By Representative Peter King (ret.)
The terrorist attacks of Sept. 11, 2001, were the deadliest attack on American soil in our nation’s history. Nearly 3,000 people were killed, including 343 FDNY firefighters. But the death and suffering did not end that day. In the years that followed, thousands more became ill after exposure to the toxic environment in and around the World Trade Center.
In the immediate aftermath of 9/11, the country united and, for a brief time, stood as one. Congress enacted the Victim Compensation Fund to provide financial assistance to those injured in the attacks and the families of those killed. But the law did not account for illnesses that would emerge years later.
It was not until several years after the attacks that evidence began to show a growing number of blood cancers, severe respiratory conditions and other illnesses among 9/11 responders and people who lived, worked or attended school nearby. I saw it firsthand in my Seaford, Long Island, community. Police officers and firefighters who had been at the World Trade Center on Sept. 11 or worked in the recovery effort for days, weeks and months afterward were struggling to breathe or weakened by cancer treatment. They were in what should have been the prime of their lives, yet many looked years older.
Early efforts
Congressional concern for those suffering from 9/11-related illnesses was bipartisan, but efforts to establish a comprehensive federal health program struggled to gain traction. In the first several years after the attacks, medical research was still establishing the nature and extent of illnesses associated with World Trade Center exposures, while existing monitoring and treatment programs operated through a patchwork of federal grants. As a result, the strongest legislative support initially came from members of the New York, New Jersey and surrounding delegations, and repeated proposals stalled in committee.
2005: Rep. Carolyn Maloney (D-N.Y.) introduced the Remember 9/11 Health Act (H.R. 566), which sought to provide health monitoring and other protections for responders, recovery workers, residents and others exposed to conditions following the attacks. The bill accumulated 29 cosponsors but did not advance out of committee.
2006: The legislative effort broadened, with Sens. Hillary Clinton (D-N.Y.) and Chuck Schumer (D-N.Y.) among those pushing proposals to fund monitoring and treatment for people with 9/11-related illnesses. Those efforts, including Clinton’s 9/11 Heroes Health Improvement Act of 2006, failed to advance but helped build momentum for a broader federal response.
Maloney also introduced an updated Remember 9/11 Health Act (H.R. 6124) that September, expanding on her earlier proposal by addressing monitoring, treatment, research and coordination of 9/11 health programs. It too stalled in committee.
Building the case
2007: The enormity of what was becoming a 9/11 health crisis could no longer be denied. Clinton reintroduced the 9/11 Heroes Health Improvement Act, but it again did not advance beyond committee.
In the House, Maloney introduced the first James Zadroga 9/11 Health and Compensation Act (H.R. 1638) in March with a bipartisan group of original supporters. The bill — named after the first NYPD officer to die from a 9/11 illness — combined long-term health programs with changes to the September 11th Victim Compensation Fund. Maloney introduced a revised and more comprehensive H.R. 3543 later that year. That version attracted 111 cosponsors but remained in committee.
Meanwhile, House and Senate hearings increasingly documented respiratory disease, mental health needs and other health effects among responders and survivors, helping build the evidentiary record for permanent federal action.
2008: Real progress was being made in convincing members of Congress of the need for action. Maloney introduced another substantially revised James Zadroga 9/11 Health and Compensation Act (H.R. 6594), with Reps. Jerrold Nadler, D-N.Y., Vito Fossella, R-N.Y., and me among its original cosponsors. The bill would have established a permanent World Trade Center Health Program within NIOSH, provided monitoring and treatment for responders and affected community members and reopened the September 11th Victim Compensation Fund for certain claims. Unlike earlier versions, H.R. 6594 received a congressional hearing on July 31. For whatever reason, however, the 9/11 health provisions were ultimately dropped from the year-end omnibus package. With Congress consumed by the presidential election and the rapidly worsening financial crisis, there was no opportunity to revive the legislation before the session ended.
The fight for passage
2009: With a new Congress, Maloney introduced H.R. 847, the James Zadroga 9/11 Health and Compensation Act, on Feb. 4. Nadler and I were among 31 original cosponsors. H.R. 847 proposed a permanent World Trade Center Health Program for responders and survivors, continued research and monitoring and reopened the Victim Compensation Fund. The measure ultimately accumulated 115 cosponsors and advanced through congressional hearings and committee consideration.
Despite resistance from elements within the Republican Party, including what I believed was a knee-jerk opposition to legislation seen as benefiting New York, we were determined to get Zadroga passed. Thankfully, Nadler and Maloney refused to get caught up in the partisan game. Kirsten Gillibrand, newly appointed to the Senate from New York, was particularly helpful. Ben Chevat, who had worked on Maloney’s staff and became deeply involved in the effort, was indispensable then, as he is now, monitoring developments constantly. Mayor Michael Bloomberg also weighed in at key moments with key players.
2010: Speaker Nancy Pelosi brought H.R. 847 back for a vote, and on Sept. 29, it passed 268-160. It now had to pass the Senate. Following negotiations, a bipartisan compromise reduced the cost of the legislation and shortened the duration of the programs. The Senate passed the revised bill on Dec. 22, the final day of the session.
The compromise meant that the World Trade Center Health Program was not permanent: It was authorized for five years, creating another fight over its future. The first major battle had been won but the war wasn’t over.
2011: President Barack Obama signed the James Zadroga 9/11 Health and Compensation Act into law on Jan. 2, establishing the World Trade Center Health Program and reopening and expanding the September 11th Victim Compensation Fund.
Protecting the program
2015: Fortunately, the fight for reauthorization in 2015 was not too difficult. By then, the program had been in place for years and was functioning effectively and economically. Expert doctors were hired, victims were treated and lives were saved.
The Zadroga reauthorization was ultimately included in the year-end federal spending package approved by Congress on Dec. 18. It extended the World Trade Center Health Program through 2090 and extended the Victim Compensation Fund for another five years, adding billions in additional funding to cover future claims.
Congresswoman Carolyn Maloney, second from right, is joined by Congressmen Charles Rangel, left, Peter King, second from left, Eliot Engel, third from left, Jerrold Nadler, right, and Frank Pallone, background right, during a news conference, Thursday, Sept. 3, 2015, in New York. Lawmakers called on Congress to prevent expiration of the James Zadroga Sept. 11 Health and Compensation Act.
Mary Altaffer/AP
Making the commitment permanent
2018: By late 2018, it became clear that the $7.375 billion allocated to the Victim Compensation Fund would not be enough to cover current and anticipated claims. The shortfall was not the result of fraud or abuse. It reflected far more claims than originally anticipated, including growing numbers of cancer, deceased and survivor claims as illnesses continued to emerge years after the attacks.
FILE - In this June 11, 2019, file image made from video, retired New York Police Detective and 9/11 responder, Luis Alvarez, speaks during a hearing by the House Judiciary Committee as it considers permanent authorization of the Victim Compensation Fund, on Capitol Hill in Washington. Alvarez, who died on Saturday, June 29, after a three-year battle with cancer that he believed was cause by working at the World Trade Center after the attacks, will be remembered with a funeral service in the Queens borough of New York on Wednesday, July 3.
US Network Pool via AP, Pool
2019: Fortunately, the battle to provide additional funding proved less difficult than the earlier fights over Zadroga. Any opposition that might have developed was squelched by the advocacy of talk show host Jon Stewart and the heart-wrenching testimony by retired NYPD Detective Luis Alvarez — his shrunken body and barely audible voice had moved the nation. Alvarez, gravely ill with 9/11-related cancer, died later that month.
Entertainer and activist Jon Stewart lends his support to firefighters, first responders and survivors of the September 11 terror attacks at a hearing by the House Judiciary Committee as it considers permanent authorization of the Victim Compensation Fund, on Capitol Hill in Washington, Tuesday, June 11, 2019.
J. Scott Applewhite/AP
The Never Forget the Heroes: James Zadroga, Ray Pfeifer, and Luis Alvarez Permanent Authorization of the September 11th Victim Compensation Fund Act passed the House 402-12 on July 12 and the Senate 97-2 on July 23.
President Donald Trump signed it into law on July 29. The law authorized the funding necessary for the Victim Compensation Fund through fiscal 2092 and extended the deadline for filing claims to Oct. 1, 2090.
The work is not finished
The World Trade Center Health Program remains as important today as ever, providing monitoring and treatment for people with 9/11-related illnesses. More than 70 cancers have been certified as 9/11-related, along with numerous respiratory and other conditions.
More than 30,000 people have enrolled in the program in just the past three years. Yet staffing shortages at the Department of Health and Human Services have left the program more than 30% below the personnel needed to operate effectively and keep pace with the thousands of people seeking treatment or evaluation for certification.
Failure to fill these positions would likely result in entirely unnecessary death and suffering. If that happens, unions such as the UFA, UFOA and PBA, along with victims and especially first responders, will once again have to take their case directly to Congress, just as Luis Alvarez, Ray Pfeifer and others did before them, putting a human face on the consequences of inaction. Sen. Kirsten Gillibrand and Rep. Andrew Garbarino will be more than willing to lead the way.
Too much has been fought for and achieved to fall short now. Preserving and strengthening the World Trade Center Health Program is part of the lasting debt America owes to the men and women affected by 9/11.
About the Author
Peter T. King is a former Republican member of the U.S. House of Representatives from New York, where he served from 1993 to 2021. During his 28 years in Congress, King represented communities on Long Island and became a leading voice on national security, counterterrorism and issues affecting 9/11 responders and survivors. He chaired the House Committee on Homeland Security during the 109th and 112th Congresses and was among the bipartisan lawmakers who helped advance legislation that ultimately became the James Zadroga 9/11 Health and Compensation Act. Before serving in Congress, King was Nassau County comptroller and a member of the Hempstead Town Council. He also served in the New York Army National Guard and earned his law degree from the University of Notre Dame.
