ROA met with Rear Admiral Christine Hunter, Deputy Director for the TRICARE Management Activity (TMA), June 8. Three important topics were discussed.
Gray Area Access to TRICARE
While a quarterly meeting, ROA did ask for a briefing on TRICARE Retired Reserve (TRR) as part of the agenda. RADM Hunter reassured ROA and the other associations in attendance that implementation still looks good for an October 1 start time. ROA reminded the admiral that there is a need for an enrollment period prior to commencement of this benefit, and mentioned that the TRICARE contractors have concerns that they haven't been given a go ahead and are nearing their milestone for an October 1 start date. RADM Hunter said she would contact the contractors and follow-up on this. Per the law, Gray Area retirees can buy into the TRR program, paying a premium equal to the full cost.
Also discussed was the implementation for access of TRICARE for dependents through age 25. Included as part of the National Defense Authorization bill, DoD health affairs cannot fully implement this program until it is signed into law. While the House has passed a provision, the Senate version could differ, affecting how things are implemented. TMA is moving ahead in advance of legislation to have much of the process in place, so that they can move ahead promptly.
The Department of Health and Human Services (HHS) has released an interim final rule about the expansion of health care to dependents under age 26 for commercial plans. The rule is 67 pages long. While DoD is not affected by this rule, TMA is studying it to determine if the TRICARE plan could include elements of the National Reform program.
Of note, the cost to include a dependent under the National Plan would be $3300 a year. Under the HHS rule, companies do not have to charge a separate premium, but this doesn't mean the benefit is free. It is expected that the cost of dependents on commercial plans will be spread across all health care beneficiaries, raising every plan's cost. One area of discussion is how a "dependent" will be defined. Under the HHS program, even if a child is married, a parent can include them as a dependent for health care plans.
TRICARE doesn't have as wide a base and up to a 1/4 of a million dependents could become eligible. Under the House language a separate premium would be charged. Using TRICARE Reserve Select as a bench mark, the anticipated cost as calculated by the Congressional Budget Office would be $2000 per year. One thing being resolved is how an above-threshold dependent will be identified in the system. While TRICARE may be extended, these young adults will not retain any of the other "dependent" benefits. It is likely that a TRICARE health card will be issued, in lieu of military ID.
Medicare/TRICARE 21 percent Doc Fee on Hold
Congress has yet to change the law, with a 21 percent cut to physician fees paid by Medicare and TRICARE still unresolved. Before the Memorial Day recess the House did pass a version which would prohibit these cuts for 19 months (until December 2011), but no action was taken in the Senate. The Senate is expected to pass legislation this week, but agreement between the two chambers is needed before it can become law. Medicare payments to doctors are on hold for the third time this year. TRICARE continues to pay, because adjustments within their system have a longer lead-time, and Congress normally delays the cuts before action by DoD is necessary.