[Congressional Record (Bound Edition), Volume 155 (2009), Part 18]
[House]
[Pages 23784-23789]
[From the U.S. Government Publishing Office, www.gpo.gov]




 PROVIDING FOR CONCURRENCE BY HOUSE WITH AMENDMENT IN SENATE AMENDMENT 
 TO H.R. 1016, VETERANS HEALTH CARE BUDGET REFORM AND TRANSPARENCY ACT 
                                OF 2009

  Mr. FILNER. Mr. Speaker, I move to suspend the rules and agree to the 
resolution (H. Res. 804) providing for the concurrence by the House in 
the Senate amendment to H.R. 1016, with amendment.
  The Clerk read the title of the resolution.
  The text of the resolution is as follows:

                              H. Res. 804

       Resolved, That upon the adoption of this resolution the 
     bill (H.R. 1016) entitled ``An Act to amend title 38, United 
     States Code, to provide advance appropriations authority for 
     certain medical care accounts of the Department of Veterans 
     Affairs, and for other purposes'', with the Senate amendment 
     thereto, shall be considered to have been taken from the 
     Speaker's table to the end that the Senate amendment thereto 
     be, and the same is hereby, agreed to with the following 
     amendment:
       Strike all after the enacting clause and insert the 
     following:

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Veterans Health Care Budget 
     Reform and Transparency Act of 2009''.

     SEC. 2. PRESIDENT'S BUDGET SUBMISSION.

       Section 1105(a) of title 31, United States Code, is amended 
     by adding at the end the following new paragraph:
       ``(36) information on estimates of appropriations for the 
     fiscal year following the fiscal year for which the budget is 
     submitted for the following medical care accounts of the 
     Veterans Health Administration, Department of Veterans 
     Affairs account:
       ``(A) Medical Services.
       ``(B) Medical Support and Compliance.
       ``(C) Medical Facilities.''.

     SEC. 3. ADVANCE APPROPRIATIONS FOR CERTAIN MEDICAL CARE 
                   ACCOUNTS OF THE DEPARTMENT OF VETERANS AFFAIRS.

       (a) In General.--Chapter 1 of title 38, United States Code, 
     is amended by inserting after section 116 the following new 
     section:

     ``Sec. 117. Advance appropriations for certain medical care 
       accounts

       ``(a) In General.--For each fiscal year, beginning with 
     fiscal year 2011, discretionary new budget authority provided 
     in an appropriations Act for the medical care accounts of the 
     Department shall--
       ``(1) be made available for that fiscal year; and
       ``(2) include, for each such account, advance discretionary 
     new budget authority that first becomes available for the 
     first fiscal year after the budget year.
       ``(b) Estimates Required.--The Secretary shall include in 
     documents submitted to Congress in support of the President's 
     budget submitted pursuant to section 1105 of title 31, United 
     States Code, detailed estimates of the funds necessary for 
     the medical care accounts of the Department for the fiscal 
     year following the fiscal year for which the budget is 
     submitted.
       ``(c) Medical Care Accounts.--For purposes of this section, 
     the term `medical care accounts of the Department' means the 
     following medical care accounts of the Veterans Health 
     Administration, Department of Veterans Affairs account:
       ``(1) Medical Services.
       ``(2) Medical Support and Compliance.
       ``(3) Medical Facilities.
       ``(d) Annual Report.--Not later than July 31 of each year, 
     the Secretary shall submit to Congress an annual report on 
     the sufficiency of the Department's resources for the next 
     fiscal year beginning after the date of the submittal of the 
     report for the provision of medical care. Such report shall 
     also include estimates of the workload and demand data for 
     that fiscal year.''.
       (b) Clerical Amendment.--The table of sections at the 
     beginning of such chapter is amended by inserting after the 
     item relating to section 113 the following new line:

``117. Advance appropriations for certain medical care accounts.''.

     SEC. 4. COMPTROLLER GENERAL REVIEW OF THE ACCURACY OF VA 
                   MEDICAL CARE BUDGET SUBMISSION IN RELATION TO 
                   BASELINE HEALTH CARE MODEL PROJECTION.

       (a) Review of Accuracy of Medical Care Budget Submission.--
     The Comptroller General shall conduct a review of each budget 
     of the President for a fiscal year that is submitted to 
     Congress pursuant to section 1105(a) of title 31 in order to 
     assess whether or not the relevant components of the amounts 
     requested in such budget for such fiscal year for the medical 
     care accounts of the Department of Veterans Affairs specified 
     in section 117(c) of title 38, United States Code, as added 
     by section 3, are consistent with estimates of the resources 
     required by the Department for the provision of medical care 
     and services in such fiscal year, as forecast using the 
     Enrollee Health Care Projection Model, or other methodologies 
     used by the Department.
       (b) Reports.--
       (1) In general.--Not later than 120 days after the date of 
     each year in 2011, 2012, and 2013, on which the President 
     submits the budget request for the next fiscal year under 
     section 1105 of title 31, United States Code, the Comptroller 
     General shall submit to the Committees on Veterans' Affairs, 
     Appropriations, and the Budget of the Senate and the 
     Committees on Veterans' Affairs, Appropriations, and the 
     Budget of the House of Representatives and to the Secretary a 
     report on the review conducted under subsection (a).
       (2) Elements.--Each report under this paragraph shall 
     include, for the fiscal year beginning in the year in which 
     such report is submitted, the following:
       (A) An assessment of the review conducted under subsection 
     (a).
       (B) The basis for such assessment.
       (C) Such additional information as the Comptroller General 
     determines appropriate.
       (3) Availability to the public.--Each report submitted 
     under this subsection shall also be made available to the 
     public.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
California (Mr. Filner) and the gentleman from Florida (Mr. Bilirakis) 
each will control 20 minutes.
  The Chair recognizes the gentleman from California.
  Mr. FILNER. Mr. Speaker, I rise in support of the Veterans Health 
Care Budget Reform and Transparency Act of 2009.
  Mr. Speaker, this is a very important bill. It's a whole new approach 
to the funding of Veterans Administration health care programs, one 
that will allow our Nation's veterans to receive timely, high quality 
and well-funded care regardless of political considerations that go 
into the budget process every year. I'm glad I was able to work with my 
colleagues in the Committee on Veterans' Affairs in both the House and 
the Senate to get this bill to the House floor today.
  This is a bipartisan response to years of chronic underfunding of VA 
medical care and happens to be the highest legislative priority of 
veterans' groups in this Nation.
  In an unprecedented step, Mr. Speaker, nine veterans' groups formed 
the Partnership for Veterans Health Care Budget Reform. These groups, 
including The American Legion, AMVETS, Blinded Veterans Association, 
Disabled American Veterans, Jewish War Veterans, Military Order of the 
Purple Heart, Paralyzed Veterans of America, Veterans of Foreign Wars, 
and the Vietnam Veterans of America all formed together to advocate for 
a VA health care budget that is sufficient, timely and predictable.
  In fact, the leadership of one of the prime organizations that took 
the leadership in this fight, the Disabled American Veterans, are 
watching this debate from the gallery. Their national commander, Bobby 
Barrera; their executive director, Dave Gorman; and their legislative 
director, Joe Violante, are watching this, and we thank them for their 
leadership in this fight.

[[Page 23785]]

  These groups put together the idea that resources for VA health care 
should be provided through advance appropriations, so that when the 
fiscal year starts on October 1, the VA will already have its budget 
figure regardless of what occurred in the year's budget that was 
funding other agencies. The result of their advocacy is H.R. 1016, 
which will pass as we pass the resolution before us on the floor.
  The VA budget, in fact, has been in place at the start of the fiscal 
year only four times in the last two decades. We all felt that this 
delay in providing vital funding, for whatever reasons that were going 
on in the House and the Senate, put the provision of health care to 
veterans at risk and hampered the VA's ability to plan its health care 
expenditures and hire needed health care professionals. This was a 
concern that was shared by current and former VA officials.
  Again this year the VA was forced to rely on funding from a 
continuing resolution, even though the House acted in a timely fashion 
and passed the FY 2010 VA spending bill in July.
  The House passed its version of the forward funding bill by a vote of 
409-1 this June. Our other colleagues in the Senate acted in August, 
and the version of the legislation before us represents a compromise 
agreement between us and our colleagues on the Senate Committee on 
Veterans' Affairs.
  The bill will ensure that VA can best plan and utilize taxpayer 
dollars to provide veterans with the health care they have earned and 
deserve. It provides a framework with which we can realize advance 
appropriations for VA medical care accounts.
  As part of the annual budget submission, the President will be 
required to submit a request for certain VA accounts for the ``fiscal 
year following the fiscal year for which the budget is submitted.'' For 
example, as part of the administration's fiscal year 2011 budget, the 
President will include budget estimates for VA medical care accounts 
for fiscal year 2012. The VA will be required to detail estimates in 
the budget documents it submits annually to Congress.
  Each July, the VA will be required to report to Congress if it has 
the resources it needs in the upcoming fiscal year in order for 
Congress to address any funding imbalances. This will help to safeguard 
against the VA facing budget shortfalls such as it faced several years 
ago.
  Finally, the Government Accountability Office will report, within 120 
days of the annual budget submission, whether VA's advance 
appropriations requests are in line with workload and cost estimates 
and the VA's budget model. It sounds a little complicated. It was 
worked out by, as I said, this really hardworking coalition of 
veterans' organizations and, in fact, bottom line and simple, it will 
make sure that a year in advance, the VA will be funded appropriately.
  I want to thank both the Appropriations and the Budget Committees for 
their assistance in moving this measure forward. The Budget Committee, 
for example, in the fiscal year 2010 budget resolution provided 
explicit language exempting the three medical care accounts of the VA, 
the accounts covered by the compromise agreement on H.R. 1016, from 
many points of order against advance appropriations. The Appropriations 
Committee, under the leadership of Chairman Obey and Chairman Edwards, 
provided for advance appropriations for the three medical care accounts 
representing an 8 percent increase above the historic levels provided 
for fiscal year 2010.
  Mr. Speaker, I would like to insert a copy of the letter from the 
veterans' groups comprising the Partnership for Veterans Health Care 
Budget Reform expressing their full support of this measure and an 
explanatory statement on the bill in the Congressional Record.
  By working together, Congress and the administration have provided 
veterans with their top legislative priority. They spoke, we listened, 
and today we are acting. I ask the rest of the House to join once again 
in unanimous support of this bipartisan bill and ask for swift action 
by the Senate before the end of this session.

                                      The Partnership for Veterans


                                    Health Care Budget Reform,

                               Washington, DC, September 29, 2009.
     Hon. Bob Filner,
     Chairman, House Committee on Veterans' Affairs, Cannon House 
         Office Building, Washington, DC.
       Dear Chairman Filner: On behalf of the Partnership for 
     Veterans Health Care Budget Reform, we write to fully endorse 
     the substitute amendment that you intend to offer to H.R. 
     1016, the Veterans Health Care Budget Reform and Transparency 
     Act. We understand that this amendment has been developed in 
     cooperation with Senate Veterans' Affairs Committee Chairman 
     Akaka and Ranking Member Burr, who join you in support of 
     this new language. We agree with all of you that adoption and 
     enactment of H.R. 1016, as amended by this substitute 
     amendment, will lead to VA health care funding that is 
     sufficient, timely and predictable.
       The Partnership, comprised of nine leading veterans service 
     organizations, has long sought a solution to the recurring 
     budget problems that have plagued the VA health care system 
     for most of the past two decades. Last year we began 
     advocating that Congress provide advance appropriations for 
     VA medical care and we were grateful that you introduced 
     legislation to authorize this funding reform. We supported 
     your reintroduction of this legislation (H.R. 1016) in 
     February and fully supported the substitute amendment you 
     offered during the Committee's markup in June, that was 
     subsequently approved by the full House with a vote of 409 to 
     1 on June 23rd. That amendment would add important new budget 
     reporting provisions for VA medical care and would increase 
     transparency of the advance appropriation process, 
     strengthening the legislation.
       The compromise substitute amendment you plan to offer on 
     the House floor retains these provisions and makes two other 
     modifications. First, your new amendment provides the 
     Government Accountability Office, GAO, with 120 days from the 
     time the President submits his budget to Congress to review 
     and report on whether the level of funding requested for VA's 
     medical care accounts is consistent with the estimates 
     generated by VA's Enrollee Health Care Projection Model. With 
     this change, GAO would have ample time to complete the review 
     and still report in a timeframe that allows Congress to 
     consider this information before finalizing future 
     appropriations levels for VA health care.
       Second, this compromise amendment limits VA's advance 
     appropriations to the three medical care accounts, Medical 
     Services, Medical Facilities, and Medical Support and 
     Compliance, contained in our original proposal, removing the 
     two additional ones, Medical and Prosthetic Research, and 
     Information Technology, added during the Committee's markup. 
     We understand the reasons for this modification and support 
     your compromise position. However, we expect that the 
     Committee will closely monitor implementation of this 
     legislation and carefully consider whether VA health care 
     would be enhanced if additional budget accounts, such as IT 
     and research, were similarly appropriated in advance.
       Mr. Chairman, the Partnership has worked for over two 
     decades to enact legislation that would assure sufficient, 
     timely and predictable funding for VA health care. With your 
     leadership, and that of Chairman Akaka, Ranking Member Burr 
     and others, as well as the crucial support of President 
     Obama, we are closer than ever to achieving an historic 
     legislative victory on behalf of all veterans. We thank you 
     for all that you have done to support these efforts, and look 
     forward to working with you on future matters of importance 
     to the men and women who have served, are serving, and will 
     serve in our nation's armed forces.
           Respectfully,
         Steve Robertson, Legislative Director, The American 
           Legion; Thomas Zampieri, Director of Government 
           Relations, Blinded Veterans Association; Herb 
           Rosenbleeth, National Executive Director, Jewish War 
           Veterans of the USA; Carl Blake, Legislative Director, 
           Paralyzed Veterans of America; Rick Weidman, Director 
           of Government Relations, Vietnam Veterans of America, 
           Inc.; Raymond C. Kelley, National Legislative Director, 
           AMVETS (American Veterans); Joseph A. Violante, 
           National Legislative Director, Disabled American 
           Veterans; Hershel Gober, National Legislative Director, 
           Military Order of the Purple Heart of the USA; Dennis 
           Cullinan, Legislative Director, Veterans of Foreign 
           Wars of the United States.
                                  ____


 Explanatory Statement Submitted by Mr. Filner, Chairman of the House 
Committee on Veterans' Affairs, Regarding the Amendment of the House of 
          Representatives to the Senate Amendment to H.R. 1016


    VETERANS HEALTH CARE BUDGET REFORM AND TRANSPARENCY ACT OF 2009

       H.R. 1016, as amended, the ``Veterans Health Care Budget 
     Reform and Transparency Act of 2009,'' reflects a Compromise

[[Page 23786]]

     Agreement reached by the Senate and House Committees on 
     Veterans' Affairs (the Committees) on the following bills 
     reported during the 111th Congress: H.R. 1016, as amended 
     (House bill); S. 423 (Senate bill). H.R. 1016, as amended, 
     passed by the House of Representatives on June 23, 2009. The 
     text of S. 423 passed the Senate as a substitute amendment to 
     the House bill on August 6, 2009.
       The Committees have prepared the following explanation of 
     H.R. 1016, as further amended to reflect a compromise 
     agreement between the Committees (Compromise Agreement). 
     Differences between the provisions contained in the 
     Compromise Agreement and the related provisions of the Senate 
     Bill and the House Bill are noted in this document, except 
     for clerical corrections, conforming changes made necessary 
     by the Compromise Agreement, and minor drafting, technical, 
     and clarifying changes.
     Section 1. Short title
       Both the House bill (section 1) and the Senate bill 
     (section 1) would provide the short title as the ``Veterans 
     Health Care Budget Reform and Transparency Act of 2009.''
       The Compromise Agreement contains this provision.
     Section 2. President's budget submission
       The House bill (section 3) would amend section 1105 of 
     title 31, United States Code, to require the President to 
     submit information on the estimates of appropriations for the 
     fiscal year following the fiscal year for which the budget is 
     submitted for the Medical Services, Medical Support and 
     Compliance, Medical Facilities, Information Technology 
     Systems, and Medical and Prosthetic Research accounts of the 
     Department of Veterans Affairs.
       The Senate bill contains no similar provision.
       The Compromise Agreement contains the House provision but 
     modifies it to require information on the estimates for three 
     accounts: the Medical Services, Medical Support and 
     Compliance, and Medical Facilities accounts.
     Section 3. Advance appropriations for certain medical care 
         accounts of the Department of Veterans Affairs
       The House bill (section 4) would amend title 38, United 
     States Code, to add a new section providing authority, 
     beginning with fiscal year 2011, for the provision of advance 
     appropriations for the Medical Services, Medical Support and 
     Compliance, Medical Facilities, Information Technology 
     Systems, and Medical and Prosthetic Research accounts of the 
     Department of Veterans Affairs. The new section would require 
     the Department of Veterans Affairs to provide additional 
     detailed budget estimates in support of advance 
     appropriations for these accounts in the annual information 
     it provides to Congress in support of the Department's budget 
     request. The House bill would also require a report to be 
     submitted annually to Congress, no later than July 31 of each 
     year, on the sufficiency of the Department's resources for 
     the fiscal year beginning after the date of the submission of 
     the report for the provision of medical care and include 
     estimates of the workload and demand data for that fiscal 
     year.
       The Senate bill (section 3) would amend title 38, United 
     States Code, to add a new section providing that, beginning 
     with fiscal year 2011, new discretionary budget authority for 
     the provision of advance appropriations for the Medical 
     Services, Medical Support and Compliance, and Medical 
     Facilities accounts of the Department of Veterans Affairs, 
     shall be made available for the fiscal year involved, and 
     shall include new discretionary budget authority for such 
     accounts that become available for the first fiscal year 
     after such fiscal year.
       The Compromise Agreement contains the House provision 
     modified to include only the three accounts specified in the 
     Senate bill.
     Section 4. Comptroller General review of the accuracy of VA 
         medical care budget submissions in relation to baseline 
         health care model projection
       Both the House bill (section 5) and the Senate bill 
     (section 4) would provide for enhanced oversight of the 
     Department of Veterans Affairs budget process by requiring 
     the Comptroller General to conduct a study of the adequacy 
     and accuracy of baseline model projections for health care 
     expenditures. Both the House bill and Senate bill would 
     require the Comptroller General to submit reports on the 
     dates in 2011, 2012, and 2013 that the President submits a 
     budget request for the next fiscal year, to appropriate 
     Committees of Congress and to the Secretary of Veterans 
     Affairs, containing statements of whether the amounts 
     requested in the budget by the President are consistent with 
     anticipated expenditures for health care in such fiscal year 
     as determined utilizing the Enrollee Health Care Projection 
     Model, its equivalent, or other methodologies.
       The Compromise Agreement contains this provision modified 
     to require the annual reports to be submitted not later than 
     120 days after the submission of the President's budget and 
     to include an assessment of the review conducted by the 
     Comptroller General as to whether or not the relevant 
     components of the budget request are consistent with the 
     estimates of the Department of Veterans Affairs for the 
     provision of medical care and services. The Committees have 
     selected a 120-day deadline to give the Comptroller General 
     sufficient time to review the President's budget following 
     its submission and to, at the very least, inform the 
     deliberations of the House and Senate Appropriations 
     Committees prior to their consideration of VA appropriations 
     bills. However, it is the Committees' desire that, 
     notwithstanding the 120-day deadline, the reports under this 
     section be submitted as quickly as possible after submission 
     of the President's budget request so as to be useful by the 
     Committees in meeting their responsibilities under the 
     Congressional Budget Act of 1974 to provide views and 
     estimates on matters within their jurisdiction to the House 
     and Senate Budget Committees, as well as during deliberation 
     on annual Congressional budget resolutions.


                         PROVISIONS NOT ADOPTED

       Section 2 of the House bill would express the Sense of the 
     Congress that the provision of health care services to 
     veterans could be more effectively and efficiently planned 
     and managed if funding was provided for the management and 
     provision of such services in the form of advance 
     appropriations.
       Section 2 of the Senate amendment expresses Congressional 
     findings which support the need for enactment of advance 
     appropriations for VA medical care.

  Mr. Speaker, I reserve the balance of my time.
  Mr. BILIRAKIS. Mr. Speaker, I yield myself as much time as I may 
consume.
  I rise in support of House Resolution 804, a resolution providing for 
the concurrence by the House in the Senate amendment to H.R. 1016, with 
amendments.
  I want to thank my committee chair, Mr. Filner. With this important 
legislation, he responded to the needs of our veterans who depend on 
the Veterans Health Administration.
  This resolution represents an agreement between the Chambers and 
provides for advance appropriations authority for certain medical care 
accounts for the Department of Veterans Affairs. An advance 
appropriations means that Congress would approve funding for VA health 
care accounts 1 year in advance of the actual fiscal year in which the 
funding would become available.
  The impetus for this legislation is clearly evident as last week we 
began a new fiscal year with a continuing resolution, because once 
again Congress failed to pass the annual funding for veterans health 
care on time. In fact, VA has received a timely budget on only four 
occasions during the last 21 years.
  It is a disservice to our veterans and wounded warriors when 
legislative budgetary impasses delay funding and prevent VA from 
effectively planning for the day-to-day operations of its health care 
system.
  It is disappointing, however, that the compromise agreement would 
provide for advance appropriations for just three VA accounts, Medical 
Services, Medical Support and Compliance, and Medical Facilities. It 
should also include advance appropriations for the information 
technology account and medical and prosthetic research accounts.
  The former Chair and current ranking member of the VA Committee, 
Steve Buyer, made a strong argument that the IT and research accounts 
should be included in any advance appropriations because they are 
closely related to the previously mentioned accounts, and having 
separate funding mechanisms could lead to unintended consequences.
  The members of the VA Committee, including the chairman, recognized 
the importance of keeping the accounts together and included them in 
the House-passed bill.
  Adding the IT accounts was also a recommendation of the Secretary of 
Veterans Affairs, Eric Shinseki. Likewise the Congressional Research 
Service analysis of advance appropriations gave support to including 
both accounts. It is unfortunate that the House position did not 
prevail in the compromise agreement. Inclusion of these accounts would 
have greatly improved the bill by providing a more comprehensive 
funding method for veterans' medical care needs.
  Nonetheless, the legislation is a very positive development for the 
VA budgeting process. It will provide a procedure that could allow more 
predictable

[[Page 23787]]

funding. It would not guarantee the VA or Congress that we will get the 
amount of the veterans health care budget exactly right.
  We must continue to work hard for the benefit of our veterans to get 
the VA budget as close as possible to the intended results. 
Implementation of this legislation will require strong congressional 
oversight to ensure we meet our objectives.
  Mr. Speaker, this resolution is a new approach in trying to remove 
the uncertainty from veterans' health care and its funding, and is 
strongly supported, as the chairman said, by the Partnership for 
Veterans Health Care Budget Reform, a coalition of nine veterans 
service organizations.
  I want to congratulate the chairman, and I strongly urge my 
colleagues to support this resolution.
  I reserve the balance of my time.
  Mr. FILNER. As I yield 2 minutes to the gentleman from Maine (Mr. 
Michaud), I would just remind the gentleman from Florida that when the 
Senate saw that the prime mover of the amendment that put those two 
extra accounts in the bill was the only one in the House that voted 
against the bill that was sent to the Senate, they didn't take that too 
seriously. I just would remind the gentleman.
  Mr. MICHAUD. Thank you very much, Mr. Chairman.
  I rise in strong support of the Veterans Health Care Budget Reform 
and Transparency Act of 2009.
  I am here today as original cosponsor of this legislation. I would 
like to express my appreciation for all of the work that the chairman 
has done on this legislation bringing it to the floor.
  This bill accomplishes a simple but crucial goal that we all share, 
to provide family funding for veterans health care.
  I represent the State of Maine with 1.3 million people. Out of that 
number, 155,000 are veterans. Maine is a State that works hard to honor 
our veterans. The talented and dedicated professional workers at Togus 
VA Medical Center do a terrific job. So do our community-based 
outpatient clinics and all VA partners. But all too often the VA's 
ability to provide the best possible care has been hamstrung by the 
appropriations process. In some cases VA has not been funded until 
after the beginning of the fiscal year. As a result, maintenance of 
facilities, cost-saving investments in technology, and ultimately care 
for our veterans was delayed or put in jeopardy. This cannot be allowed 
to occur when we are dealing with our veterans' health care benefits.
  This is a bill that is timely. The bill will provide timely, 
sufficient and predictable funding streams for VA, and that is exactly 
what this legislation is designed to do.
  Passage of this legislation today is a huge step that will help make 
sure our veterans get access to the best possible care. I want to urge 
my colleagues to support it. I want to thank all the members of the 
Veterans' Affairs Committee for their willingness to move this 
legislation forward because it will make a difference in veterans' 
lives.
  Finally, I want to thank the veterans service organizations for all 
their tenacity and hard work in getting this legislation through the 
committee and through Congress.
  Mr. BILIRAKIS. I will continue to reserve.
  Mr. FILNER. Mr. Speaker, I would yield 2 minutes to the gentlewoman 
from Illinois (Mrs. Halvorson) who as a new Member has been an 
incredibly active and committed member of our committee.

                              {time}  1515

  Mrs. HALVORSON. Thank you, Mr. Chairman.
  I rise in support of passage of H.R. 1016, the Veterans Health Care 
Budget Reform and Transparency Act of 2009, which was introduced under 
the leadership of Chairman Filner. I want to thank Mr. Filner and the 
Subcommittee on Health chairman, Mr. Michaud, for their great 
leadership on this issue. This is an urgent issue for our country's 
veterans.
  Almost 5.5 million people received care in VA health care facilities 
in 2008, and the VA's outpatient clinics registered over 60 million 
visits. This is one of the largest health care providers in the 
country. However, in fiscal 2009, for only one of the third or fourth 
times in the past 20 years, the VA received its budget prior to the 
start of the new fiscal year. So it isn't reasonable to expect that one 
of the largest and fastest-growing health care providers in the country 
can operate in the most efficient and effective manner if they don't 
even know what their budget is going to be. So this situation harms the 
VA's ability to plan services and deliver quality health care.
  As we saw again this year, the VA will be forced to defer planning 
until Congress can complete its budget and appropriations work for the 
year. Medical staff cannot be hired, equipment cannot be procured, 
waiting times increase, and the quality of care suffers. So H.R. 1016 
will solve many of these problems by funding the VA 1 year in advance. 
This bill will help the VA spend taxpayer money more efficiently while 
at the same time providing better and more comprehensive care for our 
veterans. H.R. 1016 will make sure that the VA has the resources that 
it needs to provide quality care in a timely manner without having to 
question what funds will be available next month.
  So I'm here today in an attempt to serve our veterans' best interests 
and to fight to make sure that they receive the best care possible. I 
urge my colleagues to join me in accomplishing these goals by voting 
``yes'' on H.R. 1016, as amended.
  Mr. BILIRAKIS. I continue to reserve the balance of my time.
  Mr. FILNER. Mr. Speaker, I yield 3 minutes to another new Member who 
has been a great addition to our committee, the gentleman from New 
Mexico (Mr. Teague).
  Mr. TEAGUE. Mr. Speaker, I rise today to speak in support of H.R. 
1016, the Veterans Health Care Budget Reform and Transparency Act of 
2009. I would like to thank the distinguished gentleman from 
California, Bob Filner, for introducing this bill. I'm happy to be a 
cosponsor of the legislation, but it is through his leadership as 
chairman of the Committee on Veterans Affairs that we will finally be 
able to make advance appropriations of the VA's health budget a 
reality.
  It's not right that we lapse in our care for our veterans when they 
never lapsed in the defense of our country, and it's not right that out 
of the last 22 budgets that were passed for the VA, 19 have been late. 
Our veterans served their country and provided us the security we often 
take for granted, and we owe them quality health care.
  Without a predictable and on-time funding source, it is difficult, or 
impossible, for the VA to provide our veterans with the high level of 
health care and services they deserve. That is why I led 50 Members of 
Congress to demand a provision allowing for advance appropriations in 
the fiscal year 2010 budget, and we were fortunate enough to convince 
the Budget Conference Committee to support it.
  As a result of allowing for advance appropriations in the budget, the 
Appropriations Committee decided that the Military Construction and VA 
spending bill should contain $48.2 billion in advance appropriations 
for the VA for fiscal year 2011. This represents a 15 percent increase 
over fiscal year 2009 levels and a step in the right direction for 
veterans' health care.
  Many people have compared advance appropriations to a family budget. 
A family needs to know how much their income is before they know what 
they can spend. I think that about sums up why we need this bill. I 
think that it's about common sense and being responsible.
  As a businessman, I never tried to make a purchase without knowing 
what my budget was going to be. I had to plan ahead and have a roadmap 
for all of the company's finances. Because the VA is a direct provider 
of services, they need to have the same ability to plan ahead. It's 
about delivering a quality service for our veterans.
  I urge my colleagues to take this giant step in improving the VA's 
ability to deliver quality health care services to our Nation's 
veterans.
  Mr. BILIRAKIS. Mr. Speaker, I would ask if the gentleman from 
California has additional speakers.

[[Page 23788]]


  Mr. FILNER. I do have more speakers, yes.
  Mr. BILIRAKIS. I will continue to reserve the balance of my time.
  Mr. FILNER. How much time do I have left, Mr. Speaker?
  The SPEAKER pro tempore. The gentleman from California has 7 minutes 
remaining.
  Mr. FILNER. I yield 2 minutes to another new member of our committee 
who has, again, given us a great commitment and energy to the cause of 
veterans, the gentleman from Virginia (Mr. Nye).
  Mr. NYE. Mr. Speaker, I would like to thank Chairman Filner for his 
leadership on this issue and also Chairman Michaud. I am proud to rise 
in support of this legislation that will bring a commonsense solution 
to a long-standing problem.
  For far too long, the VA health care system has been plagued with 
budgets that were too little, too late. Insufficient funding for 
veterans' health care leads to waiting lists, delayed care and veterans 
being turned away from VA hospitals and clinics. Underfunding threatens 
the very quality of care that the VA has worked so hard to achieve.
  But just as important as how much funding the VA receives is when the 
VA receives that funding. With just three exceptions, the budget has 
been late for 20 of the past 23 years, this year included. When funding 
is late, the budget levels are uncertain, and it makes it harder to 
plan ahead for the needs of our veterans.
  H.R. 1016 will solve this problem by authorizing VA's medical care 
budget in advance. Moreover, to help ensure that we have sufficient 
funding, H.R. 1016 adds transparency to the budget process by requiring 
the Government Accountability Office to audit the VA's internal budget. 
This way, we can see if the budget request accurately reflects the 
projected needs of our veterans.
  Mr. Speaker, the commitment of our men and women in uniform does not 
stop at the end of the fiscal year nor do the needs of our veterans. 
Our soldiers, sailors, airmen and marines stand ready to defend our 
Nation whenever they are called upon. We can plan for the future 
security of the United States because we know that our troops will be 
there. We owe them that same commitment in return.
  The passage of this legislation is critical to ensure that our 
veterans receive their benefits on time, and it will allow the VA to 
plan ahead to meet the needs of the new veterans returning home each 
day from Iraq and Afghanistan. No longer can we allow the care of our 
Nation's veterans to be affected by the unstable budgetary process.
  I am proud to support this legislation. I urge my colleagues to do 
the same.
  Mr. BILIRAKIS. I will continue to reserve the balance of my time, Mr. 
Speaker.
  Mr. FILNER. I yield myself 30 seconds just to say something I forgot 
when I introduced the gentleman from Maine (Mr. Michaud).
  In this process, there was a time when the executive branch seemed to 
waiver in its commitment to this effort, and Mr. Michaud's tenacity and 
his steadfast support of this makes sure that we continue down this 
path. I want to thank him for doing that.
  I yield as much time as he may consume to Mr. Hare from Illinois, a 
former member of the committee, who I wish was still on our committee.
  Mr. HARE. Mr. Speaker, I rise in strong support of H.R. 1016, the 
Veterans Health Care Budget Reform and Transparency Act of 2009. I 
would like to thank Chairman Filner for introducing this very important 
bill.
  In the 110th Congress, we gave the VA its largest funding increase in 
77 years, and we gave it to them on time; but sadly, punctual VA 
funding has not always been the case. The VA received its annual 
funding for health care programs late in 19 of the last 22 years. This 
record of tardiness is deplorable. With the ongoing wars in Iraq and 
Afghanistan, the time to fix the broken system is now.
  Late funding is more than a missed deadline. It is a veteran with 
posttraumatic stress disorder who cannot access the treatment that he 
or she needs. It's an injured hero who must wait for a prosthetic. It 
is the VA in disarray at a time when our wounded warriors are counting 
on the Department's services. That is why, in the last Congress, I 
introduced the Assured Funding for Veterans Health Care Act.
  Like the bill I introduced, advance appropriations is a means to an 
end. That end is ensuring veterans receive the best care possible from 
a VA that has access to timely, sufficient, and predictable resources. 
The legislation we are considering today will do just that. It will 
allow the VA to effectively budget and manage its health care programs 
and services, meaning it can hire the appropriate number of doctors, 
nurses, clinicians, and support staff to meet the demand for high-
quality medical care for our Nation's veterans. Anything less is 
unacceptable.
  I would also like to acknowledge and commend Chairmen Obey and 
Edwards for their strong proactive leadership in putting in an advance 
appropriation for VA health care in the fiscal year 2010 Military 
Construction and Veterans Affairs Appropriations bill. The bill that 
we're voting on today has been slightly amended from a version which 
the House passed earlier this Congress by a margin of 409-1. I 
enthusiastically support H.R. 1016.
  I want to once again thank Chairman Bob Filner for drafting a bill 
that will ensure that the VA has sufficient, timely, and predictable 
funding.
  Mr. Speaker, I urge all my colleagues to support this legislation.
  Mr. BILIRAKIS. Mr. Speaker, this compromise agreement will finally 
provide advance appropriations beginning for the fiscal year 2011 for 
three VA medical accounts. Although I prefer the House version of the 
bill, I think this is a great advancement, and I will congratulate the 
chairman and members of the VA Committee for a great job.
  I urge my colleagues to vote for H.R. 1016, as amended.
  I yield back the balance of my time.


                             General Leave

  Mr. FILNER. Mr. Speaker, I thank the gentleman from Florida for those 
words of support, and 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 House Resolution 804.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from California?
  There was no objection.
  Mr. FILNER. Mr. Speaker, this is a unique solution for a unique 
population, our veterans. Again, I want to thank the Disabled American 
Veterans and all of the members of the coalition who are watching this 
on television or in the gallery today for working so hard to come up 
with this unique approach. It is an incredibly good solution to what we 
saw as a real problem. It took creativity, it took commitment, and it 
took sticktuitiveness to get this done. I tell you, we would not have 
been here without the coalition's work. So I urge all my colleagues to 
adopt this legislation.
  Mrs. KIRKPATRICK of Arizona. Mr. Speaker, as a member of the House 
Committee on Veterans' Affairs, I am proud to have been an early co-
sponsor of the Veterans Health Care Budget Reform and Transparency 
Act--a landmark piece of legislation which would require Congress to 
approve the Department of Veterans Affairs health care budget one year 
in advance.
   Imagine being the sole breadwinner in your house and not knowing 
your annual salary until well after that year started. As you are 
forced each year to guess, you might alternate between underspending 
and overspending, between scrimping and splurging.
   Now imagine that rather than the head of a small family, you were 
the VA.
   The VA--despite its size and its undeniably important mission to 
fulfill our Nation's most sacred promise--has received its 
appropriation after the start of the fiscal year in 18 out of the last 
21 years, including, now, this fiscal year.
   The VA employs well over 250,000 staff nationwide, with more than 
222,000 of those employees directly supporting the VA's health care 
system serving 5.6 million unique patients. Last year, the Veterans 
Health Administration spent approximately $43.5 billion on medical care 
and research. These numbers make the VA the second largest agency in 
the federal government after the Department of Defense, and make the 
VHA both the Nation's

[[Page 23789]]

largest health care delivery system as well as its largest provider of 
health care education and training.
   The late appropriations and insufficient budgets have meant 
restricted access for many Veterans. When funding is short, late, or 
unpredictable, it is our Veterans who pay the price.
   Veterans in Greater Arizona are keenly aware that we need more 
medical facilities and the claims backlog is keeping many Veterans from 
the benefits they have earned. But once inside the VHA, there is no 
denying that the quality of service is very good. Numerous third party 
sources, including both the New England Journal of Medicine and Annals 
of Medicine, have concluded that the quality of care in the VA health 
care system is among the best available publicly or privately in the 
Nation.
   However, its sheer size has amplified the problems stemming from 
late appropriations, which lead to rationed care, waiting lists and 
Veterans being turned away from service.
   As Iraq and Afghanistan Veterans return and Veterans from prior 
conflicts continue to age, the number of those who need care will only 
increase, and the situation will become more critical.
   It is heartening, then, that those who support the Veterans Health 
Care Budget Reform and Transparency Act are also increasing in number. 
General Eric Shinseki, voiced his support for advance appropriations 
shortly after becoming the Secretary of Veterans Affairs. The American 
Federation of Government Employees, which represents many of the 
federal employees who work for the VA, also supports the bill, as does 
the Partnership for Veterans Health Care Budget Reform--a coalition of 
eleven Veterans service organizations representing millions of 
Veterans, servicemembers, spouses and survivors.
   In my short time on the House Committee on Veterans' Affairs, we 
have made great strides toward a budget that lives up to the sacrifices 
of our Veterans. We voted to increase the budget for the VA by $5.6 
billion--an increase of 11.7% for Veterans health care and other 
programs. We ensured that Veterans are given their fair share of the 
American Recovery and Reinvestment Act, providing $1.4 billion for 
maintenance at VA medical facilities, construction of Veterans' 
extended care facilities, and Veteran cemetery repairs, as well as 
providing one-time payments of $250 to disabled veterans.
   However, we still struggle to provide sufficient, timely, and 
predictable funding for our Veterans. When the Veterans Health Care 
Budget Reform and Transparency Act arrives at the floor of the House, I 
would urge all Members of the Arizona delegation and from all across 
the Nation to support it to ensure Veterans can get the care they have 
earned.
  Ms. WATERS. Mr. Speaker, I rise in support of H.R. 1016--To amend 
title 38, United States Code, to provide new discretionary budget 
authority for certain medical care accounts of the Department of 
Veterans Affairs. This bill would ensure sufficient, timely, and 
predictable veterans funding so that the Department of Veterans Affairs 
would have the Federal funding to better serve veterans' medical needs 
and improve health care services. This is a very timely and important 
measure as many of our troops today are returning home in need of 
accessible and adequate health care services. Therefore, I strongly 
commend my colleague Bob Filner for bringing this measure before the 
floor.
  This bill provides for a new two-fiscal-year discretionary budget 
authority for three critical accounts of the Department of Veterans 
Affairs: medical services, medical support and compliance, and medical 
facilities. Accordingly, this measure will give the Department of 
Veterans Affairs sufficient time to effectively plan how it will 
deliver the best care to a growing number of veterans with increasingly 
complex medical conditions. And to ensure that the funds are being used 
appropriately, H.R. 1016 requires the United States Comptroller General 
to conduct a study to determine the adequacy and accuracy of the 
department's budget model projections.
  My military constituents often turn to me for support in confronting 
the many challenges they face when working with the Department of 
Veterans Affairs. We have come to understand, that many of the 
challenges in efficient health care services are attributable to the 
Department of Veterans Affairs' inadequate funding. Over the last two 
decades, the appropriated funds for medical care have not been provided 
to the Department of Veterans Affairs in a timely manner. This has 
resulted in the department's problems in planning and managing care for 
enrolled veterans. Accordingly, this bill addresses this budgetary 
problem and allows for advance appropriations to ensure the department 
has the Federal backing to effectively address the medical needs of our 
Nation's veterans.
  As a vocal advocate for veterans' rights, I am pleased to add my 
voice of support for H.R. 1016. I look forward to working with my 
colleagues to ensure that we continue to provide the necessary 
resources towards improving our Department of Veterans Affairs' health 
care programs and administrative services.
  Mr. FILNER. 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 agree to the resolution, H. Res. 804.
  The question was taken.
  The SPEAKER pro tempore. In the opinion of the Chair, two-thirds 
being in the affirmative, the ayes have it.
  Mr. FILNER. Mr. Speaker, on that I demand the yeas and nays.
  The yeas and nays were ordered.
  The SPEAKER pro tempore. Pursuant to clause 8 of rule XX and the 
Chair's prior announcement, further proceedings on this motion will be 
postponed.

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