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A bill to expand VA care for veterans exposed to toxic burn pits is moving slow


President Biden spoke in Texas this afternoon with American military veterans made sick by toxic burn pits in Afghanistan and Iraq. In the past, the president has suggested that his own son Beau's rare cancer may have been caused by burn pits. He's asked Congress to send him a bill that will expand VA care for these vets. But as NPR's Quil Lawrence reports, many of them fear they won't live long enough for help to arrive.

QUIL LAWRENCE, BYLINE: Rafael Rivera didn't always take care of his health. He used to smoke cigarettes. But considering he was on patrols in southern Afghanistan, it didn't seem like the worst of his worries.

RAFAEL RIVERA: You know, you're not, like, thinking long term. When you, like, have made your last will and testament three times by the time you're 20, that's irrelevant stuff.

LAWRENCE: Rivera is muscular with a full forearm tattoo of an American flag in the shape of Long Island. When he got out of the Army, he quit smoking, got into his health. He changed his diet. He started teaching yoga. But he never started to feel healthy.

RIVERA: And then, like, a year went by without having smoked cigarette. I'm like, I'm still coughing this [expletive] up. Two years goes by, like, and I'm still struggling.

LAWRENCE: For years, Rivera resisted going to the VA. He was dreading the red tape. When he did, they told him several of his health problems were service related, like his joint pain and post-traumatic stress, but another condition they said was not connected to the war. He's got constrictive bronchiolitis.

RIVERA: But when they say, like, you know, you got moderate obstruction of your breathing, we just don't know why. And it's most probably not definitely why because of the burn pits.

LAWRENCE: Like millions of troops over 20 years, Rivera was exposed to open pits of trash burned with jet fuel, known carcinogens. And so far, the VA routinely denies the vast majority of claims for those cancers. It took 50 years for VA to accept all the conditions caused by Agent Orange in Vietnam. And history is repeating itself, says pulmonologist Dr. Anthony Szema.

ANTHONY SZEMA: That's putting the, you know, all the soldiers with - who actually have constrictive bronchiolitis in a quagmire that they're never going to get diagnosed and they're never going to get treated.

LAWRENCE: Szema directs the International Center for Excellence in Deployment Health. He says the Biden administration has added several new illnesses to the VA's list of automatic service connection for burn pits. But at this rate, Szema says, many vets will die of cancer before the VA accepts their claims.

SZEMA: Soldiers have a ticking time bomb that will get progressively worse over time.

LAWRENCE: The House just passed a sweeping bill that would force the VA to accept 23 illnesses as burn pit connected, but Republicans have objected to the $200 billion price over a decade. President Biden supports the bill, but also appears open to a less comprehensive bill in the Senate. While the debate continues, young, healthy veterans are coming down with rare cancers.

KATE HENDRICKS THOMAS: I was diagnosed with stage four breast cancer in January of 2018.

LAWRENCE: Kate Hendricks Thomas was only 38. She had served as a marine in Iraq.

HENDRICKS THOMAS: And the cancer had spread all throughout my body, which means it had been developing for a very long time. So I had skeletal metastases from my skull to my toes. My provider - my radiologist said it looked like I had been dipped in something.

LAWRENCE: She had a career she loved, a Ph.D. in public health. And she had a young family. It took her three years of fighting the VA to finally get her cancer service connected, three years of hassle when she just wanted to focus on her husband and young son. It's time she'll never get back.

HENDRICKS THOMAS: I know I don't have that much longer. I accept that reality. But I'm just trying to preserve quality of life so that I can parent and that I can enjoy people as long as possible.

LAWRENCE: She says the VA service connection means her family will get a small pension when she dies, but her hope is that the laws will change so other veterans might get VA care and benefits sooner than she did. Quil Lawrence, NPR News. Transcript provided by NPR, Copyright NPR.

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.