[Congressional Record (Bound Edition), Volume 160 (2014), Part 10]
[Senate]
[Pages 13838-13840]
[From the U.S. Government Publishing Office, www.gpo.gov]




  VETERANS ACCESS, CHOICE, AND ACCOUNTABILITY ACT OF 2014--CONFERENCE 
                                 REPORT

  The PRESIDING OFFICER. The Chair lays before the Senate the 
conference report to accompany H.R. 3230, which the clerk will report.
  The assistant legislative clerk read as follows:

       The committee of conference on the disagreeing votes of the 
     two Houses on the amendment of the House to the amendment of 
     the Senate to the bill H.R. 3230, making continuing 
     appropriations during a Government shutdown to provide pay 
     and allowances to members of the reserve components of the 
     Armed Forces who perform inactive-duty training during such 
     period, having met, after full and free conference, have 
     agreed to recommend and do recommend to their respective 
     Houses as follows:
       That the Senate recede from its disagreement to the 
     amendment of the House and agree to the same with an 
     amendment and the House agree to the same, signed by a 
     majority of the conferees on the part of both Houses.

  (The conference report is printed in the House proceedings of the 
Record of July 28, 2014.)
  Mr. McCAIN. What is the parliamentary situation?
  The PRESIDING OFFICER. The Senator from Oklahoma is to be recognized 
to raise a budget point of order.
  Mr. COBURN. Mr. President, let me say, first of all, I voted for the 
bill when it left here with the hope that we could accomplish 
something. We did accomplish some things. But it came back with $12 
billion unpaid for. Because of that, I raise a point of order against 
the emergency designation provision contained in section 8803(b) of the 
conference report for H.R. 3230, the Veterans' Access to Care Through 
Choice, Accountability and Transparency Act of 2014 pursuant to section 
403(e)(1) of the fiscal year 2010 budget resolution, S. Con. Res. 13.
  I ask for the yeas and nays.
  The PRESIDING OFFICER. The Senator from Vermont.
  Mr. SANDERS. Mr. President, pursuant to section 904 of the 
Congressional Budget Act of 1974, the waiver provisions of applicable 
budget resolutions, and section 4(g)(3) of the Statutory Pay-As-You-Go 
Act of 2010, I move to waive all applicable sections of those acts and 
applicable budget resolutions for purposes of the pending conference 
report.
  I ask for the yeas and nays.
  The PRESIDING OFFICER. Is there a sufficient second?
  There is a sufficient second.
  The yeas and nays were ordered.
  The PRESIDING OFFICER. The Senator from Arizona.
  Mr. McCAIN. Mr. President, I will speak very briefly. Mainly, I come 
here on the floor to thank the Senator from Vermont and my good friend 
from North Carolina on the hard work they and members of the Veterans 
Affairs' Committee have done on this issue. I greatly respect my dear 
friend from Oklahoma and his concern. But I would have to say to my 
colleagues: If there was ever a definition of an emergency, that 
emergency faces us today because our veterans are not receiving the 
care we owe them as a nation.
  There are veterans who are dying as we speak for lack of care. There 
is gross mismanagement. There are problems that will take our new 
Secretary of Veterans Affairs literally years to fix. I am proud that 
in this legislation there is choice, and there is the ability of the 
Secretary of Veterans Affairs to fire people who are not doing their 
job.
  Those are the important aspects, most important to me, because I 
think we can change the Veterans Administration. But the present 
situation cries out for immediate action. Obviously there were parts of 
this legislation that I did not agree with. Obviously there were parts 
that the Senator from Vermont did not agree with. But the hard work put 
together by the Senator from North Carolina and the Senator from 
Vermont--I am very proud to say we bring before you a way to put a 
final stamp on beginning to end. This is not the beginning of the end. 
This is the beginning of the beginning of our effort to help those men 
and women who have defended our Nation with honor and dignity. We owe 
them that.
  I urge my colleagues to vote in favor of the waiver of the Budget Act 
and to vote in favor of this legislation.
  Mr. SANDERS. Mr. President, yesterday the House voted 420 to 5 for 
this conference report. They understood that taking care of veterans, 
as Senator McCain just indicated--the men and women who have put their 
lives on the line to defend us, who have sacrificed so much--is a cost 
of war, and in fact what we are talking about is an emergency. That is 
what the House said overwhelmingly yesterday.
  On June 11, 2014, 6 or so weeks ago, by a vote of 93 to 3, the Senate 
supported the Sanders-McCain bill and it was emergency funded as a cost 
of war.
  This bill, as Senator Coburn indicated, is about one-third of the 
cost of what we voted on in the original Sanders-McCain bill.
  Let us defeat this point of order. Let us stand with the veterans of 
this country, let us reform the VA, and let us go forward.
  The PRESIDING OFFICER. The Senator from Oklahoma.
  Mr. COBURN. Mr. President, I will be very quick.
  What our colleagues should know is, since 2009, the VA budget has 
increased 58.7 percent, a 40-percent increase in the number of 
providers, with a 17-percent increase in the number of veterans using 
those providers. The problem is not money at the VA. The problem is 
management, accountability, and culture. So we are going to borrow $12 
billion from our children and reward the poor behavior and charge it to 
our children.
  I ask for the yeas and nays.
  The PRESIDING OFFICER. The Senator from Arizona.
  Mr. McCAIN. I would say in response to my dear friend from Oklahoma, 
I agree with every single thing that he has said. But we must embark on 
fixing this problem. The choice and the ability to give the Secretary 
of Veterans Affairs the authority to hire and fire people is important 
to me that I believe they deserve our support.

[[Page 13839]]

  I would also ask my friend from Oklahoma, can we leave here for 5 
weeks and not address this issue? There are 50 veterans in my State 
that have probably died--at least allegations are such. Can we leave 
here and not act?
  If I had written this bill with only you and me, I would say to my 
friend from Oklahoma, it would probably be $10 billion less and all of 
it paid for. But we had to negotiate, not only with the other side of 
the aisle but with the other side of the Capitol.
  So this is not perfect legislation. But for us not to pass it at this 
time would send a message to the men and women who have served this 
country that we have abandoned them. We can't do that.
  The PRESIDING OFFICER. The Senator from Tennessee.
  Mr. CORKER. Mr. President, I first thank everybody who worked on 
this. I know there are a lot of political conundrums that people find 
themselves in. We have an August recess. This issue has come up. But I 
wonder if I could ask a question of the Senator from Oklahoma, who 
knows so much about these issues.
  Our staff has looked at the CBO report, and people keep talking about 
$10 billion on the floor, but the Choice Program is only funded for 3 
years. It looks to me as if this bill is really creating an unfunded 
liability. It is a $250 billion cost over the next decade. I can't 
verify that based on the CBO numbers that have come out. But as we look 
at them, it looks as if the Choice Program continues and grows, and the 
number we are talking about is massive.
  So I do wish we had more detailed information from CBO, the kind of 
information we got on the first bill after the fact. For some reason, 
we are not getting it on this.
  But it appears to me that if this choice concept continues and we 
don't do those things to actually wind down and backfill--wind down VA 
for not providing services to these people because they are seeking it 
elsewhere--the cost of this could well be $250 billion over the next 10 
years unpaid for.
  I would like for somebody to answer that. I don't know if Senator 
Coburn or someone else could. But we are not talking about $10 billion 
is all I am saying.
  The PRESIDING OFFICER. The Senator from Oklahoma.
  Mr. COBURN. What we are talking about is an errant CBO score that 
doesn't fit with reality or the information given to them by the VA.
  The PRESIDING OFFICER. The Senator from Arizona.
  Mr. McCAIN. Mr. President, what we are talking about, really, is 
rather than get in a car or van and drive for 40 miles and hours and 
have that all reimbursed and paid for, a person will go to the local 
care provider. Common sense shows that costs one heck of a lot less, I 
would say to my colleague.
  The PRESIDING OFFICER. The Senator from Vermont.
  Mr. SANDERS. Mr. President, Senator Coburn forgot to mention one 
point when talking about the increase in VA funding. He forgot to 
mention that we were in two wars.
  He forgot to mention that 500,000 men and women came back from Iraq 
and Afghanistan with posttraumatic stress disorder and TBI, not to 
mention the loss of legs, the loss of arms, eyesight and hearing.
  He forgot to mention that many of the veterans from World War II, 
Korea, and Vietnam are getting older and need more detailed care.
  So I think it is important that we put $5 billion into the VA to 
provide the doctors, the nurses, the personnel they need, so that the 
veterans can get into the VA and have quality and timely care. That is 
what this legislation is about.
  I ask for the yeas and nays.
  The PRESIDING OFFICER. The question is on agreeing to the motion to 
waive.
  The yeas and nays have been previously ordered.
  The clerk will call the roll.
  The legislative clerk called the roll.
  Mr. DURBIN. I announce that the Senator from North Carolina (Mrs. 
Hagan), the Senator from Iowa (Mr. Harkin), and the Senator from Hawaii 
(Mr. Schatz) are necessarily absent.
  Mr. CORNYN. The following Senators are necessarily absent: the 
Senator from Tennessee (Mr. Alexander), the Senator from Mississippi 
(Mr. Cochran), and the Senator from Kansas (Mr. Roberts).
  Further, if present and voting, the Senator from Tennessee (Mr. 
Alexander) would have voted ``yes.''
  The PRESIDING OFFICER. Are there any other Senators in the Chamber 
desiring to vote?
  The yeas and nays resulted--yeas 86, nays 8, as follows:

                      [Rollcall Vote No. 253 Leg.]

                                YEAS--86

     Ayotte
     Baldwin
     Begich
     Bennet
     Blumenthal
     Blunt
     Booker
     Boozman
     Boxer
     Brown
     Burr
     Cantwell
     Cardin
     Carper
     Casey
     Chambliss
     Coats
     Collins
     Coons
     Cornyn
     Crapo
     Cruz
     Donnelly
     Durbin
     Feinstein
     Fischer
     Franken
     Gillibrand
     Graham
     Grassley
     Hatch
     Heinrich
     Heitkamp
     Heller
     Hirono
     Hoeven
     Inhofe
     Isakson
     Johanns
     Johnson (SD)
     Kaine
     King
     Kirk
     Klobuchar
     Landrieu
     Leahy
     Levin
     Manchin
     Markey
     McCain
     McCaskill
     McConnell
     Menendez
     Merkley
     Mikulski
     Moran
     Murkowski
     Murphy
     Murray
     Nelson
     Paul
     Portman
     Pryor
     Reed
     Reid
     Risch
     Rockefeller
     Rubio
     Sanders
     Schumer
     Scott
     Shaheen
     Shelby
     Stabenow
     Tester
     Thune
     Toomey
     Udall (CO)
     Udall (NM)
     Vitter
     Walsh
     Warner
     Warren
     Whitehouse
     Wicker
     Wyden

                                NAYS--8

     Barrasso
     Coburn
     Corker
     Enzi
     Flake
     Johnson (WI)
     Lee
     Sessions

                             NOT VOTING--6

     Alexander
     Cochran
     Hagan
     Harkin
     Roberts
     Schatz
  The PRESIDING OFFICER. On the motion to waive, the yeas are 86, the 
nays are 8. The motion to waive is agreed to.
  Mr. DURBIN. Mr. President, this week, the Senate confirmed Bob 
McDonald as the new Secretary of the VA and today we passed a 
compromise veterans bill that will help repair the overwhelmed Veterans 
Health Administration. These are two steps in the right direction to 
help the men and women who serve in our military receive the care they 
need when they come home.
  Bob McDonald is an excellent choice to head the VA. I met with 
McDonald soon after he was nominated for this position and there is no 
doubt he is eager to take on the task of seeing that the VA honors its 
promise to the men and women of our armed services. McDonald ran 
Proctor and Gamble for several years and knows what it means to put the 
customer first. At the VA, veterans are the customers and we have to 
provide them with the best service possible. McDonald is a veteran, a 
West Point grad, and best of all, he is from Arlington Heights, IL. I 
am confident he is the right person for this difficult job.
  After an internal audit, the VA confirmed whistleblower assertions 
that many VA employees manipulated waitlists to make wait times look 
better than they really were. The agency found that in some cases, 
staff intimidated schedulers into falsifying data. This is 
unacceptable.
  I visited the Hines VA Hospital near Chicago last Friday where I met 
with Joan Ricard, director of the facility, and Rob Nabors, President 
Obama's Deputy Chief of Staff, who is overseeing the investigation into 
problems at the VA. We discussed some problems identified by 
whistleblowers at Hines pertaining to waitlists and other issues.
  I am pleased that the Senate adopted the Veterans bill conference 
report. The House passed the bill 420-to-5 yesterday. VA Committee 
Chairman Sanders worked very hard both with Members across the aisle 
and in the House to put this bill together. It will begin to fix some 
of the problems identified by the various investigations into 
misconduct at VA medical facilities.
  This bill will allow the Secretary to fire senior staff who are not 
doing their job or who lied about secret waitlists.

[[Page 13840]]

It will create 27 new VA health facilities to expand capacity, 
including a new research lab at Hines in Chicago. That research lab is 
100-years-old and in dire need of repair. The new lease will help make 
it usable again.
  This legislation will make it easier for veterans to get the care 
they need outside the VA system if necessary. Now, any enrolled veteran 
who lives more than 40-miles from the nearest VA facility or who would 
have to wait too long for an appointment will be able to go to a 
private doctor. We need to get those waitlists down, and this is one 
way to make sure veterans are seen.
  The IG investigation has cited a shortage of doctors, nurses, and 
other staff as being partly to blame for the waitlist problem. There 
simply is not enough staff to see all the veterans who need treatment. 
The bill also provides $5 billion to hire new staff.
  These are improvements we can all agree on.
  Some have expressed concern about the cost of this bill but caring 
for veterans is part of the cost of going to war. We spent $1.7 
trillion in the Iraq War alone. We can spend $12 billion to honor the 
promise we made to our servicemembers.
  When we talk about war, we are not just talking about the thousands 
of people who died in Iraq and Afghanistan. We're talking about 200,000 
men and women who came home with major injuries, both those we can see 
and some we cannot. We are talking about people with post-traumatic 
stress and traumatic brain injury, people missing limbs and those who 
lost hearing or eyesight. Veterans who are entitled to healthcare 
services should get the best healthcare they can, and they should get 
it in a timely manner.
  There is no question that we need to fix this health care system. 
Where misconduct has been identified, those responsible should face the 
consequences, criminal or otherwise. The Sanders-Miller compromise is a 
good step in that direction. Secret waitlists and failures to provide 
care do not reflect the promise we made to the men and women who serve 
this country. Wars create veterans and veterans need medical care. 
Caring for servicemembers is part of the cost of going to war.
  The PRESIDING OFFICER. The question occurs on adoption of the 
conference report.
  The Senator from Vermont is recognized.
  Mr. SANDERS. Mr. President, before we vote, I wish to take this 
opportunity to thank Senator McCain for his intervention and making 
sure that we had serious negotiations.
  I thank the staff of the Veterans' Affairs Committee: Steve 
Robertson, Dahlia Melendrez, Travis Murphy, Jason Dean, Carlos Fuentes, 
Becky Thowman, Ann Vallandingham, Janet Gehring, Elizabeth Austin-
Mackenzie, Kathryn Monet, Katie Van Haste, Shanna Lawrie, Raphael 
Anderson, and Shannon Jackson. These guys worked really hard for 
months, and I very much appreciate what they did.
  The PRESIDING OFFICER. The question is on agreeing to the adoption of 
the conference report.
  Mr. BARRASSO. Mr. President, I ask for the yeas and nays.
  The PRESIDING OFFICER. Is there a sufficient second?
  There is a sufficient second.
  The clerk will call the roll.
  The assistant legislative clerk called the roll.
  Mr. DURBIN. I announce that the Senator from North Carolina (Mrs. 
Hagan), the Senator from Iowa (Mr. Harkin), and the Senator from Hawaii 
(Mr. Schatz) are necessarily absent.
  Mr. CORNYN. The following Senators are necessarily absent: the 
Senator from Tennessee (Mr. Alexander), the Senator from Mississippi 
(Mr. Cochran), and the Senator from Kansas (Mr. Roberts).
  Further, if present and voting, the Senator from Tennessee (Mr. 
Alexander) would have voted ``yea'' and the Senator from Mississippi 
(Mr. Cochran) would have voted ``yea.''
  The PRESIDING OFFICER. Are there any other Senators in the Chamber 
desiring to vote?
  The result was announced--yeas 91, nays 3, as follows:

                      [Rollcall Vote No. 254 Leg.]

                                YEAS--91

     Ayotte
     Baldwin
     Barrasso
     Begich
     Bennet
     Blumenthal
     Blunt
     Booker
     Boozman
     Boxer
     Brown
     Burr
     Cantwell
     Cardin
     Carper
     Casey
     Chambliss
     Coats
     Collins
     Coons
     Cornyn
     Crapo
     Cruz
     Donnelly
     Durbin
     Enzi
     Feinstein
     Fischer
     Flake
     Franken
     Gillibrand
     Graham
     Grassley
     Hatch
     Heinrich
     Heitkamp
     Heller
     Hirono
     Hoeven
     Inhofe
     Isakson
     Johanns
     Johnson (SD)
     Johnson (WI)
     Kaine
     King
     Kirk
     Klobuchar
     Landrieu
     Leahy
     Lee
     Levin
     Manchin
     Markey
     McCain
     McCaskill
     McConnell
     Menendez
     Merkley
     Mikulski
     Moran
     Murkowski
     Murphy
     Murray
     Nelson
     Paul
     Portman
     Pryor
     Reed
     Reid
     Risch
     Rockefeller
     Rubio
     Sanders
     Schumer
     Scott
     Shaheen
     Shelby
     Stabenow
     Tester
     Thune
     Toomey
     Udall (CO)
     Udall (NM)
     Vitter
     Walsh
     Warner
     Warren
     Whitehouse
     Wicker
     Wyden

                                NAYS--3

     Coburn
     Corker
     Sessions

                             NOT VOTING--6

     Alexander
     Cochran
     Hagan
     Harkin
     Roberts
     Schatz
  The PRESIDING OFFICER. Under the previous order requiring 60 votes 
for adoption of the conference report, the conference report is agreed 
to.


       MAKING CERTAIN CORRECTIONS IN THE ENROLLMENT OF H.R. 3230

  The PRESIDING OFFICER. Under the previous order, the Senate will 
proceed to consideration of H. Con. Res. 111 which the clerk will 
report.
  The assistant legislative clerk read as follows:

       A concurrent resolution (H. Con. Res. 111) directing the 
     Clerk of the House of Representatives to make certain 
     corrections in the enrollment of the bill H.R. 3230.

  The PRESIDING OFFICER. Under the previous order, the concurrent 
resolution (H. Con. Res. 111) is agreed to and the motion to reconsider 
will be considered made and laid upon the table.
  The majority leader.

                          ____________________