Markup on Pending Legislation

House Veterans Affairs Committee, Health Subcommittee

March 25, 2025 (recording here)

BILLS CONSIDERED IN MARKUP

• H.R. 217, CHIP IN for Veterans Act (Rep. Bacon)

• H.R. 1969, No Wrong Door for Veterans Act (Rep. Miller-Meeks)

• H.R. 1971, Veterans Supporting Prosthetics Opportunities and Recreational Therapy (SPORT) Act (Rep. Miller-Meeks)

• H.R. 1823, The VA Budget Accountability Act (Rep. Bergman)

• H.R. 1107, The Protecting Veteran Access to Telemedicine Services Act (Rep. Womack)

• H.R. 1336, The Veterans National Traumatic Brain Injury Act (Rep. Murphy)

• H.R. 658, To amend title 38, United States Code, to establish qualifications for the appointment of a person as a marriage and family therapist, qualified to provide clinical supervision, in the Veterans Health Administration (Rep. Brownley)

• H.R. 1644, Copay Fairness for Veterans Act (Rep. Underwood)

• H.R. 1860, The Women Veterans Cancer Care Coordination Act (Rep. Garcia)

OPENING STATEMENTS FROM THE SUBCOMMITTEE

• Chairwoman Mariannette Miller-Meeks stated that the Subcommittee had contacted the Congressional Budget Office (CBO) for preliminary cost estimates, though not all bills had estimates yet. She acknowledged that offsets were not included but would be added before full Committee or floor consideration. She mentioned bipartisan cooperation, especially on mental health and prosthetics care bills. The Chairwoman also supported the Veterans National Traumatic Brain Injury Act, which proposes a pilot program for hyperbaric oxygen therapy (HBOT) for veterans with posttraumatic stress disorder (PTSD) or traumatic brain injury (TBI).

• Ranking Member Julia Brownley waived her opening statement in the interest of time.

SUMMARY OF KEY POINTS

• The Subcommittee considered five bills en bloc: the CHIP IN for Veterans Act (H.R. 217), the Veterans Supporting Prosthetics Opportunities and Recreational Therapy (SPORT) Act (H.R. 1971), the Protecting Veteran Access to Telemedicine Services Act (H.R. 1107), the Copay Fairness for Veterans Act (H.R. 1644), and the Women Veterans Cancer Care Coordination Act (H.R. 1860).

• Ranking Member Brownley spoke in support of the en bloc, particularly on H.R. 1644 and H.R. 1860. She said that the bills focus on preventive care and cancer care coordination for women veterans. She also expressed conditional support for H.R. 1107 but urged amendments based on forthcoming VA feedback.

• Bills included in the en bloc were favorably forwarded to the full Committee.

• The Subcommittee then discussed the No Wrong Door for Veterans Act (H.R. 1969). Chairwoman Miller-Meeks introduced an amendment in the nature of a substitute (ANS) to reauthorize the Staff Sergeant Parker Gordon Fox Suicide Prevention Grant Program (SSG Fox SPGP) through 2026. She mentioned the program’s success in expanding access to mental health care for veterans and noted that its expiration would leave veterans vulnerable. She also said that the amendment would allow time to evaluate reforms while maintaining access to care.

• Rep. Maxine Dexter opposed both the underlying bill and the proposed amendment. She criticized the mandated use of the Columbia Suicide Severity Rating Scale (C-SSRS), arguing that it was too narrow and not intended to track long-term outcomes. She also expressed concern about vague language allowing healthcare providers as grantees, fearing misuse of taxpayer funds and reduced support for VA direct care. Rep. Dexter stated that insufficient data existed to justify extending the program and stressed the need to invest in proven VA services instead.

• A recorded vote on the ANS was requested. Later, the ANS passed by a 7-5 vote along party lines. The bill as amended was favorably forwarded to the full Committee.

• The VA Budget Accountability Act (H.R. 1823) was brought up for discussion. Chairwoman Miller-Meeks supported the bill, which would require a forensic audit of the VA’s budget shortfall by the Government Accountability Office. She claimed that the bill would ensure accountability and prevent future fiscal mismanagement. Rep. Jack Bergman, the bill’s sponsor, also highlighted the importance of accurate budgeting to meet veterans’ needs. He called the VA’s previous budgeting failures inexcusable and said that the audit would prevent future shortfalls and protect taxpayer dollars.

• Ranking Member Brownley supported the intent of H.R. 1823 but warned that it duplicated work already being done by the GAO and the Office of Inspector General (OIG). She recommended amending the bill at the full Committee level to ensure the efficient use of GAO resources. She also suggested that the GAO should report directly to Congress rather than routing the report through the VA.

• H.R. 1823 was favorably forwarded to the full Committee.

• The Chairwoman then discussed the Veterans National Traumatic Brain Injury Act (H.R. 1336). Rep. Greg Murphy spoke passionately in support of his bill to launch a pilot program for HBOT for veterans with PTSD and TBI. He cited 30 years of medical experience and meta-analyses, as well as personal interactions with veterans who benefited from the therapy. Rep. Murphy said that traditional treatments were failing, and he listed bipartisan co-sponsors and support from veterans service organizations (VSOs).

• Rep. Derrick Van Orden described his military experience and testified to the effectiveness of HBOT through firsthand accounts. He echoed that existing treatments were failing veterans and urged support for HBOT.

• Rep. Kelly Morrison voiced severe concern over the lack of scientific consensus around HBOT. She advocated for evidence-based medicine and introduced an amendment requiring the VA to conduct a literature review before launching the pilot. Rep. Van Orden and Rep. Murphy opposed the amendment.

• Rep. Dexter and Rep. Herb Conaway opposed H.R. 1336. They argued that the supporting research was weak and inconclusive, warning that allocating funds to unproven treatments would divert resources from effective, VA-based care. They also stressed that treatment should be based on randomized controlled trials and rigorous evidence.

• Rep. Murphy and the Chairwoman reiterated their support for H.R. 1336 based on its potential to help veterans and expand treatment options for those who need it. The Chairwoman defended the need for pilot studies when evidence was inconclusive but promising, once again spotlighting the failures of traditional VA mental health treatments.

• Rep. Morrison’s amendment failed by a 5-7 vote along party lines.

• Another amendment to H.R. 1336 was offered by Rep. Sheila Cherfilus-McCormick, requiring the GAO to update its 2015 report on HBOT efficacy. She argued that a decade-old review was outdated and a refreshed analysis would enhance transparency. Rep. Murphy supported the amendment, and it was adopted by voice vote.

• Ranking Member Brownley also offered an amendment to H.R. 1336, citing a recent incident in Michigan where a child died in an unregulated HBOT chamber. She proposed requiring HBOT providers participating in the VA program to be accredited by a recognized body to ensure safety. Rep. Murphy agreed, calling the amendment appropriate and safety-focused. The amendment was adopted.

• H.R. 1336 as amended was favorably forwarded to the full Committee.

• Ranking Member Brownley then introduced a bill to address inequities in promotional opportunities for licensed marriage and family therapists at the VA. She said that existing standards limited career advancement and discouraged qualified professionals from working at the VA. She urged her colleagues to support the bill, and it was favorably forwarded to the full Committee.

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