In the last Congressional session, the EDCoalition aggressively pursued the SERVE Act. It is also supporting the new SERVE Act which was recently filed. The Supporting Eating Disorders Recovery Through Vital Expansion Act (SERVE) Act sought to, and seeks to expand TriCare, allowing military family members over age 20 access to eating disorders care, and ensures servicemembers and their families have access to comprehensive eating disorders treatment nationwide.
It is admirable that the EDCoalition would focus on our military and the eating disorder needs within that community. My father was an Air Force pilot. Among other planes, he flew the F86 Sabre jet, the U.S.’s first swept wing fighter. I have a nephew who at 30 years old, is a Captain in the Air Force stationed at the Pentagon. I have two uncles who proudly served. And yet, with regard to eating disorders, the number differential between civilians and military personnel who suffer from this disease is staggering.
If the numbers are to be believed, 30 million Americans have or will have an eating disorder in their lifetime. There are currently approximately 1,400,000 active United States military personnel. The EDCoalition estimates that up to 8% of military personnel suffer from eating disorders. That would be 112,000.00. However, that number may be a bit high. The Armed Forces Health Surveillance Branch states that between 2013 and 2017, 1,788 active-duty troops were diagnosed with an eating disorder.
Whether you use the figure of 1,788 over five years or 112,000, both numbers pale in comparison to 30,000,000. 112,000 is approximately 1/3 of 1% of 30,000,000.
Certainly, there are aspects of Tricare which need to be amended. Stopping treatment in residential treatment centers for mental health issues including eating disorders at age 21 is nonsensical. With some persons serving in the armed forces for decades, this age limitation certainly needs to be amended.
In the past, Tricare on its website stated that it did not cover residential treatment care for eating disorders. That is no longer the case. On August 7, 2020, the U.S. Government Accountability Office issued a position letter on Tricare and eating disorders.
As one can readily tell, Table 3 in that Report provides a comprehensive list of Network and Non-network treatment facilities where eating disorder treatment is covered. This Report also states, “DOD [Department of Defense] is examining ways to improve its screening of eating disorders in the military as well as to identify possible ways to prevent such conditions in the military.”
The Report also states, “… DOD recently expanded the available research funding for eating disorders in its Peer-Reviewed Medical Research Program (PRMRP) with the goal of obtaining more comprehensive information on prevalence of eating disorders in the military and exploring ways to improve diagnosis of and treatment for the condition. In addition, the PRMRP is funding opportunities for research identifying biological and environmental risk factors associated with eating disorders, which could inform efforts to prevent or reduce the prevalence of these conditions. For example, one recently sponsored PRMRP project is developing an eating disorder screening tool for use with veterans and the military population.”
It is gratifying to see that at least one entity is pursuing research funding.
Military Veterans in Congress
With regard to Congress, military veterans constitute a strong and influential presence. The following military veterans served in the 116th Congress which just concluded:
• 96 total veterans in the 116th Congress.
• 30 were Democrats, 66 were Republicans.
• 19 served in the Senate, 77 served in the House.
• 48 served in the military after 2000.
• 21 served in the military in the 1960s or earlier.
• 19 were first-time lawmakers.
• 7 were women.
• 50 served in the Army, Army Reserve or Army National Guard.
• 17 served in the Marine Corps or Marine Corps Reserve.
• 17 served in the Air Force, Air Force Reserve or Air National Guard.
• 13 served in the Navy or Naval Reserve.
• 1 served in the Coast Guard
That constitutes about 18% of all Senators and Congresspersons with representation in both major parties. With such a strong presence, one could presume that support for eating disorder bills impacting the military would be relatively low hanging fruit.
How the EDCoalition fared with SERVE Act in the last Congress.
With regard to the SERVE Act, we can rightly presume that our military veterans serving in Congress would support this bill. However, the facts indicate otherwise.
The following table indicates the Military Veterans in Congress and whether they supporting the SERVE Act.
|District||Party||Name||Service||Era||SERVE Act Score|
|GA 9||GOP||Doug Collins||AF Reserve||2000s-2010s||No|
|WY Senate||GOP||Mike Enzi||Air Force||1960s-1970s||No|
|SC Senate||GOP||Lindsey Graham||Air Force||1980s-2010s||No|
|PA 6||Dem||Chrissy Houlahan||Air Force||1980s||No|
|VA 5||GOP||Denver Riggleman||Air Force||1990s||No|
|OR 4||Dem||Peter DeFazio||Air Force||1960s-1970s||No|
|TX 36||GOP||Brian Babin||Air Force||1970s||No|
|MS Senate||GOP||Roger Wicker||Air Force||1970s-1990s||No|
|OH 6||GOP||Bill Johnson||Air Force||1970s-1990s||No|
|GA 11||GOP||Barry Loudermilk||Air Force||1980s-1990s||No|
|UT 2||GOP||Chris Stewart||Air Force||1980s-1990s||No|
|NE 2||GOP||Don Bacon||Air Force||1980s-2010s||No|
|CA 33||Dem||Ted Lieu||Air Force||1990s-2010s||Yes|
|IL 16||GOP||Adam Kinzinger||Air Force||2000s-2010s||No|
|Georgia||Republican||Johnny Isakson||Air Force||1960s-1970s||NA|
|FL 16||GOP||Vern Buchanan||Air NG||1970s||No|
|PA 10||GOP||Scott Perry||Army NG||1980s-2010s||No|
|OK Senate||GOP||Jim Inhofe||Army||1950s||No|
|KY Senate||GOP||Mitch McConnell||Army||1960s||No|
|MA Senate||Dem||Ed Markey||Army||1960s-1970s||No|
|RI Senate||Dem||Jack Reed||Army||1970s||No|
|AK Senate||GOP||Tom Cotton||Army||2000s-2010s||No|
|IN 4||GOP||Jim Baird||Army||1960s-1970s||No|
|TN 7||GOP||Mark Green||Army||1980s-2000s||No|
|CO 6||Dem||Jason Crow||Army||1990s-2000s||Yes|
|FL 6||GOP||Michael Waltz||Army||1990s-2010s||No|
|FL 17||GOP||Greg Steube||Army||2000s||No|
|KS 2||GOP||Steve Watkins||Army||2000s-2010s||No|
|NY 11||Dem||Max Rose||Army||2010s||No|
|AK (House)||GOP||Don Young||Army||1950s||No|
|GA 2||Dem||Sanford Bishop Jr.||Army||1960s||No|
|IL 1||Dem||Bobby Rush||Army||1960s||Yes|
|MN 7||Dem||Collin Peterson||Army||1960s||No|
|NJ 9||Dem||Bill Pascrell||Army||1960s||No|
|NY 15||Dem||Jose Serrano||Army||1960s||No|
|NC 1||Dem||G.K. Butterfield||Army||1960s||No|
|CA 5||Dem||Mike Thompson||Army||1960s-1970s||Yes|
|NC 3||GOP||Walter Jones||Army||1960s-1970s||No|
|VA 3||Dem||Bobby Scott||Army||1970s||No|
|TN 1||GOP||Phil Roe||Army||1970s||No|
|TX 11||GOP||Mike Conaway||Army||1970s||No|
|LA 3||GOP||Clay Higgins||Army||1970s-1980s||No|
|TX 1||GOP||Louie Gohmert||Army||1970s-1980s||No|
|SC 2||GOP||Joe Wilson||Army||1970s-1990s||No|
|FL 2||GOP||Neal Dunn||Army||1980s||No|
|NV 2||GOP||Mark Amodei||Army||1980s||No|
|AR 1||GOP||Rick Crawford||Army||1980s-1990s||No|
|KY 2||GOP||Brett Guthrie||Army||1980s-1990s||No|
|OH 8||GOP||Warren Davidson||Army||1980s-1990s||No|
|IL 15||GOP||John Shimkus||Army||1980s-2000s||No|
|NY 1||GOP||Lee Zeldin||Army||2000s||No|
|FL 18||GOP||Brian Mast||Army||2000s-2010s||No|
|IL Senate||Dem||Tammy Duckworth||Army NG||1990s-2010s||No|
|IA Senate||GOP||Joni Ernst||Army NG||1990s-2010s||No|
|SC 4||GOP||William Timmons||Army NG||2010s||No|
|KY 5||GOP||Hal Rogers||Army NG||1950s-1960s||No|
|NY 2||GOP||Peter King||Army NG||1960s-1970s||No|
|AR 3||GOP||Steve Womack||Army NG||1980s-2000s||No|
|OH 15||GOP||Steve Stivers||Army NG||1980s-2010s||No|
|MS 1||GOP||Trent Kelly||Army NG||1990s-2010s||No|
|HI 2||Dem||Tulsi Gabbard||Army NG||2000s-2010s||No|
|KS 1||GOP||Roger Marshall||Army Reserve||2010s||No|
|MD 4||Dem||Anthony Brown||Army Reserve||1980s-2010s||No|
|OH 2||GOP||Brad Wenstrup||Army Reserve||1990s-2010s||No|
|LA 5||GOP||Ralph Abraham||Coast Guard, ANG||1980s-2010s||No|
|KS Senate||GOP||Pat Roberts||Marine Corps||1950s-1960s||No|
|CT Senate||Dem||Richard Blumenthal||MC Reserve||1970s||No|
|IN Senate||GOP||Todd Young||Marine Corps||1990s-2000s||No|
|AK Senate||GOP||Dan Sullivan||Marine Corps||1990s-2010s||No|
|IN 6||GOP||Greg Pence||Marine Corps||1970s-1980s||No|
|TX 3||GOP||Van Taylor||Marine Corps||1990s-2000s||No|
|ME 2||Dem||Jared Golden||Marine Corps||2000s||No|
|CA 8||GOP||Paul Cook||Marine Corps||1960s-1980s||No|
|IL 12||GOP||Mike Bost||Marine Corps||1970s-1980s||No|
|MI 1||GOP||Jack Bergman||Marine Corps||1970s-2000s||No|
|AZ 7||Dem||Ruben Gallego||Marine Corps||2000s||No|
|MA 6||Dem||Seth Moulton||Marine Corps||2000s||Lead|
|PA 17||Dem||Conor Lamb||Marine Corps||2000s-2010s||No|
|CA 50||GOP||Duncan Hunter||Marine Corps||2000s-2010s||No|
|WI 8||GOP||Mike Gallagher||Marine Corps||2000s-2010s||No|
|CA 24||Dem||Salud Carbajal||MC Reserve||1990s||No|
|MI Senate||Dem||Gary Peters||Navy||1990s-2000s||No|
|FL Senate||GOP||Rick Scott||Navy||1970s||No|
|CA 39||Dem||Gil Cisneros||Navy||1990s-2000s||Yes|
|NJ 11||Dem||Mikie Sherrill||Navy||1990s-2000s||Yes|
|VA 2||Dem||Elaine Luria||Navy||1990s-2010s||Yes|
|PA 14||GOP||Guy Reschenthaler||Navy||2000s-2010s||No|
|TX 2||GOP||Daniel Crenshaw||Navy||2000s-2010s||No|
|TX 22||GOP||Pete Olson||Navy||1990s||No|
|DE Senate||Dem||Thomas Carper||Navy Reserve||1960s-1990s||No|
|IN 8||GOP||Larry Bucshon||Navy Reserve||1980s-1990s||No|
|MD 1||GOP||Andy Harris||Navy Reserve||1980s-2010s||No|
|CA 20||Dem||Jimmy Panetta||Navy Reserve||2000s||No|
|IN 3||GOP||Jim Banks||Navy Reserve||2010s||No|
|MS 4||GOP||Steven Palazzo||Marine Corps/Army||1980s-2010s||No|
|AZ Senate||GOP||Martha McSally||Air Force||1990s-2010s||No|
In the Senate, of the 19 Senators who are military veterans, their support, or the lack thereof, was unanimous. Not one of the 19 Senators who served in our military supported the SERVE Act.
In the House of Representatives, 8 Congressmen and women, including the lead Congressman supported the SERVE Act. That means sixty-nine (69) Congresspersons did not support the SERVE Act.
With eating disorders allegedly being more prevalent within our military personnel, it is perplexing that our Congressmen and Congresswomen who previously served in the military, did not uniformly support the SERVE Act. So, out of fairness we should consider the other politicians in Congress and their outlook on not just the SERVE Act but on the other initiatives supported by the EDCoalition.
Congress and the SERVE Act
Our friends at the EDCoalition assemble a scorecard for Senators and Congresspersons. Each time a politician either signs a letter showing support for a bill, or introduces legislation they co-sponsored or legislation they voted directly for relating to eating disorders, they receive a positive check. A grade of 0 through 4 is then assigned to each check, with o points indicating no support and 4 indicating support. (There are other ways to increase the score such as being the sponsor and introducing the bill). Naturally, if a politician has not indicated any support at all, they receive a score of zero.
The EDCoalition makes it clear that, “It is important to note that the legislative efforts listed on this scorecard reflect a combined effort from the eating disorders community, and not solely EDC-led initiatives.” Presumably this refers to NEDA and the REDC who pay the same lobbyist, Center Road Solutions.
The EDCoalition then listed fifteen (15) bills, resolutions, letters and initiatives they supported. One would be justified in assuming that if the bills had merit, politicians, especially those who previously served in the military, would support in theory, if not practice, those bills.
The EDCoalition issued its most recent scorecard on December 15, 2020. To say the numbers are disturbing would be charitable.
In the Senate, of the 53 Republican Senators, FORTY-SEVEN (47) received a score of ZERO. This indicates no support whatsoever for eating disorder bills and resolutions. And lest one think that Republicans alone are forestalling bills on eating disorders, of the 45 Democratic Senators, TWENTY-SEVEN (27) received a score of ZERO. Of the two, Independent Senators, both had a score of ZERO, including Senator Bernie “Mittens” Sanders.
Of the Democrats in the Senate, the following well known Senators had a score of ZERO: Cory Booker (D) NJ, Elizabeth Warren (D) MASS, Diane Feinstein (D) CA, and our current Vice President Kamala Harris (D) CA.
In the House of Representatives, the numbers are equally alarming. Of the 199 Republicans, one hundred sixty-eight (168) received a score of ZERO. Of the 235 Democrats, ninety (90) received a score of ZERO. Of the Democrats in the House, the following well known Congresspersons had a score of ZERO: Adam Schiff (D) CA, Maxine Waters (D) CA, and Henry Cuellar (D) TX. Two members of the Democratic Socialist “Squad” registered scores of ZERO; Rashida Tlaib (D) MI and Ayenna Pressley (D) MASS. Two other members of the Democratic Socialist Squad, Alexandria Ocasio-Cortez (D) NY and Ilhan Omar (D) Minn each registered scores of one (1).
Apparently, eating disorder bills are being ignored by both conservative Republicans on the far right and liberal Democrats on the far left. To date no stand-alone eating disorder bill has ever made it out of Committee for debate on the House or Senate Floor. No eating disorder bill emphasizing research funding has even been introduced for eight (8) years.
With so many politicians from both sides of the aisle ignoring eating disorder bills, at what point is the community justified in demanding explanations and accountability. Even though the concepts of accountability or “perform or perish” are alien to the eating disorder community, when faced with such an overwhelming display of ineptitude and incompetence, are we not justified in looking at alternative ways of accomplishing goals?
As we saw last week, appropriations for funding of research of mental health issues are usually submitted through the National Institute of Mental Health (“NIMH”). NIMH makes funding requests to be included in the annual federal Appropriations Bill.
Statements from the EDCoalition that “meaningful progress in eating disorders treatment and intervention will only be realized to the extent we meaningfully invest in its science” ring hollow since their words are not backed by its conduct. Research means Progress. Progress means Hope. Hope begets Recovery.
As shown last week, Congressional bills have on average, a 4% chance of being enacted into law. That means we are looking at a 4% chance of success on a bill that will have an impact on 1/3 of 1% of people who suffer from eating disorders. AGAIN, THAT IS A 4% CHANCE OF HELPING 1/3 OF 1% OF THOSE WHO SUFFER FROM EATING DISORDERS.
The subject matter of bills and the subsequent lobbying efforts on those bills are dictated by those who provide the financial resources for those endeavors. So, as our families continue to suffer and our children continue to die, aren’t we entitled to transparency and honest answers to the questions of who is supplying the funding for these foolhardy ventures, who is making the decisions to pursue certain bills and why isn’t crucial research funding being pursued?
It is an absolute certainty that if an organization, like NEDA, solicits donations from the general public and as part of its solicitation efforts it represents that “… It’s time we stop treating them [eating disorders] as vanity illnesses and put serious effort into research that can help us broaden the understanding of what eating disorders are and who they affect.” … “The more funding allocated to eating disorders research, the quicker we can learn more about what causes them — and the quicker we can save more lives.” that organization has the absolute, non-delegable duty to advise its donors what specific legislative initiatives it is pursuing. Especially when that organization collaborates with other entities and jointly pay lobbyists a six figure revenue stream. As the EDCoalition publicly stated, “It is important to note that the legislative efforts listed on this scorecard reflect a combined effort from the eating disorders community, and not solely EDC-led initiatives.” Undoubtedly, this refers to NEDA and the REDC who pay the same lobbyist, Center Road Solutions.
Suppose that an organization solicits donations representing to the public in general and the eating disorder community in particular, that said donations are going toward crucial research on eating disorders but in fact, those donations are not being directed toward research based Congressional bills. Then presume that same organization conspires with other organizations, pools their funds to pay a single lobbyist to pursue bills which not only are not research based but do not pertain to the vast majority of people who suffer from this disease. If these facts are proven, then it is axiomatic that all organizations and persons participating in this subterfuge should be held accountable.
Difficult questions need to be asked. Transparent answers to these difficult questions must be demanded and can be voluntarily made. But, we cannot expect that. So, if transparent answers are not voluntarily given, they can always be discovered during sworn, deposition testimony or in a court of law.
And in a lawsuit through discovery, there is a much greater likelihood than 4%, that the answers sought will be at long last uncovered.