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Biden to sign a bill that would care for veterans made sick by toxic exposures


President Biden today plans to sign into law what is widely considered the biggest expansion of VA care ever, the PACT Act. PACT stands for Promise to Address Comprehensive Toxins. It's meant to make up for broken promises over the years to care for veterans made sick by toxic exposures in Vietnam and in Iraq and Afghanistan, where U.S. troops and Iraqis alike were exposed to things like burn pits. Quil Lawrence follows veteran affairs for NPR, and he's with us now. Good morning, Quil.

QUIL LAWRENCE, BYLINE: Good morning, Leila.

FADEL: So I just gave a shorthand version of the PACT Act. But how comprehensive is this legislation?

LAWRENCE: It covers a lot. You mentioned the burn pits, which were those open pits of burning trash and fuel in Afghanistan and Iraq that made so many veterans sick, and Vietnam vets who are still fighting to get covered for Agent Orange. But it's also vets who served during the Cold War, who were exposed to radiation from atomic testing, or Marine families who lived on Camp Lejeune from the '50s all the way through the late '80s, who were drinking contaminated water. It's veterans who served in Djibouti or Syria or Uzbekistan. If they're having respiratory issues or rare cancers, they can now contact VA. And as many as 3.5 million veterans may have a claim.

FADEL: What do you mean, may have a claim? How will this all work?

LAWRENCE: Yeah. So mostly what Congress did was just take the burden of proof away from the veterans of, you know, what caused your cancer. It's off their backs now. So for years, we've been interviewing vets who were sick and many who died waiting for the VA to determine that their cancer was related to service and not to smoking or to diet or to something with genetics. Now, if you went to war and you've got asthma or brain cancer or this long list of other ailments, they're just going to presume it's connected to your service. And just as importantly, thousands of veterans who were too sick to work from these ailments will get VA disability payments.

FADEL: OK, Quil, when we talked to you about two months ago, you said this was basically a done deal. So that was two months ago.

LAWRENCE: It looked like it was a done deal. It really - so it had passed the Senate 84 to 14. And then they found this technical error in the House version of the bill. And they just needed to delete one line, and they needed to vote on it again at the end of July. But when they did that in the Senate, 25 Republicans switched their votes, and it was widely seen as just an angry reaction to Democrats reaching a deal on totally unrelated legislation. But veterans advocates - they were already ready to celebrate. They had a big victory party ready on Capitol Hill.

FADEL: Right.

LAWRENCE: And that suddenly turned into this angry protest. And veterans camped out for six days until there was another vote and enough Republicans switched back.

FADEL: OK, so now some of these sick veterans have died. Others have been suffering for years. How soon can they expect to get help?

LAWRENCE: This is going to be phased in. And, you know, the VA has blown deadlines on phasing in programs before, but they say they're going to have a new call center and a network of trained experts to help vets make their claims ready by January. The law includes money for additional staff and even new buildings, and they're going to need it because the VA already has a backlog, and this is going to bury them in new claims. But VA is encouraging vets and survivors to apply and get things in motion. There's a feeling of support from the Biden administration. President Biden often mentioned his own son, Beau, had died of a cancer he believed was caused by burn pits. And while these vets were camping out for six days in the heat and the rain outside the Senate, the White House actually sent VA Secretary Denis McDonough over to the VA to bring pizza to them outside. There's a perception that the VA kind of wants this to work this time.

FADEL: NPR's Quil Lawrence, thank you, Quil, for your reporting.

LAWRENCE: Thanks, Leila. Transcript provided by NPR, Copyright NPR.

Leila Fadel
Leila Fadel is a national correspondent for NPR based in Los Angeles, covering issues of culture, diversity, and race.
Quil Lawrence
Quil Lawrence is a New York-based correspondent for NPR News, covering veterans' issues nationwide. He won a Robert F. Kennedy Award for his coverage of American veterans and a Gracie Award for coverage of female combat veterans. In 2019 Iraq and Afghanistan Veterans of America honored Quil with its IAVA Salutes Award for Leadership in Journalism.