$2.44 Billion Reclaimed: Inside the VA Recoupment Fight

Two women exchange cash and a check at an office desk

Under a law dating to the 1940s, veterans who received separation pay, compensation for time served, had to repay it if they later qualified for VA disability benefits. (Federal rules barred receiving both.) The VA would withhold disability checks until the debt was cleared. From 2013 to 2023, this debt recoupment structure equaled $2.44 billion in separation pay and bonuses from 112,834 veterans.

To many, this payment structure may seem like punishment to the disabled veteran. In 2023, Senator Ruben Gallego’s (AZ) Restore Veterans’ Compensation Act of 2023 which would have barred this practice, arguing the two payments serve different purposes. Since that time, the bill has been reintroduced many times. Most recently, Representative Bilirakis (FL) brought the Restore Veterans’ Compensation Act of 2026 to Congress on January 13, 2026. (HR7027 was referred to the Subcommittee on Disability Assistance and Memorial Affairs on May 7, 2026.)

“It is ridiculous to claw back money from a veteran who has put life and limb on the line, just because later in life they qualify for disability benefits,” stated Gallego, acknowledging the fact that traumatic brain injury symptoms often surface or worsen years after service.

*The bill’s chief criticism is fiscal: ending recoupment means the government forfeits future collections.

Illinois Bipartisan Act Modernizes Stroke Care

Illinois State Capitol building with banner and informational signs about stroke care and prevention

Illinois has updated how it recognizes the hospitals that treat one of the most common forms of acquired brain injury. On July 31, 2026, Gov. JB Pritzker signed HB5494 into law as Public Act 104-0706, effective January 1, 2027.

The statute directs that “the approved stroke designation levels shall coincide with the stroke designation levels recognized by Department-approved certifying bodies,” keeping Illinois aligned with national standards. It amends the Emergency Medical Services Systems Act, broadening “Primary Stroke Centers” to “Stroke Centers”. Additionally, it empowers the Illinois Department of Public Health to update designation levels and reporting through administrative rulemaking in consultation with the State Stroke Advisory Subcommittee.

No recorded statement has been made by any state politician regarding HB5494, as of yet. However, the measure was strikingly bipartisan, passing the House 112-0 and the Senate 56-0, with Democratic Rep. Barbara Hernandez as lead sponsor and Republican Senate Leader John Curran among its Senate sponsors.

Illinois Expands Coverage for Common Consequence of Brain Injury

Speech therapist pointing at speech sound cards while boy looks and practices using a mirror

Illinois has strengthened access to speech therapy for people recovering from brain injuries. On June 26, 2026, Gov. JB Pritzker signed SB 2899 into law as Public Act 104-0528. The measure amends the Illinois Insurance Code and Public Aid Code to require coverage of rehabilitative services for individuals under 19 with an early acquired speech-language disorder. It also directs Medicaid to cover rehabilitative stuttering therapies for those 21 and under. The insurance provisions take effect January 1, 2028.

The change matters for brain injury survivors, as rehabilitative speech therapy is often central to recovery. By mandating coverage of rehabilitative care, the law helps ensure that survivors have access to therapies designed to help them regain their ability to communicate.

As Senator Willie Preston (IL-16), the bill’s sponsor, said “young people [now] have access to the tools, support and treatment they need to find their voice and be heard.”

Heat, the Brain, and the Law

Red Ford pickup truck driving on a desert road under bright sun with mountains ahead

Extreme heat is a direct threat to the brain. When the body cannot shed heat fast enough, core temperature climbs and heat stroke can follow. This medical emergency leads to overheated blood damaged neurons and can result in cognitive impairment. People already living with a brain injury are especially vulnerable, as damaged temperature-regulating systems make it harder to cool down and easier to slip into confusion, seizures, or worsening symptoms.

Prevention, though, is straightforward and quite simple: hydrate constantly, rest in shade or air conditioning, avoid exertion during the hottest time of the day, and wear light clothing. Most importantly, treat dizziness, nausea, or confusion as warning signs and call 911 immediately when there is sudden confusion or a collapse.

Government response has been uneven. The Occupational Safety and Health Administration’s original Heat National Emphasis Program expired in April 2026 and was replaced by a revised, expanded federal program running through April 2031. H.R. 6213 and S. 4427 would prevent the Department of Labor from putting a national heat safety rule into action.

Profile of a human head with a detailed brain illustration and legal symbols including a gavel, scales, and law book.

On July 21, 2026, the House Education and Workforce Committee advanced the Heat Workforce Standards Act in an 18-15 party-line vote to block OSHA from finalizing such a rule. Opposing it, Rep. Alma Adams (NC) challenged colleagues to “stack boxes on Independence Avenue for a few hours without water and without shade.” In support of the bill, Rep. Tim Walberg (MI) argued that it isn’t fair to impose a “one-size-fits-all” federal mandate across very different industries, climates, and workplace environments. Though all states have extreme temperature concerns, as can be attested in the Northeast right now, it is notable that the opposition comes from not only party lines, but also from regions of the country that often have heat waves.  

Senate’s College Sports Overhaul Includes Safety

On June 2, the Protect College Sports Act, S.4668, was introduced by Senate Commerce Committee Chairman Ted Cruz (TX) alongside Ranking Member Maria Cantwell (WA), Senator Eric Schmitt (MO) and Senator Chris Coons (DE). Chiefly an overhaul of name, image and likeness rules, “It [also] establishes strong health and safety protections,” stated Cruz on June 3, a day that was headlined by a hearing with the former Alabama coach Nick Saban. The legislation would require concussion and brain-injury safety standards enforced by independent officers and create a $60 million annual trust fund for long-term conditions such as CTE.

Infographic showing four pillars of college sports safety: injury prevention, facility safety, medical support, and education preparedness.

The committee voted 19-9 on June 18 to advance it, and it now sits on the Senate calendar awaiting a floor vote. Last week, on July 13, 2026, the bipartisan Protect College Sports Act picked up two new backers, as Senators Shelley Moore Capito (WV) and Peter Welch (VT) signed on as cosponsors. Days later, Senator Eric Schmitt told the Associated Press Sports Editors that they “probably have 60 votes,” meeting the threshold the measure needs to clear the full Senate.

The bill is backed by the NCAA but is opposed by the SEC and Big Ten. However, this opposition appears to be against financial aspects of the bill and about over government overreach, and not about new safety standards. Additionally, a House companion bill, H.R. 9137, remains in committee. President Trump has urged passage “this summer”.

Hawaii’s New Strick E-Bike Law to Prevent Brain Injury

Dr. Josh Green in white coat with stethoscope in office and Hawaiian flag

Governor Josh Green signed Act 259 (HB 2021) on July 15, 2026, giving Hawaii its first comprehensive statewide e-bike framework. The law requires helmets for all riders under 18, bars anyone under 15 from operating an e-bike, and prohibits riders under 16 from using Class 2 or Class 3 models without adult supervision.

The measure grew out of an alarming rise in head trauma. Hawaii Department of Health data reported that e-bike injuries more than doubled between 2022 and 2025, from 106 to 244. Honolulu EMS also found that 81 percent of the e-bike patients that were treated wore no head protection. Honolulu-based Kapi’olani Medical Center’s trauma team reported that e-bike crashes recently became the leading cause of injury among the children it treated.

Man riding a bicycle on the sandy beach during sunset

Green, previously an emergency physician, has been blunt about the stakes. “If they have a head trauma, they’re probably going to have long-standing disability from the traumatic head injury,” he said in a September 2025 interview.

The law also reclassifies machines exceeding 28 mph as e-motorcycles, subject to licensing, registration, and insurance. California imposes comparable rules, while New Jersey now goes further, requiring helmets for e-bike riders of every age.

See also: E-Bikes and Brain Injury: The Risks, the Recovery, and the Law

Group-home Debate in NH Focuses on Those With Brain Disorders

Elderly man with walker, young woman wearing helmet, and caregiver talking outside a blue assisted living home

New Hampshire’s group homes for people with brain injuries and developmental disabilities are getting new legislative scrutiny: Gov. Kelly Ayotte signed House Bill 1763 into law on June 19, 2026, creating a committee to study how these residences are sited, built and maintained statewide, and whether siting disputes push vulnerable residents from needed care.

The panel, which was formed after neighbors in towns like Bow objected to state-backed homes appearing without notice, must report findings by Nov. 1, 2026. Sponsor Rep. Mike Drago said “residents feel blindsided” when facilities open unannounced. Disability advocate Lisa Beaudoin countered that “it is perfectly safe to have people with developmental disabilities in one’s neighborhood.” More so, advocates state that it is needed, as New Hampshire’s estimated 2,000 residents with acquired brain disorders rely on such housing to stay near family and services.

New Hampshire isn’t first to grapple with this tension. California has guaranteed small group homes equal footing with single-family houses since 1978. Connecticut adopted similar zoning-parity protections around 1980, later adding density limits after litigation. New York took a study-first approach in 2025, forming a working group on group-home families – a path New Hampshire now follows, as well.

Update: Mercury on the Mind

Industrial refinery at sunset with a yellow danger sign warning of mercury area and hazardous chemicals

Mercury is a potent neurotoxin. It is particularly dangerous for pregnant women and young children. As a 2018 TBI on the Hill piece noted, mercury exposure “may delay developmental milestones” in fetuses and children, and acute poisoning can bring tremors, slurred speech, and hallucinations.

The EPA finalized the 2012 Mercury and Air Toxics Standards, targeting coal- and oil-fired power plants. In 2024, these standards were tightened by Congress. Supporters of this heightening of standards argued that the tighter limits reduced toxic exposures tied to neurological harm. Critics countered that by 2021 mercury emissions were already down 90% from pre-2012 levels, and the 2024 update’s compliance costs outweighed its measurable benefits.

In February 2026, the EPA repealed the 2024 update, reverting to 2012 standards. In turn, on April 27, 2026, Senator Whitehouse (RI) introduced S.J.188 to reinstate 2024 standards, which would nullify the presidential proclamation from earlier this year. When the Act went to the Senate floor on June 3, 2026, the resolution failed 46-53, with voting falling in party lines, as they considered (1) Did the 2024 rule cause unnecessary economic stress on the industry, costs that are then passed on to the consumer”, and/or (2) Are the brain-protective regulations too great for the government to ignore?

FY27 Defense Bill Takes Aim at Military Brain Injuries

Stacks of defense budget documents laid out on a table with the U.S. Capitol building in the background at dusk

The Fiscal Year 2027 National Defense Appropriations Act advances several significant provisions for service members living with traumatic brain injury, moving through both chambers of Congress with bipartisan momentum this June.

The Senate Armed Services Committee approved S. 4784 on June 10 after a three-day markup. The bill includes a provision “requiring the Secretary of Defense to provide a briefing on the feasibility of regular cognitive testing and establishing blast overpressure and TBI logs, and encouraging DoD to approach brain health, blast overpressure exposure tracking, and suicide risk analysis as force health protection.” Additionally, it includes “the provision of training to the armed forces of partner nations in the Indo-Pacific and Arctic regions in the following areas: (A) Health effects and medical response related to chemical, biological, radiological, nuclear, and explosive weapons, (B) Trauma care, (C) Preventive medicine and infectious disease, (D) Post-traumatic stress disorder, (E) Suicide prevention, (F) Traumatic brain injury, (G) Medical and health intelligence, (H) Health policy and administration.”

The House version, H.R. 8800, passed committee 44-12 and includes a section that would create a working group to develop an AI-driven digital strategy for treating brain injuries, and $7.5 million for a Cognitive Performance Enhancement Program for Special Operations Forces. H.R. 8800 has not yet received a floor vote.

The Biggest Veterans Bill in Years Buries a Tinnitus Trap

U.S. flag waving with Capitol building and two military personnel silhouette, text about Veterans Act 2026

House Veterans’ Affairs Chairman Mike Bost (IL) and Senate Veterans’ Affairs Chairman Jerry Moran (KS) introduced the Take Care of America’s Veterans Act (H.R. 9237/S. 4744) on June 10, 2026. This new 554-page, 62-page bill includes many sections that affect the brain injured from multiple angles:

Led by Rep. Jack Bergman (MI), a retired Marine general, and Rep. Sarah Elfreth (MD), the BEACON Act provision authorizes roughly $60 million for VA grants targeting non-pharmacological treatments for mild-to-moderate TBI. The Precision Brain Health Research Act, championed by Sen. Jerry Moran and Sen. Angus King (ME), directs a 10-year VA research plan on repetitive low-level blast injuries. The bill’s TBI provision includes A Blast Overpressure Task Force and HBOT reporting requirement, from Rep. Gregory Murphy (NC). A catastrophic-disability supplement of $833/month would benefit many severe TBI cases.

Furthermore, the package includes the Major Richard Star Act, the Love Lives On Act, and the Veterans’ ACCESS Act, among others. Rep. Gus Bilirakis (FL), a Congressional Brain Injury Task Force member, is among 20 House cosponsors; Senate cosponsors are John Boozman (AR) and Kevin Cramer (ND).

While the bill may appear wholly beneficial, it’s controversial because it offsets costs by reclassifying tinnitus – often a TBI symptom – as a derivative condition. (A derivative condition refers to a medical, legal, or mathematical situation that results directly from a pre-existing or primary cause.) This new classification would eliminate its standalone VA rating and data shows that it could potentially cut $57 billion in benefits for 1.5 million veterans.