Military and veterans' advocacy groups are split over a congressional commission's radical proposal to privatize Tricare for military family members and retirees.

Advocates for some of the most powerful groups — the American Legion, Veterans of Foreign Wars, the Military Officers Association of America and more — offered strong opinions to the House Armed Services Committee's military personnel panel Wednesday, each based on the unique interests of their membership.

And there was no consensus.

Coming out strongly in favor of the proposal is the National Military Family Association, which represents the interests of mainly active-duty families. Karen Ruedisueli, the organization's deputy director for government relations, said the military medical system needs reform because yearly cuts and planned fee increases erode the benefit.

Ruedisueli said the proposal from the congressionally chartered Military Compensation and Retirement Modernization Commission would improve both access to and quality of care and "merits further study and serious consideration."

Reserve component associations say the ability to choose a commercial plan that would work for their families regardless of their drilling status would appeal to their membership. Also supporting the plan are groups that represent National Guard and Reserve members, who often transfer between civilian and military health plans when they are called to active duty.

"Tricare often limits access to care by confining beneficiaries to a lengthy and frustrating process for obtaining specialty care and to weak networks of civilian health care providers," said Scott Bousum, legislative director for the Enlisted Association of the National Guard of the United States.

"The adverse effect of weak provider networks is even more profound for beneficiaries living in remote locations, including reserve component members," Bousum said.

Some veterans' groups — mainly those representing troops who served one or two enlistments and were not medically retired — don't really have a dog in this fight. But they noted that problems with Tricare and the military health system do affect their members, especially during the transition period between the military health system and Veterans Affairs Department care.

"Tricare is in a death spiral," VFW senior legislative associate Brendon Gehrke said.

The Military Officers Association of America remains one of the strongest opponents of the proposal, known as Tricare Choice.

Arguing that Defense Department personnel costs have leveled out over the past few years, MOAA is pressing to reform Tricare under a unified health command, which MOAA argues would save money without negatively impacting troops and families.

"Service members stationed around the world should not have to worry about whether they have selected the appropriate retirement fund or appropriate health care plan for their families," said MOAA Government Relations Director Mike Hayden.

In its report, the compensation commission estimates that its proposed changes could save the Pentagon $26.5 billion from fiscal 2016 to fiscal 2020, and $6.7 billion a year by 2033.

The Pentagon is expected to provide its response to the commission proposals by April 1.

Lawmakers are taking the proposals seriously. Earlier this month in the Senate, Sens. Lindsay Graham, R-S.C., and Kristen Gillibrand, D-N.Y., who both sit on the Senate Armed Services Committee, questioned commissioners closely and expressed support for some of the proposal's benefits.

Rep. Tom MacArthur, R-N.J. also expressed interest. "There are things I like about it — access to a larger panel of doctors, increased choice, the ability to adjust the plans without an act of Congress," MacArthur said.

He raised the idea of a pilot program. "I come out of the business world and would never do something that would affect thousands of people without piloting or testing it and this affects millions," MacArthur said.

In her testimony, the NMFA's Ruedisueli said that while her group favors the plan, it stops short of full endorsement. She said more analysis is needed in order to determine the impact on military hospitals and clinics and out-of-pocked costs to beneficiaries.

About Patricia Kime

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

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