```

[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[S. 1023 Introduced in Senate (IS)]

<DOC>

116th CONGRESS
  1st Session
                                S. 1023

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

_______________________________________________________________________

                   IN THE SENATE OF THE UNITED STATES

                             April 3, 2019

 Ms. Stabenow (for herself, Mr. Peters, and Mr. Casey) 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, members of the reserve components of the 
      Armed Forces, and dependents who were stationed at military 
 installations at which they were exposed to perfluorooctanoic acid or 
other per- and polyfluoroalkyl substances, to provide for a presumption 
  of service connection for those veterans and members of the reserve 
                  components, 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, MEMBERS OF THE 
              RESERVE COMPONENTS, AND DEPENDENTS EXPOSED TO 
              PERFLUOROOCTANOIC ACID AND OTHER PER- AND POLYFLUOROALKYL 
              SUBSTANCES.

    (a) Hospital Care and Medical Services for Veterans and Members of 
the Reserve Components.--
            (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:
    ``(G)(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, or an individual who 
served as a member of the reserve components of 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 perfluoroalkyl and 
        polyfluoroalkyl substances, any disease, illness, or condition 
        that the Secretary, in consultation with 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, illness, or 
        condition.
    ``(iii) 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 (F)'' and inserting ``(F), or (G)''.
    (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 individuals 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)(G) 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), or a family member of a member of the reserve components 
of the Armed Forces described in such clause, 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 an individual 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 individuals stationed at 
                            certain military installations.''.
    (c) Annual Reports.--
            (1) In general.--During the three-year period beginning on 
        the date on 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)(G) 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, members of the reserve 
                components of the Armed Forces, 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, members of the reserve components, and family 
                members under such provisions of law during that 
                period.
                    (C) The number of veterans, members of the reserve 
                components, 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, members of the reserve 
                components, 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.

SEC. 3. PRESUMPTION OF SERVICE CONNECTION FOR CERTAIN INDIVIDUALS 
              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 1116 the following new section:
``Sec. 1116A. Presumption of service connection for certain individuals 
              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, illness, or condition specified in subsection (b) that 
becomes manifest in an individual 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, illness, or condition during 
the period of such service.
    ``(2) An individual described in this paragraph is--
            ``(A) 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 perfluoroalkyl 
        and polyfluoroalkyl substances, including exposure through a 
        well that provides water for human consumption that is 
        contaminated with such substances; or
            ``(B) a member of the reserve components of the Armed 
        Forces who served at a military installation described in 
        subparagraph (A).
    ``(b) Diseases or Illnesses.--A disease, illness, or condition 
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 perfluoroalkyl and 
        polyfluoroalkyl substances, any other disease, illness, or 
        condition that the Secretary, in consultation with 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 
        perfluoroalkyl and polyfluoroalkyl substances and such disease, 
        illness, or condition.''.
    (b) Clerical Amendment.--The table of sections at the beginning of 
such chapter is amended by inserting after the item relating to section 
1116 the following new item:

``1116A. Presumption of service connection for certain individuals 
                            exposed to perfluorooctanoic acid or other 
                            per- and polyfluoroalkyl substances.''.
                                 <all>
```