Floor Statements

Mr. Speaker, I move to suspend the rules and pass the bill (H.R. 1545) to amend title 38, United States Code, to clarify the authority of the Secretary of Veterans Affairs to disclose certain patient information to State controlled substance monitoring programs, and for other purposes.

Mr. Speaker, I ask unanimous consent that all Members may have 5 legislative days within which to revise and extend their remarks and include extraneous materials.

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

Mr. Speaker, I rise today in support of H.R. 1545, the VA Prescription Data Accountability Act of 2017. H.R. 1545 would require the Department of Veterans Affairs to disclose information about any individual prescribed medication by a VA employee or a provider authorized by the VA to a State Prescription Drug Monitoring Program to the extent necessary to prevent misuse and diversion of prescription medication.

Prescription Drug Monitoring Programs are Statewide electronic databases that collect and distribute information on prescription medication to certain authorized individuals or entities. They are used to identify and address prescription drug abuse, addiction, and diversion.

While 90 percent of the VA's patient population are veterans, the VA treats certain nonveterans, including Active-Duty servicemembers who receive VA care through sharing agreements with the Department of Defense, dependents, caregivers of veterans, and VA staff, to name a few.

Current law authorizes the VA to disclose information to Prescription Drug Monitoring Programs for veterans and dependents of veterans only. The VA is not authorized to disclose information for other patients.

Moreover, technological barriers prevent the VA from transmitting dependent data to Prescription Drug Monitoring Programs. That means that prescription drug information for nonveterans--10 percent of the VA's patient population, which translates to more than 700,000 veterans this fiscal year--is not being shared with Prescription Drug Monitoring Programs today.

In light of ongoing concerns about the potential for misuse or diversion of prescription medication, particularly opioid medications, it is imperative that the VA share information about all VA patients, veteran and nonveteran, to State Prescription Drug Monitoring Programs. It is a matter of public safety.

H.R. 1545 is supported by the American Legion, the Paralyzed Veterans of America, the Veterans of Foreign Wars of the United States, and by the VA, who testified before the Subcommittee on Health earlier this year that this authority would ``ensure that VA is able to fulfill its public health role in sharing vital clinical information to help guide treatment decisions.''

Mr. Speaker, this bill is sponsored by the gentlewoman of New Hampshire (Ms. Kuster), the ranking member of the Subcommittee on Oversight and Investigations, who is joined by the gentleman from Ohio (Mr. Wenstrup), the chairman of the Subcommittee on Health; the gentleman from Michigan (Mr. Bergman), the chairman of the Subcommittee on Oversight and Investigations; and the gentlewoman from California (Ms. Brownley), the ranking member on the Subcommittee on Health. I am grateful to all of them for sponsoring this legislation. It has my full support, and I urge all of our colleagues to join me in supporting it.

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

Mr. Speaker, at this time I yield 1 minute to the gentleman from Pennsylvania (Mr. Costello).

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

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

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

In over 31 years of the practice of medicine, I have seen great changes, many of them to the good. One of the things that has disturbed me greatly is the opioid epidemic that we have in this great country at this time. I am an obstetrician. I have delivered a lot of babies in my career, and it was a rare event when we saw a baby that was addicted to opioids--as a matter of fact, almost never until, literally, about 20 years ago, and 10 years ago a full-fledged epidemic.

In our hospital at home, we have a neonatal intensive care unit that cares for nothing but opioid-addicted babies. In our State of Tennessee, Mr. Speaker, we have had more people who died of prescription drug overdose deaths than died in car wrecks. It now exceeds many cancer deaths in the country.

This bill has my 100 percent support, and I certainly want to thank Ms. Kuster for her great work on this bill. We have shared a trip to Afghanistan together, as we did with Mr. Takano, and had a chance to talk about these things in great detail. I want to thank her and also the ranking member for their support in this.

I once again encourage all Members to support this legislation.

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

Mr. Speaker, I move to suspend the rules and pass the bill (H.R. 1725) to amend title 38, United States Code, to improve the treatment of medical evidence provided by non-Department of Veterans Affairs medical professionals in support of claims for disability compensation under the laws administered by the Secretary of Veterans Affairs, and for other purposes, as amended.

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 in the Record on H.R. 1725, as amended.

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

H.R. 1725, as amended, was introduced by my good friend Mr. Walz, the ranking member of the Committee on Veterans' Affairs.

This bill addresses a very serious issue. When a veteran files a claim for disability benefits, VA may need a medical opinion regarding whether the injury or illness is service connected and, if it is, the extent of the veteran's disability. The problem is that the VA often schedules a medical disability examination when one might not be needed.

Many times, a veteran will submit medical evidence from a private doctor with enough information for VA to decide the claim, but we hear about cases where VA still requires a VA examination. Ordering unnecessary disability examinations is a waste of time and resources. It takes doctors away from taking care of their patients and conducting other disability examinations.

H.R. 1725, as amended, would require VA to provide reports to Congress about its use of private medical evidence. This information will be used to help us find ways to make the disability examination more efficient for veterans.

I urge my colleagues to support H.R. 1725, as amended.

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

Mr. Speaker, I wholeheartedly endorse this bill.

Mr. Walz, Sergeant Major Walz, speaks with great passion about it. He has the Mayo Clinic in his district. I can't imagine an evaluation at the Mayo Clinic by physicians there wouldn't be adequate for the VA.

I wholeheartedly support this bill, H.R. 1725, as amended. I urge all Members to also support it.

I yield back the balance of my time.

Mr. Speaker, I move to suspend the rules and pass the bill (H.R. 1329) to increase, effective as of December 1, 2017, the rates of compensation for veterans with service-connected disabilities and the rates of dependency and indemnity compensation for the survivors of certain disabled veterans, to amend title 38, United States Code, to improve the United States Court of Appeals for Veterans Claims, to improve the processing of claims by the Secretary of Veterans Affairs, and for other purposes, as amended.

Mr. Speaker, I ask that all Members have 5 legislative days within which to revise and extend their remarks and to insert extraneous material in the Record on H.R. 1329, as amended.

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

H.R. 1329, as amended, is one of the most important bills the House will take up this year. This bill will help ensure that the benefits paid to veterans who are disabled as a result of their military service do not lose value because of inflation. H.R. 1329, as amended, authorizes a cost-of-living increase for veterans and their families next year as long as Social Security recipients receive an increase.

We pass this bill every year, and it has always enjoyed wide, bipartisan support. This year's bill was introduced by the Subcommittee on Disability Assistance and Memorial Affairs Chairman Bost and Ranking Member Esty.

I urge my colleagues to support H.R. 1329, as amended, and help disabled veterans and their families keep up with the rate of inflation.

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

Mr. Speaker, I yield 2 minutes to the gentleman from Illinois (Mr. Bost), the chairman of the Subcommittee on Disability Assistance and Memorial Affairs, Chairman Bost.

Mr. Speaker. I yield 2 minutes to the gentleman from

Florida (Mr. Bilirakis), the vice chairman of our committee.

Mr. Speaker, I yield 2 minutes to the gentleman from Maine (Mr. Poliquin), my good friend and a member of our committee.

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

I want to thank my good friend, Sergeant Major Walz for his kind words.

Certainly, what we try to do on the Veterans' Affairs Committee is leave Republican and Democrat at the door of the committee room and go and do the work of the veterans for what is best for them. It is a true pleasure and honor, if you have ever attended one of our meetings, to see that and to see the effort of all Members. And you can see here today, with seven important pieces of legislation passed, it will help improve the lives of our veterans.

I know, for me, that this time of the year--and I feel sure that my friends on the other side of the aisle feel the same way--is one of the most difficult times of the year. It is Memorial Day. And I don't think we need to forget, this coming Monday, what that means. It is for all of those who didn't make it home who protected this great country.

I know, myself, I get some guilt this time of year. I was a drafted soldier, as many of us were. I served my time in 1973 and 1974 in Korea, just south of the DMZ. Many of my friends didn't make it home from Vietnam. I still feel for them and their families.

I know every Memorial Day, when I attend a service for veterans, it is difficult for me to get through that day because I got to come home, as all of us here who are serving did. We got to raise our children and see our grandchildren be born. These men and women who died in Vietnam and other wars didn't get to do that, as young people are doing today. So I can't thank, enough, the veterans of this great Nation who serve us every day and keep us free.

Mr. Speaker, I encourage all Members to support H.R. 1329, as amended, and I yield back the balance of my time.

Mr. Speaker, I rise today in support of the rule to consider H.R. 115, the Thin Blue Line Act, introduced by my friend and colleague from Florida, Mr. Vern Buchanan.

Mr. Speaker, this week, National Police Week, we take time to honor our Nation's law enforcement officers for the work they do and the sacrifices they make to keep us safe on a daily basis. It is unconscionable that law enforcement officers are being targeted and are making the ultimate sacrifice in the line of duty; and this bill aims to make the killing or attempted killing of a law enforcement officer an aggravating factor for the imposition of the death penalty.

Mr. Speaker, I served for 6 years as a city commissioner and two of those as the mayor of my small town of Johnson City, Tennessee, and had the privilege of working with first responders, firemen, and police officers every day. It was a privilege to do it. I put on a scrub suit to go to work. They put on a Kevlar vest and put their lives in danger. I cannot say thank you enough to them and their families for the sacrifices that they make.

I commend my colleague on introducing this legislation and for the House considering it today. I urge my colleagues to support this legislation in honor of our law enforcement officers.

Mr. Speaker, the American Health Care Act in no way changes the existing regulations that allow a veteran who is eligible but not enrolled in the Department of Veterans Affairs' healthcare system from using a tax credit to purchase health insurance. Language that would have codified that legislation into law was removed from an earlier version of the bill to comply with Senate rules.

Removing language in no way changes that existing regulation or a veteran's eligibility to receive a tax credit. By the way, that is the exact same language that was in the ACA. I repeat that: the American Health Care Act in no way affects a veteran's ability to access tax credits.

I am disturbed that our colleagues in the minority, Mr. Speaker, would assert that it does, in an effort to score political points against this legislation. Fear-mongering has no place in this debate or where America's veterans are concerned.

As chairman of the Veterans' Affairs Committee, as a medical doctor, and as a veteran myself, ensuring that veterans' health care is protected is my highest priority in this Congress, and I would not stand for language in this bill or any other bill that would compromise a veteran's ability to access care.

Mr. Speaker, 7 years ago, I stood right in this well to debate the ACA, which the premise was to increase access and decrease costs. We all agree with that. But that is not exactly what happened.

In my district, in the State of Tennessee, over one-third of the counties have no place they can buy insurance; and multiple counties in my State, including the third largest, have no access. Premiums have soared over 60 percent. Eighteen of the 23 co-ops went bankrupt, including one in my State, which required people to search for other coverage.

No matter what verbiage you hear, nothing in this bill changes how veterans are treated under the law--nothing. The criticisms are flat- out wrong. I am a veteran, doctor, and chairman of the Veterans' Affairs Committee, and it ain't gonna happen.

In my State, and where I practiced medicine for over 30 years, listen to this: 60 to 70 percent of the uncollectible debt now are people with insurance.

So why do I support this bill?

One, it protects preexisting conditions;

Two, it puts patients ahead of special interests and restores a physician-patient relationship;

Three, it reforms Medicaid so that first-class people don't get second-class care; and

Four, it repeals individual mandates so that 160,000 Tennesseans don't get fined for a product they cannot afford.

Mr. Speaker, this bill isn't perfect, but it is a huge improvement over ObamaCare, and it is worthy of every Member's support.

Mr. Speaker, I rise today in support of H.R. 1180, the Working Families Flexibility Act, and encourage all of my colleagues to do the same. This commonsense piece of legislation, sponsored by my friend and colleague from Alabama, Martha Roby, would empower private sector workers with the flexibility to choose comp time as compensation for working overtime hours instead of added wages.

Specifically, the provisions of this legislation would be completely voluntary for workers, allow them to exchange their accrued time for full overtime pay at any time or for any reason, and would maintain the protections of the Fair Labor Standards Act, such as the standard 40- hour workweek.

Mr. Speaker, I have heard our friends on the other side of the aisle express opposition to giving private sector employees this choice. I would point out that the public sector employees have enjoyed the ability to use comp time to maintain a work-life balance for 30 years. We are simply doing the same thing for private sector employees that public sector employees have the right to do today.

H.R. 1180 would benefit workers who want more flexibility to decide where they spend the time, with their families or pursue entrepreneurial or education ambitions outside the workplace, and these individuals should be admired for their efforts.

At its most basic level, this legislation is about choice and the belief that hardworking employees know their needs better than Washington bureaucrats. House Republicans believe it is time to adapt our labor laws to meet the needs of a rapidly changing 21st century workplace instead of imposing a one-size-fits-all, Washington-knows- best model.

It is time to empower employees to make choices on what will allow them to better balance work with their personal lives. This commonsense legislation will ultimately improve not only their benefits but their lives.

I want to again encourage my colleagues to support H.R. 1180.

Mr. Speaker, I demand a recorded vote.

Mr. Speaker, I rise today to recognize April 3- 7 as National Retirement Planning Week.

Saving for retirement is one of the most important steps that Americans can take to build a better future for themselves and their families. Unfortunately, all too often, saving for retirement remains a distant goal that is put off in exchange for more immediate needs. The Government Accountability Office reports that 29 percent of Americans aged 55 and older have no retirement savings, and no traditional pension. With this in mind, it must be a national priority for us to communicate the importance of retirement planning. By encouraging more Americans to adequately prepare for their retirement years, we can significantly enhance retirement security in the United States.

Recognizing this week as National Retirement Planning Week is an important step to help raise awareness of this need, and I commend the members of the National Retirement Planning Coalition for their efforts to educate Americans about the importance of retirement planning. I wish them all the best as they continue this valued campaign.

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 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 rise today in support of the Self-Insurance Protection Act, H.R. 1304.

Mr. Speaker, I find it hardly plausible you could make something worse where one-third of the counties in my district have no option to buy any insurance on the exchange, and the third largest county in the State of Tennessee has no option. So I would beg to differ, Mr. Speaker.

We all want to ensure workers have access to high-quality, affordable health coverage. That is exactly what this legislation is all about.

Self-insured plans offer high-quality healthcare coverage at a reasonable cost for workers. This popular option allows employers to pay their employees' healthcare costs directly and, if costs are lower than expected, those savings can be reserved for later years to help cover their workers' future healthcare costs.

One of the benefits to self-insurance is that employers have more flexibility to customize their healthcare plans as they see fit for the unique needs of their employees. These plans are also free from many of the restrictive requirements associated with traditional healthcare plans, requirements that limit choices and force employees to purchase specific benefits they may not want or need.

As healthcare costs have risen, many employers have turned to this cost-effective model. In fact, in 2016, more than 60 percent of all employers offering health insurance coverage were self-insured, of the 160 million or so people in this country that have insurance through their job.

Even the labor unions have embraced this approach. However, employers may also take greater financial risk when providing this popular option to workers. To help mitigate that risk, many employers opt to purchase stop-loss insurance.

Stop-loss insurance is not health insurance, nor has it ever been considered health insurance under Federal law. It does not process medical claims, and it does not perform any other traditional function of health insurance. What it does instead is provide employers choosing to provide self-insurance with a financial backstop, protecting the benefits of workers and their families.

Unfortunately, the former administration threatened to regulate stop- loss insurance as traditional health insurance, a move that would put workers and their families at risk of losing access to the self-insured market. While we now have a new administration that understands the importance of providing more pathways to affordable healthcare coverage, Congress must also act to ensure that no future administration will be able to restrict the self-insurance option. The Self-Insurance Protection Act does just that.

This legislation reaffirms longstanding policies, prevents future bureaucratic overreach, and clarifies once and for all that stop-loss insurance is not health insurance. By supporting H.R. 1304, we will promote more choices and protect access to affordable healthcare coverage options for families.

Let me put this all in English. I was the mayor of Johnson City, Tennessee, where we had a self-insured plan for the teachers and for the workers there at the city. The city provided an opportunity for people to have health insurance for their families. We would accept risks up to $250,000, and then we bought policies to protect the taxpayers and the city from any costs that went above that.

What this plan also allowed us to do is put in incredibly innovative health prevention, things like wellness programs, smoking cessation, weight loss, diabetes screening, lowering cholesterol. We put all those things in that plan, which helped hold--even with insurance premiums going up, we were able to level insurance costs going up and, therefore, save the employees and the teachers money in that community. That is all it is.

Everybody buys insurance in this country to mitigate risk. When you by homeowners insurance, you say: I will have $1,000 deductible. So if I have a roof blow off, I can stand to pay $1,000, but my insurance covers the rest.

That is all this is. It just protects risk.

Mr. Speaker, I urge my colleagues to support H.R. 1304.

Mr. Speaker, I include in the Record two letters from the National Disabilities Rights Network and the National Rifle Association in support of H.R. 1181:

National Rifle Association

of America,

Washington, DC, March 7, 2017.

Dear Chairman Roe: I am pleased to write on behalf of the

National Rifle Association in support of H.R. 1181, the

``Veterans 2nd Amendment Protection Act.''

This bill would address an ongoing problem over the past 12

years in which veterans and veterans' family members for whom

fiduciaries have been appointed by the Department of Veterans

Affairs are deemed to have been ``adjudicated as . . . mental

defective[s]'' and prohibited from possessing or receiving

firearms. Such an appointment is not necessarily based on any

finding that the veteran is a danger to himself or herself or

to others.

Fortunately, the NICS Improvement Amendment Act of 2007

provided these individuals with the opportunity to seek

relief from that legal disability. However, your bill goes

one step further in protecting the rights of veterans and

family members, by ensuring that no VA proceeding going

forward will prevent a person from exercising his or her

Second Amendment rights unless a judicial authority has found

that the person's mental incapacity or disorder actually

makes him or her dangerous.

We wish you success in moving forward with this important

protection for the rights of those who have served our

country. Please don't hesitate to call me.

Sincerely,

Jason M. Quimet,

Director of Federal Affairs.

Mr. Speaker, I rise today in strong support of H.R. 1101, the Small Business Health Fairness Act, sponsored by my good friend and true American hero, Sam Johnson. I encourage all of my colleagues to do the same. This bill is an important tool to help empower small businesses to offer more affordable healthcare options to their employees.

Mr. Speaker, as a former small-business owner myself, I know that most small-business owners want to do the right thing and offer health insurance to their employees. We did so in my practice.

But many of these businesses are struggling with the cost and complexities of offering health insurance to their employees. ObamaCare has exacerbated this problem for small businesses. Thousands of jobs and thousands of small businesses have closed.

We have a better way. We are going to start by passing the American Health Care Act, which will repeal many of ObamaCare's taxes and mandates and replace it with free market reforms.

But there is much more that can be done. Perhaps the only thing that has prevented ObamaCare from causing even more widespread damage was the success of ERISA, employer-sponsored health insurance.

We believe small businesses deserve the same protections that large businesses do, and that is why we are passing this legislation today. The Small Business Health Fairness Act takes positive steps toward creating a more competitive healthcare marketplace, lowering insurance costs for many small employers.

Mr. Speaker, why would anybody care if association health plans got together and allowed me to purchase insurance across a State line?

I have a community in my district where the State line on one side of the street is Bristol, Virginia, on the other side is Bristol, Tennessee. Why would it matter? Why couldn't I purchase that insurance across the State line if it helped my employees and lowered costs?

And, by the way, Mr. Speaker, the Affordable Care Act is working so well for consumers that 18 out of 23 of the co-ops went broke, leaving hundreds of thousands of people to search for insurance coverage.

For the past 8 years, House Republicans have engaged the administration and encouraged them to work with us to implement a more patient-centered healthcare system; but, instead of working with us on a common goal, they have layered on additional costs for small businesses.

I again want to encourage my colleagues to support H.R. 1101.

Mr. Speaker, I demand a recorded vote.

Mr. Speaker, pursuant to House Resolution 198, I call up the bill (H.R. 1181) to amend title 38, United States Code, to clarify the conditions under which certain persons may be treated as adjudicated mentally incompetent for certain 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 insert extraneous material in the Record on H.R. 1181.

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

Mr. Speaker, too often, as Americans, we tend to take our freedom for granted. We should never forget we owe the freedom to our Nation's veterans. That is why it is so egregious that many veterans come home to find that they have to do battle with the VA--the very agency that is supposed to help and support them--to protect their own constitutional rights. The problem occurs when VA, for whatever reason, determines that a veteran needs assistance managing his or her VA financial benefits and decides to appoint a fiduciary.

Now, there may be many reasons that a veteran might need a fiduciary, such as a veteran who has TBI may have trouble with math and struggles to balance his or her checkbook. But it is important to remember that the decision to appoint a fiduciary is made by a VA bureaucrat, not a judge or a magistrate after ensuring that veteran's due process rights are protected.

Unfortunately, there are serious, unintended consequences when VA appoints a fiduciary. This is because, once VA decides that the beneficiary needs help with finances, even though there may be no evidence that the individual may be a danger to himself or others, the Department sends his or her name to the FBI to be added to the NICS list.

As you know, anyone whose name is on the NICS list is legally prohibited from possessing a firearm. This means that the veteran can no longer participate in sports like hunting or target shooting. The veteran is also legally obligated to relinquish any firearms he or she owns, including collector's pieces and family heirlooms.

I am opposed to the VA's existing policy not only because it deprives veterans of their constitutional rights without due process of law, I am also concerned that these veterans are not able to participate in recreational therapy programs like VA's program at the VA Grand Junction medical center in Colorado that enables veterans with physical and mental disabilities to go hunting or shooting. I know from personal experience that these therapy programs are very effective in helping these heroes recover from injuries that they have received while serving our country.

It is unfortunate that some of the opponents of this bill are perpetrating the outdated stereotypes that people who are mentally ill may be violent and should be feared. I am concerned that these false characterizations may actually deter people from seeking the health services they need.

It is hard enough for some people to admit they need help, Mr. Speaker, but image how much more difficult it is when they fear that they would be stigmatized and isolated. It is also possible that some veterans decide to avoid using VA healthcare services all together out of fear that a VA bureaucrat may decide that they are incompetent and take away their constitutional rights.

Let's take a look at the people who actually are added to the NICS list as a result of the Veterans Administration's appointing a fiduciary.

There are currently more than 1,000 children under the age of 20 here on the NICS list, likely because VA appointed a fiduciary because they are too young to handle their own money.

VA has also added the names of 107,000 people over 80 years old to the NICS list. These individuals probably just need help with their finances due to their advanced age.

But should VA really take away the Second Amendment rights from our Nation's seniors, particularly those who fought for the country? It is outrageous that the only group of people that can have their constitutional rights taken away without a hearing before a judge or magistrate are the very people who fought for those rights and their dependents. Even criminals must be convicted in a court of law before their names are added to that list, Mr. Speaker.

H.R. 1181 would simply prohibit VA from sending veterans' names to the NICS list unless there is an order from a judge or a magistrate that says the person may harm themselves or others.

This proposal has enjoyed bipartisan support in the past. In 2011, the House passed H.R. 2349, which included similar provisions, by voice vote. And just last month, both the House and Senate passed H.J. Res. 40, which prevented the Social Security Administration from implementing a similar policy to report the names of some people who have received disability insurance benefits to NICS.

H.R. 1181 also has wide support among the veterans community, including the American Legion, the VFW, and AMVETS. H.R. 1181 is also supported by the National Disability Rights Network and the National Rifle Association. Additionally, H.R. 1181 has a positive statement of the administration's support.

Mr. Speaker, veterans who fought to defend the Constitution should also be allowed the rights it protects. I urge all Members to support H.R. 1181. It is the right thing to do, and I reserve the balance of my time.

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

In America, the last time I looked, you are presumed innocent until proven guilty. What we have done with these veterans who have served this country, many of them injured in combat, is we have said you are guilty and you have to prove you are innocent to be able to own a firearm in your own home.

By the way, Mr. Speaker, people who are in a fiduciary status actually statistically have a slightly lower incarceration rate than veterans who are not. So to say that they are a danger to themselves or a danger to others is erroneous.

The other thing I would like to say is that the 21st Century Cures Act, Mr. Speaker, has codified basically the VA policy is what it did. It did not change the policy. What we are saying to veterans is that if you are an honorably discharged veteran who needs a fiduciary for whatever reason, you automatically lose a constitutionally guaranteed right.

I yield 2 minutes to the gentleman from Illinois (Mr. Bost), an active member of the Veterans Affairs' Committee.

Mr. Speaker, I yield 2 minutes to the gentleman from Colorado (Mr. Lamborn).

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

The text of this bill does not remove the names of anyone who is currently on the NICS list. It simply prohibits the VA Secretary from continuing to send the names of beneficiaries who utilize a fiduciary to the NICS list. And there is nothing in the bill that would require the VA Secretary to take any action with respect to those already on the list.

Just one other thing, Mr. Speaker, to show you how the VA's policy is not consistent: just as an example, a veteran who is rated at 100 percent disabled for PTSD is not automatically given a fiduciary, even though the symptoms required for that rating may include suicidal or homicidal ideation. So they are very inconsistent about how they do this. And of the 915,744 veterans who have a service-connected PTSD condition, only 1.7 percent of them have a fiduciary. Remember, they lose their constitutionally guaranteed right.

I yield 1\1/2\ minutes to the gentleman from Texas (Mr. Farenthold), a hardworking member of this conference.

Mr. Speaker, once again, let me state this for the record. The text of this bill does not remove the names of anyone who is currently on the NICS list, except it prohibits the VA Secretary from continuing to send the names of the beneficiaries who utilize a fiduciary to the NICS list.

I don't want guns in the hands of anybody who should not own a gun who is mentally unstable, but what we are saying is that a VA rater should be a judge or a magistrate, where you can argue both sides of this in front of them. It shouldn't be a VA bureaucrat that is doing this.

I yield 2 minutes to the gentleman from Texas (Mr. Conaway), the chairman of the Agriculture Committee.

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

I guess by listening to the debate that is going on, one would assume that someone who has a fiduciary would be a danger to themselves and others, and I think that is completely erroneous to assume that.

Let me read you excerpts of a floor statement that Senator Burr made in 2009 to show you how this can get off track. And we are going to put sort of a human face on this, just an excerpt from a letter that Jennifer wrote as the wife of Corey.

``Corey served in Iraq. He was a paramedic. He was severely injured by an IED explosion in 2004, which caused severe burns, damage to his lungs, and severe traumatic brain injury after shrapnel entered his skull. Corey spent . . . 5 years recovering from his injuries. Jennifer reports that he is walking, talking, and enjoying life at home with his two children.

``Now it gets really sad. Because of his head injury, Corey still requires help with certain things. The VA said he needed help managing his disability compensation payments, and they named Jennifer, his spouse, as his fiduciary''--his wife. ``That is where I would like to read you her letter. Again, I quote from the letter:

`` `On May 19, 2009, we had our annual fiduciary meeting with the VA field examiner. At the end of the meeting, our field examiner said he needed to read a statement to us. He read the Brady Bill statement and then stated that Corey can't own, possess, use, be around, et cetera, any firearms. He then went on to say that anyone in our household can't own a gun while living in this household.

`` `I asked him about Corey going on adaptive hunting trips and he said he couldn't. Corey stated that he had a gun that was handed down from his grandfather and that Corey was going to hand it down to his son, and the field examiner told him that he couldn't have it. He stated to Corey that if he did own a gun or be around a gun that he would be threatened with imprisonment.

`` `The way that that field examiner talked to Corey about this issue was not appropriate. The field examiner said that I could challenge it and handed me a blank sheet of paper with a VA heading. I asked the field examiner for the statement that he read to me, but he said that he had to ask his boss if he could actually provide a copy of that statement. After 2 weeks of me emailing him, I finally got the attached papers in the mail. I think the VA is taking this way out of concept, and I would greatly appreciate your support.'

``Well, in case any of my colleagues think the government would never prosecute someone like Corey for possession of a firearm, being around a firearm, I wish to read to my colleagues excerpts from the VA directive that went out to all VA regional offices on September 29, 2009, on this very issue.

``The directive is meant to inform fiduciary field examiners of their obligation if they were to witness a violation of the Brady Act. I am going to quote from this VA memorandum to the field examiners.

`` `Field examiners or other VA employees who encounter beneficiaries believed to be in violation of the Brady Act are required to notify the fiduciary activity manager as soon as safely possible. At no time should the employee place him/herself in danger. The fiduciary activity manager at the VA regional office of jurisdiction must immediately report the alleged violation to the Bureau of Alcohol, Tobacco and Firearms,' '' and here is the number.

And that is straight out of their memorandum, Mr. Speaker.

We don't want weapons, no one in this room, and none of my colleagues on the VA Committee, Republican or Democrat, want weapons in the hands of someone that is considered dangerous. But we have American heroes that are being denied their Second Amendment right to even keep their grandfather's gun. I feel that, if you want to go and have your due process rights in front of a court of law or magistrate, that is perfectly okay. That is the way our system works. But not a VA rater. They don't get to do that. And I think, by passing this bill, we will guarantee those rights to our American heroes.

I reserve the balance of my time.

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

I include in the Record two documents from the VFW and The American Legion supporting this legislation.

Veterans of Foreign Wars

of the United States,

March 8, 2017.

Hon. David P. Roe,

Chairman, House Veterans' Affairs Committee, Washington, DC.

Dear Chairman Roe: On behalf of the men and women of the

Veterans of Foreign Wars of the United States (VFW) and our

Auxiliary, I am pleased to offer the VFW's support for H.R.

1181, the Veterans 2nd Amendment Protection Act.

It is unconscionable to require veterans to choose between

the care they have earned and deserve and their

constitutional rights. Your legislation would ensure veterans

who suffer from mental health conditions no longer have to

worry about losing their 2nd amendment rights when seeking

potentially lifesaving mental health care. By elevating the

threshold for inclusion in the National Instant Criminal

Background Check System, this important legislation would

help destigmatize mental health and protect veterans'

constitutional rights.

The VFW commends your leadership on this issue and your

commitment to our nation's veterans. We look forward to

working with you to ensure the passage of this important

legislation.

Sincerely,

Carlos U. Fuentes,

Director,

VFW National Legislative Service.

Mr. Speaker, I, too, served in the military as a military doctor in the 2nd United States Infantry Division in Southeast Asia many years ago, so I have seen patients who were mentally ill. One of the things that has bothered me is that we are perpetuating an outdated stereotype that mentally ill people are prone to violence. Most are not, and perpetuating this stereotype that they are may result in their being isolated or not seeking treatment. This is unfortunate for people who suffer from mental illness and need support and understanding.

I think we do them a great disservice. My bill would require a court of law rather than a VA rating specialist--that is all we are saying here--to determine whether an individual actually poses a danger to themselves or others before their name gets sent to the FBI and added to the NICS list. A VA employee should not be able to add a veteran's name to a NICS list before that veteran has been afforded due process.

Let me explain how bad it really is. It is outrageous that a criminal has more rights than a veteran when it comes to being placed on the NICS list--at least they aren't added to the list until they have been convicted by a judge or a jury, Mr. Speaker. We should at least treat our American heroes that well.

Here is another point I would like to make: a veteran that has been rated--listening to the debate to show you how the VA system is not a standard for everyone. A VA veteran rated 100 percent for PTSD does not automatically get a fiduciary because they are 100 percent service- connected disabled because of their service even though the symptoms require that, for that rating, it may include suicidal or homicidal ideation.

All we are saying--and I think, hopefully, everyone would agree--is that you deserve as an American citizen--and especially an American citizen, Mr. Speaker, who has served this country whether in combat or not, who has served his country in the military--your day in court and at least be heard by a judge and jury.

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

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

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

Mr. Speaker, this proposal is not new. It has been passed out of committee in 2010, 2011, 2013, and this year. It passed the full House, H.R. 2349, in the 112th Congress, which is included in this proposal, by a voice vote.

On February 2, the House approved H.J. Res. 40, which nullified the Social Security Administration rule that would have similarly restricted the Second Amendment rights to certain disabled people who require help managing their finances. There is no reason that veterans who have fiduciaries should be treated any differently than Social Security beneficiaries who need help managing their finances.

Next, Mr. Speaker, veterans who need fiduciaries are not necessarily mentally ill. A veteran may not be able to handle his or her finances due to conditions such as traumatic brain injury. Furthermore, The American Legion testified in 2015 about a case in which the VA declared a veteran incompetent because he told his doctor he didn't pay his bills. But, in reality, the veteran didn't pay his bills because, like a lot of us, of the division of household responsibilities. His wife paid the bills, and he got caught up in that. Then to get out of it is a chore.

I wanted to say, once again, I really feel strongly about this because we worked on the 21st Century Cures bill on removing the stigma of mentally ill people that because someone is mentally ill, they are a danger to themselves or others. Perpetuating this stereotype, I think, is dangerous. I think it keeps people from coming in and seeking the help that they need.

Also, and I have participated in this, Mr. Speaker, at home where we have used hunting trips or fishing trips to help veterans with PTSD get back on their feet and assume--instead of treating it as a disability and saying: We are going to get you well and back on your feet and be a productive member of society.

I am afraid if we stereotype this, we will prevent people from coming in for the very needed help that they so richly have earned and need.

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

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

Mr. Speaker, as all of us in this incredible place that we are in, the House of Representatives in the Capitol of the U.S., our hearts go out to everyone, especially the families, of all those touched by that horrible tragedy that was just described. I am willing to work with anyone on the committee or otherwise in a reasonable way to keep firearms out of the hands of criminals and people who are dangerous. There is no question we are all willing to do that. But that case did not involve a veteran who had a fiduciary.

I am a strong supporter of the Second Amendment even if others aren't. I think we can all agree that veterans should not be denied the same due process rights that all other Americans receive. What this bill does is ensure that veterans do not lose their constitutional rights without a judicial hearing.

The freedoms granted under the Constitution of this great country should apply to all Americans, especially those who have been willing to put their lives at risk to protect those same freedoms. It is wrong for veterans and beneficiaries who use a fiduciary to lose their Second Amendment right without due process.

This commonsense bill would ensure that no veteran or beneficiary is declared mentally defective simply because a VA rater appoints someone to assist with the management of that person's financial affairs.

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

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

Mr. Speaker, as all of us in this room are, I am personally devastated that our Nation loses 20 of our finest citizens to suicide every day. Ending this tragedy is one of the top priorities we have on the Veteran Affairs' Committee and as a nation. We have and will continue to work with the VA to develop programs that will effectively help identify and treat veterans who may be considering ending their own lives.

But denying veterans who have fiduciaries their constitutional rights will not end veteran suicide. It is unfair to paint all veterans who may need a fiduciary with the same broad stroke and to assume that just because someone needs assistance with their financial affairs, that they may also be violent and a danger or they are contemplating suicide. That is just plain wrong.

It is unfortunate that the arguments advanced by some of the opponents of this bill reinforce the false impression that people who suffer from mental health challenges--and veterans, in particular--are dangerous. There is no evidence that people who suffer from mental illness are more likely to be more violent than people in the general population--just none. I am convinced that perpetuating this outdated and incorrect stereotype makes the situation worse, deterring people from seeking the very health services that they need.

It is difficult for some folks to admit they need help. I saw patients like that for years who finally broke down in my office and explained that they were depressed or whatever the situation may be. Imagine how much harder it is when people feel that they will be stigmatized or isolated because other people may fear them?

By passing this bill, Congress will send a strong message that people who suffer from mental illness are owed the same respect and have the same constitutional rights as every other American citizen.

Once again, Mr. Speaker, I encourage all of our Members to support H.R. 1181, and I yield back the balance of my time.

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