Five, four, three, two, one. Good afternoon. I call this hearing to order. A quorum is present. Without objection, the chair is authorized to declare a recess at any time. If you experiencing connectivity issues please make sure you or our staff contact our support so those issues can be resolved immediately. If you wish to have a document inserted into the record please ask and have your staff mail the do youmean. We will ensure all members participating have an opportunity to be recognized. Does any member have a question about the procedures or this hearing . Hearing none, we will proceed. I will recognize myself for an opening statement. We have often cited women as the Fastest Growing cohort morning veterans. Our hearing today will examine womens veterans access to the full spectrum of medical care including retructive healthcare. Todays hearing offers an opportunity to reflect on the meaning of freedom. Women veterans have signed up to fight for and defend our countrys founding ideas of freedom. That is why they that is why they served. That is why they continue to serve. Listen closely to my colleagues on the other side of the aisle womens veteran choices that are best for their own personal health and medical providers freedom to exercise their own clinical judgment are under attack. Pay attention to the kind of legislation that they support. There are so extreme that all but one of our republican colleagues on this committee thel but one of our republican colleagues on this committee have cosponsored hr 1011 a bill that would criminalize Womens Health care. It would effectively negate womens bodily autonomy once a sperm reaches an egg, with no exceptions. The practical effect of this is Womens Health care choices become murder and they have no right to pursue lifesaving Cancer Treatments or use iuds or emergency contraception. It also takes away the choice of women for science based women building treatments such as infertile fertilization. Since the Dobbs Decision we have seen a stark contrast between those who planned to be prolife and those that actually want to defend life the freedom to choose and the freedom to respect the right of privacy Women Veterans have worn the uniform of our country with pride that is why it is an insult to their service that they would be denied for making the most personal choices about their bodies in their lives in reflecting on the effect on the recent Supreme Court decision, one of the witnesses on our second panel said in their written testimony, quote the moral injury of having served a country to protect our constitution that no longer protects me and the ones i love was and still is absolutely devastating and quote fortunately President Biden and secretary mcdonough are taking bold action to prevent eminent and future hard to better inspire restoring certain Reproductive Health care freedoms that were eliminated in the wake of the Supreme Courts recent decision six days ago va published an interim final rule that remains longstanding provision on abortion counseling and authorizes va medical facilities to furnish abortions in cases of race incest and the health of the woman this ruling is a strong first step to finally puts the va on par with all other federal Health Care Programs this rule will also promote better equity between the men and women who receive care at the va by removing the gag order of what doctors can discuss with their women patients no such gag order has ever existed for man it is unacceptable that it should ever be exercised against Women Veterans who served alongside their brothers in arms and deserve the full care they have earned and need most importantly this rule will save womens lives and protect their house for decades the va providers have had to call in favors in the community to procure lifesaving abortion care for women before this interim final rule pregnant veterans with lifethreatening pregnancy complications returned away in the wake of dobbs abortion bans have been triggered in multiple states and Community Care is no longer an option now the va can provide the abortion care necessary to save womens lives when their communities and states wont they can save veteran women live when their communities and states want to be a came to this decision after came to this decision after listening to veterans across the Country Congress needs to listen to veterans and providers to over the last several decades i and Committee Woman brownley have including fellow Committee Call allred and reuben diego have been doing just that. Since early august we have traveled with our staff to four different states we drove more than 1600 miles visiting six different medical facilities and conducted several sessions for here from women to hear about their experience in the va i came away from these visits in light about the challenges of ba currently facing awestruck by the determination and strength of Women Veterans we met with Critical Care teams and Women Program members like stephanie in Oklahoma City cindy in las vegas pat in phoenix in va employees who are serving veterans in creative ways doing many hours of doing outreach and thinking new ways to show Women Veterans at the va is a place for them we have seen what leading in Womens Health care means including at va facilities with dedicated Women Clinics with separate entrances, lactation facilities, integrated Mental Health care and an overall experience designed and delivered for Women Veterans with unique needs. I will tell you that among the va providers and the veterans i met with over the last week, the news of the secretarys recent regulatory action was met with approval applause and hope. We ask and they answered on equivocally Women Veterans want them to be able to provide a full spectrum of care. They provide more health care provisions. There was a clause with the va to finally join other federal have care programs to provide lifesaving reproductive care. Hope that this critical step is a sign the va is ready to truly welcome Women Veterans. Really provide the full spectrum of care. After one listening session with womens veterans last week a young veteran named jessica shared her reaction. Quote, i felt seen, i felt heard. I felt hopeful for the future of Womens Health care at the va, and quote. We also have been fielding an Online Survey to hear from veterans across the country about receiving Reproductive Health care, contraceptive care and infertility commitment at the va. As of this week we have received over four and 50 responses from veterans. The overwhelming majority of whom support the va support counseling and abortion care in circumstances like those covered by the secretarys new regulation. So far, 90 of survey respondents have said the va should provide abortion counseling. 73 of respondents said the va should always or sometimes provide abortion care. This survey is still alive at the committees website. I encourage any veteran who is trying to access Reproductive Health care at the va to complete it. Visit veterans dot how stock of. Click the button at the top to share your story. Your responses will remain anonymous should you wish them to be. I also want to thank secretary mcdonough and President Biden for their courageous, strong, regulatory action that will save womens lives. That will save womens veterans lives. I look forward to working with the secretary to ensure the ba has everything it needs to implement this rule successfully. I know much more needs to be done to improve Women Veterans experiences at the va. I see the implementation of this rule as a big leak moment for the department. If implemented well i hope that this will attract even more providers to practice at the va. More Women Veterans to seek care at the va. This is an opportunity to improve the whole spectrum of health care for Women Veterans. Indeed, while i have heard a lot of hope in my conversation with Women Veterans in the last week, there is also a frustration about longstanding challenges. A majority of care is sent out to majority. And caseload from women Care Coordinators make it hard and difficult for Women Veterans to reach their providers and get scheduled appointments in a timely manner. Some va primary care providers are not as welltrained or as committed as they should be in caring for women. Deficiencies in private, privacy and antiharassment measures still exist within va facilities. However, these are all challenges that can be addressed if we collectively commit to doing so. In phoenix alone over 11,000 women have chosen to receive their care at the va. This is a truly astounding in laudable number. It means that we owe these 11,000 women the best experience possible. The health care they have earned and deserve. I am pleased that the newly confirmed undersecretary for health dr. Sharif all the hall is appearing before this committee today so that we can discuss with him and other leaders on the panel how the va can truly put a plan into action that can serve Women Veterans. We will also hear directly from veterans and Women Health Care providers about their experiences so we can learn more about the vas challenges and develop ways to address them. Women veteran leaders have served this country. It is past time that we do right by their service. They are watching today, listening to what we all have to say. They are listening closely to who wants to deny them the most basic respect and autonomy and who wants to support the freedom that they fought for. Thank you, i now recognize Ranking Member bost for his opening comments. Ranking member bost. Thank you mister chairman, i appreciate today to discuss the care that the va provides to Women Veterans. I would like to start off with a couple stories. I know this young man that is 42 years old, he actually serves as a judge in my hometown. He also is a Lieutenant Colonel in the United States marine corps reserve. He is an outstanding citizen. He has been a blessing to the people in his community he has worked hard he has served this nation 43 years ago a young 17 Year Old Girl had to make a choice. About three teachers told her, dont ruin your life. This is a very inconvenient to be pregnant. She made the choice to keep that child. That child is my son. That woman is my wife. Fast forward to 20 years ago, my daughter the day after my sons wedding as a matter of fact came to us, she had to be rushed to a hospital in st. Louis because she was pregnant with twins. The twins had what was known and as a conjoined communication, that is a shared umbilical cord. She was 25 weeks along, if they could just get her to 26, just 26 weeks along the babies would live. One of the babies, aliana, died in the womb. Causing her to go into labor at 25 and a half weeks. We held holly, she fought for every breath. You know, mr. Chairman, strengthening services to Women Veterans is a priority of mine. He should not question that or anyone else on this panel. You know me. You know that we want to fight for womens rights and their ability to be served by our va to deal with any issue that they might have. Those who honorably have served our country in uniform deserve the best health care and support that we can provide, regardless of gender. I have a granddaughter that just joined the navy. As a marine that is kind of hard on me but i will get over. We teaser a lot about it. You know, getting the house care that they need that start to include support, it starts families on their own way. That does not include abortion. I am proudly prolife. I believe it is a matter of my face that abortion is wrong. I also believe an emitter of law that the va does not have the authority to offer abortions. Congress made that clear in 1992 by prohibiting the va from providing abortion. 30 years later, the prohibition remains in place. It is not it has not been repealed. It has not been replaced by subsequent congressional action. That is why i am so outraged by the announcement that the va will begin providing abortion to certain veterans and va beneficiaries. Abortion counseling to anyone in those groups. This is not only wrong, it is illegal. Let me say it again, it is illegal. The president and his cronies are willfully ignoring the constitution by acting like laws are mere suggestions. The Biden Administration has made a downright habit of it. It is shameful. It is undemocratic. It mocks the duty members of congress have to represent the will of the American People in washington with our actions, with actions like this the president is doing exactly what he falsely accused duly elected republican representatives of doing just last week. Following the law is not an option, it is a requirement. By ignoring the law the va is violating the wishes and values of millions of americans who do not want to tack dollars used to pay for abortions at va or anywhere else. I am one of those americans. The law is clear and it is on our side here. I will never stop fighting to ensure that the sanctity of life is protected at the ba and everywhere else. I am working with my colleagues on the Appropriation Committee and the senate to consider sanctions against would be a for violating the anti efficiency act. Abortion is not health care, no matter what those on the other side of this issue may feel. The right to life is sacred. American value enshrines in the declaration of independence. It is one of the Rights Service members and veterans throughout history fought and died to defend. I am committed to defending it now for them and for their own born children. Mister chairman, with that i yield back. Thank you Ranking Member bossed. I just want to point out before we begin the questioning that the 91 law, the 1991 law that you tsai was superseded by a 1996 law that authorized the va to create its own medical benefit packages. Its own package, the Hyde Amendment is not applied to the va. The secretary has the authority to create the medical benefits package that characterizes the entire range of services that happens under the Veterans Health administration. I will now recognize myself for for questions. Five minutes. Oh, im sorry. Im sorry. Good it would be helpful if i introduce the witnesses. The witness panelist. Lets begin, we have with us today i am very pleased to see with us doctor sharif ellen hall, newly confirmed secretary, undersecretary for health for the Veterans Health administration. Accompanied by patricia hayes, chief officer Womens Health, but earn Health Administration for the u. S. Department of veteran affairs. Doctor Amanda Johnson director for womens Reproductive Health for the Veterans Health administration, the u. S. Department of Energy Affairs and dr. Julian flynn, acting assistant undersecretary for health care Community Care for the Veterans HealthAdministration Department for veteran affairs. Doctor sharif on the hall, you are recognized for your opening statement. Good afternoon mister chairman, ranking meter, and members of the committee. I appreciate the opportunity to discuss womens veterans access to health care. Im accompanied today by doctor patricia hayes, our chief officer at the office of Womens Health, dr. Amanda johnson, director of Reproductive Health, and dr. Julian flynn, our acting deputy under assistant secretary of health for the office of integrated veterans care. On behalf of the department i want to thank this committee for its laser focus and continued collaboration on the whole health of all Women Veterans. This critical relationship is reflected in the resources that congress has repeatedly secured and seen in President Bidens budget requests of billion for fiscal year it is paramount that we continue our progress together for the fastestgrowing demographic of veterans, women. One important access of this work is delivering the reproductive Access Services that they need when and where they n