Veterans Affairs: Health Care and Benefits for Veterans Exposed to Agent Orange
Since the 1970s, Vietnam-era veterans have attributed certain medical illnesses, disabilities, and birth defects to exposure to Agent Orange and other herbicides sprayed by the U.S. Air Force to destroy enemy crops and remove forest cover. During the last 30 years, Agent Orange legislation has established and updated the health and disability benefits of Vietnam veterans exposed to herbicides. Several laws were enacted by Congress to provide health care services to Vietnam veterans. The Veterans' Health Care, Training and Small Business Loan Act (P.L. 97-72) elevated Vietnam veterans' priority status for health care at Department of Veterans Affairs facilities by recognizing a veteran's own report of exposure as sufficient proof to receive medical care unless there was evidence to the contrary. The Veterans' Health Care Eligibility Reform Act of 1996 (P.L. 104-262) completely restructured the VA medical care eligibility requirements for all veterans. Under P.L. 104-262, a veteran does not have to demonstrate a link between a certain health condition and exposure to Agent Orange; instead, medical care is provided unless the VA has determined that the condition did not result from exposure to Agent Orange. Likewise, Congress passed several measures to address disability compensation issues of Vietnam veterans. The Veterans' Dioxin and Radiation Exposure Compensation Standards Act of 1984 (P.L. 98-542) required the VA to develop regulations for disability compensation to Vietnam veterans exposed to Agent Orange. In 1991, the Agent Orange Act (P.L. 102-4) established for the first time a presumption of service-connection for diseases associated with herbicide exposure. P.L. 102-4 authorized the VA to contract with the IOM to conduct a scientific review of the evidence linking certain medical conditions to herbicide exposure. Under this law, the VA is required to review the reports of the IOM and issue regulations, establishing a presumption of service-connection for any disease for which there is scientific evidence of a positive association with herbicide exposure. Navy veterans of the Vietnam Era (those who served in Vietnam between January 9, 1962, and May 7, 1975), who served offshore and were never physically present on Vietnamese soil, have been contesting the presumption of service-connection for Agent Orange disability benefits. In 2006, the U.S. Court of Appeals for Veterans Claims (CAVC) ruled in Haas v. Nicholson that navy veterans who served offshore during the Vietnam Era were entitled to a presumption of exposure to Agent Orange. On May 8, 2008, the U.S. Court of Appeals for the Federal Circuit (“the court”) issued a decision reversing the CAVC's decision. On June 23, 2008, the attorneys for Haas filed a petition with the court for a panel rehearing or a rehearing en banc (that is, the whole panel of judges of the court). On October 9, 2008, the court denied the petition. Following this action, Haas petitioned the U.S. Supreme Court for certiorari (asking the Supreme Court to review the decision of a lower court). On January 21, 2009, the Supreme Court denied the petition for writ of certiorari. A subsequent related proceeding, Haas v. Shinseki, on remand from the court, involved the same plaintiff and the same factual situation. On March 10, 2009, the court examined the BVA's decision, vacated that decision, and remanded the claim for further proceedings with the BVA. The Agent Orange Equity Act of 2009 (H.R. 2254), if enacted, would clarify service in Vietnam to include inland waterways, the waters offshore, and airspace above Vietnam. Under H.R. 2254, those who have been awarded the Vietnam Service Medal or the Vietnam Campaign Medal would also be eligible for disability compensation based on presumptive disease conditions relating to exposure to Agent Orange. This report will be updated as events warrant.
Veterans Affairs: Health Care and Benefits for Veterans Exposed to Agent Orange
Since the 1970s, Vietnam-era veterans have attributed certain medical illnesses, disabilities, and birth defects to exposure to Agent Orange and other herbicides sprayed by the U.S. Air Force to destroy enemy crops and remove forest cover. During the last 30 years, Agent Orange legislation has established and updated the health and disability benefits of Vietnam veterans exposed to herbicides. Several laws were enacted by Congress to provide health care services to Vietnam veterans. The Veterans' Health Care, Training and Small Business Loan Act (P.L. 97-72) elevated Vietnam veterans' priority status for health care at Department of Veterans Affairs facilities by recognizing a veteran's own report of exposure as sufficient proof to receive medical care unless there was evidence to the contrary. The Veterans' Health Care Eligibility Reform Act of 1996 (P.L. 104-262) completely restructured the VA medical care eligibility requirements for all veterans. Under P.L. 104-262, a veteran does not have to demonstrate a link between a certain health condition and exposure to Agent Orange; instead, medical care is provided unless the VA has determined that the condition did not result from exposure to Agent Orange. Likewise, Congress passed several measures to address disability compensation issues of Vietnam veterans. The Veterans' Dioxin and Radiation Exposure Compensation Standards Act of 1984 (P.L. 98-542) required the VA to develop regulations for disability compensation to Vietnam veterans exposed to Agent Orange. In 1991, the Agent Orange Act (P.L. 102-4) established for the first time a presumption of service-connection for diseases associated with herbicide exposure. P.L. 102-4 authorized the VA to contract with the IOM to conduct a scientific review of the evidence linking certain medical conditions to herbicide exposure. Under this law, the VA is required to review the reports of the IOM and issue regulations, establishing a presumption of service-connection for any disease for which there is scientific evidence of a positive association with herbicide exposure. Navy veterans of the Vietnam Era (those who served in Vietnam between January 9, 1962, and May 7, 1975), who served offshore and were never physically present on Vietnamese soil, have been contesting the presumption of service-connection for Agent Orange disability benefits. In 2006, the U.S. Court of Appeals for Veterans Claims (CAVC) ruled in Haas v. Nicholson that navy veterans who served offshore during the Vietnam Era were entitled to a presumption of exposure to Agent Orange. On May 8, 2008, the U.S. Court of Appeals for the Federal Circuit (“the court”) issued a decision reversing the CAVC's decision. On June 23, 2008, the attorneys for Haas filed a petition with the court for a panel rehearing or a rehearing en banc (that is, the whole panel of judges of the court). On October 9, 2008, the court denied the petition. Following this action, Haas petitioned the U.S. Supreme Court for certiorari (asking the Supreme Court to review the decision of a lower court). On January 21, 2009, the Supreme Court denied the petition for writ of certiorari. A subsequent related proceeding, Haas v. Shinseki, on remand from the court, involved the same plaintiff and the same factual situation. On March 10, 2009, the court examined the BVA's decision, vacated that decision, and remanded the claim for further proceedings with the BVA. The Agent Orange Equity Act of 2009 (H.R. 2254), if enacted, would clarify service in Vietnam to include inland waterways, the waters offshore, and airspace above Vietnam. Under H.R. 2254, those who have been awarded the Vietnam Service Medal or the Vietnam Campaign Medal would also be eligible for disability compensation based on presumptive disease conditions relating to exposure to Agent Orange. This report will be updated as events warrant.
Jordan: Background and U.S. Relations
This report provides an overview of Jordanian politics and current issues in U.S.-Jordanian relations. It provides a brief discussion of Jordan's government and economy and of its cooperation in promoting Arab-Israeli peace and other U.S. policy objectives in the Middle East. This report will be updated periodically to reflect new developments. Several issues in U.S.-Jordanian relations are likely to figure in decisions by Congress and the Administration on future aid to and cooperation with Jordan. These include the stability of the Jordanian regime, the role of Jordan in the Arab-Israeli peace process, Jordan's role in stabilizing Iraq, and U.S.-Jordanian military and intelligence cooperation. Although the United States and Jordan have never been linked by a formal treaty, they have cooperated on a number of regional and international issues over the years. The country's small size and lack of major economic resources have made it dependent on aid from Western and friendly Arab sources. U.S. support, in particular, has helped Jordan deal with serious vulnerabilities, both internal and external. Jordan's geographic position, wedged between Israel, Syria, Iraq, and Saudi Arabia, has made it vulnerable to the strategic designs of its more powerful neighbors, but has also given Jordan an important role as a buffer between these potential adversaries. In 1990, Jordan's unwillingness to join the allied coalition against Iraq disrupted its relations with the United States and the Persian Gulf states; however, relations improved throughout the 1990s as Jordan played an increasing role in the Arab-Israeli peace process and distanced itself from Saddam Hussein's Iraq. The United States has provided economic and military aid, respectively, to Jordan since 1951 and 1957. Total U.S. aid to Jordan through FY2009 amounted to approximately $10.72 billion. Levels of aid have fluctuated, increasing in response to threats faced by Jordan and decreasing during periods of political differences or worldwide curbs on aid funding. On September 22, 2008, the U.S. and Jordanian governments reached an agreement whereby the United States will provide a total of $660 million in annual foreign assistance to Jordan over a five-year period. P.L. 111-8, the Omnibus Appropriations Act, 2009, which was signed by President Obama on March 11, 2009, provides the full FY2009 Bush Administration request for assistance, including $263.5 in economic aid and $235 million in military assistance. H.Res. 833, which was referred to the House Committee on Foreign Affairs on October 14, 2009, commemorates the 60th anniversary of the close relationship between the United States and the Hashemite Kingdom of Jordan.
Jordan: Background and U.S. Relations
This report provides an overview of Jordanian politics and current issues in U.S.-Jordanian relations. It provides a brief discussion of Jordan's government and economy and of its cooperation in promoting Arab-Israeli peace and other U.S. policy objectives in the Middle East. This report will be updated periodically to reflect new developments. Several issues in U.S.-Jordanian relations are likely to figure in decisions by Congress and the Administration on future aid to and cooperation with Jordan. These include the stability of the Jordanian regime, the role of Jordan in the Arab-Israeli peace process, Jordan's role in stabilizing Iraq, and U.S.-Jordanian military and intelligence cooperation. Although the United States and Jordan have never been linked by a formal treaty, they have cooperated on a number of regional and international issues over the years. The country's small size and lack of major economic resources have made it dependent on aid from Western and friendly Arab sources. U.S. support, in particular, has helped Jordan deal with serious vulnerabilities, both internal and external. Jordan's geographic position, wedged between Israel, Syria, Iraq, and Saudi Arabia, has made it vulnerable to the strategic designs of its more powerful neighbors, but has also given Jordan an important role as a buffer between these potential adversaries. In 1990, Jordan's unwillingness to join the allied coalition against Iraq disrupted its relations with the United States and the Persian Gulf states; however, relations improved throughout the 1990s as Jordan played an increasing role in the Arab-Israeli peace process and distanced itself from Saddam Hussein's Iraq. The United States has provided economic and military aid, respectively, to Jordan since 1951 and 1957. Total U.S. aid to Jordan through FY2009 amounted to approximately $10.72 billion. Levels of aid have fluctuated, increasing in response to threats faced by Jordan and decreasing during periods of political differences or worldwide curbs on aid funding. On September 22, 2008, the U.S. and Jordanian governments reached an agreement whereby the United States will provide a total of $660 million in annual foreign assistance to Jordan over a five-year period. P.L. 111-8, the Omnibus Appropriations Act, 2009, which was signed by President Obama on March 11, 2009, provides the full FY2009 Bush Administration request for assistance, including $263.5 in economic aid and $235 million in military assistance. H.Res. 833, which was referred to the House Committee on Foreign Affairs on October 14, 2009, commemorates the 60th anniversary of the close relationship between the United States and the Hashemite Kingdom of Jordan.
Unconventional Gas Shales: Development, Technology, and Policy Issues
In the past, the oil and gas industry considered gas locked in tight, impermeable shale uneconomical to produce. However, advances in directional well drilling and reservoir stimulation have dramatically increased gas production from unconventional shales. The United States Geological Survey estimates that 200 trillion cubic feet of natural gas may be technically recoverable from these shales. Recent high natural gas prices have also stimulated interest in developing gas shales. Although natural gas prices fell dramatically in 2009, there is an expectation that the demand for natural gas will increase. Developing these shales comes with some controversy, though. The hydraulic fracturing treatments used to stimulate gas production from shale have stirred environmental concerns over excessive water consumption, drinking water well contamination, and surface water contamination from both drilling activities and fracturing fluid disposal. The saline “flowback” water pumped back to the surface after the fracturing process poses a significant environmental management challenge in the Marcellus region. The flowback's high content of total dissolved solids (TDS) and other contaminants must be disposed of or adequately treated before discharged to surface waters. The federal Clean Water Act and state laws regulate the discharge of this flowback water and other drilling wastewater to surface waters, while the Safe Drinking Water Act (SDWA) regulates deep well injection of such wastewater. Hydraulically fractured wells are also subject to various state regulations. Historically, the EPA has not regulated hydraulic fracturing, and the 2005 Energy Policy Act exempted hydraulic fracturing from SDWA regulation. Recently introduced bills would make hydraulic fracturing subject to regulation under SDWA, while another bill would affirm the current regulatory exemption. Gas shale development takes place on both private and state-owned lands. Royalty rates paid to state and private landowners for shale gas leases range from 12½% to 20%. The four states (New York, Pennsylvania, Texas, and West Virginia) discussed in this report have shown significant increases in the amounts paid as signing bonuses and increases in royalty rates. Although federal lands also overlie gas shale resources, the leasing restrictions and the low resource-potential may diminish development prospects on some federal lands. The practice of severing mineral rights from surface ownership is not unique to the gas shale development. Mineral owners retain the right to access surface property to develop their holdings. Some landowners, however, may not have realized the intrusion that could result from mineral development on their property. Although a gas-transmission pipeline-network is in place to supply the northeast United States, gas producers would need to construct an extensive network of gathering pipelines and supporting infrastructure to move the gas from the well fields to the transmission pipelines, as is the case for developing any new well field.
Unconventional Gas Shales: Development, Technology, and Policy Issues
In the past, the oil and gas industry considered gas locked in tight, impermeable shale uneconomical to produce. However, advances in directional well drilling and reservoir stimulation have dramatically increased gas production from unconventional shales. The United States Geological Survey estimates that 200 trillion cubic feet of natural gas may be technically recoverable from these shales. Recent high natural gas prices have also stimulated interest in developing gas shales. Although natural gas prices fell dramatically in 2009, there is an expectation that the demand for natural gas will increase. Developing these shales comes with some controversy, though. The hydraulic fracturing treatments used to stimulate gas production from shale have stirred environmental concerns over excessive water consumption, drinking water well contamination, and surface water contamination from both drilling activities and fracturing fluid disposal. The saline “flowback” water pumped back to the surface after the fracturing process poses a significant environmental management challenge in the Marcellus region. The flowback's high content of total dissolved solids (TDS) and other contaminants must be disposed of or adequately treated before discharged to surface waters. The federal Clean Water Act and state laws regulate the discharge of this flowback water and other drilling wastewater to surface waters, while the Safe Drinking Water Act (SDWA) regulates deep well injection of such wastewater. Hydraulically fractured wells are also subject to various state regulations. Historically, the EPA has not regulated hydraulic fracturing, and the 2005 Energy Policy Act exempted hydraulic fracturing from SDWA regulation. Recently introduced bills would make hydraulic fracturing subject to regulation under SDWA, while another bill would affirm the current regulatory exemption. Gas shale development takes place on both private and state-owned lands. Royalty rates paid to state and private landowners for shale gas leases range from 12½% to 20%. The four states (New York, Pennsylvania, Texas, and West Virginia) discussed in this report have shown significant increases in the amounts paid as signing bonuses and increases in royalty rates. Although federal lands also overlie gas shale resources, the leasing restrictions and the low resource-potential may diminish development prospects on some federal lands. The practice of severing mineral rights from surface ownership is not unique to the gas shale development. Mineral owners retain the right to access surface property to develop their holdings. Some landowners, however, may not have realized the intrusion that could result from mineral development on their property. Although a gas-transmission pipeline-network is in place to supply the northeast United States, gas producers would need to construct an extensive network of gathering pipelines and supporting infrastructure to move the gas from the well fields to the transmission pipelines, as is the case for developing any new well field.
Private Health Insurance Provisions of H.R. 3962
This report summarizes key provisions affecting private health insurance, including provisions to raise revenues, in Division A of H.R. 3962, the Affordable Health Care for America Act, as introduced in the House of Representatives on October 29, 2009. H.R. 3962 is based on H.R. 3200, America's Affordable Health Choices Act of 2009, which was originally introduced on July 14, 2009, and was reported separately on October 14, 2009, by three House Committees– Education and Labor, Energy and Commerce, and Ways and Means. Division A of H.R. 3962 focuses on reducing the number of uninsured, restructuring the private health insurance market, setting minimum standards for health benefits, and providing financial assistance to certain individuals and, in some cases, small employers. In general, H.R. 3962 would require individuals to maintain health insurance and employers to either provide insurance or pay a payroll assessment, with some exceptions. Several insurance market reforms would be made, such as modified community rating and guaranteed issue and renewal. Both the individual and employer mandates would be linked to acceptable health insurance coverage, which would meet required minimum standards and incorporate the market reforms included in the bill. Acceptable coverage would include (1) coverage under a qualified health benefits plan (QHBP), which could be offered either through the newly created Health Insurance Exchange (the Exchange) or outside the Exchange through new employer plans; (2) grandfathered employment based plans; (3) grandfathered nongroup plans; and (4) other coverage, such as Medicare and Medicaid. The Exchange would offer private plans alongside a public option. Based on income, certain individuals could qualify for subsidies toward their premium costs and cost-sharing (deductibles and copayments); these subsidies would be available only through the Exchange. In the individual market (the nongroup market), a plan could be grandfathered indefinitely, but only if no changes were made to the terms and conditions of that plan, including benefits and cost-sharing, and premiums were only increased as allowed by statute. Most of these provisions would be effective beginning in 2013. The Exchange would not be an insurer; it would provide eligible individuals and small businesses with access to insurers' plans in a comparable way. The Exchange would consist of a selection of private plans as well as a public option. Individuals wanting to purchase the public option or a private health insurance not through an employer or a grandfathered nongroup plan could only obtain such coverage through the Exchange. They would only be eligible to enroll in an Exchange plan if they were not enrolled in Medicare, Medicaid, and acceptable employer coverage as a full-time employee. The public option would be established by the Secretary of Health and Human Services (HHS), would offer three different cost-sharing options, and would vary premiums geographically. The Secretary would negotiate payment rates for medical providers, and items and services. The bill would also require that the Health Choices Commissioner to establish a Consumer Operated and Oriented Plan (CO-OP) program under which the Commissioner would make grants and loans for the establishment of not-for-profit, member-run health insurance cooperatives. These co-operatives would provide insurance through the Exchange. Only within the Exchange, credits would be available to limit the amount of money certain individuals would pay for premiums and for cost-sharing (deductibles and copayments). (Although Medicaid is beyond the scope of this report, H.R. 3962 would extend Medicaid coverage for most individuals under 150% of poverty; individuals would be ineligible for Exchange coverage if they were eligible for Medicaid.)
Private Health Insurance Provisions of H.R. 3962
This report summarizes key provisions affecting private health insurance, including provisions to raise revenues, in Division A of H.R. 3962, the Affordable Health Care for America Act, as introduced in the House of Representatives on October 29, 2009. H.R. 3962 is based on H.R. 3200, America's Affordable Health Choices Act of 2009, which was originally introduced on July 14, 2009, and was reported separately on October 14, 2009, by three House Committees– Education and Labor, Energy and Commerce, and Ways and Means. Division A of H.R. 3962 focuses on reducing the number of uninsured, restructuring the private health insurance market, setting minimum standards for health benefits, and providing financial assistance to certain individuals and, in some cases, small employers. In general, H.R. 3962 would require individuals to maintain health insurance and employers to either provide insurance or pay a payroll assessment, with some exceptions. Several insurance market reforms would be made, such as modified community rating and guaranteed issue and renewal. Both the individual and employer mandates would be linked to acceptable health insurance coverage, which would meet required minimum standards and incorporate the market reforms included in the bill. Acceptable coverage would include (1) coverage under a qualified health benefits plan (QHBP), which could be offered either through the newly created Health Insurance Exchange (the Exchange) or outside the Exchange through new employer plans; (2) grandfathered employment based plans; (3) grandfathered nongroup plans; and (4) other coverage, such as Medicare and Medicaid. The Exchange would offer private plans alongside a public option. Based on income, certain individuals could qualify for subsidies toward their premium costs and cost-sharing (deductibles and copayments); these subsidies would be available only through the Exchange. In the individual market (the nongroup market), a plan could be grandfathered indefinitely, but only if no changes were made to the terms and conditions of that plan, including benefits and cost-sharing, and premiums were only increased as allowed by statute. Most of these provisions would be effective beginning in 2013. The Exchange would not be an insurer; it would provide eligible individuals and small businesses with access to insurers' plans in a comparable way. The Exchange would consist of a selection of private plans as well as a public option. Individuals wanting to purchase the public option or a private health insurance not through an employer or a grandfathered nongroup plan could only obtain such coverage through the Exchange. They would only be eligible to enroll in an Exchange plan if they were not enrolled in Medicare, Medicaid, and acceptable employer coverage as a full-time employee. The public option would be established by the Secretary of Health and Human Services (HHS), would offer three different cost-sharing options, and would vary premiums geographically. The Secretary would negotiate payment rates for medical providers, and items and services. The bill would also require that the Health Choices Commissioner to establish a Consumer Operated and Oriented Plan (CO-OP) program under which the Commissioner would make grants and loans for the establishment of not-for-profit, member-run health insurance cooperatives. These co-operatives would provide insurance through the Exchange. Only within the Exchange, credits would be available to limit the amount of money certain individuals would pay for premiums and for cost-sharing (deductibles and copayments). (Although Medicaid is beyond the scope of this report, H.R. 3962 would extend Medicaid coverage for most individuals under 150% of poverty; individuals would be ineligible for Exchange coverage if they were eligible for Medicaid.)
SenateFloor: Vote: On the Conference Report – Senate – Conference Report to Accompany H.R. 2996: Conference Report Agre.. http://bit.ly/2KK2EI
SenateFloor: Vote: On the Conference Report – Senate – Conference Report to Accompany H.R. 2996: Conference Report Agre.. http://bit.ly/2KK2EI
SenateFloor: Vote: Motion to Waive Rule XXVIII Re: H.R. 2996.: Motion Agreed to 60-40 (3/5 required). 100% of Democrats.. http://bit.ly/4qUQAx
SenateFloor: Vote: Motion to Waive Rule XXVIII Re: H.R. 2996.: Motion Agreed to 60-40 (3/5 required). 100% of Democrats.. http://bit.ly/4qUQAx
House: On Motion to Suspend the Rules and Agree: H RES 729 Expressing support for designation of a “National Firefighters Memorial Day” to honor…
Date: October 29, 2009 Chamber: House Type: On Motion to Suspend the Rules and Agree Question: On Motion to Suspend the Rules and Agree: H RES 729 Expressing support for designation of a “National Firefighters Memorial Day” to honor and celebrate the firefighters of the United States Ayes: 390 Nays: 0 Result: Passed Roll Call Details
House: On Motion to Suspend the Rules and Agree: H RES 729 Expressing support for designation of a “National Firefighters Memorial Day” to honor…
Date: October 29, 2009 Chamber: House Type: On Motion to Suspend the Rules and Agree Question: On Motion to Suspend the Rules and Agree: H RES 729 Expressing support for designation of a “National Firefighters Memorial Day” to honor and celebrate the firefighters of the United States Ayes: 390 Nays: 0 Result: Passed Roll Call Details
House: On Passage: H R 3854 Small Business Financing and Investment Act of 2009
Date: October 29, 2009 Chamber: House Type: On Passage Question: On Passage: H R 3854 Small Business Financing and Investment Act of 2009 Ayes: 389 Nays: 32 Result: Passed Roll Call Details
House: On Passage: H R 3854 Small Business Financing and Investment Act of 2009
Date: October 29, 2009 Chamber: House Type: On Passage Question: On Passage: H R 3854 Small Business Financing and Investment Act of 2009 Ayes: 389 Nays: 32 Result: Passed Roll Call Details
Senate: On the Conference Report (Conference Report to Accompany H.R. 2996 )
Date: October 29, 2009 Chamber: Senate Type: On the Conference Report Question: On the Conference Report (Conference Report to Accompany H.R. 2996 ) Ayes: 72 Nays: 28 Result: Conference Report Agreed to Roll Call Details