[Congressional Record (Bound Edition), Volume 155 (2009), Part 14]
[House]
[Pages 19392-19397]
[From the U.S. Government Publishing Office, www.gpo.gov]




      VETERANS' INSURANCE AND HEALTH CARE IMPROVEMENTS ACT OF 2009

  Mr. FILNER. Mr. Speaker, I move to suspend the rules and pass the 
bill (H.R. 3219) to amend title 38, United States Code, to make certain 
improvements in the laws administered by the Secretary of Veterans 
Affairs relating to insurance and health care, and for other purposes, 
as amended.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                               H.R. 3219

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

     SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

       (a) Short Title.--This Act may be cited as the ``Veterans' 
     Insurance and Health Care Improvements Act of 2009''.
       (b) Table of Contents.--The table of contents for this Act 
     is as follows:

[[Page 19393]]

       Sec. 1. Short title; table of contents.

                 TITLE I--MATTERS RELATING TO INSURANCE

       Sec. 101. Permanent extension of duration of 
           Servicemembers' Group Life Insurance coverage for 
           totally disabled veterans.
       Sec. 102. Increased amount of Veterans' Group Life 
           Insurance.
       Sec. 103. Elimination of reduction in amount of accelerated 
           death benefit for terminally-ill persons insured under 
           Servicemembers' Group Life Insurance and Veterans' 
           Group Life Insurance.

               TITLE II--MATTERS RELATING TO HEALTH CARE

       Sec. 201. Higher priority status for certain veterans who 
           are medal of honor recipients.
       Sec. 202. Provision of hospital care, medical services, and 
           nursing home care for certain Vietnam-era veterans 
           exposed to herbicide and veterans of the Persian Gulf 
           War.
       Sec. 203. Prohibition on collection of copayments from 
           catastrophically disabled veterans.
       Sec. 204. Establishment of Director of Physician Assistant 
           Services at Veterans Health Administration of 
           Department of Veterans Affairs.
       Sec. 205. Committee on Care of Veterans with Traumatic 
           Brain Injury.
       Sec. 206. Revision of certain requirements for the pilot 
           program of enhanced contract care authority for health 
           care needs of veterans in highly rural areas.

                TITLE III--MATTERS RELATING TO BENEFITS

       Sec. 301. Benefits for qualified World War II veterans.
       Sec. 302. Waiver of housing loan fee for certain veterans 
           with service-connected disabilities called to active 
           service.

                 TITLE I--MATTERS RELATING TO INSURANCE

     SEC. 101. PERMANENT EXTENSION OF DURATION OF SERVICEMEMBERS' 
                   GROUP LIFE INSURANCE COVERAGE FOR TOTALLY 
                   DISABLED VETERANS.

       (a) Extension.--Section 1968(a) of title 38, United States 
     Code, is amended--
       (1) in paragraph (1)(A), by striking clause (ii) and 
     inserting the following new clause (ii):
       ``(ii) The date that is two years after the date of 
     separation or release from such active duty or active duty 
     for training.''; and
       (2) in paragraph (4), by striking subparagraph (B) and 
     inserting the following new subparagraph (B):
       ``(B) The date that is two years after the date of 
     separation or release from such assignment.''.
       (b) Effective Date.--The amendments made by subsection (a) 
     shall apply with respect to a person who is separated or 
     released on or after June 15, 2005.

     SEC. 102. INCREASED AMOUNT OF VETERANS' GROUP LIFE INSURANCE.

       (a) Increased Amount.--Section 1977(a) of title 38, United 
     States Code, is amended--
       (1) in paragraph (1), by inserting ``Except as provided in 
     paragraph (3),'' before ``Veterans' Group Life Insurance 
     shall be''; and
       (2) by adding after paragraph (2) the following new 
     paragraph:
       ``(3) Not more than once in each five-year period beginning 
     on the one-year anniversary of the date a person becomes 
     insured under Veterans' Group Life Insurance, such person may 
     elect in writing to increase the amount for which the person 
     is insured if--
       ``(A) the person is under the age of 60;
       ``(B) the increased amount is $25,000; and
       ``(C) the amount for which the person is insured does not 
     exceed the amount provided for under section 1967(a)(3)(A)(i) 
     of this title.''.
       (b) Effective Date.--Paragraph (3) of section 1977(a) of 
     title 38, United States Code, shall take effect on the date 
     that is 180 days after the date of the enactment of this Act.

     SEC. 103. ELIMINATION OF REDUCTION IN AMOUNT OF ACCELERATED 
                   DEATH BENEFIT FOR TERMINALLY-ILL PERSONS 
                   INSURED UNDER SERVICEMEMBERS' GROUP LIFE 
                   INSURANCE AND VETERANS' GROUP LIFE INSURANCE.

       (a) Elimination of Reduction.--Section 1980(b)(1) of title 
     38, United States Code, is amended by striking ``reduced by'' 
     and all that follows through ``the Secretary''.
       (b) Effective Date.--The amendment made by subsection (a) 
     shall apply with respect to a payment of an accelerated death 
     benefit under section 1980 of title 38, United States Code, 
     made on or after the date of the enactment of this Act.

               TITLE II--MATTERS RELATING TO HEALTH CARE

     SEC. 201. HIGHER PRIORITY STATUS FOR CERTAIN VETERANS WHO ARE 
                   MEDAL OF HONOR RECIPIENTS.

       Section 1705(a)(3) of title 38, United States Code, is 
     amended by inserting ``veterans who were awarded the medal of 
     honor under section 3741, 6241, or 8741 of title 10 or 
     section 491 of title 14,'' after ``Veterans who are former 
     prisoners of war or who were awarded the Purple Heart,''.

     SEC. 202. PROVISION OF HOSPITAL CARE, MEDICAL SERVICES, AND 
                   NURSING HOME CARE FOR CERTAIN VIETNAM-ERA 
                   VETERANS EXPOSED TO HERBICIDE AND VETERANS OF 
                   THE PERSIAN GULF WAR.

       Section 1710(e) of title 38, United States Code, is 
     amended--
       (1) in paragraph (3)--
       (A) by striking ``subsection (a)(2)(F)--'' and all that 
     follows through ``(C) in the case'' and inserting 
     ``subsection (a)(2)(F) in the case''; and
       (B) by redesignating clauses (i) and (ii) of the former 
     subparagraph (C) as subparagraphs (A) and (B) of such 
     paragraph (3) and by moving such new subparagraphs two ems to 
     the left; and
       (2) in paragraph (1)(C)--
       (A) by striking ``paragraphs (2) and (3)'' and inserting 
     ``paragraph (2)''; and
       (B) by inserting after ``on active duty'' the following: 
     ``between August 2, 1990, and November 11, 1998,''.

     SEC. 203. PROHIBITION ON COLLECTION OF COPAYMENTS FROM 
                   CATASTROPHICALLY DISABLED VETERANS.

       (a) In General.--Subchapter III of chapter 17 of title 38, 
     United States Code, is amended by adding at the end the 
     following new section:

     ``Sec. 1730A. Prohibition on collection of copayments from 
       catastrophically disabled veterans

       ``Notwithstanding subsections (f) and (g) of section 1710 
     of this title, subsection (a) of section 1722A of this title, 
     and any other provision of law, the Secretary may not require 
     a veteran who is catastrophically disabled to make any 
     copayment for the receipt of hospital care or medical 
     services under the laws administered by the Secretary.''.
       (b) Clerical Amendment.--The table of sections at the 
     beginning of such chapter is amended by inserting after the 
     item relating to section 1730 the following new item:
       ``1730A. Prohibition on collection of copayments from 
           catastrophically disabled veterans.''.

     SEC. 204. ESTABLISHMENT OF DIRECTOR OF PHYSICIAN ASSISTANT 
                   SERVICES AT VETERANS HEALTH ADMINISTRATION OF 
                   DEPARTMENT OF VETERANS AFFAIRS.

       (a) In General.--Section 7306(a) of title 38, United States 
     Code, is amended by striking paragraph (9) and inserting the 
     following new paragraph (9):
       ``(9) The Director of Physician Assistant Services, who 
     shall serve in a full-time capacity at the Central Office of 
     the Department and who shall be a qualified physician 
     assistant, who shall be responsible to and report directly to 
     the Under Secretary for Health on all matters relating to the 
     education and training, employment, appropriate utilization, 
     and optimal participation of physician assistants within the 
     programs and initiatives of the Administration.''.
       (b) Deadline for Implementation.--The Secretary of Veterans 
     Affairs shall ensure that an individual is serving as the 
     Director of Physician Assistant Services under section 
     7306(a)(9) of title 38, United States Code, as added by 
     subsection (a), by not later than 120 days after the date of 
     the enactment of this Act.

     SEC. 205. COMMITTEE ON CARE OF VETERANS WITH TRAUMATIC BRAIN 
                   INJURY.

       (a) Establishment of Committee.--Subchapter II of chapter 
     73 of title 38, United States Code, is amended by inserting 
     after section 7321 the following new section:

     ``Sec. 7321A. Committee on Care of Veterans with Traumatic 
       Brain Injury

       ``(a) Establishment.--The Secretary shall establish in the 
     Veterans Health Administration a committee to be known as the 
     `Committee on Care of Veterans with Traumatic Brain Injury'. 
     The Under Secretary for Health shall appoint employees of the 
     Department with expertise in the care of veterans with 
     traumatic brain injury to serve on the committee.
       ``(b) Responsibilities of Committee.--The committee shall 
     assess, and carry out a continuing assessment of, the 
     capability of the Veterans Health Administration to meet 
     effectively the treatment and rehabilitation needs of 
     veterans with traumatic brain injury. In carrying out that 
     responsibility, the committee shall--
       ``(1) evaluate the care provided to such veterans through 
     the Veterans Health Administration;
       ``(2) identify systemwide problems in caring for such 
     veterans in facilities of the Veterans Health Administration;
       ``(3) identify specific facilities within the Veterans 
     Health Administration at which program enrichment is needed 
     to improve treatment and rehabilitation of such veterans; and
       ``(4) identify model programs which the committee considers 
     to have been successful in the treatment and rehabilitation 
     of such veterans and which should be implemented more widely 
     in or through facilities of the Veterans Health 
     Administration.
       ``(c) Advice and Recommendations.--The committee shall--
       ``(1) advise the Under Secretary regarding the development 
     of policies for the care and rehabilitation of veterans with 
     traumatic brain injury; and
       ``(2) make recommendations to the Under Secretary--
       ``(A) for improving programs of care of such veterans at 
     specific facilities and throughout the Veterans Health 
     Administration;

[[Page 19394]]

       ``(B) for establishing special programs of education and 
     training relevant to the care of such veterans for employees 
     of the Veterans Health Administration;
       ``(C) regarding research needs and priorities relevant to 
     the care of such veterans; and
       ``(D) regarding the appropriate allocation of resources for 
     all such activities.
       ``(d) Annual Report.--Not later than June 1 of 2010, and 
     each subsequent year, the Secretary shall submit to the 
     Committees on Veterans' Affairs of the Senate and House of 
     Representatives a report on the implementation of this 
     section. Each such report shall include the following for the 
     calendar year preceding the year in which the report is 
     submitted:
       ``(1) A list of the members of the committee.
       ``(2) The assessment of the Under Secretary for Health, 
     after review of the initial findings of the committee, 
     regarding the capability of the Veterans Health 
     Administration, on a systemwide and facility-by-facility 
     basis, to meet effectively the treatment and rehabilitation 
     needs of veterans with traumatic brain injury.
       ``(3) The plans of the committee for further assessments.
       ``(4) The findings and recommendations made by the 
     committee to the Under Secretary for Health and the views of 
     the Under Secretary on such findings and recommendations.
       ``(5) A description of the steps taken, plans made (and a 
     timetable for the execution of such plans), and resources to 
     be applied toward improving the capability of the Veterans 
     Health Administration to meet effectively the treatment and 
     rehabilitation needs of veterans with traumatic brain 
     injury.''.
       (b) Clerical Amendment.--The table of sections at the 
     beginning of such chapter is amended by inserting after the 
     item relating to section 7321 the following new item:

       ``7321A. Committee on Care of Veterans with Traumatic Brain 
           Injury.''.

     SEC. 206. REVISION OF CERTAIN REQUIREMENTS FOR THE PILOT 
                   PROGRAM OF ENHANCED CONTRACT CARE AUTHORITY FOR 
                   HEALTH CARE NEEDS OF VETERANS IN HIGHLY RURAL 
                   AREAS.

       Subsection (b) of section 403 of the Veterans' Mental 
     Health and Other Care Improvements Act of 2008 (Public Law 
     110-387; 38 U.S.C. 1703 note) is amended to read as follows:
       ``(b) Covered Veterans.--For purposes of the pilot program 
     under this section, a covered veteran is any veteran who--
       ``(1) is--
       ``(A) enrolled in the system of patient enrollment 
     established under section 1705(a) of title 38, United States 
     Code, as of the date of the commencement of the pilot program 
     under subsection (a)(2); or
       ``(B) eligible for health care under section 1710(e)(3)(C) 
     of title 38, United States Code; and
       ``(2) resides in a location that is--
       ``(A) more than 60 minutes' driving distance, as determined 
     by the Secretary, from the nearest Department health care 
     facility providing primary care services, in the case of a 
     veteran seeking such services;
       ``(B) more than 120 minutes' driving distance, as 
     determined by the Secretary, from the nearest Department 
     health care facility providing acute hospital care, in the 
     case of a veteran seeking such care; or
       ``(C) more than 240 minutes' driving distance, as 
     determined by the Secretary, from the nearest Department 
     health care facility providing tertiary care, in the case of 
     a veteran seeking such care.''.

                TITLE III--MATTERS RELATING TO BENEFITS

     SEC. 301. BENEFITS FOR QUALIFIED WORLD WAR II VETERANS.

       (a) Establishment of Compensation Fund.--Subchapter II of 
     chapter 5 of title 38, United States Code, is amended by 
     adding at the end the following new section:

     ``Sec. 533. Qualified World War II Veterans Equity 
       Compensation Fund

       ``(a) Compensation Fund.--(1) There is in the general fund 
     of the Treasury a fund to be known as the `Qualified World 
     War II Veterans Equity Compensation Fund' (in this section 
     referred to as the `compensation fund').
       ``(2) Subject to the availability of appropriations for 
     such purpose, amounts in the compensation fund shall be 
     available to the Secretary without fiscal year limitation to 
     make payments to eligible individuals in accordance with this 
     section.
       ``(b) Eligible Individuals.--(1) An eligible individual is 
     an individual who--
       ``(A) during the 1-year period beginning on the date of the 
     enactment of this section, submits to the Secretary an 
     application containing such information and assurances as the 
     Secretary may require;
       ``(B) has not received benefits under the Servicemen's 
     Readjustment Act of 1944 (Public Law 78-346); and
       ``(C) has engaged in qualified service.
       ``(2) For purposes of paragraph (1), a person has engaged 
     in qualified service if the service of the person has been 
     determined to have been active duty service pursuant to 
     section 1401 of the GI Bill Improvement Act of 1977 (38 
     U.S.C. 106 note).
       ``(c) Amount of Payments.--The Secretary shall make a 
     monthly payment out of the compensation fund in the amount of 
     $1,000 to an eligible individual. The Secretary shall make 
     such payments to eligible individuals in the order in which 
     the Secretary receives the applications of the eligible 
     individuals.
       ``(d) Authorization of Appropriations.--(1) There are 
     authorized to be appropriated to the compensation fund 
     amounts as follows:
       ``(A) For fiscal year 2010, $222,000,000.
       ``(B) For fiscal year 2011, $193,000,000.
       ``(C) For fiscal year 2012, $170,000,000.
       ``(D) For fiscal year 2013, $146,000,000.
       ``(E) For fiscal year 2014, $124,000,000.
       ``(2) Funds appropriated to carry out this section shall 
     remain available until expended.
       ``(e) Reports.--The Secretary shall include, in documents 
     submitted to Congress by the Secretary in support of the 
     President's budget for each fiscal year, detailed information 
     on the operation of the compensation fund, including the 
     number of applicants, the number of eligible individuals 
     receiving benefits, the amounts paid out of the compensation 
     fund, the administration of the compensation fund, and an 
     estimate of the amounts necessary to fully fund the 
     compensation fund for that fiscal year and each of the three 
     subsequent fiscal years.
       ``(f) Regulations.--The Secretary shall prescribe 
     regulations to carry out this section.''.
       (b) Regulations.--Not later than 180 days after the date of 
     the enactment of this Act, the Secretary shall prescribe the 
     regulations required under section 532(f) of title 38, United 
     States Code, as added by subsection (a).
       (c) Clerical Amendment.--The table of sections at the 
     beginning of such chapter is amended by inserting after the 
     item related to section 532 the following new item:

       ``533. Qualified World War II Veterans Equity Compensation 
           Fund.''.

     SEC. 302. WAIVER OF HOUSING LOAN FEE FOR CERTAIN VETERANS 
                   WITH SERVICE-CONNECTED DISABILITIES CALLED TO 
                   ACTIVE SERVICE.

       Section 3729(c)(1) of title 38, United States Code, is 
     amended by inserting after ``retirement pay'' the following: 
     ``or active service pay''.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
California (Mr. Filner) and the gentleman from Florida (Mr. Stearns) 
each will control 20 minutes.
  The Chair recognizes the gentleman from California.
  Mr. FILNER. I thank the Speaker, and I yield myself such time as I 
may consume.
  I rise in strong support of passage of this bill, the Veterans' 
Insurance Health Care Improvement Act of 2009, H.R. 3219. This 
important legislation was assembled with the help of many members of 
the House Committee on Veterans Affairs, without whose efforts this 
bill would not have been possible. I'm surprised to see my friend, Mr. 
Stearns, managing the bill, having just railed against nationalization 
of health care, which is not what the Obama plan has, but then he's a 
great supporter of the veterans' health system, which I think may come 
under his definition. So I'm pleased that he supports so strongly the 
Veterans Administration health care system, which is nationalized care, 
but I wish he would support Mr. Obama's health care plan, which has 
nothing to do with nationalization.
  But I want to recognize and applaud the outstanding effort of 
especially two dynamic members on the committee who sponsored major 
insurance provisions of the bill under consideration. Mrs. Halvorson of 
Illinois sponsored the Families of Veterans Financial Security Act, 
H.R. 2774, which has become section 101 of this bill. And Mrs. 
Kirkpatrick of Arizona sponsored the Veterans and Service Members 
Accelerated Benefit Option Equity Act of 2009, H.R. 2988, which is now 
section 103 of this bill.
  These measures represent commonsense yet critical insurance 
provisions intended to ensure that our veterans, servicemembers and 
their families who have insurance-related needs receive the full 
measure of the benefit offered and that the survivors have ample 
replacement income to meet their needs. All of the provisions would 
give veterans and servicemembers greater flexibility in their insurance 
choices, and, consequently, greater peace of mind.
  Additionally, the Congressional Budget Office reports that none of 
the bills would increase Federal direct

[[Page 19395]]

spending for veterans' insurance programs. And I want to applaud, also, 
the chairman of our Disability Assistance and Memorial Affairs 
Subcommittee on these measures, Mr. Hall of New York, for his 
leadership on these measures.
  The legislation further provides for a wide variety of health care 
improvements in recognition of veterans who have sacrificed so much for 
the safety and freedom of the Nation. It enhances the lives of the 
Nation's veterans, from World War II to the current conflicts.
  Other members also contributed to the health care provisions of this, 
and I want to thank them for their efforts. For example, Mr. Mitchell 
of Arizona, who wrote H.R. 1197, the Medal of Honor Health Care Equity 
Act of 2009, which assigns a higher priority status for VA hospital 
care and medical services for veterans who are recipients of the Medal 
of Honor.
  Another provision by Mr. Hare of Illinois, H.R. 1302, would establish 
a position of director of physician assistant services within the 
Office of the Under Secretary of Veterans Affairs for Health. And Mrs. 
Halvorson from Illinois also sponsored H.R. 1335, which would prohibit 
the Secretary of Veterans Affairs from collecting certain copayments 
from veterans who are catastrophically disabled from non-service-
connected causes and have income above the means tested level.
  Mr. McNerney from California sponsored H.R. 1546, the Caring for 
Veterans with Traumatic Brain Injury Act, and that has been 
incorporated to establish a committee on the care of veterans with 
traumatic brain injury to assess the VA's ability to treat and 
rehabilitate veterans with TBI--that is traumatic brain injury--and to 
provide recommendations on how to more effectively treat these 
veterans.
  Mr. Nye of Virginia introduced H.R. 2926, which was incorporated into 
the bill to provide hospital care, medical services, and nursing home 
care for certain Vietnam-era veterans exposed to herbicides and also 
veterans of the Persian Gulf War.
  Mr. Buyer's bill, H.R. 2270, would establish a compensation fund for 
all civilian groups who are given veteran status under the G.I. Bill 
Improvement Act of 1977, and that is also in the bill.
  And finally, we have a bill introduced by Mr. Teague of New Mexico to 
waive the housing loan fee for certain veterans with service-connected 
disabilities called to active service.
  So I want to thank all of the members of our committee who've worked 
so hard to put together the important legislation we are considering 
today, and I hope my colleagues will support H.R. 3219 as amended
  Mr. Speaker, I reserve the balance of my time.
  Mr. STEARNS. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I rise in strong support of H.R. 3219, as amended, to 
amend title 38 of the United States Code, which would make improvements 
in the laws administered by the Secretary of Veterans Affairs relating 
to insurance and health care and for other purposes.

                              {time}  1415

  H.R. 3219, as amended, combines veterans' life insurance and health 
care provisions from bills by several Members that improve the lives of 
veterans, and I will highlight for my colleagues just a few of these 
this afternoon.
  The bill includes provisions of H.R. 2349, the Veterans' Group Life 
Insurance Improvement Act of 2009, that was introduced by the ranking 
member, Mr. Buyer, to allow veterans under the age of 60 to purchase up 
to $400,000 of veterans' group life insurance coverage in $25,000 
increments every 5 years. This bill gives our veterans greater 
flexibility in their life insurance choices and is supported by the VA 
and veterans service organizations. That's good.
  Another provision that has been included in H.R. 3219, as amended, is 
from H.R. 2270, also introduced by Ranking Member Buyer, which provides 
equity for all of the 28 World War II civilian groups that were later 
given veteran status under the process set up by the GI Bill 
Improvement Act of 1977.
  The bill provides equity by making all these groups eligible for the 
same $1,000 a month payment that merchant mariners of World War II 
would receive under H.R. 23, as amended, which the House passed earlier 
this year.
  One group of veterans that would benefit from this provision are the 
members of the American Volunteer Group, also known as the Flying 
Tigers. This was a distinct group of American ground crew and pilots 
who worked as part of the Chinese Air Force with U.S. Government 
approval in defense of allied strongholds before and after America's 
entrance into the war. The Flying Tigers, P-40 aircraft, with their 
distinctive shark's teeth painted on the nose of the fuselage, became 
famous for their many, many successful raids on Japanese targets in 
China, including one just 12 days after Pearl Harbor.
  Mr. Speaker, the Flying Tigers are credited with destroying 297 
aircraft, of which 229 were air-to-air victories. This statistic is 
even more impressive when you consider that they were largely 
outnumbered in almost every engagement they were involved with, and all 
of their supplies had to be flown over the Hump from India over the 
Himalayan Mountains.
  Also, Mr. Speaker, there is another well-known group. It is called 
the Women Air Force Service Pilots, WASPs. These were female pilots who 
flew noncombat missions for the United States Army Air Corps during the 
war. Over 1,000 of these brave pilots flew missions all across this 
country in support of the war effort. Although they had been promised 
to be made part of the Air Corps following the war, they were disbanded 
on December 20, 1944, with little fanfare and with little recognition.
  Earlier this year, the President signed S. 614 to award the 
Congressional Gold Medal to an estimated 300 WASPs that are still alive 
today. The passage of S. 614, coupled with the benefit provided to the 
WASPs under the bill, will finally give these brave women veterans the 
recognition they deserve.
  I want to thank the chairman, Mr. Filner, for accepting the amendment 
to include these groups in the bill so that we can provide simple 
equity for all of these veterans that were not eligible for the World 
War II GI Bill.
  I urge my colleagues to support this legislation.
  Mr. Speaker, I reserve the balance of my time.
  Mr. FILNER. Mr. Speaker, I yield as much time as she may consume to 
one of our dynamic new members of our committee, Mrs. Halvorson of 
Illinois.
  Mrs. HALVORSON. Thank you, Mr. Filner, for yielding and for your 
leadership on the Veterans' Affairs Committee.
  I rise in support of H.R. 3219. Included in H.R. 3219 is the language 
from legislation that I introduced which would eliminate copayments 
from catastrophically disabled veterans who receive medical care from 
the Department of Veterans Affairs. Right now, some catastrophically 
disabled veterans are thrown into financial hardship because of 
copayments they pay to the VA.
  Catastrophically disabled veterans have conditions that compromise 
their ability to carry out the activities of daily living, including 
such basic self-care tasks as eating, bathing, and dressing. Veterans 
in these situations have enough challenges to face on a daily basis; 
having enough resources to make their copayment should not be another 
challenge that they have to deal with.
  This legislation would allow our veterans to receive the health care 
that they deserve without adding another burden that makes it more 
difficult to afford.
  Also included in this language from my bill, the Families of Veterans 
Financial Security Act, which would make permanent the extension that 
totally disabled veterans currently receive from the Servicemembers' 
Group Life Insurance program, also known as the SGLI. The SGLI is 
operated by the VA and provides low-cost group life insurance to 
members of the uniformed services. This program was developed to make 
insurance benefits available for veterans and servicemembers who were 
not able to secure insurance from

[[Page 19396]]

private companies due to the extra risks involved in military service 
or because of a service-connected disability.
  Currently, a temporary SGLI disability extension exists to allow 
servicemembers who are totally disabled to retain their SGLI coverage 
at no cost for up to 2 years. This extension guarantees that veterans 
most in need--the ones that are seriously disabled as a result of their 
service--won't lose their life insurance coverage. This legislation 
would make the extension permanent and provide financial security to 
the families of disabled veterans.
  I urge my colleagues to support H.R. 3219.
  Mr. STEARNS. Mr. Speaker, I would like to take a moment to thank John 
Hall of New York and Doug Lamborn of Colorado, the chairman and ranking 
member on the Subcommittee on Disability Assistance and Memorial 
Affairs, and Mike Michaud of Maine and Henry Brown of South Carolina 
for all of their hard work on the legislation which was included in 
this bill. I would also like to thank Chairman Filner and Ranking 
Member Buyer for their cooperation in moving the legislation forward.
  Mr. Speaker, I urge my colleagues to support H.R. 3219, as amended, 
and I yield back the balance of my time.
  Mr. FILNER. I yield as much time as he may consume to the gentleman 
from American Samoa (Mr. Faleomavaega).
  Mr. FALEOMAVAEGA. Mr. Speaker, I rise in strong support of H.R. 3219, 
legislation to amend title 38, U.S. Code, to make certain improvements 
in the laws administered by the Secretary of Veterans Affairs related 
to insurance and health care, and for other purposes.
  Mr. Speaker, I do want to commend the gentleman from California, my 
colleague, the chairman of the Committee on Veterans' Affairs, and my 
good friend from Florida who is managing on the other side of the aisle 
this important legislation.
  Mr. Speaker, H.R. 3219, among other things, would make permanent the 
2-year extension of the free Servicemembers' Group Life Insurance 
coverage period for totally disabled veterans following separation from 
active or reserve duty, enable veterans insured under the Veterans' 
Group Life Insurance program to increase the amount of their coverage, 
and eliminate the reduction in the amount of accelerated death benefits 
for terminally ill persons insured under both the SGLI and the VGLI 
programs.
  Mr. Speaker, such improvements to the SGLI and VGLI programs would 
maximize the opportunity for totally disabled veterans, especially 
those who have no commercial insurance, the chance to obtain insurance 
coverage to pay for their medical expenses. Especially in this time of 
economic hardship, this bill would provide tremendous financial help 
and security for our veterans and their families.
  Moreover, this bill would expand existing health care programs to 
include veterans that were not otherwise qualified. For example, this 
bill would provide for the enhanced treatment authority for veterans of 
the Vietnam era, like myself, and veterans of the Gulf War who may have 
been exposed to Agent Orange, herbicides known to contain dioxin, which 
has been linked to cancer and other disorders. While the full impact of 
these herbicides remain unknown, veterans affected have shown symptoms 
including persistent memory and concentration problems, chronic 
headaches, widespread pain, gastrointestinal problems, and other 
chronic abnormalities not explained by well-established diagnoses.
  Mr. Speaker, as a Vietnam veteran myself, and a proud member of the 
100th Battalion 442nd Infantry Reserve Unit out of Hawaii, I certainly 
appreciate the service and sacrifice of my fellow servicemen in the 
United States Armed Forces.
  Again, I urge my colleagues to support this bill.


                             General Leave

  Mr. FILNER. Mr. Speaker, I ask unanimous consent that all Members may 
have 5 legislative days in which to revise and extend their remarks and 
include extraneous material on H.R. 3219, as amended, and urge my 
colleagues to unanimously support the bill.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from California?
  There was no objection.
  Mr. BUYER. Mr. Speaker, I rise in support of H.R. 3219, as amended, 
the Veterans' Insurance and Health Care Improvements Act of 2009, which 
would amend title 38, United States Code, to make certain improvements 
in the laws administered by the Secretary of Veterans Affairs relating 
to insurance and health care.
  H.R. 3219, as amended combines several pieces of legislation 
including H.R. 2349, the Veterans' Group Life Insurance Improvement Act 
of 2009, and H.R. 2270, the Benefits for Qualified World War II 
Veterans Act of 2009, both of which I introduced earlier this year.
  H.R. 2349 gives eligible veterans the option of purchasing additional 
life insurance coverage under the Veterans Group Life Insurance 
Program. They would be able to purchase this coverage every five years 
in $25,000 increments up until age 60. This provision gives these 
veterans that choice to increase their life insurance as they get older 
and may see the need to purchase more as their family grows. The costs 
of such increases in coverage would be offset by premiums veterans pay, 
so there is no direct cost to the government.
  Another provision included in H.R. 3219, as amended, is the substance 
of H.R. 2270, which provides a $1,000 monthly payment to all World War 
II civilian groups that were later given veteran status under the 
process set up by the G.I. Bill Improvement Act of 1977.
  Earlier this year, the House created an inequitable situation when we 
singled out one of these civilian groups, merchant mariners, to receive 
this payment while excluding the other 28 groups who also served 
bravely in defense of our country. I am pleased that the bill before us 
corrects this situation.
  One of these groups that are now eligible under this provision is 
American Volunteer Group also known as the Flying Tigers. These were 
civilian pilots and ground crew who fought against the Japanese before 
and after Pearl Harbor and had one of the most impressive combat 
records in the Pacific Theater.
  During the subcommittee legislative hearing on H.R. 2270, members had 
the opportunity to meet and hear testimony of 90-year-old former Flying 
Tiger, Ed Stiles, Sr.
  I had the opportunity to meet with Mr. Stiles and his family, and it 
was an absolute pleasure to hear his stories about the brave pilots and 
ground crews of the Flying Tigers who saved countless American lives by 
tying up Japanese air forces in China before and after Pearl Harbor.
  I want to thank my colleagues for including these two provisions in 
H.R. 3219, as amended. I urge my colleagues to support this 
legislation.
  Mr. HARE. Mr. Speaker, I rise in strong support of H.R. 3219, the 
Veterans' Insurance and Health Care Improvements Act of 2009.
  Earlier in this session, I introduced H.R. 1302, a bill to create a 
full-time Director of Physician Assistant (PA) Services in the 
Department of Veterans Affairs (VA) Central Office. I would like to 
thank my colleague, Representative Jerry Moran, for his leadership with 
me on this bill, as well as Chairmen Filner and Michaud, Ranking 
Members Buyer and Brown and many other VA Committee colleagues for 
joining us as cosponsors''.
  Today, I am very pleased to speak in support of H.R. 3219, which 
incorporates the provisions of my bill and eight other bills that were 
favorably considered by the House Committee on Veterans' Affairs.
  PAs have long been a key component in the Veterans Health 
Administration (VHA). Almost two thousand PAs are currently employed by 
the VA, roughly 30 percent of whom are veterans. While the PA Advisor 
position, established by Congress in 2000, has been valuable, many 
problems exist.
  For example, as the American Academy of Physician Assistants (AAPA) 
explained in written testimony on October 18, 2007, ``In one case, a 
local facility decided that a PA could not write outpatient 
prescriptions despite licensure in the state allowing prescriptive 
authority. In other facilities, PAs were told that the VA facility can 
not use PAs and will not hire PAs.'' These inconsistencies and 
restrictions not only hinder PAs currently employed by the VA, but also 
discourage PAs from even entering the VA system, ultimately impacting 
the medical care of our nation's veterans.
  PAs are the fourth fastest growing profession in the country, yet the 
VA is simply not competitive with the private sector for new PA 
graduates. The lack of a Director of PA Services at the VA prevents 
necessary recruitment and retention of the PA workforce in the VA at

[[Page 19397]]

a time when we need more health care professionals to provide necessary 
care to our Veterans.
  Considering the fact that nearly 40 percent of all VA PAs are 
projected to retire in the next five years, the VA is in danger of 
losing its PA workforce unless serious focus is directed toward 
recruitment and retention of this critical group.
  One of the biggest challenges facing current and future PAs in the VA 
system is their exclusion from recruitment and retention benefits. The 
VA designates physicians and Nurse Practitioners (NPs) as critical 
occupations. As such, these individuals receive priority in 
scholarships and loan repayment programs. Unfortunately, the VA has not 
designated the PA profession as a critical occupation despite the fact 
that the VA has determined PAs and NPs functionally interchangeable.
  Additionally, VA medical facilities, at times, post vacant positions 
for NPs only, excluding PAs. There is also a hiring trend in the VA of 
NPs outpacing PAs nearly three to one, again despite the 
interchangeability between the two specialties.
  Finally, PAs are not included in any of the VA special locality pay 
bands, so PA salaries are not regularly tracked and reported by the VA. 
There is evidence that this has resulted in lower pay for PAs employed 
by the VA compared to other health care professionals. This only serves 
as yet another deterrent for PAs to enter the VA system.
  A permanent Director at the VA Central Office (VACO) would serve as 
an advocate on behalf of PAs and work to ensure their fair treatment. 
It is time for the VA to devote serious attention to PA recruitment and 
retention. Enactment of H.R. 1302 is a start.
  As a Congressman who represents a district with rural communities, I 
know that PAs play a key role in providing medical care in rural and 
other medically underserved areas. I want to ensure that they are 
equally well utilized by the VA. I know that medical institutions like 
the Cleveland Clinic, the Mayo Clinic, the MD Anderson Cancer Clinic at 
the University of Texas, and others have a Director of PA Services to 
make sure that the PAs they employ are integrated into their health 
systems. Additionally, each branch of the Armed Services has a Chief PA 
to help the military best utilize its PA workforce. It is time for the 
VA to do the same.
  I strongly urge my colleagues to show their support of strengthening 
Veterans' healthcare by voting ``yes'' on H.R. 3219.
  Mr. TEAGUE. Mr. Speaker, I believe that this bill represents 
something that we can always use more of in government, a little common 
sense. In this case, that common sense is a simple fix that will ensure 
that disabled veterans will be able to receive the housing assistance 
that they have earned. I am the sponsor of legislation that will make 
that fix.
  My bill, H.R. 2180, will waive VA home loan fees for certain veterans 
with service-connected disabilities that have been recalled to active 
service. I am proud to say that this provision has been included in 
H.R. 3219.
  Currently, the Department of Veterans Affairs underwrites home loans 
that are made by private lenders to eligible veterans. The benefits of 
having a VA home loan are many. For example, the buyer is informed of 
reasonable value, the interest rate is negotiable, and there are no 
mortgage insurance premiums. Veterans also have the right to prepay 
without penalty, and the VA provides assistance to veteran borrowers in 
default due to financial difficulty.
  Additionally, many disabled veterans and some injured soldiers 
qualify for a waiver of home loan fees. Unfortunately, however, a 
different part of the law prevents an eligible servicemember or veteran 
from receiving a home loan funding fee waiver if the veteran is called 
up back to active duty service. This bill gets rid of this oversight in 
the law and allows all eligible servicemembers to receive the fee 
waiver, whether or not they have been called back to service.
  Mr. Speaker, I simply think that it is wrong that someone who has 
served their country and been injured as a result of that service be 
penalized because they are returning to service.
  This provision represents a common-sense solution to a problem that I 
do not think anyone anticipated. I believe that when the Congress 
established the VA Home loan program they had the best of intentions. 
This program has created an opportunity for thousands of veterans that 
simply want to be part of the American dream. With this bill we can 
correct an oversight that will help even more veterans along the way.
  I would like to take this time to thank the staff members of the 
Economic Opportunity Subcommittee who lent their expertise during the 
drafting of this bill. I truly believe that this one measure can open 
up many doors of opportunity to our veterans and hope that my 
colleagues will support its passage.
  Mr. FILNER. Mr. Speaker, I yield back the balance of my time.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentleman from California (Mr. Filner) that the House suspend the rules 
and pass the bill, H.R. 3219, as amended.
  The question was taken; and (two-thirds being in the affirmative) the 
rules were suspended and the bill, as amended, was passed.
  A motion to reconsider was laid on the table.

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