President Joe Biden and Alan Paley, National Commander of Jewish War Veterans of the U.S. A., salute during the annual National Veterans Day Observance ceremony in the Amphitheater at Arlington National Cemetery last November. Official White House Photo by Erin Scott
WASHINGTON, DC — During the State of the Union address, President Joe Biden shined a light, as he has many times in the past, on the effects of toxic exposure, declaring that he would continue to make it a priority of his administration.
“Our troops in Iraq and Afghanistan faced many dangers. One was being stationed at bases and breathing in toxic smoke from burn pits that incinerated wastes of war—medical and hazardous material, jet fuel and more,” Biden told the convened houses of Congress last month. “When they came home, many of the world’s fittest and best-trained warriors were not the same. Headaches. Numbness. Dizziness. A cancer that would put them in a flag-draped coffin.”
‘One of those soldiers was my son, Maj. Beau Biden,” he continued. “We don’t know for sure if a burning pit was the cause of his brain cancer or the diseases of so many troops, but I’m committed to finding out everything we can.”
He went on to announce that VA was expanding its presumptive conditions list to include new respiratory cancers and urged Congress to pass a law granting veterans benefits and comprehensive healthcare to servicemembers impacted by toxic exposure.
The same day as Biden’s address to Congress, VA Secretary Denis McDonough released a list of nine rare respiratory cancers linked to environmental exposure that he was proposing be added to the department’s list of presumed service-connected disabilities.
Those include: squamous cell carcinoma of the larynx, squamous cell carcinoma of the trachea, adenocarcinoma of the trachea, salivary gland-type tumors of the trachea, adenosquamous carcinoma of the lung, large cell carcinoma of the lung, salivary gland-type tumors of the lung, sarcomatoid carcinoma of the lung and typical and atypical carcinoid of the lung.
“This is the right decision,” McDonough said. “The rarity and severity of these illnesses and the reality that these conditions present a situation where it may not be possible to develop additional evidence prompted us to take this critical action.”
On the legislative side of the equation, the House passed the Honoring Our Promise to Address Comprehensive Toxics (PACT) Act last month. The bill adds 23 conditions to VA’s presumptive list, including several of the nine VA is already proposing. If the bill were to be passed as is, it could add nearly two million more veterans to VA’s benefits rolls. It also would raise already-existing benefits for 200,000 veterans.
“After years of diligent input from toxic-exposed veterans, my colleagues, our staff, VA and VSOs, we have passed the most comprehensive legislation to date to treat toxic exposure as a cost of war,” declared House VA Committee Chair Rep. Mark Takano (D-Calif). “I look forward to working with Sen. Tester to pass truly comprehensive legislation through the Senate and send it to the president’s desk. Toxic-exposed veterans do not have time to wait.”
The cost of the bill limited the number of Republicans supporting it in the House, however, and makes its passage in the Senate doubtful. The Congressional Budget Office has put the estimated cost at $430 billion, of which $281 billion would be mandatory spending that would need to be offset, either through new revenue or cuts elsewhere.
“This is a cost of war. Don’t even talk to us about price,” declared House Speaker Nancy Pelosi (D-CA) upon the bill’s passage. “This is a cost of war that we should recognize when we go.”
To that end, Senate Democrats and Republicans have sought to cut the provisions in the Honoring our PACT Act into what they consider manageable pieces. Most notable is the Health Care for Burn Pit Veterans Act, sponsored by Takano’s counterpart on the Senate Veterans’ Affairs Committee, Sen. Jon Tester (D-MT). The bill would create a one-year enrollment period in VA healthcare for post-9/11 combat veterans and would require VA to screen them for any toxic exposure they might have experienced during deployment.
That bill passed the Senate in February, but many legislators and veterans’ advocates have called it a half-measure and said providing healthcare access without addressing benefits does not do enough to help ill veterans. Tester has assured these critics that it would only be the first step in a multibill initiative to eventually achieve what the PACT Act would do all at once.
