Under pressure from Congress to determine whether to add four diseases to the list of Agent Orange-related conditions, Department of Veterans Affairs officials have disputed a scientific panel’s findings and said they will wait for additional research to conclude before making what could be a $15.2 billion decision.
In a report sent to the House and Senate Veterans Affairs committees on Monday, VA Secretary Robert Wilkie said VA experts “noted significant concerns and limitations” with several National Academies of Sciences, Engineering and Medicine, or NASEM, reports concluding that there is suggestive or sufficient evidence linking development of bladder cancer, hypothyroidism, Parkinson’s-like tremors and hypertension to exposure to herbicides for defoliation in the Vietnam War.
According to Wilkie, NASEM did not identify any “definitive causal links” between Agent Orange and the diseases, and at least two — hypertension and bladder cancer — have other risk factors besides herbicide exposure, such as age, diet and tobacco use, that can contribute to their development.
Also, Wilkie said, members of the NASEM panel, in drawing their conclusions, relied heavily on studies of Army Chemical Corps members “with known high occupational exposure” that don’t necessarily reflect the experience of most U.S. troops in Vietnam.
Given the concerns and the cost, which according to VA could run between $11.2 billion and $15.2 billion, depending on interpretations of a court ruling, VA is waiting for the results of its own studies, expected later this year, to announce any decision, the report says.
“The soonest the secretary would be able to consider adding any new presumptive conditions is in late 2020,” the report states.
The VA reports in question, the Vietnam Era Health Retrospective Observational Study, or VE-HEROES, and the Vietnam Era Mortality Study, are complete but the conclusions must be analyzed and peer-reviewed as part of the decision-making process, according to the report.
VA submitted the report to Congress Monday as required by the fiscal 2020 federal appropriations bill. Senate and House lawmakers have grown frustrated with the department for a nearly three-year delay in announcing a decision.
Dr. David Shulkin, who served as VA secretary from January 2017 to March 2018, publicly stated in late 2017 that he had made a decision on whether to add three of the diseases, but the outcome was never released.
Last October, Military Times reported that the delays resulted from 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.
According to the report, more than 190,000 veterans would be eligible for disability compensation in the first year if all four conditions were approved. VA estimated that the number would grow to 2.1 million after five years.
On Tuesday, Democrats who have pressed the VA to issue a decision expressed outrage over the report, calling it “shameful.”
Senate Minority Leader Chuck Schumer, D-N.Y., said the Trump administration "continues to deny veterans ... the treatment they deserve.”
“The report offers no explanation as to why the White House, Mick Mulvaney, and OMB continue to block these benefits and gives no plan to get veterans the coverage they need,” Schumer said. “It’s outrageous that the Trump administration is breaking our nation’s promise to our service members by leaving behind veterans suffering from Agent Orange exposure over ‘cost’ and attacking sound science from the National Academies. This is flat out unacceptable.”
Rep. Josh Harder, a California Democrat who last year introduced a House resolution urging President Donald Trump to add the diseases to the presumptive medical conditions list, said Tuesday that the science already exists to add the diseases to the list of presumptive conditions.
“This [report] confirms our suspicion that the VA is continuing to drag their feet while tens of thousands of veterans are left to suffer with these diseases without the benefits they’re owed,” Harder said. "Congress needs to step in.”
Sen. Jon Tester, D-Mont., said veterans aren’t getting “justice” and instead have been “subjected to unwarranted delays, and consistently denied access to the critical care and benefits.”
“This report is particularly troubling because the administration is denying the overwhelming scientific evidence that has already been put forth, and is instead changing the rules by seemingly forcing veterans with bladder cancer, hypothyroidism, Parkinsonism, and hypertension to meet a different — perhaps unattainable — standard,” Tester said.
In the report, Wilkie said VA “remains committed to the care of Vietnam veterans.”
VA also is committed to “the continued study of Agent Orange and its associated adverse health effects as well as regular review of all emerging evidence of adverse impacts to veterans from Agent Orange,” Wilkie wrote.
Patricia Kime is a senior writer covering military and veterans health care, medicine and personnel issues.