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“Hearing on Pending Legislation”

House Veterans Affairs Committee, Health Subcommittee Hearing

June 12, 2025 (recording here)

HEARING INFORMATION

Witnesses & Written Testimony (linked) (Panel One):

• Dr. Antoinete V. Shappell: Deputy Assistant Under Secretary for Health for Patient Care Services, Veteran Health Administration, Department of Veterans Affairs

• Dr. Isle Wiechers: Deputy Executive Director, VHA Office of Mental Health, Department of Veterans Affairs

Witnesses & Written Testimony (linked) (Panel Two):

• Mrs. Caira Benson: Caregiver Fellow, Elizabeth Dole Foundation

• Mr. David A. Coker: President, Fisher House Foundation

• Mr. Randy T. Johnson: Constituent

• Mr. Cole Lyle: Director, Veterans Affairs and Rehabilitation Division, The American Legion

• Mr. John Schmitt: CEO, iXpressGenes

Keywords mentioned:

• VA funding, health professional scholarship, mental health, service dogs, Fisher House Foundation, U.S. territories, data transparency, caregiver support, CHAMPVA

IN THEIR WORDS

OPENING STATEMENTS FROM THE SUBCOMMITTEE & OTHER MEMBERS

• Chairwoman Mariannette Miller-Meeks began by stating that the Subcommittee was considering 12 legislative proposals, many of which would optimize VA funding, talent, and mission delivery. She highlighted bills aimed at improving the student-to-employee pipeline, rural access to patient advocates, and geriatric care input from state veterans homes. She praised specific proposals like the Health Professionals Scholarship Program Improvement Act (H.R. 3767), the Representing Our Seniors at VA Act (H. R. 785), and the TRAVEL Act (H.R. 3400) for addressing resource gaps. The Chairwoman also mentioned her own Fisher House Availability Act (H.R. 3726), which would ensure service members can access unused VA lodging when receiving non-VA care, and she underscored the collective aim to evolve VA services for both mental and physical health care.

• Ranking Member Julia Brownley expressed appreciation for the hearing and stated that while Democrats supported the intent behind many Republican bills, they hoped to collaborate on improvements. She spotlighted her own bill, the CHAMPVA Children’s Care Protection Act (H.R. 1404), which would align VA coverage with private and TRICARE plans by extending eligibility to age 26. Ranking Member Brownley also endorsed Rep. Joe Morelle’s bill to support caregivers transitioning out of VA programs (H.R. 2148) and Rep. Nikki Budzinski’s mental health outreach bill. She stressed the importance of proactive VA engagement to reduce veteran suicide and improve health outcomes.

• Rep. Greg Murphy spoke in support of his bill, the Veterans PTSD Screening Act, which would direct the VA to study RNA sequencing as a tool to diagnose PTSD. He explained the science behind RNA changes under stress and how it might be used to predict or monitor PTSD. Rep. Murphy advocated for innovative diagnostic tools but cautioned against relying on RNA as the sole determinant. He argued that the bill would help expand the VA’s PTSD care toolkit without limiting existing care access.

• Rep. Nikki Budzinski introduced her bipartisan bill, the VA Mental Health Outreach and Engagement Act, which would improve the VA’s outreach to veterans with service-connected mental health conditions. She said that many veterans are unaware of how to access care for invisible wounds and stated that the bill would reduce barriers to mental health services. She also supported H.R. 3767, citing the need to address delays in hiring scholarship recipients.

• Rep. Kimberlyn King-Hinds advocated for her bill, H.R. 3400, which would address severe medical care shortages in the U.S. territories, including her home in the Northern Mariana Islands. She described how veterans must currently travel long distances to receive specialized care and called this reality both unacceptable and offensive. Her bill would place VA doctors in the territories for one-year billets to provide on-island care. She urged her colleagues to support this essential step toward equity for veterans in remote areas.

• Rep. Morgan Luttrell spoke passionately in support of the Service Dogs Assisting Veterans Act (SAVES) Act (H.R. 2605), which would expand access to service dogs for veterans. He emphasized that many veterans live with PTSD, traumatic brain injury (TBI), and other invisible wounds, and that service dogs provide life-changing support for mental and physical challenges. Rep. Luttrell said that the program would offer highly trained dogs at no cost and had bipartisan and veteran organization backing.

• Rep. John McGuire presented the VA Data Transparency and Trust Act (H.R. 3643), which would streamline VA reporting and improve congressional oversight. He pointed out that the VA’s budget has increased dramatically while suicide rates have remained unchanged, illustrating past VA budget mismanagement. Rep. McGuire’s bill would require a single comprehensive annual report to provide timely and actionable data. He argued that better data practices would align the VA with other federal agencies and ensure more informed decisions on veteran care and benefits.

SUMMARY OF KEY POINTS (PANEL ONE)

• Dr. Antoinete Shappell summarized the VA’s views on the bills under discussion. She stated that the VA supported many proposals in principle, such as H.R. 2605, H.R. 3400, and H.R. 3726, while recommending technical amendments for clarity. She noted concerns with bills like H.R. 1404 and H.R. 3767 due to resource impacts and feasibility. Dr. Shappell also expressed support, with caveats, for initiatives like RNA sequencing research, caregiver transitions, and data transparency, and offered the VA’s willingness to work with the Committee on revisions.

• Ranking Member Brownley questioned Dr. Shappell about the VA’s opposition to H.R. 1404, noting that CHAMPVA shares characteristics with private health insurance plans, such as cost-sharing, a formulary, and prior authorization requirements. Dr. Shappell replied that she would need to take many of the questions for the record but acknowledged some of those features likely apply.

• Ranking Member Brownley argued that CHAMPVA resembles an insurance plan and criticized the VA for treating CHAMPVA dependents differently than TRICARE beneficiaries. She also expressed frustration that the VA had not responded to Committee staff questions submitted seven weeks prior and asked for a timeline, which Dr. Shappell could not provide.

• Rep. King-Hinds asked about the implementation of care coordination provisions in H.R. 3400. Dr. Isle Wiechers responded that the VA would need to work with the Committee to clarify the intent of that section. Rep. King-Hinds then raised concerns about the cost and quality-of-life challenges that deter healthcare professionals from relocating to the territories and requested further discussion on recruitment and retention issues. Dr. Wiechers agreed to engage in that conversation and explained the technical amendment was intended to align bonus authority with current policy.

• Rep. Jack Bergman asked why the VHA planned to eliminate the Health Professional Scholarship Program for physician assistants (PAs) in FY 2026, especially when returning medics and corpsmen could fill vital medical roles. Dr. Wiechers stated that she would have to take the question for the record. Rep. Bergman underscored that PAs were a valuable part of the healthcare system and spoke briefly on the importance of including them in future VA planning. He also mentioned ongoing debates around medical specialties and supervision and urged the VA to prioritize workforce diversity and readiness.

• Rep. Herb Conaway discussed H.R. 3643 and asked whether the VA had the personnel and resources to comply with the bill's reporting requirements. Dr. Shappell replied that while the VA supported the bill with amendments, the current language was broad and resource-intensive, and she requested a meeting to narrow the scope.

• Rep. Conaway expressed concern that the VA lacked data on staffing changes and hiring trends, which he considered essential to oversight. Dr. Shappell acknowledged the concern and said that the department was working with the Office of Personnel Management (OPM) and the White House to exempt over 300,000 positions from the hiring freeze.

• Rep. Luttrell asked whether the VA opposed part of H.R. 2605 because it believed service dogs were not effective for PTSD. Dr. Shappell confirmed that the VA had concerns based on insufficient evidence and passed the question to Dr. Wiechers, who cited a single study. Rep. Luttrell forcefully objected, claiming that countless veterans attest to the benefits of service dogs, and he called the VA’s position unacceptable. Dr. Wiechers said she was open to working with him to align the bill’s definitions with VA policy.

• Chairwoman Miller-Meeks asked why her bill on Fisher House lodging was necessary to clarify congressional intent. Dr. Shappell explained that current law prohibits TRICARE beneficiaries from staying in VA-owned Fisher Houses, and the bill would codify eligibility for active-duty families.

• The Chairwoman also asked whether the VA supported creating a centralized public data platform, as proposed in Rep. McGuire’s bill. Dr. Shappell replied that she would have to take the question for the record.

SUMMARY OF KEY POINTS (PANEL TWO)

• Mr. David Coker described the history and mission of the Fisher House Foundation, sharing its role in providing free lodging for military and veteran families near medical centers. He noted that Fisher Houses have saved families over $650 million in out-of-pocket costs and pointed to their healing impact by keeping families close during treatment. He raised concerns about recent VA guidance restricting Fisher House access to only families of veterans receiving VA-directed care, even when rooms are available. Mr. Coker urged Congress to pass the bipartisan H.R. 3726 to restore flexibility, maintain veteran priority, and honor the foundation’s mission of keeping military and veteran families together during medical crises.

• Mr. Randy Johnson testified in strong support of H.R. 3400, which would bring VA physicians to underserved territories like the Northern Mariana Islands. He described the lack of a VA medical center, mental health services, or even a community-based outpatient clinic in the islands, forcing veterans to travel thousands of miles for care. Mr. Johnson shared powerful personal and collective stories of veterans across generations who have faced decades of denial and delay, stating that they are not seeking special treatment, just equal access to care. He asked Congress to support the bill and finally answer the call that veterans in the territories have long endured without adequate support.

• Mr. Cole Lyle voiced the American Legion’s support for nearly all of the bills under consideration, noting their alignment with priorities like suicide prevention, caregiver support, provider shortages, and equitable care. He endorsed bills expanding data transparency, improving outreach in underserved areas, supporting state veterans homes, and enabling the use of service dogs. Mr. Lyle specifically shared his personal story about his own service dog, who changed his life and helped him earn degrees and become an advocate. He testified that service dogs can be life-saving and that H.R. 605 builds on prior legislation to expand these benefits meaningfully.

• Mr. John Schmitt introduced himself as a combat veteran and the CEO of a biotech company using RNA transcriptome analysis to identify trauma-induced inflammation. He recounted the traumatic event that led to the founding of his company and shared his personal journey through PTSD and suicidal ideation. Mr. Schmitt explained how the Trauma Autoimmune Indicator (TAI) blood test can detect inflammation caused by trauma in real time and help personalize treatment strategies. He advocated for the adoption of this innovative diagnostic tool, which he called a transformational step toward proactive, precision mental health care for veterans and civilians alike.

• Mrs. Caira Benson testified as a caregiver for her permanently disabled veteran husband and as a mother of five, sharing the challenges her family faces with CHAMPVA and the burden of caregiving. She described serious delays in claims processing, insurance lapses, and bureaucratic hurdles that left her children without coverage for extended periods. Mrs. Benson strongly supported H.R. 1404 to extend CHAMPVA coverage to age 26 and H.R. 2148 to help caregivers reenter the workforce and plan for retirement after their caregiving ends.

• Ranking Member Julia Brownley asked Mrs. Benson whether she had noticed any improvements in CHAMPVA operations over the past 18 months, particularly in hold times and paperwork processing. Mrs. Benson responded that while the hold time had dropped to 1.5 hours and a callback option was now available, the core issues remained unresolved, such as delays in opening mail, broken online portals, and disconnected fax numbers. When asked what else should be prioritized beyond extending coverage to age 26, Mrs. Benson advocated for modernizing the outdated statute, establishing a provider network like TRICARE, and recognizing caregivers and their children as a vital part of the veteran health care system.

• Rep. King-Hinds questioned Mr. Johnson about his experience as a caseworker and the top three concerns raised by veterans in the Northern Mariana Islands. Mr. Johnson cited issues with travel reimbursement, difficulties coordinating care due to a lack of providers, and communication challenges with the VA. He explained that veterans often paid out of pocket for inter-island travel and were forced to take personal loans or postpone appointments while waiting for reimbursements. When asked about specialized care needs, he identified chiropractic care as a pressing gap and described the high cost of travel and lodging to access it off-island.

• Chairwoman Miller-Meeks asked how H.R. 2605 would benefit veterans across the country. Mr. Lyle responded that service dogs offered a unique form of support that cannot be replicated by pills or therapy, providing a sense of purpose that helps prevent suicide. He criticized the VA’s reliance on a single study with a flawed control group, arguing that even that study showed positive results. Mr. Lyle emphasized that countless veterans credit their service dogs with saving their lives.

• Chairwoman Miller-Meeks then asked Mr. Coker to share examples of how current policy has prevented service members and families from accessing Fisher Houses. Mr. Coker explained that families facing specialized treatment often must choose between incurring overwhelming debt to stay near their loved ones or forgoing care altogether. He claimed that no military family should have to make such a decision and that her legislation would help restore dignity and access for those affected.

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