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Beefing Up Health Care for Guard and Reserve Troops

Fall 2004

For reservists, one of the early effects of the war on terrorism might be a disruption of their health coverage. Like commuters going through a turnstile, more than 325,000 reservists, or about 40 percent of the Selected Reserve (those who train regularly), have served lengthy active duty tours since Sept. 11, 2001. A growing number of reserve families are facing their sponsors’ second or third call-up.

For the National Guard and Reserve, health insurance is tied to civilian employment and military status. About 120,000 members (14 percent) of the reserve forces are employed by the federal government and are eligible for the Federal Employee Health Benefit Program (FEHBP).

Other reservists have coverage through state or municipal governments—teachers, firefighters, public safety, health care—and others through private companies. Some are uninsured.

A September 2003 General Accounting Office study concluded that 20 percent of the National Guard and Reserve force of about 870,000 troops is uninsured. Within the junior enlisted ranks, the rate rises to 40 percent.

Even before Sept. 11, DoD acted to pay the employee’s share of the federal employees’ health plan premiums for a DoD employee who is called to active duty in support of a contingency operation. Payments are retroactive to eligible employees who have been called to active duty since Dec. 8, 1995.

Congress endorsed this approach by authorizing all other federal agencies to pay the FEHBP premiums for mobilized federal employees. This action helped propel support for reservists to have better government-sponsored health care options during all phases of their military commitment.

TRICARE kicks in when the nation calls reservists to federal duty. But reservists often don’t have any experience with TRICARE and might be reluctant to change doctors if their family doctor does not accept TRICARE. Many families confront the uneasy choice of switching doctors and accepting TRICARE or paying costly premiums during the mobilization. Families that switch to TRICARE face cancellation six months after the member comes marching home. Activated troops themselves have no choice in the matter because TRICARE is the military’s exclusive plan.

Now Congress is weighing different choices to provide health coverage options for Guard and Reserve families. This past year, Congress approved a one-year test to allow uninsured or unemployed reservists to join TRICARE on a cost-share basis. When this article went to press, DoD had just announced an implementation plan.

This year, the House and Senate are considering other approaches. The House version of the defense authorization bill for the fiscal year beginning Oct. 1 would create a three-year test to allow uninsured reservists to join TRICARE.

The Senate, on the other hand, is backing a plan that would establish permanent authority for two options: A reservist could join TRICARE for an annual fee of about $530 (more for family coverage), or have the government pay part of the family premium for employer-based coverage during mobilization. The chambers will hammer out their differences concerning reserve TRICARE later this summer.

Robust health insurance options for the National Guard and Reserve forces could encourage over-stressed reserve families to remain in the reserve, support medical readiness, and further the seamless integration of the total force.

One Step Closer to an SBP Fix

In a remarkable turn of events, the House Armed Services Committee voted May 12 to accept military Survivor Benefit Plan (SBP) champion Rep. Jeff Miller’s (R-Fla.) amendment to the FY 2005 defense bill (H.R. 4200) ending the age-62 benefit reduction in
3 1/2 years.

Miller lobbied House and Senate Armed Services Committee leaders for months, pressing the case for substantive action on SBP this year. These negotiations led to a breakthrough and produced a compromise that is better than either of Miller’s two existing bills, H.R. 548 and H.R. 3763. Under the committee-approved bill, the minimum SBP annuity for survivors age 62 and older would rise from 35 percent of covered retired pay to 55 percent by April 1, 2008. And it would authorize a one-year “open season” to let currently non-participating retirees enroll in the upgraded SBP.

This is a huge step forward in MOAA ’s fight to win an SBP fix this year. The committee’s recommendation was approved by the full House May 19. In the Senate, Mary Landrieu (D-La.) battled for an identical amendment but in the end was forced to accept a 10-year period to phase out the age-62 benefit drop.

We all need to express our deep gratitude for the outstanding efforts of Miller and Landrieu for leading the fight to right a wrong for military widows. We also need to press the House and Senate to retain the more aggressive House-passed version.



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