The Military Coalition Testifies before House Personnel Committee
AUSA President Gen. Gordon R. Sullivan, USA, Ret., sent a letter to the House Armed Services Personnel Subcommittee’s Chairman Rep. Vic Snyder, D-Ark., and Ranking Member Rep. John McHugh, R-N.Y., to express his concern about proposed TRICARE fee increases as well as the independence of the congressionally-mandated Department of Defense Task Force on the Future of Military Health Care.
The letter stated, “It appears that the members of the committee are predisposed to and indeed are expected to produce a report that will support the $1.8 billion decrement in military health care funding proposed in the President’s Fiscal Year 2008 budget.”
In a hearing this week before the Personnel Subcommittee, The Military Coalition, a group of 35 military, veterans and uniformed services organizations of which AUSA is a member, provided testimony on many issues affecting the uniformed services community. As expected, issues related to TRICARE featured prominently.
Written testimony submitted by the Coalition stated “In past years, the Coalition and the Defense Department have had regular and substantive dialogues that proved very productive in facilitating reasonably smooth implementation of such major program changes as TRICARE Prime and TRICARE for Life. The objective during those good-faith dialogues has been finding a balance between the needs of the Department and the needs of beneficiaries.”
“It is a great source of regret to the Coalition that there has been substantively less dialogue on the more recent fee increase initiatives. Beneficiary associations were kept in the dark last year until the proposed changes were delivered to Congress. Since that time, the Department has marginalized their discussions with the Military Coalition on these proposed initiatives.”
“From its actions, it is hard to draw any other conclusion than the Department’s sole concern is to extract a specified amount of budget savings from beneficiaries. In part, the savings are intended to come from increased revenues from higher fees. But the vast majority of the savings are based on the assumption that the fee increases will deter hundreds of thousands of beneficiaries from using their earned military health benefits and Medical Treatment facility efficiencies.”
“To the extent the proposed changes don’t achieve the projected savings – which both the Coalition and the Congressional Budget Office believe they will not – the inescapable inference of this budget-setting philosophy is that the Department would then seek further increases to whatever extent necessary to achieve the desired budget savings. As of October 1, 2007, DoD is free to enact proposed cost saving initiatives not bound by legislative change. Current projected savings are based on DoD’s the same as last year’s proposals and the Task Forces’ recommendations. The Coalition believes this is neither a realistic nor an appropriate basis for setting military benefit levels, and that taking that approach would undermine the whole purpose of providing military health benefits.”
“The unique package of military retirement benefits – of which a key component is a top-of-the-line health benefit – is the primary offset afforded uniformed service members for enduring a career of unique and extraordinary sacrifices that few Americans are willing to accept for one year, let alone 20 or 30. It is an unusual – and essential – compensation package that a grateful Nation provides for the relatively few who agree to subordinate their personal and family lives to protecting our national interests for so many years.”
The written testimony specifically stated that:
-- Active duty members and families should be charged no fees except retail pharmacy co-payments, except to the extent they make the choice to participate in TRICARE Standard or use out-of-network providers under TRICARE Prime.
-- For retired and survivor beneficiaries, the percentage increase in fees, deductibles, and co-payments that may be considered in any year should not exceed the percentage increase beneficiaries experience in their compensation.
-- The TRICARE Standard co-pay should not be increased further for the foreseeable future. At $535 per day, it already far exceeds inpatient co-pays for virtually any private sector health plan.
-- There should be no enrollment fee for TRICARE Standard, since Standard does not offer assured access to TRICARE-participating providers. An enrollment fee implies enrollees will receive additional services, as Prime enrollees are guaranteed access to providers in return for their fee.
-- There should be one TRICARE fee schedule for all retired beneficiaries, just as all legislators, Defense leaders and other federal civilian grades have the same health fee schedule. The TRICARE schedule should be significantly lower than the lowest tier recommended by the Defense Department, recognizing that all retired members paid large up-front premiums for their coverage through decades of arduous service and sacrifice.
The Coalition also recommended strongly against establishment of any TRICARE Standard enrollment system; to the extent enrollment may be required, any beneficiary filing a claim should be enrolled automatically, without denying the claim.
In the absence of independent voices within the Task Force, Gen. Sullivan urged Reps. Snyder and McHugh to carefully review and consider the testimony presented by The Military Coalition.
Health care was not the only topic covered in the hearing. Numerous issues were addressed including those concerning the Active/National Guard/Reserve Forces as well as retirees and survivors. The entire Military Coalition testimony is now available.
Please help AUSA and The Military Coalition get our point across. Go to our website, click on “Contact Congress” then after “Elected Officials” type your Zip Code and scroll down to “Stop Erosion of Military Health Care Benefits.” Also, legislation AUSA is currently tracking can be viewed by clicking on “Contact Congress”, then after “Issues and Legislation” click on “Current Legislation.”
Commission on the National Guard and Reserves Release Report
Saying “there is no magic pixie dust” to “make these problems go away,” the chairman of the Commission on the National Guard and Reserves recommended that Congress and the administration take the necessary steps to rewrite the charter of the National Guard Bureau, make the bureau’s chief a four-star officer and fix the responsibility on the Department of Homeland Security with the assistance of the Defense Department in determining what the military needs to provide civil authorities in times of emergency.
The commission, chaired by Arnold L. Punaro, a retired Marine Corps major general, made 23 recommendations to change laws and regulations governing the National Guard and reserves. But it stopped short of lawmakers' recommendation, notably to make the head of the National Guard a member of the Joint Chiefs of Staff and to dramatically increase the Guard and governors' input on defense budgets. Those changes would be implemented by legislation pending in both chambers (S 430, HR 718).
"Despite the Guard's importance, they are being left out of the decision-making process," Missouri Republican Christopher S. Bond, who with Leahy co-chairs the Senate's National Guard Caucus, said in a statement. "Our legislation will give them the muscle they need."
Rep. Thomas M. Davis III, R-Va., said in a statement, "The commission's recommendations for the most part won't address the issues they acknowledge."
Rep. Davis and Rep. Gene Taylor, D-Miss., wrote the House legislation creating the commission and are cosponsors of the current measure, which would go further than the panel would.
Punaro said at a press conference “there was tremendous unanimity” among panel members on not making the chief of the National Guard Bureau a member of the Joint Chiefs of Staff, but he or she would be the chief adviser to the chairman and through the chairman to the defense secretary on Guard matters both in its federal role and its state role.
It also did not recommend creating a separate funding stream for the National Guard as is the case with Special Operations Command.
Punaro said that the shortage of equipment put 88 percent of guard units at the lowest levels of readiness to deploy. He called the situation “worse than the worst days of the hollow force” of the 1970s. He added that Defense Department adage of being prepared “for the away game” was “a flawed assumption” when it came to equipping and training guardsmen for homeland missions.
One recommendation would scrap the Armed Forces Reserve Policy Board and replace it with a new panel of experts in their field from outside the Department of Defense. It would operate like the Defense Science Board and would directly advise the Secretary of defense on National Guard and reserve matters.
There are “serious problems [of determining requirements, communications, equipping, training and unity of command] that need to be fixed and go much further than the legislation required.” Punaro added that it was important that the Departments of Defense and Homeland Security, Northern Command, the National Guard Bureau and the states and governors “are working the same game plan. We cannot use sandlot pickup game approach” in dealing with homeland defense.
“The Department of Defense has not made any fundamental changes … to make this an operational reserve.” He said, “Only eight [recommendations] require legislation. The rest could be done in the executive branch. We hope they would move out smartly.”
Punaro cited the example set by Defense Secretary Robert Gates who almost immediately after taking office put an end to the cross-leveling of personnel from one unit to another by changing the policy on use of the reserve components as to what could be done quickly.
Other major recommendations include:
--Establishing a bipartisan council of 10 governors to advise the secretaries of defense and homeland security and the White House Homeland Security Council on matters related to the National Guard and civil support. “The governors are on the front line. …They are where the rubber meets the road,” Punaro said. He added, “governors should be able to direct all military assets in their states” to cope with natural or manmade disasters or emergencies.
--Putting laws and procedures in place to enable the president and a governor to consent in advance that National Guard officers called to federal duty are not relieved of the state commission and can continue to command National Guard troops and are exempt from the Posse Comitatus Act. The act bars, in most cases, federal forces from making arrests. Patricia Lewis, a former Senate Armed Services Committee staff member and a commissioner, said this “dual-hatting” of the guard commander on the scene would establish a unit of command.
-- Making the National Guard Bureau a joint activity of the Department of Defense but would not changes the bureau’s relations with the Army and Air Force related to Title X matters and planning and budgeting for Title 32 mission requirements. Title X places guardsmen under federal control; Title 32 uses federal funds to pay for state missions, such as those involved in the aftermath of Hurricane Katrina or the terrorist attacks on the United States on Sept. 11, 2001.
--Designating that either the commander or deputy commander of Northern Command come from the reserve components and only have a single deputy commander.
--Having Northern Command develop plans for consequence management and support to civil authorities that account for state-level activities and incorporate the use of National Guard and reserve forces as first military responders.
--Enhancing opportunities for reserve component officers to meet Joint Professional Military Education requirements.
--Striving to ensure that reserve component flag and general officers have the opportunities to serve in joint assignment, obtain joint experience so that can be considered for promotion to three- and four-star levels.
Answer to Military Trivia
Winston Churchill
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