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Houses of Congress a report on the financial status of the 
Department of Veterans Affairs for the preceding quarter: 
Provided, That, at a minimum, the report shall include 
the direction contained in the paragraph entitled ‘‘Quar-
terly reporting’’, under the heading ‘‘General Administra-
tion’’ in the joint explanatory statement accompanying 
Public Law 114–223. 
(INCLUDING TRANSFER OF FUNDS) 
SEC. 218. Amounts made available under the ‘‘Med-
ical Services’’, ‘‘Medical Community Care’’, ‘‘Medical Sup-
port and Compliance’’, ‘‘Medical Facilities’’, ‘‘General Op-
erating Expenses, Veterans Benefits Administration’’, 
‘‘Board of Veterans Appeals’’, ‘‘General Administration’’, 
and ‘‘National Cemetery Administration’’ accounts for fis-
cal year 2026 may be transferred to or from the ‘‘Informa-
tion Technology Systems’’ account: Provided, That such 
transfers may not result in a more than 10 percent aggre-
gate increase in the total amount made available by this 
Act for the ‘‘Information Technology Systems’’ account: 
Provided further, That, before a transfer may take place, 
the Secretary of Veterans Affairs shall request from the 
Committees on Appropriations of both Houses of Congress 
the authority to make the transfer and an approval is 
issued. 
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(INCLUDING TRANSFER OF FUNDS) 
SEC. 219. Of the amounts appropriated to the De-
partment of Veterans Affairs for fiscal year 2026 for 
‘‘Medical Services’’, ‘‘Medical Community Care’’, ‘‘Medical 
Support and Compliance’’, ‘‘Medical Facilities’’, ‘‘Con-
struction, Minor Projects’’, and ‘‘Information Technology 
Systems’’, up to $654,954,000, plus reimbursements, may 
be transferred to the Joint Department of Defense—De-
partment of Veterans Affairs Medical Facility Demonstra-
tion Fund, established by section 1704 of the National De-
fense Authorization Act for Fiscal Year 2010 (Public Law 
111–84; 123 Stat. 2571) and may be used for operation 
of the facilities designated as combined Federal medical 
facilities as described by section 706 of the Duncan Hun-
ter National Defense Authorization Act for Fiscal Year 
2009 (Public Law 110–417; 122 Stat. 4500): Provided, 
That additional funds may be transferred from accounts 
designated in this section to the Joint Department of De-
fense—Department of Veterans Affairs Medical Facility 
Demonstration Fund upon written notification by the Sec-
retary of Veterans Affairs to the Committees on Appro-
priations of both Houses of Congress: Provided further, 
That section 220 of title II of division A of Public Law 
118–42, as continued by division A of Public Law 119– 
4 is repealed. 
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SEC. 220. Of the amounts appropriated to the De-
partment of Veterans Affairs which become available on 
October 1, 2026, for ‘‘Medical Services’’, ‘‘Medical Com-
munity Care’’, ‘‘Medical Support and Compliance’’, and 
‘‘Medical Facilities’’, up to $739,918,000, plus reimburse-
ments, may be transferred to the Joint Department of De-
fense—Department of Veterans Affairs Medical Facility 
Demonstration Fund, established by section 1704 of the 
National Defense Authorization Act for Fiscal Year 2010 
(Public Law 111–84; 123 Stat. 2571) and may be used 
for operation of the facilities designated as combined Fed-
eral medical facilities as described by section 706 of the 
Duncan Hunter National Defense Authorization Act for 
Fiscal Year 2009 (Public Law 110–417; 122 Stat. 4500): 
Provided, That additional funds may be transferred from 
accounts designated in this section to the Joint Depart-
ment of Defense—Department of Veterans Affairs Med-
ical Facility Demonstration Fund upon written notifica-
tion by the Secretary of Veterans Affairs to the Commit-
tees on Appropriations of both Houses of Congress. 
(INCLUDING TRANSFER OF FUNDS) 
SEC. 221. Such sums as may be deposited into the 
Medical Care Collections Fund pursuant to section 1729A 
of title 38, United States Code, for healthcare provided 
at facilities designated as combined Federal medical facili-
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ties as described by section 706 of the Duncan Hunter 
National Defense Authorization Act for Fiscal Year 2009 
(Public Law 110–417; 122 Stat. 4500) shall also be avail-
able: (1) for transfer to the Joint Department of De-
fense—Department of Veterans Affairs Medical Facility 
Demonstration Fund, established by section 1704 of the 
National Defense Authorization Act for Fiscal Year 2010 
(Public Law 111–84; 123 Stat. 2571); and (2) for oper-
ations of the facilities designated as combined Federal 
medical facilities as described by section 706 of the Dun-
can Hunter National Defense Authorization Act for Fiscal 
Year 2009 (Public Law 110–417; 122 Stat. 4500): Pro-
vided, That, notwithstanding section 1704(b)(3) of the 
National Defense Authorization Act for Fiscal Year 2010 
(Public Law 111–84; 123 Stat. 2573), amounts trans-
ferred to the Joint Department of Defense—Department 
of Veterans Affairs Medical Facility Demonstration Fund 
shall remain available until expended. 
(INCLUDING TRANSFER OF FUNDS) 
SEC. 222. Of the amounts available in this title for 
‘‘Medical Services’’, ‘‘Medical Community Care’’, ‘‘Medical 
Support and Compliance’’, and ‘‘Medical Facilities’’, a 
minimum of $15,000,000 shall be transferred to the 
DOD–VA Health Care Sharing Incentive Fund, as au-
thorized by section 8111(d) of title 38, United States 
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Code, to remain available until expended, for any purpose 
authorized by section 8111 of title 38, United States Code. 
SEC. 223. The Secretary of Veterans Affairs shall no-
tify the Committees on Appropriations of both Houses of 
Congress of all bid savings in a major construction project 
that total at least $5,000,000, or 5 percent of the pro-
grammed amount of the project, whichever is less: Pro-
vided, That such notification shall occur within 14 days 
of a contract identifying the programmed amount: Pro-
vided further, That the Secretary shall notify the Commit-
tees on Appropriations of both Houses of Congress 14 
days prior to the obligation of such bid savings and shall 
describe the anticipated use of such savings. 
SEC. 224. None of the funds made available for 
‘‘Construction, Major Projects’’ may be used for a project 
in excess of the scope specified for that project in the origi-
nal justification data provided to the Congress as part of 
the request for appropriations unless the Secretary of Vet-
erans Affairs receives approval from the Committees on 
Appropriations of both Houses of Congress. 
SEC. 225. Not later than 30 days after the end of 
each fiscal quarter, the Secretary of Veterans Affairs shall 
submit to the Committees on Appropriations of both 
Houses of Congress a quarterly report containing perform-
ance measures and data from each Veterans Benefits Ad-
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ministration Regional Office: Provided, That, at a min-
imum, the report shall include the direction contained in 
the section entitled ‘‘Disability claims backlog’’, under the 
heading ‘‘General Operating Expenses, Veterans Benefits 
Administration’’ in the joint explanatory statement accom-
panying Public Law 114–223: Provided further, That the 
report shall also include information on the number of ap-
peals pending at the Veterans Benefits Administration as 
well as the Board of Veterans Appeals on a quarterly 
basis. 
SEC. 226. The Secretary of Veterans Affairs shall 
provide written notification to the Committees on Appro-
priations of both Houses of Congress 15 days prior to or-
ganizational changes which result in the transfer of 25 or 
more full-time equivalents from one organizational unit of 
the Department of Veterans Affairs to another. 
SEC. 227. The Secretary of Veterans Affairs shall 
provide on a quarterly basis to the Committees on Appro-
priations of both Houses of Congress notification of any 
single national outreach and awareness marketing cam-
paign in which obligations exceed $1,000,000. 
(INCLUDING TRANSFER OF FUNDS) 
SEC. 228. The Secretary of Veterans Affairs, upon 
determination that such action is necessary to address 
needs of the Veterans Health Administration, may trans-
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fer to the ‘‘Medical Services’’ account any discretionary 
appropriations made available for fiscal year 2026 in this 
title (except appropriations made to the ‘‘General Oper-
ating Expenses, Veterans Benefits Administration’’ ac-
count) or any discretionary unobligated balances within 
the Department of Veterans Affairs, including those ap-
propriated for fiscal year 2026, that were provided in ad-
vance by appropriations Acts: Provided, That transfers 
shall be made only with the approval of the Office of Man-
agement and Budget: Provided further, That the transfer 
authority provided in this section is in addition to any 
other transfer authority provided by law: Provided further, 
That no amounts may be transferred from amounts that 
were designated by Congress as an emergency requirement 
pursuant to a concurrent resolution on the budget or the 
Balanced Budget and Emergency Deficit Control Act of 
1985: Provided further, That such authority to transfer 
may not be used unless for higher priority items, based 
on emergent healthcare requirements, than those for 
which originally appropriated and in no case where the 
item for which funds are requested has been denied by 
Congress: Provided further, That, upon determination that 
all or part of the funds transferred from an appropriation 
are not necessary, such amounts may be transferred back 
to that appropriation and shall be available for the same 
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purposes as originally appropriated: Provided further, 
That before a transfer may take place, the Secretary of 
Veterans Affairs shall request from the Committees on 
Appropriations of both Houses of Congress the authority 
to make the transfer and receive approval of that request. 
(INCLUDING TRANSFER OF FUNDS) 
SEC. 229. Amounts made available for the Depart-
ment of Veterans Affairs for fiscal year 2026, under the 
‘‘Board of Veterans Appeals’’ and the ‘‘General Operating 
Expenses, Veterans Benefits Administration’’ accounts 
may be transferred between such accounts: Provided, That 
before a transfer may take place, the Secretary of Vet-
erans Affairs shall request from the Committees on Appro-
priations of both Houses of Congress the authority to 
make the transfer and receive approval of that request. 
SEC. 230. The Secretary of Veterans Affairs may not 
reprogram funds among major construction projects or 
programs if such instance of reprogramming will exceed 
$7,000,000, unless such reprogramming is approved by 
the Committees on Appropriations of both Houses of Con-
gress. 
SEC. 231. (a) The Secretary of Veterans Affairs shall 
ensure that the toll-free suicide hotline under section 
1720F(h) of title 38, United States Code— 
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(1) provides to individuals who contact the hot-
line immediate assistance from a trained profes-
sional; and 
(2) adheres to all requirements of the American 
Association of Suicidology. 
(b)(1) None of the funds made available by this Act 
may be used to enforce or otherwise carry out any Execu-
tive action that prohibits the Secretary of Veterans Affairs 
from appointing an individual to occupy a vacant civil 
service position, or establishing a new civil service position, 
at the Department of Veterans Affairs with respect to 
such a position relating to the hotline specified in sub-
section (a). 
(2) In this subsection— 
(A) the term ‘‘civil service’’ has the meaning 
given such term in section 2101(1) of title 5, United 
States Code; and 
(B) the term ‘‘Executive action’’ includes— 
(i) 
any 
Executive 
order, 
Presidential 
memorandum, or other action by the President; 
and 
(ii) any agency policy, order, or other di-
rective. 
(c)(1) The Secretary of Veterans Affairs shall con-
duct a study on the effectiveness of the hotline specified 
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in subsection (a) during the 5-year period beginning on 
January 1, 2016, based on an analysis of national suicide 
data and data collected from such hotline. 
(2) At a minimum, the study required by paragraph 
(1) shall— 
(A) determine the number of veterans who con-
tact the hotline specified in subsection (a) and who 
receive follow up services from the hotline or mental 
health services from the Department of Veterans Af-
fairs thereafter; 
(B) determine the number of veterans who con-
tact the hotline who are not referred to, or do not 
continue receiving, mental health care who commit 
suicide; and 
(C) determine the number of veterans described 
in subparagraph (A) who commit or attempt suicide. 
SEC. 232. Effective during the period beginning on 
October 1, 2018, and ending on January 1, 2026, none 
of the funds made available to the Secretary of Veterans 
Affairs by this or any other Act may be obligated or ex-
pended in contravention of the ‘‘Veterans Health Adminis-
tration Clinical Preventive Services Guidance Statement 
on the Veterans Health Administration’s Screening for 
Breast Cancer Guidance’’ published on May 10, 2017, as 
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issued by the Veterans Health Administration National 
Center for Health Promotion and Disease Prevention. 
SEC. 233. (a) Notwithstanding any other provision 
of law, the amounts appropriated or otherwise made avail-
able to the Department of Veterans Affairs for the ‘‘Med-
ical Services’’ account may be used to provide— 
(1) fertility counseling and treatment using as-
sisted reproductive technology to a covered veteran 
or the spouse of a covered veteran; or 
(2) adoption reimbursement to a covered vet-
eran. 
(b) In this section: 
(1) The term ‘‘service-connected’’ has the 
meaning given such term in section 101 of title 38, 
United States Code. 
(2) The term ‘‘covered veteran’’ means a vet-
eran, as such term is defined in section 101 of title 
38, United States Code, who has a service-connected 
disability that results in the inability of the veteran 
to procreate without the use of fertility treatment. 
(3) The term ‘‘assisted reproductive tech-
nology’’ means benefits relating to reproductive as-
sistance provided to a member of the Armed Forces 
who incurs a serious injury or illness on active duty 
pursuant to section 1074(c)(4)(A) of title 10, United 
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States Code, as described in the memorandum on 
the subject of ‘‘Policy for Assisted Reproductive 
Services for the Benefit of Seriously or Severely Ill/ 
Injured (Category II or III) Active Duty Service 
Members’’ issued by the Assistant Secretary of De-
fense for Health Affairs on April 3, 2012, and the 
guidance issued to implement such policy, including 
any limitations on the amount of such benefits avail-
able to such a member except that— 
(A) the time periods regarding embryo 
cryopreservation and storage set forth in part 
III(G) and in part IV(H) of such memorandum 
shall not apply; and 
(B) 
such 
term 
includes 
embryo 
cryopreservation and storage without limitation 
on the duration of such cryopreservation and 
storage. 
(4) The term ‘‘adoption reimbursement’’ means 
reimbursement for the adoption-related expenses for 
an adoption that is finalized after the date of the en-
actment of this Act under the same terms as apply 
under the adoption reimbursement program of the 
Department of Defense, as authorized in Depart-
ment of Defense Instruction 1341.09, including the 
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reimbursement limits and requirements set forth in 
such instruction. 
(c) Amounts made available for the purposes speci-
fied in subsection (a) of this section are subject to the 
requirements for funds contained in section 508 of division 
H of the Consolidated Appropriations Act, 2018 (Public 
Law 115–141). 
SEC. 234. None of the funds appropriated or other-
wise made available by this Act or any other Act for the 
Department of Veterans Affairs may be used in a manner 
that is inconsistent with: (1) section 842 of the Transpor-
tation, Treasury, Housing and Urban Development, the 
Judiciary, the District of Columbia, and Independent 
Agencies Appropriations Act, 2006 (Public Law 109–115; 
119 Stat. 2506); or (2) section 8110(a)(5) of title 38, 
United States Code. 
SEC. 235. Section 842 of Public Law 109–115 shall 
not apply to conversion of an activity or function of the 
Veterans Health Administration, Veterans Benefits Ad-
ministration, or National Cemetery Administration to con-
tractor performance by a business concern that is at least 
51 percent owned by one or more Indian Tribes as defined 
in section 5304(e) of title 25, United States Code, or one 
or more Native Hawaiian Organizations as defined in sec-
tion 637(a)(15) of title 15, United States Code. 
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SEC. 236. (a) The Secretary of Veterans Affairs, in 
consultation with the Secretary of Defense and the Sec-
retary of Labor, shall discontinue using Social Security 
account numbers to authenticate individuals in all infor-
mation systems of the Department of Veterans Affairs for 
all individuals not later than September 30, 2026: 
(b) The Secretary of Veterans Affairs may collect and 
use a Social Security account number to identify an indi-
vidual, in accordance with section 552a of title 5, United 
States Code, in an information system of the Department 
of Veterans Affairs if and only if the use of such number 
is necessary to: 
(1) obtain or provide information the Secretary 
requires from an information system that is not 
under the jurisdiction of the Secretary; 
(2) comply with a law, regulation, or court 
order; 
(3) perform anti-fraud activities; or 
(4) identify a specific individual where no ade-
quate substitute is available. 
(c) The matter in subsections (a) and (b) shall super-
sede section 237 of division J of Public Law 117–328. 
SEC. 237. For funds provided to the Department of 
Veterans Affairs for each of fiscal year 2026 and 2027 
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for ‘‘Medical Services’’, section 239 of division A of Public 
Law 114–223 shall apply. 
SEC. 238. None of the funds appropriated in this or 
prior appropriations Acts or otherwise made available to 
the Department of Veterans Affairs may be used to trans-
fer any amounts from the Filipino Veterans Equity Com-
pensation Fund to any other account within the Depart-
ment of Veterans Affairs. 
SEC. 239. Of the funds provided to the Department 
of Veterans Affairs for each of fiscal year 2026 and fiscal 
year 2027 for ‘‘Medical Services’’, funds may be used in 
each year to carry out and expand the child care program 
authorized by section 205 of Public Law 111–163, not-
withstanding subsection (e) of such section. 
SEC. 240. None of the funds appropriated or other-
wise made available in this title may be used by the Sec-
retary of Veterans Affairs to enter into an agreement re-
lated to resolving a dispute or claim with an individual 
that would restrict in any way the individual from speak-
ing to members of Congress or their staff on any topic 
not otherwise prohibited from disclosure by Federal law 
or required by Executive order to be kept secret in the 
interest of national defense or the conduct of foreign af-
fairs. 
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SEC. 241. For funds provided to the Department of 
Veterans Affairs for each of fiscal year 2026 and 2027, 
section 258 of division A of Public Law 114–223 shall 
apply. 
SEC. 242. (a) None of the funds appropriated or oth-
erwise made available by this Act may be used to deny 
an Inspector General funded under this Act timely access 
to any records, documents, or other materials available to 
the department or agency over which that Inspector Gen-
eral has responsibilities under the Inspector General Act 
of 1978 (5 U.S.C. App.), or to prevent or impede the ac-
cess of the Inspector General to such records, documents, 
or other materials, under any provision of law, except a 
provision of law that expressly refers to such Inspector 
General and expressly limits the right of access. 
(b) A department or agency covered by this section 
shall provide its Inspector General access to all records, 
documents, and other materials in a timely manner. 
(c) Each Inspector General shall ensure compliance 
with statutory limitations on disclosure relevant to the in-
formation provided by the establishment over which that 
Inspector General has responsibilities under the Inspector 
General Act of 1978 (5 U.S.C. App.). 
(d) Each Inspector General covered by this section 
shall report to the Committee on Appropriations of the 
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Senate and the Committee on Appropriations of the House 
of Representatives within 5 calendar days of any failure 
by any department or agency covered by this section to 
comply with this requirement. 
SEC. 243. None of the funds made available in this 
Act may be used in a manner that would increase wait 
times for veterans who seek care at medical facilities of 
the Department of Veterans Affairs. 
SEC. 244. None of the funds appropriated or other-
wise made available by this Act to the Veterans Health 
Administration may be used in fiscal year 2026 to convert 
any program which received specific purpose funds in fis-
cal year 2025 to a general purpose funded program unless 
the Secretary of Veterans Affairs submits written notifica-
tion of any such proposal to the Committees on Appropria-
tions of both Houses of Congress at least 30 days prior 
to any such action and an approval is issued by the Com-
mittees. 
SEC. 245. For funds provided to the Department of 
Veterans Affairs for each of fiscal year 2026 and 2027, 
section 248 of division A of Public Law 114–223 shall 
apply. 
SEC. 246. (a) None of the funds appropriated or oth-
erwise made available by this Act may be used to conduct 
research commencing on or after July 1, 2025, that uses 
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any canine, feline, or non-human primate unless the Sec-
retary of Veterans Affairs approves such research specifi-
cally and in writing pursuant to subsection (b). 
(b)(1) The Secretary of Veterans Affairs may approve 
the conduct of research commencing on or after July 1, 
2025, using canines, felines, or non-human primates if the 
Secretary certifies that— 
(A) the scientific objectives of the research can 
only be met by using such canines, felines, or non- 
human primates and cannot be met using other ani-
mal models, in vitro models, computational models, 
human clinical studies, or other research alter-
natives; 
(B) such scientific objectives are necessary to 
advance research benefitting veterans and are di-
rectly related to an illness or injury that is combat- 
related as defined by 10 U.S.C. 1413(e); 
(C) the research is consistent with the revised 
Department of Veterans Affairs canine research pol-
icy document dated December 15, 2017, including 
any subsequent revisions to such document; and 
(D) ethical considerations regarding minimizing 
the harm experienced by canines, felines, or non- 
human primates are included in evaluating the sci-
entific necessity of the research. 
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(2) The Secretary may not delegate the authority 
under this subsection. 
(c) If the Secretary approves any new research pursu-
ant to subsection (b), not later than 30 days before the 
commencement of such research, the Secretary shall sub-
mit to the Committees on Appropriations of the Senate 
and House of Representatives a report describing— 
(1) the nature of the research to be conducted 
using canines, felines, or non-human primates; 
(2) the date on which the Secretary approved 
the research; 
(3) the USDA pain category on the approved 
use; 
(4) the justification for the determination of the 
Secretary that the scientific objectives of such re-
search could only be met using canines, felines, or 
non-human primates, and methods used to make 
such determination; 
(5) the frequency and duration of such re-
search; and 
(6) the protocols in place to ensure the neces-
sity, safety, and efficacy of the research, and animal 
welfare. 
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(d) Not later than December 31, 2025, and bian-
nually thereafter, the Secretary shall submit to such Com-
mittees a report describing— 
(1) any research being conducted by the De-
partment of Veterans Affairs using canines, felines, 
or non-human primates as of the date of the sub-
mittal of the report; 
(2) the circumstances under which such re-
search was conducted using canines, felines, or non- 
human primates; 
(3) the justification for using canines, felines, 
or non-human primates to conduct such research; 
(4) the protocols in place to ensure the neces-
sity, safety, and efficacy of such research; and 
(5) the development and adoption of alter-
natives to canines, felines, or non-human primates 
research. 
(e) Not later than December 31, 2025, and annually 
thereafter, the Department of Veterans Affairs must sub-
mit to voluntary U.S. Department of Agriculture inspec-
tions of canine, feline, and non-human primate research 
facilities. 
(f) Not later than December 31, 2025, and annually 
thereafter, the Secretary shall submit to such Committees 
a report describing— 
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(1) any violations of the Animal Welfare Act, 
the Public Health Service Policy on Humane Care 
and Use of Laboratory Animals, or other Depart-
ment of Veterans Affairs policies related to oversight 
of animal research found during that quarter in VA 
research facilities; 
(2) immediate corrective actions taken; and 
(3) specific actions taken to prevent their recur-
rence. 
(g) The Department shall implement a plan under 
which the Secretary will eliminate the research conducted 
using canines, felines, or non-human primates by not later 
than September 20, 2026. 
SEC. 247. (a) The Secretary of Veterans Affairs may 
use amounts appropriated or otherwise made available in 
this title to ensure that the ratio of veterans to full-time 
employment equivalents within any program of rehabilita-
tion conducted under chapter 31 of title 38, United States 
Code, does not exceed 125 veterans to one full-time em-
ployment equivalent. 
(b) Not later than 180 days after the date of the en-
actment of this Act, the Secretary shall submit to Con-
gress a report on the programs of rehabilitation conducted 
under chapter 31 of title 38, United States Code, includ-
ing— 
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(1) an assessment of the veteran-to-staff ratio 
for each such program; and 
(2) recommendations for such action as the 
Secretary considers necessary to reduce the veteran- 
to-staff ratio for each such program. 
SEC. 248. Amounts made available for the ‘‘Veterans 
Health Administration, Medical Community Care’’ ac-
count in this or any other Act for fiscal years 2025 and 
2026 may be used for expenses that would otherwise be 
payable from the Veterans Choice Fund established by 
section 802 of the Veterans Access, Choice, and Account-
ability Act, as amended (38 U.S.C. 1701 note). 
SEC. 249. Obligations and expenditures applicable to 
the ‘‘Medical Services’’ account in fiscal years 2017 
through 2019 for aid to state homes (as authorized by 
section 1741 of title 38, United States Code) shall remain 
in the ‘‘Medical Community Care’’ account for such fiscal 
years. 
SEC. 250. Of the amounts made available for the De-
partment of Veterans Affairs for fiscal year 2024, in this 
or any other Act, under the ‘‘Veterans Health Administra-
tion—Medical Services’’, ‘‘Veterans Health Administra-
tion—Medical Community Care’’, ‘‘Veterans Health Ad-
ministration—Medical Support and Compliance’’, and 
‘‘Veterans Health Administration—Medical Facilities’’ ac-
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counts, $1,323,444,000 shall be made available for gen-
der-specific care and programmatic efforts to deliver care 
for women veterans. 
SEC. 251. Notwithstanding any other law, unless pre-
vented by an order issued by a federal or state court, by 
no later than September 30, 2026, the Secretary shall 
commence construction of the Community Based Out-
patient Clinic in Bakersfield, California authorized in sec-
tion 1(a)(3) of Public Law 111–82 and in accordance with 
Lease No. 36C10F20L0008 or successor lease. 
SEC. 252. Not later than 30 days after the end of 
each fiscal quarter, the Secretary of Veterans Affairs shall 
submit to the Committees on Appropriations of both 
Houses of Congress a quarterly report on the status of 
the ‘‘Veterans Medical Care and Health Fund’’, estab-
lished to execute section 8002 of the American Rescue 
Plan Act of 2021 (Public Law 117–2): Provided, That, 
at a minimum, the report shall include an update on obli-
gations by program, project or activity and a plan for ex-
pending the remaining funds. 
SEC. 253. Any amounts transferred to the Secretary 
and administered by a corporation referred to in section 
7364(b) of title 38, United States Code, between October 
1, 2018 and September 30, 2019 for purposes of carrying 
out an order placed with the Department of Veterans Af-
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fairs pursuant to section 1535 of title 31, United States 
Code, that are available for obligation pursuant to section 
7364(b)(1) of title 38, United States Code, are to remain 
available for the liquidation of valid obligations incurred 
by such corporation during the period of performance of 
such order, provided that the Secretary of Veterans Af-
fairs determines that such amounts need to remain avail-
able for such liquidation. 
SEC. 254. Unobligated balances available under the 
headings ‘‘Construction, Major Projects’’ and ‘‘Construc-
tion, Minor Projects’’ may be obligated by the Secretary 
of Veterans Affairs for a facility pursuant to section 
2(e)(1) of the Communities Helping Invest through Prop-
erty and Improvements Needed for Veterans Act of 2016 
(Public Law 114–294; 38 U.S.C. 8103 note), as amended, 
to provide additional funds or to fund an escalation clause 
under such section of such Act: Provided, That before such 
unobligated balances are obligated pursuant to this sec-
tion, the Secretary of Veterans Affairs shall request from 
the Committees on Appropriations of both Houses of Con-
gress the authority to obligate such unobligated balances 
and such Committees issue an approval, or absent a re-
sponse, a period of 30 days has elapsed: Provided further, 
That the request to obligate such unobligated balances 
must provide Congress notice that the entity described in 
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section 2(a)(2) of Public Law 114–294, as amended, has 
exhausted available cost containment approaches as set 
forth in the agreement under section 2(c) of such Public 
Law. 
SEC. 255. (a) None of the funds made available in 
this Act may be used to implement, administer, or other-
wise carry out the Department of Veterans Affairs interim 
final rule published on September 9, 2022, or any suc-
cessor to such rule, or to propose, promulgate, or imple-
ment any substantially similar rule or policy. 
(b) None of the funds appropriated in this Act shall 
be expended for any abortion, including through a medical 
benefits package or health benefits program that includes 
coverage of abortion. 
(c) The limitations established in subsection (b) shall 
not apply to an abortion— 
(1) if the pregnancy is the result of an act of 
rape or incest; or 
(2) in the case where a woman suffers from a 
physical disorder, physical injury, or physical illness, 
including a life-endangering physical condition 
caused by or arising from the pregnancy itself, that 
would, as certified by a physician, place the woman 
in danger of death unless an abortion is performed. 
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SEC. 256. None of the funds made available by this 
Act may be used for surgical procedures or hormone thera-
pies for the purposes of gender affirming care. 
SEC. 257. During the period beginning on October 
1, 2025 and ending on September 30, 2026, none of the 
funds made available by this Act may be used to admin-
ister, implement, or enforce the final rule issued by the 
Secretary of Veterans Affairs relating to ‘‘Change in Rates 
VA Pays for Special Modes of Transportation’’ (88 Fed. 
Reg. 10032) and published on February 16, 2023. 
SEC. 258. None of the funds made available by this 
Act may be used to carry out VHA Directive 1193.01, 
‘‘Coronavirus Disease 2019 Vaccination Program for Vet-
erans Health Administration Health Care Personnel’’. 
SEC. 259. None of the funds made available by this 
Act may be used to provide any services to any individual 
unlawfully present in the United States who is not eligible 
for health care under the laws administered by the Sec-
retary of Veterans Affairs. 
SEC. 260. None of the funds made available by this 
Act may be used by the Secretary of Veterans Affairs 
under section 5502 of title 38, United States Code, in any 
case arising out of the administration by the Secretary of 
laws and benefits under such title, to report a person who 
is deemed mentally incapacitated, mentally incompetent, 
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or to be experiencing an extended loss of consciousness 
as a person who has been adjudicated as a mental defec-
tive under subjection (d)(4) or (g)(4) of section 922 of 
title 18, United States Code, without the order or finding 
a judge, magistrate, or other judicial authority of com-
petent jurisdiction that such person is a danger to himself 
or herself or others. 
SEC. 261. Of the unobligated balances from amounts 
made available under the heading ‘‘Veterans Health Ad-
ministration’’ from prior appropriations Acts, including 
any funds transferred from the Medical Care Collections 
Fund to accounts under such heading, $15,889,000,000 
is hereby permanently rescinded: Provided, That no 
amounts may be rescinded from amounts that were pro-
vided under the heading ‘‘Medical and Prosthetic Re-
search’’ or amounts that were designated by the Congress 
as an emergency requirement pursuant to a concurrent 
resolution on the budget or the Balanced Budget and 
Emergency Deficit Control Act of 1985: Provided further; 
That the Secretary of Veterans Affairs shall submit to the 
Committees on Appropriations of the House of Represent-
atives and the Senate a plan for rescinding amounts pur-
suant to this section not later than 30 days after the date 
of the enactment of this Act. 
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TITLE III 
RELATED AGENCIES 
AMERICAN BATTLE MONUMENTS COMMISSION 
SALARIES AND EXPENSES 
For necessary expenses, not otherwise provided for, 
of the American Battle Monuments Commission, including 
the acquisition of land or interest in land in foreign coun-
tries; purchases and repair of uniforms for caretakers of 
national cemeteries and monuments outside of the United 
States and its territories and possessions; rent of office 
and garage space in foreign countries; purchase (one-for- 
one replacement basis only) and hire of passenger motor 
vehicles; not to exceed $15,000 for official reception and 
representation expenses; and insurance of official motor 
vehicles in foreign countries, when required by law of such 
countries, $106,000,000, to remain available until ex-
pended. 
FOREIGN CURRENCY FLUCTUATIONS ACCOUNT 
For necessary expenses, not otherwise provided for, 
of the American Battle Monuments Commission, such 
sums as may be necessary, to remain available until ex-
pended, for purposes authorized by section 2109 of title 
36, United States Code. 
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UNITED STATES COURT OF APPEALS FOR VETERANS 
CLAIMS 
SALARIES AND EXPENSES 
For necessary expenses for the operation of the 
United States Court of Appeals for Veterans Claims as 
authorized by sections 7251 through 7298 of title 38, 
United States Code, $49,000,000: Provided, That 
$3,800,000 shall be available for the purpose of providing 
financial assistance as described and in accordance with 
the process and reporting procedures set forth under this 
heading in Public Law 102–229. 
DEPARTMENT OF DEFENSE—CIVIL 
CEMETERIAL EXPENSES, ARMY 
SALARIES AND EXPENSES 
For necessary expenses for maintenance, operation, 
and improvement of Arlington National Cemetery and Sol-
diers’ and Airmen’s Home National Cemetery, including 
the purchase or lease of passenger motor vehicles for re-
placement on a one-for-one basis only, and not to exceed 
$2,000 for official reception and representation expenses, 
$115,000,000, of which not to exceed $15,000,000 shall 
remain available until September 30, 2028. In addition, 
such sums as may be necessary for parking maintenance, 
repairs and replacement, to be derived from the ‘‘Lease 
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