UNANIMOUS CONSENT REQUEST--S. 2168 -- (Senate - November 08, 2007)
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Mr. CRAIG. Mr. President, I wish to discuss my opposition to two bills reported by the Veterans' Affairs Committee, but I continue to hope we can resolve the concerns I will address today.
Unanimous consent has been sought to pass two controversial bills: S. 1233, the Veterans Traumatic Brain Injury and Health Programs Improvement Act, and S. 1315, the Veterans Benefits Enhancement Act. Although both bills are well-intended, they contain unacceptable provisions that I believe would be detrimental to the care our returning wounded warriors deserve and currently receive at VA facilities. At the very least, these provisions are controversial enough to merit considerable floor debate, and therefore I have no alternative but to oppose the unanimous consent agreement.
In the past, the Veterans' Affairs Committee has worked in a bipartisan fashion to settle differences at the committee level and avoid taking up Senate floor time to debate and amend significant veterans legislation. Unfortunately, that is not the case with S. 1233 and S. 1315. Even so, I do not want to close the door on these bills because each has numerous provisions that I support or have sponsored in the past. Both bills contain provisions to enhance the care our veterans receive, and I believe that if we can return to the negotiating table, we can find an acceptable solution to both my concerns and the concerns of my colleagues.
I would like to address these two bills separately because they clearly raise different issues. S. 1315, the Veterans Benefits Enhancement Act, contains a number of important provisions that will enhance benefits and services for America's combat veterans returning from the war in Iraq and the global war on terror and for all veterans with service-connected disabilities.
Among those provisions that I believe are important and responsible for us to provide our veterans are retroactive payments under the traumatic injury protection program of Servicemembers' Group Life Insurance for those injured outside of Operation Iraqi Freedom or Operation Enduring Freedom theaters of operation between October 7, 2001, and December 1, 2005. This will ensure that soldiers injured on their way to fight in OIF or OEF, but not in the theater of combat, are eligible for these benefits.
Other provisions in this bill will expand the housing grant assistance program available to those with severe burn injuries--injuries that are a sad and terrible reality of our current conflict. We must continue to adapt and modify the benefits our veterans receive based on the changing environment in which our soldiers fight; these provisions are a great example of our ability to do so.
However, there is a section within this bill that I vigorously oppose. In fact, this provision is the sole reason for my unwillingness to support the bill, and I would like to
explain it here today. Included in S. 1315 is a section that would expand benefits to certain Filipino veterans residing both in the United States and abroad. I have supported, and continue to support, improving benefits for Filipino veterans who fought under U.S. command during World War II. However, I believe that the approach taken in this section with respect to special pension benefits for non-U.S. citizens and non-U.S. resident Filipino veterans and surviving spouses goes beyond the intent of veterans benefits. Further, I do not believe such a provision would have the support of the American people.
Let me explain.
Pension benefits for veterans in the United States are paid at a maximum annual rate of $10,929 for those with no dependents, $14,313 for those with dependents, and $7,329 for a surviving spouse. The maximum VA pension represents somewhere between 16 percent and 31 percent of the annual U.S. household income of $46,000. Contrast that with the average Philippines household income of $2,800. The special pension for Filipino veterans in S. 1315 would amount to an astounding 86 percent to 161 percent of the Philippines household income.
This legislation did not take into account the vast discrepancy between the standard of living in the United States and the Philippines. By refusing to look at the purchasing power of the benefits being provided here, this legislation would pay veterans in the Philippines far more in benefits and pension than we pay our own veterans. It is especially ironic that a bill intending to treat Filipino veterans equitably would create such a dramatic inequity for our U.S. veterans.
Furthermore, the offset that S. 1315 uses to ensure that the bill is in compliance with congressional budget rules would have the effect of reducing pension amounts to elderly, poor, and disabled veterans predominantly residing in the United States. I acknowledge there is considerable agreement that these extra payments for certain categories of veterans were never contemplated by Congress and, therefore, are not justified. However, if presented with the choice of using the savings from eliminating these payments to provide extra pension assistance to low-income veterans in the United States or to underwrite the kind of special benefit I described earlier, I believe the American people would choose to take care of our own veterans' pensions first--and when providing benefits to the Filipino veterans, they would insist that those benefits are adjusted to reflect the real differences in costs of living between our two countries.
The other bill I would like to address today is S. 1233, the Veterans Traumatic Brain Injury and Health Programs Improvement Act. I was originally a cosponsor of this legislation and would very much like to see it move forward and be signed into law. However, there are a few provisions that are premature, considering the current capacity of our VA medical facilities, and I hope my colleagues will agree these provisions should be deferred to a later date.
The provisions I must regrettably oppose at this time are the proposed admittance of Priority 8 and Priority 4 veterans into the VA health system. To ensure VA can meet our Nation's obligation to veterans with combat or military-related disabilities, lower income veterans, and those needing specialized care like veterans who are blind or have spinal cord injuries--to ensure appropriate care for these veterans, former VA Secretary Anthony Principi suspended additional enrollments for veterans with the lowest statutory priority. This category includes veterans who are not being compensated for a military-related disability and who have higher incomes.
It has become very clear, especially over the last few years, that servicemembers returning from Iraq and Afghanistan are enduring lengthy waiting times for care. In the face of such assessments, I do not understand why we should be in a rush to open up the health care system to hundreds of thousands--if not millions--of new patients who by definition are not in need of immediate assistance or can afford private health care.
Moreover, it appears that the provision in this bill would open VA to new enrollees on the day the legislation is signed into law. Yet no plan is required to ensure that the enrollment process would be orderly and executed so as to minimize impacts on current patients, nor is there any requirement that the necessary funding be available prior to its implementation. Instead, VA would simply open the doors and wait to see who arrives. I believe that is irresponsible and unfair to the current enrollees who are in most need of care.
We should forgo opening up the VA health care system until such a time as the Secretary of the VA can certify that troops returning from Iraq and Afghanistan are being provided timely, high-quality health care and neither timeliness nor quality would suffer because of newer enrollees, such as Priority 8 veterans. VA's health care system was created primarily to care for ``he who shall have borne the battle.'' Congress should ensure that this unique group of veterans is not unduly burdened by any new influx of higher income veterans with no military-related disabilities.
Some Senators may contend that money can overcome any obstacle to providing all veterans with health care through VA. However, since any money provided for new patients would be used to acquire new staff, new equipment, and new space, it is important to know if those resources are even available.
Let's first consider where VA will find the new staff needed to care for the huge influx of patients this legislation proposes. It is widely known that our Nation has a shortage of primary care physicians and nurses to provide basic health care services in non-VA facilities. This issue was made clear in a July 2007 report from the Health Research Institute of Pricewater-houseCoopers which showed that the United States will be short nearly 1 million nurses and 24,000 physicians by 2020. In this environment, simply finding new staff to hire will be a challenge for any health care system, including VA.
Further, assuming the requisite staff can be found, I am skeptical that VA has the necessary clinical space in which to provide more primary and specialty care services. I am also skeptical that many VA facilities could open the additional operating rooms, postsurgical recovery units, and intensive care units that would be required with a large increase in patients.
Last, the Congressional Budget Office has scored this legislation at $1.3 billion for the first year of inclusion of just Priority 8s into the system, or $8.8 billion from 2008 to 2012. However, it must be noted that CBO assumed Priority 8s would only be allowed to enroll in the system for 1 year, after which enrollment would be closed. Based on past experience, it is highly unlikely that Congress will maintain such a 1-year limit and virtually certain the costs would continue to rise above and beyond what CBO projected for implementation of this legislation.
When the VA health care system can support a substantial increase in patients, I will be more than happy to address this issue with my colleagues. However, at this point, when even our returning wounded warriors are forced to sit in long waiting lines to receive care, it would be grossly irresponsible for us to move forward with this legislation, and I must therefore continue to object to its passage.
The underlying legislation also contains a provision waiving required inpatient care copayments for Priority 4 veterans with higher incomes. I have concerns with this provision as well.
The passage of this provision would change VA's policy of charging a copayment for the care of a nonservice-connected condition, to allow an exception for circumstances that have nothing to do with a veteran's ability to pay. A grateful Nation has seen fit to provide cost-free care for service-connected conditions and has generously extended the same benefit to those with limited financial resources. However, with this provision, it would no longer be relevant whether veterans could afford to contribute even modestly to the cost of their care. Rather, cost-free care would be provided to a population of patients based solely on a particular health condition. That is a bad precedent.
If this legislation passes, I believe that in the not too distant future, it will be strongly argued by higher income, service-connected veterans that their benefit--cost-free care for service-connected conditions--has been diluted. And the dilution is not fair because now they would be charged for nonservice-connected care, while those with similar economic means in Priority 4 would not be forced to make copayments for the same type of care. With this provision as precedent, a future Congress will be forced to concede to the dilution and its unfairness. Then they will probably be forced to accede to the change.
All that being said, I would like to make sure that my colleagues understand that while I am objecting to passage of these bills in their current form, I sincerely hope and believe that accommodations can be made so that we can pass these bills and get much needed improvements made to the VA health care and benefits systems. Both bills have very meaningful and well-intentioned provisions that I support; unfortunately, there are a few provisions that I believe are detrimental or simply unfair to our Nation's veterans, and for that reason I am here on the floor of the Senate explaining my reasons for objecting to passage of these bills.
I look forward to discussing with my colleagues ways that we can move these bills and reach a compromise that benefits our brave veterans.
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