Bush administration officials again have saddled Congress with an underfunded military health care budget by projecting $1.2 billion in savings they know will not be realized, say critics on Capitol Hill.
Part of the false savings, for a third straight year, is tied to the unlikely scenario that Congress will enact administration plans to raise fees, co-payments and deductibles for military retirees.
Key lawmakers say won’t that happen.
But what irritates lawmakers more is that, even if they did embrace the higher fees recommended by a Department of Defense’s Task Force, and penciled into Bush’s fiscal 2009 defense budget, the actual savings realized wouldn’t come close to matching the number that the administration projects.
Most of the $1.2 billion in assumed savings swing on the notion that if fees, co-pays and deductibles are raised for retirees, tens of thousands of users of TRICARE will drop the military benefit and switch to alternative health insurance offered by second-career employers.
That scenario defies logic, however, as even the co-chair of DOD’s task force on military health care bluntly stated during a March 12 hearing of the House armed services’ military personnel subcommittee.
“With all due respect to the department, there’s nothing they’re going to do which is going to make TRICARE more expensive than what goes on in the private sector,” said Dr. Gail Wilensky, a prominent healthcare economist. “I know they have used that argument. I don’t know what they’re thinking.”
Rep. John McHugh of New York, ranking Republican on the subcommittee, noted that the false savings built into the ‘09 budget will be harder for the armed services committees to overcome this year.
“How this committee will find the means to restore that $1.2 billion cut will be an especially difficult challenge because the House Budget resolution, which opposes the TRICARE fee increases, does not add funding to restore DOD’s assumed savings,” McHugh said in an opening statement.
McHugh vowed that the money will be found.
McHugh and Rep. Walter Jones, R-N.C., suggested that Congress won’t allow fee increases unless they are endorsed by service associations who lobby lawmakers on behalf of beneficiaries.
But Dr. Ward Casscells, the assistant secretary of defense for health affairs who testified with Wilensky, said association leaders have told him they are “willing to see a gradual increase in TRICARE fees, co-pays and deductibles as long as it’s not more than within the private sector. Because they don’t want to rob theater care” to address the rising cost of retiree care.
McHugh was incredulous.
“Are you telling this panel that the (veteran service organizations) support the increases that are contained in the DOD budget proposal?”
They, Casscells clarified, “are not in favor of an abrupt increase in fees, co-pays or deductibles” that “would catch up (for) the past 12 years when (fees were) flat.” But they do “recognize that you can’t go for another 10 years without some increase in fees and co-pays and deductibles because they know that at some point this will eat into theater care, combat casualty care and force readiness.”
“If you could get any of that in writing,” said McHugh, “I would love to see it.”
Representatives of The Military Coalition, an umbrella group that include scores of service associations and veteran organizations, have testified previously that it is unfair for DOD officials to keep fees flat for more than a decade and then try to double or triple them in a few years.
The coalition wants Congress to establish principles regarding military health benefits to protect their value from the whims of politicians and policymakers, and to establish limits on future beneficiary cost increases.
For example, fees increases for retirees and survivor beneficiaries in any given year should not exceed the percentage increase in retired pay or survivor compensation, the coalition maintains.
The coalition opposes the level of fee increases sought by the administration and specifically objects to imposing new enrollment fees on users of TRICARE Standard and TRICARE for Life. It also opposes “tiering” of fees and co-payments based on rank at retirement or level of retired pay.
The coalition argues that retirees paid large “up-front premiums” for their health care coverage through a career of arduous service.
To comment, e-mail milupdate@aol.com, write to Military Update, P.O. Box 231111, Centreville, VA 20120-1111 or visit www.militaryupdate.com.
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