On Aug. 10, 2022, President Biden signed into law a monumental expansion in VA health care and benefits. The full name of the law is The Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics (PACT) Act.

The best-known provisions of the law are those that add more than 20 new medical conditions that result in presumptive eligibility for service-connected disability benefits. Included are 11 respiratory-related conditions and several forms of cancer, including reproductive cancers, melanoma, pancreatic cancer, kidney cancer, and brain cancers such as glioblastoma. These relate primarily to burn pits, but also to other toxic exposures.  Veterans suffering from one of these conditions no longer have the difficult task of proving that their condition was caused by their exposure while serving. Adding these conditions to the list of presumptive eligibility means that all a veteran must show is that they have the condition and that they served during the timeframe or in the mission or location that applies to that presumption. Cancers and other conditions linked to Agent Orange and radiation exposure already resulted in presumptive eligibility for many veterans. However, the list of locations where veterans were known to be exposed to these agents has been expanded, leading to the ability of many more veterans to receive service-connected disability benefits. In addition, two more medical conditions were added, including hypertension, which impacts a huge number of veterans. The PACT Act also codifies a new process for evaluating and determining presumption of exposure and service connection for additional conditions. 

Eligibility for VA health care is also expanded under the Act. Now Gulf War and post 9/11 veterans are eligible if they served in theater of combat operations during a period of war after the Persian Gulf War or served in combat during a period of hostilities after November 11, 1998. The bill extends the period these veterans have to enroll in VA health care from five to ten years post-discharge. And for combat veterans who are beyond that window, the bill creates a one-year open enrollment period. The Act also requires the VA to provide a toxic exposure screening to every veteran enrolled in VA health care.

In addition, the PACT Act requires the VA to conduct new studies of veterans who served in Southwest Asia during the Gulf War and analyses of post-9/11 veterans’ health trends. The new law also directs the Secretary of Veterans Affairs to convene a new interagency working group to develop a five-year strategic plan on toxic exposure research. The Act also requires the VA to establish an outreach program for veterans regarding toxic exposure-related benefits and supports, and to require additional toxic exposure-related education and training for VA personnel.

Finally, the law includes funding to provide the VA with mechanisms to enhance claims processing, increase the workforce, and fund 31 major medical health clinics and research facilities in 19 states.