The massive federal funding bill introduced Monday would require Veterans Affairs leaders to reveal whether they plan to add new diseases to the Agent Orange presumptive conditions list.

The legislation includes a provision requiring VA to report to Congress within 30 days the reasons for a two-year delay in announcing any decisions, a cost estimate for adding new diseases and the date VA plans implement a decision.

Although the bill doesn’t name the conditions under consideration, the list includes bladder cancer, hypothyroidism, Parkinson’s-like tremors and hypertension. The National Academies of Sciences, Engineering and Medicine in 2016 said there is suggestive evidence that the first three diseases are linked to herbicide exposure. Meanwhile, in November 2018, the Academies said sufficient evidence exists to connect hypertension and monoclonal gammopathy of undetermined significance, or MGUS, a blood disorder that can cause some cancers, to defoliants.

Following release of the National Academies report in 2016, former VA Secretary David Shulkin said he had made a decision on three diseases and an announcement on the outcome would be forthcoming, but it never came.

In March, Dr. Richard Stone, executive in charge at the Veterans Health Administration, told the Senate Veterans Affairs Committee that a decision on new presumptive conditions would come “within 90 days,” but that never happened either.

VA Secretary Robert Wilkie has since said the announcement will come in early 2020.

In October, Military Times reported that the delays have been the result of objections from the Office of Management and Budget and White House advisers who raised concerns about the cost of adding new diseases to the list and requested additional scientific evidence to support the connection between herbicide exposure and the illnesses.

Senate Majority Leader Sen. Chuck Schumer, D-N.Y., said Monday that the nearly two-year delay was “outrageous,” and he and fellow Democrats pushed to have the provision in the bill that would require VA and OMB to respond.

“[They’ll] now have 30 days to deliver a plan detailing how they’ll get veterans suffering from Agent Orange exposure the coverage they need,” Schumer said. “Our veterans sacrificed a great deal in service to our country, and they absolutely deserve the treatment and benefits they’ve earned.”

Roughly 83,000 Vietnam veterans have been diagnosed with bladder cancer, hypothyroidism or have Parkinson’s-like symptoms.

More than 300,000 Vietnam veterans enrolled in VA health care have high blood pressure, which also is an age-related condition. VA officials have previously stated that it would be a challenge to determine who has high blood pressure as a result of their military service in the Vietnam War or simply a factor of their age.

VA officials have said they are waiting for the results of two research projects, the Vietnam Veterans Mortality and the Vietnam Morbidity studies, to satisfy OMB requirements before announcing a final decision.

Rep. Josh Harder, a California Democrat who previously introduced a House resolution urging President Donald Trump to add the diseases to the presumptive medical conditions list, said Tuesday that “the VA needs to get its act together.”

“We have the science. We have the backing of our veterans. We even have bipartisan agreement in Congress. It’s time for the VA to catch up,” Harder said.

The freshman congressman’s grandfather served in Vietnam and died from cardiovascular disease linked to exposure and Harder also has constituents awaiting a decision.

"Veterans like my constituent Joshua Melendez — who has bladder cancer — can’t wait for the bureaucracy to get the help they need. It’s time to get going here,” he said.

The proposed legislation, part of the fiscal 2020 appropriations package released Monday is expected to pass the Senate and the House this week.

Patricia Kime is a senior writer covering military and veterans health care, medicine and personnel issues.

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