,i  #aaf? ,,congress  #a/ ,session  ,h4 
,r4 #bajb  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,april #d1 #bjai,mr4  
,kildee 7= himself1 ,mrs4 ,d+ell1 ,ms4  
,slotk91 ,mr4 ,lev9 ( ,mi*igan1 ,ms4    
,tlaib1 ,mr4 ,khanna1 ,mr4 ,delgado1    
,ms4 ,torres ,small ( ,new ,mexico1 ,mr4
 ,pappas1 ,mr4 ,br5dan ,f4 ,boyle (     
,p5nsylvania1 ,mr4 ,sean ,patrick       
,maloney ( ,new ,york1 ,ms4 ,dean1 ,mr4 
,coh51 ,ms4 ,ku/] ( ,new ,hamp%ire1     
,mrs4 ,lawr5ce1 ,ms4 ,/ev5s1 ,mrs4      
,trahan1 & ,mr4 ,kim7 introduc$ ! foll[+
 bill2 :i* 0 ref]r$ to ! ,committee on  
,vet]ans' ,affairs  ,a ,,bill  ,to am5d 
title #ch1 ,unit$ ,/ates ,code1 to      
furni% hospital c>e & m$ical s]vices to 
vet]ans & dep5d5ts :o 7 /ation$ at      
milit>y in/allations at :i* ! vet]ans & 
dep5d5ts 7 expos$ to p]fluorooctanoic   
acid or o!r p]- & polyfluoroalkyl       
sub/ances1 to provide = a presumption ( 
s]vice connection = c]ta9 vet]ans :o 7  
/ation$ at milit>y in/allations at :i* !
 vet]ans 7 expos$ to su* sub/ances1 & = 

o!r purposes4  #a4 ,%ort title ,?is ,act
 may be cit$ z ! ,vet]ans ,expos$ to    
,toxic ,,pfas ,act or ! ,,vet ,,pfas    
,act4  #b4 ,hospital c>e & m$ical       
s]vices = vet]ans & dep5d5ts expos$ to  
p]fluorooctanoic acid & o!r p]- &       
polyfluoroalkyl sub/ances  7a7 ,hospital
 c>e & m$ical s]vices = vet]ans  7#a7 ,9
 g5]al ,p>agraph 7#a7 ( section         
#agaj7;e7 ( title #ch1 ,unit$ ,/ates    
,code1 is am5d$ by add+ at ! end !      
foll[+ new subp>agraph3  7,g7  7i7      
,beg9n+ on ! date t is #ij days aft] !  
date ( ! enactm5t ( ?is subp>agraph1    
subject to p>agraph 7#b71 a vet]an :o   
s]v$ on active duty 9 ! ,arm$ ,=ces at a
 cov]$ milit>y in/allation at :i*       
individuals 7 expos$ to sub/ances       
specifi$ 9 clause 7ii7 is eligible =    
hospital c>e & m$ical s]vices "u        
subsection 7a77#b77;,f7 = ! diseases1   
illnesses1 or conditions z specifi$ 9   
su* clause1 not)/&+ t !re is insuffici5t
 m$ical evid5ce to conclude t su*       
illness or condition is attributable to 

su* s]vice4  7ii7 ,! sub/ances &        
diseases1 illnesses1 or conditions      
specifi$ 9 ?is clause are ! foll[+3 7,i7
 ,) respect to exposure to              
p]fluorooctanoic acid--  7aa7 diagnos$  
high *ole/]ol2  7bb7 ulc]ative colitis2 
7cc7 ?yroid disease2  7dd7 te/icul>     
canc]2  7ee7 kidney canc]2 &  7ff7      
pregnancy-induc$ hyp]t5sion4  7,,ii7 ,) 
respect to exposure to o!r p]- &        
polyfluoroalkyl sub/ances1 any disease1 
illness1 or condition t ! ,secret>y (   
,vet]ans ,affairs1 9 consultation ) !   
,adm9i/rator ( ! ,ag5cy = ,toxic        
,sub/ances & ,disease ,regi/ry ( !      
,dep>tm5t ( ,heal? & ,human ,s]vices1   
det]m9es pursuant to ! /udy conduct$ "u 
section #caf ( ! ,national ,def5se      
,au?orization ,act = ,fiscal ,ye> #bjah 
7,public ,law #aae-ia7 t a positive     
association exi/s betwe5 exposure to p]-
 & polyfluoroalkyl sub/ances & su*      
disease1 illness1 or condition4  7iii7  
,= purposes ( ?is subp>agraph1 any      
s]vice by a memb] ( ! res]ve compon5ts =

 a p]iod specifi$ by ! ,secret>y at a   
cov]$ milit>y in/allation at :i*        
individuals 7 expos$ to sub/ances       
specifi$ 9 clause 7ii7 %all be treat$ z 
active duty s]vice1 not)/&+ section     
#aja7ba7 ( ?is title4  7iv7 ,9 ?is      
subp>agraph1 ! t]m cov]$ milit>y        
in/allation means a milit>y in/allation 
at :i* individuals 7 expos$ to          
p]fluorooctanoic acid or o!r p]- &      
polyfluoroalkyl sub/ances1 includ+      
exposure ?r\gh a well t provides wat] = 
human consumption t is contam9at$ ) su* 
sub/ances4  4  7#b7 ,limitation         
,p>agraph 7#b77;,b7 ( su* section is    
am5d$ by /rik+ or 7,f7 & ins]t+ 7,f71 or
 7,g74  7b7 ,family memb]s  7#a7 ,9     
g5]al ,sub*apt] ,,viii ( *apt] #ag is   
am5d$ by add+ at ! end ! foll[+ new     
section3  #aghg;,a4 ,heal? c>e ( family 
memb]s ( vet]ans /ation$ at c]ta9       
milit>y in/allations  7a7 ,9 g5]al      
,beg9n+ on ! date t is #ij days aft] !  
date ( ! enactm5t ( ?is section1 subject
 to subsection 7b71 a family memb] ( a  

vet]an describ$ 9 clause 7i7 ( section  
#agaj7;e77#a77;,g7 ( ?is title 7or :o   
w\ld be s describ$ b = ! condition by   
:i* ! individual 0 dis*>g$ or releas$ f 
! ,arm$ ,=ces7 :o resid$ at a milit>y   
in/allation cov]$ by su* clause or :o 0 
9 ut]o :ile ! "m ( su* family memb]     
resid$ at su* location %all be eligible 
= hospital c>e & m$ical s]vices furni%$ 
by ! ,secret>y = any disease1 illness1  
or condition = :i* a vet]an may receive 
hospital c>e & m$ical s]vices "u clause 
7ii7 ( su* section1 not)/&+ t !re is    
insuffici5t m$ical evid5ce to conclude t
 su* disease1 illness1 or condition is  
attributable to su* resid5ce4  7b7      
,limitations  7#a7 ,! ,secret>y may only
 furni% hospital c>e & m$ical s]vices "u
 subsection 7a7 to ! ext5t & 9 ! am\nt  
provid$ 9 advance 9 appropriations ,acts
 = su* purpose4  7#b7 ,hospital c>e &   
m$ical s]vices may n be furni%$ "u      
subsection 7a7 = a disease1 illness1 or 
condition ( a family memb] t is f\nd1 9 
accordance ) guidel9es issu$ by ! ,"u   

,secret>y = ,heal?1 to h result$ f a    
cause o!r ?an ! resid5ce ( ! family     
memb] describ$ 9 t subsection4  7#c7 ,! 
,secret>y may provide reimbursem5t =    
hospital c>e or m$ical s]vices provid$  
to a family memb] "u ?is section only   
aft] ! family memb] or ! provid] ( su*  
c>e or s]vices has exhau/$ )\t success  
all claims & rem$ies reasonably         
available to ! family memb] or provid]  
aga9/ a ?ird p>ty 7z def9$ 9 section    
#agbe7;f7 ( ?is title7 = paym5t ( su*   
c>e or s]vices1 includ+ ) respect to    
heal?-plan contracts 7z def9$ 9 su*     
section74  4  7#b7 ,cl]ical am5dm5t ,!  
table ( sections at ! beg9n+ ( su* *apt]
 is am5d$ by ins]t+ aft] ! item relat+  
to section #aghg ! foll[+ new item3     
#aghg;,a4 ,heal? c>e ( family memb]s (  
vet]ans /ation$ at c]ta9 milit>y        
in/allations4  4  7c7 ,annual reports   
7#a7 ,9 g5]al ,dur+ ! ?ree-ye> p]iod    
beg9n+ 9 ! ye> 9 :i* ! /udy conduct$ "u 
section #caf ( ! ,national ,def5se      
,au?orization ,act = ,fiscal ,ye> #bjah 

7,public ,law #aae-ia7 is submitt$ to   
,congress1 ! ,secret>y ( ,vet]ans       
,affairs %all submit to ! ,committee on 
,vet]ans' ,affairs ( ! ,s5ate & !       
,committee on ,vet]ans' ,affairs ( !    
,h\se ( ,repres5tatives an annual report
 on ! c>e & s]vices provid$ "u sections 
#agaj7;e77#a77;,g7 & #aghg;,a ( title   
#ch1 ,unit$ ,/ates ,code 7z add$ by     
subsections 7a7 & 7b77#a71              
respectively74  7#b7 ,elem5ts ,ea*      
report "u p>agraph 7#a7 %all set =? !   
foll[+3 7,a7 ,! numb] ( vet]ans & family
 memb]s provid$ hospital c>e & m$ical   
s]vices "u ! provisions ( law specifi$ 9
 p>agraph 7#a7 dur+ ! p]iod cov]$ by !  
report4  7,b7 ,! illnesses1 conditions1 
& disabilities = :i* c>e & s]vices h be5
 provid$ su* vet]ans & family memb]s "u 
su* provisions ( law dur+ t p]iod4  7,c7
 ,! numb] ( vet]ans & family memb]s :o  
appli$ = c>e & s]vices "u su* provisions
 ( law dur+ t p]iod b 7 d5i$1 includ+   
in=mation on ! reasons = su* d5ials4    
7,d7 ,! numb] ( vet]ans & family memb]s 

:o appli$ = c>e & s]vices "u su*        
provisions ( law & are await+ a decision
 f ! ,secret>y on eligibility = su* c>e 
& s]vices z ( ! date ( su* report4  7#c7
 ,vet]an def9$ ,9 ?is subsection1 ! t]m 
vet]an includes a =m] memb] ( ! res]ve  
compon5ts ( ! ,arm$ ,=ces cov]$ by su*  
section #agaj7;e77#a77;,g74  #c4        
,presumption ( s]vice connection = c]ta9
 vet]ans expos$ to p]fluorooctanoic acid
 or o!r p]- & polyfluoroalkyl sub/ances 
7a7 ,9 g5]al ,*apt] #aa ( title #ch1    
,unit$ ,/ates ,code1 is am5d$ by ins]t+ 
aft] section #aaaf ! foll[+ new section3
  #aaaf;,a4 ,presumption ( s]vice       
connection = c]ta9 vet]ans expos$ to    
p]fluorooctanoic acid or o!r p]- &      
polyfluoroalkyl sub/ances  7a7          
,presumption ( s]vice connection  7#a7  
,= ! purposes ( section #aaaj ( ?is     
title1 & subject to section #aaac ( ?is 
title1 ea* disease or illness specifi$ 9
 subsection 7b7 t becomes manife/ 9 a   
vet]an describ$ 9 p>agraph 7#b7 %all be 
consid]$ to h be5 incurr$ or aggravat$ 9

 ! l9e ( duty 9 ! active milit>y1 naval1
 or air s]vice1 not)/&+ t !re is no     
record ( evid5ce ( su* disease or       
illness dur+ ! p]iod ( su* s]vice4  7#b7
 ,a vet]an describ$ 9 ?is p>agraph is a 
vet]an :o1 dur+ active milit>y1 naval1  
or air s]vice1 s]v$ at a milit>y        
in/allation at :i* individuals 7 expos$ 
to p]fluorooctanoic acid or o!r p]- &   
polyfluoroalkyl sub/ances1 includ+      
exposure ?r\gh a well t provides wat] = 
human consumption t is contam9at$ ) su* 
sub/ances4  7b7 ,diseases or illnesses  
,a disease or illness specifi$ 9 ?is    
subsection is any ( ! foll[+3 7#a7 ,)   
respect to exposure to p]fluorooctanoic 
acid--  7,a7 diagnos$ high *ole/]ol2    
7,b7 ulc]ative colitis2  7,c7 ?yroid    
disease2  7,d7 te/icul> canc]2  7,e7    
kidney canc]2 &  7,f7 pregnancy-induc$  
hyp]t5sion4  7#b7 ,) respect to exposure
 to o!r p]- & polyfluoroalkyl sub/ances1
 any o!r disease1 illness1 or condition 
t ! ,secret>y ( ,vet]ans ,affairs1 9    
consultation ) ! ,adm9i/rator ( ! ,ag5cy

 = ,toxic ,sub/ances & ,disease ,regi/ry
 ( ! ,dep>tm5t ( ,heal? & ,human        
,s]vices1 det]m9es pursuant to ! /udy   
conduct$ "u section #caf ( ! ,national  
,def5se ,au?orization ,act = ,fiscal    
,ye> #bjah 7,public ,law #aae-ia7 t a   
positive association exi/s betwe5       
exposure to p]- & polyfluoroalkyl       
sub/ances & su* disease or illness4  7c7
 ,active milit>y1 naval1 or air s]vice  
,= purposes ( ?is section1 any s]vice by
 a memb] ( ! res]ve compon5ts = a p]iod 
specifi$ by ! ,secret>y at a milit>y    
in/allation describ$ 9 subsection       
7a77#b7 %all be treat$ z active milit>y1
 naval1 or air s]vice1 not)/&+ section  
#aja7bd7 ( ?is title4  4  7b7 ,cl]ical  
am5dm5t ,! table ( sections at ! beg9n+ 
( su* *apt] is am5d$ by ins]t+ aft] !   
item relat+ to section #aaaf ! foll[+   
new item3  #aaaf;,a4 ,presumption (     
s]vice connection = c]ta9 vet]ans expos$
 to p]fluorooctanoic acid or o!r p]- &  
polyfluoroalkyl sub/ances4  4