Congressional Budget for the United States Government for Fiscal Year 2005-Continued

CONGRESSIONAL BUDGET FOR THE UNITED STATES GOVERNMENT FOR FISCAL YEAR 2005-CONTINUED

Mr. GRAHAM of Florida. Madam President, I appreciate the Senator from North Dakota yielding me 10 minutes. I hope he will not take offense at what I am going to say.

The Senators from Oklahoma and North Dakota have just given us a very accurate and descriptive statement of how certain parts of the budget procedures operate. But let me say, I do not believe this issue is about the arcane features of budget policy; rather, they are first about choices.

When we voted in 2001 and again in 2003 for the most massive tax cuts in American history, targeted primarily at the wealthiest 10 percent of Americans, we were making a choice. One of those choices comes home today, and that is, will we be able to adequately finance our responsibility to the health care of American veterans as well as the health care of those American men and women who have been injured as a result of the ongoing wars in Afghanistan and Iraq?

That comes to the second thing this is about. This is about real people. I take a different job every month, and in November, on Veterans Day, I worked at a VA hospital in Miami, FL. While I was there, I met a returning soldier. I will use the name "John" in order to respect his confidentiality.

John is approximately 24 years old. He was born and lived most of his life in Puerto Rico. The reason he is in the Miami VA hospital is because it has responsibility for certain specialty care that is provided to veterans from most of Florida, Puerto Rico, and the U.S. Virgin Islands.

John was a member of the Puerto Rican National Guard and was called up to duty in Iraq. Prior to his reporting for duty, he married a beautiful young lady who I will call Linda. John was a tanker. He was assigned to a tank unit that led the surge from the Kuwait border into Baghdad. After the conflict ended, his tank crew was given the assignment of taking down some of the buildings Saddam Hussein had constructed in Baghdad, some of them because they were no longer safe by virtue of U.S. military action, some because of their symbolic importance. John's assignment was to stand by the side of the tank as the tank was used as a battering ram to take down these buildings. Unfortunately, in the course of this he was hit by a falling wall from one of these structures and is now a paraplegic. He is in the spinal cord injury program at the Miami VA hospital.

You can imagine the devastation of John and Linda, as their plans for a life together, functioning as a normal couple, have been devastated by this spinal cord injury.

John is who we are talking about here today and John very specifically is who we are talking about here today because this Congress, in the late 1990s, took on for the Veterans Administration the responsibility for 2 years after discharge from active duty for the care for Americans who had been injured in combat. John is one of those veterans.

Last year we asked the VA how much it was going to cost to carry out this responsibility. They did some calculations based on, first, what their experience was in the first Persian war as to what percentage of troops would be injured and become eligible for this VA service, and what is the current per-capita cost of delivering this service.

Do you know what they came up with? The cost would be $350 million. The administration objected to that cost, and after extended negotiation that figure was reduced to $100 million-less than a third of what the VA estimated the cost would be. Then do you know what happened. They didn't spend it on health care. They spent it to improve the processing capability of the VA for a variety of veterans applications. That may be desirable to do, but that is not what even the miserly $100 million was appropriated to do.

John now sits there in his wheelchair facing many years-possibly a lifetime-as a paraplegic, and his country told him last year he wasn't worthy of having that service he had been promised by the Congress. Now we are about to tell him again he is not worthy of having that service financed.

We need to be realistic. This budget for American veterans and the brave fighting men and women who are returning is totally inadequate. It does not provide even enough to cover the cost for medical inflation, including payroll increases for the health care of the current group of U.S. veterans.

This budget, unfortunately, reflects this administration's priority. If enacted, it will have a devastating effect on the men and women who have served this country with honor and those who are currently serving with honor because this administration has said this is all it is willing to do.

Rather than funding these programs as our veterans were promised, the President seeks to fund the shortfall in his request by increasing the out-of-pocket costs to the so-called higher income veterans. That means veterans who have earnings starting at approximately $24,000. We would raise the prescription drug copayment from $7 to $15. But, more importantly, we would charge a $250 enrollment fee which not only has as its goal to generate some additional revenue but, more importantly, it will artificially reduce the demand for VA services by veterans who either cannot or do not feel it would be advantageous to pay that $250 enrollment fee.

Mr. NICKLES. Madam President, will the Senator yield?

Mr. GRAHAM of Florida. If I could just finish. The Senate Committee on Veterans Affairs has reviewed this on a repeated basis. The Presiding Officer is a member of that committee, as am I. All of the members of the committee, Republicans and Democrats, rejected the proposed increases in copayments or in the $250 annual enrollment fee.

All Members agree Congress needs to appropriate sufficient funds to obviate the need for these abhorrent out-of-pocket costs to veterans.

The committee also recognized the need to protect vital specialty services. These were not included in the President's budget.

Can you believe we are not going to fund the long-term care needs of the veteran population which is aging in place and which will have increasing demands for either community-based services or institutional care as they are unable to be fully independent?

It also would substantially reduce mental health services to a population which as it ages encounters increasing and more severe mental health problems.

It is insulting to laud this budget but continue to bar veterans from the VA health care they have earned by their service.

It is unfair to double prescription drug copayments for other veterans so some veterans can have their increased costs paid through that means rather than through the appropriations to the Veterans Administration.

This is nothing short of hypocrisy to deliberately reduce demand for health care services and count that reduction in demand as if it were savings.

Mr. GRAHAM of Florida. No. I will yield when I complete my remarks, which will be soon.

The amendment my colleagues and I are debating today would provide the VA with the $1.8 million which is necessary to keep the current services in place and would also provide the funds to meet the cost of these wounded returning American service men and women like John so we will be able to honor the commitment we have made to him. It will also provide the funds to continue to meet our long-term care and mental health needs.

These numbers were not derived out of smoke. These numbers were derived by an independent budget committee. This is a committee made up of representatives of all the major veterans organizations looking at what is the realistic cost of providing appropriate service. This consortium of veterans organizations has set the bar as well as to how much VA needs will be to treat their patients.

This administration has made the war in Iraq and Afghanistan a priority, appropriately so. But at the same time, this administration does not want to provide the resources to meet the health care needs of returning combatants. This war will create a new generation of veterans, and this budget fails to take that into account.

This budget has the potential of creating a conflict between generations of veterans. It is asking the current veterans assume a further dilution in their medical services so the newly returning injured combatants will be able to receive the care for which they have been promised.

It is up to us in the Congress to see service members and veterans alike receive the benefits they have earned. We can do no less than to meet our duty to their patriotic service.

Thank you, Madam President. I would be glad to yield to the Senator from Oklahoma.

Mr. NICKLES. Madam President, I wanted to clarify. I heard my colleague say increase in copays. You are aware, I am sure, under the resolution we are not assuming any increase in copay for categories 7 or 8, and we are also not assuming the $250 deductible.

Mr. GRAHAM of Florida. Does that mean the budget is even more out of balance in terms of providing services than the one the President submitted which would have had those increases in out-of-pocket costs?

Mr. NICKLES. I thought I heard my colleague say you were opposed to these increase in copays. I was trying to make sure you are aware we did not assume an increase. We did not have that in our budget. I wanted to make sure you knew that. If you didn't, I will read it to you. It says the committee resolution does not assume the President's proposal to establish a new $250 enrollment fee for priority 7 or 8 veterans or to increase the insurance for prescription drug copayment for priority 7 and 8 veterans from $7 to $15. That is not in our resolution. I wanted to make sure you knew that.

Mr. GRAHAM of Florida. Does the resolution, therefore, contain the funds from appropriate sources to offset that which would have been raised had the President's recommendation of the prescription drug copayment increased and the enrollment fee been enacted?

Mr. NICKLES. Madam President, I want to remind our colleague to go through the Chair. I warned other people. I think I need to do that.

Our resolution, to answer my colleague's question, has a $1.4 billion increase in VA care. It assumes an increase in VA-and it is mandatory-from $61 billion to $70 billion-a 14.3 percent increase, so my colleague will know.

Mr. GRAHAM of Florida. My question was not what the totality is, but since the President assumed a substantial additional revenue source for the VA through these enrollment fees and increased copayments, how does the budget resolution propose to fund those items or to provide the replacement revenue that would come from those two items?