TREA WASHINGTON UPDATE FOR JANUARY 29, 2010
This was a big news week in Washington. The President’s State of the Union address always takes center stage, but this particular address was preceded by the dramatic election in Massachusetts in which a Republican won the special election to replace the late Senator Ted Kennedy who had held the seat for 46 years. In addition, Massachusetts was thought to be the most reliably Democratic state in the nation. Clearly, politicians take notice when such an unexpected and dramatic change takes place.
As a result, the long, some would say tedious, battle over health care reform seems to have come to a screeching halt, at least in its current form. While Congressional leaders and White House spokesmen/women have offered various opinions, no firm decision has been made about what to do next with regard to health care changes.
And while the controversial health care bill did not attack or make obvious changes in the TRICARE/TRICARE for Life (TFL) programs, despite what a multitude of emails on the internet were claiming, there is another issue that could result in drastic changes: fixing the Medicare physician payment formula.
For those who are not familiar with how the legislative process works, we have now begun the 2nd session of the 111th Congress. Among other things, it means that all of the bills that were introduced last year, but not passed or defeated, are still alive and well. What will be new are the spending bills to fund the government’s operations for FY2011 and the President’s State of the Union address was really the start of that process. The next major event will be the submission of his FY2011 budget to Congress, which they use as a starting point for their budget deliberations.
More on all of that below.
1) President Proposes 3-Year Spending Freeze on “Non-Security” Budget Items
2) Medicare (TRICARE) Reimbursement Dilemma is Acted Upon by the Senate
4) National Salute to Hospitalized Veterans Week
5) Buyer: High Veteran Unemployed Requires Swift Action
6) Veterans’ Affairs Committee Approves Bills Aimed At Military Exposures, Homelessness and Health Care
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1) President Proposes 3-Year Spending Freeze on “Non-Security” Budget Items-In his State of the Union address on Wednesday evening, the President proposed to Congress a 3-year spending freeze on what he called discretionary non-security departmental budgets. Those departments NOT subject to his proposed freeze are Defense, Veterans Affairs, and Homeland Security, the budgets involving intelligence and foreign aid. It would also not affect mandatory spending, which includes Social Security, Medicare and Medicaid.
However, his proposal received a very cool reception in Congress from both members of his own party and from Republicans. Liberals in his own party said the proposal would hurt the economic recovery, while Republicans argued it was simply too small to do any real good. And while the majority leaders in Congress tried to be totally supportive of the President’s proposals last year, this latest idea was not well received by Speaker of the House Nancy Pelosi. In an interview in Politico on Wednesday she stated her belief that defense spending should not be exempt from the 3-year freeze. She went on to state her belief that as much as 5 percent of the DOD budget could be cut “by targeting waste among contractors and the sprawling defense bureaucracy -- provided such reductions have no direct impact on troops in the field, commanders or veterans.”
TREA’s Washington office will keep a very close eye on whether, and how, this is dealt with in Congress and we’ll alert you if phone calls and emails to your Senators and Representatives are needed. Speaker Pelosi has been a very strong supporter of veterans and military retirees and meets regularly with TREA and other veterans groups. However, no matter what her intentions are, we are concerned that any cuts in the Defense budget would give DOD an excuse to once again take aim at military retiree benefits – especially TRICARE. DOD has tried for the last 5 or 6 years to cut the benefit by raising various fees, only to be stopped by Congress each time.
Two other items of note concerning the President’s State of the Union address: 1) he again proposed to end the “Don’t Ask-Don’t Tell” policy regarding gays in the military; 2) prior to the address it was announced by First Lady Michelle Obama that he will propose adding $8.8 billion to the DoD budget for programs to support military families, including expanding child care services at child development centers serving military families, for expanding counseling and other services such as financial counseling and relocation assistance. The budget proposal will also include $84 million for career development for military spouses, including tuition assistance.
2) Medicare (TRICARE) Reimbursement Dilemma is Acted upon by the Senate-The most important issue facing military retirees, and Medicare-eligible retirees in general, is the scheduled March 1 cut in Medicare – and TRICARE – payments to doctors. If Congress doesn’t take action before then, doctors will face a 21.2 percent cut in their payments. Because TRICARE reimbursement rates are tied to Medicare, military retirees who use TRICARE are affected by this as well. This is serious, because it could cause Medicare and/or TRICARE providers to either stop accepting new patients, or even drop their current patients, such as a Mayo Clinic family practice clinic in Glendale, Ariz., has done by deciding to opt out of Medicare.
On Thursday, the Senate passed a bill to authorize a huge increase in the legal ceiling on federal government borrowing which includes a provision to fix this physician reimbursement cut for five years. The House of Representative has previously passed a similar measure but there are differences so the two bodies will need to have a conference committee work out the differences and come up with identical bills.
As with nearly everything in Congress, there was a great deal of political maneuvering in all of this. According to the Congressional Quarterly (CQ) report, the measure passed on a straight party-line vote, with 60 Democrats/Independents in support and 40 Republican against.
As stated by CQ, “Democrats have rallied around the idea of pay-as-you-go, budgeting to show the public they are concerned about large deficits and the prospect of an unsustainable increase in red ink in the years ahead. But Republicans have been critical of the proposals, calling them an excuse for tax increases and noting they would exempt several costly initiatives from the requirements and do not include caps on discretionary spending.
“Democrats have blamed recent deficits on the policies of President George W. Bush’s eight-year administration — especially enactment of the 2001 and 2003 tax cuts, prosecution of the wars in Iraq and Afghanistan and creation of the Medicare drug program — all without offsetting their costs.
“[Senate Majority Leader Harry] Reid said his amendment was needed ‘because we spent the last decade spending money we didn’t have.’
“But the PAYGO amendment adopted by the Senate would not stifle the economy, he said. ‘Here’s what it doesn’t do: It doesn’t block emergency spending, it doesn’t keep businesses from creating jobs and it doesn’t prevent Congress from cutting taxes.’
“[Senate Budget Committee senior Republican member Judd] Gregg countered that the amendment amounted to nothing more than ‘political cover,’ and argued that its exemptions and waiver possibilities made it ‘something so full of holes, it will have virtually no effect on our capacity to discipline ourselves, because we’ve already shown we don’t discipline ourselves’ under the current budgetary pay-as-you-go rules.”
Fixing this Medicare physician reimbursement problem is a critical issue for TREA members and your Washington Office staff will keep a very close eye on the progress of the measures. If we need your help in flooding Congressional offices with phone calls and emails we will let you know.
3) VA Issues List of Ships with Agent Orange Exposure-The Department of Veterans Affairs Compensation and Pension (C&P) Service has initiated a program to collect data on Vietnam naval operations for the purpose of providing regional offices with information to assist with development in Haas related disability claims based on herbicide exposure from Navy Veterans.
To date, the Department of Veteran’s Affairs (VA) received verification from various sources showing that a number of offshore “blue water” naval vessels conducted operations on the inland “brown water” rivers and delta areas of Vietnam. The VA also has identified certain vessel types that operated primarily or exclusively on the inland waterways. The ships and dates of inland waterway service are listed on the Compensation & Pension Service Bulletin [PDF]. For your convenience, we also have listed the ships and dates below.
If a Veteran’s service aboard one of these ships can be confirmed through military records during the time frames specified, then exposure to herbicide agents can be presumed without further development.
All vessels of Inshore Fire
Support [IFS]
Division 93 during their entire Vietnam tour
USS Carronade (IFS 1)
USS Clarion River (LSMR 409) [Landing Ship,
Medium, Rocket]
USS Francis River (LSMR 525)
USS White River (LSMR 536)
All vessels with the
designation LST [Landing
Ship, Tank] during their entire tour
[WWII ships converted to transport supplies on
rivers and serve as barracks for brown water
Mobile Riverine Forces]
All vessels with the
designation LCVP [Landing
Craft, Vehicle, Personnel] during their entire
tour
All vessels with the
designation PCF [Patrol
Craft, Fast] during their entire tour
[Also called Swift Boats, operating for enemy
interdiction on close coastal waters]
All vessels with the
designation PBR [Patrol
Boat, River] during their entire tour
[Also called River Patrol Boats as part of the
Mobile Riverine Forces operating on inland
waterways and featured in the Vietnam film
“Apocalypse Now”]
USS Ingersoll (DD-652)
[Destroyer] [Operated
on Saigon River, October 24-25, 1965]
USS Mansfield (DD-728)
[Destroyer] [Operated
on Saigon River August 8-19, 1967 and
December 21-24, 1968]
USS Richard E. Kraus (DD-849)
[Destroyer]
[Operated on coastal inlet north of Da Nang,
June 2-5, 1966, protecting Marines holding a
bridge]
USS Basilone (DD-824)
[Destroyer] [Operated
on Saigon River, May 24-25, 1966]
USS Hamner (DD-718) [Destroyer]
[Operated
on Song Lon Tao and Long Song Tao Rivers,
August 15-September 1, 1966]
USS Conway (DD-507) [Destroyer]
[Operated
on Saigon River, early August 1966]
USS Fiske (DD-842) [Destroyer]
[Operated on
Mekong River, June 16-21, 1966]
USS Black (DD-666) [Destroyer]
[Operated on
Saigon River, July 13-19, 1966]
USS Providence (CLG-6)
[Cruiser, Light,
Guided Missile] [Operated on Saigon River 3
days during January 1964]
USS Mahan (DLG-11) [Guided
Missile Frigate]
[Operated on Saigon River October 24-28, 1964]
USS Okanogan (APA-220) [Attack
Transport]
[Operated on Saigon River July 22-23, 29-30,
1968 and August 5-6, 1968]
USS Niagara Falls (AFS-3)
[Combat Stores
Ship] [Unloaded supplies on Saigon River and
Cam Rahn Bay, April 22-25, 1968]
4) National Salute to Hospitalized Veterans Week-In a recent letter to the syndicated Annie's Mailbox, Veterans Affairs Secretary Eric Shinseki asked readers to please "take some time during the second week of February," when this "year's National Salute to Hospitalized Veterans" will be held, and "honor our veterans." Secretary Shinseki’s letter follows:
Dear Annie: Those who wear our nation's uniforms and their families bear the heaviest burdens on behalf of our nation. Both at home and abroad, our servicemen and women have sacrificed to protect this great nation from those who hope to extinguish the torch of freedom we hold high in the world.
The Department of Veterans Affairs health care facilities provide veterans not only the health care they deserve, but the recognition from a grateful nation, as well. Millions of our nation's veterans receive care in VA health facilities each and every year. VA operates the nation's largest integrated health care system, with more than 1,400 points of care, including hospitals, community clinics, community living centers, domiciliaries and readjustment counseling centers. VA staffs these facilities with more than 239,000 compassionate and dedicated health professionals and 85,000 volunteers who provide an outstanding level of care. However, it is sometimes the direct contact with their local community that provides the ultimate degree of acknowledgment to a veteran.
Last February, many of your readers provided that contact during the National Salute to Hospitalized Veterans. More than 500,000 valentines were received at VA medical centers and 19,838 visitors visited over 54,400 veteran patients. Also, four Valentines for Veterans concerts were held across the country — in Tampa and Bay Pines, Florida; Prescott, Arizona; Charleston, South Carolina; and at the Rock and Roll Hall of Fame in Cleveland, Ohio.
The act of sending a valentine, visiting with a hospitalized veteran or volunteering at one of VA's medical facilities provides a simple acknowledgment of the sacrifice our nation's veterans have endured in the cause of freedom.
This year's National Salute to Hospitalized Veterans will take place from Feb. 7-13, 2010. Getting involved is easy. To deliver a valentine or get additional volunteer information about your local VA medical center, you can find all the information you will need at VA's Volunteer Service website (www.volunteer.va.gov). From this site, you can generate an e-mail to your local VA Volunteer Service and find out whether it can use valentines or other items.
I am personally committed to ensuring our nation's veterans receive the exceptional care and respect they deserve.
We hold a sacred trust for those who have worn the uniform of the United States of America. Please take some time during the second week of February to honor our veterans. Many of our facilities are planning special events during the week and would be pleased to arrange a visit.
Once again, thank you, Annie, for your support of this outstanding program.
Sincerely — Eric K. Shinseki, Secretary of Veterans Affairs
5) Buyer: High Veteran Unemployed Requires Swift Action-Last week, Steve Buyer, the senior Republican member on the House Committee on Veterans Affairs, reached out to Democrat leaders to bring about a bipartisan, legislative effort to assist the record level numbers of unemployed veterans.
The most recent data from the Bureau of Labor Statistics shows that 968,000 veterans are unemployed compared with 807,000 last year. The data also shows an alarming 18.3 percent unemployment rate for veterans between the ages of 20 to 24.
“These numbers are inexcusable and reflect the problems that veterans of every age group face in today’s job market,” said Buyer. “Congress must act to approve a jobs bill for veterans that will help stimulate the economy by expanding opportunities for veteran owned small businesses.”
In December 2009, Buyer introduced H.R. 4220, the Promoting Jobs for Veterans Act of 2009, which contains the following provisions to help veterans find meaningful employment and career opportunities:
“Addressing the high unemployment rate among veterans must be among Congress’ top priorities for the second session of the 111th Congress,” continued Buyer. “H.R. 4420 would reduce veterans’ unemployment through targeted incentives to provide job training and entrepreneurial opportunities to those went from the battlefield to the unemployment line.”
6) Veterans’ Affairs Committee Approves Bills Aimed At Military Exposures, Homelessness And Health Care-On Thursday, the Senate Veterans’ Affairs Committee, chaired by Daniel K. Akaka (D-HI), approved comprehensive legislation to respond to potential environmental hazard exposures on military installations, expand efforts to reduce veteran homelessness, and strengthen VA health care. Chairman Akaka’s military exposure legislation would provide care for individuals exposed to environmental hazards at Camp Lejeune and Atsugi Naval Air Facility, and set up a national response for other potential military installation exposures.
The Committee approved the following bills:
Examination of Exposure to Environmental Hazards During Military Service and Health Care for Camp Lejeune and Atsugi Naval Air Facility Veterans and Their Families Act of 2010
· Provides health care for troops, veterans and dependents with potential exposures from Camp Lejeune and Atsugi Naval Air Facility,
· Creates a VA/DOD-joint Advisory Panel to study potential troop, veteran, and dependent exposure to environmental hazards on military installations, and
· Requires an annual report to monitor the recommendations of the Advisory Board, including information on individuals receiving care and benefits under the Act.
S. 1237, Homeless Veterans and Other Health Care Authorities Act of 2010:
· Expands and creates programs to reduce veteran homelessness at the local, state, and national level;
· Automatically enrolls eligible demobilizing Guard and Reserve units into VA health and dental care;
· Increases transparency within VA health care by establishing a VA Medical Center Report Card; and
· Extends health care eligibility for Gulf War veterans until 2012, including those exposed to sodium dichromate at Qarmat Ali.
The Committee also approved the nomination of Dr. Raul Perea-Henze to be VA’s Assistant Secretary for Policy and Planning. Dr. Perea-Henze was reviewed by the Committee at a previous hearing.
The bills and nominee approved on Thursday will be reported to the full Senate for consideration.
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