Biden pivots to burn pits, veterans health care amid mounting crises at home and abroad

In this April 28, 2011, photo, an Afghan National Army pickup truck passes parked U.S. armored military vehicles, as smoke rises from a fire in a trash burn pit at Forward Operating Base Caferetta Nawzad, Helmand province, south of Kabul, Afghanistan.

WASHINGTON – President Joe Biden began pivoting away from domestic and foreign crises on Tuesday to tackle a more personal issue: expanding health care for veterans who were exposed to toxicants while serving abroad.

Biden visited a Veterans Affairs clinic in Fort Worth, Texas, where he met with health care providers and veterans. The president spoke about the enduring health effects from exposure to burn pits, or massive, open-air ditches used to dispose of wartime waste that the president has linked to the death of his son Beau Biden, who died of brain cancer in 2015.

The president said his administration is studying the health effects of toxic exposure in the military and speeding up the process to identify and address adverse impacts of military-related environmental exposure. He called on Congress to pass legislation to extend eligibility for veterans exposed to toxic burn pits.

"When the evidence doesn't give a clear answer one way or another, the decision we should favor is caring for our veterans while we continue to learn more – not waiting," he said. "We're not waiting."

The trip comes as the president juggles an unfolding war in Ukraine, a push to transition the country into a new phase of the COVID-19, and rising anxiety about record-high inflation and soaring gas prices. But advocates say the president, who campaigned on a promise to help soldiers who were exposed to toxic burn pits, is long overdue on elevating the issue. 

"We knew we finally had a president who really has a direct connection and understands the issue and wanted to get something done," said Jeremy Butler, CEO of Iraq and Afghanistan Veterans of America. "That's what frustrated us because we were hoping that he would be pushing for things to happen more quickly." 

The president is turning to veterans' health care after much of his domestic agenda – including voting rights and his Build Back Better social spending plan – stalled in the Senate at the end of his first year in office. 

He devoted several minutes of his hourlong State of the Union speech last week to highlighting the long-term health effects of burn pit smoke. He called on Congress to pass legislation that would  ensure veterans exposed to toxicants in Iraq and Afghanistan have access to comprehensive health care – a move that advocates say is result of political momentum in Congress.

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Momentum on the Hill

Comedian Jon Stewart, who has championed legislation for veterans and first responder health care, spoke to White House officials ahead of Biden's speech, according to John Feal, an advocate and 9/11 first responder who works with Stewart, a former "Daily Show" host, to lobby Congress on the issue.

Stewart and Feal met in November with House Speaker Nancy Pelosi, D-Calif., to push for passage of burn pit legislation. 

Two days after Biden's speech, the House passed a sweeping bill known as the Honoring our PACT (Promise to Address Comprehensive Toxics) Act, which would expand health care benefits for millions of veterans exposed to burn pits and other toxicants in what advocates hailed as a big step toward official recognition of the long-term health problems associated with service-related exposure to toxicants.

Veterans groups have been pushing for years for the VA to designate certain medical conditions as presumptively linked to the pits, allowing veterans to access federal disability benefits. The agency requires veterans to prove their condition was directly caused by exposure. 

VA officials testified in 2020 that the agency approved only about 22% of disability claims filed by veterans related to burn pit exposure from 2007 to 2020, rejecting a vast majority of them.

The PACT Act recognizes 23 respiratory conditions and cancers considered to be either caused or worsened by exposure to toxicants during military service, removing the "burden of proof" from veterans to provide evidence of a connection between their service and health condition. 

A 2020 member survey by the Iraq and Afghanistan Veterans of America found 86% of respondents were exposed to burn pits or other toxicants.

Although the House bill garnered support from 34 GOP members, most Republicans have balked at the price tag. The Congressional Budget Office estimated the bill would cost $208 billion over the next 10 years. But Democrats say it's a moral responsibility. 

"If we are to support the cost of starting and sustaining war, we must acknowledge the financial costs of supporting those veterans it creates when it comes home," House Veterans' Affairs Committee Chairman Mark Takano, D-Calif., said at a Capitol Hill news conference the day after Biden's speech. 

The Senate has its own version of the bill, which means the two chambers will need to reconcile the differences before voting on a final package. Feal and Stewart, who helped pass the 9/11 Victim Compensation Fund reauthorization bill, are set to meet with Senate Majority Leader Chuck Schumer on Thursday. 

Biden said both bills "unite the American people" and he urged Congress to "get those bills to my desk so I can sign them immediately." 

"This is all political momentum and the will of the people," Feal said. "We had to take a back seat to the pandemic, then we had to take a back seat to the insurrection. Now we've rightfully taken a back seat to what's happening Ukraine, but it's now time."

Danielle Robinson (C) acknowledges applause after being recognized by President Joe Biden during his State of the Union address to a joint session of Congress in the U.S. Capitol's House Chamber March 01, 2022 in Washington, DC. Robinson's husband, U.S. Army Sergeant First Class Heath Robinson, died of a rare form of lung cancer and she is an advocate for service members and veterans who have been exposed to environmental hazards and burn pits while serving.During his first State of the Union address Biden spoke on his administration's efforts to lead a global response to the Russian invasion of Ukraine, work to curb inflation and to bring the country out of the COVID-19 pandemic.

An issue close to Biden's heart

Biden has frequently spoken about his son's exposure to burn pits, tying Beau Biden's 2015 diagnosis of brain cancer to his service in Iraq and Kosovo. 

Though experts have been less definitive about the link between burn pit emissions and long-term medical conditions, Biden has advocated for federal policy to allow for a presumptive link between service-related toxic exposure and ailments. 

"I’ve always believed that we have a sacred obligation to equip all those we send to war and care for them and their families when they come home," Biden said during his primetime speech last week. 

He spoke of the dangers facing troops in Afghanistan and Iraq, including breathing airborne toxicants from incinerated medical and hazard material and jet fuel that led to "a cancer that would put them in a flag-draped coffin."

He added his own son was among those soldiers, though Biden conceded that  he didn't know for sure whether a burn pit was the cause of his son's diagnosis. He vowed to "find out everything we can" about the effects of burn pits.

Thomas Porter, executive vice president for government affairs with Iraq and Afghanistan Veterans of America, said while some military installations did burn waste in small pits or trenches, others ranged as large as 10 acres in size. 

“It’s somebody’s job to douse it with jet fuel and you burn it. That’s what you have to do, every day, for over 100,000 boots on the ground in Iraq and Afghanistan,” Porter said. “So think about all the human waste that has to be burnt with jet fuel, and everybody’s breathing that.”

Porter said he developed asthma during a deployment to Kabul, Afghanistan, due to exposure to air pollution.

Biden's State of the Union address marked a turning point, according to advocates, who hope the president will use his bully pulpit to amplify an issue he frequently raised on the campaign trail. 

Rosie Torres, who founded the group Burn Pits 360 after her husband suffered lung disease following his deployment to Iraq, said Biden's personal grief is what makes him the right voice to press Congress to do more.

"They want him to know their story and know they have a Beau Biden in their family who died," she said of veterans' families. "They have this connection with him where they feel they have something in common."

Advocates are hoping Biden will be more forceful and direct about burn pits moving forward. 

"I don't want to see the president go backwards or say this is a step in the right direction," Feal said. "I want to see him say, 'This is the VA's responsibility to fix it.'

"If we could train these men and women to go to combat, we should be able to take care of them when they come home. Anything short of, 'Put a bill on my desk that I could sign,' I won't be happy." 

Contributing: Kyle Bagenstose