May 30, 2024

WASHINGTON — The Senate on Tuesday approved a bill to create a new entitlement program to treat veterans who may have been exposed to toxic substances from burning trash pits on U.S. military bases, sending President Biden legislation that would expand medical care eligibility to an estimated 3.5 million people.

The bill was approved on a lopsided bipartisan vote, 86 to 11, only days after Republicans pulled their support in a dispute over how to pay for the benefits, imperiling the legislation and drawing days of angry protests from veterans who gathered outside the Capitol to demand action.

The measure would be the biggest expansion of veterans’ benefits since the Agent Orange Act of 1991, which increased access to care for Vietnam War veterans who had been exposed to the toxic herbicide that endangered generations of Vietnamese, Laotians and Cambodians.

The new legislation would effectively presume that any American service member stationed in a combat zone for the last 32 years could have been exposed to toxic substances, allocating a projected $280 billion over the next decade to treat ailments tied to those exposures and streamlining veterans’ access to such care.

The House approved the bill last month, and Mr. Biden, who has championed the measure, was expected to quickly sign it. He has speculated that toxic substances from burn pits contributed to the brain cancer that killed his son Beau Biden, who served in Iraq, in 2015.

The legislation had drawn broad support on Capitol Hill, but just as it was expected to clear the Senate last week, Republicans in the chamber abruptly withdrew their backing, insisting that Democrats allow them a chance to limit the funding available to treat veterans.

The bill would provide guaranteed funding for treating veterans exposed to toxins by setting up a dedicated fund that would not be subject to the annual congressional spending process. Senator Patrick J. Toomey, Republican of Pennsylvania, warned that the measure was written in a way that could allow for immense new spending unrelated to veterans’ care.

Mr. Toomey tried and failed to cap the amount of money that could be put into the fund every year, a move that Denis McDonough, the secretary of veterans affairs, had warned could lead to “rationing of care for vets.”

Mr. Toomey also proposed shifting the fund for treating veterans into so-called discretionary spending after a decade, meaning that the Department of Veterans Affairs would have to request funding each year. That would subject the funding to Congress’s approval and the annual partisan spending battles on Capitol Hill, rather than having it guaranteed.

Democrats opposed both efforts, saying the legislation did not need to be changed.

“This is a bill that will work for this country, that will work for the taxpayers of this country and it will work, most importantly, for the veterans and their families,” said Senator Jon Tester, Democrat of Montana and the chairman of the Veterans’ Affairs Committee.

Susan Zeier, the mother-in-law of Heath Robinson, a member of the Ohio Army National Guard for whom the bill is named, had been protesting outside the Capitol for days to urge the Senate to pass the measure before leaving for its summer recess.

Mr. Robinson served in Iraq and died in 2020 after battling lung cancer believed to have been tied to burn pit exposure, and the bill is called the Sgt. First Class Heath Robinson Honoring Our Promise to Address Comprehensive Toxics Act of 2022.

“For me and my daughter, this is the satisfaction that we fulfilled our promise to Heath,” Ms. Zeier said. “We hope families don’t suffer like we did.”

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