Lawmakers have responded to issues surrounding toxic exposures in the military and the decades-long health crisis plaguing the veteran community with a mix of incremental efforts and sweeping health care bills. The looming question is what can make it into law this year while momentum lasts.
Some efforts, including those to provide presumptive care to those sickened by burn pits in the post-9/11 wars, could add enormous costs to the Department of Veterans Affairs, which already has a ballooning budget far outpacing inflation.
Advocates and some lawmakers stress that the stars are aligned to pass significant legislation: Toxic exposure is getting more media attention; Democrats are in control of Congress; and the president has been personally touched by the issue, believing his son Beau died after burn pit exposure in Iraq.
While burn pits are referred to as the post-9/11 generation's Agent Orange, not even all Vietnam veterans can get presumptive care.
This week, three bills on toxic exposure were introduced on Capitol Hill, including a measure from Pennsylvania Reps. Matt Cartwright, a Democrat, and Brian Fitzpatrick, a Republican, that would expand the presumption of Agent Orange exposure to veterans who served in Cambodia, Laos and Thailand during the Vietnam War. It is unclear how many vets would be impacted.
A presumption ruling makes seeking health care and disability compensation from the VA much easier, avoiding the need for veterans to submit a large volume of paperwork showing they both served in the area and were exposed to Agent Orange, which could be nearly impossible to prove.
"Many of those who have been exposed are living with cancers, heart disease or Parkinson's disease," Cartwright said in a statement. "They deserve relief for the pain and hardship this has caused for them and their families."
Another measure from Rep. Jahana Hayes and Sen. Richard Blumenthal, both Connecticut Democrats, would open up disability compensation to the 1,600 veterans exposed to radiation in the aftermath of the Palomares Nuclear DIsaster in Spain.
In January 1966, a U.S. Air Force B-52 Stratofortress bomber collided with a KC-135 Stratotanker aircraft during a midair refueling over the Spanish village of Palomares, accidentally dropping four hydrogen bombs, far more powerful than the bombs used on Japan, from 31,000 feet to the ground.
The bombs were not armed, making a nuclear explosion unlikely. But two of them set off conventional explosions designed to trigger a nuclear blast.
Troops were sent to clean up the radiation-contaminated area but were given little protective gear. The VA currently does not list Palomares as a radiation-risk activity.
"The nuclear disaster in Palomares caused untold suffering and harm to the servicemembers sent in to clean up radioactive material without adequate protective gear or warning of severe health risks," Blumenthal said in a statement. "Yet 55 years on, the VA still hasn't recognized radiation risks at Palomares, cutting off benefits and health care for these deserving veterans. They are aging and this cannot wait any longer."
In Skaar v. Wilkie, the U.S. Court of Appeals for Veterans Claims found in December that the VA had not fulfilled its legal responsibility to determine whether the method it uses to assess Palomares veterans' radiation exposure is scientifically sound and demanded that the department reexamine this policy.
Meanwhile, Rep. David Trone, D-Md., has introduced a bill to streamline and speed up the VA's process to establish presumptive care for toxic exposure.
"The least we can do is provide these heroes with the benefits they've earned in a timely manner," Trone said in a statement.
More bills are expected to follow to expand care for veterans and make it easier to navigate VA bureaucracy to get health care and disability compensation.
All proposed legislation will be debated in an upcoming House Veterans Affairs Committee hearing. A committee aide said additional legislation will be proposed to assist veterans exposed to toxins at the now-closed Fort McClellan, Alabama.
Service members there were exposed to radioactive compounds, chemical warfare agents and airborne polychlorinated biphenyls, or PCBs, chemical compounds widely used in paints, plastics and adhesives. The VA does not presume any health conditions associated with service at the base.
"Although exposures to high levels of these compounds have been shown to cause a variety of adverse health effects in humans and laboratory animals, there is no evidence of exposures of this magnitude having occurred at Fort McClellan," the VA says on its website. "There are currently no adverse health conditions associated with service at Fort McClellan."
The wide array of legislative proposals follows a yearlong commitment from VA committee leaders in both chambers of Congress to make toxic exposure a top priority.
Advocates and some lawmakers urge that this is the year to pass big-ticket bills, such as one from Sens. Kirsten Gillibrand, D-N.Y., and Marco Rubio, R-Fla., that would presume the 3.5 million veterans who deployed to the Middle East and Africa were exposed to burn pits and could seek health care and disability compensation for conditions they believe are related to service.
Like various other toxic exposure issues, the VA does not concede that the science is clear linking breathing in burning garbage for up to a year at a time and suffering health conditions such as cancers and respiratory diseases.
Presumptive care for burn pit exposure is a mammoth task for Congress, especially amid enormous spending on pandemic relief and President Joe Biden's push for a $2 trillion infrastructure package. Some hoped that the president would be a key ally on burn pits, given his son's exposure, but he has not mentioned burn pits publicly since taking office.
VA Secretary Denis McDonough told lawmakers this week that more study is needed on burn pit exposure, to the ire of advocates fed up with yet more studies that they see as a means to kick the can down the road; they fear burn pits will turn into a half-century fight for health care like Agent Orange.
Biden's proposed 2022 budget includes $882 million for VA research, which includes looking more into toxic exposure and other long-term health ailments.
-- Steve Beynon can be reached at Steve.Beynon@military.com. Follow him on Twitter @StevenBeynon.