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A Project of The Annenberg Public Policy Center

Health Care Overhaul and TRICARE


Q: Would health care overhaul efforts eliminate TRICARE health coverage for members of the military and military retirees?

A: No. This claim in a chain e-mail is false. Neither Congress nor President Obama has proposed legislation to that effect.

FULL QUESTION

I received this e-mail and is there any truth to it?

This is true. It is on pages 77, 172, 218, and 434. You have to dig to see the charges. We (retirees) would lose the Medicare for life benefit and would have to pay. We would lose TRICARE as a total care package. We would not be allowed to keep TRICARE so when Obama stands and says if you like what you have you can keep it, he lies.

This is a "Heads Up" on a battle we are facing now and down the road with the new Administration. The Congressional Budget Office (CBO) has already drafted proposed legislation that would basically reduce our TRICARE for Life benefits to a system whereby we pay deductibles and co-pays up to $6,301 the first year for you and your spouse, with future years being indexed to increase with inflation. What can we do? The article below, obtained from an Air Force Association and written by BG Bob Clements, best describes what we can do. Please read it and check the links for CBO language and do what Bob says-Send this email to every Military Retiree you know and write and email your Congressman often. For those of you that might have voted for "Change", you should do it more than often!

TRICARE FOR LIFE’S FUTURE TRICARE For Life was instituted to correct the broken promise that military retirees would receive free healthcare coverage for life and it covers the Medicare co-pay. Now a heavy assault has begun on Veterans’/Retirees’ benefits to pay for other programs our President promised during the campaign. And it is a high priority of his administration. The one item of most interest to Retired Military is in Article 189. If approved by Congress the first assault wave would hit in 2011 and would hit hard. It would initiate cost sharing to require retirees to pay the first $525 of medical cost and 50% of the next $4,725 for a first year cost of $2,888 per person. It would be indexed to increase with inflation. A reason given for this action (for PR effect) is "overuse" by Retiree s.

For those of you who are covered by TFL you will want to pay attention (Below) to what BG Bob Clements has surfaced about the future of TFL. In any case, on page 189 of the Congressional Budget Office report, see the note below on how to get to that spot, there is a strong recommendation to eventually eliminate the program as it is too expensive. Just another move to slight those of us who dedicated much of our adult lives to the defense of our country.

FULL ANSWER

Variations of the chain e-mail above previously have been debunked by such groups as the The Retired Enlisted Association and the Military Officers Association of America (three separate times). The White House has also tried to combat the claim that efforts to overhaul health care include limiting or eliminating coverage for veterans. But we’re still getting questions about it.

A List of Options

The nonpartisan Congressional Budget Office is responsible for a number of things, but drafting and proposing legislation are not among them. So contrary to what these widely forwarded e-mails claim, the CBO has not "drafted proposed legislation" that would reduce benefits for those who receive health care coverage through TRICARE or TRICARE for Life.

What the CBO did in December of last year was present a list of 115 options to the House and Senate Committees on the Budget for "reducing (or, in some cases, increasing) federal spending on health care, altering federal health care programs, and making substantive changes to the nation’s health insurance system." The CBO issues a list of such recommendations on federal spending to every Congress. The first volume of last year’s list included Option No. 96, Introduce Minimum Out-of-Pocket Requirements Under TRICARE For Life.

TRICARE is the health care program that provides coverage for active members of the military, retirees, their survivors and their dependents. In 2001, that coverage was extended to Medicare-eligible military retirees and their spouses and dependents through a program called TRICARE for Life (TFL). The program provides supplemental Medicare coverage to TRICARE beneficiaries who are enrolled in Medicare Parts A and B.

According to the CBO, TFL pays "nearly all medical costs not covered by Medicare and requires few out-of-pocket fees." By limiting the amount of expenses covered by TRICARE for Life (such as not paying the first $525 of an enrollee’s cost-sharing liabilities for calendar year 2011 and limiting coverage to 50 percent of the next $4,725 in Medicare cost sharing), the federal government could save roughly $14 billion and $40 billion through 2014 and 2019, respectively, according to the CBO.

But the CBO report doesn’t contain "a strong recommendation to eventually eliminate" the TRICARE for Life program because "it is too expensive," as the e-mail claims. The CBO didn’t advocate that Congress actually go through with any of the options it listed in its report. Instead, the agency emphasized that "in keeping with CBO’s mandate to provide objective, impartial analysis, this report makes no recommendations." Accordingly, the report lists advantages and disadvantages for all of the options.

No Cuts in Health Care Bills

It’s also false that health care overhaul bills in Congress would roll back coverage for those who benefit from the TRICARE programs.

But the e-mail claims that "this is true" and says that it appears on pages 77, 172, 218 and 434. There’s no reference to a particular bill, but we did a word search of the bills and found that the word "TRICARE" does appear on pages 77, 172, 218 and 434 of  "America’s Affordable Health Choices Act of 2009" (H.R. 3200), which was introduced in the House in July. But nowhere on those pages, or anywhere else in the legislation, does it say that beneficiaries "would lose the Medicare for life benefit and would have to pay," or "would lose TRICARE as a total care package."

Some veterans’ organizations, including the American Legion, wrote letters to House Speaker Nancy Pelosi in July voicing concern that the legislation could impact health care for veterans. But the House Committee on Energy and Commerce said that the bill wouldn’t impact TRICARE beneficiaries:

Press Office of Energy and Commerce Committee, July 31: Several veterans’ organization wrote to Speaker Pelosi yesterday raising concerns that H.R. 3200, America’s Affordable Health Choices Act, would limit care to veterans. We are writing to say that these concerns are already addressed in the legislative language and with an amendment accepted during our committee’s markup (Buyer).

Specifically, veterans’ health care will not be impacted by the House legislation. Section 202 (d)2(E) and (F) of the bill states that “members of the armed forces and dependents (including TRICARE)” and those who receive VA care will be considered as having acceptable minimum coverage – in other words, veterans will not subject to the 2.5% penalty if they are enrolled in TRICARE or VA care.

The Energy and Commerce Committee also accepted an amendment by Rep. Steve Buyer (R-IN) during the markup of the legislation to further clarify that those who participate in the VA system will be exempt from the requirements of the legislation.

Furthermore, there are no proposed cuts to TRICARE programs in the recently passed "Affordable Health Care for America Act of 2009" (H.R. 3962), which combines three different House health care bills into one. And there is also no language in either the Senate Finance Committee or Senate Health, Education, Labor and Pensions Committee health care bills that discusses eliminating coverage under TRICARE or TRICARE for Life. In fact, section 1922 of the Senate Finance Committee bill specifically states that "[n]othing in this Act shall be construed to prohibit, limit, or otherwise penalize eligible beneficiaries from receiving timely access to quality health care in any military medical treatment facility or under the TRICARE program."

Not an Administration Priority Either

The e-mail also claims that "a heavy assault has begun on Veterans’/Retirees’ benefits to pay for other programs our President promised during the campaign. And it is a high priority of [the Obama] administration." But the president has said repeatedly that he actually wants to expand coverage for veterans — not limit it.

Speaking at the Veterans of Foreign Wars Convention in August, the president said:

Obama, Aug. 17: Whether you left the service in 2009 or 1949, we will fulfill our responsibility to deliver the benefits and care that you earned. That’s why I’ve pledged to build nothing less than a 21st-century VA. And I picked a lifelong soldier and a wounded warrior from Vietnam to lead this fight—General Ric Shinseki.

We’re dramatically increasing funding for veterans health care. This includes hundreds of millions of dollars to serve veterans in rural areas as well as the unique needs of our growing number of women veterans. We’re restoring access to VA health care for a half-million veterans who lost their eligibility in recent years—our Priority 8 veterans.

And since there’s been so much misinformation out there about health insurance reform, let me say this. One thing that reform won’t change is veterans health care. No one is going to take away your benefits. That’s the truth.

The White House has also responded to claims that health care overhaul bills would jeopardize veterans’ benefits, including TRICARE and TRICARE for Life, through its Reality Check Web site.

— D’Angelo Gore

Sources

TRICARE Management Activity. "What is TRICARE?" 1 Oct 2009, accessed 2 Nov 2009.

TRICARE Management Activity. "TRICARE for Life." 30 Sep 2009, accessed 2 Nov 2009.

U.S. House. "H.R. 3200, America’s Affordable Health Choices Act of 2009." (as introduced by the House 14 Jul 2009.)

U.S. House. "H.R.3962, Affordable Health Care for America Act of 2009." (as introduced by the House 29 Oct 2009.)

U.S. Senate Committee on Finance. "S. 1796, America’s Healthy Future Act of 2009." (as passed by the Senate Finance Committee 19 Oct 2009.)

U.S. Senate Committee on Health, Education, Labor and Pensions. "In Historic Vote, HELP Committee Approves the Affordable Health Choices Act." 15 Jul 2009.

Congressional Budget Office. "Budget Options Volume I: Health Care." Dec 2008.

Press Office of Energy and Commerce Committee. "Note to Reporters: Veterans Concerns Addressed in Health Care Legislation." 31 Jul 2009.

U.S. House Committee on Energy and Commerce. Topline Changes from Introduced Bill to Blended Bill. Accessed 9 Nov. 2009.

Pelosi, Nancy. "Health Insurance Reform Daily Mythbuster: Health Insurance Reform and Veterans." 3 Nov 2009, accessed 9 Nov 2009.

The White House. "Remarks by the President on Improving Veteran’s Health Care." Office of the Press Secretary. 9 Apr 2009.

The White House. "Readout of the President’s Meeting with the National Commander and Executive Director of the American Legion." Office of the Press Secretary. 4 Aug 2009.

The White House. "Remarks by the President at the Veterans of Foreign Wars Convention." Office of the Press Secretary. 17 Aug 2009.

Strobridge, Steve . "As I See It — Budget “Options” Stir Concerns." Military Officers Association of America. 8 Jan 2009.

Lee, Jesse. "Health Insurance Reform & TRICARE." White House Blog. 11 Aug 2009, accessed 2 Nov 2009.

Miles, Donna. "Obama: Health Care Reform Won’t Affect VA, Tricare." Armed Forces Press Service. 4 Aug 2009.

Curry, Tom. "Fact or fiction? Military health benefits to be cut." MSNBC.com. 23 Oct 2009.