How Does Health Care Reform Affect You? 

4/8/2010 12:00 AM 


                                                                                                         April 8, 2010

Well, folks, the question in the title is on everyone’s mind, so I asked our AUSA government affairs staff to put together a Q and A to help allay any fears that TRICARE is going to be negatively affected by the civilian health care reform legislation.

Before we get to the Q and A, I want to give a BIG AUSA tip of the hat to House Armed Services Committee Chairman Ike Skelton, D-Mo., for introducing legislation which explicitly states that TRICARE and non-appropriated fund (NAF) health plans meet all of the health care requirements for individual health insurance.  This technical correction will ensure TRICARE beneficiaries don’t suffer any inadvertent penalties under the language of civilian health care reform legislation passed by the House yesterday. 

While beneficiaries of these programs will already meet the minimum requirements for individual health insurance and will not be required to purchase additional coverage, H.R. 4887, The TRICARE Affirmation Act, provides clarification by changing the tax code to state it in law.  The bill was approved in the House by a vote of 403 to 0.

At the bill’s introduction, Rep. Skelton said, “It is a commonly known fact that I oppose the health care reform bill as it exists currently and will vote against it tomorrow.  But, my duty as the Chairman of the Armed Services Committee compels me to ensure that the health care of our brave service men and women, our military retirees, and all of their family members is protected if the bill does indeed pass.

“In the health care bill currently under consideration in Congress, TRICARE and the Non-Appropriated Fund health plans, the programs that provide health care for these individuals, will meet the minimum requirements for individual health insurance coverage, and no TRICARE or NAF health plan beneficiary will be required to purchase additional coverage beyond what they already have.

“However, to reassure our military service members and their families and make it perfectly clear that they will not be negatively affected by this legislation, my bill, H.R. 4887, explicitly states in law that these health plans meet the minimum requirements for individual health insurance.

“Our brave men and women in uniform provide us with first-class protection, and it is our obligation to provide them—and their families—with first-class health care in return. Every day, our troops risk their lives to stand up for us on the battlefield, and I now ask my colleagues—no matter what your position may be on health care reform itself—to join me in standing up for our service members and their families." 

In addition to the legislation, Skelton, along with Reps. Bob Filner, Chairman, Committee on Veterans Affairs; George Miller, Chairman, Committee on Education and Labor; Sander Levin, Chairman, Committee on Ways and Means; and Henry Waxman, Chairman, Committee on Energy and Commerce sent a letter to the Committee on Rules advising that they reviewed the health care reform bills to assess the impact of the bills on the health care provided by the Department of Defense and the Department of Veterans Affairs.

The letter stated, “Our reviews of H.R. 3590 and H.R. 4872 lead us to believe that the intent of the bills was never to undermine or change the Department of Defense and Department of Veterans Affairs operation of their health care programs or interfere with the care that our service members receive under TRICARE.  However, we commit to look into this issue further to ensure that no unintended consequences may arise and to take any legislative action that may be necessary.”

So there you have it.  This is just a start.  One important thing to remember is that most of the changes that will occur in civilian health care are years away.  If at some point it is discovered that inadvertently something in the bill would have an adverse impact on military or veteran health care, there is plenty of time to enact legislation that will fix it – and that is what your Association is here for – to advocate for legislation that helps soldiers and their families.

Your part in all this is to maintain your membership – only with a large membership can AUSA speak loudly in numbers that resonate on Capitol Hill.  Keep the faith, troops – AUSA is here to help you.  Now here are the Q and A’s.

Q1.  Will the new legislation transfer TRICARE into another government health care program?

A1.  No.  The Patient Protection and Affordable Care Act leaves TRICARE under the sole authority of the Defense Department and the Secretary of Defense, and TRICARE is governed by an independent set of statutes.  “For the Department of Defense, and specifically for our 9.6 million TRICARE beneficiaries, this law will not affect the TRICARE benefit.  Eligibility, covered benefits, co-payments and all other features of our TRICARE program remain in place.” - Assistant Secretary of Defense (Health Affairs) Dr. Charles Rice

Q2.  What does deeming TRICARE as “qualifying coverage” mean?

A2.  It ensures that TRICARE beneficiaries will not be impacted by the new legislation’s requirement that people without qualifying coverage will have to pay a financial penalty.  Just to make it clear, the House unanimously passed separate legislation on March 20, deeming TRICARE as “qualifying coverage” under the new law.  On the Senate side, S. 3148 and S. 3162 have just been introduced to deem TRICARE "qualifying coverage".  Also, Defense Secretary Robert Gates issued a statement asserting that health reform “won’t have a negative effect on TRICARE.”

Q3.  Is TRICARE for Life (TFL) considered “qualifying coverage” under the new law?

A3.  Yes, TFL is deemed qualifying coverage under the legislation already passed by both the House and Senate.

Q4.  Can I expect my TRICARE enrollment fee, premiums, deductibles or co-pays to go up because of this legislation?

A4.  There is nothing in the legislation that would change any TRICARE fees.

Q5.  The new health care bill allows adult children to stay on their parent’s healthcare plan until age 26 if their employers don’t offer insurance.  Will TRICARE adopt this policy?

A5.  Many beneficiaries with dependent children are very interested on how the Act will impact their children age 26 and younger.  TRICARE’s current age limits - 21, or age 23, if the dependent is in a full-time school program - are set by statute, so separate legislation would be required to change them.  If changes are made to the statue governing TRICARE, then, like any other legislative initiative, time will be required for TRICARE to implement the changes.  Until that time, the benefit remains unaffected by the Patient Protection and Affordable Care Act.

To that point, Rep. Martin Heinrich, D-N.M. has introduced H.R. 4923, the TRICARE Dependent Coverage Extension Act, a bill that would increase the maximum age to 26 at which our troops and military retirees are allowed to provide health coverage to their dependent children.

Q6.  I understand Medicare is cut $500 billion under the new law. Won’t that have to cut payments to doctors and threaten TFL?

A6. It’s true that the new law reduces Medicare spending by about that much, but most of those changes are relatively less painful ones that probably won’t affect TRICARE or TFL beneficiaries much.

They include $118 billion from eliminating the extra subsidy to the Medicare Advantage HMO program (which was sold to Congress as a cost-saver, but actually costs 14 percent more per person than Standard Medicare), cutting about $150 billion from non-rural hospitals (which the hospital associations say they can handle because expanding insurance coverage to most Americans will mean they won’t have to eat the cost of serving the uninsured), and cutting back abuses in medical equipment (under current systems, Medicare will buy you a wheelchair you may only need a few months, or allow a company to rent you one for life for a permanent condition).