[Congressional Record (Bound Edition), Volume 163 (2017), Part 8]
[House]
[Pages 11412-11419]
[From the U.S. Government Publishing Office, www.gpo.gov]




         DEPARTMENT OF VETERANS AFFAIRS BONUS TRANSPARENCY ACT

  Mr. ROE of Tennessee. Madam Speaker, I move to suspend the rules and 
pass the bill (S. 114) to amend title 38, United States Code, to 
require the Secretary of Veterans Affairs to submit an annual report 
regarding performance awards and bonuses awarded to certain high-level 
employees of the Department of Veterans Affairs, as amended.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                                 S. 114

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

     SECTION 1. APPROPRIATION OF AMOUNTS.

       (a) Veterans Choice Program.--There is authorized to be 
     appropriated, and is appropriated, to the Secretary of 
     Veterans Affairs, out of any funds in the Treasury not 
     otherwise appropriated, $2,000,000,000 to be deposited in the 
     Veterans Choice Fund under section 802 of the Veterans 
     Access, Choice, and Accountability Act of 2014 (Public Law 
     113-146; 38 U.S.C. 1701 note).
       (b) Availability of Amounts.--The amounts appropriated 
     under subsection (a) shall be available for obligation or 
     expenditure without fiscal year limitation.

     SEC. 2. EXTENSION OF REDUCTION IN AMOUNT OF PENSION FURNISHED 
                   BY DEPARTMENT OF VETERANS AFFAIRS FOR CERTAIN 
                   VETERANS COVERED BY MEDICAID PLANS FOR SERVICES 
                   FURNISHED BY NURSING FACILITIES.

       Section 5503(d)(7) of title 38, United States Code, is 
     amended by striking ``September 30, 2024'' and inserting 
     ``December 31, 2027''.

     SEC. 3. EXTENSION OF REQUIREMENT FOR COLLECTION OF FEES FOR 
                   HOUSING LOANS GUARANTEED BY SECRETARY OF 
                   VETERANS AFFAIRS.

       Section 3729(b)(2) of title 38, United States Code, is 
     amended--
       (1) in subparagraph (A)--
       (A) in clause (iii), by striking ``September 30, 2024'' and 
     inserting ``December 31, 2027''; and
       (B) in clause (iv), by striking ``September 30, 2024'' and 
     inserting ``December 31, 2027'';
       (2) in subparagraph (B)--
       (A) in clause (i), by striking ``September 30, 2024'' and 
     inserting ``December 31, 2027''; and
       (B) in clause (ii), by striking ``September 30, 2024'' and 
     inserting ``December 31, 2027'';
       (3) in subparagraph (C)--
       (A) in clause (i), by striking ``September 30, 2024'' and 
     inserting ``December 31, 2027''; and
       (B) in clause (ii), by striking ``September 30, 2024'' and 
     inserting ``December 31, 2027''; and
       (4) in subparagraph (D)--
       (A) in clause (i), by striking ``September 30, 2024'' and 
     inserting ``December 31, 2027''; and
       (B) in clause (ii), by striking ``September 30, 2024'' and 
     inserting ``December 31, 2027''.

     SEC. 4. EXTENSION OF AUTHORITY TO USE INCOME INFORMATION.

       Section 5317(g) of title 38, United States Code, is amended 
     by striking ``September 30, 2024'' and inserting ``December 
     31, 2027''.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
Tennessee (Mr. Roe) and the gentleman from Minnesota (Mr. Walz) each 
will control 20 minutes.
  The Chair recognizes the gentleman from Tennessee.


                             General Leave

  Mr. ROE of Tennessee. Madam Speaker, I ask unanimous consent that all 
Members have 5 legislative days in which to revise and extend their 
remarks and to include extraneous material.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Tennessee?
  There was no objection.
  Mr. ROE of Tennessee. Madam Speaker, I yield myself such time as I 
may consume.
  Madam Speaker, I rise today in support of S. 114, as amended, a bill 
to authorize appropriations for the Veterans Choice Program. This bill 
would authorize and appropriate $2 billion for the Department of 
Veterans Affairs' Veterans Choice Fund.
  Allowing the Veterans Choice Fund to run dry is not a viable option. 
The Choice Program has provided critical care to millions of veteran 
patients.
  In March, Secretary Shulkin testified that the expiration of the 
Choice Program would be a ``disaster'' for veterans. Just a few weeks 
ago, the Acting Under Secretary for Health reiterated that sentiment 
when she testified that veteran wait times would increase if the Choice 
Program went away.
  Congress created the Choice Program in response to a nationwide wait-
time scandal in 2014 to increase access to care through VA community 
providers for veterans who either cannot access care at a VA medical 
facility within a timely manner or who live far away from the nearest 
VA medical facility. Since the Choice Program was signed into law 
almost 3 years ago, it has gone through many growing pains and evolved 
considerably.
  We know from a Government Accountability Office report from earlier 
this year that most of the veterans who use the Choice Program do so 
because VA does not offer the service that veteran needs.
  We also know that veteran demand for care through the Choice Program 
has never been higher, and, consequently, the remaining money in the 
Veterans Choice Program will run out in mid August, a few short weeks 
from now.
  We cannot allow that to happen, and with passage of S. 114, as 
amended today, we won't.
  There are allegations that providing more money for the Choice 
Program is inappropriate unless we also provide more money for the VA 
healthcare system. I fail to understand the logic of that argument.
  First, providing money for the Choice Program is providing money for 
support to the VA healthcare system. Choice is a VA program. Through 
it, VA patients and veteran patients are able to access care that would 
have otherwise have required either a long, possibly debilitating wait 
or an excessive travel time.
  Second, the idea that Congress has been pouring money into VA 
community care programs to the detriment of addressing VA's in-house 
capacity is simply erroneous. VA's bottom line has increased 
substantially since the turn of the century while most other government 
agencies have seen theirs stagnate or reduced.
  Madam Speaker, VA's budget has gone up four times since 2001. It has 
quadrupled. Two weeks ago, former Secretary Principi testified that 
since he left the Department in 2005 to the most current VA budget 
submission released in May, VA's budget increased a

[[Page 11413]]

stunning 268 percent. That growth will likely continue, which is 
appropriate, given our Nation's commitment to serving her veterans.
  Yet, especially considering that the Choice Program is just 3 years 
old, the idea that Congress is focused only on growing VA's external 
capacity is false.
  That said, there are certainly priorities that remain unaddressed in 
the bill before us, and I am committed to continuing to work on those 
in the coming months.
  However, providing $2 billion today will ensure that the Choice 
Program remains funded for the next 6 months, solving our most pressing 
issue and preventing yet another veteran access crisis like the one 
that led to the creation of the Choice Program 3 short years ago while 
we addressed other important issues.
  An important point to note is that the bill's costs are paid for 
using the same offsets that were used in the original act creating the 
Choice Fund.
  I look forward to working with the minority, our colleagues in the 
Senate, and other stakeholders to charter a long-term path forward for 
the Choice Program and to address other needs to ensure that the VA 
healthcare system remains strong and stable for generations to come.
  I am grateful to Ranking Member Walz for his leadership and 
commitment in working very closely with me to come to a mutually 
agreeable solution today and to committing to continue to stand 
shoulder to shoulder in finding solutions in the months ahead. He has 
been a great partner.
  Madam Speaker, I urge all of my colleagues to join me in supporting 
S. 114, as amended, and I reserve the balance of my time.

                              {time}  1415

  Mr. WALZ. Madam Speaker, I yield myself such time as I may consume.
  Madam Speaker, you are going to hear today and we have a series of 
bills, many of them historic in nature, many of them--all of them--
worked in a bipartisan manner.
  There has been a lot of talk lately of the one place in Congress that 
is really functioning well, and that is in the Veterans' Affairs 
Committee, and I would echo that. It is because of the commitment, the 
dedication, and the end state that all of us agree on is the best 
possible care for those warriors willing to put their lives in harm's 
way, their families, and the care that was pledged to them.
  Also, with that being said, democracy is hard. It requires us to do 
the work here, with the stakeholders, and there is no issue that has a 
more committed group of stakeholders than the veterans' community. Some 
of the names you are going to hear of veterans service organizations 
are a hallmark and a bedrock of not just veterans' issues, but of our 
communities. We work with them hand in hand to make sure that this 
Congress understands exactly what they need.
  And democracy is hard. It is that old sausage-making adage sometimes. 
It is a disappointment to me that we are on the floor because I think 
we are just a little bit early; I think we are about a day. Like we 
have before, we stood on this floor when we had a very important 
accountability bill forward, and I said at that time we were going to 
have to work with the Senate to make sure we got something passed. We 
did that, it passed, and I am proud that we were able to do that.
  It happened with the GI Bill that is coming up. The first run we went 
at it did not work because we had not built that collaboration, and I 
am disappointed today that I believe S. 114 has fallen into that.
  This is a very fast-moving problem, because I want to be clear. What 
this does is it extends veterans' access to care in the community 
through the Veterans Choice Program without providing additional 
resources for the Department of Veterans Affairs to enhance its 
internal capacity.
  I agree with my colleague who was very clear about the capacity of 
the VA, what Choice does, and I would absolutely echo not funding this 
program before we leave for the August recess is unacceptable. But not 
getting a bill that the Senate can agree on, not getting a bill that 
the President can sign, and not getting a bill that actually does what 
we are supposed to do is also not acceptable.
  The gentleman is also right: we have quadrupled the VA budget, and I 
am proud of that. I also think it is probably not lost on anyone that 
that started in 2001 at the same time that we fought America's longest 
war and are still engaged around the world, with an aging population of 
Vietnam, Korean, and World War II veterans.
  As it became apparent that the Veterans Choice Program was facing a 
funding shortfall earlier this summer, nine veterans service 
organizations--Disabled American Veterans, the American Legion, 
Veterans of Foreign Wars, Paralyzed Veterans of America, AMVETS, Iraq 
and Afghanistan Veterans of America, Military Officers Association of 
America, Military Order of the Purple Heart, and Vietnam Veterans of 
America--issued a letter which provided very clear guidance to House 
and Senate leadership and House and Senate Veterans' Affairs Committees 
in terms of a solution, and I include in the Record the letter from 
these organizations.

                                                    June 28, 2017.
     Hon. Johnny Isakson,
     Chairman, Senate Veterans' Affairs Committee, Washington, DC.
     Hon. Jon Tester,
     Ranking Member, Senate Veterans' Affairs Committee, 
         Washington, DC.
     Hon. Phil Roe, M.D.,
     Chairman, House Veterans' Affairs Committee,
     Washington, DC.
     Hon. Tim Walz,
     Ranking Member, House Veterans' Affairs Committee,
     Washington, DC.
       Dear Chairmen Isakson and Roe, Ranking Members Tester and 
     Walz: As leaders of the nation's largest veterans service 
     organizations, and on behalf of our combined five million 
     members and auxiliaries, we write to urge you to 
     expeditiously reach agreement on and advance legislation to 
     ensure continuous access to health care for millions veterans 
     enrolled in the Department of Veterans Affairs (VA) health 
     care system, including care provided through the Choice 
     program. Specifically, we call on you to reach agreement on 
     an emergency appropriation and authorization bill that would 
     address urgent resource shortfalls endangering VA's medical 
     care programs--including Choice, community care and medical 
     services. Further, in order to prevent these problems from 
     recurring in the future, we call on you to equally invest in 
     modernizing and expanding VA's capacity to meet rising demand 
     for care, as well as finally address the glaring inequity in 
     law that prevents thousands of family caregivers from getting 
     the support they need to care for their veterans severely 
     disabled before September 11, 2001.
       In recent weeks, VA Secretary David Shulkin has repeatedly 
     made clear in his public statements and congressional 
     testimony that current funding is no longer projected to be 
     adequate to meet the needs of an increasing number of 
     veterans seeking medical treatment directly through the VA 
     system as well as through community care programs, 
     particularly the Choice program. Secretary Shulkin has made 
     clear that rising demand for care by veterans has consumed 
     more VA resources than previously anticipated, threatening 
     the ability of VA to meet all of its obligations to ill and 
     injured veterans both this year and next. Although Public Law 
     115-26 extended the Choice program beyond its prior sunset 
     date of August 7, 2017, VA now projects it will likely run 
     out of funding prior to the end of fiscal year (FY) 2017 
     unless additional funding is made available. Further, based 
     on recent utilization trends, VA projects a higher demand for 
     both community care and Choice next year (FY 2018), and 
     anticipates additional funding requirements above the budget 
     request made just weeks earlier. In order to ensure 
     continuation of the Choice program--and absent an infusion of 
     new funding--VA has stated its intention to take 
     extraordinary budget actions, including pulling back 
     unobligated funding from VA medical facilities and utilizing 
     funding in FY 2017 that had been designated as carryover 
     funding for its FY 2018 budget request, thereby further 
     reducing available medical care resources for next year.
       Messrs. Chairmen and Ranking Members, our nation has a 
     sacred obligation to ensure the men and women who served and 
     sacrificed to defend our way of life receive timely, high-
     quality health care through a fully-funded VA health care 
     system, which includes community care or Choice options 
     whenever and wherever necessary. With the

[[Page 11414]]

     Choice program rapidly running out of funds and its successor 
     community care program still many months away, it is 
     imperative that Congress not allow veterans to go without 
     needed care before this transition is completed.
       We note that VA's FY 2018 budget submission included a 
     request for $3.5 billion in mandatory funds to continue the 
     Choice program. In order to meet Congressional PAYGO 
     requirements, VA also included two legislative proposals we 
     vehemently oppose which would cut billions of dollars from 
     veterans disability compensation through changes to 
     Individual Unemployabilty eligibility and rounding down cost-
     of-living adjustment (COLA) increases to ``pay'' for the new 
     Choice funding. We find it absolutely unconscionable to cut 
     benefits for disabled veterans to ``pay'' for their medical 
     care. Congress imposed these PAYGO rules on itself and 
     Congress has the authority to waive them by designating new 
     funding for the existing Choice program as emergency 
     spending, just as it did when the Choice program was created 
     in 2014 through Public Law 113-146, the Veterans Access, 
     Choice and Accountability Act (VACAA). It is our 
     understanding that the actual need to continue the Choice 
     program for the balance of this year and through the end of 
     FY 2018 is approximately $4.3 billion.
       We remind you that the primary reason the Choice program 
     was created was to address gaps in access due to the lack of 
     clinicians and clinical space necessary to provide timely 
     access to health care for all enrolled veterans. As such, 
     VACAA not only included emergency funding to allow additional 
     access to community care outside VA, it also contained 
     funding to rebuild and expand capacity inside VA. Therefore, 
     we call on you to continue this commitment to strengthen and 
     modernize the VA by providing equal emergency funding to 
     address VA's infrastructure and personnel gaps. There are at 
     least 27 VA health care facility leases awaiting funding in 
     order to be activated. In addition, there are dozens of minor 
     and major construction projects that require billions of 
     dollars in funding to sustain and expand VA's capacity to 
     provide timely care to enrolled veterans. Furthermore, VA has 
     tens of thousands of vacant positions which will require not 
     just funding, but innovative new programs to recruit and 
     retain hard-to-fill clinical positions in many areas of the 
     country. Therefore, we call on you to include an equivalent 
     level of funding--$4.3 billion--to support VA's internal 
     capacity to deliver care.
       Finally, since enactment of the Public Law 111-163 in 2010, 
     which created the Program of Comprehensive Assistance for 
     Family Caregivers (PCAFC), eligibility has been restricted to 
     caregivers of severely disabled veterans injured or made ill 
     on or after September 11, 2001. The clear intention of the 
     law was to initiate this program rapidly for post-9/11 
     veterans to address their urgent needs, thereafter working to 
     expand the program to meet the critical needs of family 
     caregivers of seriously disabled veterans of all generations 
     as soon as feasible. However seven years later, Congress has 
     yet to begin addressing the blatant unfairness facing 
     caregivers of severely disabled veterans injured prior to 
     September 11, 2001. As Secretary Shulkin and other experts 
     agree, supporting caregivers who allow veterans to remain in 
     their homes will save VA money that would otherwise need to 
     be spent for long term institutional care. Therefore, we call 
     on you to include both authorization and funding to eliminate 
     this indefensible inequity based on existing bipartisan 
     legislation in the Senate (S. 591) and the House (H.R. 1472, 
     H.R. 1802).
       While the current funding crisis must be addressed in the 
     short term through emergency funding and authorization, we 
     remain focused on moving beyond the flawed Choice program as 
     soon as practicable. We continue to urge you to work with us, 
     Secretary Shulkin and other critical stakeholders to design 
     and implement a new paradigm for veterans health care built 
     around an integrated network, with a modernized VA serving as 
     the coordinator and primary provider of care, and community 
     providers addressing remaining gaps in access and services. 
     We further urge you to consolidate all community care 
     programs through a single unified discretionary funding 
     source that includes the necessary flexibility and 
     accountability to ensure that VA can deliver the highest 
     quality of care in the most appropriate clinical settings 
     within the network.
       Messrs. Chairmen and Ranking Members, we recognize the 
     continuing attention and commitment you have all shown to 
     providing timely and accessible care to our nation's injured 
     and ill veterans, and we hope you will work with us and 
     Secretary Shulkin to address this urgent funding shortfall. 
     America's veterans have earned the right to high-quality, 
     timely and accessible health care. We believe that the 
     comprehensive plan outlined above will ensure our nation 
     continues to meet that sacred obligation and call on you to 
     support it.
           Respectfully,
         Garry J. Augustine, Executive Director, Washington 
           Headquarters, DAV (Disabled American Veterans); Robert 
           E. Wallace, Adjutant General, Veterans of Foreign Wars 
           of the United States; Joseph Chenelly, National 
           Executive Director, AMVETS; Dana T. Atkins, Lieutenant 
           General, U.S. Air Force (Ret.), President, Military 
           Officers Association of America; Rick Weidman, 
           Executive Director for Policy and Government Affairs, 
           Vietnam Veterans of America; Verna L. Jones, Executive 
           Director, The American Legion; Sherman Gillums, Jr., 
           Executive Director, Paralyzed Veterans of America; Paul 
           Rieckhoff, Founder and CEO, Iraq and Afghanistan 
           Veterans of America (IAVA); Hershel Gober, National 
           Commander, Military Order of the Purple Heart.

  Mr. WALZ. In their letter from June 28, they wrote: ``Specifically, 
we call on you to reach an agreement on an emergency appropriation and 
authorization bill that would address urgent resource shortfalls 
endangering VA's medical care programs--including Choice, community 
care and medical services. Further, in order to prevent these problems 
from recurring in the future, we call on you to equally invest in 
modernizing and expanding VA's capacity to meet rising demand for care. 
. . .''
  Choice means choosing to go to the VA hospital and choice means 
choosing to use community care. Both are equal opportunities for our 
veterans to get the care they need.
  The current bill before us does not meet the requirements asked for 
by our veterans service organizations. In fact, in order to keep the 
Veterans Choice Program going, House leadership and the Budget 
Committee have refused to see this as an emergency and are requiring $2 
billion in offsets to pay for the bill.
  While the actual offsets being offered are noncontroversial and are 
the ones the committee has used in the past, the fact that the 
leadership is requiring offsets from VA programs to pay for private 
care is wrong--all of this to appease a small vocal minority who simply 
sees any spending as unnecessary.
  On Friday, a number of the same VSOs listed above issued a joint 
statement, which noted:
  ``Veterans healthcare benefits have already been `paid for' through 
the service and sacrifice of the men and women who wore our Nation's 
uniform, millions whom suffered injuries, illnesses and lifelong 
disabilities.''
  I agree with them. Without emergency funding, robbing Peter to pay 
Paul, an analogy used by the Paralyzed Veterans of America, is not a 
viable path. It is actually robbing future Peter to pay current Paul.
  Had it been apparent VA would be facing this shortfall, Congress 
maybe would have never extended the Veterans Choice Program beyond its 
sunset of August 7 and would have, instead, begun working on 
legislation that would have consolidated VA's multiple community care 
programs into one easy-to-understand and -use program.
  I reiterate: Choice is not a permanent VA program. Now, it may end up 
being that. It may be someone's wish, but it is not. It was a short-
term fix that was testified we need to extend the program. Several 
weeks later, leadership of the VA came back and told us they are 4-
point-whatever billion dollars short and asked us to fix it. That is 
not the chairman's fault; that is not the Members of this House's 
fault; but it is our responsibility.
  Now, the question is: How do we ensure that the care is continuous? 
How do we make sure care is not interrupted? How do we make sure a 
veteran who is getting chemotherapy in the private setting right now is 
not told to not come back because we are not going to pay it?
  The sense of urgency is with all of us. What I ask is that we try and 
come back, take a look at what we can do. And I will say this: the 
chairman of the Veterans' Affairs Committee in the House has made as 
good faith an effort to do this as anyone could possibly ask. I 
understand the challenges coming from a broader caucus and asking for 
this. This, where we are at today, is significantly changed from where 
we started, but it is apparent, in the Senate, that it will not pass.
  We will not have money for the Veterans Choice Program, so we need to 
decide: Do we stand and make a statement of ideological, fiscal, 
whatever

[[Page 11415]]

they want to call it, or do we come together, unanimously agree on 
something we can move forward, build capacity into the VA to assure 
that Choice is there, everything from the research into the VA to the 
care in the communities, and come together to find that?
  Moreover, these shortages are further reinforced in Choice when you 
take into account veterans' reliance on VA's system for care has 
steadily increased. While enrollment has been flat in fiscal years 2014 
through 2016, the total number of veterans utilizing VA healthcare has 
grown by 3 percent. The total appointments in VA increased by more than 
5 percent during this period.
  In order to address that need, since the Veterans Choice Program was 
implemented, the total number of community care appointments has 
increased by 61 percent, and more than 25 million appointments were 
completed in fiscal year 2016. Over one-fifth of this care was 
completed in the Veterans Choice Program. No disagreement. Community 
care has always been there, and community care is an absolute staple of 
the VA.
  What is also not debatable is capacity inside the VA must remain 
there. Any shortfall in capacity is going to distort where people are 
getting their care.
  While we are not here to oppose the premise of veterans having access 
to care, members of my Caucus, as this stands right now, cannot go 
forward until we figure out how we are going to come to a compromise 
that gets the capacity as it should be in the VA and also allows us and 
everyone--we should never have this discussion in this House. If we 
can't find compromise that gets something across the finish line that 
actually does something for veterans, everything else is just messaging 
for politics.
  Madam Speaker, I look forward to the chairman's words, and I reserve 
the balance of my time.
  Mr. ROE of Tennessee. Madam Speaker, I yield myself such time as I 
may consume.
  Madam Speaker, I think the one way that we don't have the Veterans 
Choice Program work for veterans is not vote for S. 114. Just to 
clarify a couple of things, this $2 billion is emergency spending that 
our Budget Committee agreed to.
  I want to just for a minute kind of go over how we got to this 
position where we are right now.
  The Veterans Choice Program, in April, we were told, would last until 
next January or February. So we passed the CHOICE Act, and the 
President signed it into law. We found out a short 60 days later that 
the funds would run out in mid August--the 7th to the 15th of August is 
when the Secretary told us--so that kind of caught us off guard, and we 
had to get moving rather quickly.
  The June 28 letter that my good friend, Mr. Walz, referred to sort of 
got us started with this process. I want to go through it because the 
process is important about how we are here today.
  The Members need to understand that my efforts to work with the 
committee's ranking member and, indeed, all members of the committee on 
a path forward which addresses the concerns of all of the 
organizations, I have done that.
  Let me begin by saying I fundamentally disagree that we have 
neglected the needs of our internal VA healthcare system. We just 
passed a MILCON-VA bill last week. I stated the reasons for that in my 
earlier remarks. I think the Secretary's op-ed this morning in USA 
Today clearly makes the point.
  Madam Speaker, I include in the Record that article.

                    [From USA Today, July 24, 2017]

 Veterans Affairs Secretary: VA Health Care Will Not Be Privatized on 
                               Our Watch

                           (By David Shulkin)

       As a physician, my professional assessment is that the 
     Department of Veterans Affairs has made significant progress 
     over the past six months--but it still requires intensive 
     care. In order to restore the VA's health, we must strengthen 
     its ability to provide timely and high quality medical care 
     while improving experiences and outcomes for veterans.
       I believe the best way to achieve this goal is to build an 
     integrated system that allows veterans to get the best health 
     care possible, whether it comes from the VA or the private 
     sector.
       This is not a novel idea. No health care provider delivers 
     every treatment under the sun. Referral programs for patients 
     to get care through outside providers (known as Choice or 
     Community Care at the VA) are as essential to the medical 
     profession as stethoscopes and tongue depressors. But VA 
     attempts to offer veterans these options have frequently 
     stirred controversy.
       Some critics complain that letting veterans choose where 
     they get certain health care services will lead to the 
     privatization of VA. Nothing could be further from the truth.
       VA has had a community care program for years. Congress 
     significantly expanded these efforts in 2014 in response to 
     the wait time crisis. As a result, since the beginning of 
     this year, VA has authorized over 18 million community care 
     appointments--3.8 million more than last year, or a 26% 
     increase, according to the VA claims system.
       But as VA's community care efforts have grown, so has our 
     capacity to deliver care in-house. The VA budget is nearly 
     four times what it was in 2001. Since then, the department's 
     workforce has grown from some 224,000 employees in 2001 to 
     more than 370,000 today, according to the Office of Personnel 
     Management. And we're delivering 3 million more appointments 
     at VA facilities per year than we were in 2014.
       In other words, community care or private capacity and VA's 
     internal capacity are not mutually exclusive. We are ramping 
     up both simultaneously in order to meet the health care needs 
     of the veterans we are charged with serving. Our fiscal 2018 
     budget continues this trend. It will spend $2.7 billion more 
     for in-house VA care, compared to a $965 million increase for 
     community care. This means that the total dollar increase for 
     medical care within VA is three times that of the increase 
     for community care. Overall, when all funding sources are 
     taken into account, we expect to spend $50 billion on health 
     care services within VA and $12.6 billion on VA community 
     care in fiscal 2018.
       Even though these numbers make it abundantly clear VA is 
     not at all headed toward privatization, I understand the 
     underlying concerns of some critics. They don't want to lose 
     all that VA has to offer. I don't either--and we won't.
       Many of VA's services cannot be replicated in the private 
     sector. In addition to providing some of the best quality 
     overall health care in the country, VA delivers world class 
     services in polytrauma, spinal cord injury and 
     rehabilitation, prosthetics and orthotics, traumatic brain 
     injury, post-traumatic stress treatments and other behavioral 
     health programs. The department plays a critical role in 
     preparing our nation's doctors and nurses--70% of whom train 
     at VA facilities. And we lead the nation in innovation, with 
     VA research having contributed to the first liver transplant, 
     development of the cardiac pacemaker, advancements in 
     treatments for PTSD, cutting-edge prosthetics, and many other 
     medical breakthroughs.
       All of these factors underscore that fears of privatization 
     are simply unfounded. President Trump is dedicated to 
     maintaining a strong VA, and we will not allow VA to be 
     privatized on our watch. What we do want is a VA system that 
     is even stronger and better than it is today. To achieve that 
     goal, VA needs a strong and robust community care program.
       Veterans deserve the best. If a VA facility isn't meeting 
     the community standard for care, doesn't offer a specific 
     service, or doesn't have an appointment available when it's 
     needed, veterans should have access to care in their 
     community.
       This is precisely what they have earned and deserve. It's 
     what the VA is working with Congress and Veterans Service 
     Organizations to deliver. And it's what the system needs to 
     remain a valuable resource for our country's great veterans, 
     now and in the future.

  Mr. ROE of Tennessee. Madam Speaker, I respect the veterans service 
organizations and their point of view, and I am a member of most of 
them. I, therefore, reached an agreement with the ranking member on a 
plan to fund the Veterans Choice Program for 1 year, fund the life 
safety maintenance issues at VA facilities, approve 28 VA clinic 
leases, provide the Secretary with the tools to be more competitive in 
attracting and retaining VA physicians, and conduct a long-overdue 
asset review of VA's aging facilities.
  When the ranking member and I briefed the VSOs on this plan and then 
committee members--two separate meetings--it was clear that we needed 
to take some time to work out the differences. There was some concern 
there. And I have said that is fine. I think we can take a two-phased 
approach.
  Phase one was the one we are talking about today, and we agreed on 
that. It is necessary to fund the Veterans

[[Page 11416]]

Choice Program for 6 months to ensure that the veterans get needed 
healthcare without long drives and waits. That is exactly what we were 
dealing with 3 years ago.
  The second phase, which we would consider 6 months from now, would 
consider the remaining items I have talked about between the ranking 
member and me. During the interim, the committee would conduct open, 
transparent hearings on asset review and anything else--the leases or 
anything else--that was in that agreement. There was full transparency 
about this plan among committee members, which is why I found it a 
little disheartening now what I am hearing.
  The reality is, right now, we don't have an agreement from the Senate 
or a bill to act on, so it is time for us to act because time is 
growing short.
  There are veterans out there, Madam Speaker, that are getting 
chemotherapy as we speak. There are pregnant veterans who need to know 
if they can have their baby and have it paid for by the VA. I could go 
on and on. That is why we need to remove this right now. Then we would 
have time to work these other issues out.
  And just a couple of VA staffing issues. You hear the concern that VA 
is going to be privatized and so forth. I hear that all of the time. 
Well, this is what the VA has done, as far as their facilities are 
concerned, since 2010. I arrived here in 2009.
  Since then, the VA has added 3,600 physicians, almost 13,000 nurses--
and they are one of the largest employers of nurses in the country--
almost 4,000 LPNs, and over 3,200 nonphysician healthcare providers. I 
could go on and on. The increase in medical services has been over $10 
billion since then. So there have been huge increases.
  And just a couple of things from the VA Secretary's editorial in USA 
Today: ``But as VA's community care efforts have grown, so has our 
capacity to deliver care in-house. The VA budget is nearly four times 
what it was in 2001. Since then, the Department's workforce has grown 
from some 224,000 employees in 2001 to more than 370,000 today, 
according to the Office of Personnel Management.''
  That doesn't sound like an organization that is being privatized. It 
has grown in that capacity.
  ``And we're''--the VA--``delivering 3 million more appointments at VA 
facilities per year than we were in 2014.''
  They have grown that capacity internally.
  In our fiscal 2018 budget, the trend continues. We are going to spend 
$2.7 billion more on in-house VA care compared to a $965 million 
increase in community care. So there is a $3 billion increase in in-
house VA care versus out-of-VA care, or outside care.
  I think these are all good things. I think the fact that more 
veterans are getting care, more appointments are being made, whether 
they are in or out of the VA, is a good thing. But to make the argument 
that this is privatization is clearly not there.
  I would like to say that we can work these out. We need to make sure 
we take that anxiety away. The Secretary has clearly stated that he has 
to have this passed. I would simply pass it. It gives us 6 months, 
Madam Speaker, to work on these issues, and I am more than happy to do 
it. I have stated so to every organization out there.
  Madam Speaker, I reserve the balance of my time.
  Mr. WALZ. Madam Speaker, I yield myself such time as I may consume.
  I would just like to respond to the chairman.
  I, too, have not made the argument on privatization. I do not believe 
that is the goal here. I do not believe that is what we talked about. 
If there are those that have that, that is not the intention of this 
committee, the chairman, his staff, or anyone involved with this.
  And when we did talk--and I think this could be an interesting way 
for this House to listen to how we do this. There was transparency in 
these negotiations, and we sat in front of people and did them. And one 
of the issues in there was we had to build the capacity amongst the 
VSOs.
  We need to stop for a minute. There may be times we need to take 
those hard votes against it, but I ask all of the Members to think 
about this, Madam Speaker. All of the veterans service organizations 
have lined up in opposition to this.

                              {time}  1430

  Now, that doesn't mean that they are totally right, and it doesn't 
mean that there isn't something here we can talk and debate about. The 
question is trying to get their goodwill.
  I think when we talked the last time, we had some leases, and I am 
not calling them token, but in the budget of the big VA, which I do 
think in many cases is adequately funded, trying to get some of that to 
show the sense of goodwill.
  If I were counting on the decision being made strictly by the VA 
Committee, I would encourage people to know this would get done, but I 
am deeply concerned we are going to see a Frankenstein monster of 
appropriation process this week that in no way resembles regular order. 
That has nothing to do with this committee.
  Again I would say, if it were left to us, bifurcating this issue and 
coming back and fixing it, I have faith in that. In this House of 
Representatives and the leadership now, I do not have that, nor do the 
veterans service organizations.
  So the question here is not questioning the motive, the question here 
is not a false canard of privatization versus inside-the-VA care, it is 
not even the discussion we are having right now of the adequacy overall 
of the whole budget; it is a case of the VA leadership running a 
program, running out of money way before they had, and coming to the 
House and telling us that. And this is not and cannot be made that the 
idea is you are going to go home without funding the VA. No one will 
say that about you, and no one should say that about us. Everybody in 
this House will get this thing done and get it funded. So it is not the 
case.
  I do understand this: we are against the wall, we are under the gun, 
because they just handed us this. So it is our job to figure out how to 
build everybody into this.
  So the things that are being asked to do with the Choice Program, I 
support that. The offsets and pay-for, I disagree with. To make that 
work, our side was willing to say: Can we show some good faith and fund 
some of these leases and get some payments for these folks in terms of 
an emergency spending? But I understand the difficulty is if a spending 
bill comes, there is going to be a vocal group of folks who are going 
to make the case, as we have seen, that makes it very difficult to move 
legislation.
  Madam Speaker, you have witnessed it with healthcare, you have 
witnessed it with other things, that we are going to have to 
compromise. If we get into our corners, it is not going to work.
  So I want to be very clear. The motives of the chairman to care for 
our veterans is unquestioned, Choice being funded is unquestioned. 
Making sure there is capacity and goodwill and the funding needs in 
these leases and some of the things we are asking for is a necessity to 
make sure the Senate can pass this, and that it shows them that we are 
moving in the right direction.
  So I would ask, give us a day, have us come back at this. Don't put 
this thing on the board to fail and then let everyone else take the 
message. Everyone here knows we are going to end up here and pass 
something that can be signed into law, and that will happen. The 
questions are: Do we do damage amongst ourselves; do we keep the 
goodwill and the collaboration; or do we decide we need to make a 
message first, then come back and then blame someone because they are 
not funding the veterans? No one in here wants that to happen.
  Madam Speaker, I reserve the balance of my time.
  Mr. ROE of Tennessee. Madam Speaker, I yield myself such time as I 
may consume.
  Madam Speaker, I do agree with my good friend, the gentleman from 
Minnesota, Tim Walz. We are not going to leave here until we pass this, 
because there are veterans out there who are ill, who have served this 
country honorably, who need care.

[[Page 11417]]

  I am a physician. I have worked in a VA hospital, I have worked in a 
medical unit in Southeast Asia many years ago, I have seen the results 
and injuries of war, and I have seen the results and injuries of 
current wars. And we are going to do this.
  I know when I sat down and we put this compromise package together, 
and as openly as I could, I brought in the VSOs, I brought in both the 
Republican and Democrat sides, which we typically just check all that 
at the door in this committee, which I am thankful for, and work just 
for veterans, and there were some issues that were brought up. And I 
recognized that, and I said: Well, the smart thing to do is we know 
that Choice runs out of money in 2 to 3 weeks. We have to fund the 
veterans' healthcare now, and we will take these other issues up as a 
package and have time to debate them and discuss them. That is all this 
is about. It is about emergency spending. We recognize that, and that 
is okay with our side.
  I say the easiest way to do this is put this $2 billion bill on 
President Trump's desk, he will sign it, and veterans will have access 
to this Choice Program for the next 6 months. That is what the 
Secretary wants. He wrote a very eloquent editorial in USA Today about 
this entire issue.
  Madam Speaker, I reserve the balance of my time.
  Mr. WALZ. Madam Speaker, may I inquire how much time I have left.
  The SPEAKER pro tempore. The gentleman from Minnesota has 8 minutes 
remaining.
  Mr. WALZ. Madam Speaker, I yield 5 minutes to the gentleman from 
California (Mr. Takano), the vice ranking member of the full Committee 
on Veterans' Affairs.
  Mr. TAKANO. Madam Speaker, I rise today to oppose S. 114.
  A strong and sustainable Veterans Health Administration is critical 
to providing America's veterans with the care they deserve. By funding 
the Choice exception without investing in the VA itself, this 
legislation explicitly prioritizes the private sector at the VA's 
expense. This is not an acceptable way forward.
  Care in the community has always been and will always be important in 
ensuring veterans have access to care, the care that they have earned, 
but it would be a profound mistake to funnel billions of dollars into 
private care while neglecting the VA and the millions of veterans it 
serves every year, and that is exactly what this bill does.
  Veterans service organizations are speaking out, because they know 
what is at stake. They understand the bigger policy implications of 
today's vote.
  This legislation is a referendum on the mistaken belief that the 
private sector is better equipped to care for our Nation's veterans 
than specialized VA doctors.
  I have a statement from eight VSOs that echo these concerns, and I 
include it in the Record.

 Leading Veterans Organizations Call on Members of Congress To Defeat 
                Unacceptable Choice Funding Legislation


    Urge House to Work with Senate to Reach a Bipartisan, Bicameral 
                               Agreement

 (Joint Statement from AMVETS, DAV (Disabled American Veterans), Iraq 
    and Afghanistan Veterans Association (IAVA), Military Officers 
   Association of America (MOAA), Military Order of the Purple Heart 
  (MOPH), Veterans of Foreign Wars (VFW), Vietnam Veterans of America 
               (VVA), and Wounded Warrior Project (WWP))

       As organizations who represent and support the interests of 
     America's 21 million veterans, and in fulfillment of our 
     mandate to ensure that the men and women who served are able 
     to receive the health care and benefits they need and 
     deserve, we are calling on Members of Congress to defeat the 
     House vote on unacceptable choice funding legislation (S. 
     114, with amendments) scheduled for Monday, July 24, and 
     instead work with the Senate to reach a bipartisan, bicameral 
     agreement.
       As we have repeatedly told House leaders in person this 
     week, and in a jointly-signed letter on June 28, we oppose 
     legislation that includes funding only for the ``choice'' 
     program which provides additional community care options, but 
     makes no investment in VA and uses ``savings'' from other 
     veterans benefits or services to ``pay'' for the ``choice'' 
     program.
       Veterans health care benefits have already been ``paid 
     for'' through the service and sacrifice of the men and women 
     who wore our nation's uniform, millions of whom suffered 
     injuries, illnesses and lifelong disabilities.
       In order to ensure that veterans can receive necessary care 
     without interruption, we call on House leaders to take the 
     time necessary to work together with Senate leaders to 
     develop acceptable ``choice'' funding legislation that not 
     only fills the current funding gap, but also addresses urgent 
     VA infrastructure and resource needs that led to creation of 
     the ``choice'' program in the first place.
       All of our organizations are committed to building a future 
     veterans health care system that modernizes VA and integrates 
     community care whenever needed so that enrolled veterans have 
     seamless access to timely, quality care. However, if new 
     funding is directed only or primarily to private sector 
     ``choice'' care without any adequate investment to modernize 
     VA, the viability of the entire system will soon be in 
     danger.
       We call on leaders in both the House and Senate to work 
     together in good faith, and we remain committed to supporting 
     such efforts, in order to quickly reach an agreement that 
     ensures veterans health care is not interrupted in the short 
     term, nor threatened in the long term.

  Mr. TAKANO. The organizations signing the statement are AMVETS; the 
Disabled American Veterans; Iraq and Afghanistan Veterans Association, 
IAVA; Military Officers Association of America, MOAA; Military Order of 
the Purple Heart; Veterans of Foreign Wars; Vietnam Veterans of 
America; and Wounded Warrior Project.
  I would like to quote from a few of the paragraphs:
  ``In order to ensure that veterans can receive necessary care without 
interruption, we call on House leaders to take the time necessary to 
work together with Senate leaders to develop acceptable Choice funding 
legislation that not only fills the current funding gap, but also 
addresses urgent VA infrastructure and resource needs that led to 
creation of the Choice Program in the first place.
  ``All of our organizations are committed to building a future 
veterans healthcare system that modernizes VA and integrates community 
care whenever needed so that enrolled veterans have seamless access to 
timely, quality care. However, if new funding is directed only or 
primarily to private sector Choice care without any adequate investment 
to modernize VA, the viability of the entire system will soon be in 
danger.''
  I also have letters opposing S. 114 from the Paralyzed Veterans of 
America and the VFW. I include these letters in opposition in the 
Record.

       Washington, July 22, 2017.--Paralyzed Veterans of America 
     (Paralyzed Veterans) today weighed in on options being 
     considered to fund the veteran ``choice'' program, as the 
     House of Representatives considers a vote on a draft bill, S. 
     114 as amended, on Monday, July 24. Priorities for the 
     organization include open discussion on the best way to build 
     up specialized veteran-centric services offered by the 
     Department of Veterans Affairs (VA), while expanding access 
     to non-specialized healthcare for veterans without cutting 
     critical non-healthcare VA benefits.
       ``The notion of streamlining VA is a necessary discussion 
     that must continue. The devil is in the details, though,'' 
     said Sherman Gillums Jr., executive director of Paralyzed 
     Veterans of America. ``We do support the responsible `right 
     sizing' of VA, starting with the elimination of redundancies 
     and ultimately using cost savings to increase reinvestment in 
     VA's foundational services, such as spinal cord injury care. 
     Offsets, at least in part, may be necessary in order to 
     achieve that.''
       Offsets, or program and benefit trade-offs used for 
     budgeting purposes, are not new to VA. Past offsets include 
     fees and collections related to housing loans and extensions 
     in the reduction of certain pensions used to pay for other 
     benefits. However, this is the first time Congress is 
     requiring VA to include deficit reduction as a component of 
     the agency's plan to maintain and expand the VA Choice 
     Program. Moreover, some veteran advocates have expressed 
     staunch opposition to offsets because they require VA to 
     employ a ``rob Peter to pay Paul'' approach to funding 
     programs.
       ``Paralyzed Veterans' main concern is that using these 
     offsets to pay for VA healthcare comes at the expense of 
     expanding non-healthcare benefits, such as disability 
     compensation,'' explained Gillums. ``However, we are not 
     prepared to simply oppose offsets because we believe VA is 
     open to strengthening healthcare for our most 
     catastrophically disabled veterans, which matters above all 
     else. Paralyzed Veterans leads as an expert voice on the most 
     complex healthcare challenges these veterans face, and we 
     intend to use that voice to promote new ideas and progress.''

[[Page 11418]]

       ``The bottom line is the discussion must continue with open 
     minds on all sides,'' concluded Gillums.


                        About Paralyzed Veterans

       Paralyzed Veterans of America is the only congressionally 
     chartered veterans service organization dedicated solely for 
     the benefit and representation of veterans with spinal cord 
     injury or disease. For 70 years, we have ensured that 
     veterans have received the benefits earned through their 
     service to our nation; monitored their care in VA spinal cord 
     injury units; and funded research and education in the search 
     for a cure and improved care for individuals with paralysis.
       As a partner for life, Paralyzed Veterans also develops 
     training and career services, works to ensure accessibility 
     in public buildings and spaces, provides health and 
     rehabilitation opportunities through sports and recreation 
     and advocates for veterans and all people with disabilities. 
     With more than 70 offices and 33 chapters, Paralyzed Veterans 
     serves veterans, their families and their caregivers in all 
     50 states, the District of Columbia and Puerto Rico 
     (pva.org).
       Source: Paralyzed Veterans of America.
                                  ____


                     VFW Urges Opposition to S. 114

     From: Carlos Fuentes, VFW Legislative Director.
     Sent: Monday, July 24, 2017.
     Subject: VFW Urges Opposition to S. 114.
       On behalf of the nearly 1.7 million members of the Veterans 
     of Foreign Wars of the United States and its Auxiliary, we 
     urge all members of Congress to vote NO on S. 114, which 
     would gradually privatize the VA health care system.
       At the VFW's 118th National Convention, VFW National 
     Commander Brian Duffy asked our members what they thought of 
     this bill.
           Respectfully,

                                               Carlos Fuentes,

                           Director, National Legislative Service,
                          The Veterans of Foreign Wars of the U.S.

  Mr. TAKANO. Madam Speaker, after more than 2 years and more than $10 
billion, the VA Choice Program has failed to deliver on its promise of 
shorter wait times for veterans.
  It is time for us to recognize that private care is not the panacea 
for the complex challenge of caring for our Nation's veterans and that 
the VA's role must remain foundational to veterans' care. This bill 
does not reflect that reality.
  I urge my colleagues to reject this legislation while we continue to 
work toward a bipartisan, bicameral solution.
  Mr. ROE of Tennessee. Madam Speaker, may I inquire as to the time 
left on our side.
  The SPEAKER pro tempore. The gentleman has 9 minutes remaining.
  Mr. ROE of Tennessee. Madam Speaker, I yield myself such time as I 
may consume. I want to clarify a couple of things that have been said 
here today.
  Madam Speaker, we did work out an agreement. When I met with all of 
the interested parties, which I thought was our job, both the ranking 
member and myself did this, as we always do, we found out some issues 
that were there.
  The primary thing we have to do right now is to provide healthcare, 
or we will be right back to where we were in 2014, when there were 
waiting lists around the country and veterans dying waiting on care.
  Maybe not in urban America, but in rural America where I live, many 
of these hospitals and veterans absolutely rely on this for their 
health and welfare. The further they live away from a VA facility, the 
more they rely on Choice.
  Let me go over this again so that it is clear. I got into Congress in 
2009. I was elected then and sworn in then. The VA was spending $93.7 
billion on all VA care; that is the disability claims, healthcare, and 
cemeteries. In this fiscal year, that budget is going to be $186 
billion, where basically the discretionary budget in this Congress has 
been flat, so that money has come from other places, education, 
environment, other places that we have invested in our veterans, which 
is, and I believe to this day, a good thing to be doing.
  We have gone, in 2001, from 224,000 people, that is not a small 
organization, to 370,000 people who work for the VA today. They are 
providing that money.
  I guess what I was hearing from the other side of the aisle was if we 
didn't have the Choice Program, the wait times would have gotten 
shorter. I mean, that is the reason we have the Choice Program, was the 
VA wasn't doing it.
  The fact is, they have hired people. I mentioned here just a moment 
ago, since 2010, when I first got here, they have hired 13,000 more 
nurses, 3,600 more doctors, 3,200 more physician extenders, nurse 
practitioners and PAs. So the VA has increased its capacity, and they 
have seen millions of more visits.
  This week, we are going to take up the VA appropriations bill. I 
misspoke a minute ago; I said last week. This week, we are taking up 
the MILCON-VA appropriations bill where we talk about those things, 
about the money that we are going to spend in the VA. That is going to 
be debated this week.
  This is a separate issue. This is about providing healthcare for 
veterans after August 15, that is 2 to 3 weeks from now, when that 
program will be shut off and veterans in the middle of care will not be 
able to get care.
  It is a simple vote. We can work these other things out in the next 
few months after this very easily.
  Madam Speaker, I reserve the balance of my time.
  Mr. WALZ. Madam Speaker, I have no further speakers. I am prepared to 
close, and I yield myself the balance of my time.
  Madam Speaker, to be clear, we are very aligned on the goals here. I 
am not implying that wait times went down if we didn't have Choice. I 
was on the conference committee that created Choice as part of it. 
There is community care that has been there. There is also a $12 
billion shortfall in facilities rated D and F. We had sewer lines 
breaking and running feces back into hospitals, those types of things.
  I am not saying that maybe the money is not already there or they are 
not using it correctly. The fact of the matter is this was a program 
that was created out of the crisis of Phoenix. It did not stand up as 
quickly as it could have; it was plagued with tons of problems that 
many of us heard about. We kept committed to it. I would argue that 
they are getting their legs under them and providing care in a timely 
manner.
  It grossly overspent where it was at. We have had no audit. And I 
think we need to keep this in mind, that on this side of the aisle, I 
will be the first to talk to anyone who grandstands this and makes this 
as a case that this is a failure at the VA or the administration. I 
don't know that yet.
  What I would say is we are all in this together, so we want to get it 
done. I am simply making the case today that in light of opposition 
that is rarely seen from the VSOs in such opposition to this, that even 
though the outcome is there, and nothing the chairman said was 
incorrect, it is the spirit of what it takes to legislate that is 
missing around here. You can go to the White House after passing a bill 
in the House, and if the Senate doesn't do anything, it is not a law.
  So we have other people to deal with: constituents, veterans, 
veterans service organizations, Democrats in the Senate, Republicans in 
the Senate, Democrats on this side.
  So what I am asking is, just give a little on the side of what it 
takes to build the coalition, get the thing passed, and then let's go 
back and fund VA care and end this ridiculous argument of privatization 
versus nonprivatization. Wherever a veteran can get the care and access 
it as quickly, timely, and quality as possible is what we are trying to 
shoot for. In many cases, that is in the VA; in other cases, it is in 
the community. So this is not a drop-dead.
  My hope on this is, is that a debate, when it comes to emergency 
spending of money and depending on the Senate, is not going to split 
the goodwill, the good work, and, I would argue, the fair democracy and 
execution of how the House of Representatives is supposed to work.
  So my final statements on this would be, I am in virtual total 
agreement with the chairman on what needs to be done here. Our 
differences lie in, he is right, when I went back and talked to people, 
I could not sell to the VSOs the plan as it is, and they have every 
right to speak out on that. And we could not sell the Senate at this 
point.

[[Page 11419]]

  So what I would ask the gentleman again is, don't make us oppose this 
piece of legislation simply to make a statement for a few members. 
Bring it back when we can have the Senate, the VSOs, and everyone in 
and accomplish our goal.
  Madam Speaker, I yield back the balance of my time.

                              {time}  1445

  Mr. ROE of Tennessee. Madam Speaker, I yield myself such time as I 
may consume.
  Obviously, this has been a robust debate about a very important 
issue, which is providing timely healthcare for veterans who have been 
waiting. The ranking member and I negotiated in good faith and put an 
agreement together, which fell apart this weekend.
  We had met basically with both the VSOs and the committee members and 
had an agreement to go forward. I then backed up on that agreement 
because I realized it wasn't a consensus, and just divided it into two.
  The most pressing need, Madam Speaker, is to provide healthcare, 
whether it is chemotherapy or obstetrical care, surgery that a veteran 
may need, timely visits to the doctor. In 2 to 3 weeks we are up that 
close, and one of the reasons is, as has been stated multiple times, 
the VA gave us some really bad information 2 months ago. We thought 
this was going to last for 6 more--8 more months before we ran out of 
money in this vital program for veterans.
  This is going to get passed. For all veterans or people out there, 
citizens of this country watching this, we are going to provide this 
for our veterans.
  And I might add that not all VSOs do oppose this. Many were 
mentioned, but many others do not oppose this legislation.
  I think it is critical that we get this done, Madam Speaker, get this 
off the table this week, signed into law, work the other part of the 
agreement that we had agreed to out in the next coming weeks. I will be 
willing to work as expeditiously as possible to get this done.
  Once again, I encourage all Members to support this legislation, and 
I yield back the balance of my time.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentleman from Tennessee (Mr. Roe) that the House suspend the rules and 
pass the bill, S. 114, as amended.
  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. WALZ. Madam 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, further 
proceedings on this motion will be postponed.

                          ____________________