II 

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 perand polyfluoroalkyl substances, to provide for a presumption of service connection for those veterans and members of the reserve components, and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 


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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Veterans Exposed to 

3 Toxic PFAS Act’’ or the ‘‘VET PFAS Act’’. 

4 SEC. 2. HOSPITAL CARE AND MEDICAL SERVICES FOR VET5 ERANS, MEMBERS OF THE RESERVE COMPO6 NENTS, AND DEPENDENTS EXPOSED TO 

7 PERFLUOROOCTANOIC ACID AND OTHER 

8 PER- AND POLYFLUOROALKYL SUBSTANCES. 

9 (a) HOSPITAL CARE AND MEDICAL SERVICES FOR

10 VETERANS AND MEMBERS OF THE RESERVE COMPO11 NENTS.— 

12 (1) IN GENERAL.—Paragraph (1) of section 

13 1710(e) of title 38, United States Code, is amended 

14 by adding at the end the following new subpara15 graph: 

16 ‘‘(G)(i) Beginning on the date that is 90 days after 

17 the date of the enactment of this subparagraph, subject 

18 to paragraph (2), a veteran who served on active duty in 

19 the Armed Forces, or an individual who served as a mem20 ber of the reserve components of the Armed Forces, at 

21 a covered military installation at which individuals were 

22 exposed to substances specified in clause (ii) is eligible for 

23 hospital care and medical services under subsection 

24 (a)(2)(F) for the diseases, illnesses, or conditions as speci25 fied in such clause, notwithstanding that there is insuffiVerDate Sep 11 2014 18:39 Apr 09, 2019 Jkt 089200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S1023.IS S1023

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1 cient medical evidence to conclude that such illness or con2 dition is attributable to such service. 

3 ‘‘(ii) The substances and diseases, illnesses, or condi4 tions specified in this clause are the following: 

5 ‘‘(I) With respect to exposure to per6 fluorooctanoic acid— 

7 ‘‘(aa) diagnosed high cholesterol; 

8 ‘‘(bb) ulcerative colitis; 

9 ‘‘(cc) thyroid disease; 

10 ‘‘(dd) testicular cancer; 

11 ‘‘(ee) kidney cancer; and 

12 ‘‘(ff) pregnancy-induced hypertension. 

13 ‘‘(II) With respect to exposure to other 

14 perfluoroalkyl and polyfluoroalkyl substances, any 

15 disease, illness, or condition that the Secretary, in 

16 consultation with the Agency for Toxic Substances 

17 and Disease Registry of the Department of Health 

18 and Human Services, determines pursuant to the 

19 study conducted under section 316 of the National 

20 Defense Authorization Act for Fiscal Year 2018 

21 (Public Law 115–91; 131 Stat. 1350) that a positive 

22 association exists between exposure to perfluoroalkyl 

23 and polyfluoroalkyl substances and such disease, ill24 ness, or condition. 


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1 ‘‘(iii) In this subparagraph, the term ‘covered mili2 tary installation’ means a military installation at which 

3 individuals were exposed to perfluorooctanoic acid or other 

4 perfluoroalkyl and polyfluoroalkyl substances, including 

5 exposure through a well that provides water for human 

6 consumption that is contaminated with such substances.’’. 

7 (2) LIMITATION.—Paragraph (2)(B) of such 

8 section is amended by striking ‘‘or (F)’’ and insert9 ing ‘‘(F), or (G)’’. 

10 (b) FAMILY MEMBERS.— 

11 (1) IN GENERAL.—Subchapter VIII of chapter 

12 17 of title 38, United States Code, is amended by 

13 inserting after section 1787 the following new sec14 tion: 

15 ‘‘§ 1787A. Health care of family members of individ16 uals stationed at certain military installa17 tions 

18 ‘‘(a) IN GENERAL.—Beginning on the date that is 90 

19 days after the date of the enactment of this section, sub20 ject to subsection (b), a family member of a veteran de21 scribed in clause (i) of section 1710(e)(1)(G) of this title 

22 (or who would be so described but for the condition by 

23 which the individual was discharged or released from the 

24 Armed Forces), or a family member of a member of the 

25 reserve components of the Armed Forces described in such 


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1 clause, who resided at a military installation covered by 

2 such clause or who was in utero while the mother of such 

3 family member resided at such location shall be eligible 

4 for hospital care and medical services furnished by the 

5 Secretary for any disease, illness, or condition for which 

6 an individual may receive hospital care and medical serv7 ices under clause (ii) of such section, notwithstanding that 

8 there is insufficient medical evidence to conclude that such 

9 disease, illness, or condition is attributable to such resi10 dence. 

11 ‘‘(b) LIMITATIONS.—(1) The Secretary may only fur12 nish hospital care and medical services under subsection 

13 (a) to the extent and in the amount provided in advance 

14 in appropriations Acts for such purpose. 

15 ‘‘(2) Hospital care and medical services may not be 

16 furnished under subsection (a) for a disease, illness, or 

17 condition of a family member that is found, in accordance 

18 with guidelines issued by the Under Secretary for Health, 

19 to have resulted from a cause other than the residence 

20 of the family member described in that subsection. 

21 ‘‘(3) The Secretary may provide reimbursement for 

22 hospital care or medical services provided to a family 

23 member under this section only after the family member 

24 or the provider of such care or services has exhausted 

25 without success all claims and remedies reasonably availVerDate Sep 11 2014 18:39 Apr 09, 2019 Jkt 089200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S1023.IS S1023

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1 able to the family member or provider against a third 

2 party (as defined in section 1725(f) of this title) for pay3 ment of such care or services, including with respect to 

4 health-plan contracts (as defined in such section).’’. 

5 (2) CLERICAL AMENDMENT.—The table of sec6 tions at the beginning of such chapter is amended 

7 by inserting after the item relating to section 1787 

8 the following new item: 

‘‘1787A. Health care of family members of individuals stationed at certain military installations.’’. 

9 (c) ANNUAL REPORTS.— 

10 (1) IN GENERAL.—During the three-year period 

11 beginning on the date on which the study conducted 

12 under section 316 of the National Defense Author13 ization Act for Fiscal Year 2018 (Public Law 115– 

14 91; 131 Stat. 1350) is submitted to Congress, the 

15 Secretary of Veterans Affairs shall submit to the 

16 Committee on Veterans’ Affairs of the Senate and 

17 the Committee on Veterans’ Affairs of the House of 

18 Representatives an annual report on the care and 

19 services provided under sections 1710(e)(1)(G) and 

20 1787A of title 38, United States Code (as added by 

21 subsections (a) and (b)(1), respectively). 

22 (2) ELEMENTS.—Each report under paragraph 

23 (1) shall set forth the following: 


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1 (A) The number of veterans, members of 

2 the reserve components of the Armed Forces, 

3 and family members provided hospital care and 

4 medical services under the provisions of law 

5 specified in paragraph (1) during the period 

6 covered by the report. 

7 (B) The illnesses, conditions, and disabil8 ities for which care and services have been pro9 vided such veterans, members of the reserve 

10 components, and family members under such 

11 provisions of law during that period. 

12 (C) The number of veterans, members of 

13 the reserve components, and family members 

14 who applied for care and services under such 

15 provisions of law during that period but were 

16 denied, including information on the reasons for 

17 such denials. 

18 (D) The number of veterans, members of 

19 the reserve components, and family members 

20 who applied for care and services under such 

21 provisions of law and are awaiting a decision 

22 from the Secretary on eligibility for such care 

23 and services as of the date of such report. 


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1 SEC. 3. PRESUMPTION OF SERVICE CONNECTION FOR CER2 TAIN INDIVIDUALS EXPOSED TO PER3 FLUOROOCTANOIC ACID OR OTHER PER- AND 

4 POLYFLUOROALKYL SUBSTANCES. 

5 (a) IN GENERAL.—Chapter 11 of title 38, United 

6 States Code, is amended by inserting after section 1116 

7 the following new section: 

8 ‘‘§ 1116A. Presumption of service connection for cer9 tain individuals exposed to per10 fluorooctanoic acid or other per- and 

11 polyfluoroalkyl substances 

12 ‘‘(a) PRESUMPTION OF SERVICE CONNECTION.—(1) 

13 For the purposes of section 1110 of this title, and subject 

14 to section 1113 of this title, each disease, illness, or condi15 tion specified in subsection (b) that becomes manifest in 

16 an individual described in paragraph (2) shall be consid17 ered to have been incurred or aggravated in the line of 

18 duty in the active military, naval, or air service, notwith19 standing that there is no record of evidence of such dis20 ease, illness, or condition during the period of such service. 

21 ‘‘(2) An individual described in this paragraph is— 

22 ‘‘(A) a veteran who, during active military, 

23 naval, or air service, served at a military installation 

24 at which individuals were exposed to 

25 perfluorooctanoic acid or other perfluoroalkyl and 

26 polyfluoroalkyl substances, including exposure 


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1 through a well that provides water for human con2 sumption that is contaminated with such substances; 

3 or 

4 ‘‘(B) a member of the reserve components of 

5 the Armed Forces who served at a military installa6 tion described in subparagraph (A). 

7 ‘‘(b) DISEASES OR ILLNESSES.—A disease, illness, or 

8 condition specified in this subsection is any of the fol9 lowing: 

10 ‘‘(1) With respect to exposure to per11 fluorooctanoic acid— 

12 ‘‘(A) diagnosed high cholesterol; 

13 ‘‘(B) ulcerative colitis; 

14 ‘‘(C) thyroid disease; 

15 ‘‘(D) testicular cancer; 

16 ‘‘(E) kidney cancer; and 

17 ‘‘(F) pregnancy-induced hypertension. 

18 ‘‘(2) With respect to exposure to other 

19 perfluoroalkyl and polyfluoroalkyl substances, any 

20 other disease, illness, or condition that the Sec21 retary, in consultation with the Agency for Toxic 

22 Substances and Disease Registry of the Department 

23 of Health and Human Services, determines pursuant 

24 to the study conducted under section 316 of the Na25 tional Defense Authorization Act for Fiscal Year 


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1 2018 (Public Law 115–91) that a positive associa2 tion exists between exposure to perfluoroalkyl and 

3 polyfluoroalkyl substances and such disease, illness, 

4 or condition.’’. 

5 (b) CLERICAL AMENDMENT.—The table of sections 

6 at the beginning of such chapter is amended by inserting 

7 after the item relating to section 1116 the following new 

8 item: 

‘‘1116A. Presumption of service connection for certain individuals exposed to 

perfluorooctanoic acid or other per- and polyfluoroalkyl substances.’’. 

Æ 


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