I 
115TH CONGRESS 
2D SESSION 
H. R. 6993 
To amend title 38, United States Code, to furnish hospital care and medical 
services to veterans and dependents who were stationed at military instal-
lations 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 
SEPTEMBER 28, 2018 
Mr. KILDEE (for himself and Mr. BRENDAN F. BOYLE of Pennsylvania) intro-
duced the following bill; which was referred to the Committee on Vet-
erans’ 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 con-
nection for certain veterans who were stationed at mili-
tary installations at which the veterans were exposed 
to such substances, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
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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 VET-
ERANS 
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 subpara-
graph: 
‘‘(G)(i) Beginning on the date that is 90 days 
after the date of the enactment of this subpara-
graph, subject to paragraph (2), a veteran who 
served on active duty in the Armed Forces at a cov-
ered military installation at which individuals were 
exposed to substances specified in clause (ii) is eligi-
ble for hospital care and medical services under sub-
section (a)(2)(F) for the diseases, illnesses, or condi-
tions as specified in such clause, notwithstanding 
that there is insufficient medical evidence to con-
clude that such illness or condition is attributable to 
such service. 
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‘‘(ii) The substances and diseases, illnesses, or 
conditions specified in this clause are the following: 
‘‘(I) With respect to exposure to perfluoro-
octanoic 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 dis-
ease, illness, or condition that the Secretary of 
Veterans Affairs, in consultation with the Ad-
ministrator of the Agency for Toxic Substances 
and Disease Registry of the Department of 
Health and Human Services, determines pursu-
ant to the study conducted under section 316 of 
the National Defense Authorization Act for Fis-
cal 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 
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a period specified by the Secretary at a covered mili-
tary 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, in-
cluding 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 insert-
ing ‘‘(F), or (G)’’. 
(b) FAMILY MEMBERS.— 
(1) IN GENERAL.—Subchapter VIII of chapter 
17 is amended by adding at the end the following 
new section: 
‘‘§ 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, sub-
ject to subsection (b), a family member of a veteran de-
scribed in clause (i) of section 1710(e)(1)(G) of this title 
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(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 cov-
ered 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 fur-
nish 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 
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or the provider of such care or services has exhausted 
without success all claims and remedies reasonably avail-
able to the family member or provider against a third 
party (as defined in section 1725(f) of this title) for pay-
ment of such care or services, including with respect to 
health-plan contracts (as defined in such section).’’. 
(2) CLERICAL AMENDMENT.—The table of sec-
tions 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 Author-
ization Act for Fiscal Year 2018 (Public Law 115– 
91) is submitted to Congress, the Secretary of Vet-
erans Affairs shall submit to the Committee on Vet-
erans’ 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). 
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(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 disabil-
ities for which care and services have been pro-
vided 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 re-
port. 
(3) VETERAN
DEFINED.—In this subsection, 
the term ‘‘veteran’’ includes a former member of the 
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reserve components of the Armed Forces covered by 
such section 1710(e)(1)(G). 
SEC. 3. PRESUMPTION OF SERVICE CONNECTION FOR CER-
TAIN VETERANS EXPOSED TO PERFLUORO-
OCTANOIC 
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: 
‘‘§ 1116A. Presumption of service connection for cer-
tain 
veterans 
exposed 
to 
perfluoro-
octanoic acid or other per- and poly-
fluoroalkyl 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 speci-
fied 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 ac-
tive 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 vet-
eran who, during active military, naval, or air service, 
served at a military installation at which individuals were 
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