The Pentagon's top health official conceded before a House panel on Wednesday that the Defense Department's plans to increase Tricare fees spurred concerns among service members, their families, and the veterans and military groups that support them.
"But I want to make clear that the Tricare benefit will remain one of the most comprehensive benefits in this country and it will modernize the program for the first time in many years," said Assistant Secretary of Defense for Health Affairs Dr. Jonathan Woodson.
Veterans groups that represent the interests of the active duty as well as veterans and retirees have already signaled to Congress that they oppose any change to Tricare that may include reductions or rolled back services, new or increased fees, or increases to out-of-pocket expenses.
But as Pentagon leadership continues to argue that its ever increasing personnel costs – including health care – threaten their ability to maintain a ready force, they're out to scale back costs.
The goal is to consolidate the Tricare Prime, Extra, and Standard plans into one, and adjust deductibles and co-pays that will incentivize troops and family members to use the most affordable care, Woodson said. The plan, once rolled out, would also offer users more choice in where they get care, according to Defense Department officials.
Woodson, alongside the surgeon generals for the Army, Navy and Air Force, made a case for the Defense Department's proposed 2015 health care budget before the House Appropriations Committee.
The Defense Health Agency is seeking about $47 billion for 2015, according to Woodson.
Changes to Tricare are intended to save money, in part, by getting troops and family members to be more prudent in how they use the benefit, according to Woodson.
He got some help in making his case from Rep. Jim Moran, D-Va., who underscored the official view that a disproportionate share of health care can be laid at the feet of people who seek more expensive services when they don't need to. For example, he said, someone who takes a child with a cold to an emergency room instead of seeing a nurse.
"It's my understanding that the [DoD] has substantial data that shows it's a fairly small percentage of Tricare users , that are termed ‘super-users' of the system," that account for a significant share of the costs, Moran said. "They have much higher cost because they tend to use the most expensive forms of health care and use it more frequently."
Throughout a two and a half hour hearing, however, lawmakers voiced no serious opposition to the proposed Tricare changes.
While members of Congress agreed that health services to troops and their families' must be second to none and readily available, none disputed the arguments made by Woodson or the service medical chiefs that costs must come down.
Woodson said the 2015 budget will sustain medical resources for the services, including in research and technology, but includes changes to Tricare and other areas in order to meet challenges coming from reduced budgets.
Army Surgeon General Lt. Gen. Dr. Patricia D. Horoho said that some of her concerns are "losing the momentum toward building the health, resiliency and readiness of our armed forces [and] the loss of science and technology that has accelerated medical advances that have the American public the confidence to allow their sons and daughters to serve."
Air Force Lt. Gen. Dr. Thomas W. Travis said that even with fiscal challenges, "we have a clear responsibility to make sure military medics are well trained and well prepared for whatever contingency the future brings."
Woodson said the proposed budget is down from a $54 billion high in 2012, but continues to represent a higher portion of the base DoD budget. It is currently about 10 percent of the base, up from about 4 percent in the early 1990s.
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