Enormous health care costs needs revisiting

Sen. Lindsey Graham, R-S.C., chairman of the Senate armed services subcommittee on military personnel, says he will be “adamant’’ during negotiations with House conferees on a final defense authorization bill that it include his Senate-approved amendment to open a premium-based military health insurance plan to any drilling reservist or National Guard member.

“This is absolutely essential for me, as a senator, to see Guard (members) and reservists become eligible for military health care so we can take better care of their families and improve recruiting and readiness,’’ Graham said in an Aug. 9 phone interview.

Over the past two months, Graham said, reserve component casualties in Iraq have outnumbered active duty losses, and operational demands on reserve forces “are going to grow, not lessen. We are a long way from being able to come home from Iraq ... It’s going to take years.’’

To shore up recruiting and retention, Graham said, “We need new benefits for a new war.’’

“And one of the cornerstones of the Guard and Reserve package is allowing members and their families to access full-time military health care,’’ the senator added. “They are the only part-time federal employees not eligible for any form of government health care.’’

In July, the Senate agreed to Graham’s amendment to allow any drilling Reserve or Guard member to enroll in what now is called TRICARE Reserve Select, a premium-based version of TRICARE Standard. The House Armed Services Committee adopted a similar amendment, from Rep. Gene Taylor, D-Miss., in May. But committee chairman Rep. Duncan Hunter, R-Calif., removed it before sending the bill to the House floor. Hunter said it violated House budget rules against raising entitlement spending without a matching offset.

Sens. Hillary Clinton, D-N.Y., and Carl Levin, D-Mich., co-sponsored Graham’s amendment, and were joined by John Warner, R-Va., chairman of the Senate Armed Services Committee, who also vowed to fight for it during a House-Senate conference committee to iron out differences in the bills.

The TRICARE Reserve Select (TRS) plan passed last year is a scaled-down version of TRICARE Standard, the military’s traditional fee-for-service insurance. Reserve component members must agree to pay monthly premiums of $75 for member-only coverage or $233 for family. They also must pay Standard deductibles and co-payments. Enrollment, however, is open only to Reserve and Guard members deactivated from post-9/11 deployments. They are allowed a year’s coverage for every 90 days of continuous active duty, if they remain in drill status and subject to recall.

The Senate agreed with Graham to broaden TRS eligibility to any drilling reservist who agrees to pay premiums. The estimated cost to taxpayers is $3.85 billion over the first five years.

House Republicans and the Bush administration oppose the change, citing the known costs and also the likelihood that civilian employers will take advantage of expanded TRICARE to tighten their own health benefit offerings to employees who serve in reserve components.

Graham shrugs off the cost argument, suggesting Reserve and Guard recruiting and retention will collapse without an improved health care benefit. Also, he argued, because 20 percent of drilling reservists lack any health insurance, many report for duty medically unfit to deploy. That’s a cost burden that better health insurance will ease, Graham said.

Regarding recent reports from the Government Accountability Office and defense think-tanks that Congress is allowing spending on military compensation, particularly on deferred compensation, to soar, endangering other critical defense programs, Graham conceded that is a concern.

“Our health care costs in the out years become enormous and the TRICARE benefit for retirees and others has been locked into place in a static form for years,’’ Graham said. “We need to look at a new model, starting with new (entrants), that will have more cost-sharing (by beneficiaries) so we don’t have to pick between armaments and benefits.’’

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

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