TRICARE fee hike still on table

The House armed services subcommittee on military personnel has declined to give the Obama administration new authority it sought to phase in higher TRICARE fees on military retirees over the next four years and to peg future TRICARE fee hikes to medical inflation nationwide.

But in marking up its version of the fiscal 2013 defense authorization bill, the subcommittee did not adopt discreet language, as it has in the past years, that would block any TRICARE fee increases.

It also did not include language, as it has previously, that would prohibit the Department of Defense from using existing authority to raise co-payments on prescription drugs for dependents and retirees who use neighborhood pharmacies or the TRICARE mail order pharmacy program.

Another sign that the issue of higher TRICARE fees is not settled for this year comes from Sen. Lindsey Graham (S.C.), ranking Republican on the armed services' subcommittee on military personnel. A day before the House panel marked up its portion of its defense bill, and stayed silent on raising medical out-of-pocket costs for retirees, Graham predicted a compromise on health fee hikes between the two chambers by Sept. 30

"Between now and the end of the fiscal year, I hope we can convince the House to accept some adjustments in premiums for TRICARE, because it's just unsustainable right now," Graham told me in a phone interview.

So far House Republicans oppose the Defense Department's "balanced" approach for slicing $487 billion from defense budgets over the next decade, a figure agreed to in the Budget Control Act enacted last year.

About 10 percent of those cuts must occur to personnel accounts, defense leaders argue, primarily by raising out-of-pockets costs on military retirees through higher enrollment fees, deductibles and co-payments.

Without higher fees, national security is at greater risk, they contend.

"If Congress rejects all of the modest changes we've proposed in TRICARE fees and co-pays for retirees, than almost $13 billion in savings over the next five years will have to be found in other areas such as readiness, or we could be forced to further reduce our troop strength," Defense Secretary Leon Panetta told Pentagon reporters this month.

But Rep. Buck McKeon, R-Calif., chairman of the House Armed Services Committee, said in a speech last week the panel will "seek to eliminate the military health care fees proposed by the administration."

Ignoring that retirees are targeted for most of the fee hikes, McKeon added: "Our forces on the front lines shouldn't have to worry about caring for their families' health back home."

The House subcommittee mark not only ignores administration plans to raise TRICARE fees, it also proposes new benefits — 180-days of TRICARE Standard and TRICARE dental coverage to members of the drilling reserve who are involuntarily separated during the force drawdown now under way.

It also expresses "the sense of Congress" that military members and their families make extraordinary sacrifices over their careers, which should be viewed as a "significant pre-paid premium for their health care" in retirement. This, of course, would serve as a caution against any straight-line comparison of military benefits to what civilian workers receive.

Graham, however, was blunt in arguing that retirees must be required to pay higher fees to make their TRICARE benefit "sustainable" and to ensure that weapon modernization and force structure aren't cut more deeply than planned to satisfy reduced targets that Congress agreed to last year.

Tom Philpott can be contacted at Military Update, P.O. Box 231111, Centreville, Va. 20120-1111, or by e-mail at: [email protected]