Proposed amendments to the fiscal 2021 National Defense Authorization Act would add three diseases to the Department of Veterans Affairs' list of illnesses presumed to be linked to Agent Orange -- measures that, if approved, would provide health care and disability benefits to roughly 22,000 affected veterans.
The House and Senate amendments, proposed by Rep. Josh Harder, D-California, and Sen. Jon Tester, D-Montana, would add bladder cancer, hypothyroidism and Parkinsonism to the VA's list of 14 conditions considered related to herbicide exposure during the Vietnam War.
In 2016, the National Academies of Sciences, Engineering and Medicine deemed the three named diseases to be associated with exposure to defoliants used during the war.
But the proposals do not include hypertension, a condition that the Academies also linked to Agent Orange in 2018. Hypertension, or high blood pressure, is common among the elderly and, if included, could add more than 2 million veterans to VA disability rolls in the next 10 years, at an estimated cost of $11.2 billion to $15.2 billion, according to department estimates.
Thirty veteran and military groups have backed the proposals and asked congressional leaders to do the same.
On Tuesday, the Veterans of Foreign Wars, Vietnam Veterans of America, Military Officers Association of America and 27 other groups wrote House and Senate leaders urging them to get behind the provisions.
"We call on you to lead and pass House Amendment 264 into law and end the waiting for many of our nation's ill veterans so they can receive disability benefits," stated letters sent to House Speaker Nancy Pelosi, House Minority Leader Kevin McCarthy, Senate Majority Leader Mitch McConnell and Senate Minority Leader Chuck Schumer.
"There is more work to be done to care for those who are ill from toxic exposures, including adopting hypertension as a presumptive disease ... but with your leadership, tens of thousands of Vietnam War veterans will receive their benefits and justice," they wrote.
A decision on whether to add the three conditions has been delayed since 2017, when then-VA Secretary David Shulkin expressed support for including them but never formally announced his decision.
According to internal VA documents, Shulkin had been on the verge of including the three conditions when the Office of Management and Budget and other White House officials objected, citing what they called "limited scientific evidence" and cost.
Meanwhile, thousands of veterans have waited.
"Vietnam vets have been waiting for this for decades, and it's a national shame that it's not fixed yet," Harder told Military.com. "We have a real chance here to make this right after all this time, and we should seize the opportunity."
VA Secretary Robert Wilkie told lawmakers late last year he wants the results of two studies -- the Vietnam Era Health Retrospective Observational Study, or VE-HEROES, and the Vietnam Era Mortality Study -- to be reviewed for publication before announcing a decision on whether to broaden the presumptives list.
But lawmakers and advocacy groups have balked at the delay.
"This is something we are still fighting after how many decades from the Vietnam War?" asked Cory Titus, director of veterans benefits and Guard/reserve affairs at MOAA. "We should be making sure there aren't any service members with illnesses who aren't getting the care and benefits they earned."
In February, Rep. Mark Takano, D-California, chairman of the House Veterans Affairs Committee, penned a letter to President Donald Trump asking him to "take corrective action" and add all four diseases to the list, including hypertension.
"Your administration has the ability to add these conditions to the presumptive list and provide lifesaving benefits to more than 190,000 veterans. Without your action, tens of thousands of sick and aging veterans will continue to go without VA resources and health care in their time of need," he wrote.
The letter was signed by 77 members, all Democrats.
While hypertension is not included in the proposed amendment, the coalition of veterans and military organizations pledged to continue working on adopting it as a "presumptive disease as linked by the National Academies."
"This needs to be covered as well. This is not something that we will forget -- hypertension," Titus said.
The House and Senate Armed Services Committees have both passed their versions of the fiscal 2021 defense bill and forwarded them to their respective chambers for consideration. Currently, committees are weighing the rules for amending and deliberating the bills before they move ahead for debate.
Both Harder and Tester's proposals must make it through that process before coming up for a vote.
A legislative source said Tester's amendment has been identified for a vote.
"With a bipartisan team of lawmakers and the support of the entire veterans community, we have a strong chance to finally get this done," Harder said.
Editor's note: This story has been updated to correct the spelling of Titus' first name.