[Congressional Record (Bound Edition), Volume 155 (2009), Part 20]
[House]
[Pages 27129-27131]
[From the U.S. Government Publishing Office, www.gpo.gov]




                              HEALTH CARE

  The SPEAKER pro tempore. Under a previous order of the House, the 
gentleman from Indiana (Mr. Buyer) is recognized for 5 minutes.
  Mr. BUYER. Mr. Speaker, the President and the Democrat leaders here 
in Congress are not listening to the American people. Today, our 
Nation's unemployment rate is 10.2 percent, the highest level in 26 
years. This is an astounding level of unemployment. It tells only part 
of the story of the struggles Americans are experiencing and Washington 
is ignoring.
  A deeper look at the unemployment numbers reveals the true costs of 
the Obama-Pelosi economic policies. The actual unemployment rate in 
America is 17.5 percent. When the currently unemployed, those who are 
unable to find work and those who have given up looking for jobs are 
included, it is 17.5 percent unemployment.
  We must focus on the economy first. We should start by cutting 
government spending to shore up the U.S. dollar. We should encourage 
job creation in the private sector and increase private investment. We 
must rely on the proven methods to get our economy back on track such 
as an immediate tax relief, decreasing the capital gains tax rates, and 
reducing the tax burdens on small business.
  We are living in an economy in despair as we face a two-front war. 
The President needs to address the economy first; and, as Commander in 
Chief, he needs to make a decision on Afghanistan.
  Mr. President, you cannot vote ``present'' on Afghanistan. You need 
to make a decision.
  Instead, he and the Democrat leadership are jamming legislation 
through Congress with massive spending increases, bailouts, greater 
government control of businesses, and job-destroying taxes and 
regulations, all while leaving our troops in limbo in Afghanistan.
  Washington has it all wrong. Unfortunately, the President, Speaker 
Pelosi, and Senate Leader Reid are proceeding with a 2,032-page bill 
that promotes the government takeover of health care; and most 
Republicans have been shut out of the process.
  With little room for engagement, though, I have been successful to 
help improve a bill that I do not like. I have done this for a reason. 
It is because of our veterans. I have been able to provide important 
protections for our veterans and servicemembers who would have been 
significantly impacted by this health bill had the Democrats had their 
way at the beginning. I have been

[[Page 27130]]

able to ensure that the veterans enrolled in VA health care cannot be 
hit with a 2.5 percent tax. Also, I sought to ensure that the VA is 
reimbursed by the government-run health plan for nonservice-connected 
care it provides to the veterans. I appreciate them including these 
amendments.
  After succeeding with an amendment to ensure veterans and 
servicemembers have the ability to obtain additional health care in the 
health insurance exchange created by H.R. 3962, my amendment was 
altered; and, under H.R. 3962, veterans' and servicemembers' choice of 
health insurance will be left to the administration to determine.
  Again today I tried to fix this with an amendment, but it was denied 
in the Rules Committee. A number of veterans and military groups, 
including the VFW, share these concerns and support the amendment that 
I submitted to the Rules Committee today. I will include for the Record 
the letters from the AMVETS, Blinded Veterans Association and the 
Retired Enlisted Association.

                              {time}  1945

  Our veterans and military organizations in support of the Buyer-
McKeon amendments are the VFW, the Air Force Sergeants Association, 
MOAA, the Association of the United States Army, National Military 
Family Association, and the Enlisted Army National Guard, U.S.
  Also, there are Members who are cosponsoring these amendments: Jerry 
Moran of Kansas, Henry Brown of South Carolina, Jeff Miller of Florida, 
Brian Bilbray of California, Doug Lamborn of Colorado, Gus Bilirakis of 
Florida, Dr. Phil Roe of Tennessee, Vern Buchanan of Florida, and 
Rodney Alexander of Louisiana.
  Our veterans have earned the VA health care as well as the liberty to 
choose whatever other coverage they prefer. I find it outrageous that 
the government would attempt to dictate where and how these veterans 
and servicemembers would obtain health care.
  Additionally, under H.R. 3962, the authorities of the VA and DOD 
Secretaries are jeopardized, and the health care systems that they 
oversee could be affected by the new health care czar created in all 
but one section of this bill. Again, the Democrat leadership has not 
addressed this issue that I sought to address, and these amendments 
have been denied today.
  As the Blinded Veterans Association stated in their letter to me: 
``It is critical to ensure that the authority of the Secretary of the 
VA and the Secretary of DOD could never be challenged or obstructed by 
any provision in the bill or by a Secretary or a commissioner from 
another sector of government.''
  Finally, it is important to note that under H.R. 3962, veterans and 
servicemembers enrolled in VA health care and TRICARE will not be 
eligible for the affordable tax credits . . . available to other 
Americans living under 400% of the federal poverty level. I submitted 
an amendment, which would have allowed individuals enrolled in VA 
health care and TRICARE to receive these tax credits, and this 
amendment was denied consideration by the Democrats.
  I oppose H.R. 3962. This legislation restricts veterans' health care 
options and imposes a sweeping government takeover of our nation's 
health care system, and I support the Republican plan to improve our 
nation's health care and lower premiums, thereby increasing access to 
quality healthcare.
  According to the non-partisan Congressional Budget Office (CBO), the 
Republican health care reform legislation would reduce health insurance 
premiums by up to 10 percent for employees working in small businesses, 
up to 8 percent for individuals who do not have access to employer-
provided health insurance and up to 3 percent for employees who get 
coverage through large businesses.
  All told, under the Republican plan, health insurance premiums would 
cost Americans nearly $5,000 less than the least costly option under 
Speaker Pelosi's plan. All of this without a government takeover of our 
health care system and \1/6\ of our nation's economy.
  The Democrats' plan is not about insuring the uninsured or bringing 
down health care costs. In fact, under Democrat proposals in Congress, 
up to 114 million Americans could lose the private health insurance 
that they enjoy today, and CBO found that the House Democrats' bill 
will make health insurance more expensive than it is now, raising 
insurance premiums about 30 percent more than currently projected by 
the year 2016.
  We must focus on the uninsured and the uninsurable. The Republican 
health care plan does just that by creating new health insurance 
options for small businesses--the economic engines of our economy--
enacting real medical liability reform so that physicians can continue 
to focus on their patients and not junk lawsuits, guaranteeing 
affordable health insurance for individuals with preexisting 
conditions, protection seniors' Medicare benefits, and lowering health 
care premiums for all Americans.
  Our nation's health care system can be improved without increasing 
taxes and jeopardizing the jobs we still have in America. The President 
and Democrat leadership in Congress must reorganize their priorities. 
They must stop focusing on job-killing policies. It is time to start 
listening to Americans and fix our economy first.

                                                       AMVETS,

                                     Lanham, MD, November 6, 2009.
     Congressman Steve Buyer,
     Rayburn House Office Building,
     Washington, DC.
       Congressman Buyer: On behalf of AMVETS, one of the nation's 
     largest and most inclusive veterans' service organizations, I 
     want to express our support for your amendments to H.R. 3962, 
     the Affordable Health Care for America Act.
       Since health care reform legislation was first introduced, 
     AMVETS has vocally called on leaders in Congress to ensure 
     that any reform legislation would not have a negative impact 
     on health care options for members of our military, veterans, 
     or their loved ones. AMVETS believes that your amendments 
     help to ensure that those who have served our nation are 
     cared for appropriately.
       When the most recent version of health care reform was 
     released, AMVETS raised concerns on the clarity of the 
     language and whether or not veterans and their loved ones 
     would still have access to the health care exchange, should 
     VA and military health care prove insufficient for their 
     needs.
       AMVETS believes that the three amendments you have offered 
     today help to clarify language in the bill that members of 
     the military and veterans will still have access to the 
     exchange without penalty.
       AMVETS fully supports your amendments to ensure that our 
     nation's heroes have access to the quality health care they 
     have earned.
           Sincerely,
                                                Raymond C. Kelley,
     National Legislative Director.
                                  ____



                                 Blinded Veterans Association,

                                 Washington, DC, November 6, 2009.
     Hon. Steve Buyer,
     Ranking Member, Committee on Veterans Affairs, Cannon House 
         Building, Washington, DC.
       Dear Ranking Member Buyer: On behalf of the Blinded 
     Veterans Association (BVA), the only congressionally 
     chartered veterans' service organization exclusively 
     dedicated to serving the needs of our nation's blinded 
     veterans and their families for sixty-four years, BVA is 
     writing to express strong concerns about H.R. 3962, America's 
     Affordable Health Choices Act of 2009. As currently drafted, 
     without your amendments BVA would consider this legislation 
     inadequate because it could limit the health care choices for 
     veterans, and threaten veterans who currently utilize the 
     high quality of VA health care offered to veterans through 
     the VA health care system by forcing them into private 
     insurance plans. Earlier this year, BVA along with five other 
     congressionally chartered veterans service organizations 
     wrote to support your amendments and serious concerns about 
     provisions contained in the previous House health care reform 
     bill, H.R. 3200 that could have had negative effects on 
     veterans, their families, and the Department of Veterans 
     Affairs health care system. BVA and other VSO's had been 
     assured that key amendments by you including protection of 
     veterans enrolled in VA would be retained as the bill moved 
     forward and this is not the case today.
       The Veterans Health Administration (VHA) provides medical 
     care services to its 8 million enrolled veterans at more than 
     1,400 medical centers, outpatient clinics and other points of 
     service. With over 270,000 employees, the VHA runs the 
     largest integrated health care system in the United States, 
     and over the past decade the quality of care provided has 
     risen to amongst the finest health care systems in the 
     nation. Under H.R. 3962, VA health care and TRICARE would be 
     deemed ``qualified'' coverage but we point to this section as 
     now written as it is ambiguous and could be interpreted to 
     disqualify individuals enrolled in VA health care or TRICARE 
     from participating in the exchange. This amendment was 
     accepted at the Energy and Commerce Committee, but it failed 
     to be included H.R. 3962.
       It is critical that congress ensure in the current health 
     care reform effort to ensure that the authority of the 
     Secretary of VA and Secretary of DOD could never be 
     challenged or obstructed by any provision in the

[[Page 27131]]

     bill or by a secretary or commissioner from another sector of 
     government. As currently written, H.R. 3962, would provide 
     for the Secretary of Defense and the Secretary of VA to 
     retain sole authority over their respective health care 
     systems only as it pertains to Subtitle A, the Health 
     Insurance Exchange. The original Buyer Amendment adopted in 
     Energy and Commerce Committee did this but the current 
     legislation leaves this open and vague. Second key issue we 
     support being amended is in section 342 of the bill to allow 
     individuals enrolled in VA health care and TRICARE to be 
     eligible for affordable tax credits. Currently, H.R. 3962 
     defines an ``affordable credit eligible individual'' as one 
     who is not enrolled in acceptable coverage--which would 
     exclude individuals enrolled in VA health care or TRICARE.
       Unfortunately, as currently drafted, H.R. 3962 fails to 
     adequately recognize, protect or preserve this invaluable 
     system for our nation's 24 million veterans. BVA once again 
     supports Ranking Member Buyer amendments to ensure that 
     veterans are protected. Enrollment in VA health care, 
     especially in the case of service-connected disabled 
     veterans, should never become a bar or obstacle to the 
     receipt of benefits that non-veteran citizens receive in this 
     or any other health care reform bill. Any national health 
     reform legislation must make certain that all veterans, 
     including all of those enrolled in VA health care, remain 
     eligible to enroll in any Exchange-participating health 
     benefits plan offered under H.R. 3200 through the Health 
     Insurance Exchange, or in any other public or cooperative 
     health insurance program.
       The VHA provides a uniform medical benefits package to all 
     enrolled veterans, regardless of their enrollment priority 
     group, that emphasizes preventive and primary care, and 
     offers a full range of outpatient and inpatient services and 
     prescription medications. Accordingly, enrollment in the VHA 
     health care program must be considered acceptable coverage in 
     the same manner as members of the uniformed services and 
     their dependents, including Civilian Health and Medical 
     Program of the VA (CHAMPVA) coverage furnished under section 
     1781 of title 38 United States Code, so that they will not be 
     subject to any tax or penalty for lack of health care 
     coverage.
       Finally, BVA would stress again, that it is imperative that 
     any other health care reform legislation considered in 
     Congress, must make clear that the health care system of the 
     Department of Veterans Affairs shall be run by the Secretary 
     of Veterans Affairs to meet the health care needs of 
     veterans, dependents and survivors, and that this authority 
     shall not be infringed by any national health care 
     organizations or any other departments, agencies or 
     independent organizations of the federal government.
       Ranking Member Buyer on behalf of the Blinded Veterans 
     Association membership we represent, and for the benefit of 
     the millions of veterans living today and future veterans, we 
     support the amendments you are offering today with your 
     colleagues to clarify the current language in H.R. 3962 to 
     protect the health care system of our veterans. Unless the 
     changes and clarifications discussed above are made in the 
     legislation, we will oppose movement of H.R. 3962 or any 
     other legislation that could negatively impact the current 
     health care system for our nation's veterans.
           Sincerely,
                                                  Thomas Zampieri,
     Director, Government Relations.
                                  ____



                             The Retired Enlisted Association,

                                 Alexandria, VA, November 6, 2009.
     Hon. Steve Buyer,
     Ranking Member, Committee on Veterans Affairs, House of 
         Representatives, Washington, DC.
       Dear Congressman Buyer: The Retired Enlisted Association 
     (TREA) shares the concern that H.R. 3962 does not ensure that 
     veterans and TRICARE beneficiaries would have access to the 
     Health Care Exchange, and that the same beneficiaries would 
     be excluded from eligibility for ``affordability credits''. 
     Thus, we do support amendments to the bill that would address 
     these concerns.
       While it is no doubt true that most veterans and TRICARE 
     beneficiaries would not have a problem if the legislation 
     were enacted as it currently stands, those who live in remote 
     areas could find themselves in dire straits with regard to 
     their health care without the changes you seek. These are 
     precisely the people who frequently have difficulty in 
     accessing the health care benefits which they have earned and 
     have just as much right to as every other veteran or TRICARE 
     beneficiary.
       Finally, we recommend that the language you propose to 
     insert at the end of section 202 be changed from ``EXCEPTION 
     FOR VETERANS AND MEMBERS OF THE ARMED FORCES'' to ``EXCEPTION 
     FOR VETERANS AND MEMBERS OF THE UNIFORMED SERVICES'' NOAA and 
     USPHS members are not considered to be members of the Armed 
     Forces but are TRICARE beneficiaries.
           Sincerely,
                                                    Larry Madison,
     Legislative Director.

                          ____________________