Publisher Health

More than two decades ago, Congress declared that victims of government-caused nuclear contamination who developed cancer and other serious illnesses — including uranium miners and those exposed to radiation from Manhattan Project-era atomic tests — should receive federal compensation.

“The health of the individuals who were unwitting participants in these tests was put at risk to serve the national security interests of the United States,” read the law enacted in 1990. “The United States should recognize and assume responsibility for the harm done to these individuals.”

Now that statute, known as the Radiation Exposure Compensation Act, is in peril, set to expire in June without a clear path for renewal. And an effort to broaden it substantially beyond Cold War-era victims, to others who have been harmed by the aftereffects in the decades since, has run into a brick wall on Capitol Hill.

The Senate voted overwhelmingly in July to attach legislation renewing and expanding the program to the annual defense policy bill. But in the final version negotiated behind doors by congressional leaders, that measure, sponsored by Senators Josh Hawley, Republican of Missouri, and Ben Ray Luján, Democrat of New Mexico, was dropped.

Republicans objected to its hefty price tag, which congressional scorekeepers estimated could top $100 billion.

In an angry floor speech on Thursday, Mr. Hawley said the move amounted to Congress “rescinding” the apology it had made to victims decades ago.

“That allows this program to expire,” he said. “That turns its back on the tens of thousands of good Americans who have sacrificed for their country, who have dutifully given their health and in many cases their lives to this country, and gotten nothing.”

The original legislation was written with a narrow scope, meant to compensate those who participated in or were present for aboveground atomic bomb testing, a hallmark of the Manhattan Project in the 1940s, or uranium miners who worked between 1942 and 1971.

The law has paid out more than $2.5 billion in benefits to more than 55,000 claimants since its creation in 1990, according to congressional researchers. Claimants, who can include children or grandchildren of those who would have benefited from the program but have since died, receive a one-time payment ranging from $50,000 to $100,000.

The updated version by Mr. Hawley and Mr. Luján would expand the number of people eligible to receive compensation, and also increase the highest payout to $150,000. The law currently restricts eligibility for “down-winders,” or people who lived near one of the test sites, to those who resided in a handful of counties in Utah, Nevada and Arizona.

“The members that worked on this policy once upon a time, they left out states like New Mexico — and not just the entire state,” Mr. Luján, who has pushed to expand eligibility to individuals in most western states, said in an interview. “They left out the entire county where the first bomb was tested. That alone shows the people have been left out.”

The bill, which President Biden has endorsed, makes the case that the federal government should compensate anyone grievously sickened by the legacy of the nation’s nuclear weapons program.

It would extend access to the federal fund for 19 years and expand eligibility to Missourians sickened by radioactive waste that was never properly disposed of — and in some cases left out in the open near a creek — in St. Louis, the home of a uranium processing site in the 1940s.

A blockbuster report by The Missouri Independent, MuckRock and The Associated Press earlier this year found that generations of families growing up in the area have since faced “rare cancers, autoimmune disorders and other mysterious illnesses they have come to believe were the result of exposure to its waters and sediment.”

It wasn’t until 2016 that the Centers for Disease Control and Prevention advised residents to avoid the creek entirely, and cleanup is expected to take until 2038.

“It is true that the Manhattan Project is in the past and the Cold War-era nuclear testing is in the past,” Mr. Hawley said in an interview. “But people are still dealing with the consequences of that.”

Unless Congress passes new legislation extending the law, the fund will shut down in June. Republican leaders in both the House and Senate objected to including it in the annual defense bill, citing a report by the Congressional Budget Office estimating that the proposed renewal would introduce $140 billion in new, mandatory spending.

Mr. Hawley and Mr. Luján said they had sought to whittle down the legislation to decrease costs, but that Republicans maintained that the billions of dollars involved would still be untenable.

Congress could still try to pass the legislation on its own, but it is increasingly rare for single-issue bills to make it through both chambers and to Mr. Biden’s desk. That is why the pair had attempted to use the hulking annual defense bill, regarded as a must-pass item, to push it through. Now they are regrouping.

“Every option is on the table to be able to get this done,” Mr. Luján said.