[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[S. 2294 Introduced in Senate (IS)]

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118th CONGRESS
  1st Session
                                S. 2294

  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 those veterans and dependents were 
     exposed to perfluorooctanoic acid or other perfluoroalkyl and 
  polyfluoroalkyl substances, to provide for a presumption of service 
    connection for certain veterans who were stationed at military 
installations at which those veterans were exposed to such substances, 
                        and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             July 13, 2023

 Ms. Stabenow (for herself, Mr. Peters, Mr. Casey, and Mr. Fetterman) 
introduced the following bill; which was read twice and 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 those veterans and dependents were 
     exposed to perfluorooctanoic acid or other perfluoroalkyl and 
  polyfluoroalkyl substances, to provide for a presumption of service 
    connection for certain veterans who were stationed at military 
installations at which those 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 
              PERFLUOROALKYL 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 disease, 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 perfluoroalkyl and 
        polyfluoroalkyl substances not specified in subclause (I), any 
        disease, illness, or condition that the Secretary, 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(a) of the National Defense Authorization Act 
        for Fiscal Year 2018 (Public Law 115-91; 131 Stat. 1350) that a 
        positive association exists between exposure to perfluoroalkyl 
        and polyfluoroalkyl substances and such disease, illness, or 
        condition.
    ``(iii) For purposes of this subparagraph, any service by a member 
of the reserve components of the Armed Forces 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 perfluoroalkyl 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 of title 38, 
        United States Code, is amended by inserting after section 1787 
        the following new section:
``Sec. 1787A. Health care of family members of veterans stationed at 
              certain military installations with PFAS contamination
    ``(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 covered military installation (as 
defined in clause (iv) of such section) 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(h) 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 subchapter 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 with PFAS 
                            contamination.''.
    (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; 131 Stat. 1350) 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)(1) 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 section 1710(e)(1)(J) of title 
        38, United States Code, as added by subsection (a)(1).

SEC. 3. PRESUMPTION OF SERVICE CONNECTION FOR CERTAIN VETERANS EXPOSED 
              TO PERFLUOROOCTANOIC ACID OR OTHER PERFLUOROALKYL 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 perfluoroalkyl 
              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, air, or space 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, air, or space service, served at a 
military installation at which individuals were exposed to 
perfluorooctanoic acid or other perfluoroalkyl 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 perfluoroalkyl and 
        polyfluoroalkyl substances not specified in paragraph (1), any 
        other disease, illness, or condition that the Secretary, 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; 131 Stat. 1350) that a 
        positive association exists between exposure to perfluoroalkyl 
        and polyfluoroalkyl substances and such disease or illness.
    ``(c) Active Military, Naval, Air, or Space 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, air, or space 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 
                            perfluoroalkyl and polyfluoroalkyl 
                            substances.''.
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