When it comes to Tricare fees, there is good news
and not so good news for Tricare beneficiaries.
For the Pentagon, the news is not even that good, because the Department
of Defense, again, did not get its way.
As of Friday, May 25, both the House and the Senate
rejected the DoD’s proposals that would establish enrollment fees for Tricare
Standard and Tricare for Life in the National Defense Authorization Act for
Fiscal Year 2013. Further, the two chambers
did not accept increases to Tricare deductibles or the annual catastrophic cap.
Continuing in a pattern set by Congress since 2006,
the Pentagon has had its proposal to increase enrollment fees rejected. Seeing
that increases to enrollment fees and deductibles would generate discretionary
money, the House and Senate were not pressured to accept the Pentagon’s
proposal. However, higher enrollment fees were part of President Obama’s
proposed budget. Thus, the Pentagon is at risk of having a hole in its funding.
Beneficiaries will see increases in the pharmacy
co-payments after October 2013. Both
the House and Senate versions of the NDAA include increases. Since there are differences between the two
chambers, the final amounts will not be determined until the NDAA goes to
conference. Below is a summary of the proposed changes from both chambers:
|
|
2012
|
2013
|
2013
|
|
|
Current
|
House
|
Senate
|
|
Retail Pharmacy
|
|
|
|
|
Generic
|
$5
|
$5
|
$5
|
|
Brand
|
$12
|
$17
|
$26
|
|
Non-Formulary
|
$25
|
$44
|
N/A*
|
|
Home Delivery
|
|
|
|
|
Generic
|
$0
|
$0
|
$0
|
|
Brand
|
$9
|
$13
|
$26
|
|
Non-Formulary
|
$25
|
$43
|
$51
|
* the
Pentagon would eliminate non-formulary drugs from retail, requiring
beneficiaries to pay for these specialty prescriptions.
In
the House version of the bill, pharmacy co-payments would be increased in
Fiscal Year 2014 and beyond by the same rate as the retirement COLA increase. The Senate bill recognizes that the Pentagon
continues to have authority to increase prescription co-payments independently unless
Congress directs otherwise.
Last
September, the Obama administration suggested that the pharmacy co-payments plan
would shift retail co-pays from a dollar amount to a percentage
co-pay. The administration claims that this shift would provide savings
of $15.1 billion in mandatory funds and $5.5 billion in discretionary funds
over 10 years said the president in a speech at the White House rose garden. If Congress takes no action to alter Pentagon
authority, this option could be proposed in the next presidential budget.
In
2005, the NDAA established a health plan to give Reservists access to Tricare
for a monthly fee. However, as the health care comes with a monthly fee, many
still choose to go to Veterans Affairs facilities that provide free care from
specialists. These facilities are geographically centralized and as a result
are often invonveniently located for many reservists spread disparately across
communities. Further these facilities often encumber the patient with long,
many times tedious clerical steps before receiving initial treatment. With
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. It is because of the challenges
today’s Reservists face in obtaining affordable and efficient health care that many of our nation’s heroes go with
undiagnosed injuries or inadequate care. . In a study conducted by the Urban
Institute and the Robert Wood Johnson Foundation, an estimated that one in 10
of the nation’s 12.5 million nonelderly veterans report either not having
health insurance or using Veterans Affairs (VA) health care.[1]
It is
essential that government work to
establish a sustainable, affordable and efficient veteran health care system.
ROA
continues to advocate and testify on behalf of all Reservists and Guardsmen in
the halls of the Capitol and the Pentagon. By June 1, ROA will have a letter
posted at www.roa.org/write2congress so that members can write
their elected officials on the topic of Tricare pharmacy co-payments. Further,
members can always write to their elected officials about the various concerns
on health care for today’s Reserve forces. Let it be known that today’s health
care is not acceptable for tomorrow’s Reservist.
[1]
For a summary of the report, visit: http://www.rwjf.org/files/research/74428.quickstrike.veterans.exsummary.052412.pdf
For the full report, visit:
6 comments:
If we are to pay our way as a nation, individuals need to contribute. A tiered system would be fair both for enrollment and drugs.
TJ, we've already "payed our way".
I served in Aeromedical Evacuation from 1971 till 2006 as a reservist who was frequently deployed. To me it was one of the best jobs in the military because our function was to return wounded heroes and heroines from the worst things that had happened to them to areas of specialized treatment back here in "The World" and also to their families.
In the early 70's the casualties we flew out of VietNam were tragic enough, but in that war battlefield medicine was not nearly as advanced and the majority of those who were gravely injured died. Today, those near-mortally wounded are surviving and requiring extensive surgeries, prosthetics, and years of physical and mental rehabilitation. Even genital injuries and the negative impact on families and the need for new types of surgeries including stem cell research to help these soldiers are developing.
Essentially those injuries, which are also being funded by TRICARE are costing millions of dollars for each of these thousands of critically-injured soldiers. They deserve every bit of care they receive and more. However, instead, the administration has tried to implicate the retirees as a group that is running up the cost of TRICARE.
The medical benefits mentioned were promised to us and I feel very strongly that we've already earned them. I also believe these new casualties of war deserve the full benefit of their healthcare. The fact that it is more costly than expected for current treatments and there were no plans by the Bush administration to FUND either of these wars compounds this problem. However, it does not make this a financial issue that I'm willing to accept as my burden. Therefore the message must be clear; it is more morally acceptable to raise taxes on millionairess and other revenue generating proposals to make big oil and special interest pay their fair share than it is to be on the wrong side of history by reneging on promises made to our veterans.
Lastly for the moment this anonymous quote I noticed this spring on a men's room wall in Charleston County, SC sums up my feelings and likely those of most Veterans:
"The entitlements the politicians in this country have bestowed upon themselves should be the first place where entitlements are cut...It should be the starting point of any cuts, well before any of those previously promised by a "grateful Nation" to our Veterans..."
All active duty, veterans, reservists & guardsmen and retirees should have immediate access to health care, mental health services and pharmacy. As a nation we simply don't elect to fund the needed level of services, as do all the other developed nations. While we are the most economically successful nation, we still have a way to go to become the great nation we should and can be when it comes to a seamless, unified health care system for our military. I applaud ROA for working this issue in the halls of Congress. Bravo!
The President and Congress need to understand that our military have paid for their health care benefits through their service. They have contributed enough and should not be asked to contribute more. Comparisons to the civilian sector are irrelevant.
If a portion of our military pay was taken out as pre-payment for future medical costs after retirement, then I would agree with the assertion that we already paid our way. The fact is, we are paid a wage and given generous benefits in consideration of our service on active duty. No one said anything about free health care after retirement. We might assume we will receive it, since those who came before us got it, but I don't remember seeing that promise in any contract I ever signed. Those who are permanently injured while on active duty deserve free medical care for life. Those who leave active duty with their bodies still in one piece shouldn't have the same expectation - especially when the federal government's liabilities dwarf its assets. If we have to contribute a little more to keep TRICARE viable, then we should do it. The alternative is the whole program comes crashing down and we are out looking for private insurance.
The fact is that service men and women are paid so poorly that many are below the poverty level and many more qualify for food stamps and other welfare programs. I haven't done the math but I believe that receiving the minimum wage (with 50% kicker for overtime) for the actual hours of duty would result in a dramatic raise for many service members. And except for some inner city locations, minimum wage from a fast food outlet is much less hazardous! SERVICE RETIREES HAVE BEEN UNDERCOMPENSATED DURING THEIR SERVICE AND TRULY DESERVE THE BEST AVAILABLE MEDICAL CARE AS PART OF THEIR RETIREMENT COMPENSATION, without ANY fees or co-pays (even without the non-trivial cost of buying Medicare Part B)!
Post a Comment