Floor Statements

Mr. Speaker, I rise today in support of the rule for my bill, H.R. 849, the Protecting Seniors' Access to Medicare Act of 2017.

Mr. Speaker, this bill would repeal the Independent Payment Advisory Board, or IPAB, which was created solely as a cost containment mechanism as part of the Affordable Care Act. It has nothing to do about quality of care or access to care. I can't think of anything more important, Mr. Speaker, that this Congress should be doing than providing quality care and access to care for our senior citizens of this country, some 58 million of them.

Whatever your feelings may be about the ACA, this provision has had strong bipartisan opposition from its beginning, and it was not contained in the House Democrat's version of the bill, but was jammed in by the Senate at the end.

If you still need convincing on just how unpopular this provision of the law is, ask yourself: How often do we see a bill come to the floor under a rule that has 270 bipartisan cosponsors?

Passing this bill will send a strong message to our Senate colleagues that the time to act is now.

Mr. Speaker, the overwhelming bipartisan support for Members is only outdone by the overwhelming nationwide coalition of support.

Mr. Speaker, I include in the Record a letter from the Protect My Doctor and Me coalition, a letter that has been signed by nearly 800 groups representing patients, providers, and all sectors of the healthcare industry with support in all 50 States.

September 6, 2017.

Dear Member of Congress: The undersigned organizations--

representing Medicare beneficiaries and patients, all sectors

of the healthcare industry as well as employers and other

purchasers of health care--believe strongly that the Medicare

program must protect patient access to quality healthcare.

The Independent Payment Advisory Board (IPAB), a provision of

the Patient Protection and Affordable Care Act (PPACA), not

only poses a threat to that access but also, once activated,

will shift healthcare costs to consumers in the private

sector and infringe upon the decisionmaking responsibilities

and prerogatives of the Congress. We request your support to

repeal IPAB.

IPAB, as constructed under PPACA, is a board comprised of

Presidential appointees who will be charged with making

recommendations to cut Medicare expenditures if spending

growth reaches an arbitrary level. Once the Secretary of

Health and Human Services (HHS) implements an IPAB

recommendation, that action is not subject to administrative

or judicial review. As constructed, IPAB is granted

unprecedented powers--even the ability to change laws

previously enacted by Congress--with virtually no oversight.

The potential impact of this board causes deep concern

among our organizations and the millions of Americans we

represent. IPAB proponents suggest that the board will be an

asset in developing needed healthcare delivery reforms. That

goal, however, is not realistically achievable. The law

requires IPAB to achieve scoreable savings within a one-year

time period. Thus, instead of pursuing long-term reforms that

may not achieve immediate savings, IPAB is more likely to

consider short-term savings in the form of payment cuts for

healthcare providers. This was, in fact, the conclusion of

the Congressional Budget Office, which stated that IPAB is

most likely to focus on payment rates or methodologies for

services provided by non-exempt providers.

This would be devastating for patients, affecting access to

care and innovative therapies. Already, the number of

physicians unable to accept new Medicare patients due to low

reimbursement rates has been increasing over the past several

years. IPAB-generated payment reductions would only increase

the access difficulties faced by too many Medicare

beneficiaries. Furthermore, payment reductions to Medicare

providers will almost certainly result in a shifting of

health costs to employers and consumers in the private

sector.

Under IPAB's provisions, the responsibility for enacting

healthcare system changes of this magnitude would be

transferred from the legislative branch to the executive.

More specifically, an unelected board without adequate

oversight or accountability would be taking actions

historically reserved for the public's elected

representatives in the U.S. House and Senate. This is an

unacceptable decisionmaking process for a program that

millions of our nation's seniors and individuals with

disabilities rely upon.

Moreover, if IPAB does not act within the law's required

timeframe or if IPAB members are not appointed by the

President or confirmed by the Senate, the law transfers

IPAB's responsibilities solely to the HHS Secretary. This

places an enormous degree of power in the hands of one

unelected individual.

We strongly support bringing greater cost-efficiency to the

Medicare program. We also advocate continuing efforts to

improve the quality of care delivered to Medicare

beneficiaries.

The Independent Payment Advisory Board will achieve neither

of these objectives and will only weaken, not strengthen, a

program critical to the health and well-being of current and

future beneficiaries. We urge Congress to eliminate the IPAB

provision.

Sincerely,

1 in 9: The Long Island Breast Cancer Action Coalition; 60

Plus Alabama; 60 Plus Association; A Partnership of

Diabetics; Abbott; Actelion Pharmaceuticals; Action CF; ADAP

Advocacy Association (aaa+); AdvaMed--the Advanced Medical

Technology Association; Advocacy Council of ACAAI; Advocates

for Responsible Care (ARxC); AIDS Alliance for Women,

Infants, Children, Youth & Families; AIDS Community Research

Initiative of America; AIDS CT; AIDS Foundation of Chicago;

AIDS Outreach Montana; AIDS Resource Center Ohio; AIDS

Response Seacoast; AIDS Services for the Monadnock Region;

Alabama ACEP.

Alabama Association of Ambulatory Surgery Centers; Alabama

Council of Community Mental Health Boards; Alabama Hospital

Association; Alabama Lifespan Respite Resource Network;

Alabama Podiatric Medical Association; Alabama Society for

Clinical Social Work; Alabama Society for the Rheumatic

Diseases; Alaska Behavioral Health Association; Alaska ACEP;

Alaska Rheumatology Alliance; Alaska State Medical

Association; Alliance for Patient Access; Alliance of

Specialty Medicine; Alzheimer's & Dementia Alliance of

Wisconsin; Alzheimer's Arkansas; Alzheimer's Association--

Capital of Texas Chapter; Alzheimer's Texas; American Academy

of Allergy, Asthma & Immunology; American Academy of

Dermatology Association; American Academy of Facial Plastic

and Reconstructive Surgery.

American Academy of Neurology; American Academy of

Ophthalmology; American Academy of Otolaryngology-Head and

Neck Surgery; American Academy of Physical Medicine &

Rehabilitation; American Association for Hand

Surgery; American Association for Pediatric Ophthalmology

and Strabismus; American Association of Clinical

Endocrinologists; American Association of Clinical

Urologists; American Association of Hip and Knee Surgeons;

American Association of Neurological Surgeons; American

Association of Oral and Maxillofacial Surgeons; American

Association of Orthopaedic Surgeons; American Autoimmune

Related Diseases Association; American Behcet's Disease

Association; American College of Allergy, Asthma &

Immunology; American College of Cardiology; American

College of Emergency Physicians (ACEP); American College

of Mohs Surgery; American College of Osteopathic Family

Physicians; American College of Osteopathic Surgeons.

American College of Radiology; American College of

Rheumatology; American College of Surgeons; American Congress

of Obstetricians & Gynecologists; American Congress of

Obstetricians & Gynecologists, Oklahoma Chapter; American

Gastroenterological Association; American Glaucoma Society;

American Kidney Fund; American Liver Foundation; American

Liver Foundation Pacific Coast Division; American Medical

Association; American Military Society; American Nurses

Association; American Orthopaedic Foot and Ankle Society;

American Orthopaedic Society for Sports Medicine; American

Osteopathic Academy of Orthopedics; American Osteopathic

Association; American Osteopathic College of Rheumatology;

American Physical Therapy Association; American Podiatric

Medical Association.

American Shoulder and Elbow Surgeons; American Society for

Dermatologic Surgery Association; American Society for Mohs

Surgery; American Society for Surgery of the Hand; American

Society of Anesthesiologists; American Society of Cataract

and Refractive Surgery; American Society of Echocardiography;

American Society of Nuclear Cardiology; American Society of

Ophthalmic Administrators; American Society of Ophthalmic

Plastic and Reconstructive Surgery; American Society of

Plastic Surgeons; American Spinal Injury Association;

American Urological Association; American Uveitis Society;

AmerisourceBergen; Amgen; AMN Healthcare; Arizona Bioindustry

Association (AZBio); Arizona College of Emergency Physicians;

Arizona Radiological Society.

Arizona United Rheumatology Alliance; Arizona Urological

Society; Arkansas Chapter ACEP; Arkansas Medical Society;

Arkansas Ophthalmological Society; Arkansas Orthopaedic

Society; Arkansas Podiatric Medical Association; Arkansas

Rheumatology Association; Arthritis Foundation; Arthritis

Foundation South Central Region; Arthroscopy Association of

North America; Ascension; Association of Black Cardiologists;

Association of University Professors in Ophthalmology; Asthma

and Allergy Foundation of America; Asthma and Allergy

Foundation of America, New England Chapter; Atrius Health;

Austin Radiological Association; BEACON--Biomedical

Engineering Alliance & Consortium; Better Medicare Alliance.

Bingham County Senior Center; Bio Nebraska Life Sciences

Association; BioBuzz Workforce Foundation; Biocom;

BioFlorida; BIOForward; BioHouston; BioKansas; BioNJ;

BioNorthTX; BioOhio; Bioscience Association of West Virginia;

Biotechnology Industry Organization (BIO); BioUtah;

Birmingham Neurosurgery and Spine Group, PC; Brain Injury

Alliance of Oregon; Brain Injury Association of Nebraska;

California Academy of Eye Physicians and Surgeons; California

ACEP; California Asian Pacific Chamber of Commerce;

California Association of Health Facilities; California

Association of Neurological Surgeons, Inc; California Chronic

Care Coalition.

California Health Collaborative, California Hepatitis C

Task Force; California Life Sciences Association--CLSA;

California Medical Association California Orthopaedic

Association; California Podiatric Medical Association;

California Rheumatology Alliance; California Senior

Advocates League; California Society for Cardiac

Rehabilitation; California Urological Association;

Cambridge Chamber of Commerce; Campbell Clinic; Caregiver

Action Network; Center for Health Care Services; Center

for Healthcare Innovation; Center of Health Engagement;

Central Coast Medical Society; Central Florida Behavioral

Health Network; Centro de mi Salud; Cervical Spine

Research Society.

Charleston Parkinson's Support Group; Chattanooga-Hamilton

County Medical Society; Chemed Corporation; Citrus Council

NKFF; City of New Orleans; Cleveland Clinic; CNY HIV Care

Network; COAAA; Coalition of Asian-American IPA; Coalition of

State Rheumatology Organizations (CSRO); Colon Cancer

Alliance; Colorado BioScience Association; Colorado Cross-

Disability Coalition; Colorado Gerontological Society;

Colorado Medical Society; Colorado Podiatric Medical

Association; Colorado Radiological Society; Colorado

Rheumatology Association; Colorado Society of Eye Physicans &

Surgeons; Colorado's Insurance Consultant, LLC.

Communicating for America, Inc.; Community Access National

Network (CANN); Community Health Action Network; Community

Health Charities of Nebraska; Community Liver Alliance;

Community Oncology Alliance; Congress of Neurological

Surgeons; Connecticut Orthopaedic Society; Connecticut

Podiatric Medical Association; Council for Affordable Health

Coverage; Council of State Neurosurgical Societies; CPEM,

Inc; Crohn's & Colitis Foundation of America, Georgia

Chapter; CSRA Area Agency on Aging; Delaware Academy of

Ophthalmology; Delaware Ecumenical Council on Children and

Families; Delaware HIV Consortium; Dia de la Mujer Latina;

Easter Seals; Easter Seals Central and Southeast Ohio Inc.

Easter Seals Central Texas; Easter Seals Iowa; Easter Seals

Massachusetts; Easter Seals Nebraska; Easter Seals North

Georgia; Easter Seals of Southeastern PA; Eastern Orthopaedic

Association; EDSers United Foundation; Eisai Inc.; Eli Lilly

and Company; ELLAS; Emergency Department Practice Management

Association; Enchantment Healthcare; Endometriosis

Association; Enterprise Family Healthcare; Epilepsy

Association of the Big Bend; Epilepsy Foundation of Greater

Chicago; Epilepsy Foundation of Greater Southern Illinois;

Epilepsy Foundation of Hawaii; Epilepsy Foundation of San

Diego County.

Epilepsy Foundation of Western Wisconsin; Familia Unida

Living with MS; FCEP Florida College of Emergency Physicians;

Federation of American Hospitals; Federation of Families for

Children's Mental Health--CO Chapter; First Step House; Fleet

Reserve Association; Florida Allergy, Asthma & Immunology

Society; Florida Neurosurgical Society; Florida Orthopaedic

Society; Florida Osteopathic Medical Association; Florida

Partners in Crisis; Florida Podiatric Medical Association;

Florida Society of Dermatology and Dermatologic Surgery;

Florida Society of Rheumatology; Florida State Hispanic

Chamber of Commerce; Friends of Our Lady of Good Counsel;

Geaux Group; Georgia Bio; Georgia College of Emergency

Physicians.

Georgia Commission on Women; Georgia Neurosurgical Society;

Georgia Orthopaedic Society; Georgia Osteoporosis Initiative;

Georgia Podiatric Medical Association; Georgia Society of

Clinical Oncology;

Georgia Society of Dermatology and Dermatological Surgery;

Georgia Society of Ophthalmology; Georgia Society of

Rheumatology; Georgia Women's Institute; Global Genes; Global

Healthy Living Foundation; Global Liver Institute; Granite

State Taxpayers; Greater North Dakota Chamber; Greater

Providence Chamber of Commerce; H.E.A.L.S of the South

(Hepatitis Education, Awareness and Liver Support); Hawaii

ACEP; Hawaii Independent Physicians Association; Hawaii

Medical Association.

Hawaii Podiatric Medical Association; Health Agents for

America, Inc. (HAFA); Healthcare Innovation Exchange;

HealthCare Institute of New Jersey (HINJ); Healthcare

Leadership Council; HealthHIV; Healthy African American

Families; Hispanic CREO; Home Care Association of Washington;

Hopkins County Memorial Hospital; ICAN, International Cancer

Advocacy Network; Idaho Association of Nurse Anesthetists;

Idaho Medical Association; Idaho Orthopaedic Association;

Idaho Orthopaedic Society; Idaho Osteopathic Physicians

Association; Idaho Podiatric Medical Association; Idaho State

Dental Association; Illinois Biotechnology Innovation

Organization; Illinois College of Emergency Physicians.

Illinois Manufacturers' Association; Illinois Neurological

Institute; Illinois Podiatric Medical Association; Illinois

Society of Eye Physicians & Surgeons; Illinois State

Ambulance Association; Illinois State Medical Society;

INACEP; Independent Medical Providers Action Council; Indiana

Academy of Ophthalmology; Indiana Health Industry Forum;

Indiana Medical Device Manufacturers Council; Indiana

Neurosurgical State Society; Indiana Podiatric Medical

Association; Indiana State Medical Association; Indiana

University Health, Inc.; Infectious Diseases Society of

America; Insight Human Services; Integral Rheumatology and

Immunology Specialists (IRIS); International Foundation for

Autoimmune Arthritis; International Institute of Human

Empowerment.

International Society for the Advancement of Spine Surgery;

ION Solutions; Iowa Academy of Ophthalmology; Iowa ACEP; Iowa

Biotechnology Association; Iowa Orthopaedic Society; Iowa

Osteopathic Medical Association; Iowa Podiatric Medical

Society; Iowa State Grange; J. Robert Gladden Orthopaedic

Society; JobKeeper Alliance; Johnson & Johnson; Julian CNA

Training School; Kansas Association of Osteopathic Medicine;

Kansas Orthopaedic Society; Kansas Podiatric Medical

Association; Kansas Rheumatology Alliance; Kansas Society of

Eye Physicians & Surgeons; Kansas Urological Association;

Kendall Square Association.

Kentuckiana Rheumatology Alliance; Kentucky Academy of Eye

Physicians and Surgeons; Kentucky ACEP; Kentucky Chamber of

Commerce; Kentucky Life Sciences Council; Kentucky Medical

Association; Kentucky Psychiatric Medical Association; Kidney

Cancer Association; Kidney Care Partners; Latin American

Chamber of Commerce; Latino Commission on AIDS; Latino

Diabetes Association; Licensed Professional Counselors

Association; Life Science Tennessee; Life Sciences Greenhouse

of Central PA; Life Sciences Pennsylvania; Limb Lengthening

and Reconstruction Society; Louisiana Alumni, Sigma Kappa

GNO; Louisiana Association of Neurological Surgeons;

Louisiana Liberty 64.

Louisiana Lifespan Respite Coalition; Louisiana Orthopaedic

Association; Louisiana Podiatric Medical Association;

Louisiana Womens' Network; Lower New York Chapter, The

American Association of Clinical Endocrinologists; Lupus

Alliance of Long Island/Queens; Lupus Alliance of Upstate New

York; Lupus and Allied Diseases Association;

Lupus Foundation New England; Lupus Foundation of America;

Lupus Foundation of America, DC/MD/VA Chapter; Lupus

Foundation of Arkansas, Inc.; Lupus Foundation of Colorado;

Lupus Foundation of Florida, Inc.; Lupus Foundation of

Northern California; Lupus Foundation of PA; Lupus Foundation

of Southern California; Lupus LA; Lupus Society of Illinois;

MA Health Council.

MACEP--Massachusetts College of Emergency Physicians; Maine

ACEP; Malecare Cancer Support; Mallinckrodt Pharmaceuticals;

Manufacture Alabama; Maryland Chapter American College of

Emergency Physicians; Maryland Orthopaedic Association;

Maryland Society of Eye Physicians and Surgeons;

Massachusetts Association for Mental Health, Inc;

Massachusetts, Maine, and New Hampshire Rheumatology

Association; Massachusetts Medical Device Industry

Council (MassMEDIC); Massachusetts Medical Society;

Massachusetts Orthopaedic Association; Massachusetts Society

of Eye Physicians and Surgeons; MassBio; Maxim Healthcare

Services; Maxima Home Health LLC; Meals on Wheels North

Carolina; MedChi, The Maryland State Medical Society; Medical

Alley.

Medical Association of Georgia; Medical Association of the

State of Alabama; Medical Device Manufacturers Association

(MDMA); Medical News; Medical Oncology Association of

Southern California; Medical Society of New Jersey; Medical

Society of the State of New York; Medical University of South

Carolina (MUSC); MedTech Association; MemorialCare Health

System; Mended Hearts; Men's Health Network; Mental Health

America of Montana; Mental Health Systems; Merck;

Metropolitan Milwaukee Association of Commerce; Michigan

Association of Neurological Surgeons; Michigan Association of

Osteopathic Family Physicians; Michigan Biosciences Industry

Association--MichBio; Michigan Chamber of Commerce.

Michigan College of Emergency Physicians; Michigan Lupus

Foundation; Michigan Orthopaedic Society; Michigan

Osteopathic Association; Michigan Rheumatism Society;

Michigan Society of Eye Physicians and Surgeons; Minnesota

Academy of Ophthalmology; Minnesota Chapter ACEP; Minnesota

Medical Association; Minnesota Neurosurgical Society;

Minnesota Organization of Registered Nurses; Minnesota

Orthopaedic Society; Minnesota State Grange; Mississippi

Academy of Eye Physicians and Surgeons; Mississippi

Osteopathic Medical Association; Mississippi Society of Eye

Physicians and Surgeons; Mississippi State Medical

Association; Missouri Ambulance Association; Missouri

Association of Rural Health Clinics; Missouri Biotechnology

Association.

Missouri Chamber of Commerce and Industry; Missouri

Hospital Association; Missouri State Medical Association;

Missouri Urological Society; MoCEP--Missouri College of

Emergency Physicians; Montana ACEP; Montana BioScience

Alliance; Montana Chamber of Commerce; Montana Medical

Association; Montana Orthopedic Society; Multiple Sclerosis

Resources of Central New York, Inc; Musculoskeletal Tumor

Society; NAMI--Sheridan; NAMI Alabama; NAMI Anchorage; NAMI

Buffalo & Erie County; NAMI Clackamas; NAMI Florida; NAMI

Greater Des Moines; NAMI Hernando.

NAMI Illinois; NAMI Indiana; NAMI Iowa; NAMI Kansas; NAMI

Knox Licking County Ohio; NAMI Lewis County; NAMI Maine; NAMI

Maryland; NAMI Mass; NAMI Minnesota; NAMI Montana; NAMI

Nebraska; NAMI Nevada; NAMI New Mexico; NAMI North

Carolina; NAMI North Dakota; NAMI Northern Nevada; NAMI

Ohio; NAMI Rochester; NAMI Sioux Falls.

NAMI Skagit; NAMI Stark County; NAMI Upper Valley Idaho;

NAMI Virginia; NAMI Washington; NAMI York County; NASW Texas

Chapter; National Alliance on Mental Illness; National

Alliance on Mental Illness of Central Suffolk; National

Alliance on Mental Illness of Park County, WY; National

Association for Home Care & Hospice; National Association for

Uniformed Services; National Association of Hepatitis Task

Forces; National Association of Manufacturers; National

Association of Nutrition and Aging Services Programs

(NANASP); National Association of Social Workers--NC Chapter;

National Association of Social Workers--Virginia Chapter;

National Association of Spine Specialists; National Center

for Policy Analysis; National Coalition for LGBT Health.

National Council for Behavioral Health; National Council of

Asian Pacific Islander Physicians; National Fibromyalgia &

Chronic Pain Association; National Grange; National Hispanic

Medical Association; National Minority Quality Forum;

National Psoriasis Foundation; National Retail Federation;

National Rural Health Association; National Spasmodic

Torticollis Association; NCCEP North Carolina College of

Emergency Physicians; NC State Grange; Nebraska Medical

Association; Nebraska Rural Health Association; Nebraska

State Grange; Nebraska Taxpayers for Freedom; Neuro Network

Partners; Neurofibromatosis, Inc. Mid-Atlantic; Neurosurgical

Society of Kentucky; Nevada Academy of Ophthalmology.

Nevada Chapter ACEP; Nevada Health Care Association; Nevada

Orthopaedic Society; New England Biotech Association; New

Jersey Academy of Ophthalmology; New Jersey Association of

Mental Health and Addiction Agencies, Inc.; New Jersey

Chapter ACEP; New Jersey Mayors Committee on Life Science;

New Jersey Orthopaedic Society; New Jersey Rheumatology

Association; New Jersey State Nurses Association; New Mexico

Biotechnology & Biomedical Association (NMBio); New Mexico

Association of Nurse Anesthetists; New Mexico Chapter ACEP;

New Mexico Health Care Association; New Mexico Podiatric

Medical Association; New York ACEP; New York Regional Society

of Plastic Surgeons; New York State Neurological Society; New

York State Ophthalmological Society.

New York State Rheumatology Society; New York State Society

of Orthopaedic Surgeons, Inc.; New York State Society of

Plastic Surgeons, Inc; New York State Urological Society;

NHACEP; North American Neuro-Ophthalmology Society; North

Carolina Alliance for Retired Americans; North Carolina

Biosciences Organization; North Carolina Chamber; North

Carolina Foot & Ankle Society; North Carolina Psychological

Association; North Carolina Rheumatology Association; North

Carolina Society of Eye Physicians and Surgeons; North Dakota

Chapter ACEP; North Dakota Medical Association; North Dakota

Podiatric Medical Association; North Dakota Society of Eye

Physicians and Surgeons; North Macon Family Healthcare

Associates; Northeast Kidney Foundation; Northern Utah

Coalition, Inc.

Northwest Urological Society; Novartis Pharmaceuticals

Corporation; Occasional Riot; Ogden Branch of the NAACP; Ohio

ACEP; Ohio Association of County Behavioral Health

Authorities; Ohio Association of Medical Equipment Services;

Ohio Association of Rheumatology; Ohio Chamber of Commerce;

Ohio Council for Home Care and Hospice; Ohio Foot and Ankle

Medical Association; Ohio Jewish Communities;

Ohio Orthopaedic Society; Ohio Osteopathic Association;

Ohio State Grange; Ohio Veterans United; OKBio; Oklahoma

Academy of Ophthalmology; Oklahoma ACEP; Oklahoma Association

of Nurse Anesthetists.

Oklahoma Osteopathic Association; Oklahoma Podiatric

Medical Association, Inc.; Oklahoma Society of

Anesthesiologists; Oklahoma Society of Oral and Maxillofacial

Surgeons; Oklahoma State Medical Association; ONEgeneration;

Oregon Academy of Opthalmology; Oregon Chapter of American

College of Emergency Physicians; Oregon Medical Association;

Oregon Neurosurgical Society; Oregon Podiatric Medical

Association; Oregon Rheumatology Alliance; Oregon Society of

Anesthesiologists; Oregon Urological Society; Orthopaedic

Research Society; Orthopaedic Society of Oklahoma;

Orthopaedic Trauma Association; Osteopathic Physicians &

Surgeons of California; Pacific Northwest Chapter of TRIO; PA

Prostate Cancer Coalition.

Partnership to Fight Chronic Disease; PCa Blue Inc.;

Pediatric Orthopaedic Society of North America; Pennsylvania

Chamber of Business and Industry; Pennsylvania College of

Emergency Physicians; Pennsylvania Neurosurgical Society;

Pennsylvania State Grange; Perennial Services Network;

Pfizer; Pharmaceutical Care Management Association;

Philadelphia Rheumatism Society; PhRMA; Plaza Community

Services; Premier healthcare alliance; Prescription

Assistance Network of Stark County, Inc; Prevent Blindness

Iowa; Prevent Blindness, Ohio Affiliate; Progressive

Democrats of Central New Mexico; Progressive Leaders of

Louisiana; Prostate Health Education Network.

Radiology Associates of Macon; Rainy Day Patriots;

Respiratory Health Association; RetireSafe; Rheumatism

Society of the District of Columbia; Rheumatology Alliance of

Louisiana; Rheumatology Association of Iowa; Rheumatology

Association of Minnesota and the Dakotas; Rheumatology

Association of Nevada; Rheumatology Society of North Texas;

Rhode Island Chapter ACEP; Rhode Island Medical Society;

Rhode Island Society of Eye Physicians and Surgeons; Rhode

Island Tech Collective; Rio Grande Valley Diabetes

Association; RIPMA; Rocky Mountain Stroke Center; RTI

Surgical Inc.; Rush To Live; SAGE Utah.

Saint Agnes Healthcare; Salud U.S.A.; Sandhills Adult Day

Health Center, Inc.; San Diego County Podiatric Medical

Association; Sanofi US; SC Podiatric Medical Association

(SCPMA); Scoliosis Research Society; Sea Island Pediatrics;

Senior Connections, The Capital Area Agency on Aging; Seniors

Golden Hammer; Seniors Hospitality Center / Bonners Ferry

Senior Center; Sickle Cell Disease Association of Florida;

Sjogren's and Lupus Foundation of Hawaii; Sjogren's Syndrome

Foundation; Small Business & Entrepreneurship Council; Smile

Community Action Partnership; Society of Academic Urologists;

Society for Cardiovascular Angiography and Interventions;

Society for Vascular Surgery; Society of Military Orthopaedic

Surgeons.

Society of Urologic Oncology; Solidarity Project Advocacy

Center; South Carolina BIO; South Carolina Hospital

Association; South Carolina Medical Association; South

Carolina Medical Group Management Association (SCMGMA); South

Carolina Nurses Association; South Carolina Orthopaedic

Association; South Carolina Rheumatism Society; South

Carolina Society of Ophthalmology; South Carolina Urological

Association; South Dakota Biotech; South Dakota State Medical

Association; South Dakota State Orthopaedic Society; South

Florida Cancer Association; Southern Orthopaedic

Association; State Chamber of Oklahoma; State of Texas

Association of Rheumatologists; State of Texas Kidney

Foundation; Statewide Independent Living Council of

Hawaii.

StopAfib.org; Suicide Awareness Voices of Education;

Sunovion Pharmaceuticals Inc.; Survivors Cancer Action

Network; Takeda Pharmaceuticals, USA Inc.; TCEP Texas College

of Emergency Physicians; Tech Council of Maryland; Tennessee

Association of Long Term Care Physicians; Tennessee

Geriatrics Society; Tennessee Hemophilia and Bleeding

Disorders Foundation; Tennessee Medical Association;

Tennessee Orthopaedic Society; Tennessee Rheumatology

Society; Texas Association for Home Care and Hospice; Texas

Association of Business; Texas Association of Neurological

Surgeons; Texas BioAlliance; Texas Health Resources; Texas

Healthcare and Bioscience Institute; Texas Life-Sciences

Collaboration Center.

Texas Medical Association; Texas Neurological Society;

Texas Nurse Practitioners; Texas Orthopaedic Association;

Texas Osteopathic Medical Association; Texas Pain Society;

Texas Radiological Society; Texas State

Grange; The AIDS Institute; The Arc in Hawaii; The Arc of

Anchorage; The Benefits Consultancy; The Jewish Federations

of North America; The Macula Society; The Marilyn Fagan

Ovarian Cancer Patient Advocacy Program (ICAN-Hawaii); The

Meeting Group, Inc.; The Michael J. Fox Foundation for

Parkinson's Research; The National Association of Catholic

Nurses--U.S.A.; The National Catholic Bioethics Center; The

New England Council.

The New Mexico Association for Home and Hospice Care; The

Retina Society; The Surgery Center of Huntsville; The US

Oncology Network; The Vision Care Center; The Wall Las

Memorias Project; Twin Falls Senior Center; U.S. Chamber of

Commerce; U.S. Pain Foundation; Union Pacific Railroad

Employees Health Systems; Urban Pain Institute; Utah

Advocates; Utah Medical Association; Utah Podiatric Medical

Association; Utah Pride Center; Utah State Orthopedic

Society; Utah Support Advocates for Recovery Awareness;

Vermont Medical Society; Vermont State Association of

Osteopathic Physicians & Surgeons, Inc.; Veterans Health

Council; Vietnam Veterans of America.

Vietnamese Social Services of Minnesota; Virginia Bio;

Virginia Chamber of Commerce; Virginia Hispanic Chamber of

Commerce; Virginia Podiatric Medical Association; Virginia

Society of Eye Physicians and Surgeons; Visiting Nurse

Association; Visiting Nurse Association of Ohio; VITAS

Healthcare; Vizient, Inc.; Washington ACEP; Washington

Biotechnology & Biomedical Association; Washington

Rheumatology Alliance; Washington Rural Health Association;

Washington State Medical Association; Washington State

Orthopaedic Association; Washington State Podiatric Medical

Association; Washington State Prostate Cancer Coalition;

Washington State Urology Society; Wellness and Education

Community Action Health Network; Wellness Station.

West Virginia Academy of Eye Physicians & Surgeons; West

Virginia Academy of Otolaryngology--Head and Neck Surgery,

Inc.; West Virginia Orthopaedic Society; West Virginia State

Rheumatology Society; Western Orthopaedic Association;

Western Section of the American Urological Association;

Wisconsin Academy of Nutrition and Dietetics; Wisconsin

Academy of Ophthalmology; Wisconsin Association of

Osteopathic Physicians & Surgeons (WAOPS); Wisconsin Hospital

Association; Wisconsin Manufacturers & Commerce; Wisconsin

Medical Society; Wisconsin Rheumatology Association;

Wisconsin State Grange.

Wound Care Clinic--ESU; WPMA--Wisconsin Podiatric Medical

Association; Wyoming Chapter American College Emergency

Physicians; Wyoming Epilepsy Association; Wyoming Medical

Society; Wyoming Ophthalmological Society; ZERO--The End of

Prostate Cancer.

Mr. Speaker, let me just read one paragraph:

``IPAB, as constructed under PPACA, is a board comprised of Presidential appointees who will be charged with making recommendations to cut Medicare expenditures if spending growth reaches an arbitrary level. Once the Secretary of Health and Human Services implements an IPAB recommendation, that action is not subject to administrative or judicial review. As constructed, IPAB is granted unprecedented powers-- even the ability to change laws previously enacted by Congress--with virtually no oversight.'' Peter Orszag, President Obama's Office of Management and Budget Director, said it was the largest transfer of power from the legislative branch to a bureaucratic branch since the Federal Reserve, and that is a mouthful.

Democrats and Republicans may not always agree on how to get things done around here, but when you can bring 270 House Members together on one bill, it is pretty clear that something needs to be done immediately.

We were lucky this summer that the Medicare trustees report indicated that IPAB would not trigger until 2021 or 2022, but our back is against the wall and we must act. We cannot afford to let 15 unelected, unaccountable bureaucrats make decisions for our Nation's 58 million Medicare enrollees with no checks from Congress.

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

I refer also to a bipartisan letter I signed on December 17, 2009, that was written to the Speaker of the House at that time, Nancy Pelosi, which said the following:

``Finally, as the people's elected representatives, we must oppose any proposal to create a board that would surrender our legislative authority and responsibility for a Medicare program to unelected, unaccountable officials within the very same branch of government that is charged with implementing the Medicare policies that affect so many Americans.''

Mr. Speaker, I urge my colleagues to support this rule and support the final passage because that will show the American people you stand with America's seniors.

Mr. Speaker, I would like to include in the Record the following letter:

Congress of the United States,

Washington, DC, December 17, 2009.

Hon. Nancy Pelosi,

Speaker, House of Representatives,

Washington, DC.

Dear Madam Speaker: In July, 75 members of the U.S. House

of Representatives wrote to express strong opposition to

proposals, such as the ``Independent Medicare Advisory

Council (IMAC) Act of 2009'' and the ``Medicare Payment

Advisory Commission (MedPAC) Reform Act of 2009'' (H.R 2718,

S. 1110, S. 1380), that would divest Congress of its

authority for Medicare payment policy and place this

responsibility in an executive branch commission or board.

This letter clearly stated opposition to the inclusion of

these or any other similar proposals in health reform or any

other legislation, but with recent developments, we, the

undersigned members, believe it is imperative to restate our

strong opposition to any proposal or legislation that would

place authority for Medicare payment policy in an unelected,

executive branch commission or board.

Consistent with the July letter, on November 7, 2009, the

House passed the ``Affordable Health Care for America Act''

(H.R. 3962) did not include provisions to create an unelected

Medicare board. Yet, at present, the Senate is considering

the ``Patient Protection and Affordable Care Act of 2009,''

which includes provisions to create an ``Independent Medicare

Advisory Board'' (IMAB) that would effectively end Congress's

authority over Medicare payment policy.

To create an unelected, unaccountable Medicare commission

as envisioned in the Senate's IMAB proposal would end

Congress's ability to shape Medicare to provide the best

policies for beneficiaries in our communities around the

country. Through the legislative process, and from Medicare's

beginning, Members have been able to represent the needs of

their communities by improving benefits for seniors and the

disabled, affecting policies that fill the health care

workforce pipeline, and ensuring that hospitals are equipped

to care for diverse populations across our individual

districts. Such a responsibility is one that is not taken,

nor should be given away, lightly.

These proposals would severely limit Congressional

oversight of the Medicare program, and to place this

authority within the executive branch, without Congressional

oversight or judicial review, would eliminate the

transparency of Congressional hearings and debate. Without

the open and transparent legislative process, Medicare

beneficiaries and the range of providers who care for them

would be greatly limited in their ability to help develop and

implement new policies that improve the health care of our

nation's seniors. An executive branch Medicare board would

also effectively eliminate Congress's ability to work with

the Centers for Medicare and Medicaid Services to create and

implement demonstration and pilot projects designed to

evaluate new and advanced policies such as home care for the

elderly, the patient-centered medical home, new less invasive

surgical procedures, collaborative efforts between hospitals

and physicians, and programs designed to eliminate fraud and

abuse.

The creation of a Medicare board would also effectively

eliminate state and community input into the Medicare

program, removing the ability to develop and implement

policies expressly applicable to different patient

populations. Instead, national policies that would flow from

such a board would ignore the significant differences and

health care needs of states and communities. Geographic and

demographic variances that exist in our nation's health care

system and patient populations would be dangerously

disregarded. Furthermore, all providers in all states would

be required to comply even if these policies were detrimental

to the patients they serve. Such a commission could not only

threaten the ability of Medicare beneficiaries, but of all

Americans, to access the care they need.

Finally, as the people's elected representatives, we must

oppose any proposal to create a board that would surrender

our legislative authority and responsibility for the Medicare

program to unelected, unaccountable officials within the very

same branch of government that is charged with implementing

the Medicare policies that affect so many Americans.

Therefore, we must strongly oppose the creation of IMAB,

IMAC, a reconstituted MedPAC or any Medicare board or

commission that would undermine our ability to represent the

needs of the seniors and disabled in our own communities.

Again, we urge you to reject the inclusion of these or any

like proposal in health reform or any other legislation.

Sincerely,

Richard Neal, Gary Ackerman, Shelley Berkley, Brian

Bilbray, Tim Bishop, Marsha Blackburn, Mary Bono Mack, Ginny

Brown-Waite, Michael Burgess, G.K. Butterfield, Steve Buyer,

Kendrick Calvert, Michael Capuano, Russ Carnahan, Bill

Cassidy, Donna Christensen, Judy Chu, Yvette Clarke, William

Lacy Clay, Joe Courtney.

Joseph Crowley, Susan Davis, William Delahunt, Eliot Engel,

Sam Farr, Bob Filner, John Fleming, Barney Frank, Phil

Gingrey, Alan Grayson, Gene Green, Brett Guthrie, John Hall,

Maurice Hinchey, Mike Honda, Steve Israel, Hank Johnson,

Steve Kagen, John Lewis, Nita Lowey.

Steve Lynch, Daniel Maffei, Carolyn Maloney, Edward Markey,

Eric Massa, Doris Matsui, Jim McDermott, Jim McGovern, Jerry

McNerney, Kendrick Meek, Gregory Meeks, Jerrold Nadler, John

Olver, Bill Pascrell, Donald Payne, Laura Richardson, Phil

Roe, Mike Rogers, Dana Rohrabacher.

Bobby Rush, Linda Sanchez, Allyson Schwartz, Pete Sessions,

Pete Stark, Mike Thompson, Patrick Tiberi, John Tierney,

Edolphus Towns, Lynn Woolsey.

Mr. Speaker, I rise in support of my bill, H.R. 849, the

Protecting Seniors' Access to Medicare Act of 2017, a bipartisan bill with 270 cosponsors, that repeals two sections of the Affordable Care Act and terminates the Independent Payment Advisory Board--or the IPAB--once and for all. I thank Chairman Brady and Chairman Walden for bringing this important bill to the floor.

I also want to start by thanking my lead Democrat cosponsor from California, Dr. Raul Ruiz. Dr. Ruiz and his staff have worked tirelessly with my staff to get more cosponsors this Congress than we have ever had before, including 45 Democrats. Seeing such strong bipartisan support for my bill only makes sense, however, since doing away with the IPAB has been a bipartisan idea since it was first proposed.

In December of 2009, I joined Congressman Richard Neal and 72 other bipartisan Members in writing then-Speaker Pelosi expressing our opposition to the IPAB's creation. On the day the ACA passed the House, I filed legislation to repeal the IPAB, and have received bipartisan support in every Congress since. This is about access for seniors' care and quality of their care. By the way, the IPAB was not in the House version of the Affordable Care Act. Only the Senate sent that back over here. So it was not part of the House to begin with.

We got lucky this summer that the Medicare trustees' report did not trigger the IPAB. Otherwise, there would have been significant statutory requirements to cut Medicare within a year. These cuts would have been made to provide reimbursements, which would do nothing but drive providers out of Medicare and would eliminate options for our seniors to receive healthcare.

Peter Orszag, President Obama's Office of Management and Budget Director, said this was the greatest ceding of power from the Congress to a bureaucracy since the formation of the Federal Reserve. Remember, it has been stated here, Mr. Speaker, that the board hasn't been formed. That means one person makes these decisions, not the Congress. Medicare recipients can't come to their elected official and effect changes in this IPAB if it is enacted, and it will be.

One of the major concerns we hear today is that the CBO has estimated that this bill will cost over $17 billion that is not paid for. First of all, the CBO describes its estimates as ``extremely uncertain'' because it is quite possible that under current law, the IPAB will not be triggered.

Secondly, this is the same dilemma we were in with the sustainable growth rate--SGR. Medicare says to doctors: You go out and provide the care, but if you provide too much, we will cut your payments.

As a physician myself, having seen how much havoc the SGR wreaked every year, we can't afford to put providers through this again. We spent months and years getting that corrected. Knowing that many Members were concerned about the offsets in previous years, we have a bill on the floor today that all of our cosponsors can support.

I look forward to seeing all 270 of my cosponsors voting in favor of passage in order to preserve Medicare for our Nation's seniors. We have a chance to send a strong statement of support to Americans of Medicare age that do not want to see their healthcare arbitrarily cut by a body of 15 unelected, unaccountable bureaucrats, or the Secretary of HHS, if the board is not empaneled. If there are hard decisions to be made on Medicare, Congress should not abdicate that duty to a group of people with no oversight or legal recourse. Those decisions should be made by the people elected as representatives of the people.

Mr. Speaker, I urge my colleagues to support final passage of this bill and maintain Medicare services for our Nation's seniors, because this is truly a bipartisan issue that will affect all seniors equally.

Mr. Speaker, I rise today in support of S. 585 the Dr. Chris Kirkpatrick Whistleblower Protection Act of 2017. As Chairman of the Committee on Veterans' Affairs, protecting whistleblowers at VA is of paramount concern to ensure that we provide high quality healthcare and benefits to our nation's veterans.

This bill authored by Senator Johnson of Wisconsin was named in honor of Dr. Christopher Kirkpatrick, a former VA doctor who served our veterans at the Tomah, WI medical center. Many of us know that the Tomah VA medical center has been a facility plagued with the overprescribing of opioids to our veterans. Dr. Kirkpatrick was a brave patriot who blew the whistle on these over prescriptions and the harm that was being done to veterans, however, instead of commending him for coming forward, VA fired him on trumped up charges, which ultimately led to him taking his own life.

In my opinion, the corrosive culture within this facility and VA's actions toward Dr. Kirkpatrick left a chilling effect not only in Tomah, but across the Department. I believe that these actions made whistleblowers feel questioned and worried that they would be punished instead of being lauded and encouraged to come forward.

It is because of brave whistleblowers like Dr. Kirkpatrick that my Committee has been able to expose issues and scandals across the VA. It is because of whistleblowers that we were able to uncover the manipulation of wait times at the Phoenix Medical Center; the falsifying of records in the Philadelphia Regional Office; the fact that a VA employee participated in an armed robbery in Puerto Rico and stayed on the job following their arrest; and many more egregious behaviors at the Department that put veterans in harm's way.

I have confidence that Secretary Shulkin is committed to protecting whistleblowers, so that we never again lose another talented doctor, like Dr. Kirkpatrick. The best way to help him in this mission is to send a clear message to all VA employees, at every level in the Department, and within every level of management, that there are stiff penalties for those who retaliate against the men and women who are brave enough to come forward and protect veterans.

S. 585 builds off of our work this Congress that started with the passage of the bill I championed, the VA Accountability and Whistleblower Protection Act of 2017, which provides the Secretary of Veterans Affairs the tools he needs to hold poor employees accountable. I am pleased that the bill before us today would make needed changes to our outdated civil service laws for all Federal Government employees, which have become so archaic and complex that they tend to put the rights of retaliators above the rights of whistleblowers.

The bill before us would also provide needed reforms to information regarding VA employees who die by suicide, additional penalties for accessing a veteran's medical record, and other needed provisions to ensure that we put the needs of whistleblowers and veterans first.

I appreciate Senator Johnson and Representative Duffy for their work on this important bill and I encourage all of my colleagues to support its passage.

Madam Speaker, as a proud cosponsor, I rise today in support of H.R. 36, the Pain-Capable Unborn Child Protection Act.

Before coming to Congress, I worked as an OB/GYN physician for over 30 years, where I had the tremendous privilege to see life at all stages of development. Today's technology, like 3-D and 4-D ultrasound, has given us a window into that miracle that shows the unborn child is a living, feeling human being.

Due to medical achievements, premature babies are surviving and thriving after being born earlier and earlier, including babies born at or before 20 weeks, the 20-week cutoff by this bill. I can give you case after case. I have watched these children grow up in my hometown.

As a physician who has delivered almost 5,000 babies, it is unconscionable to me that our government allows innocent lives capable of feeling pain and enjoying life to be terminated. It is our responsibility as legislators to stand up and protect these lives who do not have a voice. This bill is an important step toward that goal, and I vote for life.

Mr. Speaker, I am honored to recognize Jim Powell, of Johnson City, Tennessee, for his 80th birthday.

In addition to being a successful businessman, Jim has devoted his life to many worthy endeavors, such as helping students achieve their dreams of attending college.

Growing up, Jim never dreamed of going to college until a teacher helped him apply for a scholarship to the University of Tennessee. Eleven years later, Jim and his wife, Sandy, opened Powell Construction Company, which has been successfully operating for the past 48 years and employs more than 500 people.

All of this wouldn't have been possible without the kind encouragement of Jim's teacher. In an effort to pay that kindness forward, Jim created the Powell Foundation, which has provided over 4,000 scholarships to the University of Tennessee and to East Tennessee State University.

Our community is a better place to live and work because of Jim and Sandy Powell. Jim exemplifies the Volunteer spirit. I commend him for his selfless contributions to east Tennessee, and wish him nothing but the best on his 80th birthday.

Happy birthday, Jim.

Mr. Speaker, I ask unanimous consent that all Members have 5 legislative days to revise and extend their remarks and include extraneous material in the Record on S. 114, as amended.

Mr. Speaker, I move to suspend the rules and pass the bill (H.R. 95) to amend title 38, United States Code, to direct the Secretary of Veterans Affairs to provide child care assistance to veterans receiving certain medical services provided by the Department of Veterans Affairs, as amended.

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

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

Mr. Speaker, I rise today in support of H.R. 95, as amended, the Veterans' Access to Child Care Act. This bill would make the Department of Veterans Affairs' successful pilot program to provide childcare assistance to veterans seeking mental or other intensive healthcare services through the VA healthcare system permanent.

I have been a ``Doctor Dad'' myself, and I know firsthand how difficult it can be to manage childcare responsibilities on top of everything else.

We know that the lack of childcare is a barrier to care for many patients and that assisting veteran parents, grandparents, and guardians in finding childcare opportunities while they are attending VA appointments will relieve a major stress point and increase access to care.

I am grateful to Congresswoman Julia Brownley, the ranking member of our Subcommittee on Health, for her leadership in sponsoring the Veterans' Access to Child Care Act.

I am proud to support this bill and urge my colleagues to do so as well.

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

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

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

Mr. Speaker, once again, I 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. 2772) to amend title 38, United States Code, to provide for requirements relating to the reassignment of Department of Veterans Affairs senior executive employees, as amended.

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

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

Mr. Speaker, I rise today in support of H.R. 2772, as amended, the VA Senior Executive Accountability Act, or SEA Act. This bill would provide needed transparency of the Department of Veterans Affairs' reassignment of members of the Senior Executive Service. Specifically, the bill would require the Secretary to personally approve of a reassignment of VA's approximately 350 SES employees.

It would also require VA to report to Congress identifying those employees who are reassigned and the cost associated with reassignments.

I thank Representative Taylor for his thoughtful legislation. And with that, Mr. Speaker, I urge all of my colleagues to join me in supporting H.R. 2772.

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

Mr. Speaker, I yield 2 minutes to the gentleman from Virginia (Mr. Taylor), the author of this bill and a Navy SEAL.

Mr. Speaker, once again, I 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. 3262) to require the Secretary of Veterans Affairs to carry out a pilot program to provide educational assistance to certain former members of the Armed Forces for education and training as physician assistants of the Department of Veterans Affairs, to establish pay grades and require competitive pay for physician assistants of the Department, and for other purposes, as amended.

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

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

Mr. Speaker, I rise today in support of H.R. 3262, as amended, the Grow Our Own Directive--or GOOD--Physician Assistant Employment and Education Act of 2017.

The PA profession has a long and storied connection with veterans as the first class of PAs was primarily composed of Army medics and Navy corpsmen who served in the Vietnam war.

And I might add, when I did basic training at San Antonio, Texas, at Fort Sam, one of the first PA classes was there.

Today, the Department of Veterans Affairs is the single largest employer of PAs in the country. Nevertheless, PAs are consistently identified as one of the top five professions where VA is experiencing the largest staffing shortages.

H.R. 3262, as amended, would help solve that by creating a pilot program to provide assistance to veterans who want to pursue education and training to become a PA and to serve their fellow veterans by working at VA medical facilities.

I am grateful to Congresswoman Ann Kuster for sponsoring this legislation and shepherding it through the legislative process, and I am confident that it will go a long way in resolving existing PA recruitment and retention issues, ensuring that VA medical facilities are appropriately staffed with high-quality PAs and, in turn, increasing access to care for veteran patients.

Mr. Speaker, I urge all of my colleagues to join me in supporting H.R. 3262, as amended, and I reserve the balance of my time.

Mr. Speaker, it is my privilege to yield 2 minutes to the gentleman from Michigan (Mr. Bergman), who is the chairman of the Subcommittee on Oversight and Investigations on the full Veterans' Affairs Committee.

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

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

Mr. Speaker, I certainly support this bill, and I want to thank both General Bergman and Ms. Kuster. We made a trip to Afghanistan together a couple of years ago. She has a dogged--and I will say ``dogged''-- commitment to the veterans in her district and to this country, and I want to thank her for bringing this piece of legislation up. I believe it will make a difference, I truly do, when it is implemented.

And I want to thank the ranking member, and his staff and mine, for bringing a lot of pieces of legislation to the House floor in the last couple of weeks. This week, especially, we have had some success here, and that means veterans had success. Certainly, the post-9/11 GI Bill that was passed this week is an enormous bill and will do good generations after no one ever remembers who was on this floor debating that bill. So I want to thank them and thank my colleagues and wish everyone a safe recess and a healthy recess.

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

Madam Speaker, I move to suspend the rules and pass the bill (S. 114) to amend title 38, United States Code, to require the Secretary of Veterans Affairs to submit an annual report regarding performance awards and bonuses awarded to certain high-level employees of the Department of Veterans Affairs, as amended.

Madam Speaker, I ask unanimous consent that all Members have 5 legislative days in which to revise and extend their remarks and to include extraneous material.

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

Madam Speaker, I rise today in support of S. 114, as amended, a bill to authorize appropriations for the Veterans Choice Program. This bill would authorize and appropriate $2 billion for the Department of Veterans Affairs' Veterans Choice Fund.

Allowing the Veterans Choice Fund to run dry is not a viable option. The Choice Program has provided critical care to millions of veteran patients.

In March, Secretary Shulkin testified that the expiration of the Choice Program would be a ``disaster'' for veterans. Just a few weeks ago, the Acting Under Secretary for Health reiterated that sentiment when she testified that veteran wait times would increase if the Choice Program went away.

Congress created the Choice Program in response to a nationwide wait- time scandal in 2014 to increase access to care through VA community providers for veterans who either cannot access care at a VA medical facility within a timely manner or who live far away from the nearest VA medical facility. Since the Choice Program was signed into law almost 3 years ago, it has gone through many growing pains and evolved considerably.

We know from a Government Accountability Office report from earlier this year that most of the veterans who use the Choice Program do so because VA does not offer the service that veteran needs.

We also know that veteran demand for care through the Choice Program has never been higher, and, consequently, the remaining money in the Veterans Choice Program will run out in mid August, a few short weeks from now.

We cannot allow that to happen, and with passage of S. 114, as amended today, we won't.

There are allegations that providing more money for the Choice Program is

inappropriate unless we also provide more money for the VA healthcare system. I fail to understand the logic of that argument.

First, providing money for the Choice Program is providing money for support to the VA healthcare system. Choice is a VA program. Through it, VA patients and veteran patients are able to access care that would have otherwise have required either a long, possibly debilitating wait or an excessive travel time.

Second, the idea that Congress has been pouring money into VA community care programs to the detriment of addressing VA's in-house capacity is simply erroneous. VA's bottom line has increased substantially since the turn of the century while most other government agencies have seen theirs stagnate or reduced.

Madam Speaker, VA's budget has gone up four times since 2001. It has quadrupled. Two weeks ago, former Secretary Principi testified that since he left the Department in 2005 to the most current VA budget submission released in May, VA's budget increased a stunning 268 percent. That growth will likely continue, which is appropriate, given our Nation's commitment to serving her veterans.

Yet, especially considering that the Choice Program is just 3 years old, the idea that Congress is focused only on growing VA's external capacity is false.

That said, there are certainly priorities that remain unaddressed in the bill before us, and I am committed to continuing to work on those in the coming months.

However, providing $2 billion today will ensure that the Choice Program remains funded for the next 6 months, solving our most pressing issue and preventing yet another veteran access crisis like the one that led to the creation of the Choice Program 3 short years ago while we addressed other important issues.

An important point to note is that the bill's costs are paid for using the same offsets that were used in the original act creating the Choice Fund.

I look forward to working with the minority, our colleagues in the Senate, and other stakeholders to charter a long-term path forward for the Choice Program and to address other needs to ensure that the VA healthcare system remains strong and stable for generations to come.

I am grateful to Ranking Member Walz for his leadership and commitment in working very closely with me to come to a mutually agreeable solution today and to committing to continue to stand shoulder to shoulder in finding solutions in the months ahead. He has been a great partner.

Madam Speaker, I urge all of my colleagues to join me in supporting S. 114, as amended, and I reserve the balance of my time.

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

Madam Speaker, I think the one way that we don't have the Veterans Choice Program work for veterans is not vote for S. 114. Just to clarify a couple of things, this $2 billion is emergency spending that our Budget Committee agreed to.

I want to just for a minute kind of go over how we got to this position where we are right now.

The Veterans Choice Program, in April, we were told, would last until next January or February. So we passed the CHOICE Act, and the President signed it into law. We found out a short 60 days later that the funds would run out in mid August--the 7th to the 15th of August is when the Secretary told us--so that kind of caught us off guard, and we had to get moving rather quickly.

The June 28 letter that my good friend, Mr. Walz, referred to sort of got us started with this process. I want to go through it because the process is important about how we are here today.

The Members need to understand that my efforts to work with the committee's ranking member and, indeed, all members of the committee on a path forward which addresses the concerns of all of the organizations, I have done that.

Let me begin by saying I fundamentally disagree that we have neglected the needs of our internal VA healthcare system. We just passed a MILCON-VA bill last week. I stated the reasons for that in my earlier remarks. I think the Secretary's op-ed this morning in USA Today clearly makes the point.

Madam Speaker, I include in the Record that article.

[From USA Today, July 24, 2017]

Veterans Affairs Secretary: VA Health Care Will Not Be Privatized on

Our Watch

(By David Shulkin)

As a physician, my professional assessment is that the

Department of Veterans Affairs has made significant progress

over the past six months--but it still requires intensive

care. In order to restore the VA's health, we must strengthen

its ability to provide timely and high quality medical care

while improving experiences and outcomes for veterans.

I believe the best way to achieve this goal is to build an

integrated system that allows veterans to get the best health

care possible, whether it comes from the VA or the private

sector.

This is not a novel idea. No health care provider delivers

every treatment under the sun. Referral programs for patients

to get care through outside providers (known as Choice or

Community Care at the VA) are as essential to the medical

profession as stethoscopes and tongue depressors. But VA

attempts to offer veterans these options have frequently

stirred controversy.

Some critics complain that letting veterans choose where

they get certain health care services will lead to the

privatization of VA. Nothing could be further from the truth.

VA has had a community care program for years. Congress

significantly expanded these efforts in 2014 in response to

the wait time crisis. As a result, since the beginning of

this year, VA has authorized over 18 million community care

appointments--3.8 million more than last year, or a 26%

increase, according to the VA claims system.

But as VA's community care efforts have grown, so has our

capacity to deliver care in-house. The VA budget is nearly

four times what it was in 2001. Since then, the department's

workforce has grown from some 224,000 employees in 2001 to

more than 370,000 today, according to the Office of Personnel

Management. And we're delivering 3 million more appointments

at VA facilities per year than we were in 2014.

In other words, community care or private capacity and VA's

internal capacity are not mutually exclusive. We are ramping

up both simultaneously in order to meet the health care needs

of the veterans we are charged with serving. Our fiscal 2018

budget continues this trend. It will spend $2.7 billion more

for in-house VA care, compared to a $965 million increase for

community care. This means that the total dollar increase for

medical care within VA is three times that of the increase

for community care. Overall, when all funding sources are

taken into account, we expect to spend $50 billion on health

care services within VA and $12.6 billion on VA community

care in fiscal 2018.

Even though these numbers make it abundantly clear VA is

not at all headed toward privatization, I understand the

underlying concerns of some critics. They don't want to lose

all that VA has to offer. I don't either--and we won't.

Many of VA's services cannot be replicated in the private

sector. In addition to providing some of the best quality

overall health care in the country, VA delivers world class

services in polytrauma, spinal cord injury and

rehabilitation, prosthetics and orthotics, traumatic brain

injury, post-traumatic stress treatments and other behavioral

health programs. The department plays a critical role in

preparing our nation's doctors and nurses--70% of whom train

at VA facilities. And we lead the nation in innovation, with

VA research having contributed to the first liver transplant,

development of the cardiac pacemaker, advancements in

treatments for PTSD, cutting-edge prosthetics, and many other

medical breakthroughs.

All of these factors underscore that fears of privatization

are simply unfounded. President Trump is dedicated to

maintaining a strong VA, and we will not allow VA to be

privatized on our watch. What we do want is a VA system that

is even stronger and better than it is today. To achieve that

goal, VA needs a strong and robust community care program.

Veterans deserve the best. If a VA facility isn't meeting

the community standard for care, doesn't offer a specific

service, or doesn't have an appointment available when it's

needed, veterans should have access to care in their

community.

This is precisely what they have earned and deserve. It's

what the VA is working with Congress and Veterans Service

Organizations to deliver. And it's what the system needs to

remain a valuable resource for our country's great veterans,

now and in the future.

Madam Speaker, I respect the veterans service organizations and their point of view, and I am a member of most of them. I, therefore, reached an agreement with the ranking member on a plan to fund the Veterans Choice Program for 1 year, fund the life safety maintenance issues at VA facilities, approve 28 VA clinic leases, provide the Secretary with the tools to be more competitive in attracting and retaining VA physicians, and conduct a long-overdue asset review of VA's aging facilities.

When the ranking member and I briefed the VSOs on this plan and then committee members--two separate meetings--it was clear that we needed to take some time to work out the differences. There was some concern there. And I have said that is fine. I think we can take a two-phased approach.

Phase one was the one we are talking about today, and we agreed on that. It is necessary to fund the Veterans Choice Program for 6 months to ensure that the veterans get needed healthcare without long drives and waits. That is exactly what we were dealing with 3 years ago.

The second phase, which we would consider 6 months from now, would

consider the remaining items I have talked about between the ranking member and me. During the interim, the committee would conduct open, transparent hearings on asset review and anything else--the leases or anything else--that was in that agreement. There was full transparency about this plan among committee members, which is why I found it a little disheartening now what I am hearing.

The reality is, right now, we don't have an agreement from the Senate or a bill to act on, so it is time for us to act because time is growing short.

There are veterans out there, Madam Speaker, that are getting chemotherapy as we speak. There are pregnant veterans who need to know if they can have their baby and have it paid for by the VA. I could go on and on. That is why we need to remove this right now. Then we would have time to work these other issues out.

And just a couple of VA staffing issues. You hear the concern that VA is going to be privatized and so forth. I hear that all of the time. Well, this is what the VA has done, as far as their facilities are concerned, since 2010. I arrived here in 2009.

Since then, the VA has added 3,600 physicians, almost 13,000 nurses-- and they are one of the largest employers of nurses in the country-- almost 4,000 LPNs, and over 3,200 nonphysician healthcare providers. I could go on and on. The increase in medical services has been over $10 billion since then. So there have been huge increases.

And just a couple of things from the VA Secretary's editorial in USA Today: ``But as VA's community care efforts have grown, so has our capacity to deliver care in-house. The VA budget is nearly four times what it was in 2001. Since then, the Department's workforce has grown from some 224,000 employees in 2001 to more than 370,000 today, according to the Office of Personnel Management.''

That doesn't sound like an organization that is being privatized. It has grown in that capacity.

``And we're''--the VA--``delivering 3 million more appointments at VA facilities per year than we were in 2014.''

They have grown that capacity internally.

In our fiscal 2018 budget, the trend continues. We are going to spend $2.7 billion more on in-house VA care compared to a $965 million increase in community care. So there is a $3 billion increase in in- house VA care versus out-of-VA care, or outside care.

I think these are all good things. I think the fact that more veterans are getting care, more appointments are being made, whether they are in or out of the VA, is a good thing. But to make the argument that this is privatization is clearly not there.

I would like to say that we can work these out. We need to make sure we take that anxiety away. The Secretary has clearly stated that he has to have this passed. I would simply pass it. It gives us 6 months, Madam Speaker, to work on these issues, and I am more than happy to do it. I have stated so to every organization out there.

Madam Speaker, I reserve the balance of my time.

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

Madam Speaker, I do agree with my good friend, the gentleman from Minnesota, Tim Walz. We are not going to leave here until we pass this, because there are veterans out there who are ill, who have served this country honorably, who need care.

I am a physician. I have worked in a VA hospital, I have worked in a medical unit in Southeast Asia many years ago, I have seen the results and injuries of war, and I have seen the results and injuries of current wars. And we are going to do this.

I know when I sat down and we put this compromise package together, and as openly as I could, I brought in the VSOs, I brought in both the Republican and Democrat sides, which we typically just check all that at the door in this committee, which I am thankful for,

and work just for veterans, and there were some issues that were brought up. And I recognized that, and I said: Well, the smart thing to do is we know that Choice runs out of money in 2 to 3 weeks. We have to fund the veterans' healthcare now, and we will take these other issues up as a package and have time to debate them and discuss them. That is all this is about. It is about emergency spending. We recognize that, and that is okay with our side.

I say the easiest way to do this is put this $2 billion bill on President Trump's desk, he will sign it, and veterans will have access to this Choice Program for the next 6 months. That is what the Secretary wants. He wrote a very eloquent editorial in USA Today about this entire issue.

Madam Speaker, I reserve the balance of my time.

Madam Speaker, may I inquire as to the time left on our side.

Madam Speaker, I yield myself such time as I may consume. I want to clarify a couple of things that have been said here today.

Madam Speaker, we did work out an agreement. When I met with all of the interested parties, which I thought was our job, both the ranking member and myself did this, as we always do, we found out some issues that were there.

The primary thing we have to do right now is to provide healthcare, or we will be right back to where we were in 2014, when there were waiting lists around the country and veterans dying waiting on care.

Maybe not in urban America, but in rural America where I live, many of these hospitals and veterans absolutely rely on this for their health and welfare. The further they live away from a VA facility, the more they rely on Choice.

Let me go over this again so that it is clear. I got into Congress in 2009. I was elected then and sworn in then. The VA was spending $93.7 billion on all VA care; that is the disability claims, healthcare, and cemeteries. In this fiscal year, that budget is going to be $186 billion, where basically the discretionary budget in this Congress has been flat, so that money has come from other places, education, environment, other places that we have invested in our veterans, which is, and I believe to this day, a good thing to be doing.

We have gone, in 2001, from 224,000 people, that is not a small organization, to 370,000 people who work for the VA today. They are providing that money.

I guess what I was hearing from the other side of the aisle was if we didn't have the Choice Program, the wait times would have gotten shorter. I mean, that is the reason we have the Choice Program, was the VA wasn't doing it.

The fact is, they have hired people. I mentioned here just a moment ago, since 2010, when I first got here, they have hired 13,000 more nurses, 3,600 more doctors, 3,200 more physician extenders, nurse practitioners and PAs. So the VA has increased its capacity, and they have seen millions of more visits.

This week, we are going to take up the VA appropriations bill. I misspoke a minute ago; I said last week. This week, we are taking up the MILCON-VA appropriations bill where we talk about those things, about the money that we are going to spend in the VA. That is going to be debated this week.

This is a separate issue. This is about providing healthcare for veterans after August 15, that is 2 to 3 weeks from now, when that program will be shut off and veterans in the middle of care will not be able to get care.

It is a simple vote. We can work these other things out in the next few months after this very easily.

Madam Speaker, I reserve the balance of my time.

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

Obviously, this has been a robust debate about a very important issue, which is providing timely healthcare for veterans who have been waiting. The ranking member and I negotiated in good faith and put an agreement together, which fell apart this weekend.

We had met basically with both the VSOs and the committee members and had an agreement to go forward. I then backed up on that agreement because I realized it wasn't a consensus, and just divided it into two.

The most pressing need, Madam Speaker, is to provide healthcare, whether it is chemotherapy or obstetrical care, surgery that a veteran may need, timely visits to the doctor. In 2 to 3 weeks we are up that close, and one of the reasons is, as has been stated multiple times, the VA gave us some

really bad information 2 months ago. We thought this was going to last for 6 more--8 more months before we ran out of money in this vital program for veterans.

This is going to get passed. For all veterans or people out there, citizens of this country watching this, we are going to provide this for our veterans.

And I might add that not all VSOs do oppose this. Many were mentioned, but many others do not oppose this legislation.

I think it is critical that we get this done, Madam Speaker, get this off the table this week, signed into law, work the other part of the agreement that we had agreed to out in the next coming weeks. I will be willing to work as expeditiously as possible to get this done.

Once again, I encourage all Members to support this legislation, and I yield back the balance of my time.

Madam Speaker, I move to suspend the rules and pass the bill (H.R. 3218) to amend title 38, United States Code, to make certain improvements in the laws administered by the Secretary of Veterans Affairs, and for other purposes, as amended.

Madam Speaker, I ask unanimous consent that all Members have 5 legislative days in which to revise and extend their remarks and to include extraneous material.

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

I rise today in support of H.R. 3218, as amended, the Harry W. Colmery Veterans Educational Assistance Act of 2017, which I introduced with Ranking Member Walz and every member of the Committee on Veterans' Affairs 2 weeks ago.

This bill and how it got to this point today is a shining example of how well Congress can and should work together. It is the result of tireless work of many veterans service organizations and the bipartisan efforts of committee members.

I am proud that the improvements and enhancements to the GI Bill that this Chamber will advance today will empower servicemembers, veterans, survivors, and dependents for generations to come.

This is the first major improvement to the GI Bill since 2011, and it encompasses 17 bills introduced by our colleagues, many who serve on the Veterans' Affairs Committee, and also others who share our committee's commitment to the men and women who have raised their right hand side to serve.

This package includes over 30 provisions and brings forward many enhancements that veterans' groups have requested for years. I have said it before and I will say it again, this isn't a package that comes along every day.

Madam Speaker, H.R. 3218, as amended, is aptly named after Mr. Harry W. Colmery, who is credited with actually writing by hand the first draft of the World War II-era GI Bill. It is only appropriate that we honor him today for his work on the first GI Bill decades ago.

This package would do a number of things, and I want to focus on just a few key improvements. First, it would eliminate the 15-year time limit to use the GI Bill benefits for future eligible beneficiaries and anyone who left active service on or after January 1, 2013.

Madam Speaker, the GI Bill, when I used it for 2 years after I got out of the military, was, at 10 years, you could no longer use it. This is a lifetime commitment to the American people, to our veterans, if they can exercise their GI Bill benefit at any time.

Let me repeat that. For the first time in the history of our GI Bill, future beneficiaries and some veterans will be able to carry these benefits with them throughout their life.

Secondly, the bill would provide significant increases in GI Bill funding for

reservists and guardsmen, including those who are currently serving on orders but do not accrue GI Bill eligibility, as well as dependents, surviving spouses, and surviving dependents.

It would also provide 100 percent GI eligibility for post-9/11 Purple Heart recipients.

Finally, it would increase opportunities for veterans to complete a science, technology, engineering, math degree, or other high technology program. That particular issue is one that I know Leader McCarthy has advocated for. It is a privilege to have him as an original cosponsor of the bill, and we thank him for his leadership in getting the bill to the House floor promptly.

The provisions I just mentioned only scratch the surface of the benefits that our veterans and survivors will receive under this bill.

The amendment to this bill before the House today provides technical and conforming changes to ensure the bill is budget-neutral over the 10-year budget window, clarifies that students impacted by the closure of ITT Tech would be able to have their GI Bill eligibility restored if they are unable to transfer their credits, and, starting in fiscal year 2022, would provide eligibility for a Yellow Ribbon Program to Active Duty servicemembers.

Madam Speaker, we owe a debt of gratitude to all the VSOs who pushed for this package. And I would be remiss if I didn't single out and give my sincere thanks to the Student Veterans of America, the American Legion, the Veterans of Foreign Wars, the Vietnam Veterans of America, Tragedy Assistance Program for Survivors, the Military Order of the Purple Heart, and Got Your Six for working tirelessly across the Hill over several months to help us make this happen.

I commend and thank them because, without a doubt, we would not be in this Chamber today on the verge of this historic moment without their efforts.

Finally, I thank Ranking Member Walz for his strong leadership and support in making this package come together. I also express my appreciation to Senators Isakson and Tester for their efforts in negotiating a strong package we can all agree on. I know they are planning to hold a markup on this companion bill to H.R. 3218, as amended, this week, and I would expect that they can pick up and pass this bill and get it to President Trump's desk before the August District Work Period.

Madam Speaker, this is a strong bill that would help thousands of student veterans for the rest of their lives. I urge my colleagues to support it, and I reserve the balance of my time.

Committee on Armed Services,

House of Representatives,

Washington, DC, July 20, 2017.

Hon. David P. Roe, M.D.,

Chairman, Committee on Veterans' Affairs, House of

Representatives, Washington, DC.

Dear Mr. Chairman: I am writing to you concerning H.R.

3218, the ``Harry W. Colmery Veterans Educational Assistance

Act of 2017.'' There are certain provisions in the bill which

fall within the Rule X jurisdiction of the Committee on Armed

Services.

In the interest of permitting your committee to proceed

expeditiously to floor consideration of this important

legislation, I am willing to waive this committee's further

consideration of H.R. 3218. I do so with the understanding

that by waiving consideration of the bill, the Committee on

Armed Services does not waive any fixture jurisdictional

claim over the subject matters contained in the legislation

which fall within its Rule X jurisdiction.

Please place a copy of this letter and your response

acknowledging our jurisdictional interest into the committee

report on H.R. 3218 and into the Congressional Record during

consideration of the measure on the House floor. The

committee also reserves the right to seek appointment to any

House-Senate conference on this legislation and requests your

support if such a request is made. Thank you for the

cooperative spirit in which you have worked regarding this

matter and others between our respective committees.

Sincerely,

William M. ``Mac'' Thornberry,

Chairman.

Madam Speaker, I think one of the greatest things in here is the lifetime benefit. When I was in my early twenties, I wouldn't have put a big bet on being 40 years old. So I know you don't ever think you are going to get there, but you do. With the changing workforce today, it is a huge benefit that I think that veterans going forward are going to appreciate and the country will benefit from.

Madam Speaker, I yield 1 minute to the gentleman from Pennsylvania (Mr. Fitzpatrick), my good friend.

Madam Speaker, I yield 2 minutes to the gentleman from Florida (Mr. Bilirakis), my distinguished colleague, a senior member and vice chair of the committee.

Madam Speaker, I yield 2 minutes to the gentleman from Florida (Mr. Rutherford), an active member of the Veterans' Affairs Committee.

Madam Speaker, I yield 2 minutes to the gentleman from Indiana (Mr. Messer), my good friend. We have served on the Education and the Workforce Committee together since he has been here, and he is in his fourth term.

Madam Speaker, it sounds like the gentleman who spent 2 years and didn't have anything to show for it was in the U.S. Congress, but that is another story altogether.

Madam Speaker, I yield 2 minutes to the gentlewoman from Indiana (Mrs. Brooks), my good friend, whom I served with on the Education and the Workforce Committee.

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

This was a process, and it took several months working with the VSOs, with our staffs, with Mr. Walz's team and our team and others to get this bill where it is. And I think, as Mr. Walz said, that as people dig into this bill, it is truly, I believe, an outstanding piece of legislation that honors the people who serve this country and will give them a benefit when they come home.

If you are 25 years old and you come home and you have a job from the military, you separate after a few years of service, and your job leaves when you are 42, you have lost that benefit now.

Now, you can go back and get retrained. We know that the average person is going to have five, six, seven different occupations during a professional working career. This will allow our veterans, I think some of the absolute finest people that grace this Nation, to be able to be the ones who are the leaders in the future because of the education benefit that they have earned with their service.

I thank my friend, Mr. Walz, for his work on this and leadership on this, along with his team and our team here.

Madam Speaker, I urge all of my colleagues to support this, and I yield back the balance of my time.

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

Madam Speaker, I move to suspend the rules and pass the bill (H.R. 282) to amend the Servicemembers Civil Relief Act to authorize spouses of servicemembers to elect to use the same residences as the servicemembers.

Madam Speaker, I ask unanimous consent that all Members have 5 legislative days to revise and extend their remarks and include extraneous material.

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

I rise today in support of H.R. 282, the Military Residency Choice Act. The Military Residency Choice Act would change the way military spouses claim State residency by allowing a spouse to claim the same State of residence as their servicemember spouse, even if they have never physically lived in that State.

I want to commend Representatives Stefanik and Wittman for their work on this bill, and I will allow them to describe it in greater detail in a moment.

Madam Speaker, I urge all of my colleagues to join me in supporting H.R. 282, and I reserve the balance of my time.

Mr. Speaker, I yield 2 minutes to the gentlewoman from New York (Ms. Stefanik), coauthor of the bill and my colleague on the Education and the Workforce Committee.

Mr. Speaker, once again, I encourage all Members to support this commonsense legislation, and I yield back the balance of my time.

Mr. Speaker, I move to suspend the rules and pass the bill (H.R. 1058) to amend title 38, United States Code, to clarify the role of podiatrists in the Department of Veterans Affairs, as amended.

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

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

Mr. Speaker, I rise today in support of H.R. 1058, as amended, the VA Provider Equity Act. This legislation would recognize the professional contribution of hardworking podiatrists within the Department of Veterans Affairs healthcare system.

The VA standard for compensating podiatrists has not been updated in 41 years. In that time, education and training for podiatrists has been revolutionized.

As a result of the VA's failure to recognize and respond to advancements in podiatry practice, it has created significant disparities in pay and advancement opportunities for podiatrists practicing at the VA in comparison to their peers in the private sector.

Consequently, the VA struggles to recruit and retain experienced, qualified podiatrists--those we want caring for our veterans--at a time when veteran need for podiatry care is increasing.

This legislation would solve that problem by allowing VA podiatrists the opportunity to seek leadership opportunities at VA medical facilities and making podiatry pay equal to physician and dentist pay within the VA healthcare system.

I am grateful to my good friend, fellow veteran, and committee member, Dr. Brad Wenstrup, the chairman of the Subcommittee on Health, for his leadership in recognizing what an important issue this is and being thoughtful and tenacious in pursuit of a solution to it.

I am proud to join Dr. Wenstrup in fully supporting this legislation and urge all of my colleagues to do the same.

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

Mr. Speaker, I yield 2 minutes to the gentleman from Ohio (Mr. Wenstrup). Colonel Wenstrup is a member of the Veterans' Affairs Committee.

Mr. Speaker, once again, I encourage all Members to support this legislation, and I yield back the balance of my time.

Mr. Speaker, I move to suspend the rules and pass the bill (H.R. 1690) to amend title 38, United States Code, to require the Secretary of Veterans Affairs to submit an annual report regarding performance awards and bonuses awarded to certain high-level employees of the Department of Veterans Affairs, as amended.

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

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

Mr. Speaker, I rise today in support of H.R. 1690, as amended, the Department of Veterans Affairs Bonus Transparency Act.

This bill would require the Department of Veterans Affairs to submit an annual report to specified congressional committees on the performance awards and bonuses presented to Senior Executive Service employees, SES employees.

I believe that, if you do excellent work, you should receive a bonus. I also believe such a bonus should be justified and that there should be some level of transparency regarding those who receive a bonus.

Mr. Speaker, I support Congresswoman Tenney's bill, and I reserve the balance of my time.

Mr. Speaker, I yield 3 minutes to the gentlewoman from New York (Ms. Tenney) who is the author of the bill.

Mr. Speaker, sometimes we sing from the same song sheet, and sometimes we don't sing from the same song sheet.

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

Mr. Speaker, once again, I encourage all Members to support this legislation, and I yield back the balance of my time.

Mr. Speaker, I move to suspend the rules and pass the bill (H.R. 1848) to direct the Secretary of Veterans Affairs to carry out a pilot program on the use of medical scribes in Department of Veterans Affairs medical centers, as amended.

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

Mr. Speaker, I rise today in support of H.R. 1848, as amended, the Veterans Affairs Medical Scribe Pilot Act of 2017, which I am proud to sponsor.

One of my priorities as chairman of the House Committee on Veterans' Affairs is to increase access to care for veteran patients. One way to do that is help hardworking Department of Veterans Affairs clinicians to be more efficient in the practice of high-quality care.

The Veterans Affairs Medical Scribe Pilot Act of 2017 would do just that by creating a 2-year pilot program to test the use of scribes in VA medical centers.

Scribes are increasingly used in the private sector to help doctors navigate and document a patient's electronic health record. That allows doctors to place their focus not on a computer screen, but squarely on the patient.

I jokingly say, Mr. Speaker, that it was electronic health records that made me a Congressman. Basically, it ran me out of the medical office. That is a slight exaggeration, but it is not too far off.

Like many doctors I hear from today, I found the increasing amount of time that I was spending attending to electronic health record requirements, necessary as they may be, detracted from the quality of my patients' interactions and significantly slowed down how smoothly my clinic day would operate. I believe the same is true at VA. Many doctors now, Mr. Speaker, are spending over half their time entering information, just basically being data entry people.

Onsite visits to VA medical facilities across the country, my staff and I always ask VA employees how we can help them provide safer, better care and see more patients. By far, one of the most common responses that we hear is a plea to ``give us scribes; give us some help.''

That is exactly what passage of H.R. 1848, as amended, will do.

This bill also includes provisions of H.R. 1662, a bill sponsored by Dr. Brad Wenstrup, the chairman of the Subcommittee on Health, which would bring VA medical centers in line with every other major healthcare system by prohibiting smoking on VA medical facility properties.

I thank Dr. Wenstrup for his leadership on this issue, and I am grateful to be working with him to make VA medical facilities healthy, smoke-free places for VA employees to serve veterans and for veterans to seek care.

Mr. Speaker, I urge all my colleagues to support me in supporting H.R. 1448, as amended, and I reserve the balance of my time.

Mr. Speaker, once again, I encourage all Members to support this legislation, and I yield back the balance of my time.