Proposed Tricare Fee Hike 'Perplexes' Military Family Advocates

Doctor and Patient
Doctor and Patient

The proposed changes to the military healthcare system in the Pentagon's fiscal 2017 budget are "perplexing" because they focus almost entirely on fee increases without also detailing care reforms, advocates and watchdogs say.

"My position has always been that if you're going to increase fees, you have to show an increase in value," said Jeremy Hilton, who helps lead the grassroots group Keep Your Promise, which lobbies for military family benefit safety. "But if it's simply increasing fees for fees' sake, than that's just going back to balancing the budget on the back of our retirees -- and that doesn't make any sense."

The defense spending plan, announced early this week as part of President Barack Obama's federal budget request, included a proposal to redesign Tricare's system around two new plans similar to the existing Tricare Prime and Standard systems. Retirees would also use one of the new systems, but would be expected to pay a yearly enrollment fee.

Currently, retiree families who use Tricare Prime pay about $560 a year to enroll in the plan, while retirees who use Standard do not pay enrollment fee. Under the new proposal, both groups would pay fees of $700 or $900 for families, depending on which Tricare plan they elect. Additionally, fees would rise for all groups, including increased catastrophic caps of $1,500 for active duty families and $4,000 for retirees.

Excluded in the budget proposal was a plan to make the Tricare system more effective or deliver better care. It's that omission, officials with the Military Officers Association of America say, which causes concern.

"We were hoping to see some specific proposals to address well-documented problems with access, continuity of care, referrals, National Guard and Reserve programs and other documented health care issues, but so far, we're left asking, ‘Where's the substance?'" Dana Atkins, the organization's president and a retired Air Force lieutenant general, said in a statement.

MOAA officials also said that they don't support the drastic fee increases associated with the new plan. Retired families under 65 who use in-network providers are likely to see an increase of $500 to $600 per year under the proposal, while those who use out-of-network providers will likely face an increase of over $1,000 per year, they said.

The House Armed Services Personnel Subcommittee is holding hearings to debate the effectives of the military healthcare system. While officials expect a Defense Department report on the system to be delivered in March, the current hearings look to examine whether or not the military treatment facilities are meeting their primary role of promoting military readiness -- and how that readiness should be defined.

"We spend a lot of time in hearings and briefings ... trying to define what the role of the military healthcare system should be and how we structure that role to meet the requirements," Rep. Joe Heck, a Republican from Nevada and chairman of the panel, said in an interview with early this month.

"How do we best ensure that the military healthcare system can meet its primary role, which is to have a ready and deployable healthcare force to take care of our men and women in uniform when they deploy," he added, "and provide a valued benefit to military members, retirees and everyone to whom the healthcare benefit has been promised?"

The budget proposal will be examined by Heck's committee as well as the full Armed Forces committees in the House and Senate before legislation is drafted authorizing the Defense Department's budget for the fiscal year beginning Oct. 1 and any Tricare changes.

Although the budget proposal had not been released at the time of Heck's comments, he told in the interview that he did not anticipate wide congressional support for moving ahead with a consolidation plan, like the one the Pentagon was rumored at the time to be proposing and then later released.

"Our job is to wade through the reports, the recommendations that are made by the outside panels, collate that with the information we've received from our own briefings and hearings, and determine what we think is the best way forward for the military health care system," he said.

-- Amy Bushatz can be reached at Follow her on Twitter at @amybushatz.

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