranking 
Member of the Committee on Veterans' Affairs, Mr. Evans, that would 
change funding of the Department of Veterans Affairs (VA) health care 
system from discretionary to mandatory spending.
  We are introducing this bill in recognition of the continually 
frustrating annual struggles to obtain sufficient funding to provide 
access to quality care for the nation's veterans in VA health care 
facilities. The current discretionary appropriations process subjects 
these veterans' health care needs--needs of the heroes who won the 
Battle of the Bulge, endured as prisoners of war in Bataan and 
Corregidor and survived human-wave assaults in the frozen Chosin 
Reservoir--to annual health funding competition with federal highway 
funding and sewage treatment projects. This reality alone vividly 
illustrates the inherent weakness in the discretionary appropriations 
process for VA health care and the need to reform it.
  Mr. Speaker, 2 years ago, we passed TRICARE for Life, a new program 
to guarantee lifelong health care for military retirees and their 
families. I was proud to support that program for hundreds of thousands 
of military families, who are now assured of free health care services 
sponsored entirely by the government. The bill we are introducing today 
would extend the same kind of guarantee to the remainder of America's 
veterans, to assure their continued access to the VA health care 
system.
  H.R. 5250 would establish a formula to fund the VA health care 
account directly from the U.S. Treasury with a method similar to that 
used by Congress to provide funding for TRICARE for Life. Veterans' 
disability compensation payments are already funded through mandatory 
formulas, and our legislation would apply the same priority to meeting 
the health care needs of our veterans.
  The bill we are introducing today would establish a base funding 
year, calculate the average cost for a veteran using VA health care, 
and then index the cost for inflation. Multiplying this average cost by 
the number of veterans who are enrolled each year on July 1st, would 
determine the funding allotment for the Veterans Health Administration 
for the next fiscal year.
  It should be noted that H.R. 5250 would neither take away the 
Secretary's power to manage the VA health care system nor to curtail 
the Secretary's control of enrollments in VA. And unlike TRICARE for 
Life, it would not extend benefits to family members of veterans.
  Mr. Speaker, for at least the past five years, veterans' usage of VA 
health care services surpassed Administration estimates. Just this past 
week, we received a revised workload estimate for FY 2003 from VA 
showing an increase of 500,000 veteran patients; and that's on top of 
the 700,000 increase in patients estimated in the budget submission 
made only five months ago. VA now estimates that there will be 4.9 
million unique veteran patients in FY 2003, versus the 3.7 million 
veterans that had been projected one year ago for FY 2002--a 31.5-
percent increase overall.
  Mr. Speaker, the continuing rise in demand for VA health care 
services is driven by many

[[Page 15258]]

factors, including the growth of new and convenient VA community-based 
outpatient clinics, improved safety and quality of care, as well as 
available prescription drug benefits. VA has increasingly become a 
supplier of prescription drugs to veterans, particularly for senior 
veterans.
  Further evidence of the urgent funding needs of VA health care comes 
from a new report issued this month by VA measuring the amount of time 
veterans are waiting for medical services. According to VA's report, 
there are at least 300,000 veterans waiting for medical appointments, 
half of whom are waiting 6 months or more; and the other half having no 
appointment at all. This is the first attempt to measure a situation 
about which we have all heard from our constituents, and we suspect 
that the scale of the problem is actually greater, since this estimate 
only counts those veterans already enrolled in the VA health care 
system.
  Mr. Speaker, we have a sacred obligation to ensure that our nation's 
veterans receive the honors and benefits that they have earned through 
their service to this nation. In the past decade, more and more 
veterans have turned to the Department of Veterans Affairs for medical 
services, particularly World War II and Korean War veterans. We have 
attempted to meet our obligation to them by passing record VA budgets 
for two years in a row. As our colleagues may recall, the House-
approved budget resolution for fiscal year 2003 contained a substantial 
$2.6 billion increase in the funding of medical care for our nation's 
veterans.
  However, the demand for services continues to outpace the supply of 
federal funding of VA health care. In the supplemental appropriations 
bill we passed, Congress included $417 million for additional health 
care funding to try to meet the current year's shortfall, and that was 
based upon the older workload estimates.
  Mr. Speaker, it is becoming increasingly clear that Congress needs to 
look at new methods and sources for veterans' health care funding, and 
the Committee on Veterans' Affairs has been seeking additional ways to 
match resources to the growing demand. Working with the Committee on 
Armed Services, we attached an amendment to the Department of Defense 
(DOD) authorization bill that would seek to increase health care 
resources sharing between the DOD and VA health care systems, and we 
hope it will see final passage this year. Also we have sought to 
increase third-party collections through the VA Medical Care 
Collections Fund with more aggressive oversight and legislative 
improvements.
  In addition, earlier this month the Committee examined ways to 
improve coordination and allocation of resources between Medicare and 
VA, since about half of the veterans receiving VA health services are 
also Medicare-eligible. Yet, despite all of these efforts, VA continues 
to struggle each year to provide all the funds needed for the tasks it 
faces in caring for millions of frail, elderly veterans.
  Mr. Speaker, with the introduction of H.R. 5250 we hope to begin an 
important debate on the future of veterans' health care and its funding 
needs. We will shortly request Administration views on the bill, and 
cost information from the Congressional Budget Office. We intend to 
meet with colleagues on both the Committees on the Budget and on 
Appropriations to obtain their views; and it goes without saying that 
we will be consulting with veterans organizations in the months ahead 
in order to learn whether this approach or a combination of other 
changes will solve this vexing problem confronting America's veterans 
and the health care system serving them.
  We urge all our colleagues to examine H.R. 5250 and work with us to 
find a means to provide dependable, stable and sustained funding for 
the health care needs of veterans of our armed forces. They deserve no 
less from a grateful nation.

                          ____________________