,,ii  #aafth ,,congress  #ast ,session  
,s4 #ajbc  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,april #c1     
#bjai,ms4 ,stabenow 7for herself1 ,mr4  
,peters1 and ,mr4 ,casey7 introduced the
 following bill2 which was read twice   
and referred to the ,committee on       
,veterans' ,affairs  ,a ,,bill  ,to     
amend title #ch1 ,united ,states ,code1 
to furnish hospital care and medical    
services to veterans1 members of the    
reserve components of the ,armed        
,forces1 and dependents who were        
stationed at military installations at  
which they were exposed to              
perfluorooctanoic acid or other per- and
 polyfluoroalkyl substances1 to provide 
for a presumption of service connection 
for those veterans and members of the   
reserve components1 and for other       
purposes4  #a4 ,short title ,this ,act  
may be cited as the ,veterans ,exposed  
to ,toxic ,,pfas ,act or the ,,vet      
,,pfas ,act4  #b4 ,hospital care and    
medical services for veterans1 members  

of the reserve components1 and          
dependents exposed to perfluorooctanoic 
acid and other per- and polyfluoroalkyl 
substances  7a7 ,hospital care and      
medical services for veterans and       
members of the reserve components  7#a7 
,in general ,paragraph 7#a7 of section  
#agaj7;e7 of title #ch1 ,united ,states 
,code1 is amended by adding at the end  
the following new subparagraph3  7,g7   
7i7 ,beginning on the date that is #ij  
days after the date of the enactment of 
this subparagraph1 subject to paragraph 
7#b71 a veteran who served on active    
duty in the ,armed ,forces1 or an       
individual who served as a member of the
 reserve components of the ,armed       
,forces1 at a covered military          
installation at which individuals were  
exposed to substances specified in      
clause 7ii7 is eligible for hospital    
care and medical services under         
subsection 7a77#b77;,f7 for the         
diseases1 illnesses1 or conditions as   
specified in such clause1               

notwithstanding that there is           
insufficient medical evidence to        
conclude that such illness or condition 
is attributable to such service4  7ii7  
,the substances and diseases1 illnesses1
 or conditions specified in this clause 
are the following3 7,i7 ,with respect to
 exposure to perfluorooctanoic acid--   
7aa7 diagnosed high cholesterol2  7bb7  
ulcerative colitis2  7cc7 thyroid       
disease2  7dd7 testicular cancer2  7ee7 
kidney cancer2 and  7ff7                
pregnancy-induced hypertension4  7,,ii7 
,with respect to exposure to other      
perfluoroalkyl and polyfluoroalkyl      
substances1 any disease1 illness1 or    
condition that the ,secretary1 in       
consultation with the ,agency for ,toxic
 ,substances and ,disease ,registry of  
the ,department of ,health and ,human   
,services1 determines pursuant to the   
study conducted under section #caf of   
the ,national ,defense ,authorization   
,act for ,fiscal ,year #bjah 7,public   
,law #aae-ia2 #aca ,stat4 #acej7 that a 

positive association exists between     
exposure to perfluoroalkyl and          
polyfluoroalkyl substances and such     
disease1 illness1 or condition4  7iii7  
,in this subparagraph1 the term covered 
military installation means a military  
installation at which individuals were  
exposed to perfluorooctanoic acid or    
other perfluoroalkyl and polyfluoroalkyl
 substances1 including exposure through 
a well that provides water for human    
consumption that is contaminated with   
such substances4  4  7#b7 ,limitation   
,paragraph 7#b77;,b7 of such section is 
amended by striking or 7,f7 and         
inserting 7,f71 or 7,g74  7b7 ,family   
members  7#a7 ,in general ,subchapter   
,,viii of chapter #ag of title #ch1     
,united ,states ,code1 is amended by    
inserting after section #aghg the       
following new section3  #aghg;,a4       
,health care of family members of       
individuals stationed at certain        
military installations  7a7 ,in general 
,beginning on the date that is #ij days 

after the date of the enactment of this 
section1 subject to subsection 7b71 a   
family member of a veteran described in 
clause 7i7 of section #agaj7;e77#a77;,g7
 of this title 7or who would be so      
described but for the condition by which
 the individual was discharged or       
released from the ,armed ,forces71 or a 
family member of a member of the reserve
 components of the ,armed ,forces       
described in such clause1 who resided at
 a military installation covered by such
 clause or who was in utero while the   
mother of such family member resided at 
such location shall be eligible for     
hospital care and medical services      
furnished by the ,secretary for any     
disease1 illness1 or condition for which
 an individual may receive hospital care
 and medical services under clause 7ii7 
of such section1 notwithstanding that   
there is insufficient medical evidence  
to conclude that such disease1 illness1 
or condition is attributable to such    
residence4  7b7 ,limitations  7#a7 ,the 

,secretary may only furnish hospital    
care and medical services under         
subsection 7a7 to the extent and in the 
amount provided in advance in           
appropriations ,acts for such purpose4  
7#b7 ,hospital care and medical services
 may not be furnished under subsection  
7a7 for a disease1 illness1 or condition
 of a family member that is found1 in   
accordance with guidelines issued by the
 ,under ,secretary for ,health1 to have 
resulted from a cause other than the    
residence of the family member described
 in that subsection4  7#c7 ,the         
,secretary may provide reimbursement for
 hospital care or medical services      
provided to a family member under this  
section only after the family member or 
the provider of such care or services   
has exhausted without success all claims
 and remedies reasonably available to   
the family member or provider against a 
third party 7as defined in section      
#agbe7;f7 of this title7 for payment of 
such care or services1 including with   

respect to health-plan contracts 7as    
defined in such section74  4  7#b7      
,clerical amendment ,the table of       
sections at the beginning of such       
chapter is amended by inserting after   
the item relating to section #aghg the  
following new item3  #aghg;,a4 ,health  
care of family members of individuals   
stationed at certain military           
installations4  4  7c7 ,annual reports  
7#a7 ,in general ,during the three-year 
period beginning on the date on which   
the study conducted under section #caf  
of the ,national ,defense ,authorization
 ,act for ,fiscal ,year #bjah 7,public  
,law #aae-ia2 #aca ,stat4 #acej7 is     
submitted to ,congress1 the ,secretary  
of ,veterans ,affairs shall submit to   
the ,committee on ,veterans' ,affairs of
 the ,senate and the ,committee on      
,veterans' ,affairs of the ,house of    
,representatives an annual report on the
 care and services provided under       
sections #agaj7;e77#a77;,g7 and #aghg;,a
 of title #ch1 ,united ,states ,code 7as

 added by subsections 7a7 and 7b77#a71  
respectively74  7#b7 ,elements ,each    
report under paragraph 7#a7 shall set   
forth the following3 7,a7 ,the number of
 veterans1 members of the reserve       
components of the ,armed ,forces1 and   
family members provided hospital care   
and medical services under the          
provisions of law specified in paragraph
 7#a7 during the period covered by the  
report4  7,b7 ,the illnesses1           
conditions1 and disabilities for which  
care and services have been provided    
such veterans1 members of the reserve   
components1 and family members under    
such provisions of law during that      
period4  7,c7 ,the number of veterans1  
members of the reserve components1 and  
family members who applied for care and 
services under such provisions of law   
during that period but were denied1     
including information on the reasons for
 such denials4  7,d7 ,the number of     
veterans1 members of the reserve        
components1 and family members who      

applied for care and services under such
 provisions of law and are awaiting a   
decision from the ,secretary on         
eligibility for such care and services  
as of the date of such report4  #c4     
,presumption of service connection for  
certain individuals exposed to          
perfluorooctanoic acid or other per- and
 polyfluoroalkyl substances  7a7 ,in    
general ,chapter #aa of title #ch1      
,united ,states ,code1 is amended by    
inserting after section #aaaf the       
following new section3  #aaaf;,a4       
,presumption of service connection for  
certain individuals exposed to          
perfluorooctanoic acid or other per- and
 polyfluoroalkyl substances  7a7        
,presumption of service connection  7#a7
 ,for the purposes of section #aaaj of  
this title1 and subject to section #aaac
 of this title1 each disease1 illness1  
or condition specified in subsection 7b7
 that becomes manifest in an individual 
described in paragraph 7#b7 shall be    
considered to have been incurred or     

aggravated in the line of duty in the   
active military1 naval1 or air service1 
notwithstanding that there is no record 
of evidence of such disease1 illness1 or
 condition during the period of such    
service4  7#b7 ,an individual described 
in this paragraph is-- 7,a7 a veteran   
who1 during active military1 naval1 or  
air service1 served at a military       
installation at which individuals were  
exposed to perfluorooctanoic acid or    
other perfluoroalkyl and polyfluoroalkyl
 substances1 including exposure through 
a well that provides water for human    
consumption that is contaminated with   
such substances2 or  7,b7 a member of   
the reserve components of the ,armed    
,forces who served at a military        
installation described in subparagraph  
7,a74  7b7 ,diseases or illnesses ,a    
disease1 illness1 or condition specified
 in this subsection is any of the       
following3 7#a7 ,with respect to        
exposure to perfluorooctanoic acid--    
7,a7 diagnosed high cholesterol2  7,b7  

ulcerative colitis2  7,c7 thyroid       
disease2  7,d7 testicular cancer2  7,e7 
kidney cancer2 and  7,f7                
pregnancy-induced hypertension4  7#b7   
,with respect to exposure to other      
perfluoroalkyl and polyfluoroalkyl      
substances1 any other disease1 illness1 
or condition that the ,secretary1 in    
consultation with the ,agency for ,toxic
 ,substances and ,disease ,registry of  
the ,department of ,health and ,human   
,services1 determines pursuant to the   
study conducted under section #caf of   
the ,national ,defense ,authorization   
,act for ,fiscal ,year #bjah 7,public   
,law #aae-ia7 that a positive           
association exists between exposure to  
perfluoroalkyl and polyfluoroalkyl      
substances and such disease1 illness1 or
 condition4  4  7b7 ,clerical amendment 
,the table of sections at the beginning 
of such chapter is amended by inserting 
after the item relating to section #aaaf
 the following new item3  #aaaf;,a4     
,presumption of service connection for  

certain individuals exposed to          
perfluorooctanoic acid or other per- and
 polyfluoroalkyl substances4  4