[Pages S2976-S2978]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                     HONORING OUR PACT ACT OF 2021

  Mr. SULLIVAN. Mr. President, I am going to talk a little bit about 
the bill that we have been debating here all week on the Senate floor, 
the Sergeant First Class Heath Robinson Honoring our PACT Act of 2022.
  Now, it is a very important bill. It is named after Sergeant First 
Class Robinson, an Ohio National Guard soldier who died in 2022 as a 
result of service-connected toxic exposure.
  This bill that we are going to be voting for final passage on 
tomorrow would deliver immediate access to healthcare for toxic-exposed 
veterans, direct the VA to evaluate diseases for presumption of service 
connection, and streamline the process for toxic-exposed veterans 
seeking disability compensation for their illness that they gained 
while serving overseas defending our Nation.
  I have supported the intent of this bill for years, and I intend to 
vote in favor of this bill tomorrow when it comes up for final passage.
  There is nothing, in my mind, that is more important than taking care 
of our veterans, but I do want to raise some concerns about how we got 
to this point, the process of this bill, which, in my view, undermined 
the likelihood of this massive new program being implemented in a way 
that benefits all American veterans so we can take care of all American 
veterans.
  Let me explain. Since my time here in the Senate, I have focused on 
these issues. I serve on the Veterans' Affairs Committee that was 
responsible, in large measure, for many aspects of this bill. I serve 
on the Armed Services Committee. I still serve in the military myself, 
in the Marine Corps Reserves, and I am honored to represent the State 
in our great Nation, Alaska, that has more veterans per capita than any 
State in the country.
  So veterans and military affairs and their families have been a core 
focus of mine since I arrived in the Senate in 2015. And in particular, 
I have been focused on this issue of toxic exposure of our service men 
and women during wartime. In fact, one of my commitments as a candidate 
for the U.S. Senate in 2014 was to work to ensure passage of the Blue 
Water Navy Vietnam Veterans Act, which I cosponsored when I got here 
and was signed into law in 2019.
  That was an outstanding commitment to our Vietnam veterans exposed to 
Agent Orange during their time, but it was belatedly fulfilled--years, 
even decades, after their service in Vietnam.
  And I took lessons from that. As a matter of fact, I think many 
Senators took lessons from that, that when the next generation of 
veterans served overseas and were exposed to toxins during their 
service, that we needed to act.

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  So that is what I have done in my career here. I have worked, taking 
the Vietnam veteran experience, particularly with Agent Orange, to make 
sure we don't repeat that--the mistakes of Agent Orange where those 
exposed to toxic substances overseas during their service and later 
came down with diseases and suffered, that we needed to take care of 
them.

  We know that toxic exposure during military service can add serious 
complications to a veteran's health, years and even decades after their 
service has concluded.
  And there is science that can correlate certain diseases and symptoms 
to exposure. That is the model that we want. Veterans suffering from 
potential exposure understand too well that getting the VA to even 
recognize and concede exposure can remain a challenging bureaucratic 
and incredibly frustrating process that leads to denials often from the 
bureaucracy.
  So early in my time here, I have been a relentless advocate on these 
issues. I will give you a few examples.
  I introduced with Senator Manchin of West Virginia the Veterans Burn 
Pits Exposure Recognition Act, which was previously passed out of 
committee in the Veterans' Affairs Committee and enjoys broad 
bipartisan support. Close to half of the Senate--Democrats and 
Republicans--was cosponsors of our bill, and almost all of the Senate 
Veterans' Affairs Committee were.
  This bill would recognize and concede exposure to toxic substances 
for those veterans who were deployed in areas where burn pits were in 
use: in Iraq, in Afghanistan, in Uzbekistan--all of these different 
areas and more.
  This bill would do away with the paperwork that made it almost 
impossible to prove exposure by these veterans. It put the onus on the 
VA and that bureaucracy.
  When crafting this bill with Senator Manchin, our offices worked 
extensively with the Senate Veterans' Affairs Committee and many of the 
veterans service organizations, particularly the Disabled American 
Veterans organization; and we worked with the VA on the language to 
make sure we were not getting ahead of the science, making sure that 
what was exposed and what were the diseases connect with science--not 
always easy, but the VA does have expertise in that area.
  I then cosponsored with Senator Blumenthal the K2 Veterans Advocacy 
Act. This bill moved the needle on three things that are known 
systematically now: that toxic substances at the base that we call K2 
in Uzbekistan, the medical conditions that K2 veterans have--and they 
are serious; something really bad was going on at the K2 base in 
Uzbekistan--and the links between the two.
  Now, we worked with the Trump White House before President Trump left 
office in 2020, before our bill passed here on the Senate floor, to get 
them to issue an Executive order for the VA to essentially do those 
things for K2 veterans.
  I introduced and had passed the bipartisan Burn Pits Accountability 
Act with Senator Klobuchar, which directs the Pentagon to include 
empirical health assessments and evaluation of whether a servicemember 
has been exposed to open burn pits or toxic airborne chemicals in their 
deployments. This bill was included in the fiscal year 2020 National 
Defense Authorization Act.
  And I sponsored the Pandemic Care For Burn Pits Exposure Act of 2020 
to ensure that servicemembers and veterans with previous exposure to 
burn pits received the care they needed during the COVID-19 pandemic.
  I am listing these bills and the work and time and the bipartisan 
nature of them because on the Veterans Affairs' Committee there has 
been no issue I have been more focused on.
  We are going to take the lessons from Vietnam, Agent Orange, and not 
say: You are going to wait three or four or five decades while you die 
of cancer.
  And I am committed to this issue, and I have been. But I am also 
committed to passing legislation that is worthy of all veterans that we 
are serving. So I have had some reservations about the current bill and 
the process by which it has come to the Senate floor, because the 
process has thwarted opportunities to make this a better bill, to make 
it serve our veterans in a better, holistic way.
  And, again, this is an issue I have been focused on since my first 
days in the U.S. Senate.
  So what are the issues?
  Well, as I mentioned, some of the things in there--a lot of the 
things in this bill are very necessary. The bill that I just mentioned 
that I cosponsored with Senator Manchin, the Veterans Burn Pits 
Exposure Recognition Act, was incorporated into the PACT Act that we 
will be voting on tomorrow, the Sergeant Robinson Honoring our PACT 
Act.
  In fact, many bipartisan bills from the Veterans' Affairs Committee 
were included in this bill that we are going to be voting on tomorrow.
  But ultimately, what we had going on in the Veterans' Affairs 
Committee was an agreement that when we brought this big bill--and it 
is big--to the Senate floor, we would have the ability to bring 
amendments to try to improve it, to try to make it better for all 
veterans in the entire VA system, a system that we know has challenges 
implementing sweeping mandates from Congress.
  This is a sweeping mandate from Congress that we are voting on. As I 
mentioned, the issue of toxic exposure, which I have been focused on 
since my first year here in the U.S. Senate, has always been a 
bipartisan bill. Four bills I just mentioned that I have led on have 
all had Democratic cosponsors leading with me as well. But what 
happened this week and last week was the bipartisan nature of trying to 
tackle one of the biggest issues facing our veterans was shut down. For 
whatever reason, and I don't know why--somebody should ask the majority 
leader--all the amendments that we were going to bring to the floor to 
make this bill better were shut down. We have not had one amendment on 
this comprehensive bill, and, like I said, a number of us have been 
focused on this issue for years.
  What were we trying to do with these amendments? We are trying to 
make this a better bill. Bring your ideas to the floor, debate them, 
vote on them. Why wouldn't we want to do that? Why wouldn't we want to 
do that? Don't we owe it to all of our veterans to do that?
  My primary concern, as I have mentioned, is making sure that not just 
the constituency impacted by this legislation, which we need--those 
exposed to toxic exposure primarily from burn pits are taken care of--
but that the whole VA system remains robust and strong. And I think 
some of the amendments--I know some of the amendments that we were 
going to bring--as a matter of fact, on the Veterans' Affairs Committee 
there was a commitment to make sure we were bringing these amendments 
to the floor--would have made this bill better.
  What are the biggest concerns? Well, I pressed the Secretary of the 
VA just yesterday in his testimony before the Veterans' Affairs 
Committee on one of the biggest concerns I have and one of the biggest 
concerns many Senators have and one of the biggest concerns our 
Veterans' Affairs Committee has, and it is this: This bill that I will 
be supporting tomorrow is estimated to bring an additional 2.5 million 
claims to the VA--2.5 million.
  My question to the Secretary was simple but really important: Mr. 
Secretary, is the VA system ready to absorb the roughly 2\1/2\ million 
additional claims that are likely to be generated in the next 3 years 
by the PACT Act? Are you ready?
  We have some ideas and amendments that we think can make it ready. 
But again, for whatever reason, the majority leader didn't want to hear 
about those.
  In an already stretched VA, with a huge backlog already and 
challenges as we speak, the Secretary testified about them yesterday, 
about hiring qualified medical personnel across the country but 
especially in my State, in Alaska. The concern that I raised with the 
Secretary yesterday, the concern that we are trying to address with the 
amendment process here on the Senate floor is this: When you bring that 
many into a system that is not ready, you can collapse the whole 
system. You can collapse the whole system.
  And then every veteran loses. A young marine with his legs amputated 
after an IED explosion in Afghanistan who needs help, he is going to be 
delayed. A Vietnam veteran who needs

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care, he is going to be delayed. A Gulf war veteran, she is going to be 
delayed. If you are collapsing the whole system, every veteran loses. 
Every veteran loses.
  Now, I have actually seen this in my State. And I know the Presiding 
Officer's State has had some challenges with the VA. Several years ago, 
I held a field hearing in Arizona on some of the challenges in the VA, 
but I have seen the system collapse in Alaska. In 2015, my first year 
in the U.S. Senate, due to legislation that had been passed the year 
before, we essentially had the system in Alaska collapse. Somehow, some 
way, legislation and ideas from the VA thought it was really smart to 
remove the ability to actually make appointments for veterans in Alaska 
not by officials from the VA who live in Alaska but somewhere in the 
lower 48--I think it was Louisiana or somewhere--not a good idea. The 
whole system cratered. I have seen it. And no veteran benefits. No one 
benefits.
  In my first year here in 2015, it was my No. 1 priority to get the VA 
to fix the broken system in Alaska, and we have made huge progress. But 
I have seen it firsthand. When a system that is supposed to take care 
of veterans craters, of course, every veteran suffers.
  So we don't want that to happen with the implementation of this 
important bill. And the Secretary of the VA assured me, assured Senator 
Tillis in questioning yesterday, that this won't happen, that the 
system won't be overburdened, that they are prepared for this.
  Well, I hope he is right. I have my doubts, but I hope he is right.
  But here is the point: A bipartisan amendment process, particularly 
from Senators--I will give you one example. Senator Moran, ranking 
member on Veterans' Affairs, has been working this issue like me for 
years. Particularly from Senators who actually know the issue, a 
bipartisan amendment process would have helped ensure that this 
possibility would be much less.
  I will give you a couple of examples of what, for whatever reason, 
the majority leader didn't want to bring up on this important 
legislation. We had amendments to make sure that the VA didn't get 
ahead of the science. You need to connect the science and exposure to 
the disease. That is simple. That is what is expected--it is not 
simple. It is a complicated process, but it is just the rigor of a bill 
that you want to make sure that those who are exposed and sick and with 
a disease are the ones who get the care.
  Right now, in this bill, there are 23 respiratory illnesses and 
cancers that will be added to the list of presumptive ailments that 
will allow a veteran to be diagnosed with toxic exposure and qualify 
for benefits and any other disease the Secretary of the VA determines 
is warranted based on a positive association with certain substances, 
chemicals, or airborne hazards. Some of those 23 presumptives, as we 
are calling them, are based on science. Some aren't. I have asked the 
VA; I have asked the Secretary: Hey, where did we get these 23? The 
answer, I am still waiting for.
  That is what the amendment process is for, to make sure this bill has 
rigor to take care of all veterans.
  Let me mention another amendment offered by Senator Moran, an 
amendment that he was promised to get a floor vote on that didn't 
happen and I think would have made the bill stronger. It would have 
preserved the Trump-era gains on community care access standards and, 
importantly, serve as a relief valve for veterans to receive care as 
millions are going to be added into the system. So, again, if you have 
2\1/2\ million additional claims and the VA is overwhelmed and now 
there is a giant backlog for everybody, this amendment would have said: 
Well, the veterans in the system can go out and get community care. 
That is a good idea. It is actually how it works in Alaska because we 
don't have a full-service VA hospital, one of only three States in the 
country. But that is a really smart idea, a safety valve. If the system 
looks like it is going to crater because it is overwhelmed, hey, let 
some doctors in town help the veterans. We couldn't bring that 
amendment up.
  So I pressed the VA Secretary on this because I have seen it when a 
system collapses, and my veterans were really hurt in Alaska when it 
did--the VA system in my State. And I am going to take his word for it 
now that the VA can handle 2\1/2\ million more claims in the next 3 
years. But I am going to be watching like a hawk--watching like a hawk 
in my oversight role. Like I said, there is nothing I care more about 
than our veterans, our military, and their family members. We had the 
opportunity on an important bill that I will be supporting to make it 
better. And we sat in the Senate all week and didn't bring up one 
amendment to even try.
  The Secretary is assuring us. OK. All good. Good to go. Well, some of 
us had ideas to make sure it would have been better to go. We couldn't 
bring them up.
  I hope there aren't problems with this implementation. If the system 
is in danger of collapsing as a result of this bill, I hope that 
whoever is majority leader at that time--2, 3, 4 years from now--
understands that the care for all veterans is what the VA is all about, 
and I hope if we need it, we will have the opportunity to bring good 
ideas to the Senate floor to fix these kind of things because veterans 
are not a partisan issue in the Senate. They are not. I have seen it my 
whole career here. I sit on the committee. I sit on the Armed Services 
Committee. But for whatever reason, our ability, in a bipartisan way, 
to try to improve this bill that we are going to vote on tomorrow was 
not granted to other Senators. And I think that was a missed 
opportunity because I think we would have made this a better bill.
  I yield the floor.
  The PRESIDING OFFICER (Mr. Kelly). The Senator from Oklahoma.

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