TRICARE health-care fees remain very controversial 

Julie Rudowski

Assistant Director, Government Affairs

You can’t make this stuff up! "The truth of the matter is the spiraling cost of health care requires us to adjust some fees and co-pays – fees and co-pays that really have not been adjusted since the TRICARE program was put into place in 1994."

That is what Dr. Jonathan Woodson, assistant Secretary of Defense for Health Affairs said about the Defense Department’s plan to raise TRICARE fees.

However, a recent reprogramming request from DoD to Congress tells a different story.

The request included an appeal to reprogram $708 million in excess funds from the Defense Health Program to "higher priority items."

The reprogramming request stated: "Funds are available because of a significant downward spike in the private sector care (PSC) cost growth rates.

"Through the first six months of [Fiscal Year] 2012, private sector care costs are growing at historically low rates of 0.6 percent for active duty and -2.7 percent for all other beneficiaries.

"The department expects these rates to moderate somewhat through the remainder of the fiscal year but continue to remain significantly lower than predicted during the budget development process."

Understandably, we at AUSA are confused.

Is this the same Defense Department that has testified repeatedly that health care costs are eating them alive?

The same Defense Department that told Congress if they blocked the TRICARE fee hikes, active duty end strength would have to be cut by 30,000 to 50,000 more than already planned?

The same Defense Department that said in testimony to the Senate Defense Appropriations Subcommittee on June 13 that fees for working-age retirees (under 65) should be increased and that they were "disappointed that the authorization committees did not support the proposed TRICARE fee initiatives that seek to control spiraling defense health care costs?"

Yup. One and the same.

By the way, the reprogramming request was dated June 26, only 14 days after the Senate Defense Appropriations Subcommittee hearing.

We are pleased to report that we are not the only confused group.

A bipartisan letter from 24 House lawmakers to Defense Secretary Leon Panetta asks some very important questions.

The letter states: "As you are aware, the House of Representatives, in our version of the FY13 NDAA declined to grant DoD the authority to raise TRICARE fees.

"We subsequently heard from DoD that our refusal to grant such authority was endangering the sustainability of TRICARE programs. We have heard that ‘TRICARE is crippling’ the DoD.

"This does not appear to be the case if DoD has a $708 million surplus in FY 2012."

The lawmakers want to know that if, as the reprogramming request states, retirees’ care costs are decreasing by 2.7 percent, how can DoD justify a request to raise fees on a class of people whose costs to the department are actually decreasing.

We would like the answer to this also. When we get the answer, please be assured that we will pass it along.

Transition from military to civilian focus of hearing. A rare joint hearing of the House Armed Services and Veterans’ Affairs committees focused on issues faced by service members as they return to civilian life.

Defense Secretary Leon Panetta and Veterans’ Affairs Secretary Erik Shinseki were the two witnesses.

Hearing topics included:

Backlog of veteran’s disability claims

FACT: As of May 2012, the VA had approximately 900,000 claims in processing, about 65 percent of them are over 125 days old with 1.25 million claims projected for 2013.

Although Congress mandated over a decade ago that the DoD and VA create a joint integrated electronic health record to facilitate the transfer of service members’ personal health information between DOD and VA health facilities, we learned that it isn’t expected to be completed until 2017.

Military suicides

FACT: Military suicides are at their highest levels in more than a decade, with an average of one suicide occurring every day so far this year.

Panetta said that DoD, in close cooperation with the VA is taking aggressive steps to try to address the suicide issue, including trying to get people to seek the kind of help they need, improving access to mental and behavioral health care and emphasizing mental fitness as well as improving the ability of leadership within the military to determine signs of suicidal behavior and to know what to do to prevent it from happening.

Unemployment

FACT: 23.3 percent of veterans between the ages of 18 and 24 are unemployed.

Shinseki said that various pieces of the VOW to Hire Heroes Act have been implemented including the Veterans Retraining Assistance Program (VRAP). He also said that people have signed up "in the tens of thousands."

Panetta said that he will move in the direction of making eight days of the Transition Assistance Program (TAP) mandatory and that the nine pilot programs the Defense Department is currently conducting will tell them "just exactly what we have to require, how do we have to mandate it, how we have to revise it."

Homelessness

FACT: An estimated 60,000 veterans are homeless.

In response to a question about homelessness, Shinseki said that the VA has established 2015 as the point in time where they intend to end veterans’ homelessness. He said that there are two pieces to veterans’ homelessness.

"One is the rescue. That is, getting everyone on the street off the street, into housing, into programs that get them treatment for substance abuse, depression, training for employment and moving on with their lives. The other piece is prevention.

"Right now, we have about 900,000 veterans in G.I. Bill programs. And that is colleges, universities, community colleges, tech trade schools. Any youngster who fails out of that program right now in this economy is at high risk of homelessness. And so our prevention effort here is to make sure youngsters get in the school, stay in the school, graduate and have an opportunity to go on and work."

Shinseki also discussed VA’s housing mortgage program.

He said that in the last year, of the approximately 90,000 veteran mortgage owners who had defaulted on their home loans, the VA was able to defer roughly 75 percent of them from being evicted from their homes.

"And that is with VA’s financial counselors getting in there, getting – helping them get control over their finances, lowering the monthly payments, extending the payment period."

We all agree that these serious problems need serious solutions. We remain concerned, however, about the pace.

We also agree with Secretary Panetta who said, "We cannot accept the old way of doing things. Things are going to have to change, things are going to have to be modified, people are going to have to respond differently.

"If we expect the same old responses to the problems we’re having, then we’re going to have the same old problems. We have got to change the way people respond to these issues."

Veteran Skills to Jobs Act becomes law. AUSA-supported legislation that will make it easier for veterans to find jobs using skills acquired through military training cleared Congress and was signed into law by President Obama.

The Veteran Skills to Jobs Act (H.R. 4155), introduced by Reps. Jeff Denham, R-Calif., and Tim Walz, D-Minn., and S.2239, introduced by Sen. Bill Nelson, D-Fla., addresses the unacceptably high rate of veteran unemployment by streamlining the federal certification process and cutting through the bureaucratic red tape, making it easier for veterans to utilize the skills they acquired in the military to find work at home.

Rather than going through the process of redundant trainings for jobs they are already qualified for, the legislation directs the head of each federal department and agency to treat relevant military training as sufficient to satisfy training or certification requirements for federal license.

Veterans with the relevant training would be eligible to receive a federal license and get back to work immediately.

Earlier this year, AUSA President Gen. Gordon R. Sullivan, USA, Ret., wrote a letter to the sponsors of the legislation thanking them for introducing the important measure and offering his and the Association’s support.