Videos & Speeches

CHOICE Act

Mr. President, I am on the floor today to speak about an issue that I spoke about just a few days ago, the CHOICE Act.

Let me take my colleagues back in history just a few months, just to last year. I don't imagine any of us don't remember the scandal the Department of Veterans Affairs was facing--the stories across the country of fake waiting lists, of services not provided, of the potential death of veterans while waiting for those services to occur. I also would think that at least many of my colleagues would agree that for much of the past few years the Senate hasn't done much of the business it was designed to do and that needed to be done in our country.

But I remember a day in August of 2014 in which the Senate and the House of Representatives were successful in passing a bill. It is somewhat embarrassing to me to be on the floor praising the accomplishment of a bill passage. It is a significant part of what should be the normal course of business of the Senate.

But those of us--and I would put all of my colleagues in this category who care about the service men and women who sacrificed for the benefit of their fellow countrymen and came home to a Department of Veterans Affairs that failed to meet their needs. I have indicated that since I came to Congress, both in the House and the Senate, I have served on the Veterans' Affairs Committee. This is an issue that we need to make certain we get right.

Just this week, in fact this morning, we passed a piece of legislation, the Clay Hunt Suicide Prevention for American Veterans Act. That is an accomplishment. I remember the testimony of the two mothers in the Veterans' Affairs Committee who came to talk to us about the importance of this legislation, their experience as mothers, and the death of their sons by suicide.

In the time that I have been in Congress, it is among the most compelling testimony I have ever heard. The part that sticks with me the most is the belief by these two mothers that had the Department of Veterans Affairs done their work, their sons would be alive. What that tells me is the decisions we make and those decisions as implemented by the Department of Veterans Affairs in some cases--in fact in many cases--are a matter of life and death.

We saw the scandal that came about last year. We know the decisions we make have huge consequences on veterans and their families. We rejoiced—at least I did--in the passage of the CHOICE Act, which gave veterans the opportunity to choose VA services, to choose health care to be provided in their hometowns by their hometown physicians and doctors.

The criteria that is set out in the CHOICE Act for that to occur is pretty straightforward. It says if you live more than 40 miles from a VA facility, you are entitled to have the VA provide the services at home, if that is what you want. It says that if those services can't be provided within 30 days of the time you need those services, then the VA shall provide those services at home if you choose. You can see the hospital, you can be admitted to the hospital of your choice, and you can be seen by the doctor of your choice.

That was actually something to rejoice about, to be excited about--that this Congress and this Senate came together and passed what I know to be a very significant and important piece of legislation. It is important for the reasons that common sense tells us it is important--that a veteran who lives a long way from a VA hospital or a VA facility can now get services at home. A veteran who had to wait in line for too long could now get those services at home.

The other aspect of that is that the Department of Veterans Affairs has told us time and again about the inability to attract and retain the necessary health care providers, the doctors and others who provide services to our veterans.

So one way to improve that circumstance is to allow other health care providers, those in your hometown, to provide that service.

The CHOICE Act was a good measure for the Department of Veterans Affairs to meet its mandate to care for our veterans, and the CHOICE Act was a good measure for veterans who live long distances from a VA facility, especially in states such as mine and the Presiding Officer's, where it is a long way to a VA facility.

So I remember the moment in which that bill passed and was sent to the President. Finally something good has come. A bill has been passed. Something important to our veterans is occurring.

But the reality is the implementation of the CHOICE Act has created many problems and, in my view, the Department of Veterans Affairs is finding ways to make that implementation not advantageous to the veteran but self-serving to the Department.

This is what catches my attention today. We are reviewing the President's budget, and within that budget is this language:

In the coming months, the Administration will submit legislation to reallocate a portion of Veterans Choice Program funding to support essential investments in VA system priorities in a fiscally responsible, budget-neutral manner.

What the President's budget is telling us is that there is excess money within the CHOICE Act. We allocated money--emergency spending--to fund the CHOICE Act, and the President's budget is telling us: Well, we think there is too much money in there. We are going to submit legislation to reallocate that money to something we think is a higher priority.

I don't expect many of my colleagues to remember, but I was on the Senate floor last week talking about a specific problem in the implementation of the CHOICE Act, and it was this: The Department of Veterans Affairs shall provide services at home to a veteran who lives more than 40 miles from a facility.

Well, the problem I described last week is that the VA has determined that if there is an outpatient clinic within that 40 miles, even though it doesn't provide the services that the veteran needs, that veteran, he or she, must drive to the VA, wherever that is located, and does not qualify for the at-home services.

Does this make any sense to any of us, that the VA says: Oh, there is an outpatient clinic within 40 miles of you, Mr. Veteran? Even though it doesn't provide the service that you need, we are still going to require you to drive to a VA hospital to receive those services and you don't qualify to go see your hometown doctor or be admitted to your hometown hospital.

Who would think--in fact, I admired Secretary McDonald in his early days at the Department in which he talked about how the VA is going to serve the veteran: The decisions we make at the VA will be directed at how do we best care for our veterans.

I respect Secretary McDonald for that attitude and approach, and I want the Department to follow his lead in accomplishing that mission.

But clearly deciding that a facility, even though it can't provide the service you need, precludes you from getting services at home makes no sense, and it certainly doesn't put the veteran at the forefront of what is in the best interest of a veteran.

So why would the Department of Veterans Affairs make that decision? We have a facility within 40 miles, but you don't qualify. So drive 3 or 4 hours to the VA hospital.

Well, one might think they have made the decision that we are going to enforce that aspect of the CHOICE Act. We are going to enforce the idea that you don't qualify because they don't have enough money to pay for those services. But, lo and behold, the President's budget says there is excess money that we now want to transfer to other priorities.

So, clearly, it is not funding issues. The Department is making decisions for some reason that makes absolutely no sense, defies common sense, and certainly doesn't put the veteran ahead of the Department of Veterans Affairs.

I don't know what the story is that these kinds of decisions would be made, but it certainly is worthy of the Senate to make certain the Department implements its moment of triumph, the CHOICE Act, in a way that benefits those we intended for the legislation to serve.