Providing for the concurrence by the House in the Senate amendment to H.R. 1016, with amendment.

Mr. Speaker, I move to suspend the rules and agree to the resolution (H. Res. 804) providing for the concurrence by the House in the Senate amendment to H.R. 1016, with amendment.

Mr. Speaker, I rise in support of the Veterans Health Care Budget Reform and Transparency Act of 2009.

Mr. Speaker, this is a very important bill. It's a whole new approach to the funding of Veterans Administration health care programs, one that will allow our Nation's veterans to receive timely, high quality and well-funded care regardless of political considerations that go into the budget process every year. I'm glad I was able to work with my colleagues in the Committee on Veterans' Affairs in both the House and the Senate to get this bill to the House floor today.

This is a bipartisan response to years of chronic underfunding of VA medical care and happens to be the highest legislative priority of veterans' groups in this Nation.

In an unprecedented step, Mr. Speaker, nine veterans' groups formed the Partnership for Veterans Health Care Budget Reform. These groups, including The American Legion, AMVETS, Blinded Veterans Association, Disabled American Veterans, Jewish War Veterans, Military Order of the Purple Heart, Paralyzed Veterans of America, Veterans of Foreign Wars, and the Vietnam Veterans of America all formed together to advocate for a VA health care budget that is sufficient, timely and predictable.

In fact, the leadership of one of the prime organizations that took the leadership in this fight, the Disabled American Veterans, are watching this debate from the gallery. Their national commander, Bobby Barrera; their executive director, Dave Gorman; and their legislative director, Joe Violante, are watching this, and we thank them for their leadership in this fight.

These groups put together the idea that resources for VA health care should be provided through advance appropriations, so that when the fiscal year starts on October 1, the VA will already have its budget figure regardless of what occurred in the year's budget that was funding other agencies. The result of their advocacy is H.R. 1016, which will pass as we pass the resolution before us on the floor.

The VA budget, in fact, has been in place at the start of the fiscal year only four times in the last two decades. We all felt that this delay in providing vital funding, for whatever reasons that were going on in the House and the Senate, put the provision of health care to veterans at risk and hampered the VA's ability to plan its health care expenditures and hire needed health care professionals. This was a concern that was shared by current and former VA officials.

Again this year the VA was forced to rely on funding from a continuing resolution, even though the House acted in a timely fashion and passed the FY 2010 VA spending bill in July.

The House passed its version of the forward funding bill by a vote of 409-1 this June. Our other colleagues in the Senate acted in August, and the version of the legislation before us represents a compromise agreement between us and our colleagues on the Senate Committee on Veterans' Affairs.

The bill will ensure that VA can best plan and utilize taxpayer dollars to provide veterans with the health care they have earned and deserve. It provides a framework with which we can realize advance appropriations for VA medical care accounts.

As part of the annual budget submission, the President will be required to submit a request for certain VA accounts for the ``fiscal year following the fiscal year for which the budget is submitted.'' For example, as part of the administration's fiscal year 2011 budget, the President will include budget estimates for VA medical care accounts for fiscal year 2012. The VA will be required to detail estimates in the budget documents it submits annually to Congress.

Each July, the VA will be required to report to Congress if it has the resources it needs in the upcoming fiscal year in order for Congress to address any funding imbalances. This will help to safeguard against the VA facing budget shortfalls such as it faced several years ago.

Finally, the Government Accountability Office will report, within 120 days of the annual budget submission, whether VA's advance appropriations requests are in line with workload and cost estimates and the VA's budget model. It sounds a little complicated. It was worked out by, as I said, this really hardworking coalition of veterans' organizations and, in fact, bottom line and simple, it will make sure that a year in advance, the VA will be funded appropriately.

I want to thank both the Appropriations and the Budget Committees for their assistance in moving this measure forward. The Budget Committee, for example, in the fiscal year 2010 budget resolution provided explicit language exempting the three medical care accounts of the VA, the accounts covered by the compromise agreement on H.R. 1016, from many points of order against advance appropriations. The Appropriations Committee, under the leadership of Chairman Obey and Chairman Edwards, provided for advance appropriations for the three medical care accounts representing an 8 percent increase above the historic levels provided for fiscal year 2010.

Mr. Speaker, I would like to insert a copy of the letter from the veterans' groups comprising the Partnership for Veterans Health Care Budget Reform expressing their full support of this measure and an explanatory statement on the bill in the Congressional Record.

By working together, Congress and the administration have provided veterans with their top legislative priority. They spoke, we listened, and today we are acting. I ask the rest of the House to join once again in unanimous support of this bipartisan bill and ask for swift action by the Senate before the end of this session.

The Partnership for Veterans

Health Care Budget Reform,

Washington, DC, September 29, 2009.

Hon. Bob Filner,

Chairman, House Committee on Veterans' Affairs, Cannon House

Office Building, Washington, DC.

Dear Chairman Filner: On behalf of the Partnership for

Veterans Health Care Budget Reform, we write to fully endorse

the substitute amendment that you intend to offer to H.R.

1016, the Veterans Health Care Budget Reform and Transparency

Act. We understand that this amendment has been developed in

cooperation with Senate Veterans' Affairs Committee Chairman

Akaka and Ranking Member Burr, who join you in support of

this new language. We agree with all of you that adoption and

enactment of H.R. 1016, as amended by this substitute

amendment, will lead to VA health care funding that is

sufficient, timely and predictable.

The Partnership, comprised of nine leading veterans service

organizations, has long sought a solution to the recurring

budget problems that have plagued the VA health care system

for most of the past two decades. Last year we began

advocating that Congress provide advance appropriations for

VA medical care and we were grateful that you introduced

legislation to authorize this funding reform. We supported

your reintroduction of this legislation (H.R. 1016) in

February and fully supported the substitute amendment you

offered during the Committee's markup in June, that was

subsequently approved by the full House with a vote of 409 to

1 on June 23rd. That amendment would add important new budget

reporting provisions for VA medical care and would increase

transparency of the advance appropriation process,

strengthening the legislation.

The compromise substitute amendment you plan to offer on

the House floor retains these provisions and makes two other

modifications. First, your new amendment provides the

Government Accountability Office, GAO, with 120 days from the

time the President submits his budget to Congress to review

and report on whether the level of funding requested for VA's

medical care accounts is consistent with the estimates

generated by VA's Enrollee Health Care Projection Model. With

this change, GAO would have ample time to complete the review

and still report in a timeframe that allows Congress to

consider this information before finalizing future

appropriations levels for VA health care.

Second, this compromise amendment limits VA's advance

appropriations to the three medical care accounts, Medical

Services, Medical Facilities, and Medical Support and

Compliance, contained in our original proposal, removing the

two additional ones, Medical and Prosthetic Research, and

Information Technology, added during the Committee's markup.

We understand the reasons

for this modification and support your compromise position.

However, we expect that the Committee will closely monitor

implementation of this legislation and carefully consider

whether VA health care would be enhanced if additional budget

accounts, such as IT and research, were similarly

appropriated in advance.

Mr. Chairman, the Partnership has worked for over two

decades to enact legislation that would assure sufficient,

timely and predictable funding for VA health care. With your

leadership, and that of Chairman Akaka, Ranking Member Burr

and others, as well as the crucial support of President

Obama, we are closer than ever to achieving an historic

legislative victory on behalf of all veterans. We thank you

for all that you have done to support these efforts, and look

forward to working with you on future matters of importance

to the men and women who have served, are serving, and will

serve in our nation's armed forces.

Respectfully,

Steve Robertson, Legislative Director, The American

Legion; Thomas Zampieri, Director of Government

Relations, Blinded Veterans Association; Herb

Rosenbleeth, National Executive Director, Jewish War

Veterans of the USA; Carl Blake, Legislative Director,

Paralyzed Veterans of America; Rick Weidman, Director

of Government Relations, Vietnam Veterans of America,

Inc.; Raymond C. Kelley, National Legislative Director,

AMVETS (American Veterans); Joseph A. Violante,

National Legislative Director, Disabled American

Veterans; Hershel Gober, National Legislative Director,

Military Order of the Purple Heart of the USA; Dennis

Cullinan, Legislative Director, Veterans of Foreign

Wars of the United States.

As I yield 2 minutes to the gentleman from Maine (Mr. Michaud), I would just remind the gentleman from Florida that when the Senate saw that the prime mover of the amendment that put those two extra accounts in the bill was the only one in the House that voted against the bill that was sent to the Senate, they didn't take that too seriously. I just would remind the gentleman.

Mr. Speaker, I would yield 2 minutes to the gentlewoman from Illinois (Mrs. Halvorson) who as a new Member has been an incredibly active and committed member of our committee.

Mr. Speaker, I yield 3 minutes to another new Member who has been a great addition to our committee, the gentleman from New Mexico (Mr. Teague).

I do have more speakers, yes.

How much time do I have left, Mr. Speaker?

I yield 2 minutes to another new member of our committee who has, again, given us a great commitment and energy to the cause of veterans, the gentleman from Virginia (Mr. Nye).

I yield myself 30 seconds just to say something I forgot when I introduced the gentleman from Maine (Mr. Michaud).

In this process, there was a time when the executive branch seemed to waiver in its commitment to this effort, and Mr. Michaud's tenacity and his steadfast support of this makes sure that we continue down this path. I want to thank him for doing that.

I yield as much time as he may consume to Mr. Hare from Illinois, a former member of the committee, who I wish was still on our committee.

Mr. Speaker, I thank the gentleman from Florida for those words of support, and 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 House Resolution 804.

Mr. Speaker, this is a unique solution for a unique population, our veterans. Again, I want to thank the Disabled American Veterans and all of the members of the coalition who are watching this on television or in the gallery today for working so hard to come up with this unique approach. It is an incredibly good solution to what we saw as a real problem. It took creativity, it took commitment, and it took sticktuitiveness to get this done. I tell you, we would not have been here without the coalition's work. So I urge all my colleagues to adopt this legislation.

I yield back the balance of my time.

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

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

I rise in support of House Resolution 804, a resolution providing for the concurrence by the House in the Senate amendment to H.R. 1016, with amendments.

I want to thank my committee chair, Mr. Filner. With this important legislation, he responded to the needs of our veterans who depend on the Veterans Health Administration.

This resolution represents an agreement between the Chambers and provides for advance appropriations authority for certain medical care accounts for the Department of Veterans Affairs. An advance appropriations means that Congress would approve funding for VA health care accounts 1 year in advance of the actual fiscal year in which the funding would become available.

The impetus for this legislation is clearly evident as last week we began a new fiscal year with a continuing resolution, because once again Congress failed to pass the annual funding for veterans health care on time. In fact, VA has received a timely budget on only four occasions during the last 21 years.

It is a disservice to our veterans and wounded warriors when legislative budgetary impasses delay funding and prevent VA from effectively planning for the day-to-day operations of its health care system.

It is disappointing, however, that the compromise agreement would provide

for advance appropriations for just three VA accounts, Medical Services, Medical Support and Compliance, and Medical Facilities. It should also include advance appropriations for the information technology account and medical and prosthetic research accounts.

The former Chair and current ranking member of the VA Committee, Steve Buyer, made a strong argument that the IT and research accounts should be included in any advance appropriations because they are closely related to the previously mentioned accounts, and having separate funding mechanisms could lead to unintended consequences.

The members of the VA Committee, including the chairman, recognized the importance of keeping the accounts together and included them in the House-passed bill.

Adding the IT accounts was also a recommendation of the Secretary of Veterans Affairs, Eric Shinseki. Likewise the Congressional Research Service analysis of advance appropriations gave support to including both accounts. It is unfortunate that the House position did not prevail in the compromise agreement. Inclusion of these accounts would have greatly improved the bill by providing a more comprehensive funding method for veterans' medical care needs.

Nonetheless, the legislation is a very positive development for the VA budgeting process. It will provide a procedure that could allow more predictable funding. It would not guarantee the VA or Congress that we will get the amount of the veterans health care budget exactly right.

We must continue to work hard for the benefit of our veterans to get the VA budget as close as possible to the intended results. Implementation of this legislation will require strong congressional oversight to ensure we meet our objectives.

Mr. Speaker, this resolution is a new approach in trying to remove the uncertainty from veterans' health care and its funding, and is strongly supported, as the chairman said, by the Partnership for Veterans Health Care Budget Reform, a coalition of nine veterans service organizations.

I want to congratulate the chairman, and I strongly urge my colleagues to support this resolution.

I reserve the balance of my time.

I will continue to reserve.

I continue to reserve the balance of my time.

Mr. Speaker, I would ask if the gentleman from California has additional speakers.

I will continue to reserve the balance of my time.

I will continue to reserve the balance of my time, Mr. Speaker.

Mr. Speaker, this compromise agreement will finally provide advance appropriations beginning for the fiscal year 2011 for three VA medical accounts. Although I prefer the House version of the bill, I think this is a great advancement, and I will congratulate the chairman and members of the VA Committee for a great job.

I urge my colleagues to vote for H.R. 1016, as amended.

I yield back the balance of my time.

General Leave

Madam Speaker, as a member of the House Committee on Veterans' Affairs, I am proud to have been an early co- sponsor of the Veterans Health Care Budget Reform and Transparency Act--a landmark piece of legislation which would require Congress to approve the Department of Veterans Affairs health care budget one year in advance.

Imagine being the sole breadwinner in your house and not knowing your annual salary until well after that year started. As you are forced each year to guess, you might alternate between underspending and overspending, between scrimping and splurging.

Now imagine that rather than the head of a small family, you were the VA.

The VA--despite its size and its undeniably important mission to fulfill our Nation's most sacred promise--has received its appropriation after the start of the fiscal year in 18 out of the last 21 years, including, now, this fiscal year.

The VA employs well over 250,000 staff nationwide, with more than 222,000 of those employees directly supporting the VA's health care system serving 5.6 million unique patients. Last year, the Veterans Health Administration spent approximately $43.5 billion on medical care and research. These numbers make the VA the second largest agency in the federal government after the Department of Defense, and make the VHA both the Nation's largest health care delivery system as well as its largest provider of health care education and training.

The late appropriations and insufficient budgets have meant restricted access for many Veterans. When funding is short, late, or unpredictable, it is our Veterans who pay the price.

Veterans in Greater Arizona are keenly aware that we need more medical facilities and the claims backlog is keeping many Veterans from the benefits they have earned. But once inside the VHA, there is no denying that the quality of service is very good. Numerous third party sources, including both the New England Journal of Medicine and Annals of Medicine, have concluded that the quality of care in the VA health care system is among the best available publicly or privately in the Nation.

However, its sheer size has amplified the problems stemming from late appropriations, which lead to rationed care, waiting lists and Veterans being turned away from service.

As Iraq and Afghanistan Veterans return and Veterans from prior conflicts continue to age, the number of those who need care will only increase, and the situation will become more critical.

It is heartening, then, that those who support the Veterans Health Care Budget Reform and Transparency Act are also increasing in number. General Eric Shinseki, voiced his support for advance appropriations shortly after becoming the Secretary of Veterans Affairs. The American Federation of Government Employees, which represents many of the federal employees who work for the VA, also supports the bill, as does the Partnership for Veterans Health Care Budget Reform--a coalition of eleven Veterans service organizations representing millions of Veterans, servicemembers, spouses and survivors.

In my short time on the House Committee on Veterans' Affairs, we have made great strides toward a budget that lives up to the sacrifices of our Veterans. We voted to increase the budget for the VA by $5.6 billion--an increase of 11.7% for Veterans health care and other programs. We ensured that Veterans are given their fair share of the American Recovery and Reinvestment Act, providing $1.4 billion for maintenance at VA medical facilities, construction of Veterans' extended care facilities, and Veteran cemetery repairs, as well as providing one-time payments of $250 to disabled veterans.

However, we still struggle to provide sufficient, timely, and predictable funding for our Veterans. When the Veterans Health Care Budget Reform and Transparency Act arrives at the floor of the House, I would urge all Members of the Arizona delegation and from all across the Nation to support it to ensure Veterans can get the care they have earned.

Mr. Speaker, I rise today to speak in support of H.R. 1016, the Veterans Health Care Budget Reform and Transparency Act of 2009. I would like to thank the distinguished gentleman from California, Bob Filner, for introducing this bill. I'm happy to be a cosponsor of the legislation, but it is through his leadership as chairman of the Committee on Veterans Affairs that we will finally be able to make advance appropriations of the VA's health budget a reality.

It's not right that we lapse in our care for our veterans when they never lapsed in the defense of our country, and it's not right that out of the last 22 budgets that were passed for the VA, 19 have been late. Our veterans served their country and provided us the security we often take for granted, and we owe them quality health care.

Without a predictable and on-time funding source, it is difficult, or impossible, for the VA to provide our veterans with the high level of health care and services they deserve. That is why I led 50 Members of Congress to demand a provision allowing for advance appropriations in the fiscal year 2010 budget, and we were fortunate enough to convince the Budget Conference Committee to support it.

As a result of allowing for advance appropriations in the budget, the Appropriations Committee decided that

the Military Construction and VA spending bill should contain $48.2 billion in advance appropriations for the VA for fiscal year 2011. This represents a 15 percent increase over fiscal year 2009 levels and a step in the right direction for veterans' health care.

Many people have compared advance appropriations to a family budget. A family needs to know how much their income is before they know what they can spend. I think that about sums up why we need this bill. I think that it's about common sense and being responsible.

As a businessman, I never tried to make a purchase without knowing what my budget was going to be. I had to plan ahead and have a roadmap for all of the company's finances. Because the VA is a direct provider of services, they need to have the same ability to plan ahead. It's about delivering a quality service for our veterans.

I urge my colleagues to take this giant step in improving the VA's ability to deliver quality health care services to our Nation's veterans.

Mr. Speaker, I rise in strong support of H.R. 1016, the Veterans Health Care Budget Reform and Transparency Act of 2009. I would like to thank Chairman Filner for introducing this very important bill.

In the 110th Congress, we gave the VA its largest funding increase in 77 years, and we gave it to them on time; but sadly, punctual VA funding has not always been the case. The VA received its annual funding for health care programs late in 19 of the last 22 years. This record of tardiness is deplorable. With the ongoing wars in Iraq and Afghanistan, the time to fix the broken system is now.

Late funding is more than a missed deadline. It is a veteran with posttraumatic stress disorder who cannot access the treatment that he or she needs. It's an injured hero who must wait for a prosthetic. It is the VA in disarray at a time when our wounded warriors are counting on the Department's services. That is why, in the last Congress, I introduced the Assured Funding for Veterans Health Care Act.

Like the bill I introduced, advance appropriations is a means to an end. That end is ensuring veterans receive the best care possible from a VA that has access to timely, sufficient, and predictable resources. The legislation we are considering today will do just that. It will allow the VA to effectively budget and manage its health care programs and services, meaning it can hire the appropriate number of doctors, nurses, clinicians, and support staff to meet the demand for high- quality medical care for our Nation's veterans. Anything less is unacceptable.

I would also like to acknowledge and commend Chairmen Obey and Edwards for their strong proactive leadership in putting in an advance appropriation for VA health care in the fiscal year 2010 Military Construction and Veterans Affairs Appropriations bill. The bill that we're voting on today has been slightly amended from a version which the House passed earlier this Congress by a margin of 409-1. I enthusiastically support H.R. 1016.

I want to once again thank Chairman Bob Filner for drafting a bill that will ensure that the VA has sufficient, timely, and predictable funding.

Mr. Speaker, I urge all my colleagues to support this legislation.