[Pages H8887-H8890]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




      MOTION TO INSTRUCT CONFEREES ON H.R. 1588, NATIONAL DEFENSE 
                 AUTHORIZATION ACT FOR FISCAL YEAR 2004

  Mr. CROWLEY. Mr. Speaker, I offer a privileged motion.
  The SPEAKER pro tempore. The Clerk will report the motion.
  The Clerk read as follows:

       Mr. Crowley moves that the managers on the part of the 
     House at the conference on the disagreeing votes of the two 
     Houses on the Senate amendment to the bill H.R. 1588 be 
     instructed to agree to the provisions contained in paragraphs 
     (3) and (4) of section 1074a(f) of title 10, United States 
     Code, as proposed to be added by section 701 of the Senate 
     amendment (relating to health care for members of reserve 
     components).

  The SPEAKER pro tempore. Pursuant to clause 7 of rule XXII, the 
gentleman from New York (Mr. Crowley) and the gentleman from New York 
(Mr. McHugh) each will control 30 minutes.
  The Chair recognizes the gentleman from New York (Mr. Crowley).
  Mr. CROWLEY. Mr. Speaker, I yield myself such time as I may consume.
  This motion is an easy one and one that should be accepted by 
everyone in this Chamber, if they are serious about supporting our 
troops and supporting our Nation. This is where I say rhetoric meets 
reality.
  My motion would instruct the conferees working on the bill 
authorizing actions by the Defense Department to allow our Nation's 
reservists and National Guard members and their families to be eligible 
to receive medical coverage from TRICARE on a cost-share basis. 
TRICARE, as my colleagues know, is the U.S. military's comprehensive 
health care plan.
  Reservists have taken on a new and more active role since the 1991 
Gulf War. Today, we see these brave young men and women risking their 
lives on a daily basis in Afghanistan, Iraq and elsewhere in this 
world. After September 11, the President signed an Executive Order 
authorizing the activation of reservists for up to 2 years of Active 
Duty, and up to 1 million reservists may be on Active Duty at any one 
time. Reservists have left their families, their friends and their jobs 
behind to serve our country, and they deserve health care for 
themselves and for their families.
  I am offering this motion today because in our Nation we are still 
facing the same problems we did during the first Gulf War call-up, poor 
medical care for reservists as they get ready to be deployed. We are 
seeing many people sent to the front lines in Afghanistan and Iraq who 
may not always be at peak readiness due to a lack of access to medical 
care necessary to ensure maximum performance. We rely on these 
reservists so much now that it would be a mistake not to include them 
in TRICARE. Their health and their ability to fight should be of our 
utmost concern.
  Our reservists should be provided with health care so they can remain 
in good health while they are not in service so that they are always 
prepared for mobilization in our global war on terrorism.
  The Congressional Budget Office estimated the cost of this program to 
be $460 million during the fiscal year 2004 and about $7.2 billion over 
a 5-year period.

                              {time}  1945

  Some Republicans and the Bush administration say that this is too 
costly, and I just do not see how that argument holds water, as the 
Bush administration has sent Congress a supplemental bill for Iraq that 
proposes over $20 billion in reconstruction and rebuilding efforts in 
Iraq alone, $20 billion in reconstruction and rebuilding in Iraq alone.
  Yes, U.S. tax dollars are rebuilding the irrigation system of Iraq, 
and this administration and this Republican Congress refuse to fund 
medical care for our Reserves and National Guard members. This $460 
million is a small price to pay to provide for our troops and to ensure 
their readiness when they are stateside. The U.S. will spend more to 
upgrade the housing of Iraqi citizens in the next month than we will on 
medical care for our Reserves and National Guard if we do not include 
this provision.
  In comparison to the tax cuts for the richest 1 percent given by this 
administration and this Congress and the enormous cost of military 
operations and reconstruction in Iraq and Afghanistan, this should be, 
quite frankly, a no-brainer.
  Some might say we need to do studies on this to see if it is 
feasible. We have done enough studies on this subject. Americans want 
action, not more studies. Studies are nice, but providing for readiness 
for our guard and reserve is a necessity. In fact, in 2002, a GAO 
report recommended Tri-Care assistance be provided during mobilizations 
targeted to the needs of Reservists and their dependents. Another GAO 
report that dealt with Reservists being mobilized during the 1990-91 
Persian Gulf War came to similar conclusions.
  We cannot afford to do another study when 40 percent of our 
Reservists on active duty between the ages of 19 and 35, 40 percent of 
those people are uninsured. Tri-Care is only extended to active duty 
and not to Reservists, even though they are required to maintain the 
same standards.
  Mr. Speaker, with the war on terrorism and continuing military 
operations in Iraq, with no valuable contribution from our European 
allies to this effort in sight, U.S. Reservists are clearly being 
called upon more and more. In fact, after September 8, it was announced 
that the deployment of Reservists in the combat theater is being 
extended from 6 months to 1 year. This is in addition to the fact that 
about half of the active duty Army is currently deployed abroad, up 
from 20 percent before 9/11.
  Certainly our heavily stressed armed services and their families 
being required to make such extensive sacrifices deserve these health 
benefits. While many Reservists do have health benefits through their 
current employers, we cannot forget the 40 percent who do not. These 
are the patriots who make up the fabric of our communities and form the 
backbone of our defense forces. We cannot keep looking the other way 
when it comes to the Reservists of our armed services.
  The administration already refuses to provide concurrent receipt for 
our veterans who are protecting our freedoms abroad. Until just this 
morning we were charging people who got injured on active duty for 
their food at U.S. military hospitals. Now we tell people, the local 
hardware store owner, the local Realtor, the stay-at-home mom raising a 
family, that we would love for them to serve as a Reservist, but we 
cannot offer them the same health care as active duty servicemen and 
servicewomen.
  We continue to ask our Reservists to live up to their duties when we 
are not willing to provide them and their families with the proper 
health care that they need and that they deserve. We are creating a 
two-tiered military, with a separate set of benefits for Reservists 
than those offered active duty servicemembers. We cannot let this 
happen.
  Join me in urging the conferees to accept the Senate provisions. 
Anything else, in my opinion, is a slap at our troops on the front line 
in our epic war against terrorism.
  Mr. Speaker, I reserve the balance of my time.
  Mr. McHUGH. Mr. Speaker, I yield myself such time as I may consume, 
and let me begin by expressing my appreciation to my friend and 
colleague, my fellow Representative, the gentleman from the great State 
of New York (Mr. Crowley), for his concern

[[Page H8888]]

and his efforts to bring this motion to the floor and before the House 
at this time.
  Clearly, Mr. Speaker, this motion to instruct is the most recent 
reflection of what is a common goal, I would hope, by all Members, and 
I do believe by all Members on both sides of the aisle, and that is a 
renewed and a very appropriate reinvigoration of concern for what is 
the reality of today's military. And that is, as again my friend, the 
gentleman from New York (Mr. Crowley), suggested, the fact that today 
the so-called active and Reserve components are seamless; that we have 
indeed a National Reserve and National Guard component that is carrying 
an equal burden.
  In my capacity as chairman of the Subcommittee on Total Force, that 
subcommittee of the Committee on Armed Services that is charged with 
the oversight and hopefully the adequate protection of the need of all 
of our men and women in uniform, regardless of their position in active 
or guard or reserve, I feel very strongly that we need to do everything 
we possibly can to adequately care and respect and respond to the needs 
of those that we ask to do so much for us.
  And as I began my opening comments here today, certainly this motion 
to instruct reflects that. It is really a continuation of other motions 
to instruct that we have had. Just last week, the gentleman from Texas, 
my colleague and my co-chair, as the chairman of the House Army Caucus, 
the gentleman from Texas (Mr. Edwards) had a motion to instruct on 
family separation pay, on imminent danger pay, that again suggested 
that when it comes to our men and women in uniform, we need to do the 
best job we possibly can, and respecting their contributions, their 
sacrifices through fair and equitable treatment, be it in pay or in 
benefits, and certainly health care is primary amongst those.
  As such, I would never suggest to any Member of this House that he or 
she come to this floor tonight and oppose this motion. That will be the 
judgment of each individual Member. I will say I intend to support it, 
and I intend to support it principally because of the symbolism 
involved that we need to do, as I have mentioned before, the best job 
we possibly can. But let me state for the record, Mr. Speaker, a couple 
of aspects that are relevant to this process as we go forward in the 
defense conference committee, of which I am a member.
  First of all, my friend from New York made some comments that frankly 
somewhat confused me. He noted that the GAO in its previous study said 
that about 40 percent of our Reserve component did not have health care 
coverage. If I heard him correctly, that is not what the GAO report 
said. And, in fact, the GAO report said quite to the contrary, that in 
2000 nearly 80 percent of Reservists had health care coverage while 
they were not on active duty, health care coverage that was provided 
through the private sector.
  And, in fact, the GAO went on to note that they had serious 
reservation about this particular initiative as embodied in the Senate 
bill to provide TRICARE coverage on a full-time, 12-month, year-in-and-
year-out basis to Guard and Reservists because of the potential 
negative effects and because of what they viewed to be a questionable 
cost-benefit analysis.
  The only thing I am aware of that in any remote way correlates with 
the gentleman's comments about 40 percent lacking is that that 2000 
survey did say that 40 percent of Reservists from drilling unit members 
live 50 miles further from their home unit. That would be a correct 
statement, but it has nothing to do with health care.
  The fact of the matter is, as I noted, according to the GAO analysis 
of the GAO study, 80 percent of our reservists have health care outside 
of the TRICARE and outside of the military-provided coverage.
  However, even with that being the case, I do respect the gentleman's 
concerns. And I think a couple of other issues that really argue to the 
contrary to some of the things he said are relevant here as well.
  As of April of this year, Mr. Speaker, a Reservist and his or her 
family who has orders placing that Reservist on active duty for more 
than 30 days is eligible and is covered by TRICARE, in spite of what I 
believe I heard the gentleman say that Reservists are not eligible for 
TRICARE. That, with all due respect, simply is not correct. No 
Reservist and no Reservist's family lack health care during wartime and 
under current law.
  So those Reservists, who I have visited, and I have been to Iraq, 
those Reservists all across this planet who are deployed and who are in 
theater indeed have coverage, as do their families. And I would note as 
well that both Houses, the House and the Senate, have included in their 
respective versions of the Defense Authorization Act that we are 
currently conferencing upon new authority, and seeing as how it is 
included in both bills I assume and I hope very fervently we are 
working very hard to ensure it is included, to provide free health care 
and dental care to Reservists prior to mobilization, before they are 
actually shipped out where they do receive coverage under current law. 
Because of the very fact, as the gentleman correctly noted, it is not 
just a question of fairness and equitability but a question of 
readiness that we do provide that as well.

  Also, I think it is important to note, because it is a concern held 
by, as I understand it, and I hope I am conveying his comments 
correctly, and I believe I am, such distinguished Members as Senator 
Warner, the chairman of that other body's full Committee on Armed 
Services, is concerned about the need to distinguish, through benefits 
and pay and such, the differences between Reservists and the 
differences between the active component.
  The cost the gentleman noted as somewhat over $460 million for 1 year 
escalates dramatically. The cost is not insignificant. The cost over 20 
years, where he noted correctly the 10-year cost is just over $7 
billion, the cost over 20 years is over $20 billion. And when you add 
that to the other things that we have afoot, the question simply is, as 
GAO noted, is this the best way to spend over $20 billion to respond to 
a need that 80 percent of the Guard and Reserve component currently do 
not experience? That is a judgment we have to make as we go through and 
try to balance the cost benefits of the entire budget.
  But as I said, at the end of the day, Mr. Speaker, the intent and the 
soul and heart of this motion to instruct is on point. Our Guard and 
Reservists are putting their lives on the line every day for us.
  Two weeks ago today, I was in my district, in a small community north 
of where I live, to attend the funeral of a 24-year-old specialist, who 
5 months before that day was married for the first time and who was 
shot by an al Qaeda sniper in Afghanistan. He was a Reservist. He was a 
man who reentered the military for one reason: he cared about this 
country and its values. And as I stood in that church and I saw the 
pain and the suffering on the faces of that family, on his new bride, 
on everyone there who cared about him, no one could convince me that 
there is too much we can do for these Guard and Reservists and too much 
we can do for our men and women in uniform.
  So I commend the gentleman for his concern, and again I would never 
counsel any Member of this House to come to this body and oppose this 
motion.
  Mr. Speaker, I reserve the balance of my time.
  Mr. CROWLEY. Mr. Speaker, I yield myself such time as I may consume; 
and I thank my good friend, the gentleman from New York (Mr. McHugh), 
for his statement. And before I recognize someone from my side, I want 
to point out for the record that according to the GAO report, from 
which I received this information, it says, and as the gentleman 
pointed out, 81 percent of the people in the Reserves are covered. If 
we take that between the years 18 and 65 years of age, we would have 81 
percent coverage. According to the GAO report, right in front of me, 
only 60 percent of junior enlisted personnel, about 90 percent of whom 
are under the age of 35, as I said in my statement between 19 and 35 
years of age, not all Reservists, but those under the age of 35, had 
coverage. Only 60 percent.
  That means, like a national average, that 40 percent have no 
coverage, just to clarify the point the gentleman made.
  Mr. Speaker, I yield such time as he may consume to the gentleman 
from Missouri (Mr. Skelton), the ranking member of the Committee on 
Armed Services and my good friend.

[[Page H8889]]

                              {time}  2000

  Mr. SKELTON. Mr. Speaker, I thank the gentleman from New York for 
yielding me this time.
  Mr. Speaker, I rise in support of the motion to instruct conferees 
offered by the gentleman from New York (Mr. Crowley). I compliment him 
for this and I also compliment the gentleman from New York (Mr. McHugh) 
for his support for this issue. This motion will direct the House 
conferees on the National Defense Authorization Act for the year 2004 
to accept the Senate provision, which would provide enhanced health 
care coverage for Reservists and National Guardsmen.
  Under section 701 of the Senate bill, members of the Selected 
Reserve, which includes the National Guard, who are alerted for 
mobilization, would receive expanded medical and dental screening. 
However, more importantly, this section would provide members of the 
Selected Reserve and Individual Ready Reserve the ability to 
participate in the Tricare program on a cost-share basis. Tricare, as 
we all know, is the military's health care system. In addition, the 
Senate section would require the Department of Defense to continue to 
pay the health care premiums for Reservists who are called to active 
duty and have other health care coverage.
  Reservists and National Guardsmen have been an integral part of every 
military operation over the past decade. Desert Shield, Desert Storm, 
Somalia, Haiti, Kosovo, Operation Noble Eagle, Operation Enduring 
Freedom and Operation Iraqi Freedom all have seen citizen soldiers 
called to active duty. The vital role the National Guard and Reserves 
play in our Nation's security has only become more clear since 
September 11.
  On the homefront, Guard and Reserve personnel were called to defend 
our Nation's airports and bridges and other important infrastructure 
across our country. Overseas, they continue to serve in Afghanistan, 
Iraq and other places around the globe.
  In the last 2 years, over 329,000 of our citizen soldiers have been 
called upon to protect our Nation's interests both here and abroad. 
Today, there are still almost 170,000 part-time volunteers serving at 
the tip of the spear.
  Those currently serving in Operation Iraqi Freedom have recently been 
informed that their deployments are being involuntarily extended. These 
Service members will have to serve at least 1 year in Iraq. Families 
who were expecting their loved ones to return home in a matter of 
months will not see their loved ones until next year. That means 
hardships for both military members and families alike. Thousands of 
Reservists who are basically part-time employees will have served full 
time for at least a year under incredibly dangerous and stressful 
conditions. Their families will have sacrificed in innumerable ways as 
well.
  The very least we can do for those who volunteer to serve their 
Nation as citizen soldiers, and for their families, is to provide 
access to quality health care for themselves as well as for their 
families. This motion by the gentleman from New York (Mr. Crowley) 
tells the conferees to agree to that very proposition. I urge my 
colleagues to join me in this motion.
  Mr. McHUGH. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, my colleague refined his earlier statement that he did 
not make in his original statement and said 19 to 35. Previously, he 
just said that 40 percent of Reservists do not have that coverage, and 
that is an important distinction. I am not trying to trip up anyone on 
details; however, I have a report, and I would be interested, I would 
ask the gentleman, this is a little unusual for the character of these 
discussions, but are we referring to GAO report 03-1004?
  Mr. CROWLEY. Mr. Speaker, will the gentleman yield?
  Mr. McHUGH. I yield to the gentleman from New York.
  Mr. CROWLEY. I am referring to GAO report 02-829, Defense Health 
Care. Also, for the record, on page 9 of my statement, and I repeat, we 
cannot afford to do another study when 40 percent of our Reservists on 
active duty between the ages of 19 and 35 are uninsured.
  Mr. McHUGH. Mr. Speaker, I have no doubt that the gentleman's written 
statement said that. I do not have his written statement, I can only 
hear what he said. I am trying to understand the statement the 
gentleman made so we can take the proper path.
  Mr. CROWLEY. I appreciate that.
  Mr. McHUGH. Mr. Speaker, I think it is important to suggest that if 
we are talking about a targeted population here, perhaps a broad-based 
response is not the most efficacious we could adopt.
  Again, in the GAO 03-1004 report, 80 percent which obviously is an 
average that includes the 19-35, have coverage, which means 20 percent 
do not have coverage. So is this the best way to do it?
  In fact, GAO's final determinate was they seriously questioned this 
particular provision in the Senate bill, not referring to it 
specifically because it was not yet there, but questioning the 
provision of 24-hour-a-day, 7-day-a-week, 12-month-a-year coverage to 
Guard and Reservists not being the most appropriate response remains, 
whether it is 60 percent, 40 percent or 80 percent.
  However, as I mentioned, and as I said, I want to thank the ranking 
member of the Committee on Armed Services, the gentleman from Missouri 
(Mr. Skelton) for, as always, his compassion and his leadership and his 
concern. There is no Member in this House I respect more than the 
gentleman.
  We do need to make every effort we can to express our concern in our 
response to Guard and Reservists, so I would not urge Members to oppose 
this motion. We need to do the best job we can, in the context of the 
money we have available, and both the House and the other body are 
trying to work to that end in the defense authorization bill, and that 
is certainly, in large measure, led by the efforts of the gentleman 
from Missouri (Mr. Skelton). I would urge my colleagues not to oppose 
this motion.
  Mr. Speaker, I yield back the balance of my time.
  Mr. CROWLEY. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, let me say that I appreciate the comments of the 
gentleman from New York (Mr. McHugh). We have known each other for 
many, many years, and I respect the gentleman's work here in the House, 
especially as it relates to our Armed Servicemen and Women. I join the 
gentleman in his remarks about the gentleman from Missouri (Mr. 
Skelton), the ranking member, and how much we respect the gentleman and 
his work, as well as how it pertains to our young men and women, and to 
those up to the age of 65.
  The gentleman from New York (Mr. McHugh) mentioned that 80 percent of 
Reservists have health care, 81 percent of those between 18 and 65 have 
health care. Officers and senior enlisted personnel are more likely 
than junior enlisted personnel to have coverage. Again, only 60 percent 
of junior enlisted personnel, about 90 percent of whom are under age 
35, had coverage, interpreting that meaning 40 percent do not have 
coverage. That is lower than the similar age group in the general 
population. So our Reservists have even less insurance than the general 
population between those years of 19 to 35. That is what we are talking 
about.
  If there was a Band-Aid approach, I would support that as well, if we 
could. That is not before us right now. We have a measure by the Senate 
that is before us that we can include in this conference report. That 
is what this motion is about, to cover all those individuals. Right 
now, we are asking many of them to make the ultimate sacrifice. I am 
sure the gentleman from New York (Mr. McHugh) has been out to Walter 
Reed Hospital, as I have. Some have given their lives, and many have 
given limbs, many of whom are not even citizens. We are making efforts 
to do away with some of the ridiculous charges, charging fees for meals 
at these hospitals when some of these people do not have arms to even 
eat those meals. We are making progress, but here is an opportunity to 
take care of a segment of the population who are willing to sacrifice 
themselves and their families and the time with their families, and 
sacrifice their opportunities at work in defense of this country. I 
think the least we can do is make sure that not only they have the 
health care coverage they need in order to perform in the defense of 
this country, but that their children and spouses have that health care 
as well.
  Mr. Speaker, I include for the Record, GAO 02-829 Defense Health

[[Page H8890]]

Care, the paragraph that specifically pertains to what I was talking 
about.

            [From GAO, September 2003, Defense Health Care]

 Most Reservists Have Civilian Health Coverage But More Assistance Is 
                      Needed When TRICARE Is Used

       Until recently, DOD has administered a transitional benefit 
     program that provided demobilized reservists and their 
     dependents 30 days of additional TRICARE coverage as they 
     returned to their civilian health care. The 2002 NDAA 
     extended the transitional period during which reservists may 
     received TRICARE coverage from 30 days to 60-120 days, 
     depending on the length of active duty service. This change 
     more closely reflects the 90 days that USERRA provides 
     reservists to apply for civilian reemployment when they are 
     mobilized for more than 181 days, and the change will provide 
     health care coverage if they elect to delay return to their 
     employment subsequent to demobilization. However, the 2002 
     NDAA did not provide any transitional benefit for dependents.
       Overall, the percentage of reservists with health care 
     coverage when they are not mobilized is similar to that found 
     in the general population--and, like the general population, 
     most reservists have coverage through their employers. 
     According to DOD's 2000 survey of Reserve Component 
     Personnel, nearly 80 percent of reservists reported having 
     health care coverage. In the general population, 81 percent 
     of 18 to 65 years old have health care upon coverage. 
     Officers and senior enlisted personnel were more likely than 
     junior enlisted personnel to have coverage. Only 60 percent 
     of junior enlisted personnel, about 90 percent of whom are 
     under age 35, had coverage--lower than the similarly aged 
     group in the general population. Of reservists with 
     dependents, about 86 percent reported having coverage. Of 
     reservists without dependents, about 63 percent reported 
     having coverage.

  Mr. HOLDEN. Mr. Speaker, I rise today not only in support of the 
gentleman from New York's motion to instruct conferees, but also in 
support of the brave men and women who actively serve in the National 
Guard and Reserves. Their commitment to service is second to none, 
whether it is providing aid during natural disasters, the war on 
domestic terrorism, or on the battlefields of Iraq and Afghanistan.
  Pennsylvania boasts the largest Army National Guard, as well as the 
fourth largest Air National Guard, making it the largest National Guard 
in the country. Many of these men and women serve at Ft. Indiantown 
Gap, the largest National Gaurd base in Pennsylvania in the heart of my 
Congressional District. Beyond all of this, the National Guard is the 
sixth largest employer in Pennsylvania and has a presence in over 100 
communities throughout the commonwealth.
  Mr. Speaker, as you can see, the National Guard and Reserves are an 
integral part of my district and of Pennsylvania. But I also know they 
are essential to every state and commonwealth, as well as the country 
as a whole. The protection they provide for us should be given back to 
them in their healthcare coverage. This is why I strongly support 
providing TRICARE coverage for these men and women.
  Medical readiness is essential for National Guard and Reserve members 
if they are to continue their role as part of a cohesive, seamless 
force. These men and women train hard, take time off from their 
civilian jobs, and make many family sacrifices in order to serve. They 
are expected to be a ready force when deployed. To facilitate the use 
of the National Guard and Reserve as an integral part of our armed 
forces, we need a consistent health care option that covers our members 
and their families whether they are deployed or not.
  In closing, Mr. Speaker, TRICARE should be an option for all members 
of the National Guard and Reserves and I support the motion to instruct 
conferees.
  Mr. CROWLEY. Mr. Speaker, I yield back the balance of my time.
  The SPEAKER pro tempore (Mr. Franks of Arizona). Without objection, 
the previous question is ordered on the motion to instruct.
  There was no objection.
  The SPEAKER pro tempore. The question is on the motion to instruct 
offered by the gentleman from New York (Mr. Crowley).
  The question was taken; and the Speaker pro tempore announced that 
the ayes appeared to have it.
  Mr. CROWLEY. Mr. Speaker, on that I demand the yeas and nays.
  The yeas and nays were ordered.
  The SPEAKER pro tempore. Pursuant to clause 8 of rule XX, further 
proceedings on this motion will be postponed.

                          ____________________