[Congressional Record (Bound Edition), Volume 158 (2012), Part 12]
[Senate]
[Pages 17094-17097]
[From the U.S. Government Publishing Office, www.gpo.gov]




     WOMEN VETERANS AND OTHER HEALTH CARE IMPROVEMENTS ACT OF 2012

  Mrs. MURRAY. Mr. President, I ask unanimous consent that the Senate 
proceed to the consideration of Calendar No. 564, S. 3313.
  The PRESIDING OFFICER. The clerk will report the bill by title.
  The bill clerk read as follows:

       A bill (S. 3313) to amend title 38, United States Code, to 
     improve the assistance provided by the Department of Veterans 
     Affairs to women veterans, to improve health care furnished 
     by the Department, and for other purposes, which had been 
     reported from the Committee on Veterans' Affairs, with an 
     amendment to strike all after the enacting clause and insert 
     in lieu thereof the following:

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Women Veterans and Other 
     Health Care Improvements Act of 2012''.

[[Page 17095]]



     SEC. 2. CLARIFICATION THAT FERTILITY COUNSELING AND TREATMENT 
                   ARE MEDICAL SERVICES WHICH THE SECRETARY MAY 
                   FURNISH TO VETERANS LIKE OTHER MEDICAL 
                   SERVICES.

       Section 1701(6) of title 38, United States Code, is amended 
     by adding at the end the following new subparagraph:
       ``(H) Fertility counseling and treatment, including 
     treatment using assisted reproductive technology.''.

     SEC. 3. REPRODUCTIVE TREATMENT AND CARE FOR SPOUSES AND 
                   SURROGATES OF VETERANS.

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

     ``Sec. 1788. Reproductive treatment and care for spouses and 
       surrogates of veterans

       ``(a) In General.--The Secretary shall furnish fertility 
     counseling and treatment, including through the use of 
     assisted reproductive technology, to a spouse or surrogate of 
     a severely wounded, ill, or injured veteran who has an 
     infertility condition incurred or aggravated in line of duty 
     in the active military, naval, or air service and who is 
     enrolled in the system of annual patient enrollment 
     established under section 1705(a) of this title if the spouse 
     or surrogate and the veteran apply jointly for such 
     counseling and treatment through a process prescribed by the 
     Secretary.
       ``(b) Coordination of Care for Other Spouses and 
     Surrogates.--In the case of a spouse or surrogate of a 
     veteran not described in subsection (a) who is seeking 
     fertility counseling and treatment, the Secretary may 
     coordinate fertility counseling and treatment for such spouse 
     or surrogate.
       ``(c) Construction.--Nothing in this section shall be 
     construed to require the Secretary to find or certify a 
     surrogate for a veteran or to connect a surrogate with an 
     injured veteran.''.
       (b) Clerical Amendment.--The table of sections at the 
     beginning of chapter 17 of such title is amended by inserting 
     after the item relating to section 1787 the following new 
     item:

``1788. Reproductive treatment and care for spouses and surrogates of 
              veterans.''.

     SEC. 4. ADOPTION ASSISTANCE.

       (a) In General.--Subchapter VIII of chapter 17 of title 38, 
     United States Code, as amended by section 3, is further 
     amended by adding at the end the following new section:

     ``Sec. 1789. Adoption assistance

       ``(a) In General.--The Secretary may pay an amount, not to 
     exceed the limitation amount, to assist a covered veteran in 
     the adoption of one or more children.
       ``(b) Covered Veteran.--For purposes of this section, a 
     covered veteran is any severely wounded, ill, or injured 
     veteran who--
       ``(1) has an infertility condition incurred or aggravated 
     in line of duty in the active military, naval, or air 
     service; and
       ``(2) is enrolled in the system of annual patient 
     enrollment established under section 1705(a) of this title.
       ``(c) Limitation Amount.--For purposes of this section, the 
     limitation amount is the amount equal to the lesser of--
       ``(1) the cost the Department would incur if the Secretary 
     were to provide a covered veteran with one cycle of in vitro 
     fertilization, as determined by the Secretary; and
       ``(2) the cost the Department would incur by paying the 
     expenses of three adoptions by covered veterans, as 
     determined by the Secretary.''.
       (b) Clerical Amendment.--The table of sections at the 
     beginning of chapter 17 of such title, as amended by section 
     3, is further amended by inserting after the item relating to 
     section 1788 the following new item:

``1789. Adoption assistance.''.

     SEC. 5. REPORT ON PROVISION OF FERTILITY COUNSELING AND 
                   TREATMENT.

       (a) In General.--Each year, the Secretary of Veterans 
     Affairs shall submit to the Committee on Veterans' Affairs of 
     the Senate and the Committee on Veterans' Affairs of the 
     House of Representatives a report on the fertility counseling 
     and treatment furnished by the Department of Veterans Affairs 
     during the year preceding the submittal of the report.
       (b) Elements.--Each report submitted under subsection (a) 
     shall include, for the period covered by the report, the 
     following:
       (1) The number of veterans who received fertility 
     counseling or treatment furnished by the Department of 
     Veterans Affairs, disaggregated by era of military service of 
     such veterans.
       (2) The number of spouses and surrogates of veterans who 
     received fertility counseling or treatment furnished by the 
     Department.
       (3) The cost to the Department of furnishing fertility 
     counseling and treatment, disaggregated by cost of services 
     and administration.
       (4) The average cost to the Department per recipient of 
     such counseling and treatment.
       (5) In cases in which the Department furnished fertility 
     treatment through the use of assisted reproductive 
     technology, the average number of cycles per person 
     furnished.
       (6) A description of how fertility counseling and treatment 
     services of the Department are coordinated with similar 
     services of the Department of Defense.

     SEC. 6. REGULATIONS ON FURNISHING OF FERTILITY COUNSELING AND 
                   TREATMENT AND ADOPTION ASSISTANCE.

       (a) In General.--Not later than 540 days after the date of 
     the enactment of this Act, the Secretary of Veterans Affairs 
     shall prescribe regulations--
       (1) on the furnishing of fertility treatment to veterans 
     using assisted reproductive technology;
       (2) to carry out section 1788 of title 38, United States 
     Code, as added by section 3; and
       (3) to carry out section 1789 of such title, as added by 
     section 4.
       (b) Limitation.--Notwithstanding any other provision of 
     law, during the period beginning on the date of the enactment 
     of this Act and ending on the date on which the Secretary 
     prescribes regulations under subsection (a), the Secretary 
     may not furnish--
       (1) to any veteran, any fertility treatment using assisted 
     reproductive technology;
       (2) any fertility counseling or treatment under section 
     1788 of title 38, United States Code, as added by section 3; 
     or
       (3) any assistance under section 1789 of such title, as 
     added by section 4.

     SEC. 7. COORDINATION WITH DEPARTMENT OF DEFENSE ON FURNISHING 
                   OF FERTILITY COUNSELING AND TREATMENT.

       The Secretary of Veterans Affairs shall coordinate the 
     furnishing of fertility counseling and treatment by the 
     Department of Veterans Affairs with the furnishing of 
     fertility counseling and treatment by the Department of 
     Defense.

  Mr. COCHRAN. Mr. President, I will not object to the request made by 
the Senior Senator from Washington, and I do not object to the policy 
provisions in this bill. However, I must point out that this bill 
indiscriminately diverts Overseas Contingency Operations funds, which 
are necessary to ensure resources, equipment, and supplies are 
available to our servicemembers deployed across the globe. This is not 
how the provisions of this bill should be paid for. Taking away funds 
intended for our men and women who are currently serving could, in 
time, place some of the veterans that this bill intends to help at 
greater risk. This legislation could also divert funding intended for 
the security of our Ambassadors, Foreign Service Officers, and other 
State Department officials, placing them at additional risk.
  Quality healthcare for those who have honorably served our country is 
something that I think all Senators, including me, support. If the 
provisions of this legislation are a priority for this body, we should 
be deliberate in determining how we should pay for them. The Senior 
Senator from Washington has put forward a thoughtful bill that merits 
consideration, but I think this body would prefer to consider other 
means to pay for new programs that do not divert funds intended to keep 
our troops well-equipped and safe.
  Mr. McCAIN. Mr. President, I do not intend to object to the request 
of the Senator from Washington, and I do not object to the policy 
provision of this bill at this time. But I strongly object to the 
Senator seeking to fund these new veterans benefits out of the 
Department of Defense budget that funds the needs of our military men 
and women serving in combat overseas.
  The cost of Senator Murray's bill, provided by the Congressional 
Budget Office, is $568 million over 5 years. To cover that cost, 
Senator Murray proposes to strip $568 million from wartime funding for 
troops in Afghanistan over the next 5 years without even considering 
the impact of that cut on their safety and security. This is 
preposterous. This bill assumes that Congress will still be passing 
emergency spending bills for Afghanistan 5 years from now, and somehow 
our troops will be able to bear the risk of having hundreds of millions 
siphoned from their critical needs for a program that has nothing to do 
with the war they are currently engaged in. Every dollar requested in 
the defense budget for our combat forces will be needed to keep them 
adequately equipped, armed, and engaged in defeating the enemy and 
coming home with honor.
  The proposed offset for this new program is an irresponsible budget 
gimmick designed to shift the funding burden for these new benefits 
from VA to DOD. Funding for the DOD Overseas Contingency Operations 
fund is within the jurisdiction of the Armed Services Committee, and 
should be considered by the full Senate, rather than slipped into a 
reported bill at the last minute without debate or discussion.
  I also am surprised that Senator Murray, a vocal supporter of 
improving the welfare of our troops, would actually propose cuts to 
funding for our combat troops without even assessing the impact of 
those cuts. The job of

[[Page 17096]]

making that assessment lies within the Armed Services Committee's 
jurisdiction, and I will seek to ensure that the Senate has an 
opportunity to make that assessment before passing any legislation that 
attempts to shift defense dollars from the direct combat needs of our 
Armed Forces to any new benefits or policies.
  Mrs. MURRAY. Mr. President, I ask unanimous consent that the 
committee-reported amendment be considered; the Murray amendment, which 
is at the desk, be agreed to; the committee-reported amendment, as 
amended, be agreed to; and that the bill, as amended, be read a third 
time.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The amendment (No. 3336) was agreed to, as follows:

                     Purpose: To provide an offset.

       At the end, add the following:

     SEC. 8. FUNDING.

       Amounts for a fiscal year to carry out this Act, section 
     7330B of title 38, United States Code, as added by section 
     2(a), section 1787 of such title, as added by section 4(a), 
     and the amendments made by this Act shall be derived from 
     amounts made available for an overseas contingency operation 
     in that fiscal year, if amounts were made available for an 
     overseas contingency operation in that fiscal year.

  The committee-reported amendment in the nature of a substitute, as 
amended, was agreed to.
  The bill (S. 3313), as amended, was ordered to be engrossed for a 
third reading and was read the third time.
  The PRESIDING OFFICER. The bill having been read the third time, the 
question is, Shall the bill pass?
  The bill (S. 3313), as amended, was passed, as follows:

                                S. 3313

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

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Women Veterans and Other 
     Health Care Improvements Act of 2012''.

     SEC. 2. CLARIFICATION THAT FERTILITY COUNSELING AND TREATMENT 
                   ARE MEDICAL SERVICES WHICH THE SECRETARY MAY 
                   FURNISH TO VETERANS LIKE OTHER MEDICAL 
                   SERVICES.

       Section 1701(6) of title 38, United States Code, is amended 
     by adding at the end the following new subparagraph:
       ``(H) Fertility counseling and treatment, including 
     treatment using assisted reproductive technology.''.

     SEC. 3. REPRODUCTIVE TREATMENT AND CARE FOR SPOUSES AND 
                   SURROGATES OF VETERANS.

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

     ``Sec. 1788. Reproductive treatment and care for spouses and 
       surrogates of veterans

       ``(a) In General.--The Secretary shall furnish fertility 
     counseling and treatment, including through the use of 
     assisted reproductive technology, to a spouse or surrogate of 
     a severely wounded, ill, or injured veteran who has an 
     infertility condition incurred or aggravated in line of duty 
     in the active military, naval, or air service and who is 
     enrolled in the system of annual patient enrollment 
     established under section 1705(a) of this title if the spouse 
     or surrogate and the veteran apply jointly for such 
     counseling and treatment through a process prescribed by the 
     Secretary.
       ``(b) Coordination of Care for Other Spouses and 
     Surrogates.--In the case of a spouse or surrogate of a 
     veteran not described in subsection (a) who is seeking 
     fertility counseling and treatment, the Secretary may 
     coordinate fertility counseling and treatment for such spouse 
     or surrogate.
       ``(c) Construction.--Nothing in this section shall be 
     construed to require the Secretary to find or certify a 
     surrogate for a veteran or to connect a surrogate with an 
     injured veteran.''.
       (b) Clerical Amendment.--The table of sections at the 
     beginning of chapter 17 of such title is amended by inserting 
     after the item relating to section 1787 the following new 
     item:

``1788. Reproductive treatment and care for spouses and surrogates of 
              veterans.''.

     SEC. 4. ADOPTION ASSISTANCE.

       (a) In General.--Subchapter VIII of chapter 17 of title 38, 
     United States Code, as amended by section 3, is further 
     amended by adding at the end the following new section:

     ``Sec. 1789. Adoption assistance

       ``(a) In General.--The Secretary may pay an amount, not to 
     exceed the limitation amount, to assist a covered veteran in 
     the adoption of one or more children.
       ``(b) Covered Veteran.--For purposes of this section, a 
     covered veteran is any severely wounded, ill, or injured 
     veteran who--
       ``(1) has an infertility condition incurred or aggravated 
     in line of duty in the active military, naval, or air 
     service; and
       ``(2) is enrolled in the system of annual patient 
     enrollment established under section 1705(a) of this title.
       ``(c) Limitation Amount.--For purposes of this section, the 
     limitation amount is the amount equal to the lesser of--
       ``(1) the cost the Department would incur if the Secretary 
     were to provide a covered veteran with one cycle of in vitro 
     fertilization, as determined by the Secretary; and
       ``(2) the cost the Department would incur by paying the 
     expenses of three adoptions by covered veterans, as 
     determined by the Secretary.''.
       (b) Clerical Amendment.--The table of sections at the 
     beginning of chapter 17 of such title, as amended by section 
     3, is further amended by inserting after the item relating to 
     section 1788 the following new item:

``1789. Adoption assistance.''.

     SEC. 5. REPORT ON PROVISION OF FERTILITY COUNSELING AND 
                   TREATMENT.

       (a) In General.--Each year, the Secretary of Veterans 
     Affairs shall submit to the Committee on Veterans' Affairs of 
     the Senate and the Committee on Veterans' Affairs of the 
     House of Representatives a report on the fertility counseling 
     and treatment furnished by the Department of Veterans Affairs 
     during the year preceding the submittal of the report.
       (b) Elements.--Each report submitted under subsection (a) 
     shall include, for the period covered by the report, the 
     following:
       (1) The number of veterans who received fertility 
     counseling or treatment furnished by the Department of 
     Veterans Affairs, disaggregated by era of military service of 
     such veterans.
       (2) The number of spouses and surrogates of veterans who 
     received fertility counseling or treatment furnished by the 
     Department.
       (3) The cost to the Department of furnishing fertility 
     counseling and treatment, disaggregated by cost of services 
     and administration.
       (4) The average cost to the Department per recipient of 
     such counseling and treatment.
       (5) In cases in which the Department furnished fertility 
     treatment through the use of assisted reproductive 
     technology, the average number of cycles per person 
     furnished.
       (6) A description of how fertility counseling and treatment 
     services of the Department are coordinated with similar 
     services of the Department of Defense.

     SEC. 6. REGULATIONS ON FURNISHING OF FERTILITY COUNSELING AND 
                   TREATMENT AND ADOPTION ASSISTANCE.

       (a) In General.--Not later than 540 days after the date of 
     the enactment of this Act, the Secretary of Veterans Affairs 
     shall prescribe regulations--
       (1) on the furnishing of fertility treatment to veterans 
     using assisted reproductive technology;
       (2) to carry out section 1788 of title 38, United States 
     Code, as added by section 3; and
       (3) to carry out section 1789 of such title, as added by 
     section 4.
       (b) Limitation.--Notwithstanding any other provision of 
     law, during the period beginning on the date of the enactment 
     of this Act and ending on the date on which the Secretary 
     prescribes regulations under subsection (a), the Secretary 
     may not furnish--
       (1) to any veteran, any fertility treatment using assisted 
     reproductive technology;
       (2) any fertility counseling or treatment under section 
     1788 of title 38, United States Code, as added by section 3; 
     or
       (3) any assistance under section 1789 of such title, as 
     added by section 4.

     SEC. 7. COORDINATION WITH DEPARTMENT OF DEFENSE ON FURNISHING 
                   OF FERTILITY COUNSELING AND TREATMENT.

       The Secretary of Veterans Affairs shall coordinate the 
     furnishing of fertility counseling and treatment by the 
     Department of Veterans Affairs with the furnishing of 
     fertility counseling and treatment by the Department of 
     Defense.

     SEC. 8. FUNDING.

       Amounts for a fiscal year to carry out this Act, section 
     7330B of title 38, United States Code, as added by section 
     2(a), section 1787 of such title, as added by section 4(a), 
     and the amendments made by this Act shall be derived from 
     amounts made available for an overseas contingency operation 
     in that fiscal year, if amounts were made available for an 
     overseas contingency operation in that fiscal year.

  The PRESIDING OFFICER. The Senator from Washington.
  Mrs. MURRAY. Mr. President, I ask unanimous consent that the 
committee-reported title amendment be agreed to, the motions to 
reconsider be laid upon the table with no intervening action or debate, 
and that any related statements be printed in the Record.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The title amendment was agreed to, as follows:

       Amend the title so as to read: ``A bill to amend title 38, 
     United States Code, to improve the reproductive assistance 
     provided

[[Page 17097]]

     by the Department of Veterans Affairs to severely wounded, 
     ill, or injured veterans and their spouses, and for other 
     purposes.''.

  The PRESIDING OFFICER. The Senator from Washington.
  Mrs. MURRAY. Mr. President, the Senate has just passed legislation 
that will bring into focus a real need for the VA to help women 
veterans and the spouses of male veterans access assistance for one of 
the most impactful and serious wounds of these wars--reproductive and 
urinary tract trauma.
  As many of my colleagues know, the nature of the current conflict we 
are involved in and the use of improvised explosive devices leave our 
servicemembers far more susceptible to very serious injuries, such as 
reproductive and urinary tract trauma. Army data shows that between 
2003 and 2011, we had 2,000 servicemembers suffering from these kinds 
of injuries. Like so many of our veterans, these men and women come 
home and want to return to their lives, to find employment and to start 
a family. But today, when they go to the VA, the fertility services 
that are available don't meet the very complex needs of these serious 
injuries. In fact, veterans who have suffered from these injuries find 
that the VA is specifically barred from providing more advanced 
assisted reproductive techniques, such as in vitro fertilization. They 
are, in fact, told--despite the fact that they have made such an 
extreme sacrifice for our country--that they can't be provided with the 
medical services they need to start a family.
  One of those veterans I have come to know is SSG Matt Keil and his 
wife Tracy, who are here with us today. Staff Sergeant Keil, whom I 
talked about this morning, was shot in the neck while he was on patrol 
in Ramadi, Iraq, on February 24, 2007, just 6 weeks after he married 
Tracy. Staff Sergeant Keil instantly became a quadriplegic. Later, when 
he came home and they wanted to start a family, Tracy and Matt were 
faced with the fact that they could not access IVF services through the 
VA, which meant they had to pay $32,000 out of their own pocket.
  Mr. President, the bill we passed today means those families who are 
coming behind Tracy and Matt won't have to go through the same fight to 
take care of something that is so vital to so many American families; 
that is, having a family of their own. This is an important step we 
have taken today in passing this out of the Senate. I am hopeful that 
the House will take it up and pass it. And I assure Tracy and Matt that 
one day, when this bill is signed into law, they will have made a true 
difference for those families who come behind them, and for that I am 
eternally grateful.
  I thank the Chair, and I yield the floor.
  The PRESIDING OFFICER. The Senator from Delaware.
  Mr. COONS. Mr. President, I wish to commend Senator Murray before she 
leaves the floor for her tireless dedication to America's Armed Forces, 
for her commitment to our veterans and her passion for addressing their 
very real and very human needs, and for bringing examples from her home 
community as well as from our country at large of just how much we owe 
our veterans and in just how many different ways they face challenges 
as they try to move forward with their lives after their service for 
us. I wanted to thank her and recognize the Senator from Washington.

                          ____________________