Congress Ramps Up Health Care Talks

March 18, 2016

The Chairman of the House Armed Services Military Personnel Subcommittee invited MOAA and a small handful of stakeholders to Capitol Hill on March 17 to discuss Pentagon proposals to reform the military's health care system (MHS).

MOAA Government Relations Director Col. Steve Strobridge, USAF (Ret) told the panel in the year of TRICARE reform, DoD's plan contained only vague statements on needed program improvements, and focused mainly on adding several new beneficiary fees and raising a wide range of others, especially for the retired community.

He noted the proposed fee schedules were designed to push more care to military hospitals and clinics, which have been the primary sources of access problems.

“Our preference would be to ensure access is improved in the [military facilities] before implementing a fee structure intended to drive more care there,” Strobridge said.

He also expressed MOAA's hope the system would establish positive “carrots” to incentivize beneficiary choices rather than financial penalty “sticks.”

“Particularly for retirees, we believe the proposed fee increases - in the range of $500 to $1,200 a year - are disproportional,” Strobridge said. “Further, the incentives seem structured as different-sized sticks, with the biggest sticks proposed for the TRICARE Standard group that, ironically, costs DoD the least money.”

Retirees in TRICARE Prime who use military facilities, as DoD wants, would see a 24 percent enrollment fee increase plus other increases in cost-shares and pharmacy copays.

Families who elect to stay with TRICARE Standard - which costs DoD less than Prime - would incur a new $900 annual enrollment fee, plus a $600 deductible for using out-of-network care, in addition to their existing 25 percent cost share for all services.

If a military family has a choice, a higher deductible for using out-of-network care might make sense. But DoD acknowledges the network system will only cover 85 percent of the population.

“MOAA believes the 15 percent of beneficiaries who have no choice other than using out-of-network providers shouldn't be charged an extra $1,200 in enrollment fees and extra deductible for having no other option,” Strobridge told the panel.

MOAA believes there should be no enrollment fee for TRICARE Standard or TFL, as neither plan guarantees access to a network of providers, as TRICARE Prime does.

“MOAA particularly disagrees with the proposal to means-test the TFL enrollment fee by making it a percentage of retired pay,” Strobridge said. “No other federal or civilian employer means-tests its retirees' service-earned health coverage, since it would penalize longer and more successful service.”

“We urge against any enrollment fee for TFL for three additional reasons: First, these older retirees already pay more for their health care than any other military beneficiaries. Second, DoD only pays 20 percent of their health costs, because Medicare is first payer. Finally, DoD costs for TFL have dropped 40 percent over the last several years.”

March 18 Tricare fees increase

All of the witnesses expressed concern DoD's budget proposal does nothing to address the serious continuity of care and consistency of coverage issues faced by the Guard and Reserve communities.

Lawmakers were receptive to MOAA's and other witnesses' inputs, and agreed the focus of military health reform must be on improving timely access to quality care rather than simply raising beneficiary fees.

 

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