To eliminate the sunset of the Veterans Choice Program, and for other purposes.

Mr. Speaker, I move to suspend the rules and pass the bill (S. 544) to amend the Veterans Access, Choice, and Accountability Act of 2014 to modify the termination date for the Veterans Choice Program, and for other purposes.

Mr. Speaker, I ask unanimous consent that all Members have 5 legislative days in which to revise and extend their remarks and add extraneous material into the Record.

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

I rise today in support of S. 544. Congress created the Choice Program in 2014 to ensure that veterans waiting in line at the Department of Veterans Affairs medical facilities across the country had an option of seeking care in their communities. Though Choice is far from perfect, 3 years later, more than a million veterans have used it to get care they needed faster and closer to home.

Choice has also led to a nationwide conversation about the importance of the VA healthcare system, the need for VA to be a better partner to community providers and hospitals everywhere, and the actions we must take to ensure that VA is well positioned to provide high-quality care to veterans for generations to come. As chairman, I am wholeheartedly committed to seeing that conversation through to a solution.

We are currently refining legislation that will provide a long-term path to make the VA healthcare system and VA's care in the community programs, including Choice, work better for veterans, for VA, for community providers, and for taxpayers alike. Our goal is to have that solution on the President's desk later this year.

However, Choice is expected to sunset just four short months from now on August 7, 2017. And when it does, the VA expects to have anywhere from $800 million to $1.2 billion left in the Choice fund.

Absent enactment of this bill or legislation like it, on August 8, those funds will no longer be available to help veterans get the care they need, with potentially tragic consequences.

During a full committee hearing last month, Secretary Shulkin testified:

``Without congressional action, veterans will have to face longer wait times for care.''

He went on to say that allowing Choice to sunset would be ``a disaster for American veterans.''

With the passage of this bill today, we can get one step closer to avoiding that disaster.

In anticipation of the program's expiration, VA has already started halting referrals to Choice for services, like maternity care and oncology care that typically require lengthy episodes of care. That means that veterans with cancer or veterans who are pregnant can no longer choose to take advantage of Choice care if they live far away from a VA medical facility or have to wait more than 30 days for the next VA appointment.

As if that wasn't bad enough, if Choice is not extended by the end of April, VA will have to stop sending referrals to Choice for many other services that veterans are relying on.

To prevent this, S. 544 would remove the August 7, 2017, sunset date from the Choice program. This will allow the program to continue working for veteran patients until all the money remaining in the veterans Choice fund--the money that Congress provided 3 years ago for this exact purpose--is fully expended.

It would also ensure that, as we move forward with ongoing efforts to create an enduring solution to the problems VA is facing, veterans are not cut off from potentially lifesaving or life-preserving care.

The bill would also eliminate the requirement for VA to act as the secondary payor for nonservice-connected care provided under Choice. This would bring Choice in line with VA's other care in the community programs and remove a pain point that, while well-intentioned, has impeded the provision of care for certain patients and challenged VA's ability to issue reimbursements to community providers in a timely consistent manner.

In addition, the bill would authorize VA to share medical record information with community providers who are jointly treating veteran patients. This would ensure that the clinicians caring for veterans, both in VA and community medical facilities, have all the information that they need to make well-informed treatment plans and provide the highest quality care.

Subsequent redisclosure of medical records information would be prohibited, meaning that personal patient information would be safeguarded from inappropriate disclosures.

As chairman, as a veteran, and as a doctor, I cannot think of anything more important that we can do today to help our Nation's veterans and pass this legislation out of the House of Representatives and swiftly deliver it to the President's desk for his signature.

I urge all of my colleagues to join me in doing that by supporting this bill today.

I reserve the balance of my time.

Mr. Speaker, I thank my friend, Ranking Member Walz, for his kind words and his hard work on this legislation also.

I yield 2 minutes to the gentleman from Florida (Mr. Bilirakis), the vice chair of the Veterans' Affairs Committee.

Mr. Speaker, I yield 2 minutes to the gentleman from Colorado (Mr. Coffman), my good friend, a veteran of both the Marine Corps and the Army, twice deployed to Iraq, and a very active member of the committee.

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

I look forward to working with Ranking Member Walz and our fellow committee members to strike the appropriate balance between ensuring protections that are in place to provide provider agreement authority from being unfairly utilized and reducing administrative burdens on small providers.

However, absent passage of this legislation today, veterans with serious need will not be able to get the care they need. Already, veterans who are pregnant or who have been diagnosed with cancer have been unable to take advantage of the increased access to care that the Choice Program provides.

I would also note that, since Choice granted VA provider agreement authority in the Choice Act 3 years ago, the committee has not heard a single instance where that authority has been improperly utilized or resulted in unfair labor practices.

Furthermore, the exclusion afforded in the Choice Act is no more generous than providers under Medicare or in TRICARE currently enjoy, and there is no reason why providers accepting veteran patients should have to deal with more administrative burdens than providers under Medicare and TRICARE. I can assure you, as a Medicare provider and a TRICARE provider, that is enough burden.

Mr. Speaker, I yield 2 minutes to the gentleman from New Jersey (Mr. Lance), my good friend and fellow classmate.

Mr. Speaker, I yield 2 minutes to the gentleman from Pennsylvania (Mr. Costello), a former member and a very active member of our committee.

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

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

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

I want to thank the majority and the minority staff that worked on this bill, and certainly the Senate, Senators Tester and Isakson, and the committee on the Senate side for getting this over here in a timely way. We needed to do this now so that we could continue care for patients that would go past August 7. We have people right now who are getting care that is going to be long term, and they would be cut off or couldn't use the Choice program.

We have heard a lot of the problems with Choice here, but it has also helped a lot of veterans. What we feel like we want the opportunity to do now is be given a little bit of time, in a bipartisan way, to work out the problems with this.

I think this goes for everyone on our committee: At the end of the day, our purpose, our goal is to provide access and the best quality of care for veterans that this country can deliver. That is the goal of our committee in a bipartisan way.

With that, once again, I encourage all of my Members to support this legislation.

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

Mr. Speaker, I thank the ranking member, the gentleman from Minnesota, for yielding.

Mr. Speaker, I rise today in support of S. 544. This legislation ensures that the approximately $1 billion left in Choice funding is spent on the critical mission of providing veterans timely access to care.

It would be an abdication of our responsibility to veterans if we allowed this money to go back to the Treasury instead of going to those who need and deserve our support.

I appreciate the efforts from my colleagues on both sides of the aisle for advancing this legislation.

The Choice Act was designed as a rapid response to the veteran wait time crisis, but its framework and implementation has been deeply flawed. Objective analyses found that it is not meaningfully reducing veterans' wait times, and its arbitrary standards have added a layer of confusion for both patients and providers.

There is bipartisan consensus that these concerns must be addressed when the Choice Act sunsets and the funding expires. We can and must do a better job of prioritizing and streamlining veterans' access to care in the community. We can and must do better than the existing Choice Act.

Now, the Choice Act was a temporary emergency measure to address an unacceptable crisis. Unfortunately, it contained language that undermined protections against workplace discrimination for Federal contractors. The next iteration of this law cannot subvert the rights of those who treat and serve our veterans.

The Office of Federal Contract Compliance Programs continues to be a vital tool for ensuring fairness and equality in the workplace. It should apply to everyone that does business with the Federal Government because the Federal Government cannot endorse discrimination of any kind.

I will fight to ensure that this committee and this Congress restores their commitment to equality and fairness as we develop a more streamlined and thoughtful method for connecting veterans with community care.

Mr. Speaker, I include in the Record a letter echoing these concerns from the Human Rights Campaign, the National Women's Law Center, The Leadership Conference on Civil and Human Rights, and the National Partnership for Women & Families.

April 5, 2017.

Dear Representative: We write to express our serious

concerns about H.R. 369/S. 544, which would eliminate the

sunset of the Veterans Choice Program. The Veterans Choice

Program currently includes a provision exempting it from

oversight by the Office of Federal Contract Compliance

Programs (OFCCP). This has diminished civil rights

protections when the Department of Veterans Affairs (VA)

enters into federal contracts for veterans' health care

services. The Veterans Choice Program was always intended to

be a temporary solution to ease the health care access crisis

faced by the veterans receiving care through the VA. We fear

that removing the sunset will open the door to extension of

the program, including extending the provision that strips

critical equal employment opportunity protections from the

men and women serving our nation's veterans. OFCCP must have

full jurisdiction to protect against employment

discrimination and promote equal employment opportunities.

The antidiscrimination rules enforced by OFCCP ensure that

federal contract dollars further equal employment opportunity

and are not used to subsidize unlawful discrimination. OFCCP

plays a unique and vital role in combating unlawful

employment discrimination by federal contractors on the basis

of sex, race, national origin, religion, color, sexual

orientation, gender identity, and disability. It also

enforces the Vietnam Era Veterans Readjustment Assistance

Act, or VEVRAA, which requires nondiscrimination and

affirmative action for special and disabled veterans of any

war, campaign, or expedition in which a campaign badge has

been authorized. In addition, OFCCP guides contractors and

subcontractors on affirmatively promoting equal opportunity

in the workplace and promotes fair and nondiscriminatory

federal contractor workplaces. Many of its regulations

require contractors to take affirmative steps to expand the

pool of individuals from which it recruits, and evaluate

their own practices to identify and address conduct that

limits equal employment opportunities for protected classes

of workers. By conducting compliance audits and systemic

investigations, through its data collection and investigative

authority, OFCCP can aid contractors in identifying and

resolving practices that limit equal employment

opportunities, without relying solely on individuals who are

willing to risk retaliation to challenge unfair employment

practices. OFCCP's historic and current role in ensuring

artificial barriers do not restrict employment based on sex,

race, color, national origin, religion, sexual orientation,

gender identity, disability, or veteran status has improved

opportunities for a wide range of workers across the country

and has ensured that federal tax dollars do not subsidize

discrimination.

Carving out the VA provider agreements from these

antidiscrimination protections, affirmative action rules, and

data reporting requirements has the effect of narrowing

employment opportunities for women, people of color, people

with disabilities, veterans, and LGBT individuals and removes

critical tools for ending employment discrimination and

harassment. Extending the provision that weakens these

protections ultimately threatens harm not only to workers,

but to those who depend on them for care.

There is no appreciable administrative burden that

justifies continuing to suspend these protections and

requirements. Federal contractors and subcontractors with

less than 50 employees and $50,000 in contracts or

subcontracts are not covered by OFCCP's affirmative action

requirements. More than 94 percent of health care and social

assistance firms had fewer than 50 employees in 2009. The

larger providers, those with 50 or more employees and $50,000

or more in federal contracts, should be well-equipped to meet

the minimal administrative obligations associated with

maintaining an affirmative action plan.

The carve-out of VA contractors from the employment

discrimination rules applicable to federal contractors not

only has a detrimental impact on the workforces affected, but

sends a disturbing message that ensuring fair treatment for

women, people of color, LGBT people, veterans, and people

with disabilities is unnecessary and inconsequential. It sets

a precedent for future carve-outs and represents a step

backward from equal opportunity. Any continuation of the

Veterans Choice Program must ensure OFCCP jurisdiction to

enforce the antidiscrimination rules and other equal

employment opportunity protections for these providers.

For further information, please contact the Human Rights

Campaign, the National Women's Law Center, the Leadership

Conference on Civil and Human Rights, or the National

Partnership for Women and Families.

Sincerely,

National Women's Law Center.

Leadership Conference on Civil and Human Rights.

National Partnership for Women & Families.

Human Rights Campaign.

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

Mr. Speaker, I, too, rise in strong support of S. 544 to eliminate the sunset on the Veterans Choice Program.

This bill will basically allow the Department of Veterans Affairs to continue spending previously appropriated resources in the Veterans Choice Program to provide direct and timely patient care to veterans. It allows the VA to charge a veteran's healthcare insurer for nonservice-connected care so that veterans aren't sent expensive medical bills, wasting time trying to figure out how to get them paid. Finally, it allows the VA to share medical information with community care providers so patient care is better coordinated.

This legislation is identical to H.R. 369, which passed unanimously in our Committee on Veterans' Affairs. It includes amendments offered by members of that committee.

I would like to take a moment, Mr. Speaker, to congratulate and thank the chairman of the committee for the bipartisan way that he approached this. The issue of veterans care is a passionate issue for all of us.

The issue of the Choice Program arose out of the crisis in Phoenix and other places in 2014, and a sunset that needed to be addressed was handled in a professional manner. It brought all parties together. I think the chairman is going to get a unanimous vote. They have got one in the Senate.

I can see that, under less steady hands, where this may have bogged down, and I appreciate the chairman's sense of urgency in getting it to this point. It puts us in a good place. So thank you for that.

It also gives us the time we need to come to a bipartisan fix for the Choice Program. We know, under the Choice Program, veterans are still waiting too long to receive care. As we said, in 2014, we all supported the Choice Act because of the crisis. Throughout the country, veterans were waiting, and in some cases dying, because they were waiting for care. If we recall right, an honorable and decent man, the VA Secretary, resigned over this crisis. So this was an important issue that needed to be addressed. We passed the Choice Act so that veterans could get that care.

The Choice Program was created as a temporary fix, designed to end this summer or when the VA spent the $10 billion. As the chairman said, there is about $1 billion left in Choice. With veterans still in need of care, we cannot possibly allow that to go back without addressing where it needs to go. It would be a waste of money, a waste of time, and it would make veterans' wait times even higher.

The bill gives us time to rewrite the Choice Program. The bill will give us time to address all of the problems with Choice so that veterans' care is managed and coordinated with VA and community care providers and so that veterans do not have wait times. It will also make sure the money will continue to be spent on veterans' health care.

I look forward to working with the chairman. As I said earlier, his steady hand and visionary leadership has gotten us to this point. It will ensure that we can figure out what the next iteration of community-based care looks like, and we can come together, bring that to the floor, and get it passed.

For this reason, I would urge my colleagues to support this legislation so veterans can receive their care now while Congress continues to work to improve upon that.

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

Mr. Speaker, I yield 2 minutes to the gentlewoman from New Hampshire (Ms. Kuster), my good friend and a friend of all veterans, our ranking member on the Oversight and Investigations Subcommittee.

Mr. Speaker, at this time it is my privilege to yield 3 minutes to the gentleman from California (Mr. Takano), my good friend and also a good friend of veterans, the vice ranking member of the full Committee on Veterans' Affairs,

Mr. Speaker, I yield 2 minutes to the gentlewoman from California (Ms. Brownley), the ranking member of our Health Subcommittee.

Mr. Speaker, I yield 3 minutes to the gentleman from Texas (Mr. O'Rourke), my good friend, the ranking member of our Economic Opportunity Subcommittee.

Mr. Speaker, may I inquire how much time I have remaining? I have two speakers to go.

Mr. Speaker, I yield 2 minutes to the gentleman from California (Mr. Correa), a good friend, a new member of the Veterans' Affairs Committee, someone who came to the House of Representatives and asked to serve veterans and be on the committee.

Mr. Speaker, I yield 1 minute to the gentleman from Nevada (Mr. Kihuen), who has taken a keen interest in veterans' issues. I am grateful that he is here today.

Mr. Speaker, once again, I would like to thank the chairman, the staff, and everyone who has been here.

I think, of all the committees that are modeling the behavior of democracy, bipartisanship, and what our government stands for, the Veterans' Affairs Committee is one that takes that responsibility seriously. The chairman always models it. I think this is a case of that.

You heard the speakers come here. This is a big issue. There may be some differences in how the delivery, long term, looks, but there is no division on getting the best and most timely care to our veterans.

With that, I encourage my colleagues to support S. 544.

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

Mr. Speaker, I would like to begin by thanking the chairman of the full committee, and I join the ranking member of the full committee in honoring the work of Chairman Roe, his staff, and his ensuring that we do the right thing for every single one of the veterans in this country that we are here to serve.

It would be easy just to criticize the Choice Program which has not worked fully as intended. Too many of the veterans that we represent are still getting bills when their provider in the community, the VA, and the third-party administrator can't resolve their differences.

Too many veterans are having too hard of a time in getting an appointment in a timely fashion. And as we learned recently, the VA still is not fully measuring the true wait time for the more than 3 million appointments that have been made through the Choice Program right now. We don't have the kind of accountability that we must have.

All the same, the Choice Program is bridging care for veterans who need it in millions of instances. To simply allow the sunset to take place without having the time necessary to work on some of the necessary fixes would be irresponsible. So thanks to the chairman and the ranking member, we are able to do that today.

We also ensure that the VA becomes the primary payer, which is going to reduce some of the billing headaches that veterans have unnecessarily been subjected to.

Mr. Speaker, I also want to point out that the bill contains the Vet Connect Act, which I was able to author with Congressman Benishek, a bipartisan bill, last session, re-introduced this session.

It is bicameral, as well, in the Senate. We have Senators Tester, Isakson, and Manchin, who authored this bill that ensures that veterans' private medical information follows them from the VA to their provider in the community and then back to the VA, ensuring that every appointment, every provider, and every doctor can make informed medical decisions on behalf of those veterans. Right now, at the current rate of inclusion of veterans' personal medical information, it would take 60 years to get all the data into the hands of the doctors who need to make that care.

This brings the VA and the veterans under the VA's care into modern medical record keeping and sharing. It honors all of the HIPAA regulations; ensures privacy of veterans' medical records; but, most importantly, ensures that they are going to get better, more informed quality care, better outcomes, better treatment. It is what the veterans that we serve have earned and deserve.

I am very proud to join my colleagues in this to work for its passage. I hope that the other Members of this body will join us in supporting this unanimously.

Mr. Speaker, I would like to congratulate the Corpus Christi students from the CITGO Innovation Academy for Engineering, Environmental & Marine Science at Moody High School for winning two awards at the Marine Advanced Technology Education International Remotely Operated Vehicle competition recently held at NASA's Johnson Space Center's Neutral Buoyancy Lab in Houston, Texas.

This competition was the final round in a series of science fairs and challenges focusing on underwater technology that can adapt to harsh ocean and space environments.

The AquaBot Technicians robotics team won the Aloha Award for team spirit and friendliness. Natasha Sanchez was named the competition's

Mr. Speaker, since first being elected to Congress, I have been fighting for our veterans to get the care they were promised and earned.

After hearing veterans tell horror story after horror story of long wait times, canceled appointments, and having to travel miles to distant cities to get treatment, Congress got something right when they passed the Veterans Choice and Accountability Act in 2014.

It created the Veterans Choice Program that allows any veteran who is unable to obtain an appointment with the VA within 30 days or has to travel more than 40 miles to a VA facility for care to see a private doctor who can see them faster and closer to home.

Though the implementation of the Veterans Choice Program has not been without hiccups, it is proving very helpful for getting veterans faster, more quality care.

I hear time and again from veterans in the district that I represent that this is working for them.

Soon, in fact later today, the House will vote on H.R. 369, to eliminate the sunset of the Veterans Choice Program and ensure the program continues after August 7.

I encourage all my colleagues to vote ``yes'' on this bill to continue Veterans Choice. I look forward to continuing to hear the great successes it provides for our veterans and for our doctors.