Same CPAP, Two Filing Dates, a Thousand Dollars a Month Apart
They could not pass the rule. So they buried it in a bill you would never read.
A ribbon that says benefits, and scissors that say otherwise. (AI-generated illustration.)
A rose by any other name smells as sweet.
A cut by any other name still bleeds.
June 26, 2026. They were a floor vote from passing it this week. Then they pulled it.
The rule was set on June 23, closed, no amendments, Section 108 sealed inside where no member could stand up and move to strike it. The vote was expected the week of June 22. It never came. House Republicans gaveled out for the week without calling it up, the floor frozen by a separate standoff over the SAVE Act even as opposition from Democrats, the VFW, DAV, and federal unions stacked up.
Do not mistake a stall for a stop. The bill is not dead. It comes back the week the floor reopens, the Senate companion behind it, and the cut is still buried on page sixty. Here is what is in it.
THE GIST
A bill named the Take Care of America’s Veterans Act hands combat-injured retirees one overdue benefit, then pays for it by rewriting how VA rates the two conditions veterans claim most: sleep apnea and tinnitus. That rewrite is Section 108, about sixty pages in. It is not a new idea from Congress. It is VA’s own proposed rule, the one the agency could not finish through four years of rulemaking, now written straight into law where no comment period, no court, and no future Secretary can undo it. Veterans already rated are protected. The bill is paid for by the ones who have not filed yet.
Two veterans, one throat
Picture two veterans with the same throat. Both have obstructive sleep apnea from the same war. Both sleep strapped to the same CPAP machine VA prescribed. The only thing separating them is a calendar.
The first filed last year. Under the rules on the books today, needing that machine earns her a 50 percent rating, worth $1,132.90 a month for a single veteran. The second files the day after this bill becomes law. Same throat, same machine, same war. His rating is 10 percent, or zero if the machine works well enough. The gap is more than a thousand dollars a month, for the rest of their lives, and the only variable is the date on the form.
That is Section 108. It sits two-thirds of the way into a 554-page bill (official text at congress.gov) with a name that tells you not to read it, and it is the quiet engine that pays for the part Congress wants on the marquee.
The bill did not have to exist. The day before this package rolled out, House Democrats filed a discharge petition to force a clean, standalone vote on the Major Richard Star Act, the very benefit now being used to sell everything stapled to it. The Star Act had the votes. It was about to move. Twenty-four hours later it surfaced instead as the centerpiece of an omnibus, with the cut to sleep apnea and tinnitus attached to its back. The Star Act never needed this bill. This bill needed the Star Act.
And the Star Act stapled into this package is not even the clean one. Rep. Raul Ruiz of California, who cosponsored the discharge petition for the standalone bill, points out that this version carries a cap the clean bill does not, so some of the combat-injured retirees it is named for still could not collect their full retirement and disability together. The bait is a discount on the bait.
The rule they could not pass
Section 108 is not something Congress invented. It is VA’s own rule.
The agency proposed this exact change in a notice of proposed rulemaking published February 15, 2022. Veterans pushed back hard in the comment period. VA went quiet, floated a revised version in September 2024, and still has not finalized it more than four years later. Read Section 108 against that proposed rule and it is the same schedule, almost line for line: zero percent when asymptomatic, 10 percent when treatment gives incomplete relief, 50 or 100 only when treatment fails or you cannot use it, 100 reserved for end-organ damage.
A rule that cannot survive the front door is being walked in through the back. Put it in a statute and the comment process that stalled it no longer applies, a future Secretary cannot reverse it with a pen, and a court has far less room to question it. They could not pass the rule. So they put it in a bill you would never read.
Why tinnitus and why sleep apnea
They did not pick at random. They picked the highest-volume claim and the highest-dollar claim in the system.
VA’s own Annual Benefits Report for fiscal year 2025 puts tinnitus first: 3,583,295 veterans carry it, and 287,138 more were granted it in that one year. Ending the standalone 10 percent rating closes the door on roughly a quarter-million new tinnitus claimants every year, each told zero where the rules today say ten. Sleep apnea brings the dollars: 763,763 service-connected ratings, the largest respiratory condition after allergic rhinitis, most at the 50 percent CPAP level Section 108 pushes toward 10 or 0.
Here is the part that should stop you cold. The marquee benefit, the Star Act in this bill, costs about $11 billion over ten years and reaches roughly 54,000 combat-injured retirees. The cut that pays for it has been scored three different ways:
$38 billion by the bill’s own boosters (Americans for Prosperity)
Up to $57 billion by VA itself, hitting as many as 1.5 million veterans
At least $60 billion by the committee’s ranking member
Pick any of those numbers. The cut is three to five times the benefit it is sold as funding. It does not offset the Star Act. It dwarfs it, and it bankrolls the entire 60-bill package on the backs of future tinnitus and sleep apnea claimants. The most expensive thing in this bill is the cut.
Yes, your rating is safe. Here is the catch.
Be clear about what this does not do, because the other side will try to catch you overstating it. If you already hold a rating for sleep apnea or tinnitus, Section 108 does not cut it. The bill says so, and the proposed rule said the same. Anyone telling current ratees their checks are about to shrink is wrong, and saying so out loud is how you keep your credibility.
Now the catch. The protection covers the rating you hold today. The new criteria govern every claim filed after the law takes effect. So the veteran at 50 percent who later files for an increase, or who gets called back for a reexamination and lands back in the system, is standing in the new world, not the old one. The bill protects the rating in effect. It does not promise that protection survives the day you ask for more. That question is not answered in the text, and it is the one veterans should be asking out loud.
Help, paid for by hurt
One group of veterans gains here, and another pays. The combat-injured retirees who finally get full concurrent receipt deserve it, and have for years. But the bill funds them by taking it out of the next generation of tinnitus and sleep apnea claimants, the cohort with no rating to grandfather and no lobby in the hearing room. The VFW said it plainly in opposing the bill: future disabled veterans should not be made to bear the cost of expanding benefits, because earned compensation is an obligation of the nation, not a piggy bank to be raided through offsets. Cutting tinnitus and sleep apnea is not a benefit to veterans. It is a benefit to some veterans, billed to others who have not walked in the door yet.
Written to be unreadable
This is how something this big moves without a fight. Not by lying. By being unreadable.
The committee’s own one-pager lists about twenty benefit bills by name, then disposes of the cut in a single sentence at the bottom:
The Take Care of America’s Veterans Act is fully offset by codifying a bipartisan change to VA’s ratings schedule.
That is the only mention. It never says Section 108. It never says tinnitus or sleep apnea. It never says who loses what.
Then came the last lock on the door. On June 23 the Rules Committee cleared the bill for the floor under a closed rule, which means no member can offer an amendment, including one to strip Section 108. A 554-page bill, a cut buried two-thirds in, set to reach the floor in a form that cannot be touched. The left will call the whole thing an attack on veterans, the right will call it overdue reform, and almost nobody on either side will read to Section 108 and tell you what it changes for the veteran filing next month. That is the job here, and it is why a veteran-run outlet has to be the one to do it.
It does not stop at 108
Section 108 is the cut you can see. It is not the only thing worth watching.
Section 601 lifts VA’s community-care access standards into statute and bars VA from counting its own telehealth when it decides whether it can see you in-house, which steers more care outside the VA.
Section 603 adds a new factor to community-care eligibility: whether a veteran “would abstain from seeking such care if required” to use the VA, paired with language that the call must stay “driven by clinical need.” Critics, including Paralyzed Veterans of America, read it as turning a veteran’s preference to skip the VA into a key that unlocks private care.
Section 674 rebuilds VA’s innovation office into a payment-model engine that can change benefit scope “as may be necessary to carry out an approved model,” and orders a review of community care against Medicare “best practices.”
Russell Lemle and Suzanne Gordon laid out that privatization arc in The American Prospect this week. This piece is the companion to theirs: they mapped the destination, this one walks the machinery.
This did not come out of nowhere
If Section 108 feels like it appeared from thin air, it did not. It is the last step in a sequence that played out in public, on the record, over three years. You do not need a secret meeting. You need a calendar.
2023. The Heritage Foundation’s Project 2025 calls in writing for an accelerated, budget-office-cleared rewrite of the rating schedule to produce “significant cost savings from revising disability rating awards for future claimants,” while leaving existing ratings in place. Cut the future, protect the present. That is the architecture of Section 108.
October 6, 2025. The Washington Post runs a series casting the disability system as bloated and gameable, with one piece arguing VA pays more for sleep apnea than for some lost limbs.
October 29, 2025. Three weeks later, the Senate Veterans’ Affairs Committee holds a hearing. Daniel Gade, a longtime critic of the compensation system, testifies that it “robs veterans of purpose and dignity” and that “only in the VA system are flat feet and tinnitus a disability.” A senator floats a commission to study cutting ratings. The chairman promises more to come.
June 10, 2026. The bill arrives, cutting the exact two conditions the Post questioned and Gade named, in the exact “future claimants” structure Project 2025 prescribed.
You do not have to prove coordination to report what it is: a documented progression from blueprint to narrative to hearing to bill, each step sourced, each pointing the same way. The honest question, and it stays a question, is whether the series and the hearing were the softening-up or whether four things lined up by chance. What is not in question is that the people pushing VA privatization see this as the finish line. Concerned Veterans for America, the Koch-funded group that has argued for it for years, praised the bill as one that would “finish the job.” When the opponents call it Project 2025 made law and the funders call it finishing the job, the only disagreement is whether that is good news.
(Full disclosure: I covered the October 29 hearing here at the time, in “The Alarm Bell.” This bill is what that hearing was building toward.)
We are still making veterans
Let me be plain about where I stand, because TQF does not hide it.
I do not support any veterans’ package that makes veterans pay for veterans’ benefits.
Not this one, not a better-written one, not a future one with a friendlier name. The cost of keeping the country’s promise to its wounded belongs to the country. If Congress cannot fund a benefit without cutting another veteran’s compensation, the problem is the budget, not the veteran.
And the timing should make every member who votes for it flinch. This spring the United States fought a war. Operation Epic Fury, the campaign against Iran, ran from late February into the spring, and by Central Command’s own count it killed at least 13 service members and wounded about 400 in action. Those 400 are not a statistic. They are the next claimants. Blast and acoustic trauma are the textbook causes of ringing ears and the traumatic brain injuries that bring on sleep apnea. The troops hurt in that war will file for the exact two conditions Section 108 rewrites, and because their claims land after this bill takes effect, they get rated under the cut, not under the rule that protects the veteran who filed last year.
A sitting congressman said it more bluntly. At the June 25 press conference, Rep. Chris Deluzio of Pennsylvania said the bill “stabs those serving right now in the back,” many of them in uniform for this spring’s war, only to be rated under the cut when they come home and file.
The VFW’s executive director, Ryan Gallucci, put the same point in plain terms:
Anybody who’s on active duty now, anybody who was injured in Kuwait from Iranian drones, anyone working on a flight line or on an aircraft carrier right now would be subject to it when they get out of the military.
Sit with that. We are still making wounded veterans, by the hundreds, and the ink on this bill is not dry. In the same season, Congress is lowering what their wounds will be worth, steering their care toward private networks, and leaving the VA they will lean on to thin out. More casualties in the front door, smaller ratings waiting for them.
The money to avoid all of it exists. Blumenthal already said where: the $1.7 trillion Military Retirement Fund could cover the roughly $11 billion Star Act without touching a single disability rating. Congress did not run out of money. It picked who pays. It picked the veteran who has not filed yet, and the 400 who came home from this spring’s war and will.
What comes next
The defenders will point to a medical rationale, and one exists on paper: VA argued in 2022 that sleep apnea should be rated on how well treatment works, and that tinnitus is a symptom rather than a disease of its own. Those are real arguments. They are also old arguments, unchanged since 2022, and they could not carry the day through four years of the process built to weigh exactly that kind of evidence. No new medicine showed up in 2026. A package that needed an offset did.
That is the deeper danger, bigger than two diagnostic codes. The rating schedule is supposed to be medical. Congress handed it to VA on purpose, so a condition and its compensation would be set by clinical evidence, not by a vote. This bill breaks that wall, writing specific rating percentages into statute as an offset to pay for something else. John Kamin, deputy director of government relations at Common Defense, told The American Prospect that the system was designed to run on medical evidence and was never meant to be a political bargaining chip. Then he named the real stakes:
It’s not a question of whether more will be cut next, but which ones.
Kyleanne Hunter, CEO of IAVA, said it in plainer words:
Today it’s tinnitus and sleep apnea. Tomorrow it could be PTSD, migraines, toxic exposure conditions, or any other disability that becomes a tempting budget target.
Once a rating is a line in a budget instead of a medical finding, no rating is safe.
Remember how this started. A clean Star Act vote was a day away when this package landed on top of it. The benefit and the cut were never one thing. They could be pulled apart, and someone already tried. At the Rules Committee on June 23, Takano moved to throw out the 554-page package and pass the Star Act on its own, funded with Defense dollars already on the books. It was voted down. The choice to keep the cut bolted to the benefit is not an accident of drafting. It was put to a vote and made on purpose.
Here is where it stands. This is still a bill, not a law. It cleared the Rules Committee under a closed rule, then Republicans pulled it from the floor this week without calling the vote. The stated reason was a separate fight over the SAVE Act that froze every House vote. The timing, with opposition piling up, was its own kind of answer. The bill is not dead. It comes back the week the floor reopens, with the Senate companion, S. 4744, behind it. Nothing has changed for a single veteran yet, and it does not have to. The ask is simple enough for a postcard:
Pass the Star Act on its own.
Fund it honestly.
Leave the rating schedule to medicine.
The window to say so is now, while it is stalled, not after it comes back.
TAKE ACTION
The issue: Section 108 of H.R. 9237 would rewrite VA’s sleep apnea and tinnitus rating criteria for all future claims, using the same schedule VA has been unable to finalize through rulemaking since 2022.
The ask: Under the closed rule, no House member can amend Section 108 out on the floor; the only vote they get is yes or no on the whole package. So the ask is direct: vote no on H.R. 9237 as written, and bring the Major Richard Star Act as a clean, honestly funded bill. In the Senate, where the package still has to move, strip Section 108 or fund the Star Act from the Military Retirement Fund instead. The clean bill is closer than it looks. As of late June the discharge petition to force a standalone Star Act vote was reported five signatures short of the 218 needed, and members are pushing to clear it by unanimous consent. Ask your representative to sign the discharge petition, and your senators to pass the Star Act by unanimous consent.
Call script (veteran): “I am a veteran in [state]. I support the Major Richard Star Act, but not this way. I am asking [Member] to vote no on H.R. 9237 as written and pass the Star Act as a clean bill. Do not pay for one benefit by cutting sleep apnea and tinnitus ratings for the veterans who come after me.”
Call script (citizen): “I am a constituent in [state]. Please ask [Member] to vote no on H.R. 9237 as written and pass the Star Act on its own, without cutting future veterans’ disability ratings to fund it.”
Who to call. Your own representative and two senators first. They answer to you as a constituent, which is what makes the call land.
US Capitol Switchboard: (202) 224-3121. Ask to be connected to your representative, or to either of your senators, by name.
Find your House member: house.gov/representatives/find-your-representative
Find your senators: senate.gov/senators
The committees writing this bill:
House Committee on Veterans’ Affairs: Chairman Mike Bost (R-IL) and Ranking Member Mark Takano (D-CA), 364 Cannon House Office Building. Reach any member through the Capitol Switchboard, (202) 224-3121.
Senate Committee on Veterans’ Affairs: Chairman Jerry Moran (R-KS) and Ranking Member Richard Blumenthal (D-CT), Room SR-412. Committee line (202) 224-9126; Chairman’s office (202) 224-2074.
Tip line: ipersist@tbirdsquietfight.com
About this publication: Tbird’s Quiet Fight is independent investigative journalism on veterans’ policy, law, and the systems meant to serve those who served. It is written and edited by Theresa Aldrich, a Navy veteran and founder of HadIt.com. No agency, command, or institution signs off on it.
AI disclaimer: I use AI as a research and editing assistant, the same way I’d use a good reference book or a sharp editor. Every word published here is reviewed, verified, and approved by me. The perspective, accuracy, and editorial decisions are mine.
Theresa “Tbird” Aldrich, Navy veteran (VAQ-34, 1983-1990), Investigative Journalist, TbirdsQuietFight.com, Founder of HadIt.com | Advisory Board Member, Veterans Healthcare Policy Institute (VHPI).