In the Senate of the United States, 

August 6, 2009. 

Resolved, That the bill from the House of Representatives (H.R. 1016) entitled ‘‘An Act to amend title 38, United 

States Code, to provide advance appropriations authority for 

certain accounts of the Department of Veterans Affairs, and 

for other purposes.’’, do pass with the following 

AMENDMENT: 

Strike out all after the enacting clause and insert: 

1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Veterans Health Care 

3 Budget Reform and Transparency Act of 2009’’. 

4 SEC. 2. FINDINGS. 

5 Congress makes the following findings: 

6 (1) Title 38, United States Code, authorizes the 

7 Secretary of Veterans Affairs to furnish hospital and 

8 domiciliary care, medical services, nursing home care, 

9 and related services to eligible and enrolled veterans, 
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1 but only to the extent that appropriated resources and 

2 facilities are available for such purposes. 

3 (2) For 19 of the past 22 fiscal years, funds have 

4 not been appropriated for the Department of Veterans 

5 Affairs for the provision of health care as of the com6 mencement of the new fiscal year, causing the Depart7 ment great challenges in planning and managing 

8 care for enrolled veterans, to the detriment of vet9 erans. 

10 (3) The cumulative effect of insufficient, late, 

11 and unpredictable funding for the Department for 

12 health care endangers the viability of the health care 

13 system of the Department and impairs the specialized 

14 health care resources the Department requires to 

15 maintain and improve the health of sick and disabled 

16 veterans. 

17 (4) Appropriations for the health care programs 

18 of the Department have too often proven insufficient 

19 over the past decade, requiring the Secretary to ration 

20 health care and Congress to approve supplemental ap21 propriations for those programs. 

22 (5) Providing sufficient, timely, and predictable 

23 funding would ensure the Government meets its obli24 gation to provide health care to sick and disabled vet25 erans and ensure that all veterans enrolled for health 
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1 care through the Department have ready access to 

2 timely and high quality care. 

3 (6) Providing sufficient, timely, and predictable 

4 funding would allow the Department to properly plan 

5 for and meet the needs of veterans. 

6 SEC. 3. TWO-FISCAL YEAR BUDGET AUTHORITY FOR CER7 TAIN MEDICAL CARE ACCOUNTS OF THE DE8 PARTMENT OF VETERANS AFFAIRS. 

9 (a) TWO-FISCAL YEAR BUDGET AUTHORITY.— 

10 (1) IN GENERAL.—Chapter 1 of title 38, United 

11 States Code, is amended by inserting after section 113 

12 the following new section: 

13 ‘‘§ 113A. Two-fiscal year budget authority for certain 

14 medical care accounts 

15 ‘‘(a) IN GENERAL.—Beginning with fiscal year 2011, 

16 new discretionary budget authority provided in an appro17 priations Act for the appropriations accounts of the Depart18 ment specified in subsection (b) shall be made available for 

19 the fiscal year involved, and shall include new discretionary 

20 budget authority for such appropriations accounts that first 

21 become available for the first fiscal year after such fiscal 

22 year. 

23 ‘‘(b) MEDICAL CARE ACCOUNTS.—The medical care 

24 accounts of the Department specified in this subsection are 
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1 the medical care accounts of the Veterans Health Adminis2 tration as follows: 

3 ‘‘(1) Medical Services. 

4 ‘‘(2) Medical Support and Compliance. 

5 ‘‘(3) Medical Facilities.’’. 

6 (2) CLERICAL AMENDMENT.—The table of sec7 tions at the beginning of chapter 1 of such title is 

8 amended by inserting after the item relating to sec9 tion 113 the following new item: 

‘‘113A. Two-fiscal year budget authority for certain medical care accounts.’’. 

10 SEC. 4. COMPTROLLER GENERAL OF THE UNITED STATES 

11 STUDY ON ADEQUACY AND ACCURACY OF 

12 BASELINE MODEL PROJECTIONS OF THE DE13 PARTMENT OF VETERANS AFFAIRS FOR 

14 HEALTH CARE EXPENDITURES. 

15 (a) STUDY OF ADEQUACY AND ACCURACY OF BASE16 LINE MODEL PROJECTIONS.—The Comptroller General of 

17 the United States shall conduct a study of the adequacy 

18 and accuracy of the budget projections made by the Enrollee 

19 Health Care Projection Model, its equivalent, or other meth20 odologies, as utilized for the purpose of estimating and pro21 jecting health care expenditures of the Department of Vet22 erans Affairs (in this section referred to as the ‘‘Model’’) 

23 with respect to the fiscal year involved and the subsequent 

24 four fiscal years. 

25 (b) REPORTS.— 
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1 (1) IN GENERAL.—Not later than the date of 

2 each year in 2011, 2012, and 2013, on which the 

3 President submits the budget request for the next fis4 cal year under section 1105 of title 31, United States 

5 Code, the Comptroller General shall submit to the ap6 propriate committees of Congress and to the Secretary 

7 a report. 

8 (2) ELEMENTS.—Each report under this para9 graph shall include, for the fiscal year beginning in 

10 the year in which such report is submitted, the fol11 lowing: 

12 (A) A statement whether the amount re13 quested in the budget of the President for expend14 itures of the Department for health care in such 

15 fiscal year is consistent with anticipated expend16 itures of the Department for health care in such 

17 fiscal year as determined utilizing the Model. 

18 (B) The basis for such statement. 

19 (C) Such additional information as the 

20 Comptroller General determines appropriate. 

21 (3) AVAILABILITY TO THE PUBLIC.—Each report 

22 submitted under this subsection shall also be made 

23 available to the public. 
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1 (4) APPROPRIATE COMMITTEES OF CONGRESS

2 DEFINED.—In this subsection, the term ‘‘appropriate 

3 committees of Congress’’ means— 

4 (A) the Committees on Veterans’ Affairs, 

5 Appropriations, and the Budget of the Senate; 

6 and 

7 (B) the Committees on Veterans’ Affairs, 

8 Appropriations, and the Budget of the House of 

9 Representatives. 

Attest: 

Secretary. 

111TH CONGRESS 

1ST SESSION H.R. 1016 

AMENDMENT