TRICARE hikes are not ‘keeping faith,’ coalition rep
March 22, 2012
by Tom Philpott
A House subcommittee expected to vote
soon on whether to recommend raising retiree TRICARE fees sharply over
the next five years heard some compelling testimony against the move
Retired Air Force Col. Steve
Strobridge, co-chair of The Military Coalition, a consortium of 34
military associations and veterans groups, traded debate points with Dr.
Jonathan Woodson, assistant secretary of defense for health affairs,
before the armed services panel on personnel.
Strobridge attacked the Obama
administration’s premise that raising TRICARE fees on military
retirees to help balance defense spending cuts in the current budget
crisis does not break faith with the force.
"If keeping faith means no changes for today’s
troops on retirement, than it’s breaking
faith to raise their [health] fees by [up to] $2000. That’s no
different from a $2000 retired pay cut,"he said.
"They say military retirees pay far less for health care
than civilians do,"Strobridge added. "Whenever somebody
gives me that argument I ask: If the military deal was so great, are you
willing to pay what they did to earn it? Would you sign up to spend the
next 20 to 30 years being deployed to Iraq, Afghanistan or any other
garden spot the government want to send you to,"he asked.
"Military people pay far steeper premiums for health
coverage than any civilian ever has or ever will."
Woodson warned that if Congress blocks
the TRICARE fee hikes, which would save almost $13 billion over five
years, then active duty strength would have to be cut by 30,000 to
50,000 more troops than already planned.
The surgeons general of the Army, Navy
and Air Force also testified but were not drawn into the TRICARE fee
The armed services committees have been
preoccupied for weeks over how to accommodate last year’s
bipartisan deal to cut defense spending by $487 billion over the next
decade. The administration’s plan to hit
that target includes TRICARE fee hikes for every category of retiree
except those retired because of disability. The plan also includes
raising TRICARE pharmacy co-pays sharply at retail outlets, and more
modestly for mail order. Higher pharmacy co-pays would impact active
duty families too.
Congress also is worried about a
"sequestration"order included in
that same law, the Budget Control Act. If not blocked or replaced by a
new deficit reduction plan by Dec. 31, sequestration would require
arbitrary defense program cuts totaling another $500 billion over 10
This atmosphere of fiscal doom might be
to blame for House and Senate defenders of military retirees making only
half-hearted or strangely ill-informed arguments lately against planned
TRICARE fee increases.
Freshmen Republicans, for example,
routinely ask why the administration isn’t proposing
similar health fee increases for federal civilians –ignoring the
fact that federal civilians pay hefty monthly premiums already, and
those payments are raised annually as health care costs rise. Woodson
made that same argument again at this hearing.
Rep. Joe Wilson (R-S.C.), chairman of
the House personnel subcommittee, called the TRICARE fee plan
"wrong-headed"and designed to
encourage retirees not to use their benefit. Woodson assured him the
goal is to save defense dollars, not "drive people away
from their TRICARE benefit."
Strobridge, director of government
relations for Military Officers Association of America, was the lone
witness on behalf of The Military Coalition and against the fee
increases. Facing a budget squeeze, he said, Defense officials decided
it was easier to save money by raising fees rather than implement
recommendations of studies to consolidate health budgets.
"They blame the budget crunch but balk at changes to make
the sy stem significantly more efficient [addressing] DoD’s
fragmented health care systems. But the recent review made only minimal
changes, in part because a key decision criterion was how hard the
change would be. So the first choice was to make retirees pay more
because it was easier,"he said.
He dismissed Woodson’s
argument that combining medical command headquarters would target only
two percent of total health spending.
"The issue on reorganization isn’t the
headquarters,"Strobridge replied. "The issue is
consolidation of responsibilities and accountability for the budget,
which we don’t have right now."
For example, Strobridge said, when a
base wants to save money, it can reduce the number of medicines
available on base, which means more beneficiaries go off base to get
prescriptions filled. It drives down base costs but drives up overall
health costs for DoD. It’s those kinds
of inefficiencies that you have to eliminate,"he said.
Woodson said that with fees, co-pays
and deductibles set for retirees in 1996, they paid 27 percent of total
health costs as the TRICARE triple insurance option took effect. With no
fee increases since then, until last October, the beneficiary cost share
fell to 10 percent. The planned fee increases would raise average out-of
pocket costs to 14 percent. That still would be only half what it was in
1996, Woodson said.
He also defended the plan to
"tier"TRICARE enrollment fees so retirees with more
income also pay more out of pocket. Military leaders, including enlisted
leaders, pushed hard for that feature, Woodson said, to protect
lower-income retirees. Strobridge called it discriminatory.
"No other federal retiree has service-earned health
benefits means tested, and it’s rare in the
civilian world. Under that perverse system, the longer and more
successfully you serve, the less benefit you earn,"he said.
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