Healthcare: A Catch-22 for Reservists

In the early hours of Thursday morning, May 16, 2012, the House Armed Services Committee approved a $643 billion defense budget for FY 2013. Notable among the HASC approved amendments to the FY13 National Defense Authorization Act (NDAA), is broad rejection of changes to the current TRICARE fee schedule With deference to TRICARE’s 9.3 million beneficiaries, including 5.5 million military retirees, Chairman Howard P. “Buck” McKeon offered a different approach in amending the bill; one that ensures fiscal responsibility while protecting the benefits earned by those who risk their lives to defend the nation. While rejecting the majority of the President’s proposal concerning TRICARE, McKeon’s mark does include an increase to pharmacy copays in 2013, and a cap on pharmacy copays beginning in 2014. More importantly, for the Reserve service members, McKeon’s mark extends Tricare Reserve Select for 180 days for members of the Selected Reserves who are involuntarily separated from service.

The decision to avoid a substantial fee hike along with the 180 day extension for Tricare Reserve Select should be applauded as an appropriate step towards meeting the health care needs of today’s 21^st century Reservists. However, it is not the ultimate solution. Unlike previous conflicts, veterans of Iraq and Afghanistan represent less than one percent of the total U.S. population. More than 840,000 National Guard and Reserve troops have served in Afghanistan and Iraq during the past decade, many having been deployed multiple times. Upon returning home, these men and women represent a battle hardened force of combat veterans. Yet despite progress as a total force, the individual toll for each service member is undeniable.  Reservists have been hastily channeled through a post-deployment process that does not adequately identify or address the personal challenges these veterans face, including signature wounds like post-traumatic stress and traumatic brain injury. While their active-duty counter parts return to military bases with free, comprehensive medical care and support networks, Reservists return to their civilian homes, often far and away from their fellow veterans and the networks of support at the military base. Ultimately identification, diagnosis, and action fall into the hands of the Reservist and his or her family.

In 2005, the NDAA established a health plan to give Reservists access to Tricare for a monthly fee. However, as it comes with a monthly fee, many still choose to go to Veterans Affairs facilities that provide free care from specialists. These facilities, like their fellow veterans, are often far and away. Further, these facilities often encumber the patient with long, many times tedious clerical steps before receiving initial treatment. Finally, with the total troop withdrawal from Iraq and the increased troop withdrawal from Afghanistan, these facilities are often overcrowded and do not give veterans the necessary time and attention they need.  Between the Tricare fees and the VA facilities, Reservists face a Catch-22 when it comes to healthcare. Coming off deployments, often carrying untold burdens, these veteran Reservists many times opt to avoid seeking help and put their healthcare on the back burner.

This Catch-22 scenario has historically been passed to successive generations without a comprehensive solution. With over ten years of conflict and the vast number of Reserve and Guard troops slated to return from deployment in the coming years, now is the time for serious consideration and review from all levels of the government to ensure that these men and women receive the services they deserve after sacrificing so much for their country.