Archived Issue: September/October 2007

Pace of Action Slows

During the first six months of the 110th Congress, NAUS worked with the new Democratic leadership to develop a budget that presented a first step toward restoring the prominence of veterans and veterans-related issues to the high priority each servicemember deserves for the value of military service and sacrifice given.

In large part, the first half of the year was successful. In March, for example, the House passed a spending and revenue plan that includes a historic $6.6 billion increase over current spending for veterans’ programs. The dramatic increase would help ensure wounded warriors and veterans returning from Iraq and Afghanistan access to high quality health care and timely consideration of veterans benefits.

The new Congress also sent a strong message to servicemembers in passage of the fiscal year 2007 Continuing Resolution, approved in February. The funding bill was required because the last Congress (the 109th) failed to approve spending bills for veterans and most of the agencies of government (except for Defense), before it adjourned. While leaving most of the domestic programs flat, veterans spending was increased $3.6 billion to meet rising health care costs and an influx of new veterans to VA.

In addition, the new Congress added $2 billion in the 2007 Iraq Supplemental legislation for military health care to cover the 2007 costs for TRICARE and to care for our military and dependents at Walter Reed and other military hospitals. A large part of this money was necessary because the Administration failed to budget for it, asking for higher fees and copays instead. In addition, $1.8 billion was added in the Supplemental to address the need of Iraq and Afghanistan veterans, including money for mental health and benefits claims, and the maintenance backlog in veterans’ hospitals, clinics and health care facilities.

NAUS appreciates the congressional gains made to date. Though we have not eliminated the SBP/DIC offsets or expanded what remains on concurrent receipt, we are encouraged by the overall measures taken to strengthen our military and honor our troops and veterans.

As we move into the final months of this first session of the 110th Congress, we regret that the pace of action seems to have slowed. At press time, for example, the 2008 National Defense Authorization Act has been delayed and movement has bogged down on veterans appropriations and defense appropriations for 2008.

There is a lot remaining on the plate for our elected members of Congress, including completion of the National Defense Authorization Act, H.R. 1585, finalizing of defense appropriations, H.R. 3222, and veterans appropriations, H.R. 2642, and completion of the Wounded Warrior bill, H.R. 1538, to properly screen and care for severely injured troops returning from war.

Authorizations: Prospects Dim for Senate National Defense Authorization Bill

NAUS is deeply disappointed that after nearly two weeks of debate in July the Senate version of the National Defense Authorization Act, H.R. 1585, was suddenly dropped from consideration, pulled from the floor because of fractious differences on Iraq policy.

For nearly half a century the Senate has approved a Defense authorization to set the policy for our national security for the upcoming year that includes troop strength, military weapons research and acquisition, service pay and bonuses, retirement matters and health care issues. More than 300 amendments, along with the main bill, hang in limbo.

As the Senate returns from its month long August break, the Defense Authorization bill awaits action and remains as one of the Senate’s most pressing issues.

Let’s take a look at some of the key elements at stake in efforts to complete the National Defense Authorization Act.

Highlights of The Senate NDAA for 2008

Many of the provisions of the Senate National Defense Authorization Act (NDAA) are similar to the House approved version, which was covered in the July/August Uniformed Services Journal.

At the start of the process, the Senate Armed Services Committee reached agreements that Chairman Carl Levin (D-MI) said and Ranking Member John McCain (R-AZ) agreed were in keeping with the “common commitment of supporting our men and women in uniform” and “the interest of the national defense.”

Led by Chairman Levin and Ranking Member McCain, the Armed Services Committee reported a bipartisan bill to the Senate on a unanimous vote, 25 to 0. Among the many critical provisions was the unanimous agreement to include the NAUS-endorsed “Dignified Treatment of Wounded Warrior Act,” which lays out a comprehensive path to address shortfalls in the care of injured members of the military.

Let’s take a look at some of the highlights of the Senate NDAA to improve military quality of life, provide troop support and assistance needed on the battlefield, strengthen our defense policy, and care for our military retirees, their dependents and survivors.

To improve the quality of life that our service men and women deserve, the NDAA continues the increases in compensation that have helped close the civilian-military pay gap to less than 4 percent today from 14 percent in 2000. The bill contains an authorization for an across-the-board 3.5 percent pay increase, a half percent higher than the average civilian wage increase.

To strengthen national defense and relieve stress on current troops, the bill increases Army and Marines end-strength to 525,400 and 189,000, respectively – an authorized increase of 13,000 for the Army and 9,000 for the Marines. In addition, more than 25 types of bonuses and special pay aimed at encouraging re-enlistment and advancement are included.

For equipment, the Defense authorization bill adds $4.5 million for MRAPs, or Mine Resistant Ambush Protected vehicles, to improve protection for our troops exposed to improvised explosive devices (IEDs). And the bill authorizes full funding for the Joint Improvised Explosive Device Defeat Office to devise equipment and tactics to overcome the enemy’s deadly use of IEDs.

For those servicemembers medically retired, the bill extends authorization under the CRSC program for special compensation to servicemembers medically retired for a combat-related disability.

As previously reported, the House voted in May to expand CRSC eligibility to these so-called Chapter 61 retirees if they served at least 15 years and have combat-related disabilities rated 60 percent or higher.

The Senate Defense authorization goes further to allow all retirees with combat-related disabilities, regardless of years served, to draw both their disability compensation and CRSC. The CRSC payments would be set based on years served before being retired for disability.

The bill also takes NAUS-endorsed action to reject the outrageous increases in TRICARE fees and co-pays proposed at the start of the year by the Department of Defense. In addition, the bill reduces the cost of pharmaceuticals to retirees, dependents, survivors and military families by authorizing the use of Federal pricing for pharmaceuticals dispensed through the TRICARE retail program.

Regarding TRICARE, NAUS reminds readers that the proposed Defense bill is also important in order to blunt DoD authority to demand more than $1.8 billion in “savings” from military retirees and their families. Without intervening congressional action, the Pentagon may regain its statutory authority on Oct. 1 to implement increased cost shares for most TRICARE participants at its discretion.

We must also recognize that the House and Senate have to sort out differences between versions of the NDAA before forging a final comprehensive legislative package. Whether a conference can be concluded before the October start of the 2008 fiscal year is now in question and measurably more difficult because of the failure to complete the bill in a timely fashion when first brought to the floor.

Amendments Offered and Pending to the Senate Defense Authorization Act

There are many key Senate amendments offered and pending that address personnel, compensation and benefit issues. Here are a number of selected highlights.

Traumatic Brain Injury Care – An amendment proposed by Senator Akaka (D-HI), adopted before debate was shut down on the NDAA, would better equip VA to respond and care for soldiers afflicted with Traumatic Brain Injury (TBI), the signature wound of the current war.

The Akaka amendment requires individual rehabilitation plans for veterans with TBI and authorizes use of non-VA facilities for the best treatments available. It would also put in place a pilot program for assisted living services and extend the period of automatic eligibility for VA health care from 2 years to 5 years for servicemembers returning from combat.

Elimination of SBP/DIC Offset – Another amendment deserving consideration is the Nelson amendment to end the SBP/DIC offset and to accelerate the start of “paid-up” SBP premiums. Sen. Nelson (D-FL) has been working more than 5 years with NAUS and other military associations to terminate the unfair reduction between survivor benefits and Veterans Affairs’ Dependency and Indemnity Compensation (DIC), paid to survivors of an active duty or retired military member who dies from a service-connected cause.

The NAUS-endorsed Nelson amendment would also accelerate the delayed date for “paid-up status” under SBP. Under current law, retirees at least 70 years of age and paying premiums for a minimum of 30 years will have premium payments ended on Oct. 1, 2008. This amendment accelerates the “paid up” provision to Oct.1, 2007. It isn’t a great deal of change, but it recognizes the inequity of asking those who entered the program prior to 1978, and who paid higher premiums relative to their expected benefits, to continue their wait.

Earlier Retirement for National Guard and Reserve – An amendment offered by Sen. Saxby Chambliss (R-GA) would lower the retirement age for members of the United States Guard and Reserve. The amendment makes Guardsmen and Reservists eligible for earlier retirement pay based on the amount of time spent on active duty. Sen. Chambliss’s amendment reduces the age requirement by three months for every 90 days performed in support of a contingency operation in a fiscal year, retroactive to 2001, and sets the minimum retirement age at 50. The way we use these troops has changed and NAUS agrees that the way we reward them should change, too.

Flexibility in Assignment of Death Gratuity – An amendment introduced by Sen. Chuck Hagel (R-NE) changes the eligibility for the military death gratuity paid to the next-of-kin of personnel killed while on active duty. Under current law, the death gratuity benefit goes to a spouse or child. When the next-of-kin is a child, the death gratuity is not accessible until the child turns eighteen. The NAUS-supported change would allow the service member to designate a grandparent, sibling or guardian to receive all or part of the military death gratuity to care for a child.

Postage Free Mailing Assistance – Sen. Hillary Clinton would amend the NDAA to allow families to send postage-free letters and care packages to their loved ones serving in Iraq and Afghanistan. The Clinton amendment would also provide free mail privileges for servicemembers hospitalized because of injury or disease. Rep. Vito Fossella attached a similar amendment to the House passed NDAA. The amendment would offer families some assistance in sharing the costs of sending a bit of home to our servicemen and women serving overseas.

Extending Military Pay Raises – Sen. Hagel also has a NAUS-endorsed amendment pending that requires all military pay raises from 2009 through 2012 to be one-half percentage point more than average private-sector raises, as measured by the Labor Department Employment Cost Index. The pay formula is identical to the one used from 2000 through 2005 to close the military-civilian pay gap from 14 percent to 4 percent. Rep. Thelma Drake (R-VA) led the charge in the House to place the “ECI + 0.5%” pay formula in the House passed NDAA.

NAUS Commends Senate Passage of Wounded Warrior and Pay Increase

After halting its consideration of the Defense bill, Senate leadership had second thoughts about dropping action on the National Defense Authorization Act. Lawmakers reached into the stalled NDAA to pull out and pass the Wounded Warrior legislation and the 3.5 percent uniformed service pay increase, H.R. 1538.

Though we would like to see quick action on the entire Defense Authorization legislation, NAUS fully supports the second look the Senate took at the NDAA. The pay raise is a critical component. And the Wounded Warrior legislation is an important step in health care coverage for the severely wounded.

NAUS encourages Congress to conclude action on H.R. 1538, the Wounded Warrior legislation. It is desperately needed for improving care for troops with Post-Traumatic Stress Disorder (PTSD) and Traumatic Brain Injury (TBI). It ensures that wounded warriors receive the broadest range of care and support with support for families who help care for their loved ones. It increases traumatic brain injury care and opens access to mental health services.

H.R. 1538 also empowers a special board to review disability ratings of 20 percent or less, and to restore to wounded warriors, if appropriate, a higher disability rating or retired status, a provision NAUS asked Congress to review earlier this year.

These are two very important issues, and NAUS commends Senate passage of these provisions. However, as outlined earlier, there are many other elements of the NDAA that deserve the same quick action.

We ask our Members and supporters to work with us to see that Congress fulfills its responsibilities and passes the entire NDAA package as one of its first priorities in September. There is more work to be done, and it is critical to the men and women in uniform that it be accomplished in a timely fashion.

Appropriations: House Approves $460 Billion Defense Appropriations Bill

As one of its last actions before the August recess, the House passed H.R. 3222, a bill to provide appropriations for the Department of Defense for fiscal year 2008.

The House bill, approved on a 395-13 vote, provides $459.6 billion for FY 2008. While $3.5 billion below the President’s request, the House bill provides an increase for Defense of $39.7 billion or about a 9.5 percent increase over current year spending.

The bill does not include, however, 2008 funding for the wars in Iraq and Afghanistan, which have been included over the past several years mainly in supplemental requests. According to House leadership and Defense Appropriations Chairman Rep. John Murtha (D-PA), these funds will be debated as part of a September supplemental.

Among the provisions of the House appropriations bill is full funding for home-station training, equipment maintenance and key readiness programs. Military base construction and related base programs are part of the Military Construction and Veterans Affairs appropriations bill, H.R. 2642, which the House passed in June and the Senate currently has under consideration.

In addition, major program activities, such as weapons procurement and R&D, are funded at or above the President’s request. The exception is in the Department’s operation account, where funding is approximately $5.7 billion below the request. These matters and war related appropriations are to be considered in a supplemental bill in September, according to Chairman Murtha.

Highlights: House Appropriations Bill

The bill approved by the House would provide $2.2 billion to cover a 3.5 percent pay raise for service members. In the past the pay raise has seldom been given an increase sufficient to cover proposed end strength increases. This time there is an improvement in an allocation that fully covers personnel costs and the associated equipping and outfitting costs. For the Army, the equipping costs are estimated at $4 billion and for the Marines the costs are more than $2 billion.

Another highlight in the House passed bill is an initiative with total funding of $2.9 billion for NAUS-supported military family advocacy programs, childcare centers and dependent education programs. This amount is an increase of $558 million over the Administration’s request and recognizes the importance of families affected by the stress and demands on the current force.

The bill also covers the $1.9 billion shortfall in health funding created by the NAUS-requested rejection of the DoD proposed fee and premium increase. In total, the bill provides $23 billion for health care costs of the military programs.

To answer equipment shortfalls, the bill provides an additional $925 million to purchase the National Guard and Reserve force equipment. The new resources will help augment the ability of these forces to meet overseas demands and respond to natural disasters at home.

Though the bill supports full funding for key weapons procurements, including the F-22 and F-35 tactical fighter program, the Army’s Future Combat System, a multi-operational system designed to transform combat abilities, would absorb an 11 percent reduction from the Administration’s request.

In the shipbuilding arena, the committee added billions to build or begin building five vessels next year – $3.1 billion for procurement of a Virginia-class nuclear submarine, as well as funds to build a Navy Amphibious Transport Dock Ship and three Navy Auxiliary Cargo and Ammunition Ships used to transport dry cargo.

The Virginia-class submarine, manufactured by Northrop Grumman and General Dynamics, cost more than $2 billion apiece and will constitute the bulk of the future attack submarine force.

The House bill also provides a 4.2 percent increase to $15 billion in the Basic Allowance for Housing, $1.6 billion more than current year funding. According to House leaders, the increase ensures no out-of-pocket expenses for service members and supports the privatization of housing units for military families.

Looking Ahead on Pentagon Funding

As we look ahead, time is short before the Oct. 1 start of fiscal year 2008. And the Senate has yet to schedule consideration of its version of the defense budget. And the House is only now beginning consideration of a separate bill to cover the costs of operations in Iraq and Afghanistan in fiscal 2008.

Regarding the war supplemental bill in the House, it is anticipated that the bill could include several controversial amendments not attempted in the regular Pentagon funding bill last July.

Among those proposals is an amendment to close the prison in Guantanamo. Another likely one could require troops to be “fully trained and equipped” before deploying to Iraq. Another is an amendment to mandate a timetable for withdrawing U.S. troops from Iraq.

The pivotal date this fall is Sept. 15, when the Administration must give Congress a new progress report on conditions in Iraq. The report, called the Petraeus Report, will be delivered to Congress just as the Defense appropriations debate resumes, this time in the Senate, when that chamber’s Defense Appropriations Subcommittee takes up its version of the bill.

If money is not in place at the start of fiscal year 2008, the Pentagon has limited authority to reprogram up to $5 billion from other accounts to handle operations. The seriousness of the situation, however, is clear, especially with war costs running upwards to $12 billion a month. The money that can be drawn upon won’t last long.

Traumatic Brain Injury

Traumatic Brain Injury (TBI) is the “signature wound” of the Global War on Terror. TBI is a complex injury with a broad spectrum of symptoms and occurs when a sudden trauma causes damage to the brain. Although brain injuries can be caused by a fall, or automobile accident, exposure to Improvised Explosive Devices (IEDs) have caused the vast majority of the military’s TBI cases thus far.

The symptoms of a blast-related TBI don’t always appear immediately, nor leave a visible wound. Since the onset of the war, military doctors have had trouble identifying and treating this particular type of brain injury. More than 3,000 cases of blast-related TBI have been treated, but experts believe thousands more have gone undetected, particularly those suffering mild forms of the injury. By some estimates, up to 30 percent of those serving, or who have served in Iraq and Afghanistan may be suffering from some level of TBI.

In July, NAUS staff, Morgan Brown and Mike Plumer, attended a special symposium on TBI, sponsored by the House Veterans’ Affairs Committee, to examine services available to servicemembers and veterans with head trauma and injury. Medical personnel, patients, family members of those suffering from TBI and advocacy groups were on hand to provide lawmakers a more complete view of the issue. The main discussion centered on the need for a coordinated effort for case management of TBI patients. Also emphasized was the importance of educating and training family members on what to expect from trauma patients.

Because of the number of service personnel affected by TBI, interest in legislation to address ways to provide treatment for traumatic brain injury remains high. At press time, nearly 30 bills with provisions addressing the care of TBI have been introduced. Three have been passed – two by the House and one by the Senate. The Senate bill, H.R. 1538, the Dignified Treatment of Wounded Warriors Act is discussed elsewhere in this legislative update.

The House version of the Wounded Warrior legislation also carries the same bill number, H.R. 1538, but because there are differences between the House and Senate versions of the bill, differences will be sorted out in conference committee. The House has also passed a second bill that addresses TBI, H.R. 2199, the Traumatic Brain Injury Health Enhancement and Long-Term Support Act. It is likely that key elements of this bill will make their way into the conference discussion on H.R. 1538. These elements include the development of a more effective screening program for TBI and the establishment of an improved program for long-term care.

NAUS believes our nation’s men and women in uniform deserve the absolute best care this nation can offer. With a number of legislative vehicles on the table, we are working to see that Congress completes effective action on this matter soon.

Dole/Shalala Commission Makes Recommendations

The nine-member President’s Commission on Care For America’s Returning Wounded Warriors, co-chaired by former Senator Bob Dole and former Health and Human Services Secretary Donna Shalala, completed its work and offered six recommendations to “serve, support and simplify the care for our injured service members.” They include an overhaul of the disability system; creation of recovery plans with recovery coordinators; a new joint e-Benefits website; guaranteeing care for PTSD from the VA for injured service members from Afghanistan and Iraq. The six areas are:

1. Immediately Create Comprehensive Recovery Plans to Provide the Right Care and Support at the Right Time and in the Right Place.

2. Completely Restructure the Disability Determination and Compensation Systems.

3. Aggressively Prevent and Treat Post-Traumatic Stress Disorder and Traumatic Brain Injury.

4. Significantly Strengthen Support for Families.

5. Rapidly Transfer Patient Information Between DoD and VA.

6. Strongly Support Walter Reed by Recruiting and Retaining First Rate Professionals Through 2011.

The report is too long to put here but we recommend you visit http://naus.org/news/DoleShalalaCommissionReport7-07.pdf.pdf and read the entire report.

Upon receiving the report, President Bush directed VA Secretary Jim Nicholson and Defense Secretary Robert Gates to implement the commission’s recommendations “so that we can say with certainty that any soldier who has been hurt will get the best possible care and treatment that this government can give.” With the report containing 35 specific action items and only 6 requiring attention by Congress, NAUS expects to see aggressive attention to the care of servicemembers as they move through the healthcare system. We will continue to monitor progress and let you know.

DoD/VA Disability Changes Proposed

As noted above, the President’s Commission on Care For America’s Returning Wounded Warriors recommended DoD and VA totally revamp the disability and compensation process.

Under the panel’s plan, the Defense Department would remain responsible for determining if a servicemember is fit for duty, but the responsibility for determining disability ratings and compensation will be transferred to the VA.

While NAUS strongly supports a greater role for VA in determining ratings, we do not agree with the Commission’s recommendation that a servicemember’s disability status should be reviewed every three years, something it refers to as “periodic review.”

The commission also urged Congress to consider authorizing short and long-term transition payments for wounded servicemembers. Once transition payments end, disabled veterans could then receive earnings-loss payments to compensate for lowered earning capacity, or quality-of-life payments to compensate for the permanent effects of physical or mental combat-related injuries.

The commission’s proposed changes are intended for individuals suffering from combat-related wounds and injuries arising from the Global War on Terror. However, one cannot underestimate the potential impact these changes may have on the disability system as a whole. It’s definitely an issue we will have to monitor very closely.

Again, NAUS has strong reservations regarding the “periodic review” recommendation, recognizing that it would aggravate the current problems of long waiting times and lack of capacity at VA facilities. Readers may recall that VA attempted a short time ago to review the cases of all veterans with PTSD. The review was quickly stopped as the process turned into a nightmare scenario with numerous PTSD veterans having anxiety attacks and many other issues. We believe that healthcare needs and checkups are best left to the veterans and the discretion of their primary care doctors.

COLA Bill

The Veterans’ Compensation Cost-of-Living Act of 2007 continues steady progress towards approval. The House bill H.R. 1284 was passed and sent to the Senate in March. The Senate bill S. 423, was approved by the full Senate Committee on Veterans’ Affairs on July 24 and was placed on the Senate calendar for consideration. See the chart above regarding the COLA rates.

House Passes Merchant Mariner Bill

On Monday July 30, the House passed H.R. 23, the NAUS-endorsed “Belated Thank You to the Merchant Mariners of World War II Act.” When the bill came to the floor, there were more than 250 House cosponsors of the legislation. The bill, passed by voice vote, now goes to the Senate where similar legislation, S. 961, introduced by Sen. Ben Nelson (D-NE), awaits consideration before the Senate Committee on Veterans’ Affairs. The Senate bill currently has 47 cosponsors.

NAUS applauds the House action and recalls the words of General Dwight Eisenhower who in 1944 expressed his admiration for the officers and men of the merchant marine saying, “They have never failed us and in all the struggles yet to come we know that they will never be deterred by any danger, hardship or privation. When final victory is ours, there is no organization that will share its credit more deservedly than the merchant marine.” We trust this measure will soon become law to ensure the long overdue acknowledgement of the service of this group of brave merchant mariners.

Veterans Legislation Moves Through House

Several important pieces of legislation were passed by the House prior to their August recess. They include H.R. 1315 the Veterans’ Benefits Improvement Act of 2007, which would improve and expand the Special Adaptive Housing grants program for severely injured veterans and to provide education assistance for eye-care professionals and a scholarship program for blind rehabilitation specialists; H.R. 2874, the Veterans’ Health Care Improvement Act of 2007, which would expand mental health services, give transportation grants to rural veterans service organizations, and broaden services for low-income and homeless veterans; and H.R. 2623, a bill to exempt the collection of co-payments for all hospice care provided by the Department of Veterans Affairs.

The House also passed H.R. 327, the “Joshua Omvig Veterans Suicide Prevention Act.” The legislation directs the Secretary of Veterans Affairs to establish a comprehensive program designed to reduce the potential incidence of suicide among veterans. It expands a number of programs to improve screening, tracking, counseling and treatment of service personnel suffering depression and related issues. The Senate version, S. 423, has yet to be considered by the Senate Veterans’ Affairs Committee.

We caution that these bills may not make it through a conference with the Senate, but some portions of them could be rolled into an omnibus bill that NAUS will push before the end of the first session of the 110th Congress. NAUS will work hard to ensure all veterans’ issues receive the full consideration they are due.