Legislative Update 13 November 2015: Calling All TRICARE Beneficiaries

We have No Action Items today.

 

 

Summary of Issues

At Issue 1. we see CALLING ALL TRICARE BENEFICIARIESCongress wants to reform military health coverage, If you are a TRICARE beneficiary, MOAA needs your help in filling out a 5-10 minute survey. (Click on CALLING ALL TRICARE BENEFICIARIES here or above to participate in the survey.  GF)

At Issue 2 we see EXACTLY WHICH HEALTH COSTS ARE “SPIRALING?”  Is the cost of military health care really out of control? MOAA’s Director of Government Relations, Col. Steve Strobridge. USAF (Ret), examines the facts and draws some conclusions in his As I See It column.  (See Issue 2 below for the details. GF) 

At Issue 3. we see CAREER RESERVISTS NEXT BIG WIN Millions of vets to receive the credit they deserve. Senate approves a major change for members of the Guard and Reserve.(See Issue 3 below for the details. GF) 

At Issue 4. we see OFFICIAL MEDICARE RATES RELEASED. 2016 Part B premiums announced,.Most beneficiaries won’t see a hike, but many MOAA members will. (See Issue 4 below for the details. GF) 

At Issue 5. we see MOAA HOSTS NATIONAL VETERANS DAY CEREMONYMOAA honors the shared sacrifice of members of the uniformed services. MOAA was privileged to serve as the 2015 host organization for the Veterans Day National Committee.

(See Issue 5 below for the details. GF) 

Collectively We Can and Are Making a Difference

 

FOR ALL, Please feel free to pass these Weekly Legislative Updates on to your group of Veteran Friends –

don’t be concerned with possible duplications – if your friends are as concerned as we are with Veteran issues, they probably won’t mind getting this from two or more friendly sources

 

ISSUES

 

Issue 2. EXACTLY WHICH HEALTH COSTS ARE “SPIRALING?” As I See It

 

By: Col. Steve Strobridge, USAF (Ret)Director, Government Relations 

Strobridge, a native of Vermont, is a 1969 ROTC graduate from Syracuse University in Syracuse, N.Y. He was called to active duty in October 1969 and began his career as a Basic Military School training officer and commander and as a military personnel officer. He subsequently served as a compensation and legislation analyst at HQ U.S. Air Force and in the Office of the Secretary of Defense as director, Officer and Enlisted Personnel Management, with intervening assignments in Thailand and Germany.

His final assignment was as chief of the Entitlements Division at HQ U.S. Air Force, with policy responsibility for military compensation, retirement and survivor benefits, and all legislative matters affecting the military community. He is a graduate of the Armed Forces Staff College and National War College. 

Strobridge retired from the Air Force in January 1994 to become MOAA’s deputy director for Government Relations. In 2001, he was appointed as director of Government Relations and elected as cochair of The Military Coalition.

He retired from MOAA in April 2013 but was recalled as Government Relations director in September 2015.   

Defense leaders have complained for years about “spiraling military health costs,” and their main proposals for action have centered on foisting more costs on beneficiaries.

Congress has acted on those concerns by raising TRICARE Prime enrollment fees 23 percent since 2011, doubling or tripling most TRICARE pharmacy copayments over that period, and requiring annual inflation-based fee hikes going forward.

The president’s budget projections still show military health care costs growing in the outyears.

Armed Services Committee leaders say they intend major action next year to reform military health coverage and that “increased fees will be a necessary part of this reform.”

But looking at the health care cost facts rather than the rhetoric also will be crucial in that effort.

Fact 1: Every year, the Pentagon budget forecasts significant cost increases for future years.

Fact 2: For the past five years, those projections have proven false, as overall DoD health costs (as reflected in annual Pentagon reports to Congress) have stayed flat.

Fact 3: DoD fee hike proposals, in the main, have targeted beneficiaries who get their care outside military hospitals and clinics.

Fact 4: For the past five years, these “purchased care” costs have remained flat (other than a $2 billion anomaly for FY 2015 that DoD has acknowledged was a one-time oversight failure on compounded medications that has now been brought under control).

Fact 5: DoD costs for TRICARE For Life (TFL) (that is, annual Pentagon deposits to the TFL trust fund, which cover both care and medications) have declined dramatically, from $10.8 billion in FY 2010 to $6.6 billion for FY 2016.

Fact 6: Virtually the only elements of the DoD health care budget that have been increasing over the past five years are care delivered in military facilities (over which the Pentagon has the most control and which mainly reflect military readiness needs) and pharmacy costs for non-Medicare-eligibles.

Fact 7: At current levels, TRICARE pharmacy copayments are at about the 50th percentile of copayments charged by civilian employer plans (as measured by the Hay Group, one of the most respected surveyors of benefit programs).

Fact 8: Congress’ multiple recent adjustments to TRICARE pharmacy copayments have been relatively arbitrary, driven in part by the need to raise more revenue to pay for other programs.

Fact 9: The 2016 $10 retail pharmacy copayment for generic drugs is more than twice the $4 copayment Wal-Mart charges for most common generics for people with no insurance.

So what can we conclude from all these facts?

Conclusion 1: DoD consistently projects large cost increases that don’t materialize. If they’ve been consistently bad at making past projections, why should we give much weight to their current projections?

Conclusion 2: If past misprojections formed the entire basis for pushing more costs to beneficiaries, one has to question the validity of continuing that argument.

Conclusion 3: If you believe the military health benefit should be at the very top tier — the gold standard that exceeds private-sector plans in recognition of currently serving and career members’ and families’ decades of service and sacrifice — then pharmacy copayments already are plenty high. The 50th percentile is not a gold standard.

Conclusion 4: If the main area of cost increases has been in care delivered through military facilities rather than care obtained from civilian providers, then maybe, just maybe, the focus of future cost-containment efforts should be on DoD’s inefficient management of those in-house programs rather than simply blaming beneficiaries for cost problems they’re not causing.

Conclusion 5: One of the main pillars of any major health care reform effort should be an explicit acknowledgement of the significant, in-kind premium value of servicemembers’ and their families’ decades of service to their country

Issue 3. CAREER RESERVISTS NEXT BIG WIN 

November 13, 2015

In recent years, House of Representatives action on significant veterans’ matters often cleared the chamber before the Senate. This year the full Senate went first by favorably voting out the “21st Century Veterans Benefits Delivery and Other Improvements Act,” which addresses veteran health care and benefits needs.

With the Senate’s action, a longstanding MOAA and Military Coalition goal of honoring certain career reservists with no active duty service as veterans, is poised to be enacted in law. The Senate bill – S. 1203, Amended – however, differs slightly from the House bill – H.R. 1384 – sponsored by Rep. Tim Walz (D-Minn.). Walz’ bill would amend the laws governing veterans benefits in Title 38 of the U.S. Code by creating a new definition honoring the career reservists as veterans, but denying them any new benefits.

The Senate provision simply honors the career reservists as veterans but does not codify the provision in Title 38. The compromise approach was apparently taken to overcome concerns that putting the honorific in Title 38 could be used in the future as a gateway to other veterans’ benefits. Walz dismissed the concern since his bill contains an explicit prohibition against new veterans benefits.

The Walz bill has cleared the full Veterans Affairs Committee. It could be voted out of the full House in the near future or combined with other measures in a House veterans omnibus. In that case, the differences between the two provisions would have to be reconciled.

Other components of the Senate bill would improve the transition process for separating servicemembers, upgrade the claims and appeals system and expand VA health care capacity. Among the changes, the bill would:

  • Revive a pilot program to hire veteran medics and corpsmen to be skilled nursing assistants in VA’s emergency departments;
  • Expand the provision of chiropractic services to veterans;
  • Accelerate recognition of DoD medical credentials to boost VA recruitment of medical providers;
  • Encourage DoD to permit veteran service organizations to assist servicemembers who are leaving the military during their Transition Assistance Program training;
  • Expand the use of video-teleconferences for hearings before the Board of Veterans Appeals;
  • Assist surviving spouses of veteran owners of small businesses; and
  • Direct GAO to study the consistency of claims decision in VA regional offices.

 

Issue 4. OFFICIAL MEDICARE RATES RELEASED

November 13, 2015

This week, Medicare released the official 2016 Part B premium rates. They’re very close to, but slightly lower than, what MOAA projected in an earlier legislative update.

(Click on  an earlier legislative update here or above to see the earlier figures. GF)

Because of the Bipartisan Budget Agreement, beneficiaries not protected by the “hold-harmless” provision will see some relief in premium costs.

Seventy percent of Part B enrollees won’t see any change from the $105 monthly premium they’re now paying.

The only people with incomes less than $85,000 ($170,000 for a married couple) who will pay the higher $122 monthly rate are those who first become eligible for Medicare in 2016, or who are not receiving a Social Security Check, or certain lower-income beneficiaries who are dually eligible for Medicare and Medicaid.

The budget agreement protected these groups and the higher-income groups from a much larger 52 percent premium increase. Under the new calculations, these groups will only pay what they would have paid anyway if there had been a normal retiree COLA.

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For more information, please visit the Medicare website.

(Click on  Medicare website here or above for more detail GF)

Issue 5. MOAA HOSTS NATIONAL VETERANS DAY CEREMONY

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November 13, 2015

On Nov. 11, MOAA’s President, Vice Adm. Norb Ryan, USN (Ret.), represented the Association’s 390,000 members at Arlington National Cemetery. President Obama, the Secretary of Veterans Affairs, and other senior officials joined Ryan at the Presidential Armed Forces Full Honor Wreath-Laying Ceremony at the Tomb of the Unknown Soldier.

Ryan made remarks at the observance program in the amphitheater. Following the ceremonies, MOAA hosted this year’s reception at the Women in Military Service for America Memorial. Veterans and military service organizations, as well as military and civilian officials, including VA Secretary Bob McDonald attended.

“I am extremely proud that MOAA was the co-host of the ceremony for the first time in our 86 year history. It was an especially significant day for our association,” said Admiral Ryan. “Honor, Valor and Love of Country have always been the defining characteristics of America’s Military. That is why we never stop serving, for if we do, we risk breaking the faith that will inspire future generations to serve.”

 

 

 
 
 

That’s it for today- Thanks for your help!