I 
111TH CONGRESS 
1ST SESSION H. R. 1016 
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 
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. FINDINGS. 
Congress makes the following findings: 
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(1) Title 38, United States Code, authorizes the 
Secretary of Veterans Affairs to furnish hospital and 
domiciliary care, medical services, nursing home 
care, and related services to eligible and enrolled vet-
erans, but only to the extent that appropriated re-
sources and facilities are available for such purposes. 
(2) For 19 out of the past 22 fiscal years, ap-
propriated funds for medical care were not provided 
to the Department of Veterans Affairs before the 
commencement of its new fiscal year, causing the 
Department great challenges in planning and man-
aging care for enrolled veterans, to the detriment of 
veterans. 
(3) The cumulative effect of insufficient, late, 
and unpredictable funding endangers the viability of 
the system and the specialized health care resources 
of the Department to maintain and improve the 
health of the Nation’s sick and disabled veterans. 
(4) Appropriation levels for the health care pro-
grams of the Department have too often proven in-
sufficient over the past decade, requiring the Sec-
retary of Veterans Affairs to ration health care and 
Congress to approve supplemental appropriations. 
(5) Providing sufficient, timely, and predictable 
funding would ensure the Government meets its obli-
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gation to provide health care to sick and disabled 
veterans and ensure that all veterans enrolled for 
care in the Department of Veterans Affairs have 
ready access to timely and high quality care. 
(6) Providing sufficient, timely, and predictable 
funding would allow the Department of Veterans Af-
fairs to properly plan for and meet the needs of vet-
erans. 
SEC. 3. ADVANCE APPROPRIATIONS FOR CERTAIN MED-
ICAL CARE ACCOUNTS OF THE DEPARTMENT 
OF VETERANS AFFAIRS. 
(a) ADVANCE APPROPRIATIONS FOR CERTAIN MED-
ICAL CARE ACCOUNTS.— 
(1) IN GENERAL.—Chapter 1 of title 38, United 
States Code, is amended by inserting after section 
113 the following new section: 
‘‘§ 113A. Advance appropriations for certain medical 
care accounts 
‘‘(a) IN GENERAL.—For each fiscal year, beginning 
with fiscal year 2011, discretionary new budget authority 
provided in an appropriations Act for the appropriations 
accounts of the Department specified in subsection (b) 
shall— 
‘‘(1) be made available for that fiscal year; and 
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‘‘(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) MEDICAL CARE ACCOUNTS AFFECTED.—The 
appropriations accounts subject to subsection (a) of this 
section are the following medical care accounts of the ‘Vet-
erans Health Administration, Department of Veterans Af-
fairs’ account: 
‘‘(1) Medical Services. 
‘‘(2) Medical Support and Compliance. 
‘‘(3) Medical Facilities.’’. 
(2) CLERICAL AMENDMENT.—The table of sec-
tions at the beginning of such chapter is amended 
by inserting after the item relating to section 113 
the following new line: 
‘‘113A. Advance appropriations for certain medical care accounts.’’. 
SEC. 4. 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-
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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.— 
(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 
fiscal year under section 1105 of title 31, United 
States Code, the Comptroller General shall submit to 
the appropriate 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 fol-
lowing: 
(A) A statement whether the amount re-
quested in the budget of the President for ex-
penditures of the Department for health care in 
such fiscal year is consistent with anticipated 
expenditures of the Department for health care 
in such fiscal year as determined utilizing the 
Model. 
(B) The basis for such statement. 
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(C) Such additional information as the 
Comptroller General determines appropriate. 
(3) AVAILABILITY TO THE PUBLIC.—Each re-
port submitted under this subsection shall be made 
available to the public by the Comptroller General. 
(4) APPROPRIATE COMMITTEES OF CONGRESS 
DEFINED.—In this subsection, the term ‘‘appro-
priate committees of Congress’’ means— 
(A) the Committees on Veterans’ Affairs, 
Appropriations, and the Budget of the Senate; 
and 
(B) the Committees on Veterans’ Affairs, 
Appropriations, and the Budget of the House of 
Representatives. 
Æ 
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