Rep. Phil Roe Introduces the Blue Water Navy Vietnam Veterans Act of 2019
Washington, D.C. – Today, Rep. Phil Roe, M.D. (R-Tenn.) Ranking Member of the House Committee on Veterans’ Affairs introduced the Blue Water Navy Vietnam Veterans Act of 2019.
“The Blue Water Navy Vietnam Veterans Act of 2019 would ensure that our Vietnam Veterans receive the benefits they deserve. This bill mirrors the language of the Blue Water Navy Vietnam Veterans Act of 2018, which passed the House 382 – 0 during the 115th Congress. One of my final acts as Chairman in 2018 was holding a bipartisan press conference to urge the Senate to pass H.R 299. Needless to say, despite the endless efforts of Senate Veterans Affairs’ Committee Chairman Isakson and Ranking Member Tester, the Senate never passed the legislation. This is why I have introduced this bill that mirrors the Blue Water Navy Vietnam Veterans Act of 2018 and I encourage my colleagues in the House to once again swiftly pass this bipartisan piece of legislation.
“Currently, Blue Water Navy Vietnam veterans are unable to receive the presumption of exposure to Agent Orange because VA’s presumption policy extends only to those who served on land in Vietnam or in Vietnam’s inland waterways. This legislation would extend the presumption of exposure of Agent Orange to our Blue Water Navy Vietnam Veterans. I hope that my colleagues in the House and Senate waste no time in passing this bill and sending it to President Trump so we can ensure that Blue Water Navy Vietnam veterans receive the benefits they deserve.”
Senate Passes Veterans Benefits and Transition Act
The United States Senate passed Ranking Member Jon Tester’s 21st bipartisan bill, capping off a landmark Congress with numerous victories for America’s veterans.
Tester’s Veterans Benefits and Transition Act contains 18 bipartisan bills, including the following six bipartisan Tester-authored bills to honor Native American veterans, better protect student veterans, and increase the transparency and accountability of the VA’s historic electronic health records transition.
The Servicemembers Improved Transition through Reforms for Ensuring Progress “SIT-REP” Act:Forces schools that receive G.I. Bill benefits to adopt a policy that it will not impose a late fee, restrict a student veterans’ access to campus facilities, or otherwise punish a student veteran due to a late payment of tuition or fees from the VA.
Tribal Veteran Burial Benefits Act:Authored by Tester and Senator Dean Heller (R-Nev.), the VA can now provide headstones or burial markers to a Native American veteran’s spouse and dependents who wish to be buried alongside their loved one in a tribal veterans’ cemetery.
Veteran Debt Fairness Act:Following reports that the VA had been forcing veterans to repay benefits to the VA, Tester authored legislation with Senators Sherrod Brown (D-Ohio) and Richard Blumenthal (D-Conn.) to require the VA to update its information technology systems so that affected veterans are able to review and revise information about their dependents electronically.
Veterans Fair Debt Notice Act:Tester authored this legislation with Senator Deb Fischer (R-Neb.) to require the VA to notify veterans with a straightforward, easy-to-understand electronic or standard mail notification of any debt that veteran owes to the VA and the steps they can take to dispute that debt.
Veterans’ Electronic Health Record Modernization Oversight Act:As the VA undertakes the largest electronic health records change in history, Tester and Blumenthal authored legislation to make the modernization program’s key planning and implementation efforts more transparent and hold the VA accountable by requiring the VA to notify Congress in the event of any significant cost increase, schedule delay, loss of veteran health data or breach of privacy.
Veterans’ Dental Care Eligibility Expansion and Enhancement Act:The VA is required to report on the possibility of expanding veterans’ access to dental care. By analyzing access and affordability through VA dental care, oral health needs of eligible veterans, and the number of providers needed to provide such care.
“This legislation is the product of hard work, compromise and bipartisanship,” said Tester, Ranking Member of the Senate Veterans’ Affairs Committee. “Sending another VA reform bill to the President’s desk sends a clear message to our nation’s veterans: Serving our men and women in uniform is a responsibility that we should all take very seriously. I have been honored to work with Chairman Isakson this Congress to accomplish so much for our nation’s veterans.”
News from National Academies of Sciences, Engineering and Medicine
Nov. 15, 2018
FOR IMMEDIATE RELEASE
Hypertension Upgraded in Latest Biennial Review of Research on Health Problems in Veterans That May Be Linked to Agent Orange Exposure During Vietnam War
WASHINGTON — The latest in a series of congressionally mandated biennial reviews of the evidence of health problems that may be linked to exposure to Agent Orange and other herbicides used during the Vietnam War found sufficient evidence of an association for hypertension and monoclonal gammopathy of undetermined significance (MGUS). The committee that carried out the study and wrote the report, Veterans and Agent Orange: Update 11 (2018), focused on the scientific literature published between Sept. 30, 2014, and Dec. 31, 2017.
From 1962 to 1971, the U.S. military sprayed herbicides over Vietnam to strip the thick jungle canopy that could conceal opposition forces, destroy crops that those forces might depend on, and clear tall grass and bushes from the perimeters of U.S. bases and outlying encampments. The most commonly used chemical mixture sprayed was Agent Orange, which was contaminated with the most toxic form of dioxin. These and the other herbicides sprayed during the war constituted the chemicals of interest for the committee. The exact number of U.S. military personnel who served in Vietnam is unknown because deployment to the theater was not specifically recorded in military records, but estimates range from 2.6 million to 4.3 million.
Hypertension was moved to the category of “sufficient” evidence of an association from its previous classification in the “limited or suggestive” category. The sufficient category indicates that there is enough epidemiologic evidence to conclude that there is a positive association. A finding of limited or suggestive evidence means that epidemiologic research results suggest an association between exposure to herbicides and a particular outcome, but a firm conclusion is limited because chance, bias, and confounding factors could not be ruled out with confidence. The committee came to this conclusion in part based on a recent study of U.S. Vietnam veterans by researchers from the U.S. Department of Veterans Affairs (VA), which found that self-reported hypertension rates were highest among former military personnel who had the greatest opportunity for exposure to these chemicals.
The committee concluded that there was sufficient evidence of an association between exposure to at least one of the chemicals of interest and MGUS, a newly considered condition. This finding is based on a recent study in which investigators found a statistically significant higher prevalence of MGUS in Vietnam veterans involved in herbicide spray operations than in comparison veterans. MGUS is a clinically silent condition that is a precursor to the cancer multiple myeloma, but only an estimated 1 percent of MGUS cases progress to multiple myeloma each year.
While some new studies suggest an association might exist between exposure to the chemicals of interest and Type 2 diabetes, the committee could not come to a consensus on whether this and the other available evidence continued to be limited or suggestive, or merited elevation to sufficient. Both newly and previously reviewed studies consistently show a relationship between well-characterized exposures to dioxin and dioxin-like chemicals and measures of diabetes health outcomes in diverse cohorts, including Vietnam veteran populations. The risk factors for diabetes, such as age, obesity, and family history of the disease, were controlled for in the analyses of most studies reviewed. However, some members of the committee believed that the lack of exposure specificity and the potential for residual uncontrolled confounding influences complicated attribution of the outcome to the chemicals of interest.
In addition, VA asked the committee to focus on three health outcomes: possible generational health effects that may be the result of herbicide exposure among male Vietnam veterans, myeloproliferative neoplasms, and glioblastoma multiforme. The evidence of association for exposure to the chemicals of interest and glioblastoma (and other brain cancers) remains inadequate or insufficient, the committee concluded. While it is appropriate for VA be mindful of the concerns raised about the possible association between Vietnam service and glioblastoma, the outcome is so rare and the information concerning herbicide exposures so imprecise, that it is doubtful that any logistically and economically feasible epidemiologic study of veterans would produce meaningful results regarding the association between exposures and the disease. For this reason, the committee recommended that VA should focus on fostering advancements to inform improved glioblastoma treatment options.
There are relatively few studies on the health effects of paternal chemical exposures on their descendants, and none address Vietnam veterans specifically. Therefore, the committee recommended further specific study of the health of descendants of male Vietnam veterans.
Myeloproliferative neoplasms and myelodysplastic syndromes are diseases of the blood cells and bone marrow. The committee’s search of epidemiologic literature yielded only one relevant paper on these diseases — a study of these cancers in Vietnam veterans that was reviewed in a previous update. Given this paucity of research, the committee recommended that investigators should examine existing databases on myeloid diseases to determine whether there are data available that would allow for an evaluation of myeloproliferative neoplasms in Vietnam veterans and others who have been exposed to dioxin and the other chemicals of interest.
Although progress has been made in understanding the health effects of military herbicide exposure and the mechanisms underlying these effects, significant gaps in knowledge remain. The committee restated recommendations for research activities outlined in previous updates in this series, including toxicologic, mechanistic, and epidemiologic research. Such work should include efforts to gain more complete knowledge through the integration of information in existing U.S. Department of Defense and VA databases.
The committee noted that the difficulty in conducting research on Vietnam veteran health issues should not act as a barrier to carrying out such work. There are many questions regarding veterans’ health that can only be adequately answered by examining veterans themselves, thereby properly accounting for the totality of the military service experience.
The study was sponsored by the U.S. Department of Veterans Affairs. The National Academies of Sciences, Engineering, and Medicine are private, nonprofit institutions that provide independent, objective analysis and advice to the nation to solve complex problems and inform public policy decisions related to science, technology, and medicine. They operate under an 1863 congressional charter to the National Academy of Sciences, signed by President Lincoln. For more information, visit nationalacademies.org.