Legislative News is AUSA Government Affairs Directorate's
weekly electronic newsletter, and is published
every Monday when Congress is in session.
In this issue:
HOW DOES HEALTH CARE REFORM AFFECT YOU?
We’ve received numerous calls and emails about the health care reform bill recently signed into law by President Obama. Many of you want to know how this sweeping new program will affect you. Here are the most common questions you have asked and the answers.
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 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.
AUSA was informed late last week that 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).
We expect many more questions to be asked as the details of this new law emerge. Updates will be provided in this Newsletter as well as AUSA’s newspaper and website, www.ausa.org.
MEDICARE/TRICARE PAYMENT FIX HELD HOSTAGE
House leaders passed legislation that would delay (to May 1) the 21 percent cut in Medicare/TRICARE payments to physicians.
But the Senate’s effort to delay the cuts was held up by Sen. Tom Coburn, R-Okla., who refused to go along with the “unanimous consent” procedure that would have passed the bill quickly. Sen. Coburn objected because there is no cost offset to the bill. Under Senate rules, any senator can object to bringing a bill to the floor for action.
Instead of sticking around to resolve this critical issue, the Senate joined their House counterparts and left town for a two-week recess. The 21 percent cut takes effect on April 1.
What happens now is a mystery. Last month when we faced the same scenario, the Centers for Medicare and Medical Services said all Medicare reimbursements filed by physicians would be held for 10 business days to give Congress additional time to sort it out.
We are hearing that doctors are advising their patients that they will no longer accept Medicare patients because they are tired of dealing with the yearly (or monthly now) threat of a payment cut. Because TRICARE reimbursement rates are tied to Medicare, this affects the entire military community.
Please contact your elected officials and let them know this is unacceptable. Go to the AUSA website, www.ausa.org, click on “Contact Congress”, type in your zip code beside “Elected Officials”, and scroll down to “Prevent the 21% Cut in Medicare/TRICARE Payments”.
Congress’ continuing games of last-minute budget “chicken” put millions of seniors and military families at risk.
AUSA ON THE HILL
AUSA’s Vice President for Education LTG Ted Stroup, USA, Ret., and Government Affairs Director Bill Loper presented a "Once a Soldier...Always a Soldier" book to Rep. Phil Roe, R-Tenn., who served in the Army Medical Corps in Korea during the 1970's.
Rep. Roe was quick to check the book to find other members of Congress who wore Army green. He serves on the House Veterans' Affairs Committee where he works to ensure that veterans' benefits are available to those who protected and defended our nation.
Also on the Hill, Bill Loper visited the office of newly-elected Senator Scott Brown, R-Mass., who will be in the next edition of the "Once a Soldier" book based on his almost 30-year career in the Massachusetts Army National Guard. Mr. Loper presented a packet of AUSA publications and our resolutions to the Senator's military legislative assistant.