Federal Flight Deck Officer Improvement Act of 2004

Mr. Speaker, today, along with Representative Rob Simmons of Connecticut, Chairman of the Veterans' Affairs Subcommittee on Health, and three dozen other cosponsors, I am introducing H.R. 2475, the Veterans Health Care Full Funding Act, legislation to ensure full funding for the Department of Veterans Affairs' health care system.-

This bill would fulfill the central recommendation of the President's Task Force To Improve Delivery of Health Care for Our Nation's Veterans, which reported an alarming mismatch between demand for services and available resources that threatened the quality of VA health care. The Task Force recommended that the veterans' health care funding process should be overhauled in order to achieve full funding.

As early as 1993, national veterans organizations were calling for guaranteed funding for VA health care. Last year I introduced H.R. 5250, legislation to achieve that goal by funding VA health care through a permanently fixed formula, one possible approach recommended by the President's Task Force.

The legislation we are introducing today takes the other major approach identified by the Task Force, establishing an independent board of experts on health care economics, with an independent budget and staff, to determine the annual funding levels necessary for veterans' medical care and to be included in the Administration's budget.

Under our legislation, a three-member Funding Review Board would be appointed by the Secretary of Veterans Affairs for staggered 15-year terms. The Board would have full access to VA's economic, actuarial and other data relevant to determining health care funding, as well as the Office of Management and Budget's (OMB) economic and forecasting analysis, but would be independent of both.

The Board would produce an annual budget request and a budget forecast for funding necessary to provide full health care benefits in a timely and cost-efficient fashion to all enrolled veterans in Priority Groups 1-7, primarily those injured or disabled while serving their nation, or with low income levels. The amount calculated by the Board for the next fiscal year would become the President's budget request submitted to Congress. From that point forward, the congressional budget and appropriations process would remain unchanged.

To ensure that veterans are receiving timely care, the legislation would require VA to provide care in a timely manner; if VA is unable to furnish care to veterans who need it within reasonable timeframes, it would be obligated to contract for that care with private sector health care providers.

In order to promote fiscal discipline within VA health care, the Board would be required to identify areas where VA program efficiencies and savings can be achieved, as well as be required to consider recommendations from OMB.

Mr. Speaker, for at least the past five years, veterans' usage of VA health care services has surpassed every Administration estimate-- Republican and Democrat. The continuing rise in demand for VA health care services has been driven by many factors, including VA's establishment of over 650 new and more convenient VA community-based outpatient clinics for primary care, improved safety and quality of care, and the availability of VA prescription drug benefits. VA has become an increasingly important supplier of prescription drugs to veterans, particularly senior veterans who lack a drug benefit from the Medicare program.

Further evidence of the urgent funding needs of VA health care comes from a report issued last year measuring the amount of time veterans are waiting for medical services. According to VA's report, there were nearly 300,000 veterans waiting for initial medical appointments, half of whom were waiting 6 months or more; and the other half having no appointment at all. While the VA has indicated progress is being made to reduce this waiting list, the Secretary's decision to halt enrollment of Priority 8 veterans for the remainder of this year is another clear indicator that VA is not properly equipped to handle the current demand for medical services because it lacks the funding to do so.

The President's Task Force (PTF) was established in May, 2001 to improve collaboration and resource sharing between the Departments of Defense and Veterans Affairs health care systems. Within months of the start of its deliberations, the Task Force discovered that a mismatch between demand for VA health care services and available resources prevented VA and DOD from achieving the full advantages of sharing and threatened the quality of VA health care. The PTF recommended in its report that the current budget and appropriations process be reformed. Let me quote from the report:

The Federal Government should provide full funding to

ensure that enrolled veterans in Priority Groups 1 through 7

(new) are provided the current comprehensive benefit in

accordance with VA's established access standards. Full

funding should occur through modifications to the current

budget and appropriations process, by using a mandatory

funding mechanism, or by some other changes in the process

that achieve the desired goal.

The PTF identified two possible approaches to addressing current problems with the funding process: make veterans health care funding a mandatory budgetary item, or create an independent Board of experts, actuaries, or other outside officials to dispassionately review needs and determine funding levels. Both approaches would have the same goal: to achieve full funding to meet demand in a timely manner.

Mr. Speaker, the Veterans Health Care Full Funding Act would accomplish this goal by establishing a funding process similar to one already used by the Department of Defense. Our legislation is modeled on a provision in the 2001 Floyd Spence Defense Authorization Act, Public Law 106-398, popularly known as ``TRICARE for Life.'' Under this legislation, an outside panel of experts and actuaries was established to determine future funding levels to meet health care needs of military retirees and their families in the TRICARE program. Our legislation is modeled on this successful program.

In addition, our legislation would codify standards for veterans' access to health care. Without a requirement that VA meet reasonable access standards, veterans could continue to be denied access to care regardless of any funding. I would like to recognize and thank my colleague on the Veterans' Affairs Committee, Representative Ginny Brown-Waite, who has introduced separate legislation, H.R. 2357, to achieve this very goal. The standards established in the Brown-Waite bill are incorporated in the legislation we are introducing today.

The VA budget for fiscal year 2003 contained a record $2.6 billion increase in the funding of medical care for our Nation's veterans and this year, based upon our Committee's recommendations, the House approved another record veterans budget, increasing overall veterans spending by $6.2 billion, including about a $3 billion increase for medical care. But even with these historic increases,

VA may not be able to meet demand for medical services.

Mr. Speaker, with the introduction of the Veterans Health Care Full Funding Act, H.R. 2475, we hope to move beyond debate and discussion and finally get on the fast track to legislative action. It's time to fix the funding system for veterans' health care. I urge all my colleagues to carefully review and consider supporting the Veterans Health Care Full Funding Act, H.R. 2475, to provide dependable, stable and sustained funding to meet the health care needs of veterans of our armed forces. They deserve no less from a grateful nation.

Mr. Speaker, today, on behalf of myself and 72 of my colleagues, I am introducing H.R. 2318 the ``Assured Funding for Veterans Health Care Act of 2003.'' Starting in Fiscal Year 2005, the bill would require the Secretary of the Treasury to provide funding for the Department of Veterans Affairs Health Care System based on the number of enrollees in the system and the consumer price

index for hospital and related services. I believe the measure I am offering will create a vastly improved funding system that better responds to the needs of our veterans.

Last week the President's Task Force to Improve Health Care Delivery For Our Nation's Veterans issued its final report. In it, the ``growing mismatch between funding and demand'' is repeatedly referenced. To address this problem, the report recommended: The Federal Government should provide full funding to ensure that enrolled veterans in Priority Groups 1 through 7 (new) are provided the current comprehensive benefit in accordance with VA's established access standards. Full funding should occur through modifications to the current budget and appropriations process, by using a mandatory funding mechanism, or by some other changes in the process that achieve the desired goal. (p. 77)

In addition, the Task Force addressed the need to clarify standards of access for Priority 8 veterans. Priority 8 veterans are the so- called ``high-income'' veterans without compensable service-connected conditions. Who are these individuals? Anyone with an income level of more than the geographically adjusted Housing and Urban Development threshold for low-income housing is considered ``high income''. In some communities, this means veterans with incomes of more than $24,644-- most often work-a-day folks who sometimes have to choose between prescription drugs and heat or groceries. My bill would cover these veterans.

Some will say that we've done well by our veterans this year. I would say it might well have gone the other way. This body passed a budget resolution that would have required us to cut veterans benefits during a period of war. It still remains unclear how veterans' health care will fare when pitted against such disparate programs as low-income housing, the space program and other independent agencies. Other health programs such as Medicare and TRICARE for Life are not subject to the same types of considerations because funding for these programs is based on need.

The result of this funding process is the ``growing mismatch'' addressed by the President's task force--the system is starving! We all have heard the numbers of veterans who have waited more than six months for health care services. There were more than 200,000 veterans in the queue at the beginning of the year. Even with increases proposed in the joint budget resolution, VA will still impose some regulatory constraints on access and has identified more than a billion in illusory ``management efficiencies.''

Last year, I cosponsored H.R. 5250, the ``Veterans Health Care Funding Guarantee Act of 2002'' with 129 other members of the House. The bill I am offering today closely resembles that legislation. The Congressional Budget Office slapped a hefty price tag on H.R. 5250 largely assuming huge increases in demand would result if the veterans' health care system were adequately funded! Think about this--our budget office assumes that our health care system for veterans is so fiscally deprived that a fairer funding system that responds to changes in demand would create a run on health care!

Our veterans deserve better than a chronically underfunded health care system. I believe veterans--all veterans--have earned the right to access the health care system that was created to serve their needs. The price we pay as a Nation for assuring timely access to high-quality health care services is small in relation to the price we have asked them to pay in securing our freedom.

I urge my colleagues to join me and the 72 other members of the House that believe this is the right thing to do for our veterans. Every major veterans service organization, including The American Legion, Disabled American Veterans, and Veterans of Foreign Wars, has stated support for this bill. Join us in the fight to do the right thing for our veterans. Join me in cosponsoring the ``Assured Funding for Veterans Health Care Act of 2003''.