[Congressional Record Volume 171, Number 62 (Monday, April 7, 2025)]
[House]
[Pages H1435-H1437]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




             VIETNAM VETERANS LIVER FLUKE CANCER STUDY ACT

  Mr. BOST. Mr. Speaker, I move to suspend the rules and pass the bill 
(H.R. 586) to direct the Secretary of Veterans Affairs to study and 
report on the prevalence of cholangiocarcinoma in veterans who served 
in the Vietnam theater of operations during the Vietnam era, and for 
other purposes, as amended.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                                H.R. 586

       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 ``Vietnam Veterans Liver Fluke 
     Cancer Study Act''.

     SEC. 2. STUDY ON THE PREVALENCE OF CHOLANGIOCARCINOMA IN 
                   VETERANS WHO SERVED IN THE VIETNAM THEATER OF 
                   OPERATIONS DURING THE VIETNAM ERA.

       (a) Epidemiological Study.--Not later than 120 days after 
     the date of enactment of this Act, the Secretary of Veterans 
     Affairs, in consultation with the Director of the Centers for 
     Disease Control and Prevention of the Department of Health 
     and Human Services, shall commence an epidemiological study 
     on the prevalence of cholangiocarcinoma in covered veterans 
     of the Vietnam era, using data from the Veterans Affairs 
     Central Cancer Registry and the National Program of Cancer 
     Registries. The study shall include--
       (1) an identification of the rate of incidence of 
     cholangiocarcinoma in covered veterans of the Vietnam era and 
     in residents of the United States, from the beginning of the 
     Vietnam era to the date of enactment of this Act; and
       (2) for each of the groups specified in paragraph (1), an 
     identification of the percentage of individuals with 
     cholangiocarcinoma by various demographic characteristics, 
     including by age, gender, race, ethnicity, and the geographic 
     location of the patient at the time of diagnosis.
       (b) Reports to Congress.--
       (1) Initial report.--Not later than one year after the 
     completion of the study under subsection (a), the Secretary 
     shall submit to Congress a report containing--
       (A) the results of the study under subsection (a); and
       (B) recommendations for administrative or legislative 
     actions required to address issues identified in the study 
     under subsection (a).
       (2) Follow-up reports.--The Secretary shall periodically 
     submit to the Congress a follow-up reports, as determined by 
     the Secretary, to provide updates to the information included 
     in the initial report under paragraph (1) and information 
     collected pursuant to subsection (c).
       (c) Continued Tracking of Cholangiocarcinoma in Covered 
     Veterans of the Vietnam Era.--The Secretary shall track the 
     prevalence of cholangiocarcinoma in covered veterans of the 
     Vietnam era using

[[Page H1436]]

     the Veterans Affairs Central Cancer Registry, and provide 
     such information to Congress in follow-up reports submitted 
     under subsection (b)(2).
       (d) Definitions.--In this section:
       (1) The term ``Vietnam era'' has the meaning given such 
     term in section 101 of title 38, United States Code.
       (2) The term ``covered veterans of the Vietnam era'' means 
     veterans who served in the Vietnam theater of operations 
     during the Vietnam era.

     SEC. 3. EXTENSION OF CERTAIN LIMITATION OF PENSION PAYMENTS.

       Section 5503(d)(7) of title 38, United States Code, is 
     amended by striking ``November 30, 2031'' and inserting 
     ``December 31, 2031''.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
Illinois (Mr. Bost) and the gentleman from California (Mr. Takano) each 
will control 20 minutes.
  The Chair recognizes the gentleman from Illinois.


                             General Leave

  Mr. BOST. Mr. Speaker, I ask unanimous consent that all Members have 
5 legislative days in which to revise and extend their remarks on H.R. 
586, as amended.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Illinois?
  There was no objection.
  Mr. BOST. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I rise today in support of H.R. 586, as amended, offered 
by Representative LaLota from New York, my friend and fellow veteran.
  Representative LaLota's bill would require VA to conduct a study and 
produce a report on the frequency of bile duct cancer for veterans who 
served in and around the Vietnam war.
  Mr. Speaker, it goes without saying that many Vietnam veterans 
suffered greatly in service to their country. Thousands of Vietnam 
veterans still live with invisible and visible wounds of war today.
  My own uncle is one of them. He served in Vietnam and, like so many 
others, suffered debilitating injuries from his service. Sadly, many 
never received the treatment or recognition they deserved when they 
came home.
  Today, we are still learning about the full extent of the health 
risks these veterans faced, some of which weren't understood at the 
time.
  One risk may have come from something as simple and routine as eating 
local food during their deployment. Certain uncooked fish consumed in 
Southeast Asia are known to carry a parasite called a liver fluke. The 
parasite can cause infection and long-term scarring that may lead to 
bile duct cancer. This is a rare but serious illness here in the U.S. 
and one more commonly found in the region where our veterans served.
  This bill would require VA to study whether bile duct cancer is 
linked to service in Vietnam and whether this rare condition should be 
considered service-connected.
  One of VA's most important missions is to care for the injuries 
veterans sustain while they serve this country. This study would help 
uphold that sacred obligation.
  Mr. Speaker, I thank my fellow veteran, Mr. LaLota, for his 
leadership on this bill on behalf of our veterans. I urge my colleagues 
to support H.R. 586, as amended.
  Mr. Speaker, I reserve the balance of my time.
  Mr. TAKANO. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I rise to express my support for H.R. 586, the Vietnam 
Veterans Liver Fluke Cancer Study Act, as amended.
  Liver fluke is a serious parasitic infection that is a well-
recognized risk factor for the development of bile duct cancer.
  H.R. 586, as amended, would require VA, in consultation with the 
Centers for Disease Control and Prevention, to commence an 
epidemiological study on the prevalence of bile duct cancer in veterans 
who served in the Vietnam war versus their nonveteran U.S. resident 
counterparts.
  This legislation requires VA to submit a report with the results of 
the study broken out by age, gender, race, ethnicity, and geographic 
location.
  I certainly understand why Vietnam war veterans would be concerned 
about their exposure to this disease and believe we should do 
everything possible to ensure veterans have access to care and 
treatment for diseases they may have been exposed to as a part of their 
service. However, I must note that the context in which we are 
considering this legislation is vastly different than the last time the 
bill was considered by the House just under 7 months ago.
  In fact, under Secretary Kennedy's leadership in the past week, the 
CDC, or Centers for Disease Control, has cut 18 percent of its 
workforce. Many of these roles have been in global and environmental 
health roles, which means the individuals in offices best suited to 
assist with the requirements of this bill may no longer even exist at 
the CDC.
  Vietnam war veterans deserve answers about their health and access to 
the best treatments. Under this administration's chaotic and damaging 
workforce cuts across all sectors of government, it will be harder than 
ever to get these answers.
  I will support this bill today, but I urge my colleagues to consider 
that implementation of this bill will be harder than it needs to be in 
the new CDC workforce realities that we are now in. These workforce 
cuts have real and lasting consequences, including for our veterans.
  In addition, while I support the underlying goals of this measure, I 
must express concern over the majority's decision to offset its cost by 
diverting pension payments from some of the VA's oldest and sickest 
veterans.
  The VA pension programs exist specifically to assist our most 
vulnerable veterans and their survivors. Slashing these benefits, 
particularly when other support systems are also under threat, poses a 
significant risk for those who rely on them most.
  I recognize that this offset has been employed historically and in 
some form since the 1960s. However, in light of this administration's 
ongoing efforts, enabled by a complacent Republican-led Congress, to 
systematically weaken VA, we must reevaluate whether it remains 
appropriate to rely on this offset. I believe it would be prudent to 
discuss with the Senate whether a more appropriate offset can be 
identified before this bill becomes law.
  Mr. Speaker, with those caveats I have identified, I support this 
legislation, and I ask my colleagues to do the same.
  Mr. Speaker, I reserve the balance of my time.
  Mr. BOST. Mr. Speaker, I yield such time as he may consume to the 
gentleman from New York (Mr. LaLota), the sponsor of this bill.

  Mr. LaLOTA. Mr. Speaker, I thank the chairman for yielding.
  Mr. Speaker, a weekend or two ago in Suffolk County, I stood with 
nearly 1,000 Long Islanders at a Vietnam war Veterans Day ceremony. The 
theme of the day was simple but powerful: Welcome home.
  Welcome home after serving in a war that was unpopular at home.
  Welcome home after surviving brutal jungle and guerrilla warfare.
  Welcome home after losing more than 58,000 brothers and sisters in 
arms.
  Welcome home to a nation and a healthcare system that wasn't ready to 
care for your wounds, seen and unseen.
  Today, Vietnam veterans across my district and across the country are 
still fighting. This time, the enemy isn't on a battlefield overseas. 
It is a silent killer, bile duct cancer, caused by a parasite known as 
the liver fluke.
  Multiple studies have confirmed what these veterans have suspected 
for decades. Those who served in Vietnam face a much higher risk of 
contracting, suffering from, and dying from this disease.
  Here is the most disappointing part, Mr. Speaker. The Department of 
Veterans Affairs continues to hide behind a familiar excuse: We don't 
have enough data.
  Let me tell you what we do have. In 2018, the Northport VA Medical 
Center on Long Island, right in the heart of my district, conducted the 
first of its kind study on this issue. From a small sample of 50 
Vietnam veterans, 24 percent tested positive for exposure to the liver 
fluke parasite.
  That study raised the alarm and called for further research, 
standardized treatment, and expanded access to care for affected 
veterans at VA facilities across the country.
  Instead of urgent action, we got bureaucratic delay. It wasn't until 
2024, 6 years later, that a second followup study was finally 
completed. What did

[[Page H1437]]

it find? Exactly what our veterans had been saying all along. Marines 
who served in Vietnam were 30 percent more likely to die from this 
disease than those who served elsewhere.
  Still, the VA refuses to acknowledge this as a service-connected 
condition. Mr. Speaker, that is unacceptable.
  We have seen this pattern before with Agent Orange, the blue water 
Navy, and now, again, with liver fluke: Delay, denial, deflection.
  In response, I introduced H.R. 4424, the Vietnam Veterans Liver Fluke 
Cancer Study Act, a bipartisan bill requiring the VA, in partnership 
with the CDC, to conduct a nationwide study and finally confront the 
truth: Bile duct cancer caused by the liver fluke parasite is a 
service-related illness.
  Since the VA won't act, Congress must because our Vietnam veterans 
deserve more than parades and speeches. They deserve answers, care, and 
our action.
  Mr. Speaker, every day we wait, more veterans die without the care 
they deserve. Let's not repeat the failures of the past.
  Mr. Chairman, I thank Chairman Bost for his support of this 
legislation. I urge all of my colleagues to join me in standing with 
those who once stood for us. They answered the call. Now, it is our 
turn.

                              {time}  1700

  Mr. TAKANO. Mr. Speaker, I have no additional speakers, and I yield 
myself the balance of my time to close.
  Mr. Speaker, I ask all of my colleagues to join me in supporting H.R. 
586, the Vietnam Veterans Liver Fluke Cancer Study Act, as amended, and 
I yield back the balance of my time.
  Mr. BOST. Mr. Speaker, I encourage all Members to support this bill, 
and I yield back the balance of my time.
  The SPEAKER pro tempore (Mr. Norman). The question is on the motion 
offered by the gentleman from Illinois (Mr. Bost) that the House 
suspend the rules and pass the bill, H.R. 586, as amended.
  The question was taken.
  The SPEAKER pro tempore. In the opinion of the Chair, two-thirds 
being in the affirmative, the ayes have it.
  Mr. BOST. Mr. Speaker, on that I demand the yeas and nays.
  The yeas and nays were ordered.
  The SPEAKER pro tempore. Pursuant to clause 8 of rule XX, further 
proceedings on this motion will be postponed.

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