More than 3.5 million veterans who were exposed to toxic substances on overseas deployments will gain easier access to health and disability benefits under a bill that cleared the Senate Tuesday.
The 86-11 vote ended weeks of delay that began with a constitutional concern over an obscure tax provision that had to be removed. And the holdup grew longer after an 11th-hour objection from Republican senators last week who pushed for an amendment to change how some Department of Veterans Affairs health care spending is accounted for in the budget.
President Joe Biden is certain to sign the bill into law in the coming days.
The legislation, long sought by veterans groups, means that millions of veterans suffering health problems will no longer have to prove their illnesses were caused by exposure to toxic substances from military deployments. Many served at bases that used open-air burn pits to dispose of trash and hazardous waste.
The bill would make servicemembers who contracted any of 23 conditions — from brain cancer to hypertension — after being deployed to Iraq, Afghanistan and other combat zones automatically eligible for VA benefits. The measure is expected to cost nearly $280 billion over a decade, according to the Congressional Budget Office.
The road to final passage was cleared after Democrats agreed to allow a vote on an amendment from Sen. Patrick J. Toomey, R-Pa., that was designed to foreclose the possibility of what he called “a massive unrelated spending binge” by Democrats.
Toomey and other conservatives had raised objections to the bill because it would reclassify nearly $400 billion in current-law VA spending from discretionary to mandatory accounts, thereby potentially freeing up more budget authority to increase discretionary spending on domestic programs unrelated to veterans. His amendment would keep current VA spending in discretionary accounts.
Toomey had been pushing for a simple-majority vote on his amendment. But after days of public protests over the delay of passage from veterans groups and comedian Jon Stewart, Toomey tweeted his agreement to a 60-vote threshold for GOP amendments, which is what Majority Leader Charles E. Schumer had offered.
"There's no better message we can send to the … veterans that have camped out for nights in front of the Capitol that their long wait and the wait of veterans everywhere is finally over," Schumer said in urging swift passage Tuesday before the vote.
The 60-vote threshold appeared designed to ensure that the amendment would be defeated in the 50-50 Senate. Adoption of any amendments would send the bill back to the House for yet another floor vote.
Toomey's amendment was rejected, 47-48, with Sen. Susan Collins, R-Maine, the sole GOP "no" vote.
Collins later explained that her opposition to Toomey's amendment was "mainly because I think veterans would find it difficult to understand why we would oppose mandatory spending" for their health care.
The Senate also considered two other amendments with a 60-vote threshold as part of the agreement reached by the chamber's leaders.
An amendment by Sen. Rand Paul, R-Ky., would have offset part of the cost of the expanded veterans benefits by eliminating all funding for the U.S. Agency for International Development for 10 years, except for aid to Israel. It was rejected, 7-90.
And an amendment by Sen. Marsha Blackburn, R-Tenn., would have made toxic-exposed veterans eligible for a VA program offering health care services through providers who aren't affiliated with the department, including private practices or those providing services they can't obtain at the nearest VA clinic.
In brief floor remarks, Blackburn said the VA itself has "neither infrastructure nor personnel" to be able to serve veterans covered under the new program.
But Senate Veterans' Affairs Chairman Jon Tester, D-Mont., argued the VA would have sufficient resources and that Blackburn's amendment was a backdoor attempt to outsource services to the private sector.
"We should not privatize the VA; that's what this amendment is about," Tester said. Blackburn's amendment received a majority vote, 48-47, but it fell short of the 60 votes needed for adoption.
Blue slip problem
While both chambers had passed nearly identical measures in recent months, a second vote was deemed necessary to remove an obscure tax provision added by the Senate that drew objections from the House.
Since the House had never considered the tax provision, it ran afoul of a constitutional requirement that all revenue measures must originate in the House. The formal procedure is known as a blue slip after the sheet of paper House tax writers use to lodge a constitutional complaint and send the measure back to the Senate to fix.
In this case, the House simply called up a new version using an unrelated shell vehicle rather than formally send the measure back to the Senate. The revised bill stripped out the offending tax provision, which would have let doctors, nurses and other health care providers receive tax-free buyouts of their contracts if they agree to work for the VA at rural veterans clinics.
When the revised bill came back from the House last month, many expected it to sail through the Senate since that chamber had passed it 84-14 in June. But Toomey had spent time making his case to GOP colleagues about the budget scorekeeping issue.
And the key cloture vote last week occurred right after top Democrats struck a deal with Sen. Joe Manchin III, D-W.Va., on an expanded budget reconciliation package Republicans oppose. After that pact was announced, some two dozen GOP senators that voted for passage of the earlier bill voted against cloture on the new version stripped of the blue-slipped tax provision.
"They made such a huge mistake with veterans. They just let their immediate emotions overcome them," Schumer told reporters Tuesday. "But I’m glad they recouped. All’s well that ends well."
Aidan Quigley and Lindsey McPherson contributed to this report.