Congressional Record Statement of Senator Daniel K. Akaka  

Mr. President, today I introduce legislation to correct a deficiency in the law governing health care for veterans.  Under current law, originally enacted on November 30, 1999, a veteran who is enrolled in VA's health care system can be reimbursed for emergency treatment received at a non-VA hospital.  However, the statute only permits such VA reimbursement if the veteran has no other outside health insurance, no matter how limited that other coverage might be. 

This sole payor provision means that a veteran who has any insurance is not entitled to reimbursement from VA for emergency medical treatment received at a non-VA facility.  This is true even if the veteran's insurance policy does not cover the full amount owed. 

The bill I am introducing would amend current law so that a veteran who has outside insurance would be eligible for reimbursement in the event that any outside insurance does not cover the full amount of the emergency care.  VA would be authorized to cover the difference between the amount the veteran's insurance will pay and the total cost of care.  In essence, VA would become the payor of last resort in such cases.  This would keep the veteran from being burdened by exorbitant medical fees with no insurance with which to pay them. 

In addition to amending current law in a prospective manner, this legislation would also allow the Secretary of Veterans Affairs to retroactively apply this law to emergency treatment received between the effective date of the current law and the date of enactment of the legislation I am introducing today. 

One example of the sort of case to which this discretionary authority might apply in one that came to the Committee's attention involving a disabled Vietnam veteran who was in a serious motorcycle accident which led to a medical bill for emergency room care of over $100,000.  This veteran, who lived in Illinois, had state mandated auto insurance which included a medical benefit of $10,000.   Since he had this other insurance, VA was precluded from paying for his care and the veteran was personally responsible for the difference between the amount covered by his state-required policy and the total charge for his care.  Had this veteran had no insurance at all, VA would have paid the entire amount.

Mr. President, I urge our colleagues to cosponsor this legislation and to work with me and the other members of the Veterans' Affairs Committee to address this gap in VA benefits. 

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February 10, 2009