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Health Cost & Retirees
Tom Philpott | December 16, 2005
Military retirees under age 65 learned here last week that they could face sharply higher healthcare costs under a plan by senior Defense officials that would at least double TRICARE fees by 2008, and tie future fee increases to the annual percentage rise in healthcare costs nationwide.

Hundreds of retirees, upset by the news, are sending e-mails to this columnist and posting angry comments on various internet sites, contrasting the changes now proposed to past promises of free lifetime healthcare if they stayed long enough to retire.

It’s an echo of complaints heard in the mid-1990s from an older generation of retirees as they were being turned away from military hospitals and advised to use Medicare and buy supplemental insurance to meet their medical needs.  The groundswell of complaints then led to lawsuits, a grassroots effort to restore promised benefits, aggressive lobbying by service associations and, finally, to votes in Congress in 2000 to establish TRICARE for Life and TRICARE Senior Pharmacy for 1.5 million elderly retirees as well as spouses and survivors.

The situation is different for younger retirees.  It is true that, just 15 years ago, some recruiters still were promising free lifetime care.  In 1999 then-chairman of the Joint Chiefs, Army Gen. Hugh Shelton, gave Congress quotes from a 1991 Army recruiting brochure, promising "superb health care…for the rest of your life if you serve a minimum of 20 years."

Still the number of under-65 retirees now citing promises of free healthcare is surprising, for two reasons.  One, most of these retirees, unlike the older generation, have not been receiving free healthcare.  They either are enrolled in TRICARE Prime, a managed care plan that collects an annual fee and co-payments for doctor visits, or they use TRICARE Standard, the fee-for-service option, which carries a deductible and patients also pay a hefty cost-share of any services received.

A second cause for surprise over how many younger retirees argue that they were promised free lifetime care is the history of recent court battles in which the older generation of retirees lost that argument.

Coincidentally, the lawyer and war hero who led the legal fight, retired Air Force Col. George “Bud” Day, announced this month that he and his grassroots volunteers, which created Class Act Group to raise funds for the court challenge, are laying down their swords effective Dec. 31.

Reached by phone at his law office in Fort Walton Beach, Fla., Day said retirees 65 and older “got about 95 percent” of medical benefits they had sought, but the gains weren’t won in court.  Instead the case helped to influence Congress to correct an injustice to elderly beneficiaries by enacting the TRICARE for Life and the TRICARE Senior Pharmacy plan.

The lawsuit, Schism and Reinlie v. U.S, was decided Nov. 18, 2002, by the U.S. Court of Appeals for the Federal Circuit in Washington D.C.  The court acknowledged ``moral claims'' by retirees to free lifetime healthcare but found no law or service regulation had authorized free, unconditional medical care.  If recruiters promised that, even if ordered to do so by service leaders, the promises were invalid because they were not backed by law.

Day had explained while shaping his case that claims to lifetime care from retirees who entered service on or after June 7, 1956, were weaker because of a law signed that day that made access to service medical care conditional for retirees based on available space in military hospitals.

"Congress -- and only Congress -- can authorize [lifetime medical] benefits," wrote the court.  Yet it never had.  In June 2003, the Supreme Court declined to review the decision.

During its last two years, Class Act turned to lobbying Congress to pass the Keep Our Promise to America's Military Retirees Act (HR 602), which would waive Medicare Part B premiums, bringing these older retirees nearer to the promise of free lifetime health care.

For younger retirees, HR 602 would make them eligible for the menu of healthcare plans allowed federal civilian employees under the Federal Employees Health Benefit Plan.  The Defense Department would pick up costs normally covered by TRICARE Standard.  Assuming that 25 percent of under-age 65 retirees shifted to the FEHBP, the Congressional Budget Office estimated the bill’s cost at $2 billion in direct spending the first year.

After hurricanes ravaged the Gulf coast, Day said he visited Congress and “ran a trap line” on prospects for passage of HR 602.  Members told him they weren’t good, given the cost of Katrina and the war in Iraq.  Day and his staff therefore voted to close down the Class Act Group, seeing a greater need to for Congress to spend any extra money on hurricane relief.

Also, Day said, retiree contributions to Class Act had slowed.

“I think people have gotten used to the idea that they are going to have to pay Medicare Part B premiums,” he said. Volunteers also were tired and satisfied with what they achieved in helping to persuade Congress to adopt TRICARE for Life and the senior drug benefit.

Day, 80 and a Medal of Honor recipient, said he will leave to others the fight ahead for younger retirees.

“Frankly, if I were a [younger] military guy I would be a little unhappy ... a little stirred up” about the proposed TRICARE fees, he said.

They are.  But they also know, thanks to Day, what the courts will say.

To comment, write Military Update, P.O. Box 231111, Centreville, VA, 20120-1111, e-mail milupdate@aol.com or visit www.militaryupdate.com

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Copyright 2012 Tom Philpott. All opinions expressed in this article are the author's and do not necessarily reflect those of Military.com.

 
About Tom Philpott

Tom Philpott has been breaking news for and about military people since 1977. After service in the Coast Guard, and 17 years as a reporter and senior editor with Army Times Publishing Company, Tom launched "Military Update," his syndicated weekly news column, in 1994. "Military Update" features timely news and analysis on issues affecting active duty members, reservists, retirees and their families. Tom also edits a reader reaction column, "Military Forum." The online "home" for both features is Military.com.

Tom's freelance articles have appeared in numerous magazines including The New Yorker, Reader's Digest and Washingtonian. His critically-acclaimed book, Glory Denied, on the extraordinary ordeal and heroism of Col. Floyd "Jim" Thompson, the longest-held prisoner of war in American history, is available in hardcover and paperback.