Mr. Speaker, pursuant to House Resolution 860, I call up the bill (H.R. 4673) to amend title 38, United States Code, to provide for the automatic enrollment of eligible veterans in patient enrollment…
Mr. Speaker, pursuant to House Resolution 860, I call up the bill (H.R. 4673) to amend title 38, United States Code, to provide for the automatic enrollment of eligible veterans in patient enrollment system of Department of Veterans Affairs, and for other purposes, and ask for its immediate consideration in the House.
Mr. Speaker, I ask unanimous consent that all Members may have 5 legislative days in which to revise and extend their remarks and to insert extraneous material on H.R. 4673, as amended.
Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, I rise today in support of H.R. 4673, as amended, my bill, the Ensuring Veterans' Smooth Transition, or EVEST Act.
I have made suicide prevention a top priority for the House Veterans' Affairs Committee. Last Congress, we passed bipartisan, bicameral mental health legislative packages, including the Commander John Scott Hannon Veterans Mental Health Improvement Act and the Veterans COMPACT Act. This Congress, we continued this work by passing the Sergeant Ketchum Rural Veterans Mental Health Act into law, but there is always more to do.
EVEST builds on our work and finally closes one of the most glaring gaps for veterans being able to successfully access high-quality VA health services, the enrollment process. We shouldn't be trying to hide VA care from those who earned it.
We know that the months following transition out of the military can be very stressful and particularly risky for new veterans in terms of mental health. With the EVEST Act, servicemembers will be automatically enrolled in VA care during their transition out of the military, with the choice to opt out. This helps simplify the process and prevents veterans from potentially missing out on lifesaving care. It also keeps veterans from having to opt into VA care later and attempt to navigate a new bureaucracy all on their own.
The symptoms of PTSD can be significantly improved in veterans who receive prompt mental healthcare. A 2014 study led by researchers at the San Francisco VA Medical Center looked at nearly 40,000 Iraq and Afghanistan veterans who received VA mental
healthcare between 2001 and 2011 and had a post-deployment diagnosis of PTSD. They found that veterans who sought and received care soon after the end of their service had lower levels of PTSD upon follow-up a year after they initiated care. Each year that a veteran waited to initiate treatment, there was about a 5 percent increase in the odds of their PTSD either not improving or getting worse.
Mr. Speaker, I include in the Record the study from the San Francisco VA Medical Center.
[From Psychiatric Services, Dec. 2014]
Timing of Mental Health Treatment and PTSD Symptom Improvement Among
Iraq and Afghanistan Veterans
(By Shira Maguen, Ph.D.; Erin Madden, M.P.H.; Thomas C. Neylan, M.D.; Beth E. Cohen, M.D., M.A.S.; Daniel Bertenthal, M.P.H.; Karen H. Seal,
A smooth care transition from DOD to VA can help support veterans as they adjust to the next phase of their lives and provide easy access to healthcare should any challenges arise.
Everyday Americans find it difficult and frustrating to sign up for healthcare. Now, imagine that you have just come off Active-Duty military service where, for years you were told when and where to show up for your healthcare. You probably heard something about VA services during your transition assistance program but, frankly, you were focused on everything you had to do to finalize your separation from the military and possibly looking for new employment and relocating your family.
Now, after having separated from the military, you are a veteran, and maybe for the first time you have to figure out how to check your eligibility for VA healthcare and navigate the system while potentially also facing some new stress in your personal and family life. This is completely avoidable with EVEST, which simply enrolls you in the VA healthcare for which you are already eligible, ensuring that when you need VA, there aren't any unnecessary roadblocks to seeing a doctor.
Now, let me say that again. This legislation has nothing to do with a veteran's eligibility, nor does it change VA standards or who is eligible. It only connects eligible veterans to VA care faster and easier.
We know that veterans are much more likely to use VA services and care when the process to enroll is simple, and we know that VA care is world class. EVEST is a straightforward tool that will allow us to simplify the transition process and take steps toward preventing veteran suicide.
Automatic enrollment is something policymakers and veterans service organizations and stakeholders have been trying to advance for years, and with EVEST it will finally become a reality.
Paralyzed Veterans of America and Disabled American Veterans have formally endorsed this legislation. The Nurses Organization of Veterans Affairs, the American Federation of Government Employees, the Veterans Healthcare Policy Institute, and the American Psychological Association also support EVEST.
Again, Mr. Speaker, I include in the Record letters of support from the Nurses Organization of Veterans Affairs and the Veterans Healthcare Policy Institute.
Nurses Organization of
Veterans Affairs,
January 14, 2021.
Chairman Mark Takano,
Committee on Veterans' Affairs,
Washington, DC.
Dear Chairman Takano: On behalf of the nearly 3,000 members
of the Nurses Organization of Veterans Affairs (NOVA) we
would like to offer our strong support for your bill, H.R.
4673, Ensuring Veterans' Smooth Transition Act (EVEST).
As nurses, caring for Veterans is our number one priority.
Your bill will provide Veterans with the option of enrolling
in VA healthcare during the critical months following their
transition to civilian life and ensure servicemembers
separating from active duty receive the critical health care
to which they are eligible.
Your bill will also help eliminate barriers to care--
including those who may not know they are even eligible to
receive care at VA. It will also help to assure the Veteran
that they are not alone in seeking care for any physical or
mental health condition acquired during their military
service.
Offering automatic enrollment with an opt out will help to
lessen the burden of navigating the VA healthcare system at a
time when they are dealing with many challenges as they
transition to civilian life.
NOVA believes that most Veterans will find care provided
them within the VA is suited to their individual and complex
needs and cannot be matched in the private sector. Many
providers at the VA are Veterans themselves so they
understand what it means to serve and are trained to provide
a Whole Health approach to the Veteran patients' health and
well-being.
Thank you for your leadership on this issue and your
continued support for Veterans and the healthcare
professionals who care for them.
Sincerely,
Taryn-Janae Wilcox-Olson, MHS, RN,
President, Nurses Organization of Veterans Affairs (NOVA).
Mr. Speaker, I wish to thank Speaker Pelosi and Leader Hoyer for considering this legislation today, and I urge the rest of my colleagues to support this vital legislation to increase access to care and ensure a smooth transition to civilian life for veterans.
Mr. Speaker, I reserve the balance of my time.
Mr. Speaker, I yield myself such time as I may consume.
I reiterate that we should not be hiding the care that our veterans have earned. Let me quickly say that this bill has been in the public domain for 2 years. It was reintroduced last summer, and the minority had over 6 months to talk with us and the VA about it.
Furthermore, the committee has held six hearings on suicide prevention and transition since 2019. The common sense of this bill shines through.
And let me also add that regarding the capacity of VA--and I am glad that the ranking member has entered the statement of administrative support into the Record; that statement clearly says and declares the administration's support and its willingness to work with the administration.
Data shows that VA enrollment has been going down in recent years, and while new enrollment hovers around 400,000 per year, it used to be double that, around one million per year, and using current assumptions, VA projects veteran enrollment in VHA to remain relatively steady from 2019 to 2029.
I am very confident about VA's ability to absorb the additional veterans that will take advantage of VA's world-class healthcare.
Mr. Speaker, I yield 5 minutes to the gentleman from Indiana (Mr. Mrvan), my good friend and a member of the House Committee on Veterans Affairs and the chairman of the Subcommittee on Technology Modernization.
Mr. Speaker, I yield myself such time as I may consume.
I want to add that, in response to the esteemed ranking member, VA formally supports this legislation and has been discussing auto enrollment for years.
VA has already been working to make transition into VA healthcare smoother with Solid Start and will soon have data showing that warm handoffs have a positive impact on veteran outcomes without overwhelming the VA system.
In response to the criticism that VSOs have not had input, I want to point out that VSOs, including Paralyzed Veterans of America and Disabled American Veterans, have already formally endorsed EVEST. Why? Because the common sense of this legislation shines through.
All VSOs have had a chance to weigh in, and many did. The Nurses Organization of Veterans Affairs, the American Federation of Government Employees, the Veterans Health Policy Institute, and the American Psychological Association also support this legislation.
Mr. Speaker, I yield 3 minutes to the gentleman from California (Mr. Correa), my good friend and a former member of the House Veterans' Affairs Committee who now serves on the Agriculture Committee, Homeland Security Committee, and House Judiciary Committee.
Mr. Speaker, I yield myself such time as I may consume.
Let me say that the amendments that we are considering to this bill today, which I consider friendly, will address many of the ranking member's concerns about the reaching out.
I yield 3 minutes to the gentleman from Connecticut (Mr. Himes), my good friend who serves on the Financial Services Committee and the Permanent Select Committee on Intelligence.
Mr. Speaker, I yield myself the balance of my time.
Mr. Speaker, let me just say, in response to my friend, the esteemed ranking member, that his MTR, which would delay implementation in order to avoid harm to our veterans, dare I say that the harm is in the delay.
I am reminded of a quote from the VFW's Pat Murray that we had at yesterday's roundtable on toxic exposure: Our pay-for for this bill and our pay-for, frankly, for all that we do for veterans was the ticket that we sent servicemembers overseas to serve. I repeat: Our pay-for was the ticket we sent servicemembers overseas to serve.
And a little further discussion on the pay-for issue: The Congressional Budget Office does not estimate that this bill will increase mandatory spending and does not require an offset. These are the rules we play by.
Again, we are not creating new eligibility here. The only cost of this bill is veterans seeking care that they are already eligible for. We are all better off when veterans are seeking the care that they need, and we should not be hiding that care for which they are eligible.
Automatic enrollment in VA healthcare for eligible veterans is a long-needed suicide prevention tool. We cannot put a price tag on protecting the health and safety of our veterans. Many of these veterans would go on to use VA healthcare even if they are not automatically enrolled, and the minority does not give a compelling reason why we should hinder or make that process more difficult for our veterans.
Again, I repeat, we should not be hiding the care for which our veterans are already eligible.
Mr. Speaker, I ask that all my colleagues join me in passing H.R. 4673, as amended, and I anticipate we will see a big bipartisan vote today.
Mr. Speaker, I yield back the balance of my time.
Mr. Speaker, pursuant to section 5 of House Resolution 860, I rise to offer the four amendments en bloc to H.R. 4673.
Mr. Speaker, I rise today in support of these en bloc amendments. Seamlessly connecting veterans with the benefits and care they earned through their service is paramount to the transition process.
The Delgado amendment No. 1 makes sure that VA can easily notify veterans regarding care and services through mass texting. As technology and communication methods improve, so should how VA uses those capabilities to easily inform veterans of their benefits. Texting eligible veterans to tell them they have been auto-enrolled in VA healthcare is an effective, simple way to increase awareness of the care available to them.
The Delgado amendment No. 2 requires GAO to submit a report to determine the best methods to notify veterans regarding their automatic enrollment in VA healthcare. This amendment will strengthen the underlying bill and inform best practices for how VA can ensure veterans have the information they need regarding their access to care and services.
Getting information to veterans in an effective manner is crucial to their transition into civilian life, and the Delgado amendment No. 2 will help improve how VA communicates an eligible veteran's enrollment in VA healthcare so they can easily access the care they need.
The Hayes amendment requires that VA notify veterans who opt out of automatic enrollment that they may elect to enroll at a later date. We understand there will be some veterans who opt out for auto-enrollment for a variety of reasons, but it is our duty that they know that the VA will be waiting for them if their future needs change.
Ensuring VA adopts and scales best practices related to auto- enrollment while also learning from any issues that arise during its rollout is important to the long-term effectiveness of the aims of H.R. 4673.
The Tlaib amendment requires the VA to submit a report a year after the first veteran is auto-enrolled in VA healthcare to preserve lessons learned from the rollout. This report will help improve auto-enrollment for both the VA administrators implementing the program and veteran users alike.
Mr. Speaker, I urge my colleagues to support the en bloc amendments, and I reserve the balance of my time.
Mr. Speaker, may I inquire how much time is remaining.
Mr. Speaker, I yield 2 minutes to the gentleman from Connecticut (Mr. Courtney), my good friend who serves on the House Committee on Armed Services as chairman of the Subcommittee on Seapower and Projection Forces and the Committee on Education and Labor.
Mr. Speaker, I yield an additional 30 seconds to the gentleman from Connecticut (Mr. Courtney).
Mr. Speaker, I yield 2\1/2\ minutes to the gentlewoman from Michigan (Ms. Tlaib), my good friend and author of this amendment. She serves on the Financial Services Committee, the Natural Resources Committee and the Oversight and Reform Committee.
Mr. Speaker, I yield 2\1/2\ minutes to the gentleman from Texas (Mr. Green), my good friend and member of the Financial Services Committee where he is chairman of the Subcommittee on Oversight and Investigations.
Mr. Speaker, I have no further speakers. I am prepared to close. I ask all my colleagues to support me in supporting these four amendments.
Mr. Speaker, I yield back the balance of my time.
Mr. Speaker, I rise in support of the Escobar amendment to H.R. 4673.
Mr. Speaker, seamlessly connecting veterans with the benefits and care they have earned through their service is paramount to the transition process. The Escobar amendment extends the automatic enrollment in VA healthcare to eligible veterans discharged within 90 days before enactment of the underlying bill.
Mr. Speaker, many of the 175,000 veterans who served in Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn are unaware of their eligibility for 5 years of VA healthcare upon separation. Automatically enrolling recently separated eligible veterans into VA healthcare will support our aim to prevent veteran suicides and improve their access to care during their transition to civilian life.
Mr. Speaker, I urge my colleagues to support the Escobar amendment.