▶ 0:19:26Chair Moran: I apologize for being maybe five minutes late. [gavel] I want to thank our witnesses for being here this afternoon. Last year the va research celebrated its centennial anniversary.
▶ 0:19:44Chair Moran: Over the last 100 years it has revolutionized medicine worldwide from the first cardiac pacemaker implantation to pioneering the internationally recognized standard for grading prostate cancer with the gleason score. Please continue to transform the day-to-day lives of many veterans, but they benefit civilians as well.
▶ 0:20:07Chair Moran: In 2016, the va entered into a partnership with the prostate cancer foundation establishing the advancements of a program that have fast tracked life-saving fda approvals and made certain veterans in rural areas are receiving those same cutting-edge therapies as those who live near hospitals. The va has a long history in leaving the world in medical innovation and I hope they continue to lead that long into the future.
▶ 0:20:43Chair Moran: The va's precision oncology program for cancer of the prostate. Congress has the opportunity to safeguard this program funding, protect its infrastructure and make sure veterans battling prostate cancer continue receiving access to world-class care and the specially tailored care they have earned and deserved.
▶ 0:21:06Chair Moran: I look forward to hearing our witnesses how we can better equip our research community to be stronger, sustainable, and more successful. High-yield to the ranking member's colleague, the former chairman of this committee, senator murray for her opening remark. You can do more than one. For opening remarks.
▶ 0:21:28Senator Murray: Thank you very much Mr. chairman and to our witnesses. I think senators on both sides of this I'll have a real appreciation for the research enterprise which has been at the forefront of cutting edge science for more than 100 years.
▶ 0:21:44Senator Murray: It has led to breakthroughs like the pacemaker, the first successful liver transplant, the nicotine patch, and ct scanning but I'm not sure the trump administration has that same appreciation and I'm concerned by the actions of this administration that have demoralized staff and created instability in research funding and put up barriers that has slowed the research process.
▶ 0:22:10Senator Murray: On the first day of the administration all va research staff became subject to a hiring fees and -- freeze and probationary firings. Research to predict stroke risk was put on hold, and roman into clinical trials for advanced cancer was delayed and a clinical trial in florida on preventing dementia and heart disease was canceled. Mr. chairman, I could go on. I've heard a lot of stories like that, so I'm deeply concerned.
▶ 0:22:41Senator Murray: In addition, the department and forced vacancy cuts and staffing caps on facilities, though those cuts technically exclude research staff. A study at a va site in the pacific northwest was delayed because staffing caps prevented them from hiring nurses needed to administer that study. These workforce actions have taken a toll on employees central to getting new research studies up and running.
▶ 0:23:10Senator Murray: Va researchers report start up for their studies often stretch to more than a year. Those delays are partially due to way wildly inefficient hiring process for va research staff. Researchers are reporting to ask that the time to hire a new member of the staff now often takes up to six months. As a result of planned study on rsv missed its enrollment window and could not even enroll participants.
▶ 0:23:38Senator Murray: Another clinical trial closed after it took six months to hire a researcher. The study's principal investigator and its lead clinician both resigned after that debacle. Va researchers are not only being undermined by delays in cuts at the department, but also by instability in cuts at other federal agencies like the national institutes of health which frequently provides funding for va researchers.
▶ 0:24:03Senator Murray: A researcher's nih grant for studying opioid use disorders on my already -- minorities was canceled because it was deemed d.e.I.. Nonfederal funding is down a third or more due to the previous year. The omb as published a proposed rule that would require all federal grants, including those for va research, to be approved by political appointees.
▶ 0:24:35Senator Murray: That doesn't make sense, let a political appointee overrule a scientist on what research is worth pursuing and funding? So given the current state of va research under this administration, there is a demoralized workforce and they have limited access to non-va funding so it is inexplicable to me to request a decrease in funding for fiscal year 2027.
▶ 0:25:01Senator Murray: I'm speaking in place of senator blumenthal but I can tell you right now as vice chair of appropriations, it is my intention to rip trump's budget up and write a new one. I hope the va witnesses will take the concerns seriously and commit to taking actions to address them. If va wants to recruit and retain the brightest minds to conduct research and provide clinical care for our nation's heroes, it has to work to restore the trust it has lost with a lot of its research staff.
▶ 0:25:31Senator Murray: This committee and this congress should stand up for research and it should stand up for science and for veterans. That's where I am, Mr. chairman.
▶ 0:25:41Chair Moran: Acting executive director for discovery, education, and affiliate networks, accompanied by la'toya prieur and Dr. michael kelley. Doctor, you are recognized to testify.
▶ 0:26:07Dr. Zhang: Chairman moran and members of the committee, thank you for the opportunity, the standard governing our work is simple, every dollar must be directly tied to veterans health and well-being. I'm joined by the chief of human capital management and the executive director of the national oncology program.
▶ 0:26:34Dr. Zhang: I'm currently serving as the acting executive director of the office of discovery, education, and affiliate networks. I lead the research, innovation, and clinical training programs. For 100 years va research has led to advances well beyond the va including the first cardiac pacemaker, the nicotine patch and the foundational work that created the modern ct scanner.
▶ 0:27:06Dr. Zhang: That same principle shapes what we do not pursue. Va research is not a general-purpose science portfolio. It is a targeted investment in questions that matter to veterans. Enforced through peer review, institutional review boards, and the office of research oversight. This administration has taken a disciplined, veterans first approach to research.
▶ 0:27:28Dr. Zhang: The president's fiscal year 2027 budget requests over $480 billion for va, including over $150 billion in discretionary funding and over $54 billion in the toxic exposures fund to expand care for veterans impacted by environmental and occupational exposures.
▶ 0:27:52Dr. Zhang: Va has sharpened its research enterprise to prioritize measurable clinical benefit, accountability, and faster translation from discovery into care and the strategy is already producing results. We have grown the cancer, clinical, and research network to more than 100 va medical facilities, giving veterans access to cutting-edge clinical trials closer to home.
▶ 0:28:16Dr. Zhang: Hour-long cancer precision oncology program has delivered more than 100 lung cancer screening scans, identifying cancers earlier when treatment is most effective. The million veteran program includes more than one million enrolled veterans, and unparalleled resource for advancing precision medicine.we measure success not by the number of projects funded, but by the number of veterans whose lives are improved.
▶ 0:28:45Dr. Zhang: President trump's accelerated medical treatments for serious mental illness executive 14 401 recognizes not all veterans respond to standard mental health treatments. In response, va announced a randomized placebo-controlled trial of mdma-assisted therapy for ptsd and alcohol use disorder, with plans to enroll approximately 80 veterans through the va providence and va connecticut health care systems.
▶ 0:29:10Dr. Zhang: This is part of a broader psychedelic research portfolio of 19 additional active trials supported by more than $23 million in external funding, hall conducted under rigorous federal safety protocols.
▶ 0:29:27Dr. Zhang: Va continues to lead research on toxic exposures including burn pits and agent orange and traumatic brain injury and blast pressure to develop next-generation brain health biomarkers and conducting a national clinical trial for mild tbi treatment. Looking ahead, our strategy is built on three priorities. Expanding access to high-quality clinical trials, delivering real-world clinical impact, and leveraging va's data for veterans' benefit.
▶ 0:29:58Dr. Zhang: These priorities are executed through several programs. The cooperative studies program leading a landmark trial comparing non-invasive colorectal cancer screening with colonoscopies with deliberate outreach to rural veterans. Speeding translation of evidence-based findings to routine care.and 's research -- and the million veterans program's research into ptsd and cardiovascular health.
▶ 0:30:32Dr. Zhang: Including suicide prevention, opioid safety, oncology, and diagnostic imaging under our trustworthy ai framework, which prioritizes privacy, security, and clinical validation at every stage. In conclusion, va's research legacy is one of groundbreaking discovery benefiting veterans and the american public alike. We will continue strengthening the oversight and mission focused vision and aligned with our strategic priorities. Mr.
▶ 0:31:01Dr. Zhang: Chairman, thank you and the committee for this opportunity and we welcome any questions.
▶ 0:31:05Chair Moran: Thank you very much. Ms. prieur, this committee continues to hear that onboarding of central research personnel routinely takes up to 5-6 months. It is a competitive scientific market, I have to assume we are losing top-tier researchers because of the va's centralized hiring process that takes so long.
▶ 0:31:30Chair Moran: Research personnel included in the 30 hiring pilot, how many have been hired and what other strategies are pursued or am I wrong in my assumption?
▶ 0:31:39Ms. Prieur: Thank you for that question come of va researchers are included in the secretary's 30 day time to hire initiative. That initiative was just rolled out nationwide on july 13, so it is too early to provide you with results at this moment. What I can share with you is that physician and nurse hiring has been prioritized.
▶ 0:32:07Ms. Prieur: Each morning, my staff pulls a list of all physicians and nurses that have been certified back to us by hiring officials. And we make sure those tentative and official job offers are prioritized over all others. While there may be some instances where it took five or six months to hire a researcher, overall the time to hire researchers is 77 days.
▶ 0:32:38Ms. Prieur: And that is below the office of personnel management's 80-day to hire metric and that is how we measure success.
▶ 0:32:45Chair Moran: Is that 77 days less than it used to be? Is there a pattern that shows improvement?
▶ 0:32:53Ms. Prieur: That 77 days -- that 77 days is a bit more than fiscal year 2025. We were at 74 days.
▶ 0:33:17Chair Moran: Dr. zhang, all the research priority here is in the fy 27 budget request, seeing a decrease in funding except for homeless research, which is flat funding. How was the department managing the important research for suicide prevention, precision oncology, traumatic brain injury and other priorities that saw a decrease in requested funding with less money and fewer staff?
▶ 0:33:45Dr. Zhang: Thank you, senator, for the question. I would say right now that the 2% cut in our funding for fiscal year 2026 is really around the multiyear nature of medical research and contract personnel attrition, but no program cuts have actually occurred. We feel very strongly we are able to still support the mission with our current proposed funding.
▶ 0:34:13Chair Moran: Um, let me ask an additional somewhat related question. I raised the concern several years ago about funding research that was not focused on areas likely to achieve improved outcomes for veterans, so the question is how has the va focused on prioritizing what research it funds and I assume or please confirm that there is a component about the places that were most likely to get the
▶ 0:34:44Chair Moran: Most benefits?
▶ 0:34:45Dr. Zhang: Thank you, senator, for the question. I think this is a place where va research has actually done some pretty incredible work already thinking about this. Our organization has really thought about how we become more of an enterprise for research all through the view and the mission of supporting the veteran.
▶ 0:35:07Dr. Zhang: The work that I wish I could take credit for but I just started in this role, but the work that the leaders across research have already done to prioritize the funding and also the agenda for research across the organization has really been around this concept called the actively managed portfolios and these are how we try to accelerate the issues and topics like traumatic brain injury,
▶ 0:35:38Dr. Zhang: Precision oncology, and other areas to accelerate the work faster. We have to find a balance between actively managed portfolios and funding the full scope of science and research for veteran benefit so we also have broad portfolio strategy to support that as well, so I think we are in -- actually trying to do that and we are in the process of creating more of a data informed pathway to get to accountability, get to impact, and really get to veteran
▶ 0:36:08Dr. Zhang: Benefit faster.
▶ 0:36:09Chair Moran: Thank you for that answer. Dr. kelly, I have questions to you, and I will submit them in writing. Senator murray.
▶ 0:36:18Sen. Murray: You know, women as we all know are the fastest growing veteran population, but I'm still very frustrated by the lack of progress and investment in understanding their really unique health care needs.
▶ 0:36:33Sen. Murray: Women veterans, especially those with ptsd or military sexual trauma, are more likely to experience earlier menopause with one va study finding there are -- they are three more times likely than any civilian woman to reach menopause before the age of 40.
▶ 0:36:51Sen. Murray: It is really important to make sure that our women veterans receive the evidence-based, high-quality health care they deserve but to get there we need a really strong investment in menopause research at va and dod, which is why I was proud to introduce the bipartisan servicewomen and veterans menopause research which will do that. What are the biggest gaps in our understanding of menopause in women veterans?
▶ 0:37:17Dr. Zhang: Thank you, senator, for that question. Just a kind of set the stage. The office of discovery education affiliate networks is really the office that oversees research, academics, innovation, and partnerships and I tell you this because I think women's health and I agree with you that women self and the women population of veterans is clearly growing and going to be incredibly important not just for research but for academics,
▶ 0:37:49Dr. Zhang: Innovation, and frankly for partnerships. To that end, I think we are going to try to continue to support that from a research standpoint. Our budget for women's health research remained steady at approximately $40 million per year. When it comes to your question about where the biggest gaps in my would like to take that for the record and give you the actual, accurate information as best we can.
▶ 0:38:12Sen. Murray: If you could get that back to me and tell me why you think continued investment in menopause research is critical?
▶ 0:38:19Dr. Zhang: I think all investment in areas of increase for veteran care is going to be important. Although I don't know specifically about that particular component of women's health, clearly given that the increase in women veterans utilizing va resources is growing, we have to partner and do this work can find the places we can make an impact.
▶ 0:38:43Sen. Murray: I think that is why my bill is so important because we clearly have a lack of understanding but it is really critical and I hope I can work with the chairman to get that past. Now, the president's budget proposes a substantial reduction to va's research program, not only to cuts -- through cuts to dedicated research but also reduced -- reduce support for medical care and the support programs that research relies on.
▶ 0:39:14Sen. Murray: It raises serious concerns about va's ability to maintain its research and develop new innovations that improve veteran care. If congress were to cut $43 million from the budget, which high-priority research areas are most at risk? Can you tell us? Is it cutting toxic exposure research, cancer research, prosthetics research?
▶ 0:39:38Dr. Zhang: Thank you, senator murray, for that question. To be very direct, I think our goal would be to try to preserve the gem that is to be a research as much as we could. Certainly, I do not have direct control of the budget, so we will do whatever, we will take whatever --
▶ 0:39:59Sen. Murray: In your capacity you know where the money is, where do you see those kinds of cuts hitting research the most?
▶ 0:40:05Dr. Zhang: Yes, thank you for that question. I don't know right now. I would say that I would look for things that are not our actively managed portfolios which are our key acceleration priorities and to focus on things we were exploring at an early stage to make cuts if we had to.
▶ 0:40:26Sen. Murray: So the budget has been proposed but you haven't thought about what the consequences are?
▶ 0:40:31Dr. Zhang: Sorry?
▶ 0:40:32Sen. Murray: The president sent the budget proposal, you see the cuts in it, you haven't thought as an agency about where you're going to have to put those cuts in?
▶ 0:40:41Dr. Zhang: Thank you, from our perspective, the budget cut is really reflecting the attrition of contracts and also staff that have left during that time. Our actual plans and support for research have not been affected by those budget cuts.
▶ 0:41:02Sen. Murray: Ok, we do know last year nine researchers were terminated with no warning and the research stopped, so you can't say that cutting personnel does not impact research. I only have five seconds left.
▶ 0:41:15Sen. Murray: I want to emphasize what I said in the opening remarks about the pending omb rule that would really undermine our current system and take away decision-making power from our experienced scientists and just allow political appointees whether this administration or a future one decide where research is going to go. That is really concerning to va research. We need decisions based on science not based on somebody is mad at somebody in any administration.
▶ 0:41:45Chair Moran: Senator sheehy.
▶ 0:41:48Senator Sheehy: Thank you, chairman. Dr. zhang, recently you alluded to some of it in your comments, we have seen the mdma assisted therapy trial and a broad array of other research on novel therapeutics for ptsd and substance abuse and others. Broadly speaking, what is your assessment so far and what do you think the future can look like?
▶ 0:42:12Dr. Zhang: Thank you, senator sheehy. We are very excited to support the frontiers of treatment for difficult things like ptsd and substance abuse, alcohol abuse as well, using tools like psychedelic medicine. What we are trying to do in research is support this frontier work. I know Dr.
▶ 0:42:35Dr. Zhang: Weekers has been briefing this committee on that and I would say for further information, turn to her. Our goal is to support the science and support the frontiers from our perspective.
▶ 0:42:53Sen. Sheehy: In the vein of getting the solutions to the field as quickly as possible, we also want to be prepared for enterprise-level rollout of these type of therapeutics, both the care and the products themselves.
▶ 0:43:10Sen. Sheehy: Has there been any product given to lifecycle management and the actual rolling out of novel therapies, training of the staff, and how the logistics of that going to happen once we get fda approval and once we get to va wide enterprise approval? Is that planning process begun?
▶ 0:43:26Dr. Zhang: Yes, we have actually been really thinking about and I would say this is not just for psychedelics, for a lot of lines of our research. One of our core goals is how do we rapidly translate that to veteran impact?
▶ 0:43:43Dr. Zhang: When it pertains specifically to psychedelics, we have created an integrated project team to think about this from a science standpoint, but also how do we operationalize this when it is safe and the science supports it to benefit veterans?
▶ 0:44:01Sen. Sheehy: That's good to hear because whether it is 22 a day or veterans paying for their own trips to mexico or elsewhere to get these treatments, the sooner we can roll them out the better and the worst thing that can happen is we finish the trials, the double-blind studies, everything comes out great and then it is another 5-10 years of bureaucratic rollout. No offense, but that's generally how the government works and we still have veterans in need.
▶ 0:44:27Sen. Sheehy: It is just as important that we conduct the research and also fast-track without cutting corners the logistics of how we are physically going to roll that out when the time comes and a core component of that will be our community care networks, which there are existing providers that already do this in the private sector, so we don't have to reinvent the wheel in every case. There could be times where we can leverage that network in this sector as well. Thanks for your work on this. Appreciate you being here.
▶ 0:44:55Dr. Zhang: Thank you, senator sheehy. I would just say I think from my perspective, I'm still relatively new frankly to the va. I just joined the organization a little under three years ago but I'm a second-generation va physician. My mom is a primary care doctor at the eerie va -- erie va.
▶ 0:45:22Dr. Zhang: Although I'm not a veteran, my family has benefited from the va for about half my life so and understand the value of the organization, what a gem research is at va, how is at -- I would has improved not only veteran care, but american care, and frankly care for humanity. So, that is the pathway and kind of the overarching direction I want you all to know we have at va.
▶ 0:45:50Dr. Zhang: It is not just me, it is everyone I work with. And I work with so many researchers that are also veterans. It is such an incredible thing to see. The mission is so important and that is what we do this work.
▶ 0:46:04Chair Moran: Thank you for your comments. Senator boseman.
▶ 0:46:12Senator Boseman: Thank you and ranking member blumenthal for holding the hearing today and we appreciate all the witnesses for being here. Va research has transformed care for veterans while advancing medicine for all americans. This health care -- as health care continues to evolve, it is important va remain a leader so veterans continue to have access to the best possible care. Mr.
▶ 0:46:40Senator Boseman: Chairman, thank you for your leadership on precision oncology and recently introducing the precision oncology program for cancer and prostate authorization act. We appreciate your proposal to designate the little rock va medical center as a center of excellence for that program.
▶ 0:47:05Senator Boseman: Arkansas has built a strong partnership and I believe it is well-positioned to become a national leader in precision oncology and research care for veterans, as it has in the past. Dr. kelley, in fiscal year 2020 four, congress provided $5 million to expand the position -- precision oncology program to cancer of the prostate and increased academic cancer center partnerships.
▶ 0:47:36Senator Boseman: It's my understanding that va instead use those funds to establish a broader precision oncology research program covering multiple cancers. Can you please clarify the va's view on the program and how va is ensuring the original congressional intent behind the funding has been followed?
▶ 0:47:55Dr. Kelley: Thank you, Dr. boseman -- boozman, for that question. To answer your question, when we were looking at the assignment that was given to us through the cleveland all act and 2022 about how to manage the future of it, we looked to the knowledge we've
▶ 0:48:27Dr. Kelley: Gained from other types of systems integration so we could expand the act across the entire enterprise. We looked particularly to the one precision oncology program which was at 114 sites. That was a good site that we knew worked. That's I had done two notable goals. One was molecular testing.
▶ 0:48:59Dr. Kelley: The testing rate had increased most recently to up to over 80%. That was one thing. We noticed the testing rate was able to go up.
▶ 0:49:19Dr. Kelley: For prostate cancer molecular testing rate identified by the foundation and an additional seven were identified to increase the geographic distribution.
▶ 0:49:39Dr. Kelley: What we saw was that even with those 21 sites we could expand to over 100 sites which is what we have done for the cancer, clinical, and research network. That was one aspect of that.
▶ 0:49:53Dr. Kelley: We also saw that lpop was able to rollout from nothing to over one billion lung cancer screenings so we get impact every place in the entire country so that is why we built the expansion on and then we also were able to roll in other programs we had used in the past.
▶ 0:50:20Dr. Kelley: Such as the testing program called npop which provides all the testing services and we also have germline.
▶ 0:50:31Chair Moran: We appreciate that. I guess the question is did we use the money?
▶ 0:50:37Dr. Kelley: Yes, so that money was used --
▶ 0:50:40Sen. Boozman: According to congressional intent.
▶ 0:50:43Dr. Kelley: That money was on the research side I believe. We used the clinical money to support the clinical operations, but the $5 million was for research to be directed in that fashion and that is what I understand was the basis for using that money to expand specifically for prostate cancer , so the selection of sites identifies only one cancer they have to do and that is prostate cancer.
▶ 0:51:11Sen. Boozman: Very good. Thank you.
▶ 0:51:14Chair Moran: Senator blackburn.
▶ 0:51:17Senator Blackburn: Thank you, Mr. chairman, thank you to you all for being here. Dr. zhang, I want to come to you. I represent tennessee and we have a wonderful program that takes place between vanderbilt university and the va. As you know, the tennessee valley health care is right there on the vanderbilt university campus.
▶ 0:51:51Senator Blackburn: And that system, that va system there has more than 60 researchers that hold dual appointments at vanderbilt and the va and they are supporting over 50 million dollars in va funded research and as you know as you know is you were talking with senator sheehy, this benefits veterans all across the country and we appreciate that.
▶ 0:52:17Senator Blackburn: What I would like to hear from you all is what strategies are you looking at to really increase these partnerships, these centers of excellence and to build this out further. I think that having these partnerships with research institutions like vanderbilt is going to be much more helpful than just trying to stovepipe some of your work.
▶ 0:52:48Dr. Zhang: Thank you, senator blackburn. I want to first acknowledge the incredible work happening in the tennessee region particularly when it comes to an incredibly strong partnering with an incredibly strong academic affiliate particularly in fields like in cancer, really some opportunities to partner and think about what is next.
▶ 0:53:15Sen. Blackburn: Behavioral health. And of course in nashville there were so much expertise in health care just in general, the business of medicine is in nashville. I think that as we think about the future of research and frankly academics and innovation at va that we have to think about setting foundations and infrastructure. In the first 100 years of research at va have been pretty incredible.
▶ 0:53:45Sen. Blackburn: I've heard it time and again. The big wins and I think as we think about the future we have to be flexible and think about how we partner, both with incredible academic groups, but also with others to make the future happen in america for veterans. So I don't have anything specific to say about how we are going to do that at vanderbilt other than just good timing.
▶ 0:54:12Sen. Blackburn: A couple of weeks ago we just had a great intro conversation with the vanderbilt university senior leaders. >> see, I think a strategic plan you are building out would be important. So what are you doing with planting for centers of excellence -- planning for centers of excellence for different disciplines in health care?
▶ 0:54:34Dr. Zhang: That is actually what I was going to get to, the perfect -- purpose of that conversation was to talk about that specifically enter find that synergy between the incredible work happening at vanderbilt to the incredible work happening with our enterprise agreements.
▶ 0:54:50Sen. Blackburn: Ok, and how are you engaging medical school students when you are on a campus like vanderbilt? So how are you doing that engagement to encourage these that are getting ready to go through a residency and into practice to stay engaged with the va and veterans' health?
▶ 0:55:14Dr. Zhang: Thank you, senator, I think that's a great point. I don't have the specifics on the agreements we have, but are academic affiliates, we have well over 90% of all medical schools if not more affiliated with va, so clearly building the pipeline.
▶ 0:55:41Dr. Zhang: Whether it is clinicians researchers or both and that is part of the value which is unique to va which is our dean organization has both research academics, innovation and partnerships altogether when one group and my intention is to utilize those in a synergistic way to build the future.
▶ 0:56:04Sen. Blackburn: Ms. prieur, mi saying your name right?
▶ 0:56:11Ms. Prieur: Prieur, ma'am.
▶ 0:56:17Sen. Blackburn: How many union employees are there in the va now?
▶ 0:56:22Ms. Prieur: I would have to take that back for the record, ma'am.
▶ 0:56:25Sen. Blackburn: Let's get that for the record. I also want to know how many full-time or full-time equivalents are actually showing up to work and working in person five days a week.
▶ 0:56:42Sen. Blackburn: One of the biggest complaints we have in our office is an I've got six offices in tennessee is the fact that va caseworkers are very slow to get back to the veterans and I know that the secretary has done an amazing job working that backlog down.
▶ 0:57:09Sen. Blackburn: It was about a one million case backlog when secretary collins came in and I think they are under 200,000 now. But the employees, the rudeness, the lack of caring, the being focused on themselves and not on the veteran, this is something that as a team we need to work on and we need to correct that.
▶ 0:57:39Sen. Blackburn: The va is about the veteran, first and foremost. Those employees are there to serve the veteran. If we could get that information and be helpful in making sure we have a service-oriented approach to our veterans, I would be ever so gratefully appreciative and thank you all for being here and for your work to serve veterans.
▶ 0:58:05Ms. Prieur: Yes, happy to take that back and respond to you.
▶ 0:58:08Chair Moran: Senator blackburn, thank you. Senator king.
▶ 0:58:13Senator King: I apologize for being late, perhaps we could use ai to figure out why senators have three hearings at the same time. It appears this year's proposed budget is over a $40 million cut in various research lines. Is that accurate?
▶ 0:58:41Dr. Zhang: Thank you, senator king. Actually, respectfully, I think the number is about 2%, which is $23 million and that is largely reflecting the multiyear nature of medical research and is about contracts and personnel attrition, not program cuts.
▶ 0:59:02Senator King: So you would argue that, well a two percent cut in a 3.5% inflation world is really about a 5.5% cut in resources. Mi wrong?
▶ 0:59:21Dr. Zhang: Thank you, senator king.
▶ 0:59:22Sen. King: Real dollars to spend next year on research, you have less next year than last year.
▶ 0:59:27Dr. Zhang: It doesn't change the mission of the office of research and development, which is to support veteran focused research.
▶ 0:59:35Sen. King: I get that, but it is ammunition and resources, is it not?
▶ 0:59:40Dr. Zhang: It is 2% below last year and it is largely affecting contracts and attrition.
▶ 0:59:47Sen. King: And 3.5% inflation, it is 5% below last year in real dollars. What is the status of personnel? How many fta's were engaged in research in january 2025 and how many today?
▶ 1:00:07Dr. Zhang: Thank you, so in fy 25, awardee funded 3531 researchers out of 7000 va researchers total. If you want the actual numbers to your specific question, I have to take that for the record and get back to you.
▶ 1:00:29Sen. King: I differ somewhat with senator blackburn, people doing research don't necessarily have to be in a va office to do research, and some cases that is not where they want to be or should be. So I want to note that. What is the relationship with va research with nih?
▶ 1:00:50Dr. Zhang: Thank you, senator king. We work with nih and our va researchers get funded by nih and I think we have a very collaborative nature with them through both the macro level and large initiatives through the individual researcher who can get funded both intramural he through va funds -- intramurally
▶ 1:01:20Dr. Zhang: Through va funds and extra-murally through nih.
▶ 1:01:24Sen. King: I know this administration has gone to some lengths to end so-called d.e.I. Programs. Would avi -- a va research study into menopause and women's health be considered d.e.I.?
▶ 1:01:42Dr. Zhang: Thank you, senator king. I can say that our women's health research continues to be a very important part of our portfolio. Our budget proposed for next year is unchanged. We serve all veterans. The goal is to focus on taking care of veterans, including our women veterans.
▶ 1:01:59Sen. King: Does that include black veterans if there are special health benefits they might need? High blood pressure for example. Would that be a d.e.I. Project?
▶ 1:02:09Dr. Zhang: Thank you, we serve all veterans, and fact one of the big kind of accomplishments for va research in our first 100 years is some of the work that was fundamental to figuring out that high blood pressure could be treated to save and improve people's risk of getting strokes and heart disease came from va.
▶ 1:02:30Sen. King: So no va projects have been canceled because of their perceived relationship to d.e.I.? Is that what you are saying?
▶ 1:02:38Dr. Zhang: I would have to take that for the record.
▶ 1:02:41Sen. King: I would appreciate that. If you wanted to take for the record the number of fte's, but I presume, first question --is the hiring freeze still in effect?
▶ 1:02:53Dr. Zhang: The answer is no, but I'm going to pass it off to my colleague, Ms. prieur.
▶ 1:02:59Ms. Prieur: Dr. zhang is correct, there is not a hiring freeze in va.
▶ 1:03:05Sen. King: There was, correct?
▶ 1:03:07Ms. Prieur: There was.
▶ 1:03:13Sen. King: When was that terminated? When were people allowed to start rehiring?
▶ 1:03:15Ms. Prieur: I would have to take that back. The hiring freeze started with the executive order and I don't have the exact date when it was lifted.
▶ 1:03:23Sen. King: Do you know how many people, how many vacancies were created by the hiring freeze and also how many took the fork in the road letter?
▶ 1:03:32Ms. Prieur: I can take that back for the record. I can share that our attrition rate for fiscal year 2025 was at 11% and that is significantly higher than most years. Right now, we are at five .9%.
▶ 1:03:49Sen. King: So 11% attrition when there is a hiring freeze is a real loss of people, right?
▶ 1:03:55Ms. Prieur: Yes, senator.
▶ 1:03:57Sen. King: Thank you, Mr. chairman.
▶ 1:03:59Chair Moran: Thank you very much to our panel. We have votes at 5:30 so I'm going to move to the second panel, so again we are grateful for the time you spent with us. I welcome our second panel to the witness table. That panel consists of Ms. gina carithers, president and ceo of the prostate cancer foundation, Dr.
▶ 1:04:28Chair Moran: Glenn graham, the former director of neurology programs at va. Dr. graham, thank you. >> [indiscernible]
▶ 1:04:56Chair Moran: Who did? Well, there is one. They are here. All right. Always the detective. Thank you much, thank you very much for being here, both of you. Dr. graham, you are recognized for your testimony.
▶ 1:05:19Dr. Graham: Thank you very much, senator, thanks to the committee members. I appreciate the opportunity to comment on the future of va research. After 35 years of federal service, I retired from the va in 2025 as the executive director of the national neurology clinical programs. My testimony is my own opinions.
▶ 1:05:46Dr. Graham: I am the current president of the nonprofit association of va neurology services. Our goal is for veterans and their descendants to lead longer, healthier, more productive lives. Va researchers have as has already been stated done amazing things.
▶ 1:06:10Dr. Graham: Va led research has particularly focused on advancing rehabilitation, functional electrical stimulation, powered prosthetic lens -- limbs, and arms. The first mechanistically new therapy for pain and over 20 years. It is a recognized national and international leader benefiting veterans and us all.
▶ 1:06:39Dr. Graham: However, recent changes have the potential to adversely affect the future of va research. Other va researchers that benefit. The 2% proposed average cut across fy 2027 in the research budget is unfortunate. While it may seem modest, the impacts are likely greater than the magnitude suggests.
▶ 1:07:05Dr. Graham: The loss of research persisting power -- purchasing power is closer to 5%. At a time when traditional funders of research like nih are undergoing major changes, the va budget takes on even greater importance. Research expenditures represent only about 1% of vha budget.
▶ 1:07:31Dr. Graham: Funding and protected time for research and access to the wealth of clinical and genetic data within the va integrated health care system has been a reliable incentive to attract and retain difficult specialists in neurology who would unlikely be considering a va career. They deliver care to veterans that is often only available after lengthy wait times if it is available at all.
▶ 1:08:00Dr. Graham: Without them, specialist wait times will lengthen and access will decline. Va remains essential to train the next generation of health care practitioners. It requires an active research portfolio and experienced intramural support with funding and protected time. Without this, it will not be attractive for trainees.
▶ 1:08:28Dr. Graham: It is also a critical and early career bridge to launch va research and clinical careers. Another concern is the current work environment and work culture, given the perception of changes within the va system recruiting clinicians of all sorts is becoming increasingly difficult. Staffing models prioritize clinical care, but often to the detriment of the other congressionally mandated missions including research.
▶ 1:08:56Dr. Graham: Clinicians interested in incorporating research and teaching in their practice will look elsewhere with careers no longer tenable in va. Additionally, cuts and hiring restrictions are adversely affecting central research staff. The current way of counting staff puts va medical centers that employ research engaged physicians that divide their time between va and an academically affiliated institution at a disadvantage.
▶ 1:09:28Dr. Graham: Moving va to the community discourages research. They do not learn about relative va research. Their data are lost to the va system. It denies veterans serious options and delays clinical research. In summary, veterans, the institutions of vha and the public a benefited greatly through va's robust research program over the years.
▶ 1:09:59Dr. Graham: Congress wisely establish the four missions of vha, clinical care, education and training, research, and emergency preparedness. These vital missions are mutually supportive and to a considerable extent inseparable. I request the va research mission receive robust funding and policy support for its own sake and to allow the other va missions to succeed. I've submitted some additional testimony, thank you for your attention.
▶ 1:10:27Chair Moran: Thank you for your appearance before us today. Now, Ms. carithers. Thank you, chairman moran, and to the other members of the committee.
▶ 1:10:40Chair Moran: My name is gina carithers, the president and ceo of the prostate cancer foundation, we represent the largest private research philanthropy and prostate cancer having been founded in 1993 when there was one drug that treated prostate cancer, androgen deprivation therapy. We have raised more than $1 billion since 1993 that has gone directly to research for therapies to extend the lives of men impacted by this disease.
▶ 1:11:11Chair Moran: That has generated today, under our seed funds, at least 16 fda approved therapies. To give you a bit on the prostate cancer's impact on our veterans. Prostate cancer is the most common cancer in our U.S. veterans. There are about 200,000 veterans living with this disease, about 15,000 diagnosed each year and treated within the va system.
▶ 1:11:43Chair Moran: Prostate cancer is not screened for in the va. In the U.S. it is largely not screened for at this time. The program we talk about today is actually targeted for advanced disease. That is disease that has laughs -- left the prostate because it has not been diagnosed in its early stage.
▶ 1:12:05Chair Moran: The pop cap program has been developed specifically to address the men whose disease has moved beyond the prostate. This is where men are at great risk for death from this disease. The way this program works is we take genes from the patient, their dna, and we also when we have biopsy tissue take the biopsy tissue and look at somatic mutations, those specific to the cancer itself.
▶ 1:12:36Chair Moran: This allows for targeted treatments, treatments specific to either the man's dna or in fact to the cancer's dna to then be targeted to treat and extend the life of that patient. To give you a background on pop cap, to fill the gap in 2016, the prostate cancer foundation pledged $50 million to pioneer a large private-public partnership within the va and that is where pop cap came from.
▶ 1:13:07Chair Moran: The result was a network of centers of excellence and that has been addressed a little bit. They are invested in both clinical and research teams that work on genetic testing and counseling of the men offering fda approved drugs that target prostate cancer mutations and a chance for veterans to enroll in clinical trials specific to the new treatments for these cancer treatments.
▶ 1:13:33Chair Moran: We have seen that across this era that we have generated 27 clinical trials that have yielded more than 850 peer-reviewed publications. Pop cap's success is tangible. In one study, veterans treated at a va center of excellence were 50 7% more likely to receive precision testing and care than veterans received outside the va, three times more
▶ 1:14:05Chair Moran: Likely to receive testing compared to before popcap started. Here's the story of a west point graduate and an army veteran with advanced prostate cancer. When he did not respond to standard treatment, his center of excellence Dr. ordered the testing. A drug was identified that was work in his specific cancer and over five years later, this veteran is alive and enjoying his family and his two-year-old granddaughter.
▶ 1:14:34Chair Moran: That is the impact of finding treatments that work on genetic mutations. Since popcapsince pop caps find, since popcapsince pop caps finds commitment to this program has risen to 65 million dollars, driven entirely by private philanthropy. The pop cap authorization act would deepen this to a permanent establishment that would require at least one center of excellence in each region that the v.a. Serves.
▶ 1:15:03Chair Moran: It would also require every senator to apply a full prostate clinical team and dedicated research staff, enabling more veterans to access precision testing, targeted treatments and clinical trials no matter where they live. Each of our veterans dedicated his life for the safety and freedom of our country. They should be the first, not the last, to benefit from medical breakthroughs.
▶ 1:15:28Chair Moran: The popcap act of 2026 will drive this care, advance clinical trials and benefit men, the women in their lives, and their families nationwide. It will amplify the impact of private philanthropy, helping protect the pop cap program and centers of excellence now will offer this for future generations.
▶ 1:15:52Chair Moran: Ms. carithers, thank you to you and your foundation for your valuable and lifesaving work. Thank you for the support of the popcap 26 act. Let me ask you about -- let me ask it this way. What was the vision of the prostate cancer foundation, when it created the partnership with the v.a.?
▶ 1:16:24Chair Moran: Is the v.a. For filling that dream -- fulfilling that dream of the foundation?
▶ 1:16:30Ms. Carithers: Thank you, that is a great question. I think the prostate cancer foundation had the vision of bringing to our veterans leading edge cancer research, and the defensive treatments they could offer. That vision has been sustained. We look at it as wanting to can -- wanting to continue to be sustained.
▶ 1:17:00Ms. Carithers: Men and their families have definitely benefited from once you are diagnosed, to then understand your genetic profile and what treatments may work when standard treatments don't. From our perspective, it should be a sustainable program. Our vision is being realized. We are continuing to work with our v.a.
▶ 1:17:23Ms. Carithers: Clinical trial teams and we work to support their efforts in publication and dissemination of their research. The v.a. Has also been a terrific partner in this. They have been able to establish the chronic -- the clinical trial researchers in this -- in these programs and help them develop careers within the v.a., is essential to the treatment of men with prostate cancer.
▶ 1:17:50Chair Moran: You mentioned screening, but I'm not sure what the point was. We don't screen at the v.a.? Was there a point to be made in that regard?
▶ 1:18:00Ms. Carithers: I appreciate you asking that. Today, -- in 2012 in the united states, the U.S. preventative task force service made a decision to stop screening for prostate cancer in the country. At that time, roughly 1% of men in the country were diagnosed with metastatic disease, disease that has left the prostate and is now in the bones and lymphatic tissue.
▶ 1:18:30Ms. Carithers: Today we are roughly diagnosing 25% of our men in this country with advanced metastatic disease. Disease that leaves the prostate is far more challenging to treat, and typically requires lifetime treatment. Screening, early detection is a simple blood test. When we move away from a simple blood test, to see if men have elevated psa over time, we lose the opportunity to have early intervention.
▶ 1:19:01Ms. Carithers: Hence we are chasing advanced disease. We focus on making drugs for this part of the disease. However, if we could bring back screening, and we could implement screening in the prostate cancer population for men and veterans as we have with lung cancer. Screening is essential. Early diagnosis leads to effective outcomes. In prostate cancer, 95% of our patients are cared when they are diagnosed early.
▶ 1:19:31Chair Moran: In my own annual physical, not to get personal, but there seems to be confusion. I am often given the option, rather than the doctor telling me what should transpire. I hope that there is the correct standard. Apparently there is disagreement or uncertainty about what you said. Is that true?
▶ 1:19:55Ms. Carithers: It is an interesting situation. In 2018 the guidance came back, to call for shared decision-making. Shared decision-making leaves the patient responsible, when in fact there is a time in the primary care office for a conversation to ensue.
▶ 1:20:15Ms. Carithers: In many cases, if we have men with cardiovascular disease or other health challenges, the restriction of time inside your physician's office may not leave time to talk about what screening could be.
▶ 1:20:27Chair Moran: Thank you. I have a couple seconds left, Dr. graham but let me ask you two quick questions. Less competitive salaries, you mentioned. How less competitive were the salaries in your time at the v.a.?
▶ 1:20:45Dr. Graham: Thank you for the question. Certainly, there is a lot more challenge than just income in private practice. I think one factor that we often face is particularly among jr. Physicians. They often leave training with a large amount of debt.
▶ 1:21:16Dr. Graham: Some of the advantages of a v.a. Career in terms of work -- not in terms of work but long-term benefits, or things that come with a lifetime career. Often, jr. Physicians are focused on eating their family started, buying a home, paying off their education loans. Often, the problem is when even a small amount of money early on , when young physicians are facing a lot of debt is a big deterrent.
▶ 1:21:42Chair Moran: That makes sense to me. Senator blumenthal.
▶ 1:21:46Ranking Member Blumenthal: Thank you Mr. chairman. Thank you, to the witnesses who are here now, and to those who testified on the first panel, I apologize. I had a conflicting obligation. I will ask that my opening statement be put in the record. Thank you.
▶ 1:22:11Ranking Member Blumenthal: As I say in my opening statement, I'm concerned about the effects of staffing cuts, shortages in funds for research, various actions taken by this administration that may inhibit or impede the kind of research that is done by the v.a.. In the past, the v.a. Has been a innovative force in american medicine.
▶ 1:22:42Ranking Member Blumenthal: It has been a source of basic science, progress and health systems research. A bright star, in the constellation of resources in our health care system in the united states. Dr. graham, I would like to ask you. You had a long history in the v.a., thank you.
▶ 1:23:13Ranking Member Blumenthal: Before you left the department, how would you characterize morale among your colleagues, including those conducting research?
▶ 1:23:20Dr. Graham: Thank you for that question. I would say that staff in general were under a great deal of stress. Particularly researchers were concerned that with hiring delays, with attrition of staff, support staff, laboratory staff, as well as increased demands on physicians to do -- devote themselves to the clinical missions, there was a lot of
▶ 1:23:50Dr. Graham: Concern. More broadly among other staff, I would say there was anxiety and fear. Fear of reductions in force, fear of job loss. Particularly when there were opportunities to take early retirement, there were good folks that we lost in the organization. They were afraid that if they didn't take that option and they were laid off, they would have nothing.
▶ 1:24:21Dr. Graham: In general it was difficult, because people in the v.a. Were dedicated civil servants. They felt the federal service was an honor and a privilege. Yet somehow, the federal civil servants were treated as a public enemy. That created a hostile work environment that I did. Not understand I could say I had staff, people that reported to me, that were more upset and distraught and anxious than I've ever seen in my professional career.
▶ 1:24:52Dr. Graham: Clearly, it is very important that you have psychological safety, that you be a high reliability organization. That staff, nurses, doctors, whatever, are safe to report errors, point out potential areas where inefficiencies occur, harm could occur. In a context where people are more afraid of losing their job or being reprimanded or scapegoated, that does not foster a culture of safety.
▶ 1:25:23Dr. Graham: That is bad in health care.
▶ 1:25:24Ranking Member Blumenthal: Thank you. As I mentioned in my opening statement, the department in its 2027 budget request cuts funding by $42 million for research. Can you think of any justification for that kind of cut?
▶ 1:25:45Dr. Graham: No I can't, particularly given the accomplishments of the v.a. I think this comes at a very bad time. Other sources of federal funding are facing uncertainty at this time. V.a. Research being a constant reliable source of research helping veterans, would be very welcome. I think the v.a. Return on investment has been very good. If we look at the v.a.
▶ 1:26:14Dr. Graham: Budget, only 1% goes to research. That is not a big investment, considering the return.
▶ 1:26:24Ranking Member Blumenthal: Ms. carithers, will that kind of cut in research impact the precision oncology program for cancer of the prostate?
▶ 1:26:34Ms. Carithers: If the cut is taken across the board, absolutely. Prostate cancer, the precision oncology advancements in prostate cancer are phenomenal. They benefit our veterans, they benefit all men in our society. Because you not only get a treatment that works against your cancer.
▶ 1:27:04Ms. Carithers: It extends your life and the quality of your life. For that, we would see that those cuts have a detrimental impact on our prostate cancer precision oncology research.
▶ 1:27:14Ranking Member Blumenthal: My time has expired. I thank you both for your testimony. And to the chairman, thank you for having this hearing.
▶ 1:27:22Chair Moran: Senator king.
▶ 1:27:25Sen. King: This is a basic question, not about research. Do veterans who are enrolled in v.a. Health care have routine annual physicals? Is that part of the medical structure?
▶ 1:27:45Ms. Carithers: If you are asking me, I did not know if that is part of the structure.
▶ 1:27:54Dr. Graham: I can comment based on my time at v.a. We have a system where every veteran should have a primary care provider panel, and they should get annual reviews.
▶ 1:28:07Sen. King: I'm wondering if that is a routine physical. Several people nodded. Is that a policy of the v.a. Health system or not? No one knows. I will find out and take it for the record. I am astounded that we don't do psa tests. I understand there is a problem of false positives, but there are ways of dealing with that over time.
▶ 1:28:37Sen. King: You can do a biopsy. I love the work that your foundation has done, but the best intervention is the one that happens early, as opposed to later when it's a far higher risk and more expensive. Should we be doing psa tests routinely? -- shouldn't we be doing psa tests routinely?
▶ 1:29:04Ms. Carithers: It is an extremely basic component of health care. For all men in society or anywhere. If you look at data for screening, you can make the argument, does it benefit overall survival? The challenge is if we are diagnosing men in their 50's, it is clearly yes.
▶ 1:29:26Ms. Carithers: Because if you get metastatic prostate cancer, your time for survival with aggressive disease is seven to 10 years, maximum with the best drugs. If you have a mutation in your disease that goes undetected, then your death can happen within the first 24 to 36 months. So the answer is yes. If we have early detection, we are saving the lives of the younger men of our society.
▶ 1:29:58Ms. Carithers: Does it work for those men in their 70's? The argument has been they don't get aggressive disease. The challenge is the men we are looking at. One man had a mutation, 72 years old. He had a rare mutation. His cancer was already outside the prostate.
▶ 1:30:25Ms. Carithers: In fact, the treatments and his overall survival time will probably be 75 years of age.
▶ 1:30:31Sen. King: If he had been screened at 55 or 60, or whenever this problem arose, it would have been much more treatable?
▶ 1:30:40Ms. Carithers: That's true. Whenever we diagnose prostate cancer in the early stage, before it leaves the prostate, we have two very common treatment methods. One is radiation, one is surgery. They both have similar outcomes. This is the simplest. And for those men, we see the statistics, you have 97% to 99% cured in five years.
▶ 1:31:10Ms. Carithers: The prostate cancers that will recur are those that are aggressive diseases. Then you have the opportunity to find it and treat it again.
▶ 1:31:19Sen. King: Dr. graham, I found your testimony disturbing. The effect of what has been going on, on the morale and recruitment and retention in the v.a. Health system. Our veterans deserve the best care possible, that means the best providers possible. If good providers are leaving or not joining, that is a long-term problem that should be addressed.
▶ 1:31:48Sen. King: I hope the administration will take steps to rectify that morale killer.
▶ 1:31:54Dr. Graham: I absolutely agree. At the time when I was still at the v.a., I was struck by the people who had gone through the entire recruitment process up to basically signing on, basically signing on. One media source said that early in the first part of 2025, about 40% of jobs offered to positions in the v.a. Were declined.
▶ 1:32:24Dr. Graham: I think this is a real concern.
▶ 1:32:26Sen. King: Thank you. Thank you Mr. chairman.
▶ 1:32:29Chair Moran: I think the members for participating. I'm sorry that we have our schedules that exist as they do. I think you both for your testimony. Ms. carithers, I think there are three males on this committee here, that are at the age where it is important for us to hear what you have to say. Let me ask either of you, if you have anything you would like to add, or tell us that we have not asked you about.
▶ 1:33:00Chair Moran: Are you comfortable where you are?
▶ 1:33:01Dr. Graham: Just one or two points if you could indulge me. We talk about this budgetary cut, 2%. The v.a. Brings in approximately half $1 billion in non-re-a research funds from nih, department of defense, private foundations.
▶ 1:33:26Dr. Graham: My worry is if our research is deprecated, if startup times are slow, if research support staff and clinician scientists are not there, we will lose more money to the v.a. From these other sources of funding, by far, than the 2% cut. I worry about that, because I think research has done wonderful things.
▶ 1:33:53Dr. Graham: I worry about veterans losing the opportunity to participate in clinical research, who may be sent to the community, scattered all over the place, and never hear about research conducted at the v.a. Of whatever sort. I think that is contained in my written statement.
▶ 1:34:13Chair Moran: You said that earlier, and I made a note of it. In my mind, that means community care is a portion, a part of the v.a. System. How do we rectify the challenge that might be added to a veteran who is generally cared for in the community. It is often people from my state, in rural areas. How do we make sure they have the information and the awareness, that the v.a. Has trial programs, and can participate in research?
▶ 1:34:44Dr. Graham: I think for this to occur, it is going to take a concerted effort. A much greater effort to outreach to veterans who get all or most of their care in the community, that they can still participate in v.a. Research.
▶ 1:34:59Chair Moran: Senator blumenthal.
▶ 1:35:01Ranking Member Blumenthal: Thank you Mr. chairman. And again, my apologies for my late arrival. I want to put on the record, that I am continuing to work for a bicameral and bipartisan agreement, to advance our shared priorities, and I emphasize shared priorities, in the take care of american veterans act.
▶ 1:35:30Ranking Member Blumenthal: Particularly the major richard starr act, which both the chair and I support. I will ask again, when we agreed is appropriate for passage of a modified version of the take care of america's veterans act. My proposal will replace the major richard starr act language in that bill, with my legislation to fully repeal the wounded veterans tax.
▶ 1:36:05Ranking Member Blumenthal: It uses unobligated dod funds to offset the cost of the bill. Striking the controversial offset to cut more than $56 billion in future benefits for disabled veterans, who suffer from sleep apnea or tinnitus.
▶ 1:36:24Ranking Member Blumenthal: Yesterday in his testimony before the appropriations committee, secretary hegseth said there are about 75 billion dollars in unobligated funds from hr one, and he said all of it could be not obligated by the end of the year.
▶ 1:36:43Ranking Member Blumenthal: That supports my view that we should utilize a portion of that already appropriated dod funding in hr one, which is the best and bipartisan alternative, to the current offset in the take care of america's veterans act. I am hopeful that we can move forward on a substitute version.
▶ 1:37:13Ranking Member Blumenthal: And again, I look forward to working with my colleagues on both sides of the aisle in an effort to pass it through the senate as quickly as possible. Thank you.
▶ 1:37:25Chair Moran: I too share a view of finding a path forward on the richard starr act, and an opportunity to address a number of issues. 60 some pieces of legislation. One of them was mentioned by senator murray today, as a priority of hers, with regard to menopause in women. That is included in the take care of america's veterans act.
▶ 1:37:54Chair Moran: I look forward to finding that path that not only takes care of the richard starr act, but this broad array of widely supported by dso and veterans across the country, pieces of legislation. We've had six years of people sponsoring the richard starr act, six years in which people have said we are for the act, but it has failed to pass year after year.
▶ 1:38:20Chair Moran: And in part, that is because there is not an offset to pay for it, which is required by law. Not only in the richard starr act, but in the other provisions in the legislation that is now included in this package. We asked again today, the congressional budget office, if the pay for it you are suggesting is something that counts as a pay for, under the paygo act, passed by congress years ago. The answer was no.
▶ 1:38:51Chair Moran: I worry we are on the same path of having a conversation, let's do this and get it done, and we end up in the same position we've been in, for a long time. I look forward to you and I having another conversation. We have not talked one on one, much about this since the act was introduced. There needs to be a way that satisfies the needs of the law but hasn't outcome.
▶ 1:39:27Chair Moran: I want an outcome and I am working to achieve that.
▶ 1:39:28Ranking Member Blumenthal: I think we share. . That view the only change I am making in the take care of america's veterans act is in that pay for, so as not to deprive disabled veterans of funds they need and deserve, for a department of defense obligation.
▶ 1:39:56Ranking Member Blumenthal: We should not be making veterans pay for a department of defense obligation. I think that we have the authority, to take that money from hr one and use it in a way that serves the interests of our veterans. The programs are worthwhile and important.
▶ 1:40:25Ranking Member Blumenthal: I look forward to continuing our conversation.
▶ 1:40:27Chair Moran: We will, for a slight moment longer right now. I am so interested in getting the richard starr act and these other pieces completed, passed by congress and signed by the president. This is not jurisdiction. This issue of the richard starr act is not the jurisdiction of the veterans committee. Senator blumenthal is looking for a defense pay for.
▶ 1:40:57Chair Moran: The issue, by jurisdiction arises in the armed services committee, of which he is a member. And we would be glad to have you accomplish this. I know senator blumenthal tried in a markup just a few weeks ago, to get this done, unsuccessfully. Because it is such an important opportunity for us, to meet the needs of veterans, I am looking for a way that has a result that we can accomplish. We agree on that.
▶ 1:41:32Sen. King: Let's add annual physicals for veterans.
▶ 1:41:40Chair Moran: This is such an important issue that we need to find ways that reach a conclusion, when we've been able -- unable to do so for so long. My mom was a baby notch and she accused me, her congressman of delaying until she was no longer alive. I tried to convince my mom that was not the case. But that legislation took years to come to fruition. She was dead.
▶ 1:42:11Chair Moran: I want to make sure that the veterans who would benefit from that legislation are still living, by the time that congress is able to act.
▶ 1:42:20Ranking Member Blumenthal: And just for the record, as senator king notes, I was denied a vote. Never had a vote.
▶ 1:42:32Chair Moran: I would call that not a result. Our witnesses may be less interested in this topic. I know people in the audience care about this gratefully -- greatly, and we are really engaged in trying to solve a problem that has existed for a long time. No other questions. I want to once again thank our witnesses. It was very useful testimony, thank you.
▶ 1:43:01Chair Moran: Each member has five legislative days to submit statements or questions for the record. A number of those were going to be submitted, so we will be asking you to respond to what you said, any senator who would like to submit such a question, please do so in a timely manner. I asked for witnesses to respond for the record to questions. . They have received with that, our hearing is adjourned.