Chiropractic Care Available to All Veterans Act

I thank the gentleman for yielding, and I want to thank also not only you but also in particular Ms. Herseth Sandlin and Mr. Michaud for their work on this bill.

I'm pleased to support H.R. 1470, the Chiropractic Care Available to All Veterans Act, that would require a phased implementation to provide chiropractic care in all VA medical centers by December 31, 2011.

Under a policy guidance that I gave under the House Republican alternative budget resolution for fiscal year 2008, we provided an additional $100 million for veterans medical services to support the hiring of doctors of chiropractic care at all 155 VA medical centers. I have history dating back to the 106th Congress for supporting chiropractic care.

The Military Personnel Subcommittee of the House Armed Services Committee worked to include chiropractic care services as a benefit in the military health facilities and through TRICARE.

VA is currently offering chiropractic care in 30 VA medical centers and provides chiropractic care on a fee-for-service basis for veterans who are geographically distant from a VA medical facility. In fiscal year 2006, the VA paid over $1 million to fee-based chiropractic providers to treat roughly 3,000 veterans, and I support the passage of this bill.

I would also note, Mr. Speaker, that I'm very concerned because the chairman just spoke that the reason, words to the effect, that he's brought these seven bills to the floor is to represent what a grateful Nation bestows. But what I'm concerned about the seven bills being considered today under the suspension of the rules, only one, H.R. 2199, is being considered with a bill report having been filed.

I believe this is yet another way in which the majority of this Veterans' Affairs Committee is breaking with past practices. When you do not file a report with a bill that comes to the floor, you are essentially denying Members of the minority the opportunity to file supplemental, minority and additional views on legislation under House rule XI, clause 2(i).

Since the time of Sonny Montgomery, the Committee on Veterans' Affairs has filed bill reports with every veterans bill other than resolutions such as H. Res. 392 or a facility naming bill; which is what I'm asking for Mr. Filner to do to honor the recipient of the Medal of Honor with regard to the naming of the VA medical center in Albuquerque, NM, and the minority has thus had the opportunity to file views.

The veterans bills being considered by the House today, H.R. 67, H.R. 1660, H.R. 612, H.R. 1470 and H.R. 2239, were all ordered favorably reported, with the exception of H.R. 1470, ordered reported from the Committee on Veterans' Affairs with amendments. However, the chairman of the Veterans' Affairs has filed no bill with reports on any of them. Not only does this deprive the minority of the opportunity to file views, but it deprives veterans and the rest of the interested public from having important legislative history which discusses the background of legislation and explains the committee's intent as well as the amendments.

All of this is compounded by the fact that most of these bills were ordered reported without hearings that would have provided an historical record for legislation. The majority also has not bothered to obtain the position of the administration on most of these bills.

There is no reason for taking such shortcuts. I would have filed additional views on H.R. 1660, in particular, if the opportunity had been available. These are not expedited pieces of legislation involving an emergency situation. There has been ample time to follow the customary regular order and do that which is right.

We will now be at a disadvantage when conferring with the Senate. I fully expect the House to pass these bills overwhelmingly, but it is not a good way to legislate on behalf of our Nation's veterans.

I understand all the committees operate under the suspension of the rules to bring legislation to the floor. I wish that there were a collegial relationship between the chairman and the ranking member. It does not exist, unfortunately.

If, in fact, he would confer and work with us, we wouldn't have to work these things out or make an attempt to work these things out on the House floor.

Once again, I will make an attempt, and I will ask Chairman Filner if he would call up Heather Wilson's bill and allow us, when we return after the Memorial Day break, to have Heather Wilson's bill, H.R. 1474, brought to the House floor under the suspensions.

Mr. Chairman, I yield to you.

Parliamentary Inquiry

I would yield to the chairman for a parliamentary inquiry and respond to the question.

Mr. Speaker, once again, reclaiming my time, the American people get to see the abuse of power that I have to deal with.

Rather than working collegially with us, with regard to filing reports, it's just, well, we don't have to do it. We'll just bring it to the floor. It doesn't matter. Really? Is that how we're going to legislate? We're just going to be sloppy about the Nation's business? I don't think that's a proper way of paying respect to our Nation's veterans, and it's very unfortunate.

I yield to my colleague, the chairman of the committee, to respond to my question that will you permit, under the suspension of the rules, to consider H.R. 474 when we return after Memorial Day break so that we may honor Raymond Jerry Murphy and rename the Albuquerque VA Medical Center after him.

Mr. Chairman, I yield to you.

I do not yield for a parliamentary inquiry. I think the purpose of my yielding to the chairman was to get a good response, whereby we have criteria, before the committee, with regard to how we name VA medical centers.

There is an individual, all the criteria have been satisfied, and I asked a very simple question of the chairman, if he would suspend the rules and bring it to the floor. I have written him twice. He doesn't respond to the letters. It has passed the Senate. A bill lays upon the desk, and I asked a very simple question.

All he wants to do is a parliamentary inquiry. So maybe we will be enlightened if I let him do a parliamentary inquiry.

Mr. Chairman, I yield to you for a parliamentary inquiry.

Parliamentary Inquiry

Thank you. I would yield back to the gentleman, since he did not address a parliamentary inquiry during his question. I yield to him, if you would like to have a statement.

Pardon? I yield to the chairman.

Well, this is pretty interesting. It's pretty hard to run the Nation's business if the chairman will not even respond to somebody on the House floor.

It's also very disappointing if, in fact, this is the way we are supposed to honor America's veterans whereby the chairman of the majority party is acting like this.

I suppose what I should do is work with my good friend Mr. Michaud, who is the chairman of the Health Subcommittee, who has the ability to call this bill up and to mark this bill up. Obviously, even though he were to mark this up in the subcommittee, it would still be held at the full committee, if the chairman wants to continue to play politics.

Mr. Speaker, I move to suspend the rules and pass the bill (H.R. 1470) to amend the Department of Veterans Affairs Health Care Programs Enhancement Act of 2001 to require the provision of chiropractic care and services to veterans at all Department of Veterans Affairs medical centers.

Mr. Speaker, I yield myself such time as I may consume.

We are continuing with a packet of seven bills from the Veterans' Affairs Committee that is really a thank-you in prelude to Memorial Day, a thank-you to our Nation's veterans. Memorial Day is a tribute to those who gave the ultimate sacrifice.

What we are saying is we're honoring them and all our veterans who are living with us in the United States. And as I said earlier, no matter where we are on the current debate on the war in Iraq, we are united in saying that every young woman, every young man who returns from that battle gets all the care, the attention, the love, the honor, the dignity that a grateful Nation can bestow. And that's what we are saying in these bills today.

We have already passed a bill which extends from 2 years to 5 years the ability of any returning servicemember in combat to access the VA health care system. Two years was not sufficient for those who might have brain injuries, who might have PTSD, posttraumatic stress disorder. These are, in many cases, hidden diseases. You don't know that you have it. A doctor may not diagnose it at first, and so as time goes by, you may feel the need to access the VA health care system. So we have extended that from 2 years to 5 years.

In addition, we have passed a new outreach program to meet especially the needs of rural veterans, and we will continue this package in the hour ahead.

Veterans returning home from the wars in Iraq and Afghanistan should be able to depend on medical services that they want being available in the system of health care that was built to take care of them and their unique needs.

For those returning veterans seeking care in a VA health care system, we know that the most common health problems are under the category of musculoskeletal ailments, principally joint and back disorders. We hear a lot about brain injury and PTSD, and those we have to give a lot of resources to, but 42 percent of veterans coming to the health care system have been presented to the VA with the needs of joint and back disorders.

This bill, the Chiropractic Care Available to All Veterans Act, requires

that chiropractic services be made available in not fewer than 75 VA medical centers by the end of December 2009 and all the health care centers by the end of 2011.

Undoubtedly the returning servicemembers will be able to benefit from this care. I speak from experience as I have had chiropractic care a good part of my life. I am confident that with expansion of these services within VA, many veterans will be able to find relief from their pain.

Since the creation of the VA health care system, the Nation's doctors of chiropractic have been kept outside and all but prevented from providing proven, cost-effective and needed care to veterans. So we are grateful that access is becoming wider and wider.

The support for VA chiropractic service is bipartisan. Former Secretary of Veterans Affairs Anthony Principi released a policy directive before his departure several years ago regarding the true and full integration of chiropractic care in the VA.

Secretary Nicholson and I have developed a solid working relationship, and chiropractic care is an area where we will be working closely together. Both Republican and Democratic Members have supported the inclusion of chiropractic care in the VA.

I have worked very closely with chiropractic patients, particularly our veterans, as well as with various associations dedicated to the profession such as the American Chiropractic Association.

Veterans are returning home from combat expecting to receive needed services. Let us not disappoint them. Expansion of chiropractic services is the right thing to do, and it is the least we can do for our returning heroes.

I urge support of H.R. 1470.

Mr. Speaker, I reserve the balance of my time.

Mr. Speaker, I yield as much time as she may consume to the gentlewoman from South Dakota (Ms. Herseth Sandlin).

Mr. Speaker, I have a parliamentary inquiry.

Mr. Speaker, is it a requirement that committees have to file reports with legislation that is very straightforward?

I thank you, and I hope the ranking member heard that.

Mr. Speaker, am I required to engage in political debate with the ranking member when we are discussing a bill very important to veterans?

I would inform the ranking member that I am not going to respond to political debate.

It's your time.

Mr. Speaker, I yield as much time as she may need to the gentlelady from Florida (Ms. Corrine Brown), who has now for 15 years fought side by side with me on behalf of our Nation's veterans. She is a fighter, and we are proud of her. You have the floor, Ms. Brown.

Mr. Speaker, I ask unanimous consent that all Members may have 5 legislative days in which to revise and extend their remarks and to include extraneous material on H.R. 1470.

Mr. Speaker, I yield back the balance of my time.

Mr. Speaker, on that I demand the yeas and nays.

Mr. Speaker, I move to suspend the rules and pass the bill (H.R. 612) to amend title 38, United States Code, to extend the period of eligibility for health care for combat service in the Persian Gulf War or future hostilities from two years to five years after discharge or release, as amended.

Mr. Speaker, I yield myself such time as I may consume.

Mr. Speaker, not all of the returning veterans from the OEF/OIF suffer from obvious wounds. Those who suffer from an external injury are readily identified and receive immediate care for that injury. However, many of our returning veterans, and on this I include, Mr. Speaker, Guard and Reserve units who have been ordered to combat, are coming back with injuries that are not external. They are hidden wounds of the war, such as post-traumatic stress disorder, PTSD, forms of brain injury, which may not be evident without further diagnosis, which may not be evident to the soldier or to the doctor looking at him.

Unlike the physical wounds, mental wounds are not easily identified and may go undetected. PTSD is a mental health condition that is triggered by a traumatic event which causes an intense fear and/or helplessness. Some of the symptoms for this condition include reexperiencing the trauma through nightmares, obsessive thoughts, flashbacks. We know that this condition may not reveal itself for many months or maybe for years after experiencing the event.

We listened to veterans, veteran service organizations, family members, and we heard them say that their returning veterans needed more time to access the VA health care system when they came home from war.

Conditions like PTSD and traumatic brain injury are the driving force behind this bill, the Returning Servicemember VA Healthcare Insurance Act of 2007. It extends from 2 years to 5 years following discharge or release the eligibility period for veterans. And, as I said, we include Guard and Reserve units all those who served in combat during or after the Persian Gulf War are eligible to receive hospital care,

medical services, or nursing home care provided by the Secretary of Veterans Affairs. It provides for an additional 3 years of eligibility for veterans discharged more than 5 years before the enactment of this act who may not have enrolled in the VA health care system.

This system is recognized throughout the country, and indeed the world, as providing safe quality health care to our veterans. Two years was simply not enough time for returning OEF/OIF veterans to utilize this very important benefit. We are fixing that with this piece of legislation. It is a bill that will have a profound effect most immediately on our veterans returning from war. I urge my colleagues to support the bill.

Mr. Speaker, I reserve the balance of my time.

Mr. Speaker, I have no further speakers, and I reserve the balance of my time.

Mr. Speaker, I want to thank the ranking member for his helpful amendment to this bill. As I said earlier, this is a very important bill to thousands and thousands of returning veterans. They have basically unfettered access to one of the best health care systems in the world without going through a lot of red tape, without going through a lot of paperwork to prove that they are eligible. They will have 5 years.

And it is most important for our Reserve and Guard units, who are not eligible for the benefit structure of the VA system. They are not eligible for most of the benefits of the GI bill. And we are trying to make an effort to bring them in under the VA benefits under what we call ``total force structure.''

So this bill is important to thousands of people, those that are coming back from the Marines or Army and those that are in the Guard and Reserve units. All of them now will have 5 years where these hidden injuries, brain injury, or post-traumatic stress disorder may become evident, and they may seek help. Now they will be able to do it without any of the bureaucratic entanglements. And I think this will have a remarkable impact on the lives of our Nation's veterans.

And I will tell you, as George Washington said more than 200 years ago, ``The morale of our fighting troops is dependent, most of all, on how they feel they're going to be treated when they come home.'' When they know they will have 5 years to come to the VA, they will know that a Nation is caring for them and is responsive to their needs.

I would ask, Mr. Speaker, unanimous consent that all Members may have 5 legislative days in which to revise and extend their remarks and include extraneous material on H.R. 612, as amended.

Mr. Speaker, I urge my colleagues to unanimously support this bill, and I yield back the balance of my time.

Mr. Speaker, on that I demand the yeas and nays.

Mr. Speaker, I often say that the opportunity to serve on Veterans' Affairs Committee is one of the greatest privileges I have been given in my short time in Congress. The action on the floor of the House today is another reminder of how it is truly an honor to serve on this Committee. Earlier this afternoon the House passed several pieces of legislation to improve outreach and care to our nation's veterans.

Memorial Day is the day for Americans to officially honor the heroes who have fallen in service to our country, and a day to pray for and remember the brave souls who have given the ultimate sacrifice. We are the beneficiaries of those who serve and who have served to preserve the peace and freedom we enjoy.

As a nation, we honor the bravery of those who have fought and died for our country and recognize the tremendous sacrifices they and their families have made. But to truly honor these heroes it is our duty as a grateful nation to not just spend the day remembering their service, but to provide the promised support and benefits to the soldiers and veterans who served with and followed them. These bills help provide that support.

H.R. 67, the Veterans Outreach Improvement Act, creates a grant program to allow the VA to partner with State and county veteran organizations to reach out to veterans and their families to ensure they are aware of their eligibility for benefits.

This bipartisan bill also increases acountability in spending taxpayer dollars by requiring reports on how the grants in this program have been used to improve outreach. I am proud to be a cosponsor of this bill and am pleased it has passed the House.

H.R. 612 is an extremely important piece of legislation. This bill will extend access to VA Healthcare for Iraq and Afghanistan veterans from two years to five years. This is vital to the health of our veterans returning from Iraq because of the nature of Traumatic Brain Injury and Post Traumatic Stress Disorder.

In some cases, TBI and PTSD symptoms do not emerge until several years after the injury occurred. With the current freeze on Category 8 veteran enrollment in VA healthcare, this means that some OIF/OEF will realize they suffered a brain injury while deployed but be locked out of the system.

They might not have health insurance to cover their treatment, and will not have crucial medical documents that will help them receive disability benefits.

By expanding their eligibility for 3 additional years, Congress is acting to limit the damage done by the President's Category 8 veterans enrollment freeze. I was proud to also cosponsor this legislation.

Another extremely important bill to our Iraq and Afghanistan veterans is H.R. 2199, the Traumatic Brain Injury Health Enhancement and Long Term Support Act.

TBI is the signature injury of the war in Iraq and this bill vastly improves the VA's ability to provide care for brain injury.

This bill requires the VA to establish a program to screen veterans for TBI and establish a program of long term care for acute TBI victims.

Currently, of the nearly 1,300 VA health care facilities in the United States, only 4 have specialized TBI programs. This bill allows the VA to partner with private facilities to provide treatment the VA cannot immediately provide.

It also establishes centers of research and a national database so we can better understand the causes and symptoms of TBI. Hopefully, this will allow us to better treat victims in the future. This bill contains provisions of H.R. 1944, a bill I originally cosponsored.

H.R. 1470 expands chiropractic care to all VA facilities throughout the country by 2011. During a subcommittee hearing on returning Iraq and Afghanistan veterans, several OIF veterans suggested that back injuries will be a long term problem for this generation of veterans. This bill will help the VA better prepare for this new wave of patients.

I am proud that these bills passed the House today and that I could support their passage.

Congress has a responsibility to live up to our promises to our veterans. Today was another down payment on fulfilling these promises.

Through my role on the Veterans Affairs Committee, I pledge to continue to push for legislation that will improve services for our veterans and treat them with the respect they have worked so hard to earn.

Madam Speaker, since the creation of the Department of Veterans Affairs' health care system, the Nation's doctors of chiropractic have been, until recently, kept outside and all but prevented from providing proven, cost-effective and much-needed care to veterans--including many in need of the health care services that doctors of chiropractic are licensed to provide.

A little history: Over the years, representatives of the Department of Veterans Affairs have come before the House of Representatives Veterans' Affairs Committee and have insisted that chiropractic benefits are available to veterans and that no bias exists within the VA against the chiropractic profession. Access is becoming greater, and hopefully the bills I am introducing will not be necessary, but for all practical purposes, access to chiropractic care, until very recently, had been non-existent within the VA system. Chiropractic care was so seldom offered to veterans that it could have been fairly said to be a phantom benefit.

Because of the track record of neglect, in recent years Congress enacted 3 separate statutes seeking to ensure veterans access to chiropractic care (Public Law 106-117, Public Law 107-135 and Public Law 108-170). The last of those statutes gave explicit authority to the VA to hire doctors of chiropractic as full-time employees. I'm proud to have worked with colleagues on both sides of the aisle to help advance those initiatives.

In addition, former VA Secretary Anthony Principi released policy directives before his departure regarding the true and full integration of chiropractic care within the VA, and it is beginning to happen, offered in more than 25 medical centers. But we must remain concerned until we see these polices firmly in place and working well in all VA treatment facilities.

As insurance, the enactment of the legislation I propose will guarantee the right of a veteran to obtain this important service at the local VA without the cost and stumbling blocks of going through potentially hostile gatekeepers.

I am proud to re-introduce a bill that former Congressman Jeb Bradley had introduced in the last session of Congress: H.R. 1470, the ``Chiropractic Care Available to All Veterans Act,'' and to reintroduce my bill from the last session: H.R. 1471, the ``Better Access to Chiropractors to Keep Our Veterans Healthy Act (BACK Our Veterans Health Act).''

The first, H.R. 1470, requires that the provision of chiropractic services and care be phased in so that it will be provided at not fewer than 75 medical centers by December 31, 2009 and at all medical centers by December 31, 2011. Within five years, all veterans will have access to chiropractic care if and when they need it.

The second, H.R. 1471, is designed to provide veterans with direct access to chiropractic care at VA hospitals and clinics. The measure directly prohibits discrimination among licensed health care providers by the VA when determining which services a patient needs.

In developing these bills, I have worked closely with chiropractic patients, particularly our veterans, who know the benefits of chiropractic care and bear witness to the positive outcomes and preventative health benefits of chiropractic care. I also was pleased to work with the American Chiropractic Association (ACA), the nation's largest chiropractic organization and the national voice of doctors of chiropractic and their patients. I have been told by the ACA that there are more than 60,000 doctors of chiropractic and in excess of 25 million chiropractic patients across America. Some of these doctors certainly should be directly available to our veterans. Finally, I am a chiropractic patient myself and have been greatly helped by chiropractic care for physical problems caused by an automobile accident. I hate to think that veterans do not have this same opportunity for relief from pain.

A large number of all medical problems in the returning soldiers from Iraq and Afghanistan--42 percent--are musculoskeletal injuries, which are injuries that are often directed to chiropractors. So the timing could not be better for passage of these bills.

Accordingly, I urge my colleagues to join me in supporting unimpeded access to chiropractic care throughout the veterans' health care system and help enact these measures.