Health Care

Tricare reform not in House plans this year

SitRep Major military health care changes on hold

A controversial plan to overhaul the military health care system won't move forward as part of next year's defense spending bill introduced recently in Congress. But lawmakers say reform remains a real possibility in the near future.

The House Armed Services Committee will not consider a sweeping overhaul of the military's Tricare health program in its fiscal 2016 defense bill, panel Republicans said Tuesday.

While the committee plans to address massive changes to the military retirement system in its version of the bill being rolled out this week, it will not include recommendations from the Military Compensation and Retirement Modernization Commission to move non-active-duty Tricare beneficiaries to civilian health insurance plans, according to Rep. Joe Heck, R-Nev., chairman of the committee's personnel panel.

"Tricare was probably the most difficult recommendation to evaluate from the commission, and we couldn't do justice to it with only a three-month review," Heck said.

But he did not rule out future Tricare reform, saying the compensation commission's recommendations warrant further study and a stand-alone military health reform bill could come as early as this year or be embedded in the fiscal 2017 defense authorization bill.

Heck and Rep. Mac Thornberry, R-Texas, chairman of the full House Armed Services Committee, said that in delaying any decision on Tricare reform, the committee weighed concerns from military and veterans advocacy groups over the potential impact of the changes, including the effect on the military health system, cost and access to care.

The Pentagon's fiscal 2016 budget proposal also called for changes to Tricare that would have introduced new fees for retirees and families for primary care appointments at military facilities, penalty fees for overuse of emergency rooms for non-emergency care and enrollment fees for Tricare for Life based on retirement income.

But the committee also rejected those proposals in its bill.

Committee aides said members did not want to approach changes to Tricare in "piecemeal" fashion and wanted the Obama administration's response to the commission recommendations before deciding how to proceed on military health care reform.

The House version of the defense authorization bill also omits a commission recommendation to change a Tricare program designed to offset the costs of caring for dependents with complex medical conditions.

The commission said the Tricare Extended Care Health Option, or ECHO, program, should be changed to cover the same services as Medicaid so severely ill dependents or children with chronic conditions don't lose access to care when their military parents move.

According to committee staff, lawmakers liked the concept but said that because Medicaid funds are administered by each individual state, more research was needed to understand the scope of the issue.

The House version of the bill does include a variation of another commission proposal, calling for the creation of a unified medical command.

Heck and Thornberry said such a command, made up of the current, Army, Navy and Air Force medical departments, would help streamline operations and eliminate duplication of services and administration.

"Before we start asking for higher co-pays, we need to make sure we have squeezed efficiency out of everything else," Thornberry said.

The commission had recommended that a broader four-star Joint Readiness Command be created to manage "the readiness as well as the interoperability, efficiency and 'jointness' of the entire military force" that would that would include a subordinate joint medical command.

The Senate Armed Services Committee is meeting this week to begin drafting its own version of the fiscal 2016 defense authorization bill. Differences between the House and Senate drafts will be worked out in a conference.

In the past, proposed changes to Tricare have met with fierce opposition from veterans groups and military support organizations who oppose fee increases and any reductions to military health benefits.

But the groups have split over the commission's proposals to move beneficiaries to private insurance plans, with some favoring what they say would be the plan's improved access to care and quality health treatment, and others charging that could cost the Pentagon billions of dollars and destroy a system that has proven itself through 14 years of combat operations.

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