Washington, DC — The introduction of the Chemical Safety Improvement Act signals the increased national attention to public health threats as a result of weak federal regulation of toxic chemicals. While we welcome the elevation of this issue, Health Care Without Harm cannot support the proposed legislation without substantive changes to assure the measure is protective of health.

The bill’s introduction in the Senate comes in the context of mounting scientific evidence linking chemical exposures to widespread diseases and conditions, including cancers, learning and developmental disabilities, birth defects, and asthma. These diseases are increasing in the general population and place a significant and costly burden on the nation and on the health care sector.

“There is increasing concern in the health care community about the link between widespread exposure to chemicals and the overwhelming epidemic of chronic disease burdening the U.S. health care system,” stated Gary Cohen, President of Health Care Without Harm. “In order to reduce the chronic disease burden of Americans and to contain health care costs, we need to eliminate toxic chemicals that have trespassed into our bodies and into our lives.” 

Health Care Without Harm has been in the forefront of efforts to address the threat of toxic chemicals in commerce and to leverage the nation’s health care institutions and practitioners to adopt purchasing changes and support an overhaul of the current chemical management system so it is protective of all people.

Reform of our nation’s 40-year-old federal statute—the Toxic Substances Control Act—is urgently needed to protect health. While the proposed legislation signals bipartisan engagement, it falls well short of the major improvements necessary to do so. We will be actively working to make the Chemical Safety Improvement Act more protective of human health and the environment, while urging allies—including major health systems and purchasers in the health care sector—to do the same. In particular, we are urging:

• An explicit requirement to adequately define and protect the most vulnerable populations. Vulnerable populations, including developing babies and infants, pregnant women, and people who live in communities with significant existing chemical and non-chemical environmental exposures, must be protected. Evidence clearly shows that these groups are not only disproportionately exposed but they are also more biologically susceptible to the impacts of toxic chemicals, and those impacts can be long-lasting and costly. Currently, the bill does not explicitly require protection of these groups when making a safety determination for a chemical.
• A review of all chemicals based on adequate information to determine if they pose hazards to health and the environment. A thorough review of all chemicals for safety is necessary to assure that the chemicals used in commerce will be safe. Currently, the bill does not establish a minimum set of screening criteria in order to decide whether a chemical is of high or low priority. As written, the bill allows a chemical to be deemed of low priority based only on available data, which unfortunately are inadequate for that purpose for most chemicals. Once a chemical is designated a low priority, the U.S. Environmental Protection Agency (EPA) would not be able to require additional safety data, and States would be prohibited from taking action on that chemical.
• The preservation of States’ ability to act. In the absence of federal action, States have been adopting policies to protect the public from chemicals of concern, which has led to important protections for the general public. The proposed bill would preempt States from taking action simply by EPA’s announcing its intent to do a safety assessment. EPA would not be required to regulate or engage in a safety assessment of a chemical before preempting State action. States also would be prohibited from taking action on low-priority chemicals. This would eliminate one of the most important avenues for public health protection and a safety net when the federal government fails to act. 
• A clearer path to get dangerous chemicals out of the marketplace. One of the flaws of the existing law is that the standard for action is so high that few chemicals have been phased out of commerce, despite clear evidence of the potential for harm from certain chemical exposures. The proposed bill requires an extra level of analysis and red tape before EPA could phase out the production and use of a chemical, even after a chemical fails a safety determination. The agency will only want to pursue this option for the very worst chemicals, yet these cumbersome provisions could have the perverse impact of slowing down action on those chemicals most in need of regulation. 
• Meaningful deadlines and timetables. The Chemical Safety Improvement Act generally lacks deadlines and timetables for EPA to complete a minimum number of safety determinations. The history of environmental laws is that they achieve their clearest results when there are such deadlines and requirements. 

The health care sector has long identified weaknesses in our nation’s regulatory system and sought to change its purchasing policies to reduce the use of chemicals of concern. While many health systems and group purchasing organizations invest significant time and resources to identify products free from chemicals that are harmful to human health or the environment, the current level of investment is not sustainable, nor is it feasible for most health care institutions. 

More broadly, our nation’s health care system, communities, and families cannot sustain the current costs of treating disease. The United States spends over $7,000 per person per year directly on health care. While it is difficult to quantify how much money would be saved by updating our current chemical management system, there is considerable agreement in the sector that significant reductions in chemical exposures would lead to decreased rates of chronic disease and lowered health care costs.

“Congress has the unprecedented opportunity to enact truly preventative and health protective legislation that will also lead to significant health care cost savings,” stated Cohen. “The scientific evidence linking environmental exposures to increased rates of many diseases and health conditions makes modernizing our national chemical laws both an urgent ethical imperative and critical economic initiative.”