I
104TH CONGRESS
2D SESSION
H. R. 3950
To amend title 38, United States Code, to reorganize the veterans health
system; to improve access to, and the quality and efficiency of, care
provided to the Nation’s veterans; to operate the veterans health system
based on the principles of managed care, and for other purposes.
IN THE HOUSE OF REPRESENTATIVES
AUGUST 2, 1996
Mr. LONGLEY introduced the following bill; which was referred to the
Committee on Veterans’ Affairs
A BILL
To amend title 38, United States Code, to reorganize the
veterans health system; to improve access to, and the
quality and efficiency of, care provided to the Nation’s
veterans; to operate the veterans health system based
on the principles of managed care, and for other pur-
poses.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) SHORT TITLE.—This Act may be cited as the ‘‘GI
Bill of Health’’.
authority to recover costs, where appropriate, for
providing such services.
SEC. 3. PURPOSES.
The purposes of this Act are as follows:
(1) To reorganize the veterans health system to
improve access to, and the quality and efficiency of,
care for the Nation’s veterans.
(2) To operate the veterans health system based
upon the principles of managed care.
(3) To ensure all veterans with service-con-
nected disabilities have access to all services nec-
essary for the treatment of such disabilities at no
charge.
(4) To ensure all special-category veterans, as
defined in law, along with indigent veterans and vet-
erans with service-connected disabilities, receive a
continuum of health care services at no charge or re-
duced charge.
(5) To control the cost of operating the veter-
ans health care system by encouraging veterans who
do not currently receive care in Department of Vet-
erans Affairs facilities to enroll in Veterans Health
Plans.
(6) To improve the long-term financial health of
the veterans health system by attracting resources
into the system from other Federal programs, third-
party payers, and employers of veterans.
(7) To permit the veterans health system to re-
tain all payments made to the Department of Veter-
ans Affairs for health care services.
(8) To eliminate unnecessary, duplicative, or
contradictory regulations that hamper the ability of
the veterans health system to operate effectively and
efficiently.
SEC. 4. VETERANS HEALTH CARE SECURITY.
Title 38, United States Code, is amended by inserting
after chapter 17 the following new chapter:
‘‘CHAPTER 18—VETERANS HEALTH SYSTEM
‘‘SUBCHAPTER I—ENROLLMENT
Sec.
‘‘1801. Enrollment of veterans.
‘‘1802. Enrollment of veterans’ dependents.
‘‘1803. Enrollment of CHAMPVA eligibles.
‘‘1804. Enrollment process.
‘‘SUBCHAPTER II—ELIGIBILITY
‘‘1805. Eligibility definitions.
‘‘1806. Eligibility for benefits.
‘‘SUBCHAPTER III—BENEFITS
‘‘1807. Basic benefits package.
‘‘1808. Comprehensive benefits package.
‘‘1809. Supplemental health benefits packages.
‘‘SUBCHAPTER IV—PAYMENT POLICIES
‘‘1810. Payment policies for entitled veterans.
‘‘1811. Payment policies for certain veterans and veterans’ dependents enrolled
in a Veterans Health Plan.
‘‘1812. Payment policies for veterans eligible for federally-administered health
care programs.
‘‘1813. Payment policies for eligible veterans and veterans’ dependents with
Medicare Supplemental health insurance coverage.
‘‘1814. Payment policies for fee-for-service benefits.
‘‘SUBCHAPTER V—FINANCING
‘‘1815. Creation of Department of Veterans Affairs Health Plan Fund.
‘‘1816. Guaranteed funding of Federal Costs.
‘‘1817. Resource allocation.
‘‘SUBCHAPTER VI—DELIVERY OF HEALTH CARE SERVICES
‘‘1818. Responsibilities of the Secretary of Veterans Affairs.
‘‘1819. Responsibilities of Veterans Health Plans and Veterans Health Plan
Directors.
‘‘SUBCHAPTER VII—STATE HEALTH CARE SYSTEMS
‘‘1820. State health care reform.
‘‘1821. Applicability of State law.
‘‘1823. General definitions.
‘‘SUBCHAPTER VIII—GENERAL PROVISIONS
‘‘1822. Budget reporting requirements.
‘‘SUBCHAPTER I—ENROLLMENT
‘‘§ 1801. Enrollment of veterans
‘‘The Secretary shall establish a process for the en-
rollment into Veterans Health Plans of entitled and eligi-
ble veterans.
‘‘§ 1802. Enrollment of veterans’ dependents
‘‘The Secretary shall establish a process for the en-
rollment into Veterans Health Plans of the dependents of
enrolled veterans, as defined in section 1805(c) of this
title.
‘‘§ 1803. Enrollment of CHAMPVA eligibles
‘‘The Secretary shall establish a process for the en-
rollment into Veterans Health Plans, in the same manner
as a veteran, of individuals who are eligible for benefits
under section 1713 of this title.
‘‘§ 1804. Enrollment process
‘‘(a) The Secretary shall provide for a continuous
open enrollment period of 18 months following implemen-
tation of the GI Bill of Health, during which period enti-
tled and eligible veterans and their dependents may first
enroll in a Veterans Health Plan.
‘‘(b) For each entitled or eligible veteran, when the
veteran first becomes eligible to enroll in a Veterans
Health Plan, there shall be an initial enrollment period
of not less than 30 days during which the veteran may
first enroll in such Veterans Health Plan.
‘‘(c) The Secretary shall establish an annual period
of not less than 30 days during which entitled and eligible
veterans may enroll in a Veterans Health Plan. Such an-
nual enrollment period shall coincide with the annual open
season under the Federal Employees Health Benefits Pro-
gram as established under chapter 89 of title 5. All Veter-
ans Health Plans shall designate the same annual enroll-
ment period.
‘‘(d) If a veteran enrolls in a Veterans Health Plan,
such veteran may at the same time enroll the veteran’s
dependents in the Plan as a family enrollment.
‘‘(e) In the case of a veteran who experiences a
change of family composition through marriage, divorce,
birth or adoption of a child, or similar circumstances, the
Secretary shall provide for a special enrollment period in
which the veteran is eligible to change the individual or
family basis of enrollment in a Veterans Health Plan.
‘‘(f) Enrollment of a dependent of an enrolled veteran
shall be considered timely if a request for enrollment is
made within 30 days of a marriage or birth or adoption
of a child if family coverage is available as of such date.
‘‘(g) Dependent coverage shall become effective on
the date of the marriage of a spouse or the date of the
birth or adoption of a child.
‘‘(h) Coverage of a dependent under a policy under
this chapter may not be canceled by reason of the death
of the veteran, except that coverage of a dependent spouse
or child of a spouse may be canceled in the event that
the spouse remarries, unless such remarriage is annulled
or made void by a court of law.
‘‘(i) The Secretary may terminate coverage for non-
payment of premiums.
‘‘(j) The Secretary shall guarantee that the terms of
coverage, including the amount of any premiums or other
cost-sharing requirements, and the availability of benefits
shall not be changed for a full enrollment period of not
less than one year, notwithstanding an enrolled veteran’s
change in income or degree of service-connected disability,
except that the Secretary shall have the discretion to re-
duce or eliminate the premium and cost-sharing charges
for any veterans who qualified as entitled under section
1805(a)(8) of this title.
‘‘SUBCHAPTER II—ELIGIBILITY
‘‘§ 1805. Eligibility definitions
‘‘(a) An ‘entitled’ veteran under this chapter includes
the following categories of veterans:
‘‘(1) Any veteran with a service-connected dis-
ability.
‘‘(2) Any veteran whose discharge or release
from the active military, naval or air service was for
a disability incurred or aggravated in the line of
duty.
‘‘(3) Any veteran who is in receipt of, or who,
but for a suspension pursuant to section 1151 of
this title (or both such a suspension and the receipt
of retired pay), would be entitled to disability com-
pensation, but only to the extent that such a veter-
an’s continuing eligibility for such care is provided
for in the judgment or settlement provided for in
such section.
‘‘(4) Any veteran who is a former prisoner of
war.
‘‘(5) Any veteran of the Mexican border period
or World War I.
‘‘(6) Any veteran who is unable to defray the
expenses of necessary care as determined under sec-
tion 1722(a) of this title.
‘‘(7) Any veteran who served on active duty in
the Republic of Vietnam during the Vietnam era and
who the Secretary finds may have been exposed dur-
ing such service to dioxin or was exposed during
such service to a toxic substance found in a herbi-
cide or defoliant used in connection with military
purposes during that era, notwithstanding that there
may be insufficient medical evidence to conclude that
such illness or disability may be associated with such
exposure.
‘‘(B) Any veteran who the Secretary finds was
exposed to ionizing radiation from the detonation of
a nuclear device in connection with such veteran’s
participation in the test of such a device or with the
American occupation of Hiroshima and Nagasaki,
Japan, during the period beginning on September
11, 1945, and ending on July 1, 1946, notwith-
standing that there may be insufficient medical evi-
dence to conclude that such illness or disability may
be associated with such exposure.
‘‘(C) Any veteran who served on active duty in
the Southwest Asia theater of operations during the
Persian Gulf War and who the Secretary finds has
an illness or disability which may be associated with
exposure to a toxic substance or environmental haz-
ard, notwithstanding that there may be insufficient
medical evidence to conclude that such illness or dis-
ability may be associated with such exposure.
‘‘(D) Any veteran who while on active duty was
exposed to mustard gas while participating in full-
body, field, or chamber experiments to test protec-
tive clothing or equipment during World War II and
who the Secretary finds has an illness or disability
which may be associated with such exposure, not-
withstanding that there may be insufficient medical
evidence to conclude that such illness or disability
may be associated with such exposure.
‘‘(8) Any veteran who suffers a catastrophic ill-
ness or injury, payment for which would render such
veteran destitute as determined under criteria estab-
lished by the Secretary.
‘‘(9) Any veteran proven to be uninsurable in
the private health insurance market, as determined
under criteria established by the Secretary.
‘‘(b) An ‘eligible’ veteran under this chapter shall in-
clude all veterans who do not qualify under subsection (a)
as ‘entitled’.
‘‘(c) A ‘dependent of a veteran’ under this chapter
shall include, for any veteran enrolled in a Veterans
Health Plan—
‘‘(1) a spouse;
‘‘(2) a widow or widower who has not remar-
ried, unless such remarriage has been annulled or
made void by a court of law; and
‘‘(3) an unmarried child, spouse’s child or
adopted child who—
‘‘(A) has not attained the age of 21;
‘‘(B) has not attained the age of 23, is en-
rolled in a full-time course of study at an insti-
tution of higher learning, and is in fact depend-
ent on the veteran for one half of the child’s
support; or
‘‘(C) is incapable of self-support due to a
mental or physical incapacity that occurs while
a dependent of a veteran under subparagraph
(A) or (B), and is in fact dependent on the vet-
eran for one half of the child’s support.
§ 1806. Eligibility for benefits
‘‘(a) Upon enrollment in a Veterans Health Plan, a
veteran who qualifies as entitled under section 1805(a)(1)
of this title shall receive—
ing requirement, and the availability of benefits under a
Veterans Health Plan benefits package, shall not be
changed for a full enrollment period of not less than one
year, notwithstanding an enrolled veteran’s change in in-
come or degree of service-connected disability, except that
the Secretary shall have the discretion to reduce or elimi-
nate the premium and cost-sharing charges for any vet-
eran who qualifies under section 1805(a)(8) of this title.
‘‘SUBCHAPTER III—BENEFITS
‘‘§ 1807. Basic benefits package
‘‘(a) The Secretary shall have the authority to estab-
lish a basic benefits package consisting of the following
items, care, and services:
‘‘(1) Hospital services.
‘‘(2) Services of health professionals.
‘‘(3) Women’s health services.
‘‘(4) Medical and surgical services.
‘‘(5) Outpatient services.
‘‘(6) 24-hour emergency services.
‘‘(7) Preventive health care services, including
those services defined in section 1701(9) of this title.
‘‘(8) Diagnostic services.
‘‘(b) The Secretary shall establish an individual and
family schedule of premiums, deductibles, copayments,
and coinsurance charges for the basic benefits package
created under this section, based upon the fully-allocated
cost to provide the items, care, and services set forth in
this section. The annual deductible under the basic bene-
fits package shall be set a rate equivalent to two times
the deductible established under section 1808(b) of this
title for the comprehensive benefits package.
‘‘(c) The Secretary shall not be required to provide
any care or service listed in the basic benefits package cre-
ated under this section within a Department facility, so
long as such service is provided through a provider con-
tract, medical resource-sharing agreement, or similar ar-
rangement.
‘‘§ 1808. Comprehensive benefits package
‘‘(a) The Secretary shall have the authority to estab-
lish a comprehensive benefits package consisting of the fol-
lowing items, care, and services:
‘‘(1) Hospital services, including psychiatric
hospital care.
‘‘(2) Services of health professionals.
‘‘(3) Medical and surgical services.
‘‘(4) Outpatient services.
‘‘(5) 24-hour emergency services.
‘‘(6) Preventive care services, including those
services defined in section 1701(9) of this title.
‘‘(7) Diagnostic services.
‘‘(8) Women’s health services.
‘‘(9) Pediatric services.
‘‘(10) Mental health and substance abuse pre-
vention and treatment.
‘‘(11) Hospice care.
‘‘(12) Home health care.
‘‘(13) Extended care services.
‘‘(14) Authorized transportation services.
‘‘(15) Durable medical equipment.
‘‘(16) 
Outpatient 
prescription 
drugs 
and
biologicals.
‘‘(17) Investigational devices and treatments.
‘‘(18) Routine vision testing and eye care serv-
ices.
‘‘(b) The Secretary shall establish an individual and
family schedule of premiums, deductibles, copayments,
and coinsurance charges for the comprehensive benefits
package created under this section, based upon the fully-
allocated cost to provide the items, care, and services set
forth in this section.
‘‘(c) The Secretary shall have the discretion to add
benefits to the comprehensive benefits package created
under this section upon a finding that such additional ben-
efits are necessary to provide effective and cost-efficient
health care to veterans.
‘‘(d) The Secretary shall not be required to provide
any care or service listed in the comprehensive benefits
package created under this section within a Department
facility, so long as such care or service provided through
a provider contract, medical resource-sharing agreement,
or similar arrangement.
‘‘§ 1809. Supplemental health benefits packages
‘‘(a)(1) The Secretary shall provide to veterans the
care and services authorized under chapter 17 of this title
in accordance with the terms and conditions applicable to
such care and services under such chapter, notwithstand-
ing whether such care and services are included in the
basic or comprehensive benefits packages established
under sections 1807 and 1808 of this title, respectively.
Care and services provided under this subsection shall be
administered by Veterans Health Plans as a specialized
services supplemental health benefits package and shall in-
clude prosthetic and orthotic services, blind rehabilitation
services, services necessary for the rehabilitation of veter-
ans with spinal cord dysfunction, and treatment for chron-
ic psychiatric illnesses such as Post Traumatic Stress Dis-
order (PTSD). The specialized services supplemental
health care benefits package may include long-term care
services only to the extent provided under subsection (b).
‘‘(2)(A) In order to meet the special needs of veter-
ans, the Secretary may offer to veterans described in sub-
paragraph (B) one or more supplemental health benefits
packages for care and services provided under chapter 17
of this title but not otherwise included in the basic or com-
prehensive benefits packages established under sections
1807 and 1808 of this title, respectively, and not otherwise
provided under subsection (b).
‘‘(B) A veteran may be offered a specialized services
supplemental health benefits package under this sub-
section only if such veteran does not otherwise qualify to
receive such care and services under paragraph (1).
‘‘(C) The Secretary shall establish premiums,
deductibles, copayments, and coinsurance charges for a
specialized services supplemental health benefits package
based upon the fully-allocated cost to provide such serv-
ices.
‘‘(b) The Secretary shall have the discretion to pro-
vide long-term care services (including nursing home care,
domiciliary care, respite care, adult day care, home health
care, and community residential care) to veterans under
the authority provided in chapter 17 of this title in accord-
ance with the terms and conditions to such care under
such chapter.
‘‘(c)(1) The Secretary may establish and offer to vet-
erans and veterans’ dependents supplemental health bene-
fits packages for care and services, not otherwise provided
in the basic, comprehensive or specialized services supple-
mental health benefits packages established in sections
1807, 1808, and 1809(a) of this title, respectively.
‘‘(2) The Secretary shall establish a schedule of pre-
miums, deductibles, copayments, and coinsurance charges
for supplemental health benefits packages established
under this subsection, based upon the fully-allocated cost
to provide such care and services. For the purposes of
paragraph (1), such schedule shall include both an individ-
ual and a family rate.
‘‘SUBCHAPTER IV—PAYMENT POLICIES
‘‘§ 1810. Payment policies for entitled veterans
‘‘(a) The Secretary may not impose any charge
(whether a premium, deductible, copayment, coinsurance,
or other amount)—
‘‘(1) for any medically necessary and appro-
priate care or services provided under section
1806(a) of this title to a veteran who qualifies as en-
titled under section 1805(a)(1) of this title;
‘‘(2) for any medically necessary and appro-
priate care or services provided under section
1806(b)(1) of this title to a veteran who qualifies as
entitled under section 1805(a)(1) of this title and
has a service-connected disability rated at 50 percent
or greater;
‘‘(3) for any medically necessary and appro-
priate care or services provided under section
1806(b)(2)(A) of this title to a veteran who qualifies
as entitled under section 1805(a)(1) of this title and
has a compensable service connected disability rated
at less than 50 percent and does not choose to pur-
chase the comprehensive benefits package under sec-
tion 1806(b)(2)(B) of this title; or
‘‘(4) for any medically necessary and appro-
priate care or services provided under section
1806(b)(3) of this title to a veteran who qualifies as
entitled under sections 1805(a)(2)–(a)(9) of this
title.
‘‘(b) The Secretary shall grant a premium discount
for the purchase of the comprehensive benefits package
established in section 1808 of this title in accordance with
the provisions of section 1806(f) of this title for any medi-
cally necessary and appropriate care and services provided
under section 1806(b)(2)(B) of this title. Such premium
discount shall be based upon the individual premiums es-
tablished under section 1808(b) of this title.
‘‘§ 1811. Payment policies for certain veterans and
veterans’ dependents enrolled in a Veter-
ans Health Plan
‘‘The Secretary shall establish premiums, copay-
ments, deductibles, and coinsurance charges for care and
services provided under sections 1807, 1808 and 1809 of
this title to veterans and veterans’ dependents who enroll
in a Veterans Health Plan to receive such care and serv-
ices under sections 1806(c), 1806(d), 1809(a)(2) and
1809(c) of this title. The Secretary shall set such rates
based upon the fully-allocated cost to provide care. The
cost to provide care shall not take into account costs other-
wise recovered by the Secretary under section 1816 of this
title.
‘‘§ 1812. Payment policies for veterans eligible for
federally-administered health care pro-
grams
‘‘(a) For purposes of this section, the term ‘federally-
administered health care program’ shall include Medicare
and Medicaid, as established in the Social Security Act;
the Civilian Health and Medical Program of the Uni-
formed Services (CHAMPUS), as established under chap-
ter 55 of title 10 or its successor; the Federal Employees
Health Benefits Program (FEHBP), as established under
chapter 89 of title 5; and the Indian Health Service (IHS),
as established under the Indian Health Care Improvement
Act (25 U.S.C. 1601 et seq.).
‘‘(b) For purposes of any federally-administered
health care program, a Veterans Health Plan or Depart-
ment facility shall be deemed to be a qualified provider
or carrier, notwithstanding any other provision of law.
‘‘(c) The Secretary of health and Human Services,
the Director of the Office of Personnel Management, the
Secretary of the Interior, the Secretary of Defense, and
any other administrator of a federal health care program
shall enter into an agreement with the Secretary to treat
the Veterans Health Plan as a qualified provider or car-
rier, including treatment as a qualified Medicare Health
Maintenance Organization as defined in section 1876 of
the Social Security Act, for veterans covered by this chap-
ter, in any case in which the Secretary seeks to enter into
such an agreement.
‘‘(d) In the case of care provided under this chapter
to a veteran who is eligible for benefits under a federally-
administered health care program, the federally-adminis-
tered health care program shall reimburse the Veterans
Health Plan or facility providing services as a qualified
provider on the same basis as that program reimburses
other qualified providers.
‘‘(e) When the Secretary provides care—
‘‘(1) under section 1806(a) of this title to a vet-
eran who qualifies as entitled under section
1805(a)(1) of this title;
‘‘(2) under section 1806(b)(1) of this title to a
veteran who qualifies as entitled section 1805(a)(1)
of this title and has a service-connected disability
rated at 50 percent or greater;
‘‘(3) under section 1806(b)(2)(a) of this title to
a veteran who qualifies as entitled under section
1805(a)(1) of this title and has a compensable serv-
ice-connected disability rated at less than 50 percent
and does not choose under section 1806(b)(2)(B) of
this title to purchase the comprehensive benefits
package established in section 1808 of this title; or
‘‘(4) under section 1806(b)(3) of this title to a
veteran who qualifies as entitled under sections
1805(a)(2)–(a)(9) of this title;
the veteran shall not be required to pay any otherwise ap-
plicable deductible or copayment that is not covered by
the federally-administered health program, notwithstand-
ing any other provision of law.
‘‘(f) When the Secretary provides care to any veteran
not described in subsection (e), the Secretary shall require
such veteran to pay to the Veterans Health Plan any oth-
erwise applicable deductible or copayment that is not cov-
ered by the federally-administered health program.
‘‘§ 1813. Payment policies for eligible veterans and
veterans’ dependents with Medicare Sup-
plemental health insurance coverage
‘‘When the Secretary provides care on an enrolled or
fee-for-service basis to—
‘‘(1) a veteran described in section 1806(c) of
this title who has coverage under a Medicare Supple-
mental health insurance plan as established under
the Social Security Act; or
‘‘(2) a veteran’s dependent who has coverage
under a Medicare Supplemental health insurance
plan as established under the Social Security Act;
the Secretary has the authority to establish, charge,
recover and collect payment for such care or services
from the Medicare Supplemental health insurance
plan to the extent that the veteran or veteran’s de-
pendent (or the provider of the care or services)
would be eligible to receive payment for such care or
services from such party if the care or services had
not been furnished by the Secretary.
‘‘§ 1814. Payment policies for fee-for-service benefits
‘‘The Secretary shall establish and charge rates for
care and services provided to veterans who elect to obtain
services in a Veterans Health Plan on a fee-for-service
basis without enrolling in a Veterans Health Plan. Such
rates shall be based upon the fully-allocated cost to provide
the care and services received.
‘‘SUBCHAPTER V—FINANCING
‘‘§ 1815. Creation of Department of Veterans Affairs
Health Plan Fund
‘‘(a)(1) There is hereby established in the Treasury
a revolving fund to be known as Department of Veterans
Affairs Health Plan Fund (Veterans Health Plan Fund).
‘‘(2) The Secretary of the Treasury shall deposit into
the Veterans Health Plan Fund the balance of funds re-
maining in the Medical-Care Cost Recovery Fund as of
the date of the enactment of this chapter. If the balance
in the Medical-Care Cost Recovery Fund on that date is
less than $0, $0 shall be credited to the Veterans Health
Plan Fund.
‘‘(b) Any amount received by the Department by rea-
son of the furnishing of health care services to a veteran
or veteran’s dependent, including amounts received as pre-
miums, copayments, coinsurance, deductibles, reimburse-
ments from private health insurance or federally-adminis-
tered health plans and from other out-of-pocket payments
made by veterans, shall be credited to the Veterans Health
Plan Fund.
‘‘(c) Amounts in the Veterans Health Plan Fund
shall be available until expended by the Secretary for the
delivery of health care services under chapters 17 and 18
of this title.
‘‘§ 1816. Guaranteed funding of Federal costs
‘‘(a) The Secretary of the Treasury shall deposit into
the Veterans Health Plan Fund on the first day of each
fiscal-year quarter, from amounts not otherwise appro-
priated, the amount certified to the Secretary of the
Treasury under subsection (b) with respect to that quar-
ter.
‘‘(b) Not later than 30 days before the beginning of
each fiscal-year quarter, the Secretary of Veterans Affairs
shall certify to the Secretary of the Treasury the amount
determined for that quarter under this subsection.
‘‘(1) The amount to be certified to the Sec-
retary of the Treasury for any fiscal-year quarter
shall be the amount equal to—
‘‘(A) the product of—
‘‘(i) the projected number of veterans
who qualify as entitled under section
1805(a)(1) of this title and have a service-
connected disability rated at 50 percent
plus the projected number of veterans who
qualify 
as 
entitled 
under 
section
1805(a)(2)–(a)(9) of this chapter; and
‘‘(ii) the capitated enrollment amount
for such categories of veterans; plus
‘‘(B) the product of—
‘‘(i) the projected number of veterans
who qualify as entitled under section
1805(a)(1) of this title and have a compen-
sable service-connected disability rated at
less than 50 percent; and
‘‘(ii) the capitated enrollment amount
for such category of veterans; plus
‘‘(C) the product of—
‘‘(i) the projected number of other
veterans who will receive care and services
under the provisions of chapters 17 and 18
of this title at no charge to the individual
or to a provider other than the Depart-
ment; and
‘‘(ii) the capitated enrollment amount
for such categories of veterans; plus
‘‘(D) the product of—
‘‘(i) the projected number of veterans’
dependents who qualify for care under sec-
tion 1803 of this title; and