[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4249 Introduced in House (IH)]

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118th CONGRESS
  1st Session
                                H. R. 4249

  To amend title 38, United States Code, to furnish hospital care and 
   medical services to veterans and dependents who were stationed at 
   military installations at which the veterans and dependents were 
  exposed to perfluorooctanoic acid or other per- and polyfluoroalkyl 
  substances, to provide for a presumption of service connection for 
certain veterans who were stationed at military installations at which 
 the veterans were exposed to such substances, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             June 21, 2023

Mr. Kildee (for himself, Mr. Lawler, Mrs. Dingell, Mr. Fitzpatrick, Ms. 
Slotkin, Mr. Posey, Ms. Tlaib, Ms. Stevens, Mr. Boyle of Pennsylvania, 
  Ms. Dean of Pennsylvania, Mr. Khanna, Ms. DelBene, Mr. Kilmer, Mr. 
   Carson, Ms. Lee of California, Ms. Ross, Mr. Neal, Ms. Titus, Mr. 
  McGovern, Mr. Grijalva, Mr. Gottheimer, Ms. Kuster, Mr. Schiff, Ms. 
  Porter, and Ms. Pettersen) introduced the following bill; which was 
             referred to the Committee on Veterans' Affairs

_______________________________________________________________________

                                 A BILL


 
  To amend title 38, United States Code, to furnish hospital care and 
   medical services to veterans and dependents who were stationed at 
   military installations at which the veterans and dependents were 
  exposed to perfluorooctanoic acid or other per- and polyfluoroalkyl 
  substances, to provide for a presumption of service connection for 
certain veterans who were stationed at military installations at which 
 the veterans were exposed to such substances, and for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Veterans Exposed to Toxic PFAS Act'' 
or the ``VET PFAS Act''.

SEC. 2. HOSPITAL CARE AND MEDICAL SERVICES FOR VETERANS AND DEPENDENTS 
              EXPOSED TO PERFLUOROOCTANOIC ACID AND OTHER PER- AND 
              POLYFLUOROALKYL SUBSTANCES.

    (a) Hospital Care and Medical Services for Veterans.--
            (1) In general.--Paragraph (1) of section 1710(e) of title 
        38, United States Code, is amended by adding at the end the 
        following new subparagraph:
    ``(J)(i) Beginning on the date that is 90 days after the date of 
the enactment of this subparagraph, subject to paragraph (2), a veteran 
who served on active duty in the Armed Forces at a covered military 
installation at which individuals were exposed to substances specified 
in clause (ii) is eligible for hospital care and medical services under 
subsection (a)(2)(F) for the diseases, illnesses, or conditions as 
specified in such clause, notwithstanding that there is insufficient 
medical evidence to conclude that such illness or condition is 
attributable to such service.
    ``(ii) The substances and diseases, illnesses, or conditions 
specified in this clause are the following:
            ``(I) With respect to exposure to perfluorooctanoic acid--
                    ``(aa) diagnosed high cholesterol;
                    ``(bb) ulcerative colitis;
                    ``(cc) thyroid disease;
                    ``(dd) testicular cancer;
                    ``(ee) kidney cancer; and
                    ``(ff) pregnancy-induced hypertension.
            ``(II) With respect to exposure to other per- and 
        polyfluoroalkyl substances, any disease, illness, or condition 
        that the Secretary of Veterans Affairs, in consultation with 
        the Administrator of the Agency for Toxic Substances and 
        Disease Registry of the Department of Health and Human 
        Services, determines pursuant to the study conducted under 
        section 316 of the National Defense Authorization Act for 
        Fiscal Year 2018 (Public Law 115-91) that a positive 
        association exists between exposure to per- and polyfluoroalkyl 
        substances and such disease, illness, or condition.
    ``(iii) For purposes of this subparagraph, any service by a member 
of the reserve components for a period specified by the Secretary at a 
covered military installation at which individuals were exposed to 
substances specified in clause (ii) shall be treated as active duty 
service, notwithstanding section 101(21) of this title.
    ``(iv) In this subparagraph, the term `covered military 
installation' means a military installation at which individuals were 
exposed to perfluorooctanoic acid or other per- and polyfluoroalkyl 
substances, including exposure through a well that provides water for 
human consumption that is contaminated with such substances.''.
            (2) Limitation.--Paragraph (2)(B) of such section is 
        amended by striking ``or (I)'' and inserting ``(I), or (J)''.
    (b) Family Members.--
            (1) In general.--Subchapter VIII of chapter 17 is amended 
        by adding at the end the following new section:
``Sec. 1787A. Health care of family members of veterans stationed at 
              certain military installations
    ``(a) In General.--Beginning on the date that is 90 days after the 
date of the enactment of this section, subject to subsection (b), a 
family member of a veteran described in clause (i) of section 
1710(e)(1)(J) of this title (or who would be so described but for the 
condition by which the individual was discharged or released from the 
Armed Forces) who resided at a military installation covered by such 
clause or who was in utero while the mother of such family member 
resided at such location shall be eligible for hospital care and 
medical services furnished by the Secretary for any disease, illness, 
or condition for which a veteran may receive hospital care and medical 
services under clause (ii) of such section, notwithstanding that there 
is insufficient medical evidence to conclude that such disease, 
illness, or condition is attributable to such residence.
    ``(b) Limitations.--(1) The Secretary may only furnish hospital 
care and medical services under subsection (a) to the extent and in the 
amount provided in advance in appropriations Acts for such purpose.
    ``(2) Hospital care and medical services may not be furnished under 
subsection (a) for a disease, illness, or condition of a family member 
that is found, in accordance with guidelines issued by the Under 
Secretary for Health, to have resulted from a cause other than the 
residence of the family member described in that subsection.
    ``(3) The Secretary may provide reimbursement for hospital care or 
medical services provided to a family member under this section only 
after the family member or the provider of such care or services has 
exhausted without success all claims and remedies reasonably available 
to the family member or provider against a third party (as defined in 
section 1725(f) of this title) for payment of such care or services, 
including with respect to health-plan contracts (as defined in such 
section).''.
            (2) Clerical amendment.--The table of sections at the 
        beginning of such chapter is amended by inserting after the 
        item relating to section 1787 the following new item:

``1787A. Health care of family members of veterans stationed at certain 
                            military installations.''.
    (c) Annual Reports.--
            (1) In general.--During the three-year period beginning in 
        the year in which the study conducted under section 316 of the 
        National Defense Authorization Act for Fiscal Year 2018 (Public 
        Law 115-91) is submitted to Congress, the Secretary of Veterans 
        Affairs shall submit to the Committee on Veterans' Affairs of 
        the Senate and the Committee on Veterans' Affairs of the House 
        of Representatives an annual report on the care and services 
        provided under sections 1710(e)(1)(J) and 1787A of title 38, 
        United States Code (as added by subsections (a) and (b)(1), 
        respectively).
            (2) Elements.--Each report under paragraph (1) shall set 
        forth the following:
                    (A) The number of veterans and family members 
                provided hospital care and medical services under the 
                provisions of law specified in paragraph (1) during the 
                period covered by the report.
                    (B) The illnesses, conditions, and disabilities for 
                which care and services have been provided such 
                veterans and family members under such provisions of 
                law during that period.
                    (C) The number of veterans and family members who 
                applied for care and services under such provisions of 
                law during that period but were denied, including 
                information on the reasons for such denials.
                    (D) The number of veterans and family members who 
                applied for care and services under such provisions of 
                law and are awaiting a decision from the Secretary on 
                eligibility for such care and services as of the date 
                of such report.
            (3) Veteran defined.--In this subsection, the term 
        ``veteran'' includes a former member of the reserve components 
        of the Armed Forces covered by such section 1710(e)(1)(J).

SEC. 3. PRESUMPTION OF SERVICE CONNECTION FOR CERTAIN VETERANS EXPOSED 
              TO PERFLUOROOCTANOIC ACID OR OTHER PER- AND 
              POLYFLUOROALKYL SUBSTANCES.

    (a) In General.--Chapter 11 of title 38, United States Code, is 
amended by inserting after section 1116B the following new section:
``Sec. 1116C. Presumption of service connection for certain veterans 
              exposed to perfluorooctanoic acid or other per- and 
              polyfluoroalkyl substances
    ``(a) Presumption of Service Connection.--(1) For the purposes of 
section 1110 of this title, and subject to section 1113 of this title, 
each disease or illness specified in subsection (b) that becomes 
manifest in a veteran described in paragraph (2) shall be considered to 
have been incurred or aggravated in the line of duty in the active 
military, naval, or air service, notwithstanding that there is no 
record of evidence of such disease or illness during the period of such 
service.
    ``(2) A veteran described in this paragraph is a veteran who, 
during active military, naval, or air service, served at a military 
installation at which individuals were exposed to perfluorooctanoic 
acid or other per- and polyfluoroalkyl substances, including exposure 
through a well that provides water for human consumption that is 
contaminated with such substances.
    ``(b) Diseases or Illnesses.--A disease or illness specified in 
this subsection is any of the following:
            ``(1) With respect to exposure to perfluorooctanoic acid--
                    ``(A) diagnosed high cholesterol;
                    ``(B) ulcerative colitis;
                    ``(C) thyroid disease;
                    ``(D) testicular cancer;
                    ``(E) kidney cancer; and
                    ``(F) pregnancy-induced hypertension.
            ``(2) With respect to exposure to other per- and 
        polyfluoroalkyl substances, any other disease, illness, or 
        condition that the Secretary of Veterans Affairs, in 
        consultation with the Administrator of the Agency for Toxic 
        Substances and Disease Registry of the Department of Health and 
        Human Services, determines pursuant to the study conducted 
        under section 316 of the National Defense Authorization Act for 
        Fiscal Year 2018 (Public Law 115-91) that a positive 
        association exists between exposure to per- and polyfluoroalkyl 
        substances and such disease or illness.
    ``(c) Active Military, Naval, or Air Service.--For purposes of this 
section, any service by a member of the reserve components for a period 
specified by the Secretary at a military installation described in 
subsection (a)(2) shall be treated as active military, naval, or air 
service, notwithstanding section 101(24) of this title.''.
    (b) Clerical Amendment.--The table of sections at the beginning of 
such chapter is amended by inserting after the item relating to section 
1116B the following new item:

``1116C. Presumption of service connection for certain veterans exposed 
                            to perfluorooctanoic acid or other per- and 
                            polyfluoroalkyl substances.''.
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