Ailing ‘blue water’ veterans of Vietnam are closer to gaining VA benefits

by Stars and Stripes, Tom Philpott

After months negotiating with Senate colleagues, the House Veterans’ Affairs Committee voted unanimously on Tuesday to send to the full House a bill likely to become the vehicle to qualify 90,000 ailing sea service veterans for Agent Orange-related disability pay and health care from the Department of Veterans Affairs.

These former naval warriors of the Vietnam War, called “Blue Water Navy Veterans,” have been pressuring Congress for decades to have their illnesses recognized as being caused, as likely as not, by exposure to Agent Orange and other herbicides sprayed on forests and jungle areas during that long war.

The argument is that surely clouds of the toxin also reached ships patrolling in territorial waters or contaminated water that, once desalinated, was used by Sailors and Marines for showering and other purposes while steaming off the coast.

Veterans who served on the ground in Vietnam or patrolled its inland waters, even for a day, have been eligible for VA compensation and care if diagnosed with one of 14 ailments associated with Agent Orange exposure. But independent U.S. scientists who studied the issue concluded in 2011 that they can’t find enough information to determine if Blue Water Navy Veterans were exposed.

As a result, VA refuses to presume their illnesses, though on the Agent Orange presumptive list, were likely caused by service off of Vietnam. A lone exception is allowed for Blue Water veterans with non-Hodgkin’s lymphoma.

Rep. Phil Roe, R-Tenn., chairman of the House committee, predicts the Blue Water Navy Vietnam Veterans Act of 2017 (HR 299) will be signed into law this year. He credited the fact that he and hard-working committee staff, for the first time, found a way to cover the $1 billion cost without violating House budget rules against raising a department’s mandatory, or entitlement, spending.

The “pay for” solution identified, which Senate colleagues have endorsed and major veteran service organizations found acceptable, is to raise modestly the funding fee on initial-use VA-backed home loans. VA estimates that the increase will average $2.94 monthly for homeowners with zero down payment loans, $2.82 monthly for 5 percent down loans and $2.14 per month for 10 percent.

The fee would not affect loans to any veteran with VA-rated disabilities.

“We finally got it,” Roe said in a phone interview the day after his committee forward to the full House the Blue Water Navy bill, 14 smaller bills to help veterans and also a piece of comprehensive legislation whose title Roe shortened to the VA Mission Act (HR 5674). He described HR 5674 as a “monumental” legislative achievement to improve veterans’ access to quality health care. Among its many features is long-sought expansion of the comprehensive VA caregiver program to older generations of veterans, although on a phased, gradual schedule.

The Mission Act, which has an official title four times as long, was negotiated over months by Roe and Rep. Tim Walz, of Minnesota, ranking Democrat on the committee, counterparts Sens. Johnny Isakson, R-Ga., and Jon Tester, D-Mont., chairman and ranking member on the Senate Veterans’ Affairs Committee, and with close scrutiny of new VA leaders and the Trump White House.

Roe called it a bicameral, bipartisan package that committee members risked derailing, and “returning to square one,” if they insisted on amending it.

The bill also would consolidate and reform VA’s community care programs and extend funding for the Veterans Choice Program for one year. That’s how long VA estimates it would take to implement community care reforms and streamline seven current programs down to one. Other provisions would strengthen VA’s ability to recruit and retain quality medical personnel and also to realign, streamline and modernize VA medical infrastructure.

Roe explained that the VA would remain primary coordinator of veterans’ care, including for care delivered in the private sector. The Mission Act also would give VA authority to create “a transparent, objective process” to recommend ways to realign and strengthen VA’s “crumbling medical infrastructure.”

The current caregiver program, open only to post-9/11 veterans seriously injured in the line of duty, requires that applicants be unable to perform just one activity of daily living, such as preparing meals or showering unattended. Months ago, Roe proposed that any expansion of caregiver benefits to older generations include a tightening of eligibility criteria for new applicants, specifically that they be unable to perform three or more activities of daily living, making VA eligibility consistent with caregiver benefits under Medicaid, Medicare or private insurance.

“I still have that concern, Tom,” Roe said. “I haven’t changed my mind on that. But there are compromises made to get a bill of this nature done.”

The Mission Act needs to be passed and signed into law by Memorial Day, Roe said, to avoid the current Choice program running out of money, which would lead to denial or interruption of community-based care for thousands of veterans.

Roe observed that the Mission Act is complex and some provisions will take more time to implement than the Blue Water Navy bill. A four-year phase-in period for caregiver expansion, for example, wouldn’t start until VA can certify it has upgraded information technology to properly support it. That will give Congress more chances to tighten eligibility if deemed necessary to contain costs, Roe said.

Thirty-eight military associations and veteran service organizations sent a joint letter to committee leaders praising the VA Mission Act, calling it “historic” and a “carefully crafted compromise” that “represents a balanced approach to ensuring timely access to care while continuing to strengthen the VA health care system that millions of veterans choose and rely on.”

Rick Weidman, executive director for policy for Vietnam Veterans of America, signed the letter. A day after all these bills cleared committee, Weidman said older veterans got “lots of things we really wanted, first and foremost caregiver benefits for pre-9/11 veterans. Quite bluntly, a lot of our guys are alive because their wife has taken care of them for the last 40 years.”

Weidman said he was happy, but not surprised, to see Blue Water Navy legislation advance because “Dr. Roe gave us his word that it would pass this Congress.” He also credited vet groups “beating the drum” for the 90,000 until “everybody got to the point where they said, ‘It’s time to do this.’ That was the thing with Dr. Roe and Sen. Isakson. ‘Let’s do this before they’re all dead.’ ”

Despite the careful construction and breadth of the VA Mission Act, which Roe said he wants to rename to honor two former prisoners of war in Vietnam – Sen. John McCain and Rep. Sam Johnson – serving their final year in the Congress – Roe said he probably is more excited about helping the Blue Water veterans.

“I made a commitment when I took over this chairmanship that if I did one thing, I wanted to get this done for these men – their mostly men – who served. And I think we have. I think we found the sweet spot” to win passage.

Roe served two years in the Army Medical Corps in the Vietnam War era. His wartime generation is dying off at a rate of 523 vets a day, he said. “It’s past due to treat them the same as anybody else who suited up and went to Vietnam.”

The current Blue Water bill was introduced by Rep. David Valadao, R-Calif., in April 2017 and has 329 co-sponsors. An identical bill from Sen. Kirsten Gillibrand, D-N.Y., has half of the Senate as co-sponsors. Roe expects swift passage.

“We really worked this bill like no other I’ve worked on since I’ve been in Congress,” Roe said, “where we really just pulled the barriers down, went across to the other side, worked with them.”

Whether wartime herbicide made these veterans ill can’t be proven, Roe said.

“I just want to make the presumption in favor of the veterans, in case it is doing that to them,” he said. “I’m very passionate about that.”