Senate lawmakers have recommended a comprehensive study on the future of TRICARE, including an evaluation of various options for replacing the purchased care component of the military health system (MHS).

Detailed research and analysis are essential first steps for any changes to service-earned benefits. MOAA will urge lawmakers to add a requirement for stakeholder input, including from MOAA and other military service organizations.

[RELATED: House NDAA Draft Would Reverse Planned Cuts, Closures at 41 Military Hospitals and Clinics]

Study Details

Section 765 in the Senate draft of the FY 2027 National Defense Authorization Act directs the Pentagon to contract with a federally funded research and development center for a study that includes an in-depth analysis of future options for the military health system, including:

• Maintaining the TRICARE program using large managed care support contractors offering provider networks.
  
  
• Creating a marketplace of plans under the TRICARE program analogous to the Federal Employee Health Benefit Plan.
  
  
• Eliminating large managed care support contracts and requiring health care providers to accept beneficiaries enrolled in the TRICARE program as a condition of participating in the Medicare program or directly establishing a network of providers without the use of a managed care support contractor.
  
  
• Integrating the MHS managed care support contract with the VA community care model.

[RELATED: What House NDAA Amendments Could Mean to Your TRICARE Coverage]

The report would include an analysis of the MHS’ sufficiency to provide a world-class health care benefit as well as operational readiness factors including sufficiency to provide combat casualty care, force health protection, forward-deployed medical care during sustained armed conflict, and pandemic response.

Long-Term Challenges

The Senate Armed Services Committee (SASC) report accompanying the NDAA draft does not provide context for the TRICARE evaluation. However, concerns about the future viability of TRICARE have persisted for many years.

More than a decade ago, the Military Compensation and Retirement Modernization Commission (MCRMC) noted that because TRICARE’s reimbursements were discounted off Medicare rates, some civilian providers “would not accept new TRICARE patients even though they would accept new Medicare patients.”

The MCRMC’s 2015 report recommended replacing TRICARE with a selection of commercial insurance plans offered through a Pentagon health benefit program administered by the Office of Personnel Management. Congress rejected the recommendation, but the report findings eventually led to numerous TRICARE changes made by lawmakers.

MOAA’s Role

Preserving the military health care benefit is central to MOAA’s mission. MOAA’s advocacy helped defeat numerous proposals that would have shifted greater costs onto TRICARE For Life beneficiaries and working-age retirees – with the help of our members, MOAA led efforts to block five consecutive administration budget request proposals for a TRICARE For Life enrollment fee in fiscal years 2013-2017 and grandfather working-age retirees from numerous fee increases.

As discussions about the future of TRICARE continue, MOAA will remain vigilant in ensuring that any proposed changes enhance – not diminish – the quality, accessibility, affordability, and value of military health care for beneficiaries.