Toxins bill set to expand care for veterans exposed to Agent Orange

Tens of thousands of Vietnam-era veterans stand to benefit as Congress nears the finish line on massive legislation to expand health coverage for those exposed to toxins during their military service.

The Sgt. 1st Class Heath Robinson Honoring Our PACT Act — which is mainly aimed at expanding care to veterans exposed to toxic burn pits — also expands care to veterans who were exposed to Agent Orange outside of Vietnam.

The provisions are a win for veterans advocacy groups, who say that the bill expands a narrow understanding of exposure to the herbicide, which has been linked to a variety of illnesses.

“Agent Orange did not pick and choose … it affected everybody everywhere it was used,” said Patrick Murray, director of national legislative service at Veterans of Foreign Wars.

“We think this is just correcting something that should have been done years ago, and we’re very grateful,” he added.

The House most recently passed the PACT Act on July 13 by a vote of 342-88, about a month after the Senate passed the bill by a bipartisan 84-14 vote.

The upper chamber must pass the measure again, as the House version of the bill includes technical changes from the measure passed last month. The bill then heads to President Biden’s desk, where he is expected to sign it.

Among its provisions, the bill would expand the Department of Veterans Affairs’ (VA) presumptions of service-connected illness related to Agent Orange exposure for those who were exposed in Thailand, Cambodia, Laos, Guam, American Samoa and Johnston Atoll.

Veterans who were deployed in Vietnam were first granted presumed coverage for Agent Orange-related illnesses in 1991 under the Agent Orange Act.

Agent Orange was the most-used herbicide during the Vietnam War, where it was deployed to clear out forests and vegetation that could be used by enemy forces.

The U.S. also used the herbicide along the Ho Chi Minh Trail, which connected northern and southwest Vietnam via military transport routes through Laos and Cambodia. The herbicide was also used in Thailand to clear jungle around military bases.

Murray said that over time, the herbicide became a “quick fix” anytime vegetation needed to be cleared in areas not in Vietnam, leading it to be used in places where it wasn’t necessary, like Guam and American Samoa.

“Places in Vietnam, where maybe you did need that expedited measure done, that’s one thing,” Murray said. “But in American Samoa, there was no enemy that we needed to identify immediately. It was just, ‘This will get a job done.’”

After use of Agent Orange was banned in the early 1970s, remaining batches were taken to Johnston Atoll — a U.S. controlled island 700 miles southeast of Hawaii — where they were later destroyed, according to the Aspen Institute.

The VA presumes that about two dozen types of illness are caused by exposure to Agent Orange, meaning that exposed veterans who have been diagnosed with those conditions don’t have to prove their ailments are related to military service.

The agency’s benefits tied to Agent Orange largely apply to those who served in Vietnam, about 12 miles offshore from the waters of Vietnam, or those who were on regular perimeter duty of either a U.S. military installation or Thai air force base.

Veterans who served in the Korean Demilitarization Zone, were assigned in units that had C-123 aircraft or were involved in testing or storage of Agent Orange also qualify to receive benefits.

Veterans seeking benefits have typically needed to prove that they served, prove something happened to them in service and then prove that what happened is related to military service.

“Most veterans now are really missing two parts,” said Cory Titus, director of veteran benefits and guard/reserve affairs for the Military Officers Association of America, “The only thing they can prove is that ‘I was in service.’ They’re sick, but they can’t connect it back to their time in uniform.”

The Congressional Budget Office estimated last year that about 50,000 veterans and survivors of deceased veterans would receive compensation due to the PACT Act expanding presumptive exposures outside of Vietnam.

The agency also estimated that 51,000 veterans would receive compensation under another provision that would presume hypertension was caused by exposure to Agent Orange. That number would increase to about 464,000 by 2031.

Asked about how many veterans stand to benefit from the Agent Orange provisions of the bill, the VA told The Hill that it would make those estimates once the PACT Act has been passed.

“It will take several weeks to develop these projections after the final PACT Act language is received,” the agency said.

As the legislation nears the finish line, advocacy groups say more will need to be done to address the impact of toxic exposures for veterans.

“The nature of war is hard — you don’t always know what service members are exposed to,” Titus said.

“But certainly, what we need to do is reduce the risk, we need to reduce the exposures and we need to make sure that the information that we know about exposures is translating to veterans’ service records down the line.”