Looming spending cuts pose a significant threat to military medical research and could harm health services for troops, families and retirees, top Army, Navy and Air Force medical commanders told Congress.

Testifying before the House Appropriations Committee's defense panel Tuesday, the military services' surgeons general said proposed budget caps would have a "detrimental impact" on the Defense Department health system and urged lawmakers to fix the issues before the cuts go into effect.

Lt. Gen. Patricia Horoho said the Army Medical Command would be forced to close some inpatient and acute care surgical centers if budget caps remain in place.

"Devastating reductions to both civilian personnel and military end strength would impact every Army medicine program," Horoho told lawmakers on the budget funding panel.

Air Force Lt. Gen. Thomas Travis said the budget caps, often referred to as sequestration, are "a threat to research dollars" that would put pressure on "restoration, modernization, sustainment of our facilities and research dollars."

"And not just the organic research dollars for the military medical community, but for our partner institutions," he added.

Under rules passed by Congress in 2011, the defense budget would be cut by roughly $40 billion in fiscal 2016 unless Congress amends the Budget Control Act.

Rep. Rodney Frelinghuysen, R-N.J., chairman of the defense panel, said "everyone on his committee hates sequestration" and will work toward a solution.

"It's a straitjacket we'd like to get out of," Frelinghuysen told the surgeons general. "We're trying to extricate ourselves so that it does the minimum amount of harm to the important work that you do."

The Pentagon's proposed fiscal 2016 budget seeks $47.8 billion for health care, including $32.2 billion to care for more than 9 million active-duty personnel, family members and retirees.

The plan also proposes to consolidate Tricare into a single system and also suggests new fees to provide wrap-around coverage for Medicare-eligible retirees and increased fees for retirees and their family members below age 65.

Navy Surgeon General Vice Adm. Matthew Nathan said the services' medical commands remain concerned about maintaining the levels of readiness and quality of care honed over the past 14 years of combat operations and continuing to develop cutting-edge procedures and treatment techniques.

"You have heard the unified chant from all of us that we need to maintain an organic critical mass of research funding stream," Nathan said.

According to Horoho, in the last round of budget cuts, the Army laid off some contracted physicians and medical specialists and never recovered that expertise.

Air Force Lt. Gen. Doug Robb, director of the Defense Health Agency, said should the cuts occur, the priority within the health system will remain its patients.

"Our commitment to quality of care is sacrosanct — we will not allow quality to suffer or place any patient at risk," Robb said. "But there are significant, negative long-term effects on the overall military health system that could undermine our efforts to support readiness."

About Patricia Kime

Patricia Kime is a senior writer covering military and veterans health care, medicine and personnel issues.

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