In a year in which Congress has strained for legislative achievements, a big one is in sight. When senators return from a Memorial Day recess spent honoring those who gave their lives for the United States, they will take up a bipartisan bill that will broaden dramatically America's commitment to take care of sick veterans.
The bill would offer new health care and tax-free disability benefits as high as $3,332 a month to as many as 3.5 million veterans at a cost the Congressional Budget Office has pegged at $278.5 billion over 10 years.
Under the legislation, crafted by Senate Veterans’ Affairs Chairman Jon Tester, D-Mont., and ranking member Jerry Moran, R-Kan., the Veterans Affairs Department would consider a veteran with any of 23 conditions — as varied as brain cancer and hypertension — who was deployed to a combat zone during the wars in Iraq or Afghanistan automatically eligible for care at government cost.
By contrast, under current law, the veteran must demonstrate that his or her illness was the result of military service in order to qualify for benefits.
Presuming a cause
There's little doubt that many veterans were sickened by exposure to chemicals while they served, including smoke from burn pits in which troops disposed of garbage, such as medical materials and vehicle parts, by dousing it in jet fuel and setting it ablaze.
The practice was widespread during the wars in Iraq and Afghanistan, and medical experts say exposure is linked to a host of illnesses that can present themselves years later, including cancers, chronic respiratory conditions and lung damage.
But for the better part of the post-9/11 era, the military did not keep thorough records of where burn pits were used. The smoke from the pits can also travel for miles, potentially affecting troops far afield. For veterans trying to prove that they qualified for toxic exposure treatment through the VA, it could be their word against the Pentagon’s.
“I was in a very small, remote patrol base in southern Afghanistan, and we had a burn pit like everybody did. When I got out in 2011, there was nothing in my medical record that proved I was near a burn pit, because the DOD wasn’t tracking this stuff,” said Travis Horr, a Marine Corps veteran and the government affairs director for Iraq and Afghanistan Veterans of America, an advocacy group.
The bill would also extend, from five years to 10 years, the period following veterans' separation from the military in which they can seek out health care from the VA. If within that time period the veteran qualifies for care, he or she will continue to receive it indefinitely.
Also in the legislation is an expansion of benefits for veterans exposed to radiation during the Cold War, an expansion of the list of illnesses linked to the use of Agent Orange during the Vietnam War and an extension of benefits to Vietnam War-era veterans who served in Thailand, Laos, Cambodia and Guam and may have been exposed to Agent Orange there.
It would also greatly expand the VA’s physical footprint by setting up 31 new, major medical clinics across 19 states while hiring thousands more claims processors and staff.
The legislation largely mirrors, and slightly expands on, a House bill by Veterans' Affairs Chairman Mark Takano, D-Calif., that passed 256-174 in March. President Joe Biden issued a statement at the time saying he supported the measure.
Republicans who opposed the House bill argued that its likely price tag of more than $300 billion over 10 years was too expensive.
The Congressional Budget Office projected that direct benefit payments for disability compensation would increase by $208 billion over a decade under the House bill, while health care costs, paid for through the annual appropriations process, plus VA administrative costs, could require an additional $114 billion.
The CBO estimates health care and related costs in the Senate bill will run $113 billion, while disability compensation will be another $152 billion. VA disability benefits range from $153 to $3,332 a month in tax-free payments, depending on the severity of the ailment.
In February, the Senate passed by voice vote a narrower version of the bill that the Congressional Budget Office said would cost $1 billion over a decade. It would expand health care to more veterans who served in areas with known toxic exposure, but wouldn’t provide disability compensation.
House Democrats said that Senate bill wouldn't help enough veterans — just 16,000 out of the 3.5 million potentially eligible Iraq and Afghanistan veterans — and declined to take it up.
In the interim, Democrats argued it was not necessary to offset the cost with new taxes or fees, or budget cuts elsewhere, because of ill veterans' pressing needs, and they derided the Senate's original bill as stingy.
“It’s the cost of war,” Speaker Nancy Pelosi, D-Calif., said after the House's March vote. "For the Republicans to go to the floor and say their veterans really don't want this help with their health because it's going to cost money and they're more concerned about the budget … than they are about their health, oh really? You just gave tax cuts in 2017 to the richest people in America. Tax cuts for the rich, cancer for our veterans."
A coalition of more than 40 veterans groups also backed the Democrats' argument, while comedian Jon Stewart — who successfully lobbied Congress to provide compensation to people exposed to toxic air in New York City from the Sept. 11 terrorist attack — joined the cause and raised the pressure.
During a Sunday speech at a Memorial Day weekend event in Washington, Stewart said it was difficult not to be frustrated with Congress and the American people for taking so long to address the burn pits issue.
“This may be one of the lowest-hanging fruit of the American legislative agenda,” he said. “Those that took up arms in defense of this country suffered grievous harm in that defense.”
The new Senate bill would establish a “Cost of War Toxic Exposures Fund” to cover the costs of the benefits it would create.
Takano has said he's satisfied, likely ensuring that the House will follow the Senate and send the bill to Biden for his signature.