H.R. 217, CHIP IN for Veterans Act; H.R. 1969, No Wrong Door for Veterans Act; H.R. 1971, Veterans Supporting Prosthetics Opportunities and Recreational Therapy (SPORT) Act; H.R. 1823, The VA Budget Accountability Act; H.R. 1107, The Protecting Veteran Access to Telemedicine Services Act; H.R. 1336, The Veterans National Traumatic Brain Injury Act; H.R. 658, To amend title 38, United States Code, to establish qualifications for the appointment of a person as a marriage and family therapist, qualified to provide clinical supervision, in the Veterans Health Administration; H.R. 1644, Copay Fairness for Veterans Act; and H.R. 1860, The Women Veterans Cancer Care Coordination Act.

Hospitals and Health Care

2025-03-25

Loading video...

Source: Congress.gov

Summary

The subcommittee convened for a markup session to consider several legislative proposals related to veterans' healthcare and Department of Veterans Affairs (VA) operations. The meeting involved discussions on various bills, proposed amendments, and ultimately resulted in forwarding multiple pieces of legislation to the full committee for further consideration.[ 00:19:48 ]

Themes

Consensus on Diverse Veteran Support Bills

The subcommittee favorably advanced a block of five bills, demonstrating bipartisan support for initiatives like the Copay Fairness for Veterans Act (H.R. 1644), which aims to eliminate preventive care copays for veterans, mirroring private insurance standards. Also included were H.R. 1860, focusing on improved cancer care coordination for women veterans, and H.R. 1107, which seeks to make permanent the flexibility for VA prescribers to issue controlled substances via telemedicine without an in-person exam. While concerns were noted regarding the VA's views on the telemedicine bill, members expressed overall support for the en bloc package.

Reauthorization and Reform of the Fox Grant Program

Discussion around H.R. 1969 centered on the reauthorization of the Fox Grant program, which provides vital mental health services to veterans.[ 00:26:51-00:27:57 ]

Citation requires full transcript

Sign in to continue

Sign in
 An amendment in the nature of a substitute (ANS) was proposed to reauthorize the program through 2026, allowing time for thoughtful reforms.[ 00:27:57-00:28:03 ]

Citation requires full transcript

Sign in to continue

Sign in
 However, Dr. Dexter raised significant concerns about the ANS, particularly its mandate for a single screening tool (Columbia Suicide Severity Rating Scale) to measure program success and the expanded eligibility for healthcare providers as grantees without clear guardrails. She argued against investing in programs without proven efficacy at the expense of direct VA care, warning against inefficient use of taxpayer dollars. Despite these concerns, the ANS passed.

VA Budget Accountability

H.R. 1823, the VA Budget Accountability Act, garnered support for its goal of increasing transparency and accountability in the VA's financial management.[ 00:31:03-00:31:14 ]

Citation requires full transcript

Sign in to continue

Sign in
 The bill mandates a forensic audit by the Comptroller General to investigate last year's alleged budget shortfall.[ 00:31:03-00:31:14 ]

Citation requires full transcript

Sign in to continue

Sign in
 Representative Bergman emphasized the importance of accurate budgeting to ensure veterans receive earned care and prevent mismanagement of taxpayer funds. Ranking Member Brownlee, while supportive, requested amendments to prevent duplication of efforts with existing GAO and OIG reports and to refine the reporting process. The bill was favorably forwarded to the full committee.

Debate on Hyperbaric Oxygen Therapy (HBOT) for Veterans

H.R. 1336, proposing a pilot program for hyperbaric oxygen therapies (HBOT) for veterans with TBI or PTSD, sparked a passionate and divided debate. Proponents, including Dr. Murphy, Representative Van Orden, and Chair Miller-Meeks, advocated for HBOT based on anecdotal success stories, meta-analyses, and the urgent need for new treatments given high veteran suicide rates. They emphasized listening to veterans and expanding treatment options beyond traditional, often ineffective, approaches. Opponents, including Dr. Morrison, Dr. Dexter, and Dr. Conaway, questioned the scientific rigor of existing evidence for HBOT, citing VA testimony and concerns about resource allocation to unproven therapies. They stressed the importance of evidence-based medicine and avoiding the waste of taxpayer money on treatments that may not be effective or divert funds from proven services. Two amendments were adopted: one by Representative Cherfilus-McCormick to require an updated GAO report on HBOT efficacy, and another by Ranking Member Brownlee to ensure HBOT providers are accredited for safety. An amendment by Dr. Morrison to require a full literature review was defeated. The bill, as amended, was favorably forwarded.

Promotional Equity for Marriage and Family Therapists at VA

H.R. 658, introduced by Ranking Member Brownlee, addressed inequities in promotional opportunities for licensed marriage and family therapists (LMFTs) within the VA.[ 01:04:49-01:04:58 ]

Citation requires full transcript

Sign in to continue

Sign in
 The current VA qualification standards were highlighted as a barrier, limiting LMFTs from advancing to supervisory positions unless they were licensed through a specific accrediting body. This limitation discourages qualified therapists from serving veterans at the VA, as other organizations do not impose similar restrictions. The Chair, despite some policy concerns, supported moving the bill forward for further consideration. The bill was favorably forwarded.

Tone of the Meeting

The meeting generally maintained a productive and cooperative tone, especially when considering bills with clear bipartisan support or technical adjustments.[ 00:23:49-00:23:55 ]

Citation requires full transcript

Sign in to continue

Sign in
 However, discussions surrounding H.R. 1336, concerning hyperbaric oxygen therapy, became notably contentious and emotional, reflecting deep divisions between members who prioritized scientific evidence and those who emphasized anecdotal success and the urgency of addressing veteran suffering. Procedural moments also indicated some initial difficulty with the new electronic voting system and maintaining strict order during passionate exchanges.

Participants

Transcript

On a few of the bills being considered, I look forward to addressing our policy concerns and working with the minority on moving these bills forward.  In accordance with committee rules, the subcommittee has contacted the Congressional Budget Office seeking informal preliminary cost estimates for each of these bills being considered this afternoon.  While many of the bills on our agenda will most likely have a score, we do not have estimates for all of the bills on today's markup.   None of the bills today include the offsets that would be necessary to move the bills forward.  However, as we discuss what bills will go to the full committee markup and then to the floor, we'll add offsets to ensure that we are in accordance with House rules and that we are protecting the American taxpayer.  I look forward to working with Ranking Member Brownlee and the other members of the subcommittee to find offsets for the common sense proposals considered today.  Of note, there are still multiple opportunities to improve and make necessary changes to these bills.   Ranking Member Brownlee and I will continue working with our colleagues on the committee and any stakeholders that have feedback on these bills as we continue to work through the legislative process to bring the best bills forward.  A majority of the bills on today's agenda, including my bills, are focused on ensuring quality mental health and prosthetic care and have bipartisan support.   I understand, however, that the minority may have concerns with several of our bills, including Representative Murphy's bill, H.R.  1336, which would establish a pilot program to provide hyperbaric oxygen therapies to veterans suffering from traumatic brain injury or post-traumatic stress disorder.  I commend Representative Murphy for his efforts.  We should be doing all we can to help our veterans suffering from the wounds sustained during their service   and furnishing promising HBOT therapies that take meaningful steps towards that end.  I now recognize Ranking Member Brownlee for any opening remarks you may have.
Thank you, Madam Chair, for organizing this afternoon's markup.  In the interest of promptly proceeding with our markup and the oversight hearing to follow, I will forego an opening statement.
Thank you for that gracious concession, Ranking Member Brownlee.  Today we have on block H.R.  217, H.R.  1971, H.R.  1107, H.R.  1644, and H.R.
?
Unknown
1860.
I now ask unanimous consent to consider the following five bills on block, H.R.  217, H.R.  1971, H.R.  1107, H.R. 1644,   and H.R.
?
Unknown
1860.
Hearing no objections, so ordered.  The clerk shall report the bill.
H.R.
?
Unknown
217.
To amend Title 38, the bills were circulated in advance pursuant to committee rules.  I ask that the reading of the bills be dispensed with and the bills be open to amendment at any point.  Without objection, so ordered.  Does any member wish to speak on any of the bills included in the on block?
I wish to speak.
The chair recognized Ranking Member Brownlee.
Thank you, Chairwoman.  I'm glad that   This en bloc includes two bills that are priorities of our Democratic members.  This includes Representative Underwood's Copay Fairness for Veterans Act, H.R. 1644,   which will eliminate financial barriers that could prevent veterans from accessing basic preventive health care.  This legislation will waive co-pays for certain immunizations, certain services recommended by the United States Preventive Service Task Force, and preventive services for women, including contraceptives approved by the FDA.  Under the Affordable Care Act, almost all private health insurance plans are required   to provide coverage of preventive services without charging copays.  However, while most civilians have been able to access preventive services without copays for nearly 15 years, thanks to the ACA, the same guarantee does not exist for veterans who access care at the VA.  Representative Underwood's bill would correct this.

Sign up for free to see the full transcript

Accounts help us prevent bots from abusing our site. Accounts are free and will allow you to access the full transcript.

Sign up