Keeping fees means cutting force

If Congress blocks Defense Department plans to raise TRICARE fees for military retirees and beneficiary co-pays on drug prescriptions filled off base, the services will have to make even deeper cuts in force strength than now planned, the military’s top health official told lawmakers last week.

“Given the constraints of the Budget Control Act, if no adjustments are made in TRICARE fees and we don’t achieve 12-plus-billion dollars in savings over the (five-year defense plan), additional force structure cuts will need to be made,” Dr. Jonathan Woodson, assistant secretary of defense for health affairs told the House subcommittee on military personnel. That’s the reality “everyone needs to understand in these very difficult times,” he said.

Woodson and his boss, Jo Ann Rooney, acting under secretary of defense for personnel and readiness, defended the proposed 2013 personnel budget, including TRICARE fee increases, during a surprisingly brief hearing that included bursts of criticism from Republicans on the subcommittee.

Rep. Joe Wilson, R-S.C., subcommittee chairman, challenged the mantra of military leaders in recent weeks, including Defense Secretary Leon Panetta and Army Gen. Martin Dempsey, chairman of the Joint Chiefs, that the 2013 budget “keeps faith” with service members and their families.

“Certainly, no one expected personnel programs to escape close scrutiny,” Wilson said. “However, contrary to the public statements by the Department of Defense that military personnel programs and benefits have been protected under this budget proposal, the totality of the personnel related cuts (is) proportionate to cuts taken in any other budget category.”

Wilson warned that a proposed cut in active duty strength of more than 100,000 personnel over five years will “exact a human cost on our military families. The loss of the skills and experience … will directly diminish our combat capability when it is very likely we will continue to be engaged in conflict (with) enemies who dream of a long war.”

But Wilson said, “the most disturbing budget proposals are the increases in health care premiums. And the increases are up to 340 percent” for some, he said, a reference to phased increases over five years targeting retirees who draw more than $45,178 a year in retired pay.

Rep. Austin Scott, R-Ga., a freshman House member, called the fee increases eyed for TRICARE Prime, the managed care option, “draconian.” And then he struck a theme being adopted by several Republicans, that federal civilian employees too should shoulder higher health fees.

This administration, Scott said, holds “a general belief … that health care should be free for everybody other than the people in the military.”

In fact, federal civilians pay substantial monthly premiums for health insurance, and the premiums increase yearly with health care costs. In answering Scott, however, Rooney simply noted that most TRICARE fees have been frozen since at least 1996. Last October Prime enrollment fees for working-age retirees were raised by $60 a year and also indexed to inflation.

Rooney explained too that military leaders were involved in shaping the proposed fee increases and strongly support the planned increases.