In addition to including promised reforms to military health care, the defense policy bill, recently approved by the House Armed Services Committee, also included programs and personnel not requested by the Pentagon. Specifically, the $610 billion measure added $18 billion in unrequested items. Even more controversial is the committee’s plan to shift funds from the Overseas Contingency Operations (OCO) account to pay for the unrequested items in the base budget. The move essentially means that the OCO account, which is exempt from budget caps, would only have enough money to fund overseas operations for half a year, requiring the next president to come back to Congress seeking additional funds for the remainder of fiscal 2017. Secretary of Defense Ash Carter isn’t a fan of the committee’s plan.
Carter said in a recent Senate hearing that the move amounts to “gambling” with troops’ funding at a time of war and called it “deeply troubling” and “flawed.” “It would spend money on things that are not DoD’s highest unfunded priorities across the joint force. It buys force structure without the money to sustain it and keep it ready, effectively creating hollow force structure, and working against our efforts to restore readiness,” Carter said. Carter added that the House committee’s plan is a “step in the direction of unraveling the Bipartisan Budget Act,” which the secretary cited as giving the department much-needed budget stability. “It’s another road to nowhere, with uncertain chances of ever becoming law, and a high probability of leading to more gridlock and another continuing resolution – exactly the kind of terrible distraction we’ve seen for years, that undercuts stable planning and efficient use of taxpayer dollars, dispirits troops and their families, baffles friends, and emboldens foes,” Carter said. Adding, “I cannot support such maneuvers.” Carter later reiterated his position telling reporters that he considers the move “objectionable on the face of it.” Chairman of the House Armed Services Committee Mac Thornberry, R-Texas, fired back at the secretary. In a statement Thornberry said, “What’s objectionable is deploying troops who aren’t fully trained, whose equipment is worn out, and who didn’t get the resources they needed back home to be ready to face our enemies overseas. “What’s objectionable is cutting the military well below levels anyone thinks is wise, denying our troops their pay raise for three years in a row, forcing them to live in crumbling barracks or work in hangars that have literally been condemned.
I am determined to turn our readiness crisis around, even if I have to do it over the Secretary’s objections.” Health care reform The committee’s plan to reform military health care would combine the current TRICARE program into two options: TRICARE Prime which will remain the managed care option and TRICARE Preferred which is a hybrid of the current TRICARE Standard and Extra options. Beneficiaries choosing this option would receive their care from a network of civilian providers. Under the committee’s plan, all personnel now serving or who will retire before 2018 will stay within the current TRICARE fee structures, with enrollment fees adjusted to the cost of living, but that could change in 2020. At that time, retirees selecting the new TRICARE Preferred option would pay an enrollment fee if DoD can demonstrate and independently validate im provements to access and care. Further, anyone enlisting after Jan. 1, 2018, would pay an annual fee for services. The committee also voted to remove administration and control of budgetary matters of medical facilities from the individual services and place it under the control of the Defense Health Agency (DHA).
AUSA does not support this provision. Since DHA and the services will likely have different priorities, resources will be diverted from where the Army needs them most, and moved to where a bureaucratic agency wants them. Further, decisions on what services to deliver at which MTFs should not be made on the basis of “business” criteria. The MTFs are readiness platforms, and that should be the perspective through which decisions on specific services should be made. There were many other items in the House bill that AUSA does support. In an effort to address well-publicized problems with access to care and referrals, the Committee voted to: Eliminate referrals for urgent care. Maintain urgent care facilities that will remain open through 11:00 p.m. Extend care at Military Treatment Facilities (MTF) primary care clinics beyond normal business hours. Expand public-private partnerships to increase and complement MTF services provided to beneficiaries. Enable retirees to purchase durable medical equipment at the DoD cost. Standardize appointment scheduling and first-call resolution when contacting clinics. Increase the number of available appointments.
Maximize the use of telehealth and secure messaging. Establish new trauma centers at military medical centers in areas with unmet patient demand. Other amendments approved by the committee include: An increase to the Army’s active duty end strength by 20,000 to 480,000, up from the 460,000 requested by the administration. The Army National Guard would get 15,000 new troops while the Army Reserve would increase by 10,000. The president’s budget requested 335,000 for the National Guard and 195,000 for the Army Reserve. A 2.1 percent pay raise as opposed to the 1.6 percent included in the president’s budget request. 14 days of leave for service members whose spouses give birth. Dual military families who adopt a child would each receive 14 days of leave. Authorization for the secretary of defense to develop and implement a comprehensive strategy to optimize practices across the defense commissary and exchange system that reduce the reliance of the system on appropriated funds. A requirement that both men and women register for the draft. Establishment of a “Commission on National Defense Strategy for the United States” to examine and make recommendations to the president; defense secretary and congressional committees. An extension of the chairman of the Joint Chiefs’ term from two years to four years and requirement that term be staggered outside of the presidential election cycle.
Exemption from furlough for “dual status technicians,” which are National Guard personnel who serve as civilian maintenance employees. Requirement that military investigators have specific training on retaliation and a requirement for a minimum confinement period for members of the military convicted of certain sex-related offenses. Changes on how military retirement pay is distributed to divorced spouses. By the time the paper goes to press, the full House will have voted on the FY17 defense authorization bill and the Senate Armed Services Committee will have approved their version. Look for details in next month’s column.
Julie Cameron Rudowski
Assistant Director Government Affairs