Comprehensive Veterans Health and Benefits and Military Retirement Pay Restoration Act of 2014

Floor Speech

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Madam President, every Veterans Day and every Memorial Day many of us, regardless of our political views, go out into our communities and we speak about our respect and admiration for the veterans of this country. As chairman of the Senate Committee on Veterans' Affairs for the last year, I have learned that regardless of political ideology, virtually all Members of the Congress in fact mean what they say and do understand and do appreciate the enormous sacrifices veterans and their families--and their families--have made for our Nation.

Sadly, everybody in this country knows we are living at a time when the Congress is virtually dysfunctional and partisanship runs rampant. But I have found on my committee and in the Congress as a whole that Members do understand the sacrifices made by the men and women who put their lives on the line and do, although we have differences of opinion, want to do the right thing to defend those who have defended us.

The good news is that President Obama and the Congress, in a bipartisan way, have made significant progress in addressing a number of the problems facing veterans in this country. The President's budgets have been generous and I think Congress has acted in a responsible way.
That is the good news. But the bad news is that we still have a very long way to go if we are to keep faith with those who have put their lives on the line to defend us. We have made progress, but we still have a long way to go. I hope very much that we will go down that road together and we will tell the American people that in the midst of all of the partisanship, all of the politics, at least on this one issue we can stand together and protect the interests of those people who have sacrificed so much for our country.

Congress cannot bring back to their families those who died in battle. As the Presiding Officer knows, just in the recent wars in Iraq and Afghanistan, we have lost over 6,700 troops. Congress cannot restore the legs and the arms and the eyesight that roadside explosions have taken away from brave men and women. Congress cannot simply snap its fingers and magically cure the hundreds of thousands who returned from Iraq and Afghanistan with post-traumatic stress disorder or traumatic brain injury or those who suffer from the pain and humiliation of sexual assault. As a nation, however, while we cannot magically solve those problems, we can in fact--and it is our responsibility, in fact--do everything we can to help ease and ameliorate the problems facing our veterans and their families. We can't solve it all--we know that--but we can go further in ameliorating some of the problems facing veterans and their families.

I will give my colleagues a few examples. Congress can help the 2,300 men and women who were looking forward to having families but who suffered reproductive injuries in Iraq and Afghanistan. I believe Senator Murray will come to the floor. She has long been a champion of this issue, as have been others. Let me give my colleagues one case out of 2,300: Army veteran Matt Keil of Colorado was wounded by sniper fire in Iraq in 2007. The sniper's round struck Matt's neck, causing severe damage to a vital artery and his spinal cord. Through sheer determination and with the love and resolve of his wife Tracy, Matt's condition improved. He and Tracy began to consider having children. Doctors assured them that having children could be possible with the help of in vitro fertilization. The Keil family paid more than $30,000 for reproductive treatments. Congress can help the Keil family and others to ease that financial burden. That is a cost of war. We should be there for that family and for the other families who want the opportunity to have children.

Congress can help the tens of thousands of family members who every single day provide loving care for those who were severely injured in World War II, in Korea, in Vietnam, and in other wars. Let me give my colleagues another example.

In March of 1969, Miles Epling was on patrol in Vietnam when a booby trap detonated, killing some of his fellow marines and leaving him without legs. He returned home to West Virginia in a wheelchair. From that point on, he has required around-the-clock help from those around him. His family provided that help without receiving any training, any assistance or any financial support.

Here is the very good news--and we should be very proud of this, in a bipartisan way, as a Congress: In 2010, 4 years ago, Congress passed a very strong and excellent caregivers program for post-9/11 veterans. It is a program that is working well in providing significant help to caregivers of those post-9/11 veterans. I want everybody to put themselves in the place of a wife or sister or mother or brother who around the clock--around the clock, 24/7, 365 days a year--is providing care to folks who have suffered serious injuries in one war or another. We provided support for those caregivers post-9/11, for Iraq and Afghanistan, but we did not do that for the other wars. Now is the time for us to expand the caregivers program for the families of all disabled veterans who are in the same position that Miles is in. That is the fair thing to do, that is the right thing to do, and that is included in this comprehensive piece of legislation.

Because we have the moral obligation to do the very best we can for veterans, the Senate Veterans' Affairs Committee has brought forth comprehensive legislation that is strongly supported by virtually every veteran and military organization in the country. Today I thank the American Legion, the Veterans of Foreign Wars, the Disabled American Veterans, the Vietnam Veterans of America, the Military Officers Association of America, the Iraq and Afghanistan Veterans of America, the Paralyzed Veterans of America, the Gold Star Wives of America, and the dozens of other veterans organizations that are strongly supporting this comprehensive piece of legislation.

In their statement of support, the DAV writes:

This massive omnibus bill--

That is the bill that is going to be on the floor in a short period of time. The DAV writes:

This massive omnibus bill, unprecedented in our modern experience, would create, expand, advance, and extend a number of VA benefits, services and programs that are important to DAV and to our members. For example, responding to a call from DAV as a leading veterans organization, it would create a comprehensive family caregiver support program for all generations of severely wounded, injured and ill veterans. Also, the bill would authorize advance appropriations for VA's mandatory funding accounts to ensure that in any government shutdown environment in the future, veterans benefits payments would not be delayed or put in jeopardy. This measure also would provide additional financial support to survivors of servicemembers who die in the line of duty, as well as expanded access for them to GI Bill educational benefits. A two-plus year stalemate in VA's authority to lease facilities for health care treatment and other purposes would be solved by this bill. These are but a few--

``A few''--

of the myriad provisions of this bill that would improve the lives, health, and prospects of veterans--especially the wounded, injured and ill--and their loved ones.

That is from the Disabled American Veterans. I thank them very much for their support. The truth is that we have letters of support that are similar in nature from dozens of other veterans organizations, and we thank them again for their support.

Madam President, may I ask the time situation--how much time each side has and how much time is remaining?

The PRESIDING OFFICER. The majority has 24 minutes remaining of the 35 minutes originally granted, and the minority has 35 minutes.

Mr. SANDERS. Very good.

What I would like to do now is yield to the former chairperson of the Veterans' Affairs Committee, somebody who has done an outstanding job for veterans. She has focused on one issue that I feel very strongly about; that is, the need to help those veterans who would like to have children but as a result of war wounds are unable to do so.

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I will very briefly touch on some of the other provisions in the bill.

We restore full COLA for military retirees. As we all know, the House and the Senate passed and the President signed the bill to undo the provision in the Budget Act, but they did not include those members of the military who signed up after January 2014. They are still suffering from a cut in the COLA. We address that.

This bill does expand VA health care and among other ways it provides dental care. I don't know about other States, but in my State--and I suspect all over this country--in talking to veterans, they think dental care is part of health care. Right now, except for service-connected situations, dental care is not provided. We have a major pilot project to say to veterans: Yes, dental care is part of VA health care and you can get that.

As to advanced appropriations for the VA, not everybody knows this, but we were 7 to 10 days away from disabled veterans not getting their checks when the government was shut down. This legislation ensures veterans receive consistent access to the benefits they have earned by establishing advanced appropriations for the mandatory accounts at VA.

We move forward in a bipartisan way to end the benefits backlog. My colleague from North Carolina pointed out it is a serious issue. Everybody agrees it is a serious issue. I think the VA is making some progress. This legislation has significant language to help the VA move forward in that area.

This legislation would extend from 5 years to 10 years unfettered access to VA health care for recently separated veterans to address their health care needs early.

This legislation renews our vow to hire veterans, making sure veterans get the employment opportunities many are now lacking when they come back from Iraq and Afghanistan.

This legislation deals in a significant way with the horrendous issue of sexual assault, making sure victims of sexual assault--women and men--get the care they need at the VA.

I will conclude by saying this is a serious bill which deals with a very serious issue. My hope is every Member treats the needs of veterans with the respect they deserve. I look forward to the debate which I am confident we will have.

Clearly, this is not a perfect bill, and I know there are Members who have ideas as to how they can improve it. This is what the legislative process is about. My sincere hope, however, is amendments which are brought forth deal with veterans issues and not amendments which are not relevant and not germane to this discussion.

The PRESIDING OFFICER. The Senator's time has expired.

Mr. SANDERS. I ask unanimous consent for an additional 30 seconds.

The PRESIDING OFFICER. Without objection, it is so ordered.

Mr. SANDERS. The ranking member and I have disagreements, and that is what the legislative process is about. Let's debate the issues on the floor.

I hope we show our respect to the veterans by not getting into issues that have nothing to do with veterans' needs. I hope we are not off debating Iran or ObamaCare or gay marriage or whatever it may be. I guess those are good political issues for some people. I hope people understand how significant and important the issue itself is--the needs of our veterans--and we stay focused on that issue as we bring forth amendments.

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Mr. President, I look forward to discussing in the next several days the issues Senator Coburn raised, but I did want to make one clarification, and I hope the Senator is listening. He repeatedly indicated this legislation opens the door to every one of the 22 million veterans in America, and then proceeded to say that once you open the door, you are going to have inadequate care because we don't have the resources to take care of 22 million veterans. That simply is inaccurate and that is not in the legislation.

There is nothing in the legislation that says we open the door to every veteran in America regardless of income. So when people talk about the VA suddenly being flooded by veterans and care being diminished because of the huge increase into the system, that is just not true.

What is true? What is true right now is we have an absurd and complicated income eligibility system throughout this country. What happens in the State of Vermont or the State of California--one's eligibility for the VA, if you are a priority 8--is different and dependent upon the county in which you live. So in Vermont, you can be living in a county where if your income level is $45,000 a year you are eligible for VA health care, but in a county where the line is drawn just across the street, you may not be eligible. In States such as California or Georgia, which have many, many, many counties, you have the absurd situation where a person living on one side of the street is eligible for VA health care, but the person living on the other side of the street is not eligible for VA health care.

This is totally absurd, and we end up having hundreds and hundreds and hundreds of different income eligibility standards. So what this legislation does is not open the door--and I hope my Republican colleagues will not continue to say it because it is not true--but it does say that in a State where you have different income eligibility standards based on counties, what we will do is have one income eligibility standard per State, that being the highest level. So we will have 50 different standards--50 different standards for 50 different States--not have hundreds and hundreds and hundreds of different standards. In every State there will be an income eligibility level, but it will not open the door for health care to 22 million veterans.

Second of all, we were very careful in this legislation to say, if a veteran who, under this bill, would be eligible for VA health care, a veteran who can newly access VA health care, we absolutely have to have the medical infrastructure available so that all veterans will get the quality care they need; so that new veterans coming in will not diminish service for other veterans. In this bill we make clear--and we made this clear in our long discussion with the Disabled American Veterans--the priority for the VA remains those veterans who are injured in action, those veterans who need that care. That is the highest priority that we establish.

So when people say we are opening the door to all veterans, care is going to be diminished, that simply is not true. That is not what the bill says.

Thirdly, let me reiterate some of the provisions in this bill, because before we vote on final passage--and, by the way, I want to take this opportunity to thank every Member of the Senate for voting to proceed. I think it is time we had some very serious debate about VA health care, and now is the time to do it. But let me reiterate a point I made earlier. Senator Coburn raised important issues, Senator Burr before him raised important issues, and we should debate those issues. But in all due respect for the veterans of this country, who have sacrificed so much, let us not politicize this debate on veterans issues by bringing in sanctions against Iran or let us not bring in ObamaCare, let us not bring in the dozens of other issues that are out there. Let us debate this issue on its merits. Let us bring forth amendments which deal with veterans issues.

Senator Coburn and Senator Burr have amendments which deal with veterans issues. I welcome those amendments. Let us have those debates. Nobody ever suggested this bill is perfect. There are a lot of Senators out there, Democrats and Republicans, who have ideas about how we can improve the services and the programs we provide to veterans. I welcome those ideas. But do not destroy this legislation by politicizing it, by doing what we have done month after month, year after year, which is why the American people have so much contempt for what goes on in Congress. Let us focus on veterans issues.

We have differences of opinion. Let us debate those issues. Let us not bring in extraneous matters, poison pills, which will give people a reason to vote against this bill. Let us debate veterans issues.

Let me talk about some of the issues in this bill that my Republican colleagues did not talk about. No. 1, I am proud--I hope we are all proud--that recently we made sure the promises made to military retirees were kept, that we rescinded the 1-percent COLA decrease that was in the bipartisan budget agreement. But we did not go far enough. Men and women who are joining the military after January 2014 are still subject to that decrease in COLA.

Are we in favor of keeping promises to all veterans, including the new members of the Armed Forces or are we not? Let us debate that issue. I believe that we keep our promises to all veterans. That is in the bill. If people want to oppose that, they have the right to oppose that.

We have heard in several instances that the VA does not have the medical infrastructure to take care of the needs of veterans, and that is true. That is why in this bill we authorize the VA to enter into 27 major medical facility leases in 18 States and in Puerto Rico--18 States and Puerto Rico.

So don't come forward and say ``gee, VA does not have the infrastructure to take care of veterans needs'' but then vote against a provision that significantly expands VA health care capabilities. I talked a moment ago about what we mean by expanding VA health care. We do away with the absurdly complicated bureaucratic situation that now exists in which there are hundreds of different income eligibility standards in the 50 States of the country. We reduce it to 50. In California or Vermont, you will know whether you are eligible for health care as a Priority 8 veteran.

Does it open the opportunity for more veterans to come into VA health care? It does. The reason is because VA provides good-quality health care to our veterans, which is why the veterans throughout this country whom I have talked to and in patient satisfaction surveys approve and are supportive of VA health care. More want to come into the system.

We heard just how terrible and awful VA health care is, and then we heard: We don't want to open the doors because it is going to be flooded with new people coming into VA health care. You can't have it both ways. If VA health care is so terrible, why are you afraid of new people coming into VA health care? The answer is that if you go out to the veterans community, they will tell you: Yeah, there are problems in VA. But there are problems in every health care institution in this country. Over 30,000 Americans die every single year because they don't get to the doctor when they should because they don't have health care. I don't want any veterans to be part of that number.

Hospitals all over this country are struggling with an epidemic of infections. The VA has done better than many other medical institutions in addressing that.

In terms of telehealth--which is so important to veterans in my rural State and in rural States all over the country--guess which medical institution is leading the country in terms of telehealth. It is the Veterans' Administration. That means a veteran can walk into a VA community-based outreach clinic in rural West Virginia and have a teleconference with a specialist in any other part of the country. VA has been cutting-edge in terms of telehealth.

We talk about medical technology and medical health care records. Guess which health care institution in America has led the effort in terms of medical and health care technology. It has been the VA.

So I find it interesting that on one hand some of my colleagues tell us how terrible VA health care is, and on the other hand they are nervous that hundreds of thousands of veterans may want to access VA health care because, in fact, it is one of the best health care institutions in the country.

Does VA have problems? Of course it has problems. I am not aware of any health care institution in America that does not have its share of problems. The difference between the VA and many private or nonprofit hospitals is--and it should be this way--by law, every problem at the VA makes it to the front pages. My guess is that if a hospital in West Virginia or Vermont screws up, they don't necessarily make it to the front pages. Because VA is public and by law they have to be transparent, they are on the front pages.

In terms of advanced appropriations for VA, my friends on the other side have a bit of a problem with that. I don't. I find it interesting that when our Republican colleagues in the House shut down the U.S. Government because they don't like and wanted to defund ObamaCare, we were 7 days to 10 days away from preventing disabled veterans from getting the checks they need in order to survive. So I believe advanced funding for the VA to make sure that they are never put in that position again, that there is money in the bank to pay the benefits we owe to our veterans in the event of another government shutdown, is good public policy.

As I mentioned earlier, when we talk about health care, in my view, we have to talk about dental care as well. If people do not have adequate dental care, it impacts their employability, say if they are missing front teeth. People get sick from infections if they don't have adequate dental care. I think we owe it to our veterans to make sure they do.

This legislation provides a pilot project for 30,000 veterans to begin to access dental care within the VA. We will see how that pilot goes. I suspect we are going to see a huge need out there. And if some of my colleagues think veterans are not entitled to dental care, then we have a difference of opinion. That is fine. Let's debate it. But I think dental care is an intrinsic part of health care in general. I think we have a dental care crisis in the United States of America and within the dental community. Right now dental care is available to those veterans who have suffered service-connected dental problems but not available to veterans in general. I want to change that.

I have heard the discussion about the backlog. Every Member of the Senate is concerned about the backlog. We have had hearings in the Senate about the backlog. I am really glad that today people are concerned about the backlog. I just wonder where they were 5 years ago when--before Obama became President--the VA was probably the largest institution in this Nation, if not the world, that still did all of its benefits processing work on paper, not digitally.

When Secretary Shinseki became Secretary of the VA, he said: We are going to bring the VA into the 21st century. We are going to go from paper to digital, to an electronic system.

That is what they have been doing, and what we have seen is real progress. Is it fast enough for me? No, it is not. But Secretary Shinseki has told me personally and our committee that they are on track, so by the end of 2014 all VA claims will be processed within 120 days with 98 percent accuracy. That is pretty good. Just think for a moment what a huge task that is. Individual veteran files wider than this, with years and years of records, have to be put into a digital system. That is what they are doing, and they are making progress. In this legislation, we have brought forth Republican and Democrat ideas to make sure that they are, in fact, on target and that they reach the very ambitious goals Secretary Shinseki brought forth.

So if you are interested in the claims backlog, vote for this legislation because we have bipartisan language in it to make sure veterans do not have to wait years to get their claims processed.

My friend from Oklahoma said he is not sympathetic to the idea that veterans should pay instate tuition, which is essentially what we meant when we passed the post-9/11 GI educational bill. Every time we bring forth legislation, we hear all of the reasons why we should not go forward in providing services and benefits to our veterans.

I would argue--and many economists would agree with me--that one of the most significant pieces of legislation passed in the modern history of the United States of America was the GI bill of World War II. That bill said to the millions of people who fought in World War II, in that terrible war: When you come home, no matter what your income is, you will be eligible to get a higher education. As a result of that legislation, millions of soldiers who returned were able to go to college. They became businessmen, they became doctors, they became lawyers. And one of the reasons the economy of the United States of America expanded significantly for the middle class was a direct result of that very important GI bill.

What we said several years ago was that we should take that premise and apply it to the men and women who served post-9/11 in Iraq and Afghanistan. It was quite a political debate here. Some of my Republican friends had their doubts. We passed it, and today over 1 million veterans and their family members are now getting a college education. In my view, that was exactly the right thing to do.

One of the problems is that veterans move about. So if they go from the State where they have lived their whole life--for example, they lived in Vermont and go to California--and the GI bill promises them instate tuition, it turns out the tuition in the State they are in now may be a lot higher than in their home State and sometimes makes it impossible for them to go to college.

We agree with virtually all the veterans organizations that the intent of the post-9/11 GI education bill was to make sure they get instate tuition. So if somebody from California comes to Vermont, they get our instate tuition. If somebody from Vermont goes to California, they get their instate tuition. Not doing so denies many people a higher education.

Previously, this Congress passed language which says that if you served in Iraq and Afghanistan, you are going to get 5 years of free health care, which was the right thing to do. It turns out not everybody learned about the benefit. Four or five years have come and gone. What we say to those veterans is, we are going to give you another 5 years to take advantage of that provision.

Senator Murray from Washington--the former chair of the Veterans' Affairs Committee who preceded me--and Senator Reid earlier today talked about the employment situation for veterans. I think we all know we are in a tough economy. Real unemployment is close to 13 percent. Youth unemployment is higher. So when somebody who gets out of the service and comes home to look for a job--it is hard to do.

I believe we have to do what we can to make sure that when people leave the service they can find a job. That is what this legislation does. We also want to make sure the skills acquired by the men and women of our Armed Forces while on Active Duty or in the National Guard become applicable to civilian life as well, and we have language in this bill that does that.

There is another issue which I didn't hear my Republican colleagues talking about but which is a very important part of the bill. We have a situation where some 2,300 veterans who served in Iraq and Afghanistan have come back with a variety of wounds that make it impossible for them to have children. I will give one example.

Army veteran Matt Keil of Colorado was wounded by sniper fire in Iraq in 2007. The sniper's round struck Matt's neck, causing severe damage to a vital artery and his spinal cord. Through sheer determination and with the love and resolve of his wife Tracy, Matt's condition improved. He and Tracy began to consider having children. Doctors assured them that having children could be possible with the help of in vitro fertilization. The Keil family paid more than $30,000 for reproductive treatments.

In the legislation on the floor now, we say that is wrong. If a servicemember who was injured in war wants to have a family and is unable to have a family, we should make it possible for them to do so. If some of my colleagues on the other side disagree, that is fine. Let's have that debate.

I think we owe it to the 2,300 men and women who were wounded in battle. They should have the opportunity to raise a family.

We all know that one of the uglier aspects of military service in recent years has been the epidemic of sexual assault. When we send people into the military, we do not want to see men and women being sexually assaulted. I know the Department of Defense is working hard to address this issue, but the fact is that many veterans who came home from war were sexually assaulted. This legislation contains important provisions that would improve the delivery of care and benefits to veterans who experienced sexual trauma while serving in the military.

This provision was inspired by Ruth Moore. She struggled for 23 years to receive VA disability compensation. This is a woman who was sexually assaulted and had a very difficult time proving that and getting the care she needed. We address that issue in this legislation.

In 2010, the Congress took a very significant step forward in saying to family members who were caring for disabled vets that we understood how terribly difficult it is for them. There are wives, sisters, brothers, and other family members who, 7 days a week, 24 hours a day, are on call for veterans who have suffered serious injuries, and that is tough. That is very tough and stressful. There are wives and sisters and brothers out there who don't get any time off. They are on call 7 days a week.

We passed a caregivers act that provides a modest stipend. It provides training and time off for people who are caring for veterans 7 days a week. It says, you can have a day off. We will send in a nurse. We did that for post-9/11 veterans. The truth is there are tens of thousands of families who are experiencing and going through the same issues and have been doing so for decades. I believe it is appropriate that we expand the caregivers act to every generation of veterans and make sure that those families get the help they need.

I have heard some of my Republican colleagues say this legislation simply opens the door to every veteran in America to come in, and that when they come in, the quality of care is going to be diminished. That is simply an inaccurate statement, and I hope my colleagues read the legislation before they repeat that. It is not true. What we do is end the absurd and complicated situation of having hundreds and hundreds of different income eligibility standards. Instead of many hundreds of standards, there will be one in each State, and it will be the highest standard, which will mean that more veterans are able to come into VA health care. It does not open the door. We have been clear in saying we will not bring more veterans in until we make sure we have the infrastructure to deal with those veterans.

Some people have said: Well, why do you want to bring more veterans into the VA? The answer is pretty simple. I talked to many veterans in Vermont who would like to get into VA health care because of the respect and the knowledge about the needs of veterans and the high quality of care they get, and the fact that there is a strong network of primary health care facilities all over the country which they can access.

I will conclude for the moment by saying I very much appreciate the fact that every single Member of the Senate--I believe there were 99 votes--voted to proceed on this debate. I look forward to this debate. It is an important debate. I look forward to serious amendments which address the needs of veterans. I think it would be very disrespectful to the veterans community if we started injecting into this debate totally extraneous and highly political and partisan issues.

The issue of sanctions in Iran is a very important issue. People have honest differences of opinion. That is not an issue regarding VA health care. It is not an issue regarding the caregivers program. It is not an issue regarding dental care for our veterans.

Let's respect veterans and have this debate on veterans issues and not on extraneous political issues which will divide us. Let's try to come together and not be divided.

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