Women Veterans and Other Health Care Improvements Act of 2012

Mr. President, I come to the floor today to request that we have unanimous consent for S. 3313, which is the Women Veterans and Other Health Care Improvement Act of 2012, which was unanimously supported by the members of the Veterans' Affairs Committee to be moved out of this body today.

This legislation not only builds upon previous laws that we have passed to improve VA services for women veterans and veterans with families, but it also brings a new focus to the need for the VA to do more to help women veterans and the spouses of male veterans have access to assistance for one of the most impactful and serious wounds of these wars, reproductive and urinary tract trauma.

As many of you know, the nature of the current conflicts and the use of improvised explosive devices leaves servicemembers far more susceptible to those kinds of injuries. In fact, Army data shows that between 2003 and 2011 nearly 2,000 of our servicemembers have suffered those kinds of battle injuries.

Like so many of our veterans, these men and women come home and look to returning to their lives, to finding employment, and to starting a family. Yet what they find when they go to the VA is that the fertility services that are available don't meet their complex needs for these injuries. In fact, veterans suffering from those kinds of injuries find that the VA now is specifically barred from providing more advanced assisted reproductive techniques, such as in vitro fertilization or IVF. They are told when they come home that despite the fact they have made such an extreme sacrifice for our Nation, we can't provide them with the medical services they need to start a family--veterans such as SSG Matt Keil and his wife Tracy, who is here with us today. I am so proud of her and her courage in making sure this is available for families like hers.

Staff Sergeant Keil was shot in the neck while he was on patrol in Ramadi,

Iraq, on February 24 of 2007, 6 weeks after he married the love of his life, Tracy. The bullet went through the right side of his neck, hit a major artery, went through his spinal cord, and exited through his left shoulder blade. Staff Sergeant Keil instantly became a quadriplegic. Doctors informed Tracy that her husband would be on a ventilator for the rest of his life and would never move his arms or his legs. Staff Sergeant Keil eventually defied the odds and found himself off that ventilator and beginning a long journey of physical rehabilitation.

Around that same time, Tracy and her husband started exploring the possibilities of starting a family together--something that is a dream of so many young people in America today. Having children was all they could talk about once they adjusted to their new normal. With Staff Sergeant Keil's injuries preventing him from having children naturally, Tracy turned to the VA for assistance and began to explore her options for fertility treatments. Feeling defeated after being told the VA had no such programs in place for her in her situation, Tracy and Staff Sergeant Keil decided to pursue IVF through the private sector. While they were anxious to begin this chapter of their lives, they were confronted with the reality that TRICARE did not cover any of the costs related to Tracy's treatments because she did not have any fertility issues beyond her husband's injury. Left with no further options, the Keils decided this was important enough to them that they were willing to pay out-of-pocket to the tune of almost $32,000 per round of treatment.

Thankfully, on November 9, 2010, just after their first round of IVF, Staff Sergeant Keil and Tracy welcomed their twins Matthew and Faith into the world--two beautiful children. Tracy told me--and these are her words:

The day we had our children, something changed in both of

us. This is exactly what we had always wanted. Our dream had

arrived. The VA, Congress, and the American people have said

countless times that they want to do everything they can to

support my husband or make him feel whole again, and this is

your chance. Having a family is exactly what we needed to

feel whole again. Please help us make these changes so that

other families can share in this experience.

That is what Tracy said to me.

I have heard from these severely injured veterans, and while the details of their stories vary, the common thread that runs through all of them is that these veterans were unable to obtain the type of assistance they needed. Some have spent tens of thousands of dollars in the private sector, just as Tracy and her husband did, to get the advanced reproductive treatments they needed to start a family. Sadly, others have watched their marriages dissolve because of the stress of infertility in combination, of course, with the stresses of readjusting to life after a severe injury, which drove their relationships to a breaking point.

Any servicemember who sustains this type of serious injury deserves so much more. The bill I am here today trying to get passed will give the VA broad authority to offer advanced fertility treatments to the most severely wounded veterans, their spouses, or surrogates. It also gives the VA authority to determine how best to offer those benefits. It reverses this troubling barrier to care and will bring the VA in line with the military, which provides these services to this same group of servicemembers.

This is commonsense legislation. It should pass without delay. In fact, the New York Times recently ran an editorial on this bill, and it said:

In more than a decade of combat overseas, the military and

the VA have continually had to adjust to the challenges of

new traumas with new treatments, as with the epidemic of

brain injuries and post-traumatic stress. Adapting the VA

health system to better meet reproductive health needs should

be part of that response. It is one compassionate way to

fulfill the country's duty to our wounded veterans.

They also noted that even this Congress should be capable of a bipartisan agreement to pass it, and I couldn't agree more. I can't think of any reason why any Republican or Democrat won't join us today in getting this bill passed. This is about giving veterans, who have sacrificed absolutely everything, every option we have to help them fulfill a dream of simply starting a family. It says we are not turning our backs on the catastrophic reproductive wounds that have become a signature of these wars. It says to all of these brave men and women, who didn't ask questions when they were in harm's way, that we won't let politics get in the way of our commitment to them.

The VA has an obligation to care for the combat wounded, and that should include access to the care they need. Our women veterans deserve this, our male veterans deserve this, and our military and veteran families deserve this.

My understanding is that the objections have been removed, and we expect this bill to be passed tonight when we clear the bills as we end discussions. I thank all of my colleagues who have stepped up to make the reality of a family real to these men and women who have served us so well in combat, have come home with extremely serious wounds, and who--because this legislation hopefully will pass this body and hopefully we will get the House to pass it--will then have their dream of having a family become a reality.

I am very proud to have worked on this bill in a bipartisan way to move it out of our Veterans' Committee. My understanding is that we will be able to clear this bill tonight and move it along its way to the President for his signature and give hope to many men and women who served our country to have a family once again.

Thank you, Mr. President. I yield the floor, and I suggest the absence of a quorum.

Mr. President today, as Chairman of the Senate Committee on Veterans' Affairs, I introduce the Women Veterans and Other Health Care Improvement Act of 2012. I am incredibly proud of the women and men who have served or are serving our nation in uniform, and I strongly believe we must do all that we can to honor them.

That is why I introduced legislation, which was signed into law as part of the Caregivers and Veterans Omnibus Health Services Act of 2010, which helped to transform the way that the Department of Veterans Affairs, VA, addresses the needs of women veterans. Among other things, this law required the VA to provide neonatal care, train mental health professionals to provide mental health services for sexual trauma, and develop a child care pilot program. VA has an obligation to provide veterans with quality care and we have an obligation to make sure that VA does so. The legislation I am introducing today builds upon that effort to make additional improvements to VA's services for women veterans and veterans with families.

The nature of the current conflict and increasing use of improvised explosive devices leaves servicemembers, both male and female, at increased risk for blast injuries including spinal cord injury and trauma to the reproductive and urinary tracts. Army data shows that between 2003 and 2011 more than 600 women and men experienced these life-changing battle injuries while serving in Iraq or Afghanistan.

As they return from the battlefield, the VA system must be equipped to help injured veterans step back into their lives as parents, spouses, and citizens. These veterans have served honorably and have made the ultimate sacrifice for our great nation. They deserve the opportunity to pursue their goals and dreams, whether that includes pursuing higher education, finding gainful employment, purchasing their first house, or starting their own family. VA has many programs that help veterans pursue the educational, career, or homeownership dreams and goals that they deferred in service to this country, yet it falls short when it comes to helping severely wounded veterans who want to start a family. These veterans often need far more advanced services in order to conceive a child.

The Department of Defense and the Tricare program are already able to provide advanced fertility treatments, including assisted reproductive technology, to servicemembers with complex injuries. However; not all injured servicemembers are well situated to have a child at the time they are eligible for that coverage, and some are no longer eligible for Tricare by the time they are ready.

VA's fertility counseling and treatment options are limited and do not meet the complex needs of severely injured veterans. I have heard from severely injured veterans whose injuries have made it impossible for them to conceive children naturally. While the details of these stories vary, the common thread that runs through them all is that these veterans were unable to obtain the type of assistance they need. Some have spent tens of thousands of dollars in the private sector to get the advanced reproductive treatments they need to start a family. Others have watched their marriage dissolve because the stress of infertility, in combination with the stresses of readjusting to life after severe injury, drove their relationship to a breaking point. Any servicemember who sustains this type of serious injury deserves so much more. It is our responsibility to give VA the tools it needs to serve them, and the Women Veterans and Other Health Care Improvement Act is a start at doing that.

This legislation also requires VA to build upon existing research framework to gain a better understanding of the long-term reproductive health care needs of veterans, from those who experience severe reproductive and urinary tract trauma to those who experience gender- specific infections in the battlefield. A recent Army Task Force Report found that women in the battlefield experience high rates of urinary tract infections and other women's health conditions. After a decade at war, many women servicemembers are still at increased risk for women's health difficulties due to deployment conditions and a lack of predeployment women's health information, compounded by privacy and safety concerns. Little is known about the impact that these issues and injuries have on the long-term health care needs of veterans. Additional research will provide critical information to help VA improve services for veterans.

VA has come a long way in addressing the unique health needs and challenges that women face. Yet for all of its recent progress, VA can and must do more to ensure that women veterans are receiving the care that they need and deserve. Work remains to make VA a friendly environment for women veterans and veterans with families. Many women veterans are single mothers, making it difficult for them to take full advantage of the services that VA offers. The Women Veterans and Other Health Care Improvement Act creates a pilot program that provides child care to veterans seeking readjustment counseling at VA's Vet Centers. It also helps VA ensure that women veterans can get the information that they need in order to access VA health care and benefits.

This is not a section by section review of all the provisions within this legislation. However, I have provided an appropriate overview of the major benefits of this legislation and how it would improve the lives of our veterans and their families. The promise that we make to our veterans is sacred and knows no gender. To honor our veterans, we must honor this promise for each and every one of them.

Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Mr. President today, as Chairman of the Senate Committee on Veterans' Affairs, I introduce the Women Veterans and Other Health Care Improvement Act of 2012. I am incredibly proud of the women and men who have served or are serving our nation in uniform, and I strongly believe we must do all that we can to honor them.

That is why I introduced legislation, which was signed into law as part of the Caregivers and Veterans Omnibus Health Services Act of 2010, which helped to transform the way that the Department of Veterans Affairs, VA, addresses the needs of women veterans. Among other things, this law required the VA to provide neonatal care, train mental health professionals to provide mental health services for sexual trauma, and develop a child care pilot program. VA has an obligation to provide veterans with quality care and we have an obligation to make sure that VA does so. The legislation I am introducing today builds upon that effort to make additional improvements to VA's services for women veterans and veterans with families.

The nature of the current conflict and increasing use of improvised explosive devices leaves servicemembers, both male and female, at increased risk for blast injuries including spinal cord injury and trauma to the reproductive and urinary tracts. Army data shows that between 2003 and 2011 more than 600 women and men experienced these life-changing battle injuries while serving in Iraq or Afghanistan.

As they return from the battlefield, the VA system must be equipped to help injured veterans step back into their lives as parents, spouses, and citizens. These veterans have served honorably and have made the ultimate sacrifice for our great nation. They deserve the opportunity to pursue their goals and dreams, whether that includes pursuing higher education, finding gainful employment, purchasing their first house, or starting their own family. VA has many programs that help veterans pursue the educational, career, or homeownership dreams and goals that they deferred in service to this country, yet it falls short when it comes to helping severely wounded veterans who want to start a family. These veterans often need far more advanced services in order to conceive a child.

The Department of Defense and the Tricare program are already able to provide advanced fertility treatments, including assisted reproductive technology, to servicemembers with complex injuries. However; not all injured servicemembers are well situated to have a child at the time they are eligible for that coverage, and some are no longer eligible for Tricare by the time they are ready.

VA's fertility counseling and treatment options are limited and do not meet the complex needs of severely injured veterans. I have heard from severely injured veterans whose injuries have made it impossible for them to conceive children naturally. While the details of these stories vary, the common thread that runs through them all is that these veterans were unable to obtain the type of assistance they need. Some have spent tens of thousands of dollars in the private sector to get the advanced reproductive treatments they need to start a family. Others have watched their marriage dissolve because the stress of infertility, in combination with the stresses of readjusting to life after severe injury, drove their relationship to a breaking point. Any servicemember who sustains this type of serious injury deserves so much more. It is our responsibility to give VA the tools it needs to serve them, and the Women Veterans and Other Health Care Improvement Act is a start at doing that.

This legislation also requires VA to build upon existing research framework to gain a better understanding of the long-term reproductive health care needs of veterans, from those who experience severe reproductive and urinary tract trauma to those who experience gender- specific infections in the battlefield. A recent Army Task Force Report found that women in the battlefield experience high rates of urinary tract infections and other women's health conditions. After a decade at war, many women servicemembers are still at increased risk for women's health difficulties due to deployment conditions and a lack of predeployment women's health information, compounded by privacy and safety concerns. Little is known about the impact that these issues and injuries have on the long-term health care needs of veterans. Additional research will provide critical information to help VA improve services for veterans.

VA has come a long way in addressing the unique health needs and challenges that women face. Yet for all of its recent progress, VA can and must do more to ensure that women veterans are receiving the care that they need and deserve. Work remains to make VA a friendly environment for women veterans and veterans with families. Many women veterans are single mothers, making it difficult for them to take full advantage of the services that VA offers. The Women Veterans and Other Health Care Improvement Act creates a pilot program that provides child care to veterans seeking readjustment counseling at VA's Vet Centers. It also helps VA ensure that women veterans can get the information that they need in order to access VA health care and benefits.

This is not a section by section review of all the provisions within this legislation. However, I have provided an appropriate overview of the major benefits of this legislation and how it would improve the lives of our veterans and their families. The promise that we make to our veterans is sacred and knows no gender. To honor our veterans, we must honor this promise for each and every one of them.

Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Mr. President, I ask unanimous consent that the Senate proceed to the consideration of Calendar No. 564, S. 3313.

Mr. President, I ask unanimous consent that the committee-reported amendment be considered; the Murray amendment, which is at the desk, be agreed to; the committee-reported amendment, as amended, be agreed to; and that the bill, as amended, be read a third time.

Mr. President, I ask unanimous consent that the committee-reported title amendment be agreed to, the motions to reconsider be laid upon the table with no intervening action or debate, and that any related statements be printed in the Record.

Mr. President, the Senate has just passed legislation that will bring into focus a real need for the VA to help women veterans and the spouses of male veterans access assistance for one of the most impactful and serious wounds of these wars--reproductive and urinary tract trauma.

As many of my colleagues know, the nature of the current conflict we are involved in and the use of improvised explosive devices leave our servicemembers far more susceptible to very serious injuries, such as reproductive and urinary tract trauma. Army data shows that between 2003 and 2011, we had 2,000 servicemembers suffering from these kinds of injuries. Like so many of our veterans, these men and women come home and want to return to their lives, to find employment and to start a family. But today, when they go to the VA, the fertility services that are available don't meet the very complex needs of these serious injuries. In fact, veterans who have suffered from these injuries find that the VA is specifically barred from providing more advanced assisted reproductive techniques, such as in vitro fertilization. They are, in fact, told--despite the fact that they have made such an extreme sacrifice for our country--that they can't be provided with the medical services they need to start a family.

One of those veterans I have come to know is SSG Matt Keil and his wife Tracy, who are here with us today. Staff Sergeant Keil, whom I talked about this morning, was shot in the neck while he was on patrol in Ramadi, Iraq, on February 24, 2007, just 6 weeks after he married Tracy. Staff Sergeant Keil instantly became a quadriplegic. Later, when he came home and they wanted to start a family, Tracy and Matt were faced with the fact that they could not access IVF services through the VA, which meant they had to pay $32,000 out of their own pocket.

Mr. President, the bill we passed today means those families who are coming behind Tracy and Matt won't have to go through the same fight to take care of something that is so vital to so many American families; that is, having a family of their own. This is an important step we have taken today in passing this out of the Senate. I am hopeful that the House will take it up and pass it. And I assure Tracy and Matt that one day, when this bill is signed into law, they will have made a true difference for those families who come behind them, and for that I am eternally grateful.

I thank the Chair, and I yield the floor.

Mr. President, last week heads of state, key policymakers, and foreign aid implementers met in Washington to examine ``Frontiers in Development.'' It was my pleasure to provide the conference keynote address Monday in which I pressed for greater transparency in global financial transactions and investments. This includes both U.S. foreign assistance funding and payments that companies make to foreign governments for oil, natural gas and mineral developments. Fuller disclosure improves accountability to citizens of both our country and the recipient country and would set an important example for other countries to provide more clarity about their own foreign assistance programs. Transparency in energy and mineral payments is already required for U.S.-listed companies by law in the Cardin-Lugar provision of the Dodd-Frank Act, and thanks to American leadership, the European Union is preparing similar legislation. Now, it is timely to enact legislation requiring the U.S. to disclose where and for what purpose it provides foreign assistance dollars across the globe. Further, taxpayers and foreign aid recipients have a right to know the impacts of these funds.

That is why I am introducing The Foreign Aid Transparency and Accountability Act, which will require the President to disclose this information through a publicly accessible website in a timely manner.

The U.S. provides assistance through a host of federal agencies including the Departments of State, Defense and Agriculture, as well as agencies including the U.S. Agency for International Development, USAID, and the Millennium Challenge Corporation, MCC. While our Federal budget is available for public review, there is currently no single source required by law where one can review in what amount and for what purpose U.S. dollars flow to individual countries and programs. President Obama early in his administration promised to bring more transparency to our international development programs. But so far, the efforts by the State Department, USAID, the MCC and others to display this information through the Foreign Assistance Dashboard have been inadequate. There is a meager amount of data on the Dashboard, and it is often woefully out of date.

My legislation is the identical version to that introduced earlier in this Congress by Congressman Ted Poe of Texas, which now has more than 50 House co-sponsors. I compliment Representative Poe on the bill and appreciate the bipartisan support he has already garnered for it in the House. I look forward to working to enact the legislation in this Congress, bringing greater transparency and accountability to taxpayer funding of foreign assistance programs in a timely manner.

Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.