For the first time today, members of the House Committee on Science, Space, and Technology met to discuss the health of astronauts and the moral obligations that NASA has to provide former astronauts with lifetime health care. NASA doesn’t currently provide health care to astronauts after they retire from the space agency, but Congress is considering passing legislation to authorize NASA to do so. In addition, the space agency would like to closely observe astronauts’ health, conducting MRIs of astronauts’ eyes and screening for cancer — in order to better understand how the human body is affected by space travel.

Monitoring astronauts’ health presents a unique opportunity for NASA to study the long-term effects of space travel on the human body. That’s key for planning future Mars missions; if people are sent, they’ll be in space for at least three years. No one knows yet what that might do to the human body — but astronauts who’ve spent less time in space might be able to offer clues.

"We wanna get there [to Mars] but we want not to put your lives at stake."

"We wanna get there [to Mars] but we want not to put your lives at stake," said Rep. Ed Perlmutter (D-CO). "There’ll be some level of risk. I know I … wanna make sure that, when you do put your lives at risk and your health for who knows how long down the road, we as the United States of America help you with your health care."

Former NASA astronaut Scott Kelly was at the meeting. He returned to Earth in March after spending 340 days on the International Space Station, the longest period of time any American has spent in space. Kelly talked about the physical challenges he experienced after return: skin rashes, swollen legs, and flu-like symptoms.

People who spend time in space experience all sorts of physical problems. Microgravity causes bone loss, putting astronauts at risk for kidney stones and broken bones when they get back to Earth. They may also suffer back injuries, as time spent without gravity can alter back alignment.

Microgravity also affects the cardiovascular system. In space, astronauts endure muscle loss, including in their heart. That can cause cardiac problems to astronauts when they return to Earth. Microgravity also stiffens arteries, affecting the body’s ability to control blood pressure. Because of this, astronauts can develop low blood pressure when they come back to Earth.

Space radiation could make astronauts more likely to get cancer

Vision problems are also common. Astronauts experience swelling in the back of their eyes when they return to Earth, which leads to poorer eyesight. Those who’ve spent more time in space are also more likely to get cataracts, but NASA still isn’t exactly sure why that happens. That’s not all. Astronauts on the ISS are exposed to 10 times more radiation than on Earth, which makes them more likely to develop cancer later in life.

All of this explains why the Institute of Medicine recommended that NASA "provide preventative long-term health screening and surveillance of astronauts and lifetime health care to protect their health, support ongoing evaluation of health standards, improve mission safety, and reduce risks for current and future astronauts." In its 2015 NASA authorization act, Congress required NASA to come up with a plan to implement the recommendations and indicate how much money the agency would need to do so.

NASA has a moral obligation to provide for lifetime health care coverage for retired astronauts

NASA has the moral obligation to provide for lifetime health care for all illnesses, said Jeffrey Kahn, chairman of the ethics committee at the National Academies of Sciences that issued the 2014 report, at the hearing. That’s even the case if the astronauts’ ailments don’t necessarily stem from space. "We as a country and a society owe astronauts protection and provision of care throughout their lifetimes without asking the question about whether what they might suffer from in terms of injury or health needs was a result of their time in space or not," Kahn said.

NASA proposed at the hearing to expand the basic monitoring it already does. The space agency runs a voluntary health screening program for former astronauts, called the Lifetime Surveillance of Astronaut Health. But only 60 percent of the 280 living NASA astronauts actually take part in the program, said Richard Williams, NASA’s chief health and medical officer. An authorized health care program for all astronauts could help NASA gather much more data and increase participation, Williams said. "Given the group is so small, the data from each single one of them is precious," he said.

An extended monitoring program is estimated to cost NASA an extra $400,000 a year, Williams said, for a total of $800,000. Overall, the cost of health care for all NASA astronauts and their families would be around $2.4 million to $6.5 million a year, according to Rep. Brian Babin (R-TX).

Gathering health data can also inform us on the long-term effects of space travel

NASA needs talk to the Department of Labor and the Department of Veteran Affairs, which both provide treatment for health conditions federal government employees develop because of their work, said Rep. Donna Edwards (D-MD). Many astronauts, for example, used to be in the military and are already entitled to lifetime health care coverage. "It is a little bit problematic that 60 percent of the astronauts are retired military and you haven’t engaged the VA into this discussion before presenting a legislative proposal, but I hope that that happens really soon," Edwards told Williams.

Several speakers emphasized both the obligation NASA has to its former astronauts, as well as the possibility of learning more about how space alters the body. "Our flights and our careers have been paid for by taxpayers’ dollars. We owe those taxpayers those data to help them make informed decision about spaceflight," said Michael Lopez-Alegria, a former NASA astronaut and the president of the Association of Space Explorers-USA.