Letter to SECDEF Warns Against TRICARE Fee Hikes, Medical Billet Cuts

Letter to SECDEF Warns Against TRICARE Fee Hikes, Medical Billet Cuts
Photo by Lisa Ferdinando/DoD

The Military Coalition (TMC), a group of military and veterans service organizations representing a combined 5.5 million-plus membership, urged DoD leadership in a March 8 letter to protect the military health system from proposals that threaten the health care benefit, medical readiness, and the pipeline of uniformed health care providers.


MOAA co-chairs TMC and many of its committees, including the health care committee.


The letter addressed three topics DoD leaders will consider as they undertake the FY 2022 administration budget request: medical billet cuts, funding for the Uniformed Services University of Health Sciences (USU), and, potentially, TRICARE fee increases as a means of reducing military health system (MHS) spending.


“The current pandemic has highlighted the risks of eliminating surge capacity within the medical system,” said the letter, sent to Secretary of Defense Lloyd Austin. “Proposed billet cuts risk compromising not only combat casualty care, but also DoD’s ability to effectively provide healthcare and humanitarian support in times of crisis. Medical end strength reductions could also lead to access to care problems for beneficiaries if civilian medical systems lack capacity to absorb patient care moved out of military treatment facilities.”




Medical billet cuts were first proposed in the FY 2020 budget request. Since then, MOAA has highlighted the risks of such reductions to both readiness and beneficiary care. MOAA successfully advocated for a halt to medical billet cuts, including additional reporting requirements and congressional oversight, in National Defense Authorization Act (NDAA) legislation for both FY 2020 and FY 2021. With TMC, MOAA is now urging the new administration to reconsider cuts to military medical end strength.


The letter also asked DoD leaders to maintain funding for USU, an essential accession source of uniformed services medical providers including clinical psychologists, nurse practitioners, and certified registered nurse anesthetists, in addition to physicians. USU was targeted for cuts during DoD’s defense-wide review, a zero-based review of all organizations outside the military departments. Funding was reinstated with the FY 2021 NDAA thanks in part to MOAA members’ efforts to raise awareness of the issue.


[RELATED: Bipartisan Legislation Would Repeal TRICARE Select Enrollment Fee for Some Retirees]


Although DoD has not requested TRICARE cost-sharing hikes since the FY 2018 administration budget request, fee increases remain a looming threat, particularly when DoD’s budget is constrained. TMC’s letter reviewed the series of TRICARE out-of-pocket cost increases implemented since 2018 and underscored the importance of fulfilling obligations to servicemembers, retirees, their families, and survivors by refraining from any further shift of military health care costs to beneficiaries.


MOAA will provide an update on proposals impacting the military health system when the budget is released in the coming days.


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About the Author

Karen Ruedisueli
Karen Ruedisueli

Ruedisueli is MOAA’s Director of Government Relations for Health Affairs and also serves as co-chair of The Military Coalition’s (TMC) Health Care Committee. She spent six years with the National Military Family Association, advocating for families of the uniformed services with a focus on health care and military caregivers.