Comprehensive toxic exposure legislation that could provide new health care and disability benefits to millions of veterans is headed to the White House to become law after Senate lawmakers ended a week of turmoil surrounding the bill with a strong bipartisan vote.

The Promise to Address Comprehensive Toxics Act — better known as the PACT Act — was adopted Tuesday by a 86-11 vote after a lengthy series of procedural moves by senators.

Advocates called the move a historic change in how the Department of Veterans Affairs approaches toxic exposure injuries, in particular ones caused by burn pits used in combat zones. It was also the culmination of years of lobbying for sick veterans and nearly a week of constant protest on Capitol Hill.

One week ago, 42 Senate Republicans blocked consideration of the measure in a surprise move that left veterans advocates panicked and upset.

But after five days of an around-the-clock “fire watch” on the Capitol steps by veterans — some of whom suffer from burn pit injuries from their service — the GOP lawmakers relented and allowed the legislation to move forward.

“This was all of us coming together for our veterans,” said Rosie Lopez-Torres, co-founder of the advocacy group Burn Pits 360, which helped author the legislation. “Knowing that we now have what we’ve been waiting on for 13 years, I think it’s time for a celebration.”

What the bill does

The bill would potentially provide new support for about 3.5 million veterans, about one in every five living in America today.

“What it does is make sure that veterans who have been exposed to toxins … are made whole again,” said Senate Veterans’ Affairs Committee Chairman Jon Tester, D-Mont.

“We send these men and women off to war, we tell them to go off and protect our freedoms. They do it, and oftentimes things happen that change their lives. Sometimes we can see the injuries. Sometimes we can’t, especially in cases with toxic burn pits.”

The burn pit provisions of the PACT Act have received the most attention in recent months, in part because of the visibility of those injuries. Tens of thousands of veterans from the wars in Iraq and Afghanistan have developed rare respiratory conditions and cancers in the years following their deployments, believed caused by poisonous smoke from massive burn pits used to dispose of a host of military waste.

Now, under the bill, veterans who served in those war zones would be granted presumptive benefits status for 23 respiratory illnesses and cancers believed linked to the toxic smoke. That would speed up disability payouts to those individuals, awarding them up to several thousand dollars a month.

Veterans who served in the recent wars would also be given five more years of medical care coverage under VA (they currently get five years) regardless of their health status.

Veterans from older generations would also see new support under the measure. It dramatically expands benefits for illnesses believed to be linked to burn pit smoke in Iraq and Afghanistan, Agent Orange exposure in Vietnam and proximity to other harmful military contaminants in varied service eras.

And the bill would codify recent changes in how VA approaches a host of military toxic exposure claims, lowering standards for proof and offering presumptive status for some rare illnesses believed linked to them.

Advocates for years have lamented burdensome procedures to get VA to recognize their service-connected illnesses.

Why the bill was stalled

On Tuesday, Tester praised the final passage of the measure but also acknowledged that getting the legislation finished “took far too long.” That critique included both years of fighting over bill specifics and the unexpected delays of the last week.

Despite the final bipartisan vote, Republican lawmakers for months have voiced concerns about the cost of the measure — nearly $300 billion over the next 10 years — and the potential impact on VA benefits workloads.

Senate leaders thought they had calmed those concerns with changes to the measure negotiated between Tester and Senate Veterans’ Affairs Committee ranking member Jerry Moran, R-Kan., earlier this spring. Those moves included adding money for more staff and more VA facility leases, and deferring some benefits for a few years.

The House last month voted 342–88 to advance the measure, with key Republican leaders giving their blessing. But when the measure returned for procedural votes last week, all but eight Senate Republicans blocked it, saying they had newfound concerns with budgetary accounting issues.

Sen. Pat Toomey, R-Pa., led that charge, saying that changes in discretionary spending rules included in the bill could lead to budget malfeasance in the future. But his recommended fixes were rejected in a 47-48 amendment vote shortly before final passage (60 votes were needed for adoption).

“There is no doubt that the cost of caring for our veterans is high,” Moran said shortly before the Senate votes. “The truth is, freedom is not free. There is always a cost to war. And we need to remind ourselves that cost is not fully paid when the war ends.”

White House support

The measure now heads to the White House, where President Joe Biden has already pledged to sign it into law. Advocates are expecting a significant public signing ceremony in coming days.

That event will be in sharp contrast to the last few days of protest outside the Capitol, where dozens of veterans camped to show their disapproval for the lawmakers blocking the bill.

The protest was held in shifts around the clock, with veterans seeking cover under nearby trees and bus stops during frequent overnight Washington, D.C. downpours. Supporters — including the White House — sent water bottles and pizzas to help with the effort, and made frequent stops to chat with veterans as lawmakers inside negotiated a final compromise.

Comedian Jon Stewart (who has spoken at numerous press conferences on the issue in recent years) and activist John Feal (a key voice in the fight for benefits for Sept. 11, 2001 first responders in New York) held frequent news events in recent days to amplify the message.

The protest ended Tuesday with nearly 100 veterans being invited into the Senate chamber to witness the final vote first-hand.

“This victory is the culmination of years of relentless work by all the national veterans and military organizations,” said IAVA Executive Director for Government Relations Tom Porter.

“In the end, it was our commitment to the mission of following through for our brothers and sisters in arms, many who are no longer with us. We did this for them.”

Veterans Affairs officials have said in recent days that they are preparing for the changes outlined in the bill, but have not yet offered any guidance on how veterans can apply for the new benefits or health care access.

Leo covers Congress, Veterans Affairs and the White House for Military Times. He has covered Washington, D.C. since 2004, focusing on military personnel and veterans policies. His work has earned numerous honors, including a 2009 Polk award, a 2010 National Headliner Award, the IAVA Leadership in Journalism award and the VFW News Media award.

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