IB 
Union Calendar No. 87 
111TH CONGRESS 
1ST SESSION H. R. 1016 
[Report No. 111–171] 
To amend title 38, United States Code, to provide advance appropriations 
authority for certain medical care accounts of the Department of Vet-
erans Affairs, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
FEBRUARY 12, 2009 
Mr. FILNER (for himself, Mr. MICHAUD, Ms. HERSETH SANDLIN, Mr. MITCH-
ELL, Mr. HALL of New York, Mr. MCNERNEY, Mr. WALZ, Mr. HARE, 
Mrs. TAUSCHER, Mr. HODES, and Mr. SESTAK) introduced the following 
bill; which was referred to the Committee on Veterans’ Affairs 
JUNE 19, 2009 
Additional sponsors: Mr. TEAGUE, Mrs. KIRKPATRICK of Arizona, Mr. JONES, 
Mr. LOEBSACK, Mr. BUCHANAN, Mr. ADLER of New Jersey, Ms. JACK-
SON-LEE of Texas, Mr. KAGEN, Mr. BOSWELL, Mrs. NAPOLITANO, Mr. 
PLATTS, Mr. YOUNG of Alaska, Mr. HINCHEY, Mr. DEFAZIO, Mr. 
TERRY, Mr. HOLT, Ms. KOSMAS, Mr. ELLSWORTH, Mr. GORDON of Ten-
nessee, Mr. CARNAHAN, Mr. SCHRADER, Mr. FRANK of Massachusetts, 
Ms. SCHAKOWSKY, Mr. BRADY of Pennsylvania, Mr. SCHAUER, Mr. 
WELCH, Mr. ELLISON, Mr. WEXLER, Mrs. DAHLKEMPER, Ms. HIRONO, 
Mr. COURTNEY, Mr. KLEIN of Florida, Ms. BERKLEY, Mr. JACKSON of 
Illinois, Mr. BISHOP of New York, Mr. BOREN, Mr. LOBIONDO, Mr. TIM 
MURPHY of Pennsylvania, Mr. SMITH of Washington, Mr. BRALEY of 
Iowa, Mr. AL GREEN of Texas, Mr. MORAN of Kansas, Ms. PINGREE of 
Maine, Mr. GARRETT of New Jersey, Mr. HIGGINS, Ms. WATSON, Mr. 
SPACE, Mr. GERLACH, Mr. ALTMIRE, Ms. TITUS, Mr. HASTINGS of Flor-
ida, Mr. HEINRICH, Mr. NYE, Mr. RODRIGUEZ, Mr. LUJA´N, Mr. TIAHRT, 
Mr. CONNOLLY of Virginia, Mr. PETERS, Mr. DOYLE, Mr. BOCCIERI, Mr. 
GUTIERREZ, Mr. MURPHY of Connecticut, Mr. GRIJALVA, Mr. MCGOV-
ERN, Mrs. DAVIS of California, Mr. BLUMENAUER, Ms. SUTTON, Mr. 
ROSS, Ms. KILPATRICK of Michigan, Mr. BOUCHER, Mr. KISSELL, Mr. 
SABLAN, Ms. MARKEY of Colorado, Mr. MAFFEI, Mr. OBERSTAR, Mr. 
PATRICK J. MURPHY of Pennsylvania, Mr. PASTOR of Arizona, Mr. DON-
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NELLY of Indiana, Mr. LARSEN of Washington, Mr. KING of New York, 
Ms. EDDIE BERNICE JOHNSON of Texas, Mr. BILBRAY, Mr. MCINTYRE, 
Mr. TONKO, Mr. MCMAHON, Mr. CLEAVER, Mr. COSTELLO, Ms. 
SCHWARTZ, 
Mr. 
POLIS
of 
Colorado, 
Mrs. 
HALVORSON, 
Mr. 
LATOURETTE, Ms. JENKINS, Mr. LEE of New York, Mrs. BLACKBURN, 
Mr. MEEK of Florida, Mr. GONZALEZ, Mr. CUMMINGS, Mr. SIRES, Mr. 
GALLEGLY, Mr. DELAHUNT, Mr. CARNEY, Mr. KLINE of Minnesota, Mr. 
PETERSON, Mr. GRIFFITH, Ms. TSONGAS, Mr. KILDEE, Mr. POE of 
Texas, Mr. SNYDER, Mr. PERRIELLO, Ms. CORRINE BROWN of Florida, 
Ms. WOOLSEY, Mr. ETHERIDGE, Mr. ISRAEL, Mrs. MCCARTHY of New 
York, and Mr. MASSA 
JUNE 19, 2009 
Reported with amendments, committed to the Committee of the Whole House 
on the State of the Union, and ordered to be printed 
[Strike out all after the enacting clause and insert the part printed in italic] 
[For text of introduced bill, see copy of bill as introduced on February 12, 2009] 
A BILL 
To amend title 38, United States Code, to provide advance 
appropriations authority for certain medical care ac-
counts of the Department of Veterans Affairs, and for 
other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Veterans Health Care 
Budget Reform and Transparency Act of 2009’’. 
SEC. 2. SENSE OF CONGRESS. 
It is the sense of Congress that the provision of health 
care services to veterans could be more effectively and effi-
ciently planned and managed if funding was provided for 
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the management and provision of such services in the form 
of advance appropriations. 
SEC. 3. PRESIDENTS’ BUDGET SUBMISSIONS. 
Section 1105(a) of title 31, United States Code, is 
amended by adding at the end the following new paragraph: 
‘‘(36) information on estimates of appropriations 
for the fiscal year following the fiscal year for which 
the budget is submitted for the following accounts of 
the Department of Veterans Affairs: 
‘‘(A) Medical Services. 
‘‘(B) Medical Support and Compliance. 
‘‘(C) Medical Facilities. 
‘‘(D) Information Technology Systems. 
‘‘(E) Medical and Prosthetic Research.’’. 
SEC. 4. ADVANCE APPROPRIATIONS FOR CERTAIN AC-
COUNTS OF THE DEPARTMENT OF VETERANS 
AFFAIRS. 
(a) ADVANCE APPROPRIATIONS
FOR CERTAIN AC-
COUNTS.— 
(1) IN GENERAL.—Chapter 1 of title 38, United 
States Code, is amended by inserting after section 116 
the following new section: 
‘‘§ 117. Advance appropriations for certain accounts 
‘‘(a) IN GENERAL.—For each fiscal year, beginning 
with fiscal year 2011, discretionary new budget authority 
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provided in an appropriations Act for the appropriations 
accounts of the Department specified in subsection (c) 
shall— 
‘‘(1) be made available for that fiscal year; and 
‘‘(2) include, for each such appropriations ac-
count, advance discretionary new budget authority 
that first becomes available for the first fiscal year 
after the budget year. 
‘‘(b) ESTIMATES REQUIRED.—The Secretary shall in-
clude in documents submitted to Congress in support of the 
President’s budget submitted pursuant to section 1105 of 
title 31, United States Code, detailed estimates of the funds 
necessary for the accounts of the Department specified in 
subsection (c) for the fiscal year following the fiscal year 
for which the budget is submitted. 
‘‘(c) ACCOUNTS SPECIFIED.—The accounts specified in 
this subsection are the following accounts of the Department 
of Veterans Affairs: 
‘‘(1) Medical Services. 
‘‘(2) Medical Support and Compliance. 
‘‘(3) Medical Facilities. 
‘‘(4) Information Technology Systems. 
‘‘(5) Medical and Prosthetic Research. 
‘‘(d) ANNUAL REPORT.—Not later than July 31 of each 
year, the Secretary shall submit to Congress an annual re-
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port on the sufficiency of the Department’s resources for the 
next fiscal year beginning after the date of the submittal 
of the report for the provision of medical care. Such report 
shall also include estimates of the workload and demand 
data for that fiscal year.’’. 
(2) CLERICAL AMENDMENT.—The table of sec-
tions at the beginning of such chapter is amended by 
inserting after the item relating to section 116 the fol-
lowing new item: 
‘‘117. Advance appropriations for certain accounts.’’. 
SEC. 5. COMPTROLLER GENERAL STUDY ON ADEQUACY 
AND ACCURACY OF BASELINE MODEL PRO-
JECTIONS OF THE DEPARTMENT OF VET-
ERANS AFFAIRS FOR HEALTH CARE EXPENDI-
TURES. 
(a) STUDY OF ADEQUACY AND ACCURACY OF BASE 
LINE MODEL PROJECTIONS.—The Comptroller General 
shall conduct a study of the adequacy and accuracy of the 
budget projections made by the Enrollee Health Care Pro-
jection Model (in this section referred to as the ‘‘Model’’), 
its equivalent, or other methodologies utilized for the pur-
pose of estimating and projecting health care expenditures 
of the Department of Veterans Affairs with respect to the 
fiscal year involved and the subsequent four fiscal years. 
(b) REPORTS.— 
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(1) IN GENERAL.—Not later than the date of 
each year in 2011, 2012, and 2013, on which the 
President submits the budget request for the next fis-
cal year under section 1105 of title 31, United States 
Code, the Comptroller General shall submit to the ap-
propriate committees of Congress and to the Secretary 
of Veterans Affairs a report. 
(2) ELEMENTS.—Each report under this para-
graph shall include, for the fiscal year concerning the 
year for which the budget is submitted, the following: 
(A) A statement whether the amount re-
quested in the budget of the President for expend-
itures of the Department for health care in such 
fiscal year is consistent with anticipated expend-
itures of the Department for health care in such 
fiscal year as determined utilizing the Model. 
(B) The basis for such statement. 
(C) Such additional information as the 
Comptroller General determines appropriate. 
(3) AVAILABILITY TO THE PUBLIC.—Each report 
submitted under this subsection shall be made avail-
able to the public by the Comptroller General. 
(4) APPROPRIATE
COMMITTEES
OF
CONGRESS 
DEFINED.—In this subsection, the term ‘‘appropriate 
committees of Congress’’ means— 
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