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116th Congress    }                                   {         Report
                        HOUSE OF REPRESENTATIVES
 1st Session      }                                   {        116-152

======================================================================



 
NEVER FORGET THE HEROES: PERMANENT AUTHORIZATION OF THE SEPTEMBER 11TH 
                      VICTIM COMPENSATION FUND ACT

                                _______
                                

 July 12, 2019.--Committed to the Committee of the Whole House on the 
              State of the Union and ordered to be printed

                                _______
                                

    Mr. Nadler, from the Committee on the Judiciary, submitted the 
                               following

                              R E P O R T

                        [To accompany H.R. 1327]

      [Including cost estimate of the Congressional Budget Office]

    The Committee on the Judiciary, to whom was referred the 
bill (H.R. 1327) to extend authorization for the September 11th 
Victim Compensation Fund of 2001 through fiscal year 2090, and 
for other purposes, having considered the same, report 
favorably thereon without amendment and recommend that the bill 
do pass.

                                CONTENTS

                                                                   Page
Purpose and Summary..............................................     1
Background and Need for the Legislation..........................     2
Hearings.........................................................    15
Committee Consideration..........................................    16
Committee Votes..................................................    16
Committee Oversight Findings.....................................    16
New Budget Authority and Tax Expenditures........................    16
Congressional Budget Office Cost Estimate........................    16
Duplication of Federal Programs..................................    28
Performance Goals and Objectives.................................    28
Advisory on Earmarks.............................................    28
Section-by-Section Analysis......................................    29
Changes in Existing Law Made by the Bill, as Reported............    31

                          Purpose and Summary

    H.R. 1327, the ``Never Forget the Heroes: Permanent 
Authorization of the September 11th Victim Compensation Fund 
Act,'' would extend the authorization for the September 11th 
Victim Compensation Fund (``VCF'') until 2090. The VCF provides 
compensation for those individuals who were physically injured 
as a result of the September 11, 2001 terrorist attacks on the 
United States, as well as for those physically injured as a 
result of their involvement in debris removal efforts 
thereafter and for the families of those killed in the attacks. 
H.R. 1327 also directs that funds not otherwise appropriated be 
placed into the VCF in ``such sums as may be necessary'' to 
fund its payment of claims and its administrative expenses. 
With respect to any awards to claimants that were reduced 
because of the current funding deficiency faced by the VCF, the 
bill directs the VCF Special Master to pay the claimant the 
difference between the amount to which the claimant is entitled 
to and the amount that the claimant was actually paid when 
there is sufficient funding to do so. It also provides the VCF 
Special Master with the discretion to grant awards for 
noneconomic losses in amounts beyond the statutory caps 
contained in current law when special circumstances warrant. 
Finally, the bill would ensure that, with respect to the 
calculation of economic losses, the limit of $200,000 annual 
gross income is adjusted based on the Consumer Price Index for 
All Urban Consumers at least once every five years.
    House Judiciary Committee Chairman Jerrold Nadler (D-NY), 
together with Representatives Carolyn Maloney (D-NY), and Peter 
King (R-NY), introduced H.R. 1327 on February 25, 2019. As of 
this writing, this bipartisan measure has 332 cosponsors, 
including all Democratic Members of the Committee as well as 
Ranking Member Doug Collins (R-GA) and Committee Members Ben 
Cline (R-VA), Mike Johnson (R-LA), Debbie Lesko (R-AZ), and Guy 
Reschenthaler (R-PA). H.R. 1327 is also supported by 21 law 
enforcement organizations,\1\ more than 200 mayors and local 
government officials,\2\ the New York Police Department 
Sergeants Benevolent Association,\3\ and the International 
Union of Operating Engineers.\4\
---------------------------------------------------------------------------
    \1\Letter from 21 Law Enforcement Organizations to Rep. Steve Cohen 
(D-TN), Chairman, Subcomm. on the Constitution, Civil Rights, & Civil 
Liberties of the H. Comm. on the Judiciary, et al. (June 10, 2019).
    \2\Letter from Local Government Officials to Rep. Nancy Pelosi (D-
CA), Speaker of the House, et al. (June 10, 2019).
    \3\Letter from the New York Police Department Sergeants Benevolent 
Association to Rep. Carolyn Maloney (D-NY) et al., Feb. 28, 2019.
    \4\Letter from the Int'l Union of Op. Engineers to Rep. Carolyn 
Maloney (D-NY) (Mar. 5, 2019).
---------------------------------------------------------------------------

                Background and Need for the Legislation


                               BACKGROUND

I. September 11, 2001 attacks and environmental toxins

    On September 11, 2001, terrorists hijacked four commercial 
airliners and flew two of them into the World Trade Center 
(``WTC'') towers in New York City and one into the Pentagon in 
Arlington, Virginia while crashing a fourth aircraft in 
Shanksville, Pennsylvania (``9/11 attacks''). Almost 3,000 
people were killed in the collapse of the WTC alone, including 
hundreds of firefighters, police officers, and other first 
responders. Additionally, 125 people were killed at the 
Pentagon and 246 people (excluding the hijackers) aboard the 
four hijacked aircraft. According to Newsweek, more American 
lives were lost on that day as a result of the 9/11 attacks 
than on any other day in U.S. history with the exception of the 
Civil War battle of Antietam.\5\
---------------------------------------------------------------------------
    \5\Leah McGrath Goodman, 9/11's Second Wave: Cancer and Other 
Diseases Linked to the 2001 Attacks Are Surging, Newsweek, Sept. 7, 
2016, available at https://www.newsweek.com/2016/09/16/9-11-death-toll-
rising-496214.html.
---------------------------------------------------------------------------
    Beyond the devastating loss of life, the collapse of the 
WTC towers and the adjacent buildings released numerous 
hazardous substances into the environment. These hazardous 
substances included hundreds of tons of asbestos, nearly half a 
million pounds of lead, and untold amounts of glass fibers, 
steel, and concrete. The substances formed into a massive cloud 
of toxic dust and smoke which blanketed parts of New York City 
and New Jersey and was blown or dispersed into many of the 
surrounding office buildings, schools, and residences. In 
addition to the debris, fires burned for many months, partly 
due to the 150,000 gallons of oil stored in the buildings, 
which emitted particulate matter, various heavy metals, and 
other potentially deadly substances. All told, the building 
collapses dumped about one million tons of dust on the area 
around Lower Manhattan, creating a 16-acre disaster zone. It is 
estimated that approximately 400,000 people, including ``rescue 
and recovery workers, residents, students and school staff, 
building occupants, and passersby,'' were exposed to ``the 
immense cloud of dust and debris, the indoor dust, the fumes 
from persistent fires, and the mental trauma'' of the WTC's 
collapse.\6\
---------------------------------------------------------------------------
    \6\Joe Murphy et al., Measuring and Maximizing Coverage in the 
World Trade Center Health Registry, Statistics in Medicine (Nov. 16, 
2006), available at http://www.nyc.gov/html/doh/wtc/downloads/pdf/wtc/
wtc-article-20070207.pdf.
---------------------------------------------------------------------------
    The Natural Resources Defense Council, in its report on the 
environmental impact of the WTC collapse, stated that the 
simultaneous release of thousands of toxic components 
constituted a ``pollution event'' and called it ``an 
unprecedented environmental assault for Lower Manhattan.''\7\ 
According to the Federal Emergency Management Agency, ``as many 
as seven contaminants of potential concern may have spread into 
buildings as a result of the collapse of the WTC 
buildings.''\8\ Evidence accumulated since the collapse of the 
WTC indicated that the air was hazardous, notwithstanding 
safety assurances from the Environmental Protection Agency 
(``EPA''), and that exposure to these hazards have caused 
serious physical injury and death.
---------------------------------------------------------------------------
    \7\Megan Nordgren, Eric Goldstein, & Mark Izeman, The Environmental 
Impacts of the World Trade Center Attacks, Natural Resources Defense 
Council, at 3 (2002).
    \8\Office of the Inspector General, Federal Emergency Management 
Agency, FEMA's Delivery of Individual Assistance Program, New York, 
September 2001 (hereinafter ``FEMA Report''), at 25 (Dec. 18, 2002).
---------------------------------------------------------------------------

II. Federal Government's failure to acknowledge human exposure and 
        health consequences

    The day after the collapse of the WTC towers, a top federal 
scientist issued a warning against the quick reoccupation of 
Lower Manhattan because of possible threats to health from 
asbestos and other toxins. In response to a White House request 
for a health advisory, Dr. Ed Kilbourne, an associate 
administrator at the U.S. Agency for Toxic Substances and 
Disease Registry, wrote: ``We are concerned about even being 
asked to write a document for the public about reentry at this 
point. Does this mean that unrestricted access to the WTC 
vicinity is imminent?''\9\
---------------------------------------------------------------------------
    \9\Dr. Kilbourne warned that the bulk dust samples analyzed by the 
EPA contained four times the established standard of asbestos, which he 
labeled a ``substantial concentration.'' He also strongly cautioned 
that it was ``important to characterize how far significant levels of 
asbestos extend before allowing unrestricted access by unprotected 
individuals.'' New York Daily News (October 28, 2003).
---------------------------------------------------------------------------
    Even before the WTC's collapse, the EPA knew that the 
towers contained 400 to 1,000 tons of asbestos. The EPA became 
aware of this danger following the 1993 terrorist attack on the 
WTC.\10\ Yet after the 9/11 attacks, the EPA repeatedly assured 
New Yorkers that the air was ``safe to breathe.''\11\ On 
September 18, 2001, for example, EPA Administrator Christine 
Todd Whitman announced to the public that results of EPA tests 
indicated ``little risk to rescue workers or the public.''\12\
---------------------------------------------------------------------------
    \10\Office of Inspector General, Federal Emergency Management 
Agency, FEMA's Development of Individual Assistance Programs: New 
York--September 11, 2001; Gonzales, Juan, Fallout: The Environmental 
Consequences of the World Trade Center Collapse 91 (2003).
    \11\Jeremy P. Jacobs, EPA Regulators Say They've Learned From 9/11 
Blunders, But Critics Remain Unconvinced, N.Y. Times, Sept. 9, 2011, 
available at https://archive.nytimes.com/www.nytimes.com/gwire/2011/09/
09/09greenwire-epa-regulators-say-theyve-learned-from-911-blu-
24494.html?pagewanted=all.
    \12\Ex-EPA Chief Grilled Over Her 9/11 Role, Albion Monitor, Jun. 
26, 2007, available at http://www.albionmonitor.com/0706a/
whitmantestimony.html
---------------------------------------------------------------------------
    Ms. Whitman has since admitted that her reassurances made 
in September 2001 about air quality in and around the WTC site 
were wrong and she has apologized for making them.\13\ Lila 
Nordstrom, a student at Stuyvesant High School, which is 
located in the area contaminated by the 9/11 attacks in New 
York City, testified at a hearing before the Subcommittee on 
the Constitution, Civil Rights, and Civil Liberties 
(``Subcommittee'') on the need to reauthorize the September 
11th Victim Compensation Fund. In explaining her subsequent 
illnesses incurred from being exposed to such contamination, 
she explained:
---------------------------------------------------------------------------
    \13\Former EPA Head Admits She Was Wrong to Tell New Yorkers Post-
9/11 Air Was Safe, The Guardian, Sept. 10, 2016, available at https://
www.theguardian.com/us-news/2016/sep/10/epa-head-wrong-911-air-safe-
new-york-christine-todd-whitman.

        I am sitting before you as someone who was present on 
        9/11 but I was not caught in the dust cloud. There is 
        no reason that my respiratory health or my 
        gastrointestinal health . . . should have been impacted 
        by the events of 
        9/11. I only have these conditions because I was sent 
        back [into the school building and surrounding area.] 
        And I was only sent back because the Federal Government 
        assured New Yorkers that the air downtown was safe to 
        breathe.\14\
---------------------------------------------------------------------------
    \14\The Need to Reauthorize the September 11th Victim Compensation 
Fund: Hearing Before the Subcomm. on the Constitution, Civil Rights, 
and Civil Liberties of the H. Comm. on the Judiciary, 116th Cong., 
Unofficial Tr. 83-84 (2019) [hereinafter ``VCF Hearing''].

    Indeed, Ms. Whitman's statements from September 2001 have 
since been widely discredited and were suspect even at the 
time. Less than a month after the fall of the WTC towers, the 
Ground Zero Elected Officials Task Force released sample 
results from dust collected in two downtown apartments having 
asbestos levels nearly 460 times the EPA's allowable limit.\15\ 
Historically, the EPA has stated that any level of asbestos is 
a public heath danger and that asbestos-containing material 
must be handled and disposed of following specific procedures 
under the law.\16\ Moreover, toxic hazards present in the WTC 
area, including asbestos and toxins about which the EPA had not 
even inquired (including acid gases, volatile organic compounds 
and heavy metals) were confirmed by other public and private 
agencies.\17\
---------------------------------------------------------------------------
    \15\Eric J. Chatfield (Ph.D) and John R. Kominshy (M.Sc., CIH, CSP, 
CHMM), Summary Report: Characterization of Particulate Found in 
Apartments After Destruction of the World Trade Center (October 12, 
2001).
    \16\Office of Inspector General, Environmental Protection Agency, 
EPA's Response to the World Trade Center Collapse: Challenges, 
Successes, and Areas for Improvement, Rpt. No. 2003-P-00012, at 65 
(Aug. 21, 2003).
    \17\Sierra Club, Pollution and Deception at Ground Zero, Sierra 
Club Report, Appendix E (August 2004).
---------------------------------------------------------------------------
    On September 17, 2001, the United States Geological Survey 
presented to the WTC emergency response teams its chemical 
leach tests of WTC dust, which was found to be highly 
caustic.\18\ A week later, New York Daily News columnist Juan 
Gonzalez reported that dust samples taken from within two 
blocks of Ground Zero by the New York Environmental Law & 
Justice Project showed asbestos levels were nearly five times 
higher than the 1% definitional threshold of ``asbestos 
containing material,'' as well as significant amounts of 
fiberglass.\19\ Newsweek also reported that more asbestos was 
released into lower Manhattan than EPA tests had originally 
indicated, ``and in potentially more dangerous forms.''\20\ On 
February 21, 2002, Dr. Thomas Cahill of the University of 
California at Davis testified in New York City about his air 
sampling results, which showed that there were very high levels 
of ultra-fine toxic particulates in the air from Ground 
Zero.\21\
---------------------------------------------------------------------------
    \18\Andrew Schneider, ``Public Was Never Told That Dust from Ruins 
is Dangerously Caustic,'' St. Louis Post Dispatch (February 10, 2002).
    \19\Juan Gonzalez, ``Doc's WTC Note: Don't Hurry Back,'' N.Y. Daily 
News (Oct. 28, 2003).
    \20\Id.
    \21\EPA National Ombudsman First Investigative Hearing on World 
Trade Center Hazardous Waste Contamination, hosted by U.S. 
Representative Jerrold Nadler (Feb. 21, 2002), available at: http://
www.nyenvirolaw.org/PDF/Transcript-EPA-OmbudsmanHearing-2-23-2002.pdf.
---------------------------------------------------------------------------

III. Escalating health impact

    As a result of incomplete medical monitoring both before 
and after the 9/11 attacks, experts may never know the full 
extent of the damage caused by the attacks, nor predict with 
certainty all of the future adverse health effects from 
exposure to toxins from the WTC and other 9/11-related sites. 
There is, however, growing certainty that such exposure has 
caused adverse health effects in thousands of responders, 
workers, and others at or near Ground Zero in the immediate 
aftermath of 9/11.
    Ongoing medical monitoring and related studies of groups of 
people exposed to WTC toxins have yielded very troubling health 
statistics on illnesses related to such exposure. Within a few 
years of 9/11, these studies connected exposure to myriad 
severe symptoms, including respiratory diseases presenting as 
asthma or asthma-like conditions, pulmonary fibrosis, and 
significant loss of lung function (now commonly referred to 
jointly as ``World Trade Center cough''\22\); upper respiratory 
conditions, including chronic sinusitis; and gastrointestinal 
problems. These medical problems have been documented in peer-
reviewed scientific publications of research studies done by 
several independent research groups.
---------------------------------------------------------------------------
    \22\Levin, S.M., Physical Health Status of World Trade Center 
Rescue and Recovery Workers and Volunteers--New York City, July 2002--
August 2004,'' Centers for Disease Control and Prevention (Sept. 10, 
2004).
---------------------------------------------------------------------------
    Based on the evidence, it is clear that these disorders are 
occurring at a much higher rate than would be expected in such 
populations and that the disorders are due to the toxic 
exposures related to 9/11. Dr. Jacqueline Moline, Director of 
the Northwell Queens World Trade Center Health Program, 
testified at the Subcommittee's June 11, 2019 hearing that 
``over 50 percent of firefighters who worked the World Trade 
Center site had developed a persistent respiratory condition. 
Rates of asthma remain elevated along with a variety of other 
diseases.''\23\ As early as 2006, a Mount Sinai Medical Center 
study of responders and recovery workers reported that lower 
respiratory disease was found in 46% of those evaluated; upper 
respiratory health problems in 64%; and mental health problems 
in 32%.\24\ The study found that nearly 70% of the 19,000 first 
responders tracked in the study suffered from new or worsened 
respiratory symptoms.\25\ Similar results have been found in 
other studies of groups exposed to WTC toxins.\26\
---------------------------------------------------------------------------
    \23\VCF Hearing, Unofficial Tr. at 46.
    \24\Mt. Sinai WTC Medical Monitoring Program, The World Trade 
Center Disaster and the Health of Workers: Five-Year Assessment of a 
Unique Medical Screening Program (Sept. 6, 2006).
    \25\Id.
    \26\Ninety-nine percent of exposed firefighters, who were screened 
and monitored through the FDNY-WTC Medical Screening and Treatment 
Program, reported at least one new onset respiratory symptom while 
working at the WTC site. Progress Since 9/11: Protecting Public Health 
and Safety Against Terrorist Attacks, Hearing Before the Subcommittee 
on National Security, Emerging Threats and International Relations of 
the House Committee on Government Reform, (testimony of J. Kelly Kerry, 
MD, Chief Medical Officer, Bureau of Health Services, FDNY and Co-
Director, FDNY-WTC Medical Program New York City) (Feb. 28, 2006).
---------------------------------------------------------------------------
    While many of the above conditions can improve with medical 
treatment, the ultimate medical outcome for people currently 
being treated or who will become ill in the future is 
uncertain. In many cases, individuals suffer from progressive 
loss of pulmonary capacity. Many of these patients have become 
incapacitated because of that pulmonary disease. Lung function 
rapidly deteriorates, and the individuals become increasingly 
incapable of performing job duties or even everyday activities 
that healthy people take for granted. With the increasing loss 
of lung function, such individuals become incapacitated and 
unable to work. As Dr. Moline testified, ``Studies have shown 
the impact of 9/11 exposures, not only on health, but also on 
employment, as individuals with WTC related health conditions 
were more likely to retire before age 60.''\27\
---------------------------------------------------------------------------
    \27\VCF Hearing (written statement of Dr. Jacqueline Moline, M.D., 
M.Sc., Director, Northwell Health Queens World Trade Center Program, at 
4) [hereinafter ``Moline Statement''].
---------------------------------------------------------------------------
    A decade after the 9/11 attacks, responders and survivors 
began suffering from a second, more severe wave of adverse 
health effects among populations exposed to 9/11 toxins. For 
instance, there were reported increases in cases of serious 
lung diseases, including sarcoidosis and interstitial lung 
disease, among exposed populations a decade after 9/11.\28\ 
Michael O'Connell, a 9/11 first responder who engaged in 
recovery work at the WTC site and is now a retired Lieutenant 
with the Fire Department of New York, testified that more than 
six years after 9/11 he ``was one of the youngest and first 
firefighters diagnosed with sarcoidosis,'' which was ``a rare 
autoimmune disease,'' and, as a result, he was unable to 
continue working as a full-duty firefighter.\29\ Sarcoidosis is 
a multisystem disorder characterized by small inflammatory 
nodules that can affect any organ but are often found in the 
lungs and can severely limit air flow into the lungs. 
Interstitial lung disease is a condition in which the lung 
gradually loses its elasticity, preventing the patient from 
getting adequate oxygen into the bloodstream and normally 
requiring lung transplantation.
---------------------------------------------------------------------------
    \28\See, e.g., Cancer may be ``third wave'' of WTC illnesses, 
Associated Press (May 31, 2007), available at http://www.msnbc.msn.com/
id/18969197/; Gabriel Izbicki, M.D., et al., World Trade Center 
``Sarcoid-Like'' Granulomatous Pulmonary Disease in New York City Fire 
Department Rescue Workers, Chest Journal (Jan. 26, 2007) (noting that 
the incidence of sarcoidosis was significantly (nearly 8 times) 
increased when compared to the years before 9/11), abstract available 
at: http://www.chestjournal.org/content/131/5/1414.abstract.
    \29\VCF Hearing, Unofficial Tr. at 69.
---------------------------------------------------------------------------
    Since 2011, medical experts have also seen cancer rates 
dramatically increase among those exposed to 9/11 contaminants, 
and these cancers constitute a third wave of adverse health 
effects among populations exposed to 9/11 toxins.\30\ As Dr. 
Moline testified before the Subcommittee:
---------------------------------------------------------------------------
    \30\Jonathan M. Samet, M.D., et al., The Legacy of World Trade 
Center Dust, The New England Journal of Medicine (May 31, 2007), 
available at http://content.nejm.org/cgi/content/full/356/22/2233.

          Here we are nearly 20 years later . . . As someone 
        who specializes in occupational diseases, I am used to 
        diseases with long latency--40, 50, 60 or more years 
        after someone has had exposure . . . Since 2012, . . . 
        there have been 11,824 people with cancers certified by 
        the [WTC Health Program]. This includes 2,614 prostate 
        cancers, 552 lung cancers, 741 breast cancers, as well 
        as over 35 male breast cancers, 667 thyroid cancers, 
        and dozens more . . . To date, there have been 571 
        cases of lymphoma certified.\31\
---------------------------------------------------------------------------
    \31\Moline Statement at 3.

    Part of the difficulty in predicting an exact number of 
people who could develop 9/11-related cancer in the future 
stems from the fact that cancers can have a very long latency 
period. Different forms of cancer have different latency 
periods\32\, with some forms of cancer such as mesothelioma not 
manifesting symptoms in their victims until 20 to 50 years 
after exposure to carcinogens.\33\ Experts note, however, that 
although it is thus far difficult to establish conclusively a 
causal connection between exposure to 9/11-related toxins and 
increased cancer rates, the results they are seeing among 
individuals exposed to the mix of carcinogens at the WTC site 
is ``odd, unusual and troubling.''\34\
---------------------------------------------------------------------------
    \32\See John Howard, Minimum Latency & Types or Categories of 
Cancer, World Trade Center Health Program, Nov. 7, 2014 (outlining the 
different minimum latency periods for five types or categories of 
cancer covered by the WTC Health Program, ranging from a minimum 
latency period of 2.5 years for thyroid cancer to an 11-year-minimum 
latency period for mesothelioma).
    \33\Aria Bendix, 14 Years Later, Here's What We Know About 9/11 And 
Cancer, Citylab.com, Sept. 10, 2015, available at https://
www.citylab.com/equity/2015/09/14-years-later-heres-what-we-know-about-
911-and-cancer/403888/.
    \34\Jonathan M. Samet, M.D., et al., The Legacy of World Trade 
Center Dust, The New England Journal of Medicine (May 31, 2007), 
available at http://content.nejm.org/cgi/content/full/356/22/2233.
---------------------------------------------------------------------------
    Recent studies have further bolstered the increasingly 
strong link between exposure to 9/11-related toxins and cancer, 
as evident in the sharp increase in cancer rates among 9/11 
responders and survivors. For example, a January 2019 Rutgers 
University study identified a significant increase in head and 
neck cancers among 
9/11 responders, finding a 40 percent increase in diagnoses of 
such cancers among this population between 2009 and 2012.\35\ 
The study's lead author stated that ``[s]ince cancers are 
diseases of long latency, the findings of significant excess 
cancer in this period point to a newly emerging trend that 
requires ongoing monitoring and treatment of WTC-exposed 
persons.''\36\ Last year, The New York Post reported that, 
according to the WTC Health Program,\37\ almost 10,000 ``first 
responders, downtown workers, residents, students and others 
[had] cancer deemed 9/11-related'' and that the ``number of 
cancer patients has rapidly risen since the federal program 
started tracking the disease in 2013,''\38\ The Post also 
reported that ``epidemiology studies have confirmed that 9/11 
rescue and recovery workers have significantly higher rates of 
thyroid cancer and skin melanoma, which is potentially fatal, 
than found in the general population, and face a higher risk of 
bladder cancer.''\39\
---------------------------------------------------------------------------
    \35\World Trade Center responders at increased risk for head and 
neck cancers: 9/11 first responders' health still threatened from 
exposure at deadly attack, study finds, Science Daily (Jan. 17, 2019), 
available at https://www.sciencedaily.com/releases/2019/01/
190117090432.htm.
    \36\Id.
    \37\The WTC Health Program provides medical monitoring and 
treatment for responders at the WTC and related sites in New York City, 
Pentagon, and Shanksville, PA, and survivors who were in the New York 
City disaster area. It was created by the same legislation that re-
opened the VCF in 2011. James Zadroga 9/11 Health and Compensation Act 
of 2010, Pub. L. No. 111-347 (2010).
    \38\Susan Edelman, Nearly 10K People Have Gotten Cancer From Toxic 
9/11 Dust, N.Y. Post, Aug. 11, 2018, available at https://nypost.com/
2018/08/11/nearly-10k-people-have-gotten-cancer-from-toxic-9-11-dust/.
    \39\Id.
---------------------------------------------------------------------------
    As Ms. Nordstrom, who has been diagnosed with 9/11-related 
asthma, gastroesophageal reflux disease, chronic 
rhinosinusitis, and post-traumatic stress disorder, testified 
at the Subcommittee's June 11, 2019 hearing:

          I haven't even had my 20th high school reunion yet, 
        but I already have five former classmates with 
        lymphomas that I just know personally. My friend 
        Michele is in remission from thyroid cancer. Other 
        classmates of mine have been diagnosed with rare bone 
        cancers, testicular cancers, melanomas . . . Classmates 
        are also starting to die now. Just a couple of months 
        ago, Cathy Choy, who graduated just a year after me 
        [from Stuyvesant High School], passed away at aged 33 
        of a 9/11-linked gastric cancer . . . And that is just 
        my school.\40\
---------------------------------------------------------------------------
    \40\VCF Hearing, Unofficial Tr. at 53.

    The Subcommittee also received testimony from a number of 
other witnesses who were 9/11 responders or survivors who have 
since developed 9/11-related cancers or had a loved one who 
died from a 9/11-related cancer. Thomas Mohnal is a retired 
Supervisory Agent of the Federal Bureau of Investigation who 
was a responder at the Pentagon crash site on 9/11 and 
subsequently participated in the investigation of the 9/11 
attacks.\41\ As part of his duties, he sifted through 
contaminated debris and human remains and inhaled contaminated 
air while collecting evidence.\42\ He testified that in August 
2016, 15 years after 9/11, he was diagnosed with three tumors 
that were consistent with lymphoma and that he has had 18 
cycles of chemotherapy treatment, two bone marrow biopsies, and 
nine PET/CT scans.\43\ In 2017, he was certified by the WTC 
Health Program for his illness, meaning that he is suffering 
from a 9/11-related lymphoma.\44\
---------------------------------------------------------------------------
    \41\VCF Hearing (written statement of Thomas J. Mohnal, retired 
Supervisory Special Agent, Federal Bureau of Investigation, at 1) 
[hereinafter ``Mohnal Statement''].
    \42\Id. at 2.
    \43\Id. at 3.
    \44\Id.
---------------------------------------------------------------------------
    Anesta St. Rose Henry testified as to her experiences as 
the widow of construction worker Candidus Henry, who died of 9/
11-related glioblastoma, a brain cancer, just two weeks prior 
to her appearance at the Subcommittee's June 11, 2019 
hearing.\45\ Mr. Henry had been assigned to wash the dust and 
debris off of trucks that were transporting contaminated 
materials from the WTC site to barges for removal.\46\ He had 
been diagnosed with glioblastoma in 2017, 15 years after he 
stopped working at the WTC site.\47\
---------------------------------------------------------------------------
    \45\VCF Hearing (written statement of Anesta St. Rose Henry at 
unnumbered 1) [hereinafter ``Henry Statement''].
    \46\Id.
    \47\Id. at unnumbered 2.
---------------------------------------------------------------------------
    Luis Alvarez, a retired New York Police Department bomb 
squad detective and 9/11 responder at the WTC site, was 
scheduled to receive his 69th round of chemotherapy the day 
after the hearing.\48\ He had developed 9/11-related liver 
cancer that had metastasized throughout the rest of his body. 
Sadly, Detective Alvarez passed away at age 53 just two and 
half weeks after testifying before the Subcommittee.\49\
---------------------------------------------------------------------------
    \48\VCF Hearing (written statement of Luis Alvarez, retired 
Detective, New York Police Department, at unnumbered 1) [hereinafter 
``Alvarez Statement''].
    \49\Sam Roberts, Luis Alvarez, Champion of 9/11 Responders, Dies at 
53, N.Y. Times, June 29, 2019, available at https://www.nytimes.com/
2019/06/29/obituaries/luis-alvarez-dead.html.
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IV. September 11th Victim Compensation Fund

    The September 11th Victim Compensation Fund (``VCF''), 
which is administered by the Department of Justice, provides 
compensation for individuals who were physically injured as a 
result of the 9/11 attacks or debris removal efforts, or for 
the families of those killed in the attacks. The first 
iteration of the VCF operated from 2001 to 2004. Congress then 
reopened the VCF in response to the fact that thousands of 
individuals were manifesting symptoms from illnesses stemming 
from injuries caused by the 9/11 attacks or the debris removal 
efforts in the aftermath of those attacks long after the 
deadline for filing claims under the original VCF. Congress 
extended the authorization for the VCF in December 2015 for an 
additional five years and authorization for the VCF is 
currently set to expire in December 2020.
    As of June 30, 2019, the VCF had received 50,730 
eligibility claims and found 24,037 claimants eligible for 
compensation, making an initial award determination for 22,939 
of those claims.\50\ It has also issued revised awards for 
5,970 claims due to an amendment or appeal of a claim.\51\ Of 
the eligibility claims submitted, 16,319 had yet to be 
processed.\52\ The VCF has awarded a total of $5,222,632,837.43 
from its reopening in 2011 through June 30, 2019.\53\
---------------------------------------------------------------------------
    \50\September 11th Victim Compensation Fund, VCF Program 
Statistics, July 8, 2019, available at https://www.vcf.gov/pdf/
VCFMonthlyReportJune2019.pdf.
    \51\Id.
    \52\Id.
    \53\Id.
---------------------------------------------------------------------------
            A. VCF 1
    Shortly after the 9/11 attacks, Congress created the 
original VCF (``VCF 1'') to provide compensation for economic 
and noneconomic losses for individuals who were physically 
injured, or for relatives of those who were killed, as a result 
of the 9/11 attacks.\54\ Congress intended for the VCF to 
provide an alternative to 9/11-related tort litigation. Any 
person who chose to seek compensation from the VCF waived the 
right to sue for damages for 9/11-related injuries.\55\ Awards 
for noneconomic losses were to be offset by any collateral 
sources of compensation, such as pensions or workers 
compensation benefits. VCF 1 operated from 2001 to 2004 and 
awarded over $7 billion to 2,880 surviving representatives of 
those who died in the attacks and to 2,680 individuals who were 
injured in the attacks or in rescue efforts immediately 
following the attacks.\56\ Congress did not impose any overall 
spending limit on VCF 1.
---------------------------------------------------------------------------
    \54\Air Transportation Safety and System Stabilization Act of 2001, 
Pub. L. No. 107-42 (2001), codified at 49 U.S.C. Sec. 4101 note.
    \55\Id.
    \56\H. Rept. 111-560, Part 2, at 32.
---------------------------------------------------------------------------
            B. VCF 2
    Congress reopened the VCF in 2011 (``VCF 2'') with the 
passage and enactment of the James Zadroga 9/11 Health and 
Compensation Act of 2010.\57\ In addition to reopening the VCF 
and keeping the original structure of VCF 1 intact, the Act 
expanded eligibility for the VCF to include those who 
participated in debris removal efforts in the months following 
the attack.\58\ VCF 2 was set to close in October 2016. 
Congress capped funding for VCF 2 at $2.775 billion to cover 
both the payment of awards and administrative costs.
---------------------------------------------------------------------------
    \57\Pub. L. No. 111-347 (2010).
    \58\Id.
---------------------------------------------------------------------------
            C. 2015 Reauthorization
    On December 18, 2015, President Barack Obama signed into 
law appropriations legislation that extended authorization for 
the VCF for five more years, among other things.\59\ The 
legislation also added an appropriation of $4.6 billion to 
cover awards and expenses during the reauthorization period, 
and also appropriated money to pay any claims awarded prior to 
the reauthorization period for which there had been 
insufficient funding to pay all valid claims in full, with the 
proviso that the VCF could not spend any more than the total 
amount appropriated to the VCF (i.e., $2.775 billion for pre-
December 18, 2015 VCF 2 claims, $4.6 billion for post-December 
18, 2015 claims, for a total of $7.375 billion.)\60\ The 
reauthorization legislation also included changes to the VCF's 
policies and procedures for evaluating claims and calculating 
losses. Most notably, with respect to compensation for 
noneconomic losses like pain and suffering, the bill added a 
cap of $250,000 per claim if the claim was based on cancer, and 
a cap of $90,000 for non-cancer claims.\61\ The bill also 
limited the calculation of economic loss to a maximum of 
$200,000 annual gross income per claimant.\62\ Finally, the 
reauthorization also required the VCF Special Master to conduct 
an annual assessment of policies and procedures to ensure, 
among other things, that the VCF would not spend more money 
than the $4.6 billion allocated by Congress to pay claims for 
which the Special Master postmarks and transmits award 
determinations after December 18, 2015.\63\
---------------------------------------------------------------------------
    \59\Consolidated Appropriations Act, 2016, Title IV, Pub. L. No. 
114-113 (2015).
    \60\Id.
    \61\Id.
    \62\Id.
    \63\Id.
---------------------------------------------------------------------------
            D. VCF Eligibility and Compensation
    In order to be eligible for a VCF award, an individual 
must: (1) register a claim by the relevant deadline; (2) obtain 
a certification from the WTC Health Program for treatment of a 
physical injury or condition that is determined to be a result 
of the 9/11 attacks or debris removal following the attacks; 
and (3) demonstrate presence at a 9/11 crash site or along 
debris removal routes at some point between September 11, 2001 
and May 30, 2002, the day that debris removal efforts 
officially ended.\64\ Where relevant, a claimant must also 
timely dismiss, withdraw, or settle any 9/11-related lawsuit; 
if already compensated under VCF 1, establish a new condition 
or loss that was not previously compensated for; and, if the 
individual filing the claim is someone other than the victim, 
show that the claimant is authorized to act on the victim's 
behalf.\65\ Once the VCF determines that an individual is 
eligible for compensation, it calculates awards based on the 
specific circumstances of the individual claimant, determining 
non-economic loss amounts based on the nature and severity of 
the claimant's physical injury or condition as well as any 
economic loss.\66\ The VCF must subtract from the award amount 
certain ``collateral offsets,'' which are benefits paid to the 
claimant by other entities for the eligible 9/11 condition, 
including disability benefits, life insurance payments, or 
settlements from 9/11-related lawsuits.\67\
---------------------------------------------------------------------------
    \64\VCF Hearing (written statement of Rupa Bhattacharyya, Special 
Master, September 11th Victim Compensation Fund, at 3) [hereinafter 
``Bhattacharyya Statement'']; September 11th Victim Compensation Fund, 
Policies and Procedures, Feb. 2019, available at https://www.vcf.gov/
pdf/VCFPolicy.pdf [hereinafter ``VCF Policies and Procedures''] See 
also September 11th Victim Compensation Fund, VCF General Information, 
Feb. 2019, available at https://www.vcf.gov/pdf/VCF_InfoSheet.pdf.
    \65\VCF Policies and Procedures.
    \66\Bhattacharyya Statement at 3.
    \67\Id.
---------------------------------------------------------------------------
            E. 2019 Announcement of Funding Deficiency and Award 
                    Reductions
    On February 15, 2019, the VCF Special Master, Rupa 
Bhattcharyya, published the VCF's Seventh Annual Status Report 
and Third Annual Reassessment of Policies and Procedures.\68\ 
The Special Master is required to ensure each year that the 
VCF's policies and procedures do not result in the payment of 
more money than the total amount allocated for its funding, in 
this case, $7.375 billion.\69\ After completing the most recent 
assessment, the Special Master determined that there was 
insufficient funding to pay all pending and projected claims 
under then-current VCF policies and procedures, mainly because 
of a sharp increase in the number of claims in the preceding 
four months.\70\ According to the report, the VCF had already 
paid $5 billion in awards as of the date of the report, with $2 
billion remaining to pay future awards with two years remaining 
in the VCF's authorization and thousands of claims yet to be 
decided.\71\ As a result, the Special Master announced that the 
VCF would substantially reduce awards to ensure that the VCF 
did not run out of money.\72\
---------------------------------------------------------------------------
    \68\Rupa Bhattacharyya, Special Master, September 11th Victim 
Compensation Fund, Seventh Annual Status Report and Third Annual 
Reassessment of Policies and Procedures, Feb. 15, 2019, [hereinafter 
``Special Master Report''] available at https://www.vcf.gov/pdf/
VCFStatusReportFeb2019.pdf.
    \69\Air Transportation Safety and System Stabilization Act of 2001, 
Pub. L. No. 107-42, Sec. Sec. 406(d)(2)(C)(i)(II) and (ii) (2001); 
Bhattacharyya Statement at 5.
    \70\Special Master Report at 42-43; Bhattacharyya Statement at 5-6.
    \71\Special Master Report at 43; see also Bhattacharyya Statement 
at 6.
    \72\Id.
---------------------------------------------------------------------------
    In her testimony before the Subcommittee on June 11, 2019, 
Special Master Bhattacharyya stated that the VCF was ``able to 
pinpoint several new trends, which reflect significant changes 
to the composition of the VCF's claimant population since 
Congress last examined [the VCF authorizing statute] in 2015'' 
that explained the sharp increase in claims.\73\ First was a 
dramatic increase in claims filed on behalf of those who have 
died as a result of their 9/11-related physical health 
condition.\74\ Second was ``a marked increase in cancer 
claims.''\75\ Third was ``a marked increase in claims from the 
survivor population, meaning those who lived, worked, or went 
to school in the [WTC] area.''\76\ According to the Special 
Master, these trends, combined with the fact that deceased 
claims and cancer claims tend to be higher value awards, 
resulted in the VCF expending available funds more quickly than 
anticipated.\77\
---------------------------------------------------------------------------
    \73\Bhattacharyya Statement at 6.
    \74\Id.
    \75\Id.
    \76\Id.
    \77\Id.
---------------------------------------------------------------------------
    In determining how to respond to the funding deficiency, 
the Special Master sought to ensure that funding be prioritized 
for awards for those with the most debilitating conditions (as 
required by the statute), that every individual suffering from 
a physical health condition as a result of 9/11 receive at 
least some compensation, and that at least some allowance be 
made for claimants who had already filed their claims as of 
February 2019.\78\ The Special Master ``concluded that the 
fairest way to implement the required reduction of awards was 
to do so across the board'' and that this approach was 
consistent with the ``clear majority'' of public comments that 
the VCF received on how best to respond to the funding 
deficiency.\79\ In light of these goals, the VCF announced that 
effective February 25, 2019, it would substantially reduce 
awards for pending and future claims.\80\ For any claim or 
amendment to a claim submitted on or before February 1, 2019, 
the economic and non-economic loss amounts (prior to 
subtraction of any offsets) were to be reduced by 50%.\81\ For 
any claim or amendment to a claim submitted on or after 
February 2, 2019, the economic and non-economic loss amounts 
(prior to subtraction of any offsets) were to be reduced by 
70%.\82\ Offsets must be subtracted in full from the calculated 
reduced award, meaning that it is possible that some claimants 
who might otherwise have been entitled to compensation from the 
VCF may receive nothing.\83\ According to the Special Master, 
835 claims have been subject to these cuts so far.\84\
---------------------------------------------------------------------------
    \78\September 11th Victim Compensation Fund, Determination of 
Funding Insufficiency: Questions and Answers, March 2019, available at 
https://www.vcf.gov/pdf/VCFFIQandA.pdf [hereinafter ``Funding Q&A''].
    \79\Bhattacharyya Statement at 7.
    \80\Funding Q&A.
    \81\Id.; Bhattacharyya Statement at 8.
    \82\Id.
    \83\Bhattacharyya Statement at 8; VCF Hearing, Unofficial Tr. at 
81-82.
    \84\Bhattacharyya Statement at 8.
---------------------------------------------------------------------------

                        NEED FOR THE LEGISLATION

    H.R. 1327 would extend the authorization for the VCF until 
2090. It would also direct that funds not otherwise 
appropriated be placed into the VCF in ``such sums as may be 
necessary'' to fund the VCF's payment of claims and its 
administrative expenses. With respect to any claimants whose 
awards were cut because of the current funding deficiency faced 
by the VCF, the bill directs the VCF Special Master to pay the 
difference between the amount that the claimant is entitled to 
and the amount that the claimant was actually paid when there 
is sufficient funding to do so. It also provides the VCF 
Special Master with the discretion to issue awards for 
noneconomic losses in amounts beyond the statutory caps 
contained in current law when special circumstances warrant. 
Finally, the bill would ensure that, with respect to the 
calculation of economic losses, the limit of $200,000 annual 
gross income is periodically adjusted based on at least once 
every five years.
    A long-term extension of the VCF's authorization is 
necessary in light of the substantial evidence outlined above 
that 9/11-related illnesses, including cancers, continue to 
manifest themselves in responders and survivors after long 
latency periods and that they will continue to do so for 
decades to come. Given the uncertainty surrounding the exact 
number of those who will become ill in the future from 9/11-
related diseases, on the one hand, and the certainty that many 
more people will become sick, on the other, a long-term 
reauthorization is justified. By extending the VCF's 
authorization to 2090, H.R. 1327 ensures that almost all of 
those alive today who may be impacted by a 9/11-related health 
condition and who would otherwise meet the VCF's eligibility 
requirements can be compensated in the future. Experience from 
two short five-year authorization periods since 2011 has 
demonstrated that the need for the VCF is long-term. As the VCF 
Special Master testified:

          while the population of potential claimants is a 
        finite set, its exact numbers are unknown. There is no 
        accurate count of how many people might have been 
        exposed to toxins stemming from the attacks, and there 
        is considerable uncertainty about the number of 
        individuals who ultimately will fall ill due to the 
        long latency periods that can elapse before 
        manifestation of the cancers determined to be related 
        to 9/11 exposure.\85\
---------------------------------------------------------------------------
    \85\Bhattacharyya Statement at 5.

Dr. Moline testified that while it is ``not possible to know 
the exact number [of people who will develop 9/11-related 
illnesses in the next 25 to 50 years], there are going to be 
10,000 to 20,000 more cancers . . . plus other diseases,'' 
including ``lung diseases that may require lung transplants'' 
and ``sarcoidosis, which is a fairly rare disease but is common 
in World Trade Center-exposed individuals.''\86\ And, as 
advocate Jon Stewart put it in his Subcommittee testimony, 
``the idea that you can only give [9/11 responders] five more 
years of the VCF because you are not quite sure what is going 
to happen five years from now? Well, I can tell you, I am 
pretty sure what is going to happen five years from now: more 
of these men and women are going to get sick, and they are 
going to die.''\87\
---------------------------------------------------------------------------
    \86\VCF Hearing, Unofficial Tr. at 82.
    \87\Id. at 78.
---------------------------------------------------------------------------
    For the same reasons, there should be no overall spending 
limitation on the VCF, as was the case with VCF 1, and H.R. 
1327 rightly does not include such an overall spending 
limitation. Indeed, as VCF Special Master Bhattacharyya 
outlined in her testimony, it was, in part, a combination of 
increases in cancer and other types of claims that were 
unanticipated during consideration of the last reauthorization 
in 2015 and the overall funding limitation of $7.375 billion 
that led to the current funding deficiency and, with it, the 50 
percent and 70 percent cuts in awards. Congress must not make 
the same mistake again.
    H.R. 1327 also ensures that those VCF claimants whose 
awards were cut by either 50 or 70 percent because of the 2019 
funding deficiency have their awards fully restored. As many of 
the responder and survivor witnesses at the Subcommittee 
hearing testified, there is no justification for valuing some 
victims' lives at 50 to 70 percent less than other similarly-
situated victims or denying some victims the opportunity to 
receive any compensation at all should the VCF be allowed to 
expire in 2020, solely because of when they happen to become 
ill.\88\
---------------------------------------------------------------------------
    \88\Henry Statement at unnumbered 1 (``The reason I have to worry 
is because Congress thinks its ok for my husband's life to be worth at 
least 70% less than other construction workers that have died or become 
sick from being at Ground Zero. If he died 2 years ago, everything 
would be ok. I feel horrible for those that will die 2 years from now 
because their families will get nothing [if Congress does not 
reauthorize the VCF]''); Mohnal Statement at 1, 3 (``My life was 
certainly worth no more or less than the other First Responders that 
came to the Pentagon and whether it is Shanksville, the World Trade 
Center or the Pentagon, we were one then and we are one now as we sit 
before you . . . I am here today to ask why Congress believes that my 
life is no worth the same as those that became sick before me and some 
how my life is worth more than those that will most certainly come 
after me''); O'Connell Statement at 5 (``how is it fair that I was duly 
compensated, but others that are now sick and dying from their exposure 
will not be? It seems unfair that I was unlucky to get sick, but lucky 
in that I got sick early, so that I could avoid a potential cut, or 
worse, having no VCF after December 2020?''); Alvarez Statement at 
unnumbered 2 (``Now the 9/11 illnesses have taken many of us and we are 
all worried about our children, our spouses and our families and what 
happens if we are not here. The VCF has done a wonderful job and 
treated my family with great respect. But my life isn't worth more than 
the next responder to get cancer. My family's needs are not worth less 
than others that have already died''); Nordstrom Statement at 6 (``A 
responder or a survivor who gets sick in 2027 deserves the same help 
that they would've have [sic] received if they got sick in 2017'').
---------------------------------------------------------------------------
    To the extent that there is a concern that the VCF is 
intended mostly to help those from the New York City region, 
the witnesses provided testimony that establishes that the VCF 
is of national significance and that people from every part of 
the country are impacted by it. To begin with, it should go 
without saying that the 9/11 attacks were an act of war against 
the United States, not just an attack on New York City. As Mr. 
Stewart put it,

          I am awfully tired of hearing that it is a 9/11 New 
        York issue. Al-Qaida didn't shout `Death to Tribeca.' 
        They attacked America. And these men and women and 
        their response to it is what brought our country back. 
        It is what gave a reeling Nation a solid foundation to 
        stand back upon, to remind us of why this country is 
        great, of why this country is worth fighting for.\89\
---------------------------------------------------------------------------
    \89\VCF Hearing, Unofficial Tr. at 78.

It is also worth noting that the VCF is a national program, and 
---------------------------------------------------------------------------
as VCF Special Master Bhattacharyya testified, the

        VCF has received claims from individuals in every state 
        of the nation. This includes those who traveled to New 
        York City, the Pentagon, and Shanksville from all over 
        the country as part of the response efforts, both in 
        official capacities and as volunteers, and those who 
        have relocated elsewhere in the intervening years since 
        the attacks.\90\
---------------------------------------------------------------------------
    \90\Bhattacharyya Statement at 2. See also Mohnal Statement at 2 
(describing how FBI agents and members of the Evidence Response Teams 
from FBI offices around the country were deployed to the Pentagon to 
assist in the terrorism investigation); Nordstrom Statement at 6 
(``Stuyvesant alumni alone live in locales from rural Tennessee, to 
coastal Oregon, to Texas and beyond. Thousands of other New York City 
kids have begun their adult lives in other parts of the country as 
well'').

    H.R. 1327's grant of discretionary authority to the Special 
Master to exceed the current statutory caps on awards for 
noneconomic losses is necessary to ensure that, in rare cases, 
the Special Master may exceed the cap when special 
circumstances warrant. For example, current law caps awards for 
non-economic loss for non-cancer claims at $90,000, but a 
claimant who may require a double-lung transplant because of a 
non-cancer but nonetheless severe lung condition may need more 
than $90,000 to be made whole.
    In addition, H.R. 1327 would require the Special Master to 
index the current $200,000 annual gross income limitation to 
the Consumer Price Index for All Urban Consumers. This 
provision ensures that calculations of economic loss accurately 
reflect increasing consumer prices and that a lack of such 
indexing will not effectively function as a cut in award 
amounts.
    While the terrorists who carried out the 9/11 attacks bear 
the ultimate moral responsibility for the harms inflicted on 
Americans on that terrible day, the federal government also 
bears moral responsibility for causing or exacerbating the 
illnesses that many responders and survivors now suffer from, 
years after 9/11. As noted above, many people in Lower 
Manhattan relied on the EPA's false assurances that the air was 
safe to breath in the immediate aftermath of the attacks. As 
such, the federal government, acting through Congress and the 
Executive Branch, bears an obligation to act quickly to extend 
the VCF and help those who became sick or whose illnesses were 
worsened because of such reliance. As Dr Moline noted in her 
testimony, ``Soon, the day will come when there are more people 
who have died of WTC related illnesses after 9/11 than perished 
on that horrible day when our nation was attacked.''\91\
---------------------------------------------------------------------------
    \91\Moline Statement at 4.
---------------------------------------------------------------------------

                                Hearings

    For the purposes of section 103(i) of H. Res. 6 of the 
116th Congress, the following hearing was used to consider H.R. 
1327: Hearing on ``The Need to Reauthorize the September 11th 
Victim Compensation Fund'' held before the Subcommittee on the 
Constitution, Civil Rights, and Civil Liberties on June 11, 
2019.\92\ The Subcommittee heard from two witness panels. The 
first panel consisted of Rep. Carolyn Maloney (D-NY) and Rep. 
Peter King (R-NY), two of the lead sponsors of H.R. 1327. The 
second panel consisted of a bipartisan witness panel consisting 
of: (1) Rupa Bhattacharyya, Special Master of the September 
11th Victim Compensation Fund; (2) Dr. Jacqueline Moline, a 9/
11 health care provider; (3) Lila Nordstrom, a 9/11 WTC 
survivor; (4) Anesta Maria St. Rose Henry, widow of a 
construction worker Candidus Henry, who was a WTC responder; 
(5) Tom Mohnal, a retired Federal Bureau of Investigation 
Supervisory Agent and Pentagon responder; (6) Luis Alvarez, a 
retired New York Police Department detective and WTC responder; 
(7) Michael O'Connell, a retired Fire Department of New York 
lieutenant and WTC responder; and (8) Jon Stewart, advocate for 
9/11 responders and survivors. At the hearing, the witnesses 
testified about the work of the VCF; the continuing emergence 
of new cases of serious and life-threatening illnesses with 
long latency periods, including cancers, among 9/11 responders 
and survivors linked to their exposure to 9/11-related toxins; 
and the impact of substantial cuts in awards that the VCF 
instituted effective since February 2019 due to a funding 
deficiency.
---------------------------------------------------------------------------
    \92\VCF Hearing.
---------------------------------------------------------------------------

                        Committee Consideration

    On June 12, 2019, the Committee met in open session and 
ordered the bill, H.R. 1327, favorably reported without 
amendment by voice vote, a quorum being present.

                            Committee Votes

    In compliance with clause 3(b) of rule XIII of the Rules of 
the House of Representatives, the Committee advises that no 
rollcall votes occurred during the Committee's consideration of 
H.R. 1327.

                      Committee Oversight Findings

    In compliance with clause 3(c)(1) of rule XIII of the Rules 
of the House of Representatives, the Committee advises that the 
findings and recommendations of the Committee, based on 
oversight activities under clause 2(b)(1) of rule X of the 
Rules of the House of Representatives, are incorporated in the 
descriptive portions of this report.

               New Budget Authority and Tax Expenditures

    Clause 3(c)(2) of rule XIII of the Rules of the House of 
Representatives is inapplicable because this legislation does 
not provide new budgetary authority or increased tax 
expenditures.

               Congressional Budget Office Cost Estimate

    In compliance with clause 3(c)(3) of rule XIII of the Rules 
of the House of Representatives, the Committee sets forth, with 
respect to the bill, H.R. 1327 the following estimate and 
comparison prepared by the Director of the Congressional Budget 
Office under section 402 of the Congressional Budget Act of 
1974:

                                     U.S. Congress,
                               Congressional Budget Office,
                                     Washington, DC, July 11, 2019.
Hon. Jerrold Nadler,
Chairman, Committee on the Judiciary,
House of Representatives, Washington, DC.
    Dear Mr. Chairman: The Congressional Budget Office has 
prepared the enclosed cost estimate for H.R. 1327, the Never 
Forget the Heroes: Permanent Authorization of the September 
11th Victim Compensation Fund Act.
    If you wish further details on this estimate, we will be 
pleased to provide them. The CBO staff contact is Jon Sperl, 
who can be reached at 226-2860.
            Sincerely,
                                         Phillip L. Swagel,
                                                          Director.
Enclosure.
        cc: Honorable Doug Collins
            Ranking Member

[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
        

    The bill would
           Appropriate such sums as are necessary for 
        the September 11th Victim Compensation Fund (VCF) to 
        pay claims to eligible victims through fiscal year 2090
           Require the VCF to fully compensate 
        claimants who have received reduced awards in the past 
        because of declining balances in the fund
    Estimated budgetary effects would primarily stem from
           Payments to currently eligible claimants and 
        to those found eligible in the future
           Costs to administer the VCF
    Areas of significant uncertainty include
           Identifying incidence rates for adverse 
        health conditions, particularly cancer, in the eligible 
        population
           Estimating the number of people who will 
        file successful claims
    Bill Summary: H.R. 1327 would authorize the appropriation 
of whatever amounts are necessary for the September 11th Victim 
Compensation Fund to pay claims to eligible people through 
fiscal year 2090. The bill also would require the VCF to fully 
compensate claimants who have received reduced awards in the 
past because of declining fund balances.
    Estimated Federal Cost: The estimated budgetary effect of 
H.R. 1327 is shown in Table 1. The costs of the legislation 
fall within budget function 750 (administration of justice).

                                                   TABLE 1.--ESTIMATED BUDGETARY EFFECTS OF H.R. 1327
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                          By fiscal year, millions of dollars--
                                ------------------------------------------------------------------------------------------------------------------------
                                   2019     2020     2021     2022     2023     2024     2025     2026     2027     2028     2029   2019-2024  2019-2029
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                              Increases in Direct Spending
 
Cost of Claims Filed Before
 Enactment:
    Estimated Budget Authority.        0      600      940    1,370    1,260        0        0        0        0        0        0      4,170      4,170
    Estimated Outlays..........        0      600      940    1,370    1,260        0        0        0        0        0        0      4,170      4,170
Cost of Claims Filed After
 Enactment:
    Estimated Budget Authority.        0      350      440      570      590      600      610      620      630      670      700      2,550      5,780
    Estimated Outlays..........        0      350      440      570      590      600      610      620      630      670      700      2,550      5,780
Administrative Costs:
    Estimated Budget Authority.        0        0        7        7       18       33       33       33       33       33       33         65        230
    Estimated Outlays..........        0        0        7        7       18       33       33       33       33       33       33         65        230
      Total:
        Estimated Budget               0      950    1,387    1,947    1,868      633      643      653      663      703      733      6,785     10,180
         Authority.............
        Estimated Outlays......        0      950    1,387    1,947    1,868      633      643      653      663      703      733      6,785     10,180
--------------------------------------------------------------------------------------------------------------------------------------------------------

    Background: The Congress created the September 11th Victim 
Compensation Fund in 2001 to compensate people (or their heirs) 
who were injured or killed in the terrorist attacks of 
September 11, 2001. The fund compensates eligible claimants or 
their surviving personal representatives (often, family 
members) for their economic and noneconomic losses.\1\
---------------------------------------------------------------------------
    \1\Economic losses consist of lost earnings or benefits related to 
employment; personal losses of business or employment opportunities; 
losses due to death; burial costs; and medical expenses that a claimant 
has already paid. Noneconomic losses consist of physical and emotional 
pain, physical impairment, disfigurement, loss of enjoyment of life, 
and other losses except psychological or mental health conditions, 
which are not covered.
---------------------------------------------------------------------------
    In 2004, after paying $7.0 billion in claims, the VCF 
closed. In 2011, the James Zadroga 9/11 Health and Compensation 
Act of 2010, appropriated $2.775 billion to the VCF for five 
years to pay new claims. On December 18, 2015, the Congress 
extended the VCF's authority to accept claims for five more 
years and appropriated an additional $4.6 billion.
    Under current law, payments to claimants and the 
administrative costs of the VCF are capped at $7.375 billion, 
and people have until December 18, 2020, to file claims.
    After that date, CBO expects, the VCF will spend its 
remaining balances--which totaled about $3.2 billion at the 
beginning of fiscal year 2019--to pay eligible claims. The fund 
is expected to cease operations near the beginning of fiscal 
year 2023.
    If balances are insufficient to pay the full amounts 
awarded, claimants will receive payments in proportion to the 
fund's balance. Beginning in February 2019, the VCF's special 
master began to reduce some award payments because the fund's 
administrators anticipated that the VCF would not have 
sufficient funds to pay all valid claims. In June 2019, the 
special master reported that the program had awarded $5.174 
billion in compensation since 2011, and that the fund would 
need $4.616 billion above the current appropriation to pay all 
remaining claims including those expected to be filed before 
the statutory deadline.\2\
---------------------------------------------------------------------------
    \2\See the testimony of Rupa Bhattacharyya, Special Master, 
September 11th Victim Compensation Fund, before the Subcommittee on the 
Constitution, Civil Rights and Civil Liberties of the House Committee 
on the Judiciary (June 11, 2019), https://go.usa.gov/xyrzh (PDF, 288 
KB).
---------------------------------------------------------------------------
    Claims process: Under the Zadroga Act, prospective 
claimants must register with the VCF to be eligible to file a 
claim or to preserve their right to file a claim in the future. 
Claimants are considered to have met the registration deadline 
if they submit their application within two years of the date 
on which they knew (or reasonably should have known) the 
following had occurred:
           They suffered physical harm as a result of 
        the attacks on September 11, or as a result of 
        hazardous exposure during the rescue period or during 
        debris removal;
           They have received a diagnosis by a medical 
        professional that is approved by the VCF as a 
        qualifying physical injury or health condition;\3\ and
---------------------------------------------------------------------------
    \3\Qualifying health conditions and physical injuries under the 
Zadroga Act and VCF program regulations include various types of 
cancer, aerodigestive disorders, musculoskeletal disorders, and acute 
traumatic injury. The VCF does not pay claims for post-traumatic stress 
disorder or psychological or mental health conditions. See Eligibility 
Definitions and Requirements, 28 C.F.R. Sec. 104.2 (2016), http://
tinyurl.com/y4t5oup4.
---------------------------------------------------------------------------
           They have a determination by a government 
        entity, such as the World Trade Center (WTC) Health 
        Program or a state or local government, that their 
        injury or condition was caused by exposure at the 
        attack sites or other locations during specified 
        periods.\4\
---------------------------------------------------------------------------
    \4\Under the Zadroga Act and VCF program regulations, claimants 
must document their physical presence at an attack site or other 
specified location during a specific period and for a minimum duration. 
For example, people who participated in rescue and cleanup in Lower 
Manhattan between September 11 and September 30, 2001, must document 
their presence for at least 24 hours at that location. See Filing for 
Compensation, 28 C.F.R. Sec. 104.22 (2016), http://tinyurl.com/
y5ok38sy.
---------------------------------------------------------------------------
    Most of the people registered with the VCF have been 
diagnosed with an eligible condition confirmed by the WTC 
Health Program, which is administered by the Centers for 
Disease Control and Prevention (CDC).\5\
---------------------------------------------------------------------------
    \5\The WTC Health Program provides treatment and monitoring to 
eligible first responders and survivors. Participation is not a 
prerequisite for registering with the VCF.
---------------------------------------------------------------------------
    Claimants must meet statutory requirements and be found 
eligible by the VCF to obtain compensation. Award amounts for 
noneconomic losses are based on the type and severity of the 
victim's condition and the degree to which those conditions 
affect the victim's ability to maintain normal activities and 
enjoyment of daily life. Almost all successful claimants have 
received compensation for noneconomic losses. About one-fifth 
of successful claimants also have received compensation for 
economic losses, including loss of wages and employer-provided 
benefits. Their claims are calculated based on occupational 
disability and are offset by any other payments they receive 
(such as disability benefits).
    Claims data: Since the VCF was reopened in 2011, the 
program has paid awards to about 22,400 claimants at a cost of 
about $5.2 billion (see Table 2). Thirty-seven percent of those 
awards were paid to people with cancer and 63 percent were paid 
to people who had noncancerous conditions alone. From January 
2017 to the present, the share of awards paid to claimants with 
cancer has risen to 45 percent. Since 2017, the average amount 
of awards for both cancerous and noncancerous conditions also 
increased, in large part because the size of revisions to 
awards increased over that period.

         TABLE 2.--CBO'S ESTIMATE OF CLAIMS AND AWARDS PAID FROM THE VICTIM COMPENSATION FUND SINCE 2011
----------------------------------------------------------------------------------------------------------------
                                                                                                      Total Cost
                                                               Number of    Percentage    Average     of Claims
                      Health Condition                           Claims     of Claims      Award      (Millions
                                                                                         (Dollars)   of dollars)
----------------------------------------------------------------------------------------------------------------
                                     Claims Paid From 2011 Through May 2019
 
Cancer......................................................        8,310           37      351,000        2,920
Noncancerous................................................       14,120           63      160,000        2,260
                                                             ---------------------------------------------------
    Total...................................................       22,430          100         n.a.        5,180
                            Subset of Claims Paid From January 2017 Through May 2019a
 
Cancer......................................................        4,960           45      413,000        2,050
Noncancerous................................................        5,980           55      213,000        1,270
                                                             ---------------------------------------------------
    Total...................................................       10,940          100         n.a.       3,320
----------------------------------------------------------------------------------------------------------------
n.a. = not applicable.
aAverage award amounts and the total costs of claims combine compensation received from initial awards plus
  compensation received later in revised awards. As a result, the $3,320 million estimated to have been spent on
  claims from January 2017 through May 2019 includes some compensation from initial awards that was spent by the
  Victim Compensation Fund before 2017.

    From the time the VCF reopened in 2011 through May 2019, 
more than 47,000 claims for compensation have been filed; those 
claims have the following status:\6\
---------------------------------------------------------------------------
    \6\See September 11th Victim Compensation Fund, ``VCF Program 
Statistics (As of May 31, 2019)'' (accessed July 3, 2019), https://
go.usa.gov/xygBh (PDF, 426 KB).
---------------------------------------------------------------------------
           About 22,400 received compensation,
           About 17,600 are under review, and
           About 7,200 either have been determined to 
        be ineligible or cannot be processed because of 
        problems with documentation.
    Over that period, nearly 6,000 claimants qualified for 
additional compensation--revisions of original awards--either 
because claimants successfully appealed a denial or because 
they filed an amendment seeking a revised award determination 
on the basis of new information or because of a newly diagnosed 
health condition.
    Basis of estimate: For this estimate, CBO assumes that the 
bill will be enacted near the end of fiscal year 2019.
    CBO's estimate of payments under H.R. 1327 is based on an 
analysis of the number, amounts, and type of awards the fund 
has paid in recent years; estimates of the incidence rates of 
qualifying health conditions--cancerous and noncancerous--in 
the eligible population; and estimates of the number of people 
who would successfully file claims.
    As shown in Table 2, the VCF has paid awards to about 
22,400 claimants over the history of the program. CBO's 
estimate of the costs of H.R. 1327 is based on an analysis of 
the costs to compensate three groups of claims:
           19,000 additional claims, filed before 
        October 1, 2019, that CBO estimates will not yet have 
        been paid by the time this legislation is enacted;
           Several hundred claims that have already 
        been paid at reduced compensation levels because of 
        declining fund balances; and
           18,100 new claims that CBO estimates will be 
        filed and paid after October 1, 2019.
    CBO estimates that all of the 19,000 claims filed by 
October 1, 2019 will be paid by 2023 (see Table 3). Some 
payments under the current program have been reduced to 
accommodate the fund's declining balances.

     TABLE 3.--CBO'S ESTIMATE OF AMOUNTS REQUIRED TO FULLY PAY CLAIMS FILED WITH THE VICTIM COMPENSATION FUND
                                               BEFORE OCTOBER 2019
----------------------------------------------------------------------------------------------------------------
                                                                                                      Total Cost
                                                               Number of    Percentage    Average     of Claims
                      Health Condition                           Claims     of Claims      Award      (Millions
                                                                                         (Dollars)   of dollars)
----------------------------------------------------------------------------------------------------------------
                                                Estimated Claims
 
Cancer......................................................        8,550           45      415,000        3,550
Noncancerous................................................       10,450           55      214,000        2,240
                                                             ---------------------------------------------------
    Total...................................................       19,000          100         n.a.        5,790
----------------------------------------------------------------------------------------------------------------


                   Estimated Total Cost to Pay Claims
 
Estimated Total Cost to Fully Pay Claims Filed Before              5,790
 October 2019........................................
Less Estimated Unobligated Balancesa.................              1,620
                                                      ------------------
Estimated Net Additional Cost Under H.R. 1327b.......              4,170
------------------------------------------------------------------------
VCF = Victim Compensation Fund; n.a. = not applicable.
aThe unobligated balances is CBO's estimate of amounts already
  appropriated to the VCF that will be available to pay claims at the
  end of September 2019.
bThe net additional cost under the bill includes about $250 million in
  compensation that would be paid, retroactively, to claimants who
  received awards at reduced levels. Starting in late February 2019, the
  VCF began reducing the value of some claims in anticipation of the VCF
  running out of funding.

    Estimated cost to fully pay claims filed before fiscal year 
2020: The 19,000 claims that CBO estimates will have been filed 
by the beginning of fiscal year 2020 and that will eventually 
receive awards include more than 15,000 claims currently in 
review that CBO estimates will be approved, 2,800 claims that 
have documentation problems that CBO estimates eventually will 
be resolved, and 1,200 eligible claims that CBO estimates will 
be filed by the time the legislation is enacted.
    The amount of an award depends on whether the claim is for:
           A cancerous or noncancerous condition,
           Injury or death, and
           Economic loss, noneconomic loss, or both.
    Using information provided by the VCF about the number and 
amounts of awards paid over the 2011-2019 period, CBO estimates 
that all 19,000 claimants will receive awards of varying size 
over the 2020-2023 period. The largest determinant of 
differences in the size of awards is whether the compensation 
is for cancer or for a noncancerous illness.\7\ The amount also 
depends on whether a claimant would be eligible for additional 
compensation for economic losses and whether the claim is for 
an individual who has died.
---------------------------------------------------------------------------
    \7\CBO estimates that the average cancer award for claims filed 
before enactment (as shown in Table 3) and for claims that would be 
filed over the 2020-2029 period (as shown in Table 4) would be roughly 
double the average noncancerous award. Much of the difference is 
attributable to VCF regulations, which authorize the program to award 
up t $250,000 in noneconomic damages to claimants with cancer and up to 
$90,000 to claimants with noncancerous illnesses. See Determination of 
Presumed Economic Losses for Injured Claimants, 28 C.F.R. Sec. 104.46 
(2016), http://tinyurl.com/y5tlu4lb.
---------------------------------------------------------------------------
    CBO's estimates of average awards for each type of claim 
combine compensation from initial awards with any additional 
compensation provided in revisions to those awards. CBO 
estimated the distribution and average amount of each type of 
claim on the basis of data provided by the VCF for 2017 to the 
present. The estimate of the costs of full compensation for all 
claims filed before the end of fiscal year 2019 is summarized 
in Table 3.
    Of the 19,000 claims, CBO estimates that 45 percent will be 
for cancer and 55 percent will be for noncancerous conditions 
and that compensation would be provided for noneconomic losses 
alone in 76 percent of those cases. Six percent of the claims 
would be for victims who have died, CBO estimates.
    In total, CBO estimates, full compensation for those 19,000 
claims would cost about $5.8 billion. Based on the program's 
activity in recent years, CBO estimates that the VCF would 
process 4,000 to 5,000 claims annually and would close out that 
set of claims in 2023.
    By October 2019, CBO estimates, VCF will carry unobligated 
balances of $1.6 billion to cover claims. Under current law, 
those balances will be spent over the 2020-2023 period to pay 
claims filed before October 2019--with some awards reduced 
because of insufficient funding. As a result, CBO estimates, 
compensating all 19,000 claimants for the full value of their 
estimated awards would cost an additional $4.2 billion.\8\ That 
additional amount would be attributable to H.R. 1327.
---------------------------------------------------------------------------
    \8\The $4.2 billion includes $250 million in compensation that 
would be paid, retroactively, to claimants who received awards at 
reduced levels. Starting in late February 2019, the VCF began reducing 
the value of some claims in anticipation of the VCF running out of 
funding. Using information provided by the VCF about the number of 
claims that have been subject to reduction and the value of those 
reductions so far, CBO estimates that claimants subject to reductions, 
in the aggregate, will be paid about $250 million less than the full 
value of their awards through the end of fiscal year 2019. H.R. 1327 
would make that estimated amount available to fully compensate those 
claimants.
---------------------------------------------------------------------------
    Estimate of claims filed and paid after October 1, 2019: 
The second component of CBO's analysis focused on the 
population that CBO estimates will develop qualifying health 
conditions--and seek compensation--after enactment of H.R. 
1327. CBO estimates that future claims--those filed and paid 
after enactment--would total roughly 18,000 over the 2020-2029 
period (see Table 4).

 TABLE 4.--CBO'S ESTIMATE OF THE FUTURE COST OF CLAIMS FILED WITH AND PAID BY THE VICTIM COMPENSATION FUND AFTER
                                                 OCTOBER 1, 2019
----------------------------------------------------------------------------------------------------------------
                                                                                                      Total Cost
                                                               Number of    Percentage    Average     of Claims
                      Health Condition                           Claims     of Claims      Award      (Millions
                                                                                         (Dollars)   of dollars)
----------------------------------------------------------------------------------------------------------------
Cancer......................................................       11,470           63      395,000        4,530
Noncancerous................................................        6,600           37      190,000        1,250
                                                             ---------------------------------------------------
    Total...................................................       18,070          100         n.a.        5,780
----------------------------------------------------------------------------------------------------------------
n.a. = not applicable.

    Affected Population and Mortality. According to New York 
City's World Trade Center Health Registry, more than 410,000 
people, including 90,000 first responders, were directly 
exposed to environmental contaminants in the aftermath of the 
September 11 attacks.\9\ To date, about 95,000 people--80 
percent of them first responder--participate in the WTC Health 
Program.\10\ About half of those participants have been treated 
for health conditions; others who are at risk of developing 
illnesses, particularly cancer, are being monitored by the 
program.
---------------------------------------------------------------------------
    \9\For more information, see NYC 9/11 Health, ``World Trade Center 
Health Registry'' (accessed July 3, 2019), https://go.usa.gov/xyTxX.
    \10\Currently, about 75,000 first responders and 20,000 other 
survivors are enrolled in the WTC Health Program. About 3 percent of 
those enrollees have psychological ailments only, which do no qualify 
for compensationn from the VCF. Over the history of the WTC Health 
Program, 2,355 enrollees have died.
---------------------------------------------------------------------------
    To estimate the number of people who will develop health 
conditions in future years and would seek compensation from the 
VCF under H.R. 1327, CBO first reduced the eligible population 
of 410,000 exposed people, to account for the following 
information:
         About 67,000 people that CBO estimates have 
        died since 2001,
         Roughly 22,500 people who already have 
        received full compensation from the VCF, and
         About 19,000 claimants expected to file before 
        October 2019 who already are accounted for elsewhere in 
        this cost estimate.
    For the remaining potential claimants--estimated to total 
about 300,000 people in 2020--CBO used CDC's mortality data to 
remove from that group the estimated number of deaths from all 
possible causes over the 2020-2029 period.
    Cancer Incidence. CBO used CDC's current data on incidence 
rates for cancer in the general population to estimate the 
number of people in the affected population who can be expected 
to develop cancer each year. CBO used rates that account for 
differences in the incidence of cancer by sex, age, race, and 
ethnicity in a manner that is representative of the reported 
demographic characteristics of the eligible population.
    CBO also reviewed several recent studies on cancer 
incidence in the population directly exposed to carcinogens as 
a result of the attacks. Those studies indicate that the 
incidence of several types of cancer--particularly prostate and 
skin cancers--is elevated in the exposed population. However, 
the magnitude of the increase varies widely by the type of 
cancer.\11\ Demonstrated increases in cancer incidence range 
from 5 percent to 20 percent higher among people directly 
exposed to carcinogens at the attack sites compared with rates 
in the general population. Most of the published research has 
focused on first responders and recovery workers, who 
experienced greater exposures to carcinogens than other 
survivors did.\12\
---------------------------------------------------------------------------
    \11\ See Eli J. Kleinman and others, ``NYPD Cancer Incidence Rates 
1995-2014 Encompassing the Entire World Trade Center Cohort,'' Journal 
of Occupational and Environmental Medicine, vol. 57, no. 10, pp. e101-
e113 (October 2015), https://doi.org/10.1097/JOM.0000000000000542.
    \12\ See Ankura Singh and others, ``Estimation of Future Cancer 
Burden Among Rescue and Recovery Workers Exposed to the World Trade 
Center Disaster,'' Journal of the American Medical Association (JAMA) 
Oncology, vol. 4, no. 6 (June 2018), pp. 828-831, https://doi.org/
10.1001/jamaoncol.2018.0504; Jiehui Li and others, ``Ten-Year Cancer 
Incidence in Rescue/Recovery Workers and Civilians Exposed to the 
September 11, 2001 Terrorist Attacks on the World Trade Center,'' 
American Journal of Industrial Medicine, vol. 59, no. 9 (September 
2016), pp. 709-721, https://doi.org/10.1002/ajim.22638; and Samara 
Solan and others, ``Cancer Incidence in World Trade Center Rescue and 
Recovery Workers, 2001-2008,'' Environmental Health Perspectives, vol. 
121, no. 6 (June 2013), pp. 699-704, https://doi.org/10.1289/
ehp.1205894.
---------------------------------------------------------------------------
    On that basis, CBO estimates that cancer incidence would be 
about 11 percent higher, on average, among first responders and 
recovery workers and about 6 percent higher among other 
eligible survivors, relative to the general population. (The 
estimated incidence of cancer for the combined populations of 
responders and survivors, using a weighted average, is about 8 
percent higher.)
    About a third of the claims paid by the VCF since it 
reopened in 2011 have involved cancer diagnoses; however, that 
percentage is increasing. Over the past year, for example, 50 
percent of claims included compensation for cancer. Using 
information from the WTC Health Program and the VCF, CBO 
estimates that both the number of cancer claims and the share 
of total claims that involve cancer relative to noncancerous 
conditions will continue to increase, driven principally by 
increases in cancer incidence related to age and to the amount 
of time elapsed since exposure.\13\
---------------------------------------------------------------------------
    \13\CBO estimates that cancer claims will grow from about 50 
percent of new claims in 2020 to over 80 percent by 2029 because 
noncancerous conditions are more likely to become evident sooner--in 
years closer to the terrorist attacks--and victims are more likely to 
be treated earlier. Moreover, because many types of cancer have long 
latencies--mesothelioma, for example, has an average latency of more 
than 30 years--the incidence of those cancers will increase as those 
who were exposed grow older. CBO also estimates that claims for 
deceased victims will grow from about 6 percent of new claims in 2020 
to 18 percent by 2029 because of the increase in mortality as the 
affected population ages and as cancer incidence rises. Since 2011, 
over 90 percent of awards paid to deceased claimants have involved 
cancer. CBO estimates that share will continue to increase over the 
2020-2029 period.
---------------------------------------------------------------------------
    Over the VCF's history, about 60 percent of all awards for 
cancer claims have been made to first responders, but in the 
past several years the share of new cancer claims from other 
survivors--who constitute the bulk of the remaining exposed 
population--has risen to 50 percent. CBO expects that, over the 
next 10 years, the share of cancer claims from those survivors 
will continue to rise; correspondingly, CBO's projection of 
future cancer rates is weighted more heavily toward its 
estimate for cancer incidence in that group. Over the 2020-2029 
period, CBO expects that 31,000 will develop cancer out of the 
remaining population of about 265,000 in 2029.
    Incidence of Noncancerous Illnesses. Using data from the 
WTC Health Program about the number of people who have been 
newly certified with illnesses since 2015, CBO estimates that 
about 19,000 people out of the remaining population can be 
expected to develop noncancerous illnesses over the next 10 
years. In producing that estimate, CBO accounted for trends in 
the ratio of cancer to noncancerous claims in recent years, 
which show that the share of noncancerous claims is declining. 
The WTC Health Program and other observers have noted that 
noncancerous conditions are more likely to be identified and 
treated earlier because noncancerous symptoms generally present 
sooner than cancer symptoms do. Accordingly, CBO estimates that 
the number of new noncancerous illnesses will decrease 
gradually over time. To date, the WTC Health Program has 
certified more than 40,000 people with noncancerous illnesses 
(mostly aerodigestive disorders, which affect both the 
respiratory and the digestive tracts). The VCF has paid claims 
to more than 14,000 people for noncancerous conditions alone.
    Filing a Claim With the Victim Compensation Fund. After 
estimating the number of people in the exposed population who 
will develop eligible health conditions, CBO estimated how many 
in that group would enroll in the WTC Health Program and 
receive certification that their conditions are related to the 
September 11, 2001, terrorist attacks. Although enrollment in 
the WTC Health Program is not a prerequisite for filing a claim 
with the VCF, enrollment in that program is the primary 
predictor of who will file a VCF claim. Over 85 percent of VCF 
registrants have certified their conditions through that 
program and over 90 percent of those enrollees have registered 
with the VCF.
    Currently, about 95,000 people participate in the WTC 
Health Program. To arrive at an estimate of the share who will 
develop health conditions and enroll in the program, CBO 
estimated the proportion of the eligible population that may 
have developed health conditions since 2001 and compared that 
information with the number of enrollees with certified 
conditions. Since the WTC Health Program began in 2011, CBO 
estimates, roughly two-thirds of those who have developed 
conditions have received certification--although significant 
uncertainty surrounds that estimate.
    If two-thirds of the people who develop eligible illnesses 
go on to enroll, CBO anticipates that participation in the WTC 
Health Program would grow by an average of 3,200 members (with 
certified health conditions) annually over the next decade. 
That pace is consistent with growth over the past five years.
    Finally, to estimate how many WTC Health Program members 
would submit VCF claims and receive awards, CBO used data from 
the VCF's February 2019 annual report about the stages of 
claim-filing activity over the program's history.\14\ CBO 
estimates that, over the 2020-2029 period, nearly 33,000 people 
will be certified by the WTC Health Program with eligible 
health conditions, and that about 18,100 within that group--55 
percent--would file claims and receive awards from the VCF.\15\ 
Of those claims, CBO estimates, 63 percent will be for cancer 
and 37 percent will be for noncancerous conditions alone. On 
average, 1,800 claims would be approved annually and the number 
of awards would gradually increase over the next decade, driven 
primarily by rising rates of cancer and by higher approval 
rates for filed claims.
---------------------------------------------------------------------------
    \14\See September 11th Victim Compensation Fund, Seventh Annual 
Status Report and Third Annual Reassessment of Policies and Procedures 
(February 2019), https://go.usa.gov/xygNY (PDF, 555 KB).
    \15\That estimate reflects data reported by the VCF about the 
percentage of WTC Health Program enrollees who register with the VCF 
(90 percent), the percentage of VCF registrants who file claims (57 
percent), and the percentage of filed claims that receive awards (75 
percent). CBO estimates that, at each stage, the rate of advancement to 
the next would rise gradually over the ensuing 10 years as a result of 
greater awareness among potential claimants about the opportunity to 
file a claim, increases in the number and severity of illnesses that 
compel people to seek compensation, and a gradual resolution of 
documentation problems that impede award approval.
---------------------------------------------------------------------------
    Award Payments. To estimate future awards from the VCF, CBO 
used data on the number and average amounts of awards for 
different types of claims over the program's history.\16\ CBO 
estimated amounts, on average, since 2017 (as shown in Table 2) 
and in most cases made an upward adjustment for each type of 
award over the 2020-2029 period to account for trends observed 
since 2011.\17\ CBO estimates that the average amount for most 
types would increase by about 0.5 percent annually.
---------------------------------------------------------------------------
    \16\ In addition to accounting for differences between compensation 
for cancer and noncancerous conditions, CBO's analysis accounted for 
differences in the size of awards for economic and noneconomic 
compensation and awards for deceased and living claimants.
    \17\ Notably, CBO estimates that awards for economic losses will 
decrease from 24 percent of new claims in 2020 to 20 percent in 2029 as 
claimants age and leave the workforce, reducing their earnings and 
benefits. As a result, CBO estimates, on average, cancerous and 
noncancerous awards will be lower over the 2020-2029 period than for 
earlier claims because a declining share of awards will include 
compensation for economic losses.
---------------------------------------------------------------------------
    In total, CBO estimates, under H.R. 1327, the VCF would pay 
claims totaling $5.8 billion over the 2020-2029 period, to the 
18,100 claimants who file after the date of enactment (see 
Table 4).
    Administrative Costs. Under current law, the VCF is 
authorized to spend whatever amounts are necessary to carry out 
the program. Because the legislation would extend the period of 
the operation through fiscal year 2090, CBO estimates that H.R. 
1327 would increase direct spending to cover continued 
administrative costs.
    In fiscal year 2018, the VCF spent $28 million to 
compensate 172 employees, maintain the program's software 
system, and provide contractor support. Because of a surge in 
claims late in 2018 and early in 2019, the program is hiring 10 
additional employees to process the backlog.
    Under H.R. 1327, CBO expects, the VCF will operate with 
about 180 employees for the next several years as the program 
processes a significant backlog of claims. Its administrative 
costs are estimated to range from $30 million to $33 million 
each year.
    Uncertainty CBO's cost estimate for H.R. 1327 reflects 
considerable uncertainty in several areas:
           Identifying the number of people affected by 
        the terrorist attacks on September 11, 2001, and the 
        number of people that will seek treatment and 
        compensation for injury or death;
           Comparing incidence rates in the exposed and 
        unexposed populations for adverse health conditions, 
        especially cancer; and
           Estimating both the number of people who 
        ultimately will be approved for compensation and the 
        amount of their awards.
    Filing a Claim With the Victim Compensation Fund. One 
difficulty is projecting the precise rate at which affected 
people will seek treatment from or be monitored by the WTC 
Health Program. CBO expects that many people who were harmed 
will instead seek treatment from other providers or forgo 
treatment of related illnesses and conditions.
    Enrollment in the WTC Health Program is not a prerequisite 
for filing a claim with the VCF, but more than 85 percent of 
VCF registrants have received certification for their 
conditions from that program; participation in the WTC Health 
Program is therefore the primary predictor of VCF claim-filing 
activity.
    If 95 percent of the people who develop health conditions 
participate in the program, compared with the two-thirds (66 
percent) assumed in this estimate, the cost of the legislation 
would increase by $2.6 billion over the 2020-2029 period. 
Conversely, if one-third (33 percent) of that group 
participates, the legislation's costs would be $2.8 billion 
smaller over that period.
    Cancer Incidence. It is not possible to project the degree 
to which cancer incidence rates will differ among people in the 
exposed and unexposed populations. There also is significant 
uncertainty about latency periods between exposure and 
incidence for many forms of cancer.
    If average incidence rates were 30 percent higher among the 
exposed population, compared with the 8 percent higher assumed 
in this estimate, the legislation's cost would be $1.1 billion 
higher over the 2020-2029 period. Conversely, if incidence 
rates were 1 percent higher, the cost of the legislation would 
be $0.3 billion lower over that period.
    Combined Uncertainty Scenarios. Using both high-end 
scenarios described above--95 percent participation in the WTC 
Health Program and 30 percent higher cancer rates--then CBO 
estimates the legislation's cost would increase by $4.1 billion 
over the 2020-2029 period.
    Using both low-end scenarios described above--33 percent 
participation in the WTC Health Program and 1 percent higher 
cancer rates--then CBO estimates the legislation's costs would 
be $3 billion lower over that period.
    Pay-As-You-Go considerations: The Statutory Pay-As-You-Go 
Act of 2010 establishes budget-reporting and enforcement 
procedures for legislation affecting direct spending or 
revenues. The net changes in outlays that are subject to those 
pay-as-you-go procedures are shown in Table 5.

                                             TABLE 5.--CBO'S ESTIMATE OF PAY-AS-YOU-GO EFFECTS OF H.R. 1327
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                    By fiscal year, millions of dollars--
                                                   -----------------------------------------------------------------------------------------------------
                                                     2019   2020   2021    2022    2023    2024   2025   2026   2027   2028   2029  2019-2024  2019-2029
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                               Net Increase in the Deficit
 
Statutory Pay-As-You-Go PEffect...................      0    950   1,387   1,947   1,868    633    643    653    663    703    733     6,785     10,180
--------------------------------------------------------------------------------------------------------------------------------------------------------

    Increase in long-term deficits: CBO estimates that enacting 
the H.R. 1327 would increase on-budget deficits by more than $5 
billion in at least one of the four 10-year periods beginning 
in 2030.
    Mandates: None.
    Estimate comparison: On June 11, 2019, the special master 
of the VCF provided testimony to the Congress indicating that 
the VCF would require $4.616 billion more than the $7.375 
billion currently appropriated for the program to fully pay the 
cost of all eligible claims under current law.\18\ That 
estimate--totaling $11.991 billion--assumes that no more claims 
would be filed after December 18, 2020, the current statutory 
deadline for filing claims. The VCF has not published an 
estimate of the costs to pay claims filed beyond that date 
under a scenario that assumes continuation of the program.
---------------------------------------------------------------------------
    \18\See the testimony of Rupa Bhattacharyya, Special Master, 
September 11th Victim Compensation Fund, before the Subcommittee on the 
Constitution, Civil Rights and Civil Liberties of the House Committee 
on the Judiciary (June 11, 2019), https://go.usa.gov/xyrzh (PDF, 288 
KB). The estimates in that testimony are based on information in 
September 11th Victim Compensation Fund, Seventh Annual Status Report 
and Third Annual Reassessment of Policies and Procedures (February 
2019), https://go.usa.gov/xygNY (PDF, 555 KB).
---------------------------------------------------------------------------
    CBO's estimates of the cost to pay claims and the 
administrative costs of the program are consistent with the 
VCF's estimate through December 20, 2020. CBO's analysis was 
based on data provided by VCF, and CBO made similar assumptions 
about the number and types of claims that would be approved for 
an award up to that date. CBO's estimate of H.R. 1327 differs 
from the VCF's because it also includes the estimated the costs 
of continuing to pay claims beyond December 2020, over the 
entire 2020-2029 period.
    Estimate prepared by: Federal costs: Jon Sperl; Mandates: 
Lilia Ledezma.
    Estimate reviewed by: Kim Cawley, Chief, Natural and 
Physical Resources Cost Estimates Unit; H. Samuel Papenfuss, 
Deputy Assistant Director for Budget Analysis; Theresa Gullo, 
Assistant Director for Budget Analysis.

                    Duplication of Federal Programs

    No provision of H.R. 1327 establishes or reauthorizes a 
program of the federal government known to be duplicative of 
another federal program, a program that was included in any 
report from the Government Accountability Office to Congress 
pursuant to section 21 of Public Law 111-139, or a program 
related to a program identified in the most recent Catalog of 
Federal Domestic Assistance.

                    Performance Goals and Objectives

    The Committee states that pursuant to clause 3(c)(4) of 
rule XIII of the Rules of the House of Representatives, H.R. 
1327 would reauthorize the September 11th Victim Compensation 
Fund until 2090 and fully compensate claimants whose awards 
were cut because of the Fund's current funding insufficiency.

                          Advisory on Earmarks

    In accordance with clause 9 of rule XXI of the Rules of the 
House of Representatives, H.R. 1327 does not contain any 
congressional earmarks, limited tax benefits, or limited tariff 
benefits as defined in clause 9(d), 9(e), or 9(f) of rule XXI.

                    Duplication of Federal Programs

    No provision of H.R. 1327 establishes or reauthorizes a 
program of the federal government known to be duplicative of 
another federal program, a program that was included in any 
report from the Government Accountability Office to Congress 
pursuant to section 21 of Public Law 111-139, or a program 
related to a program identified in the most recent Catalog of 
Federal Domestic Assistance.

                    Performance Goals and Objectives

    The Committee states that pursuant to clause 3(c)(4) of 
rule XIII of the Rules of the House of Representatives, H.R. 
1327 would extend authorization of the September 11th Victim 
Compensation Fund until 2090 and restore awards that were cut 
because of insufficient funds.

                      Section-by-Section Analysis

    The following discussion describes the bill as reported by 
the Committee.
    Section 1. Short title. Section 1 sets forth the bill's 
short title as the ``Never Forget the Heroes: Permanent 
Authorization of the September 11th Victim Compensation Fund 
Act.''
    Section 2. September 11th Victim Compensation Fund of 2001. 
Section 2(a) of the bill amends Section 410 of the Air 
Transportation Safety and System Stabilization Act (``Act''). 
Section 410 of that Act provides, in relevant part, that there 
be a fund created in the United States Treasury called the 
``Victims Compensation Fund'' into which is deposited, among 
other monies, $4.6 billion to be appropriated out of any money 
in the Treasury that is not otherwise appropriated for fiscal 
year 2017, for the purpose of paying claims filed with the 
September 11th Victim Compensation Fund between the time post-
2015 implementing regulations for were updated and 5 years 
after the date of enactment of the 2015 reauthorization bill 
(Dec. 18, 2020) and for which the VCF had not postmarked and 
transmitted a final award determination to the claimant as of 
December 18, 2015. These are referred to in the Act as ``Group 
B'' claims. Section 2(a)(1) of the bill strikes the provision 
appropriating $4.6 billion to pay ``Group B'' claims and 
replaces it with an appropriation for ``such sums as may be 
necessary for fiscal year 2019 and each fiscal year thereafter 
through fiscal year 2090, to remain available through such 
fiscal year.'' This provision is intended to ensure that there 
are sufficient funds available to pay Group B VCF claims for 
the remainder of the authorization period so as to avoid in the 
future the kind of funding deficiency that the VCF is currently 
facing.
    Section 2(a)(2) of the bill amends Section 410(e) of the 
Act, which provides that upon completion of all payments, the 
(Treasury) Victims Compensation Fund shall be permanently 
closed. Section 2(a)(2) of the bill strikes ``Upon completion 
of all payments under this title'' and replaces it with ``On 
October 1, 2090.'' This ensures that the VCF will exist long 
enough to compensate victims whose 9/11-related diseases have 
long latency periods and also comports the VCF's authorization 
period with that of the WTC Health Program.
    Section 2(b) amends Section 405(a)(3)(B) of the Act. 
Section 405(a)(3)(B) provides the timeframe within which claims 
may be filed with the September 11th Victim Compensation Fund. 
Currently, the end date for filing claims is set at 5 years 
after the date of enactment of the James Zadroga 9/11 Victim 
Compensation Fund Reauthorization Act, which would be December 
18, 2020. Section 2(b) strikes this end date and replaces it 
with October 1, 2089, or one year before the 9/11 VCF is set to 
expire under the bill.
    Section 2(c) amends Section 406(d)(2) of the Act. Section 
406(d)(2) currently governs Group B claims, among other things 
by capping the total amount that could be spent on paying Group 
B claims to the $4.6 billion that was appropriated for that 
purpose, including by requiring the Special Master to develop 
policies and procedures to ensure that total expenditures, 
including administrative expenses, do not exceed the $4.6 
billion appropriation and to prioritize claimants who are 
suffering from the most debilitating physical conditions to 
ensure that such claimants are not unduly burdened by such 
policies and procedures. It also requires the Special Master to 
conduct an annual reassessment of agency policies and 
procedures to ensure the VCF's compliance with these 
requirements. If, upon reassessment, such policies or 
procedures do not meet these requirements, the Special Master 
must take such additional actions or make such modifications as 
are necessary to comply with these requirements. Section 
2(c)(1) of the bill strikes the requirement of an annual 
reassessment of policies and procedures and replaces it with a 
requirement of a reassessment for ``not less than once every 5 
years'' after December 18, 2015. Section 2(c)(2) of the bill 
adds a new subsection D to the end of Section 406(d)(2). New 
subsection D provides that with respect to Group B claim awards 
that were subject to reductions because of insufficient funds, 
the Special Master shall, in the first fiscal year when 
sufficient funds become available, pay the difference between 
the amount the claimant was entitled to and the amount the 
claimant was actually paid. This provision is intended to 
address the cuts in awards announced by the Special Master in 
February 2019 due to insufficient funding for the VCF.
    Section 2(d) of the bill amends Section 405(b)(7)(A) of the 
Act. Section 405(b)(7)(A) imposes caps on awards for 
noneconomic losses for Group B claimants. These caps are 
$250,000 for noneconomic losses from any type of cancer and 
$90,000 for any noneconomic losses from conditions other than 
cancer. Section 2(d) of the bill adds a provision allowing the 
Special Master to exceed these limitations for Group B claims 
if the Special Master determines that the pain and suffering of 
the claimant is so excessive as to render the amount of the 
applicable limitation insufficiently compensatory.
    Section 2(e) of the bill amends Section 405(b)(7)(B)(ii) of 
the Act. Section 405(b)(7)(B)(ii) imposes a limitation on the 
calculation of economic losses in determining the amount of an 
award for economic loss. Specifically, it provides that for the 
purpose of calculating each year of any lost earnings or other 
employment benefits, the annual gross income of the claimant 
for each year is capped at $200,000. Section 2(e) of the bill 
amends this annual gross income limitation by requiring the 
Special Master to adjust this $200,000 annual gross income 
limitation not more than once every 5 years by the percentage 
increases in the Consumer Price Index for All Urban Consumers 
for the October preceding the date of adjustment to the October 
that precedes 5 years before the date of the adjustment.

         Changes in Existing Law Made by the Bill, as Reported

    In compliance with clause 3(e) of rule XIII of the Rules of 
the House of Representatives, changes in existing law made by 
the bill, H.R. 1327, as reported, are shown as follows:

         Changes in Existing Law Made by the Bill, as Reported

  In compliance with clause 3(e) of rule XIII of the Rules of 
the House of Representatives, changes in existing law made by 
the bill, as reported, are shown as follows (existing law 
proposed to be omitted is enclosed in black brackets, new 
matter is printed in italic, and existing law in which no 
change is proposed is shown in roman):

         AIR TRANSPORTATION SAFETY AND SYSTEM STABILIZATION ACT



           *       *       *       *       *       *       *
TITLE IV--VICTIM COMPENSATION

           *       *       *       *       *       *       *


SEC. 405. DETERMINATION OF ELIGIBILITY FOR COMPENSATION.

  (a) Filing of Claim.--
          (1) In general.--A claimant may file a claim for 
        compensation under this title with the Special Master. 
        The claim shall be on the form developed under 
        paragraph (2) and shall state the factual basis for 
        eligibility for compensation and the amount of 
        compensation sought.
          (2) Claim form.--
                  (A) In general.--The Special Master shall 
                develop a claim form that claimants shall use 
                when submitting claims under paragraph (1). The 
                Special Master shall ensure that such form can 
                be filed electronically, if determined to be 
                practicable.
                  (B) Contents.--The form developed under 
                subparagraph (A) shall request--
                          (i) information from the claimant 
                        concerning the physical harm that the 
                        claimant suffered, or in the case of a 
                        claim filed on behalf of a decedent 
                        information confirming the decedent's 
                        death, as a result of the terrorist-
                        related aircraft crash es of September 
                        11, 2001, or debris removal during the 
                        immediate aftermath;
                          (ii) information from the claimant 
                        concerning any possible economic and 
                        noneconomic losses that the claimant 
                        suffered as a result of such crashes or 
                        debris removal during the immediate 
                        aftermath; and
                          (iii) information regarding 
                        collateral sources of compensation the 
                        claimant has received or is entitled to 
                        receive as a result of such crashes or 
                        debris removal during the immediate 
                        aftermath.
          (3) Limitation.--
                  (A) In general.--Except as provided by 
                subparagraph (B), no claim may be filed under 
                paragraph (1) after the date that is 2 years 
                after the date on which regulations are 
                promulgated under section 407(a).
                  (B) Exception.--A claim may be filed under 
                paragraph (1), in accordance with subsection 
                (c)(3)(A)(i), by an individual (or by a 
                personal representative on behalf of a deceased 
                individual) during the period beginning on the 
                date on which the regulations are updated under 
                section 407(b)(1) and ending on [the date that 
                is 5 years after the date of enactment of the 
                James Zadroga 9/11 Victim Compensation Fund 
                Reauthorization Act] October 1, 2089.
                  (C) Special master determination.--
                          (i) In general.--For claims filed 
                        under this title during the period 
                        described in subparagraph (B), the 
                        Special Master shall establish a system 
                        for determining whether, for purposes 
                        of this title, the claim is--
                                  (I) a claim in Group A, as 
                                described in clause (ii); or
                                  (II) a claim in Group B, as 
                                described in clause (iii).
                          (ii) Group a claims.--A claim under 
                        this title is a claim in Group A if--
                                  (I) the claim is filed under 
                                this title during the period 
                                described in subparagraph (B); 
                                and
                                  (II) on or before the day 
                                before the date of enactment of 
                                the James Zadroga 9/11 Victim 
                                Compensation Fund 
                                Reauthorization Act, the 
                                Special Master postmarks and 
                                transmits a final award 
                                determination to the claimant 
                                filing such claim.
                          (iii) Group b claims.--A claim under 
                        this title is a claim in Group B if the 
                        claim--
                                  (I) is filed under this title 
                                during the period described in 
                                subparagraph (B); and
                                  (II) is not a claim described 
                                in clause (ii).
                          (iv) Definition of final award 
                        determination.--For purposes of this 
                        subparagraph, the term ``final award 
                        determination'' means a letter from the 
                        Special Master indicating the total 
                        amount of compensation to which a 
                        claimant is entitled for a claim under 
                        this title without regard to the 
                        limitation under the second sentence of 
                        section 406(d)(1), as such section was 
                        in effect on the day before the date of 
                        enactment of the James Zadroga 9/11 
                        Victim Compensation Fund 
                        Reauthorization Act.
  (b) Review and Determination.--
          (1) Review.--The Special Master shall review a claim 
        submitted under subsection (a) and determine--
                  (A) whether the claimant is an eligible 
                individual under subsection (c);
                  (B) with respect to a claimant determined to 
                be an eligible individual--
                          (i) the extent of the harm to the 
                        claimant, including any economic and 
                        noneconomic losses; and
                          (ii) subject to paragraph (7), the 
                        amount of compensation to which the 
                        claimant is entitled based on the harm 
                        to the claimant, the facts of the 
                        claim, and the individual circumstances 
                        of the claimant.
          (2) Negligence.--With respect to a claimant, the 
        Special Master shall not consider negligence or any 
        other theory of liability.
          (3) Determination.--Not later than 120 days after 
        that date on which a claim is filed under subsection 
        (a), the Special Master shall complete a review, make a 
        determination, and provide written notice to the 
        claimant, with respect to the matters that were the 
        subject of the claim under review. Such a determination 
        shall be final and not subject to judicial review.
          (4) Rights of claimant.--A claimant in a review under 
        paragraph (1) shall have--
                  (A) the right to be represented by an 
                attorney;
                  (B) the right to present evidence, including 
                the presentation of witnesses and documents; 
                and
                  (C) any other due process rights determined 
                appropriate by the Special Master.
          (5) No punitive damages.--The Special Master may not 
        include amounts for punitive damages in any 
        compensation paid under a claim under this title.
          (6) Collateral compensation.--
                  (A) In general.--The Special Master shall 
                reduce the amount of compensation determined 
                under paragraph (1)(B)(ii) by the amount of the 
                collateral source compensation the claimant has 
                received or is entitled to receive as a result 
                of the terrorist-related aircraft crashes of 
                September 11, 2001.
                  (B) Group b claims.--Notwithstanding any 
                other provision of this title, in the case of a 
                claim in Group B as described in subsection 
                (a)(3)(C)(iii), a claimant filing such claim 
                shall receive an amount of compensation under 
                this title for such claim that is not greater 
                than the amount determined under paragraph 
                (1)(B)(ii) less the amount of any collateral 
                source compensation that such claimant has 
                received or is entitled to receive for such 
                claim as a result of the terrorist-related 
                aircraft crashes of September 11, 2001.
          (7) Limitations for group b claims.--
                  (A) Noneconomic losses.-- [With respect to]
                          (i) In general._Except as provided in 
                        clause (ii), with respect to  a claim 
                        in Group B as described in subsection 
                        (a)(3)(C)(iii), the total amount of 
                        compensation to which a claimant filing 
                        such claim is entitled to receive for 
                        such claim under this title on account 
                        of any noneconomic loss--
                                  [(i)] (I) that results from 
                                any type of cancer shall not 
                                exceed $250,000; and
                                  [(ii)] (II) that does not 
                                result from any type of cancer 
                                shall not exceed $90,000.
                          (ii) Exception.--The Special Master 
                        may exceed the applicable limitation 
                        under clause (i) for a claim in Group B 
                        as described in subsection 
                        (a)(3)(C)(iii) if the Special Master 
                        determines that the pain and suffering 
                        of the claimant is so excessive as to 
                        render the amount of the applicable 
                        limitation under clause (i) 
                        insufficiently compensatory.
                  (B) Determination of economic loss.--
                          (i) In general.--Subject to the 
                        limitation described in clause (ii) and 
                        with respect to a claim in Group B as 
                        described in subsection (a)(3)(C)(iii), 
                        the Special Master shall, for purposes 
                        of calculating the amount of 
                        compensation to which a claimant is 
                        entitled under this title for such 
                        claim on account of any economic loss, 
                        determine the loss of earnings or other 
                        benefits related to employment by using 
                        the applicable methodology described in 
                        section 104.43 or 104.45 of title 28, 
                        Code of Federal Regulations, as such 
                        Code was in effect on the day before 
                        the date of enactment of the James 
                        Zadroga 9/11 Victim Compensation Fund 
                        Reauthorization Act.
                          (ii) Annual gross income 
                        limitation.-- [In considering]
                                  (I) In general._Subject to 
                                subclause (II), in considering  
                                annual gross income under 
                                clause (i) for the purposes 
                                described in such clause, the 
                                Special Master shall, for each 
                                year of any loss of earnings or 
                                other benefits related to 
                                employment, limit the annual 
                                gross income of the claimant 
                                (or decedent in the case of a 
                                personal representative) for 
                                each such year to an amount 
                                that is not greater than 
                                $200,000.
                                  (II) Adjustment.--The Special 
                                Master shall adjust the amount 
                                of the limitation under 
                                subclause (I) not more 
                                frequently than once every 5 
                                years to reflect the percentage 
                                by which the Consumer Price 
                                Index for All Urban Consumers 
                                published by the Department of 
                                Labor for the month of October 
                                immediately preceding the date 
                                of adjustment exceeds the 
                                Consumer Price Index for All 
                                Urban Consumers published by 
                                the Department of Labor for the 
                                month of October that 
                                immediately precedes the date 
                                that is 5 years before the date 
                                of adjustment.
                  (C) Gross income defined.--For purposes of 
                this paragraph, the term ``gross income'' has 
                the meaning given such term in section 61 of 
                the Internal Revenue Code of 1986.
  (c) Eligibility.--
          (1) In general.--A claimant shall be determined to be 
        an eligible individual for purposes of this subsection 
        if the Special Master determines that such claimant--
                  (A) is an individual described in paragraph 
                (2); and
                  (B) meets the requirements of paragraph (3).
          (2) Individuals.--A claimant is an individual 
        described in this paragraph if the claimant is--
                  (A) an individual who--
                          (i) was present at the World Trade 
                        Center, (New York, New York), the 
                        Pentagon (Arlington, Virginia), the 
                        site of the aircraft crash at 
                        Shanksville, Pennsylvania, or any other 
                        9/11 crash site at the time, or in the 
                        immediate aftermath, of the terrorist-
                        related aircraft crashes of September 
                        11, 2001; and
                          (ii) suffered physical harm or death 
                        as a result of such an air crash or 
                        debris removal;
                  (B) an individual who was a member of the 
                flight crew or a passenger on American Airlines 
                flight 11 or 77 or United Airlines flight 93 or 
                175, except that an individual identified by 
                the Attorney General to have been a participant 
                or conspirator in the terrorist-related 
                aircraft crashes of September 11, 2001, or a 
                representative of such individual shall not be 
                eligible to receive compensation under this 
                title; or
                  (C) in the case of a decedent who is an 
                individual described in subparagraph (A) or 
                (B), the personal representative of the 
                decedent who files a claim on behalf of the 
                decedent.
          (3) Requirements.--
                  (A) Requirements for filing claims during 
                extended filing period.--
                          (i) Timing requirements for filing 
                        claims.--An individual (or a personal 
                        representative on behalf of a deceased 
                        individual) may file a claim during the 
                        period described in subsection 
                        (a)(3)(B) as follows:
                                  (I) In the case that the 
                                Special Master determines the 
                                individual knew (or reasonably 
                                should have known) before the 
                                date specified in clause (iii) 
                                that the individual suffered a 
                                physical harm at a 9/11 crash 
                                site as a result of the 
                                terrorist-related aircraft 
                                crashes of September 11, 2001, 
                                or as a result of debris 
                                removal, and that the 
                                individual knew (or should have 
                                known) before such specified 
                                date that the individual was 
                                eligible to file a claim under 
                                this title, the individual may 
                                file a claim not later than the 
                                date that is 2 years after such 
                                specified date.
                                  (II) In the case that the 
                                Special Master determines the 
                                individual first knew (or 
                                reasonably should have known) 
                                on or after the date specified 
                                in clause (iii) that the 
                                individual suffered such a 
                                physical harm or that the 
                                individual first knew (or 
                                should have known) on or after 
                                such specified date that the 
                                individual was eligible to file 
                                a claim under this title, the 
                                individual may file a claim not 
                                later than the last day of the 
                                2-year period beginning on the 
                                date the Special Master 
                                determines the individual first 
                                knew (or should have known) 
                                that the individual both 
                                suffered from such harm and was 
                                eligible to file a claim under 
                                this title.
                          (ii) Other eligibility requirements 
                        for filing claims.--Except with respect 
                        to claims in Group B as described in 
                        subsection (a)(3)(C)(iii), an 
                        individual may file a claim during the 
                        period described in subsection 
                        (a)(3)(B) only if--
                                  (I) the individual was 
                                treated by a medical 
                                professional for suffering from 
                                a physical harm described in 
                                clause (i)(I) within a 
                                reasonable time from the date 
                                of discovering such harm; and
                                  (II) the individual's 
                                physical harm is verified by 
                                contemporaneous medical records 
                                created by or at the direction 
                                of the medical professional who 
                                provided the medical care.
                          (iii) Date specified.--The date 
                        specified in this clause is the date on 
                        which the regulations are updated under 
                        section 407(b)(1).
                          (iv) Group b claims.--
                                  (I) In general.--Subject to 
                                subclause (II), an individual 
                                filing a claim in Group B as 
                                described in subsection 
                                (a)(3)(C)(iii) may be eligible 
                                for compensation under this 
                                title only if the Special 
                                Master, with assistance from 
                                the WTC Program Administrator 
                                as necessary, determines based 
                                on the evidence presented that 
                                the individual has a WTC-
                                related physical health 
                                condition, as defined by 
                                section 402 of this Act.
                                  (II) Personal 
                                representatives.--An individual 
                                filing a claim in Group B, as 
                                described in subsection 
                                (a)(3)(C)(iii), who is a 
                                personal representative 
                                described in paragraph (2)(C) 
                                may be eligible for 
                                compensation under this title 
                                only if the Special Master, 
                                with assistance from the WTC 
                                Program Administrator as 
                                necessary, determines based on 
                                the evidence presented that the 
                                applicable decedent suffered 
                                from a condition that was, or 
                                would have been determined to 
                                be, a WTC-related physical 
                                health condition, as defined by 
                                section 402 of this Act.
                  (B) Single claim.--Not more than one claim 
                may be submitted under this title by an 
                individual or on behalf of a deceased 
                individual.
                  (C) Limitation on civil action.--
                          (i) In general.--Upon the submission 
                        of a claim under this title, the 
                        claimant waives the right to file a 
                        civil action (or to be a party to an 
                        action) in any Federal or State court 
                        for damages sustained as a result of 
                        the terrorist-related aircraft crashes 
                        of September 11, 2001, or for damages 
                        arising from or related to debris 
                        removal. The preceding sentence does 
                        not apply to a civil action to recover 
                        collateral source obligations, or to a 
                        civil action against any person who is 
                        a knowing participant in any conspiracy 
                        to hijack any aircraft or commit any 
                        terrorist act.
                          (ii) Pending actions.--In the case of 
                        an individual who is a party to a civil 
                        action described in clause (i), such 
                        individual may not submit a claim under 
                        this title--
                                  (I) during the period 
                                described in subsection 
                                (a)(3)(A) unless such 
                                individual withdraws from such 
                                action by the date that is 90 
                                days after the date on which 
                                regulations are promulgated 
                                under section 407(a); and
                                  (II) during the period 
                                described in subsection 
                                (a)(3)(B) unless such 
                                individual withdraws from such 
                                action by the date that is 90 
                                days after the date on which 
                                the regulations are updated 
                                under section 407(b)(1).
                          (iii) Settled actions.--In the case 
                        of an individual who settled a civil 
                        action described in clause (i), such 
                        individual may not submit a claim under 
                        this title unless such action was 
                        commenced after December 22, 2003, and 
                        a release of all claims in such action 
                        was tendered prior to the date on which 
                        the James Zadroga 9/11 Health and 
                        Compensation Act of 2010 was enacted.

SEC. 406. PAYMENTS TO ELIGIBLE INDIVIDUALS.

  (a) In General.--Subject to the limitations under subsection 
(d), not later than 20 days after the date on which a 
determination is made by the Special Master regarding the 
amount of compensation due a claimant under this title, the 
Special Master shall authorize payment to such claimant of the 
amount determined with respect to the claimant.
  (b) Payment Authority.--For the purpose of providing 
compensation for claims in Group A as described in section 
405(a)(3)(C)(ii), this title constitutes budget authority in 
advance of appropriations Acts in the amounts provided under 
subsection (d)(1) and represents the obligation of the Federal 
Government to provide for the payment of amounts for 
compensation under this title subject to the limitations under 
subsection (d).
  (c) Additional Funding.--
          (1) In general.--The Attorney General is authorized 
        to accept such amounts as may be contributed by 
        individuals, business concerns, or other entities to 
        carry out this title, under such terms and conditions 
        as the Attorney General may impose.
          (2) Use of separate account.--In making payments 
        under this section, amounts contained in any account 
        containing funds provided under paragraph (1) shall be 
        used prior to using appropriated amounts.
  (d) Limitations.--
          (1) Group a claims.--
                  (A) In general.--The total amount of Federal 
                funds paid for compensation under this title, 
                with respect to claims in Group A as described 
                in section 405(a)(3)(C)(ii), shall not exceed 
                $2,775,000,000.
                  (B) Remainder of claim amounts.--In the case 
                of a claim in Group A as described in section 
                405(a)(3)(C)(ii) and for which the Special 
                Master has ratably reduced the amount of 
                compensation for such claim pursuant to 
                paragraph (2) of this subsection, as this 
                subsection was in effect on the day before the 
                date of enactment of the James Zadroga 9/11 
                Victim Compensation Fund Reauthorization Act, 
                the Special Master shall, as soon as 
                practicable after the date of enactment of such 
                Act, authorize payment of the amount of 
                compensation that is equal to the difference 
                between--
                          (i) the amount of compensation that 
                        the claimant would have been paid under 
                        this title for such claim without 
                        regard to the limitation under the 
                        second sentence of paragraph (1) of 
                        this subsection, as this subsection was 
                        in effect on the day before the date of 
                        enactment of the James Zadroga 9/11 
                        Victim Compensation Fund 
                        Reauthorization Act; and
                          (ii) the amount of compensation the 
                        claimant was paid under this title for 
                        such claim prior to the date of 
                        enactment of such Act.
          (2) Group b claims.--
                  (A) In general.--The total amount of Federal 
                funds paid for compensation under this title, 
                with respect to claims in Group B as described 
                in section 405(a)(3)(C)(iii), shall not exceed 
                the amount of funds deposited into the Victims 
                Compensation Fund under section 410.
                  (B) Payment system.--The Special Master shall 
                establish a system for providing compensation 
                for claims in Group B as described in section 
                405(a)(3)(C)(iii) in accordance with this 
                subsection and section 405(b)(7).
                  (C) Development of agency policies and 
                procedures.--
                          (i) Development.--
                                  (I) In general.--Not later 
                                than 30 days after the date of 
                                enactment of the James Zadroga 
                                9/11 Victim Compensation Fund 
                                Reauthorization Act, the 
                                Special Master shall develop 
                                agency policies and procedures 
                                that meet the requirements 
                                under subclauses (II) and (III) 
                                for providing compensation for 
                                claims in Group B as described 
                                in section 405(a)(3)(C)(iii), 
                                including policies and 
                                procedures for presumptive 
                                award schedules, administrative 
                                expenses, and related internal 
                                memoranda.
                                  (II) Limitation.--The 
                                policies and procedures 
                                developed under subclause (I) 
                                shall ensure that total 
                                expenditures, including 
                                administrative expenses, in 
                                providing compensation for 
                                claims in Group B, as described 
                                in section 405(a)(3)(C)(iii), 
                                do not exceed the amount of 
                                funds deposited into the 
                                Victims Compensation Fund under 
                                section 410.
                                  (III) Prioritization.--The 
                                policies and procedures 
                                developed under subclause (I) 
                                shall prioritize claims for 
                                claimants who are determined by 
                                the Special Master as suffering 
                                from the most debilitating 
                                physical conditions to ensure, 
                                for purposes of equity, that 
                                such claimants are not unduly 
                                burdened by such policies or 
                                procedures.
                          (ii) Reassessment.--Beginning 1 year 
                        after the date of enactment of the 
                        James Zadroga 9/11 Victim Compensation 
                        Fund Reauthorization Act, and [each 
                        year thereafter] not less than once 
                        every 5 years thereafter until the 
                        Victims Compensation Fund is 
                        permanently closed under section 
                        410(e), the Special Master shall 
                        conduct a reassessment of the agency 
                        policies and procedures developed under 
                        clause (i) to ensure that such policies 
                        and procedures continue to satisfy the 
                        requirements under subclauses (II) and 
                        (III) of such clause. If the Special 
                        Master determines, upon reassessment, 
                        that such agency policies or procedures 
                        do not achieve the requirements of such 
                        subclauses, the Special Master shall 
                        take additional actions or make such 
                        modifications as necessary to achieve 
                        such requirements.
                  (D) Compensation reduced by special master 
                due to insufficient funding.--
                          (i) In general.--With respect to any 
                        claim in Group B as described in 
                        section 405(a)(3)(C)(iii) for which, 
                        prior to the date of enactment of this 
                        subparagraph, the Special Master had 
                        advised the claimant that the amount of 
                        compensation for such claim has been 
                        reduced on the basis of insufficient 
                        funding, the Special Master shall, in 
                        the first fiscal year following such 
                        date of enactment that sufficient 
                        funding becomes available under this 
                        title, pay to the claimant an amount 
                        that is, as determined by the Special 
                        Master, equal to the difference 
                        between--
                                  (I) the amount the claimant 
                                would have been paid under this 
                                title if sufficient funding was 
                                available to the Special Master 
                                at the time the Special Master 
                                determined the amount due the 
                                claimant under this title; and
                                  (II) the amount the claimant 
                                was paid under this title.
                          (ii) Definitions.--For purposes of 
                        this subparagraph:
                                  (I) Insufficient funding.--
                                The term ``insufficient 
                                funding'' means funding--
                                          (aa) that is 
                                        available to the 
                                        Special Master under 
                                        section 410(c), as in 
                                        effect on the day 
                                        before the date of 
                                        enactment of this 
                                        subparagraph, for 
                                        purposes of 
                                        compensating claims in 
                                        Group B as described in 
                                        section 
                                        405(a)(3)(C)(iii); and
                                          (bb) that the Special 
                                        Master determines is 
                                        insufficient for 
                                        purposes of 
                                        compensating all such 
                                        claims and complying 
                                        with subparagraph (A).
                                  (II) Sufficient funding.--The 
                                term ``sufficient funding'' 
                                means funding--
                                          (aa) made available 
                                        to the Special Master 
                                        for purposes of 
                                        compensating claims in 
                                        Group B as described in 
                                        section 
                                        405(a)(3)(C)(iii) 
                                        through an Act of 
                                        Congress that is 
                                        enacted after the date 
                                        on which the amount of 
                                        the claim described in 
                                        clause (i) has been 
                                        reduced; and
                                          (bb) that the Special 
                                        Master determines is 
                                        sufficient for purposes 
                                        of compensating all 
                                        claims in such Group B.
  (e) Attorney Fees.--
          (1) In general.--Notwithstanding any contract, the 
        representative of an individual may not charge, for 
        services rendered in connection with the claim of an 
        individual under this title, more than 10 percent of an 
        award made under this title on such claim.
          (2) Limitation.--
                  (A) In general.--Except as provided in 
                subparagraph (B), in the case of an individual 
                who was charged a legal fee in connection with 
                the settlement of a civil action described in 
                section 405(c)(3)(C)(iii), the representative 
                of the individual may not charge any amount for 
                compensation for services rendered in 
                connection with a claim filed under this title.
                  (B) Exception.--If the legal fee charged in 
                connection with the settlement of a civil 
                action described in section 405(c)(3)(C)(iii) 
                of an individual is less than 10 percent of the 
                aggregate amount of compensation awarded to 
                such individual through such settlement, the 
                representative of such individual may charge an 
                amount for compensation for services rendered 
                to the extent that such amount charged is not 
                more than--
                          (i) 10 percent of such aggregate 
                        amount through the settlement, minus
                          (ii) the total amount of all legal 
                        fees charged for services rendered in 
                        connection with such settlement.
          (3) Discretion to lower fee.--In the event that the 
        special master finds that the fee limit set by 
        paragraph (1) or (2) provides excessive compensation 
        for services rendered in connection with such claim, 
        the Special Master may, in the discretion of the 
        Special Master, award as reasonable compensation for 
        services rendered an amount lesser than that permitted 
        for in paragraph (1).

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SEC. 410. VICTIMS COMPENSATION FUND.

  (a) In General.--There is established in the Treasury of the 
United States a fund to be known as the ``Victims Compensation 
Fund'', consisting of amounts deposited into such fund under 
subsection (b).
  (b) Deposits Into Fund.--There shall be deposited into the 
Victims Compensation Fund each of the following:
          (1) Effective on the day after the date on which all 
        claimants who file a claim in Group A, as described in 
        section 405(a)(3)(C)(ii), have received the full 
        compensation due such claimants under this title for 
        such claim, any amounts remaining from the total amount 
        made available under section 406 to compensate claims 
        in Group A as described in section 405(a)(3)(C)(ii).
          (2) The amount appropriated under subsection (c).
  (c) Appropriations.--There is appropriated, out of any money 
in the Treasury not otherwise appropriated, [$4,600,000,000 for 
fiscal year 2017, to remain available until expended] such sums 
as may be necessary for fiscal year 2019 and each fiscal year 
thereafter through fiscal year 2090, to remain available 
through such fiscal year , to provide compensation for claims 
in Group B as described in section 405(a)(3)(C)(iii).
  (d) Availability of Funds.--Amounts deposited into the 
Victims Compensation Fund shall be available, without further 
appropriation, to the Special Master to provide compensation 
for claims in Group B as described in section 
405(a)(3)(C)(iii).
  (e) Termination.-- [Upon completion of all payments under 
this title] On October 1, 2090 , the Victims Compensation Fund 
shall be permanently closed.

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