[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4249 Introduced in House (IH)]
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118th CONGRESS
1st Session
H. R. 4249
To amend title 38, United States Code, to furnish hospital care and
medical services to veterans and dependents who were stationed at
military installations at which the veterans and dependents were
exposed to perfluorooctanoic acid or other per- and polyfluoroalkyl
substances, to provide for a presumption of service connection for
certain veterans who were stationed at military installations at which
the veterans were exposed to such substances, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
June 21, 2023
Mr. Kildee (for himself, Mr. Lawler, Mrs. Dingell, Mr. Fitzpatrick, Ms.
Slotkin, Mr. Posey, Ms. Tlaib, Ms. Stevens, Mr. Boyle of Pennsylvania,
Ms. Dean of Pennsylvania, Mr. Khanna, Ms. DelBene, Mr. Kilmer, Mr.
Carson, Ms. Lee of California, Ms. Ross, Mr. Neal, Ms. Titus, Mr.
McGovern, Mr. Grijalva, Mr. Gottheimer, Ms. Kuster, Mr. Schiff, Ms.
Porter, and Ms. Pettersen) introduced the following bill; which was
referred to the Committee on Veterans' Affairs
_______________________________________________________________________
A BILL
To amend title 38, United States Code, to furnish hospital care and
medical services to veterans and dependents who were stationed at
military installations at which the veterans and dependents were
exposed to perfluorooctanoic acid or other per- and polyfluoroalkyl
substances, to provide for a presumption of service connection for
certain veterans who were stationed at military installations at which
the veterans were exposed to such substances, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Veterans Exposed to Toxic PFAS Act''
or the ``VET PFAS Act''.
SEC. 2. HOSPITAL CARE AND MEDICAL SERVICES FOR VETERANS AND DEPENDENTS
EXPOSED TO PERFLUOROOCTANOIC ACID AND OTHER PER- AND
POLYFLUOROALKYL SUBSTANCES.
(a) Hospital Care and Medical Services for Veterans.--
(1) In general.--Paragraph (1) of section 1710(e) of title
38, United States Code, is amended by adding at the end the
following new subparagraph:
``(J)(i) Beginning on the date that is 90 days after the date of
the enactment of this subparagraph, subject to paragraph (2), a veteran
who served on active duty in the Armed Forces at a covered military
installation at which individuals were exposed to substances specified
in clause (ii) is eligible for hospital care and medical services under
subsection (a)(2)(F) for the diseases, illnesses, or conditions as
specified in such clause, notwithstanding that there is insufficient
medical evidence to conclude that such illness or condition is
attributable to such service.
``(ii) The substances and diseases, illnesses, or conditions
specified in this clause are the following:
``(I) With respect to exposure to perfluorooctanoic acid--
``(aa) diagnosed high cholesterol;
``(bb) ulcerative colitis;
``(cc) thyroid disease;
``(dd) testicular cancer;
``(ee) kidney cancer; and
``(ff) pregnancy-induced hypertension.
``(II) With respect to exposure to other per- and
polyfluoroalkyl substances, any disease, illness, or condition
that the Secretary of Veterans Affairs, in consultation with
the Administrator of the Agency for Toxic Substances and
Disease Registry of the Department of Health and Human
Services, determines pursuant to the study conducted under
section 316 of the National Defense Authorization Act for
Fiscal Year 2018 (Public Law 115-91) that a positive
association exists between exposure to per- and polyfluoroalkyl
substances and such disease, illness, or condition.
``(iii) For purposes of this subparagraph, any service by a member
of the reserve components for a period specified by the Secretary at a
covered military installation at which individuals were exposed to
substances specified in clause (ii) shall be treated as active duty
service, notwithstanding section 101(21) of this title.
``(iv) In this subparagraph, the term `covered military
installation' means a military installation at which individuals were
exposed to perfluorooctanoic acid or other per- and polyfluoroalkyl
substances, including exposure through a well that provides water for
human consumption that is contaminated with such substances.''.
(2) Limitation.--Paragraph (2)(B) of such section is
amended by striking ``or (I)'' and inserting ``(I), or (J)''.
(b) Family Members.--
(1) In general.--Subchapter VIII of chapter 17 is amended
by adding at the end the following new section:
``Sec. 1787A. Health care of family members of veterans stationed at
certain military installations
``(a) In General.--Beginning on the date that is 90 days after the
date of the enactment of this section, subject to subsection (b), a
family member of a veteran described in clause (i) of section
1710(e)(1)(J) of this title (or who would be so described but for the
condition by which the individual was discharged or released from the
Armed Forces) who resided at a military installation covered by such
clause or who was in utero while the mother of such family member
resided at such location shall be eligible for hospital care and
medical services furnished by the Secretary for any disease, illness,
or condition for which a veteran may receive hospital care and medical
services under clause (ii) of such section, notwithstanding that there
is insufficient medical evidence to conclude that such disease,
illness, or condition is attributable to such residence.
``(b) Limitations.--(1) The Secretary may only furnish hospital
care and medical services under subsection (a) to the extent and in the
amount provided in advance in appropriations Acts for such purpose.
``(2) Hospital care and medical services may not be furnished under
subsection (a) for a disease, illness, or condition of a family member
that is found, in accordance with guidelines issued by the Under
Secretary for Health, to have resulted from a cause other than the
residence of the family member described in that subsection.
``(3) The Secretary may provide reimbursement for hospital care or
medical services provided to a family member under this section only
after the family member or the provider of such care or services has
exhausted without success all claims and remedies reasonably available
to the family member or provider against a third party (as defined in
section 1725(f) of this title) for payment of such care or services,
including with respect to health-plan contracts (as defined in such
section).''.
(2) Clerical amendment.--The table of sections at the
beginning of such chapter is amended by inserting after the
item relating to section 1787 the following new item:
``1787A. Health care of family members of veterans stationed at certain
military installations.''.
(c) Annual Reports.--
(1) In general.--During the three-year period beginning in
the year in which the study conducted under section 316 of the
National Defense Authorization Act for Fiscal Year 2018 (Public
Law 115-91) is submitted to Congress, the Secretary of Veterans
Affairs shall submit to the Committee on Veterans' Affairs of
the Senate and the Committee on Veterans' Affairs of the House
of Representatives an annual report on the care and services
provided under sections 1710(e)(1)(J) and 1787A of title 38,
United States Code (as added by subsections (a) and (b)(1),
respectively).
(2) Elements.--Each report under paragraph (1) shall set
forth the following:
(A) The number of veterans and family members
provided hospital care and medical services under the
provisions of law specified in paragraph (1) during the
period covered by the report.
(B) The illnesses, conditions, and disabilities for
which care and services have been provided such
veterans and family members under such provisions of
law during that period.
(C) The number of veterans and family members who
applied for care and services under such provisions of
law during that period but were denied, including
information on the reasons for such denials.
(D) The number of veterans and family members who
applied for care and services under such provisions of
law and are awaiting a decision from the Secretary on
eligibility for such care and services as of the date
of such report.
(3) Veteran defined.--In this subsection, the term
``veteran'' includes a former member of the reserve components
of the Armed Forces covered by such section 1710(e)(1)(J).
SEC. 3. PRESUMPTION OF SERVICE CONNECTION FOR CERTAIN VETERANS EXPOSED
TO PERFLUOROOCTANOIC ACID OR OTHER PER- AND
POLYFLUOROALKYL SUBSTANCES.
(a) In General.--Chapter 11 of title 38, United States Code, is
amended by inserting after section 1116B the following new section:
``Sec. 1116C. Presumption of service connection for certain veterans
exposed to perfluorooctanoic acid or other per- and
polyfluoroalkyl substances
``(a) Presumption of Service Connection.--(1) For the purposes of
section 1110 of this title, and subject to section 1113 of this title,
each disease or illness specified in subsection (b) that becomes
manifest in a veteran described in paragraph (2) shall be considered to
have been incurred or aggravated in the line of duty in the active
military, naval, or air service, notwithstanding that there is no
record of evidence of such disease or illness during the period of such
service.
``(2) A veteran described in this paragraph is a veteran who,
during active military, naval, or air service, served at a military
installation at which individuals were exposed to perfluorooctanoic
acid or other per- and polyfluoroalkyl substances, including exposure
through a well that provides water for human consumption that is
contaminated with such substances.
``(b) Diseases or Illnesses.--A disease or illness specified in
this subsection is any of the following:
``(1) With respect to exposure to perfluorooctanoic acid--
``(A) diagnosed high cholesterol;
``(B) ulcerative colitis;
``(C) thyroid disease;
``(D) testicular cancer;
``(E) kidney cancer; and
``(F) pregnancy-induced hypertension.
``(2) With respect to exposure to other per- and
polyfluoroalkyl substances, any other disease, illness, or
condition that the Secretary of Veterans Affairs, in
consultation with the Administrator of the Agency for Toxic
Substances and Disease Registry of the Department of Health and
Human Services, determines pursuant to the study conducted
under section 316 of the National Defense Authorization Act for
Fiscal Year 2018 (Public Law 115-91) that a positive
association exists between exposure to per- and polyfluoroalkyl
substances and such disease or illness.
``(c) Active Military, Naval, or Air Service.--For purposes of this
section, any service by a member of the reserve components for a period
specified by the Secretary at a military installation described in
subsection (a)(2) shall be treated as active military, naval, or air
service, notwithstanding section 101(24) of this title.''.
(b) Clerical Amendment.--The table of sections at the beginning of
such chapter is amended by inserting after the item relating to section
1116B the following new item:
``1116C. Presumption of service connection for certain veterans exposed
to perfluorooctanoic acid or other per- and
polyfluoroalkyl substances.''.
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