Lawmakers and advocates want to help troops and veterans who have been exposed to environmental pollutants during their military service.
But while many support a comprehensive $282 billion package that could expand Department of Veterans Affairs benefits and services to roughly 3.5 million veterans, some are questioning an approach that would be the largest piece of military exposure legislation since the Agent Orange Act of 1991 was approved.
During a roundtable Wednesday on the Honoring Our Promise to Address Comprehensive Toxics, or PACT, Act, Illinois Rep. Mike Bost, the House Veterans Affairs Committee's ranking Republican, said he supports providing health care to ill veterans while deciding how to proceed to expand benefits.
"We need to focus on taking action steps now to expand care to those who need it most before it's too late. Additionally, we still need to identify a way to pay for toxic exposure legislation. We don't have hundreds of billions of dollars laying around. I remain committed to finding a way to support toxic-exposed veterans in a way that is fiscally responsible for future generations," Bost said.
The bill’s sponsor and Committee Chairman Rep. Mark Takano, D-Calif., was adamant that lawmakers need to support the legislation, despite the price tag.
"We know the true cost of our promise, but we cannot renege on our responsibility to toxic-exposed veterans because of any preconceived sticker shock," he said.
The bill includes a provision that would recognize that all troops who served in Iraq, Afghanistan and other specified locations in the last 20 years were exposed to toxic emissions from burn pits and other airborne hazards during deployments.
It would establish a list of 23 diseases as presumed linked to exposure to airborne pollutants, a designation that would allow veterans who develop them to get access to health care and expedited disability benefits.
And it would add hypertension to the list of diseases considered linked to exposure to defoliants used in Vietnam -- a provision that would expand access to health care and expedited disability benefits to more than 150,000 Vietnam War veterans.
Rep. Mike Levin, D-Calif., called the proposal the "cost of doing what is so obviously the right thing."
"Everybody here wants to do the right thing, but only some want to pay for it," Levin said.
Lawmakers heard from representatives of more than a dozen veterans service organizations and advocates, including comedian Jon Stewart, who took up the cause of veterans exposed to toxic pollutants after successfully advocating for the extension of benefits to first responders and their families affected by the terrorist attacks on Sept. 11, 2001.
Stewart called the idea of dividing up the bill "unacceptable."
"The only conversation we should be having is a collaborative effort to bring the VA together and create first-rate toxic exposure health care. And not health care first and benefits later, because if you're sick with pancreatic cancer and not receiving your benefits, what are you living on?" Stewart said.
Whether the bill will receive a vote this year remains to be seen. The Senate and House have both been preoccupied with passing a voting rights bill and salvaging portions of the $1.75 billion social spending package known as Build Back Better.
A spokesman for House Speaker Nancy Pelosi, D-Calif., told Military.com in November that she "looks forward to working with [the] House Veterans' Affairs Committee and the Biden administration to find a path forward for comprehensive toxic exposure legislation in this Congress."
Takano said Wednesday that Pelosi has "committed to bringing this bill to the floor very soon" for a vote by the full chamber.
In August, the VA created a list of illnesses eligible for expedited disability compensation for veterans exposed to burn pits during overseas deployments, beginning with three conditions: asthma, rhinitis and sinusitis.
The department announced in November that it is examining whether more conditions, including some types of cancer and constrictive bronchiolitis, a rare lung disease that decreases the flow of oxygen into the bloodstream, should be added to the list.
Decisions are expected later this year.
Advocates praised the effort but said more needs to be done and done faster.
"We estimate there are as many as 750,000, Iraq and Afghanistan veterans currently ineligible for VA health care enrollment due to the fact that they've been unable to establish a service-connected disability within five years of a discharge. That's 750,000 veterans who served in areas of known exposure who are now operating without a safety net," Wounded Warrior Project Government Affairs Specialist Aleks Morosky said.
"At the end of the day, [veterans are] losing their homes, losing their vehicles or losing their jobs. The injustice behind all of this continues on. It's not OK to treat the veterans the way they're being treated," said Rosie Torres, cofounder of Burn Pits 360.
-- Patricia Kime can be reached at Patricia.Kime@Military.com. Follow her on Twitter @patriciakime.