May 20, 2016
The Senate Armed Services Committee approved its version of the FY 2017 Defense Authorization Bill (S. 2943), and it's considerably different from the one approved by House lawmakers on a range of issues.
On non-healthcare issues, the bill would:
- approve force levels recommended in the president's budget rather than increases like the House bill recommended;
- make the Special Survivor Indemnity Allowance permanent at the $310 monthly rate;
- provide a 1.6 percent military pay raise (vs. the 2.1 percent House proposal);
- enable the family to either move early or remain at their current duty station for up to six months while their servicemember begins a new assignment to increase stability under certain circumstances;
- require a test of privatizing military commissaries at five locations;
- impose a 25 percent cut in 4-star billets and another 25 percent cut from other flag-officer billets; and
- require women to register for the draft.
For TRICARE, the Senate bill makes no changes to TRICARE For Life.
But it would adopt most of the DoD-proposed fee increases for other beneficiaries, including:
- requiring a new annual enrollment fee for TRICARE Standard that would start at $150/$300 (single/family) as of Jan. 1, 2018, and rise to $450/$900 over the next five years;
- raising the TRICARE Prime annual enrollment fee 24 percent to $350/$700 (single/family);
- raising the annual cap on out-of-pocket expenses to $1,500 for currently serving families and $4,000 for retired families (vs. current $1,000/$3,000);
- giving DoD discretion to implement a pilot program authorizing Guard and Reserve members to elect coverage under the auspices of the federal employees health insurance program;
- eliminating TRICARE Standard deductibles for care from DoD network providers, but doubling the deductible to $300/$600 (single/family) for out-of-network care;
- changing TRICARE Standard co-pays for various provider visits to a flat fee vs. a percentage of TRICARE-approved charges;
- adjusting annual enrollment fees by the Consumer Price Index for Health Care Services established by the Bureau of Labor Statistics;
- adjusting co-pays, doctor visit cost shares, the catastrophic cap, and other flat fees by the same percentage as the retired pay COLA;
- roughly doubling pharmacy copays over a 9-year period, including raising the mail-order copay for generic drugs from the current zero to $11, effective in 2020; and
- authorizing DoD to collect a “no-show” fee for missed appointments at military medical facilities.
Like the House-passed bill, the Senate bill would move most responsibilities for military health care programs from the Army, Navy, and Air Force to the Defense Health Agency. This would place military medical facilities, healthcare delivery, and personnel and budget responsibilities directly under DoD for unified planning and execution.
The bill also includes a wide range of provisions aimed at improving access and quality of care, including:
- eliminating referral requirements under TRICARE Prime for urgent and specialty care;
- requiring a single appointment system for all military medical facilities;
- expanding telehealth capabilities;
- requiring a DoD plan to improve pediatric care;
- allowing military beneficiaries to enroll in federal civilian dental/vision plans; and
- requiring new accountability standards for military healthcare leaders at all levels.
MOAA appreciates and supports the Senate Armed Services Committee's efforts to directly address the well-documented access, quality, and efficiency problems of the military health system.
But we believe the proposed beneficiary fee increases are significantly too high and fail to adequately consider the very high non-cash premiums career servicemembers and families are required to pay up-front through decades of service and sacrifice.
Senate leaders plan to bring the defense bill up for full Senate consideration as early as next week.
MOAA has been working with several senators to sponsor important amendments to the bill to protect commissaries, help disabled retirees, and increase the military pay raise.
Please act now to send your senators this MOAA-suggested message.
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