To amend title 38, United States Code, to establish the position of Director of Physician Assistant Services within the office of the Under Secretary of Veterans Affairs for Health.

Mr. Speaker, I move to suspend the rules and pass the bill (H.R. 3219) to amend title 38, United States Code, to make certain improvements in the laws administered by the

Secretary of Veterans Affairs relating to insurance and health care, and for other purposes, as amended.

I thank the Speaker, and I yield myself such time as I may consume.

I rise in strong support of passage of this bill, the Veterans' Insurance Health Care Improvement Act of 2009, H.R. 3219. This important legislation was assembled with the help of many members of the House Committee on Veterans Affairs, without whose efforts this bill would not have been possible. I'm surprised to see my friend, Mr. Stearns, managing the bill, having just railed against nationalization of health care, which is not what the Obama plan has, but then he's a great supporter of the veterans' health system, which I think may come under his definition. So I'm pleased that he supports so strongly the Veterans Administration health care system, which is nationalized care, but I wish he would support Mr. Obama's health care plan, which has nothing to do with nationalization.

But I want to recognize and applaud the outstanding effort of especially two dynamic members on the committee who sponsored major insurance provisions of the bill under consideration. Mrs. Halvorson of Illinois sponsored the Families of Veterans Financial Security Act, H.R. 2774, which has become section 101 of this bill. And Mrs. Kirkpatrick of Arizona sponsored the Veterans and Service Members Accelerated Benefit Option Equity Act of 2009, H.R. 2988, which is now section 103 of this bill.

These measures represent commonsense yet critical insurance provisions intended to ensure that our veterans, servicemembers and their families who have insurance-related needs receive the full measure of the benefit offered and that the survivors have ample replacement income to meet their needs. All of the provisions would give veterans and servicemembers greater flexibility in their insurance choices, and, consequently, greater peace of mind.

Additionally, the Congressional Budget Office reports that none of the bills would increase Federal direct spending for veterans' insurance programs. And I want to applaud, also, the chairman of our Disability Assistance

and Memorial Affairs Subcommittee on these measures, Mr. Hall of New York, for his leadership on these measures.

The legislation further provides for a wide variety of health care improvements in recognition of veterans who have sacrificed so much for the safety and freedom of the Nation. It enhances the lives of the Nation's veterans, from World War II to the current conflicts.

Other members also contributed to the health care provisions of this, and I want to thank them for their efforts. For example, Mr. Mitchell of Arizona, who wrote H.R. 1197, the Medal of Honor Health Care Equity Act of 2009, which assigns a higher priority status for VA hospital care and medical services for veterans who are recipients of the Medal of Honor.

Another provision by Mr. Hare of Illinois, H.R. 1302, would establish a position of director of physician assistant services within the Office of the Under Secretary of Veterans Affairs for Health. And Mrs. Halvorson from Illinois also sponsored H.R. 1335, which would prohibit the Secretary of Veterans Affairs from collecting certain copayments from veterans who are catastrophically disabled from non-service- connected causes and have income above the means tested level.

Mr. McNerney from California sponsored H.R. 1546, the Caring for Veterans with Traumatic Brain Injury Act, and that has been incorporated to establish a committee on the care of veterans with traumatic brain injury to assess the VA's ability to treat and rehabilitate veterans with TBI--that is traumatic brain injury--and to provide recommendations on how to more effectively treat these veterans.

Mr. Nye of Virginia introduced H.R. 2926, which was incorporated into the bill to provide hospital care, medical services, and nursing home care for certain Vietnam-era veterans exposed to herbicides and also veterans of the Persian Gulf War.

Mr. Buyer's bill, H.R. 2270, would establish a compensation fund for all civilian groups who are given veteran status under the G.I. Bill Improvement Act of 1977, and that is also in the bill.

And finally, we have a bill introduced by Mr. Teague of New Mexico to waive the housing loan fee for certain veterans with service-connected disabilities called to active service.

So I want to thank all of the members of our committee who've worked so hard to put together the important legislation we are considering today, and I hope my colleagues will support H.R. 3219 as amended

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

Mr. Speaker, I yield as much time as she may consume to one of our dynamic new members of our committee, Mrs. Halvorson of Illinois.

I yield as much time as he may consume to the gentleman from American Samoa (Mr. Faleomavaega).

Mr. Speaker, I ask 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. 3219, as amended, and urge my colleagues to unanimously support the bill.

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

Mr. Speaker, I rise in strong support of H.R. 3219, the Veterans' Insurance and Health Care Improvements Act of 2009.

Earlier in this session, I introduced H.R. 1302, a bill to create a full-time Director of Physician Assistant (PA) Services in the Department of Veterans Affairs (VA) Central Office. I would like to thank my colleague, Representative Jerry Moran, for his leadership with me on this bill, as well as Chairmen Filner and Michaud, Ranking Members Buyer and Brown and many other VA Committee colleagues for joining us as cosponsors''.

Today, I am very pleased to speak in support of H.R. 3219, which incorporates the provisions of my bill and eight other bills that were favorably considered by the House Committee on Veterans' Affairs.

PAs have long been a key component in the Veterans Health Administration (VHA). Almost two thousand PAs are currently employed by the VA, roughly 30 percent of whom are veterans. While the PA Advisor position, established by Congress in 2000, has been valuable, many problems exist.

For example, as the American Academy of Physician Assistants (AAPA) explained in written testimony on October 18, 2007, ``In one case, a local facility decided that a PA could not write outpatient prescriptions despite licensure in the state allowing prescriptive authority. In other facilities, PAs were told that the VA facility can not use PAs and will not hire PAs.'' These inconsistencies and restrictions not only hinder PAs currently employed by the VA, but also discourage PAs from even entering the VA system, ultimately impacting the medical care of our nation's veterans.

PAs are the fourth fastest growing profession in the country, yet the VA is simply not competitive with the private sector for new PA graduates. The lack of a Director of PA Services at the VA prevents necessary recruitment and retention of the PA workforce in the VA at a time when we need more health care professionals to provide necessary care to our Veterans.

Considering the fact that nearly 40 percent of all VA PAs are projected to retire in the next five years, the VA is in danger of losing its PA workforce unless serious focus is directed toward recruitment and retention of this critical group.

One of the biggest challenges facing current and future PAs in the VA system is their exclusion from recruitment and retention benefits. The VA designates physicians and Nurse Practitioners (NPs) as critical occupations. As such, these individuals receive priority in scholarships and loan repayment programs. Unfortunately, the VA has not designated the PA profession as a critical occupation despite the fact that the VA has determined PAs and NPs functionally interchangeable.

Additionally, VA medical facilities, at times, post vacant positions for NPs only, excluding

PAs. There is also a hiring trend in the VA of NPs outpacing PAs nearly three to one, again despite the interchangeability between the two specialties.

Finally, PAs are not included in any of the VA special locality pay bands, so PA salaries are not regularly tracked and reported by the VA. There is evidence that this has resulted in lower pay for PAs employed by the VA compared to other health care professionals. This only serves as yet another deterrent for PAs to enter the VA system.

A permanent Director at the VA Central Office (VACO) would serve as an advocate on behalf of PAs and work to ensure their fair treatment. It is time for the VA to devote serious attention to PA recruitment and retention. Enactment of H.R. 1302 is a start.

As a Congressman who represents a district with rural communities, I know that PAs play a key role in providing medical care in rural and other medically underserved areas. I want to ensure that they are equally well utilized by the VA. I know that medical institutions like the Cleveland Clinic, the Mayo Clinic, the MD Anderson Cancer Clinic at the University of Texas, and others have a Director of PA Services to make sure that the PAs they employ are integrated into their health systems. Additionally, each branch of the Armed Services has a Chief PA to help the military best utilize its PA workforce. It is time for the VA to do the same.

I strongly urge my colleagues to show their support of strengthening Veterans' healthcare by voting ``yes'' on H.R. 3219.

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

Mr. Speaker, I rise in strong support of H.R. 3219, as amended, to amend title 38 of the United States Code, which would make improvements in the laws administered by the Secretary of Veterans Affairs relating to insurance and health care and for other purposes.

H.R. 3219, as amended, combines veterans' life insurance and health care provisions from bills by several Members that improve the lives of veterans, and I will highlight for my colleagues just a few of these this afternoon.

The bill includes provisions of H.R. 2349, the Veterans' Group Life Insurance Improvement Act of 2009, that was introduced by the ranking member, Mr. Buyer, to allow veterans under the age of 60 to purchase up to $400,000 of veterans' group life insurance coverage in $25,000 increments every 5 years. This bill gives our veterans greater flexibility in their life insurance choices and is supported by the VA and veterans service organizations. That's good.

Another provision that has been included in H.R. 3219, as amended, is from H.R. 2270, also introduced by Ranking Member Buyer, which provides equity for all of the 28 World War II civilian groups that were later given veteran status under the process set up by the GI Bill Improvement Act of 1977.

The bill provides equity by making all these groups eligible for the same $1,000 a month payment that merchant mariners of World War II would receive under H.R. 23, as amended, which the House passed earlier this year.

One group of veterans that would benefit from this provision are the members of the American Volunteer Group, also known as the Flying Tigers. This was a distinct group of American ground crew and pilots who worked as part of the Chinese Air Force with U.S. Government approval in defense of allied strongholds before and after America's entrance into the war. The Flying Tigers, P-40 aircraft, with their distinctive shark's teeth painted on the nose of the fuselage, became famous for their many, many successful raids on Japanese targets in China, including one just 12 days after Pearl Harbor.

Mr. Speaker, the Flying Tigers are credited with destroying 297 aircraft, of which 229 were air-to-air victories. This statistic is even more impressive when you consider that they were largely outnumbered in almost every engagement they were involved with, and all of their supplies had to be flown over the Hump from India over the Himalayan Mountains.

Also, Mr. Speaker, there is another well-known group. It is called the Women Air Force Service Pilots, WASPs. These were female pilots who flew noncombat missions for the United States Army Air Corps during the war. Over 1,000 of these brave pilots flew missions all across this country in support of the war effort. Although they had been promised to be made part of the Air Corps following the war, they were disbanded on December 20, 1944, with little fanfare and with little recognition.

Earlier this year, the President signed S. 614 to award the Congressional Gold Medal to an estimated 300 WASPs that are still alive today. The passage of S. 614, coupled with the benefit provided to the WASPs under the bill, will finally give these brave women veterans the recognition they deserve.

I want to thank the chairman, Mr. Filner, for accepting the amendment to include these groups in the bill so that we can provide simple equity for all of these veterans that were not eligible for the World War II GI Bill.

I urge my colleagues to support this legislation.

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

Mr. Speaker, I would like to take a moment to thank John Hall of New York and Doug Lamborn of Colorado, the chairman and ranking member on the Subcommittee on Disability Assistance and Memorial Affairs, and Mike Michaud of Maine and Henry Brown of South Carolina for all of their hard work on the legislation which was included in this bill. I would also like to thank Chairman Filner and Ranking Member Buyer for their cooperation in moving the legislation forward.

Mr. Speaker, I urge my colleagues to support H.R. 3219, as amended, and I yield back the balance of my time.

Mr. Speaker, I rise in support of H.R. 3219, as amended, the Veterans' Insurance and Health Care Improvements Act of 2009, which would amend title 38, United States Code, to make certain improvements in the laws administered by the Secretary of Veterans Affairs relating to insurance and health care.

H.R. 3219, as amended combines several pieces of legislation including H.R. 2349, the Veterans' Group Life Insurance Improvement Act of 2009, and H.R. 2270, the Benefits for Qualified World War II Veterans Act of 2009, both of which I introduced earlier this year.

H.R. 2349 gives eligible veterans the option of purchasing additional life insurance coverage under the Veterans Group Life Insurance Program. They would be able to purchase this coverage every five years in $25,000 increments up until age 60. This provision gives these veterans that choice to increase their life insurance as they get older and may see the need to purchase more as their family grows. The costs of such increases in coverage would be offset by premiums veterans pay, so there is no direct cost to the government.

Another provision included in H.R. 3219, as amended, is the substance of H.R. 2270, which provides a $1,000 monthly payment to all World War II civilian groups that were later given veteran status under the process set up by the G.I. Bill Improvement Act of 1977.

Earlier this year, the House created an inequitable situation when we singled out one of these civilian groups, merchant mariners, to receive this payment while excluding the other 28 groups who also served bravely in defense of our country. I am pleased that the bill before us corrects this situation.

One of these groups that are now eligible under this provision is American Volunteer Group also known as the Flying Tigers. These were civilian pilots and ground crew who fought against the Japanese before and after Pearl Harbor and had one of the most impressive combat records in the Pacific Theater.

During the subcommittee legislative hearing on H.R. 2270, members had the opportunity to meet and hear testimony of 90-year-old former Flying Tiger, Ed Stiles, Sr.

I had the opportunity to meet with Mr. Stiles and his family, and it was an absolute pleasure to hear his stories about the brave pilots and ground crews of the Flying Tigers who saved countless American lives by tying up Japanese air forces in China before and after Pearl Harbor.

I want to thank my colleagues for including these two provisions in H.R. 3219, as amended. I urge my colleagues to support this legislation.

Mr. Speaker, I rise in strong support of H.R. 3219, legislation to amend title 38, U.S. Code, to make certain improvements in the laws administered by the Secretary of Veterans Affairs related to insurance and health care, and for other purposes.

Mr. Speaker, I do want to commend the gentleman from California, my colleague, the chairman of the Committee on Veterans' Affairs, and my good friend from Florida who is managing on the other side of the aisle this important legislation.

Mr. Speaker, H.R. 3219, among other things, would make permanent the 2-year extension of the free Servicemembers' Group Life Insurance coverage period for totally disabled veterans following separation from active or reserve duty, enable veterans insured under the Veterans' Group Life Insurance program to increase the amount of their coverage, and eliminate the reduction in the amount of accelerated death benefits for terminally ill persons insured under both the SGLI and the VGLI programs.

Mr. Speaker, such improvements to the SGLI and VGLI programs would maximize the opportunity for totally disabled veterans, especially those who have no commercial insurance, the chance to obtain insurance coverage to pay for their medical expenses. Especially in this time of economic hardship, this bill would provide tremendous financial help and security for our veterans and their families.

Moreover, this bill would expand existing health care programs to include veterans that were not otherwise qualified. For example, this bill would provide for the enhanced treatment authority for veterans of the Vietnam era, like myself, and veterans of the Gulf War who may have been exposed to Agent Orange, herbicides known to contain dioxin, which has been linked to cancer and other disorders. While the full impact of these herbicides remain unknown, veterans affected have shown symptoms including persistent memory and concentration problems, chronic headaches, widespread pain, gastrointestinal problems, and other chronic abnormalities not explained by well-established diagnoses.

Mr. Speaker, as a Vietnam veteran myself, and a proud member of the 100th Battalion 442nd Infantry Reserve Unit out of Hawaii, I certainly appreciate the service and sacrifice of my fellow servicemen in the United States Armed Forces.

Again, I urge my colleagues to support this bill.

General Leave