In 2007, Sgt. Robert B. Brown of Regimental Combat Team 6, Combat Camera Unit watches over the civilian firefighters at the burn pit as smoke and flames rise into the night sky behind him in Fallujah, Iraq. Now, Congress is considering a bill related to toxic exposure from burn pits. USMC photograph by Cpl. Samuel D. Corum
WASHINGTON, DC – The Honoring Our PACT Act–the comprehensive toxic exposure legislation that passed with broad bipartisan support in the House–is looking increasingly like it will get a vote in the Senate.
Last month, Senate Majority Leader Chuck Schumer (D-NY) said that he was committed to holding a vote on the bill. And in a Senate VA Committee hearing on the bill, questions directed at VA Secretary Denis McDonough revolved more around what would happen if the legislation were passed rather than enumerating reasons why it shouldn’t.
When the Honoring Our Promise to Address Comprehensive Toxics (PACT) Act passed the House in March, many legislators were skeptical that the bill could get through the Senate as is. The bill would simultaneously open VA healthcare to veterans exposed to toxins during service, add 23 new diseases to VA’s list of conditions presumed to be caused by exposure to burn pits, and reform VA’s process for adding new presumptive conditions to its list. The effort would result in benefits for tens of thousands of veterans and has been estimated to cost $208 billion over the next decade, a price tag that many Republicans have balked at.
Both Democrats and Republicans in the Senate have talked about breaking the bill into smaller chunks, and even passed legislation in February creating a one-year VA open enrollment for all post 9/11 veterans. The bill has been received in the House, but no action has been taken on it.
Meanwhile, since its passage in the House, clamoring from veterans’ advocates for the Senate to pass the Honoring Our PACT Act has only grown louder.
“As Majority Leader, I am here to say that we will vote on the Honoring Our PACT Act this Congress and put everyone on the record for getting our veterans treatment for cancers, respiratory diseases, and the countless other illnesses caused by exposure to burn pits and other toxins,” Schumer said during a visit to a Veterans Outreach Center in Rochester last month. “Our nation told these veterans that if they put their lives and health on the line to protect our freedoms, we would take care of them. It’s long past time to keep that promise.”
VA leaders have also gone on the record supporting the bill. At the hearing last month, McDonough said, “We support the bill for many reasons, but the first is that it helps the VA accomplish a priority goal. Getting more veterans into VA care. Because study after study shows that vets in VA care do better. Addressing toxic exposure is also a top priority of this administration.”
McDonough’s one major fault with the legislation as currently written is the section reforming VA’s presumptive condition process, which he said the department has made significant strides in reforming on its own.
“We need to ensure the presumptive process created by this bill allows VA and future secretaries to act with transparency, efficiency, and public participation for the benefit of veterans, not create additional administrative burdens that slow down decision-making,” he declared.
The bill would require the creation of an advisory committee on toxic exposure that would provide advice to the Secretary on decisions about presumptive conditions.
“The House is trying to force our hand to get us to do things. [They’re] trying to build institutional capacity around us to force us to be more transparent in what we do, then have us report to a new commission and get the commission to agree to what we’re doing, and then proceed. I get what they’re trying to do, which is to get us to move quicker. But I think the tools they use to force us to do that would actually slow us down,” McDonough said.
As for the inevitable surge of new veterans entering the VA healthcare and benefits systems, McDonough said that the best way that Congress could ensure the department is prepared is to pass President Biden’s budget and to cut through the red tape around the VA leasing process.
“Facility space is critical for caring for veterans. The PACT Act thankfully will bring millions more into our care. Yet of 31 large medical facility leases in the proposed budget, 21 have been pending for years,” he told the committee. “We’re the only agency in the federal government that requires full Congressional authorization for each lease.”
On the benefits side, McDonough said that VA has already added on nearly 1,500 new claims processors and VA will need to add more if the legislation is enacted.
“We have an estimate that says under the PACT Act over the next three fiscal years we’ll have about 1.5 to 2 million [additional] claims filed,” McDonough said. “We process in any given year about 1.5 million claims.”
If hypertension were to be added to the presumptive list of conditions caused by toxic exposure, the estimated additional claims could reach 2.5 million, he added.
McDonough also advocated for the streamlining of the benefits process.
“We should try to shorten steps where we can,” he said. “The requirement for additional exams I think is superfluous in many cases. We should also automate the process where we can.”
As the Senate works towards bringing the bill to a vote, veterans service organizations are holding rallies across the country calling on legislators to pass the bill. Jon Stewart, comedian and vocal supporter of the bill, has appeared at several, bringing with him the same righteous indignation he employed in his support of healthcare reform for 9/11 first responders.
“[Vietnam veterans] went through this same struggle with Agent Orange and here we are forcing it now on our Gulf War veterans, our Iraq and Afghanistan veterans. It’s a moral outrage,” Stewart declared at a rally in Kansas City, MO, last month. [The Senate says] they just want to take their time. Fifteen years, twenty years–we just want to get it right. Delay, deny, hope you die. That’s what this is.”