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An airman tosses unserviceable uniform items into a burn pit at Balad Air Base, Iraq, on March 10, 2008. Members of the Senate Veterans’ Affairs Committee announced Wednesday, May 18, 2022, that they have reached an agreement that would expand eligibility for health care and benefits to all veterans exposed to burn pits and other toxins.

An airman tosses unserviceable uniform items into a burn pit at Balad Air Base, Iraq, on March 10, 2008. Members of the Senate Veterans’ Affairs Committee announced Wednesday, May 18, 2022, that they have reached an agreement that would expand eligibility for health care and benefits to all veterans exposed to burn pits and other toxins. (Julianne Showalter/U.S. Air Force)

WASHINGTON — Members of the Senate Veterans’ Affairs Committee announced Wednesday that they have reached an agreement that would expand eligibility for health care and benefits to all veterans exposed to burn pits and other toxins.

Sens. Jon Tester, D-Mont., chairman of the committee, and Jerry Moran of Kansas, the ranking Republican on the committee, introduced the Sergeant First Class Heath Robinson Honoring Our Promise to Address Comprehensive Toxics, or PACT, Act of 2022. The senators called the legislation historic and said the bill will provide long overdue health care services and benefits for all veterans exposed to toxins.

“For far too long, our nation’s veterans have been living with chronic illnesses as a result of exposures during their time in uniform,” Tester and Moran said in a joint statement. “Today, we’re taking necessary steps to right this wrong with our proposal that’ll provide veterans and their families with the health care and benefits they have earned and deserve.”

The PACT Act seeks to provide an easy path to health care and benefits for veterans who served near open-air burn pits, which were used throughout the 1990s and the post-9/11 wars to burn garbage, jet fuel and other materials. Veterans diagnosed with cancer, respiratory issues and lung disease at young ages have blamed exposure to the toxic fumes, but the Department of Veterans Affairs contended for years that there wasn’t sufficient evidence to support their claims.

The bill also would improve the VA’s workforce, health care facilities and claims processing to speed up efforts to meet the needs of veterans. Additionally, the bill would expand health care eligibility to post-9/11 combat veterans and add 23 conditions related to burn pits and other toxic exposures to the VA’s list of service presumptions. It will also expand presumptions related to Agent Orange exposure to include Thailand, Cambodia, Laos, Guam, American Samoa and Johnston Atoll, strengthen federal research on toxic exposure, and improve the VA’s resources and training.

The bill is named for Sgt. 1st Class Heath Robinson, who was diagnosed with a rare autoimmune disorder and lung cancer after serving with the Army National Guard in Kosovo and Iraq, where he experienced prolonged exposure to burn pits. He died in 2020.

In March, senators began negotiating a sweeping measure aimed at expanding eligibility for health care and benefits to millions of veterans exposed to burn pits and other toxins. The Senate Veterans’ Affairs Committee discussed the PACT Act, which passed through the House in early March but was at odds with a Senate strategy to address the problem of toxic exposure health care.

House lawmakers proposed a major reform bill, but senators opted for a more incremental approach to the issue. In February, the Senate passed the Health Care for Burn Pit Veterans Act, which would expand health care to veterans but doesn’t address other benefits. The sponsors of the bill insisted the measure is just a first step in a three-phase approach that would add more benefits incrementally.

The House PACT Act would increase spending by about $318 billion during the next decade, according to estimates from the Congressional Budget Office. The Senate’s initial bill would come with a price tag of about $1 billion.

VA Secretary Denis McDonough testified in March of two changes that his department wants to make to the bill before it’s passed. One is to amend a section that he believes would inadvertently delay the process to approve presumptive conditions. When a condition is on the presumptive list, it means the government acknowledges a veteran’s military service caused the medical condition, and it lowers the amount of evidence that a veteran must provide to receive benefits.

The PACT Act could create a commission to oversee the VA’s efforts to add presumptive conditions. While the idea is intended to speed up the process, McDonough said he believed it could do the opposite.

“I get what they’re trying to do, which is to get us to move quicker, but I think the tools they use to get us to do that would actually slow us down,” he said.

McDonough also wanted Congress to add a provision to the bill that would authorize 31 pending leases for VA medical facilities nationwide. Under the law, the VA must receive legislative approval to lease major medical facilities, but Congress has not authorized them on a regular basis.

“Facility space is critical to caring for veterans, and the PACT Act will bring millions more into our care,” McDonough said. “Yet, of 31 large medical facility leases, 21 have been pending for years. We urge you to approve those so we can be genuinely responsive to veterans’ needs.”

In April, the veterans organization Disabled American Veterans held a news conference in Kentucky to press lawmakers to pass the PACT Act and have veterans and their families share stories of how the toxic exposures affected them. Comedian Jon Stewart was not there in person but spoke at the event via Zoom.

“It's time that we recognize the toxic wounds or wounds, whether it's [Camp] Lejeune, or whether it's in Iraq and Afghanistan, or whether it's in Vietnam, or whether it was in the Persian Gulf, war exposes soldiers to dangerous and deadly substances,” Stewart said. “And those substances may not manifest for years. A toxic wound is a wound that goes off. It's an [improvised explosive device] that goes off in your body seven years later, 10 years later.”

Andy Marshall, DAV’s national commander, said the veteran organization is pleased the Senate Veterans’ Affairs Committee has reached an agreement on the PACT Act and calls on all senators to support the legislation.

"DAV and a coalition of veterans organizations have worked for years to develop and pass comprehensive military toxic exposure legislation to ensure every generation of veterans exposed to burn pits and other battlefield toxins receive the medical care and disability benefits they have earned," Marshall said in a prepared statement. "This breakthrough announcement is a major step toward moving the PACT Act through Congress and onto the president’s desk for his signature."

Stewart will be in Washington, D.C., and join veteran service organizations to hold a Pass the PACT Act Rally on May 29 at the RFK Fairgrounds Stage at 1 p.m.

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Sara Samora is a Marine Corps veteran and the veterans reporter for Stars and Stripes. A native Texan, she previously worked at the Houston Business Journal and the New Braunfels Herald-Zeitung. She also serves on the boards of Military Veterans in Journalism and the Houston Association of Hispanic Media Professionals.
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