In a push to provide expanded health care for members of the National Guard and reserves, the Guard’s leadership is using a new operational planning team to push for change both through legislation and through partnering with other government agencies.

The task force, which first began meeting last October, aims to get no-fee health care for guardsmen and reservists regardless of duty status. Under current regulations, reserve component servicemembers can’t get full health care benefits until they are mobilized on federal orders for at least 30 days.

“We established an operational planning team to address and develop recommendations around no-fee health care and to find ways to address access and continuity of care challenges unique to the National Guard,” Gen. Daniel Hokanson, the chief of the National Guard Bureau, told attendees at the National Guard Association of the United States (NGAUS) conference in Reno, Nevada last week.

While the team’s first priority is no-cost health care, it is also advocating for ways to expand existing health care services, find new sources of health care from other agencies and advocate for legislation, according to a written statement provided by a National Guard spokesperson.

“This effort will help identify opportunities to improve systems, shape legislative initiatives, and establish and inform strategic partnerships to better meet the health care needs of the non-federalized force,” said the statement.

Legislative efforts

While both the House and the Senate have introduced legislation to offer guardsmen comprehensive health care coverage, so far nothing has made it into law.

“On one hand, this is good news. Congress is recognizing there’s a problem when 20% of the joint force doesn’t necessarily have access to health care. Although there is still no unified National Defense Authorization Act (NDAA) language, we’re getting closer,” Hokanson said.

Congress has made several failed attempts to legislate expanded coverage for reserve service members. Legislation re-introduced in May by Reps. Andy Kim (D-N.J.) and Trent Kelly (R-Miss.) called the “Healthcare for Our Troops Act” would provide every reserve-component service member no-fee coverage through TRICARE Reserve Select. In a statement about the bill, Kim said it would provide no-cost healthcare coverage for over 800,000 reserve component service members.

The provision did not make it into the final House NDAA for fiscal 2024. A statement from NGAUS said the language was axed because it was considered “new spending” and would not be allowed under the debt ceiling agreement. Both the House and Senate versions of the 2024 NDAA offered provisions for no-cost dental care for reserve components.

Aside from fully covered health care, the task force is looking at options for expanded health care coverage for guardsmen who use TRICARE, the Defense Department’s health plan. Currently, for reserve component members, TRICARE operates like health insurance and involves healthcare with premiums and copays, but not all reserve component troops live near TRICARE providers. Hokanson said more than 237,000 reserve component service members live outside TRICARE coverage areas.

To improve that coverage, the task force wants to find ways to expand service through partnerships with other health agencies.

“We will continue to develop critical partnerships with the Defense Health Agency, [the Department of ]Veterans Affairs and our parent services to close the health care gap in coverage,” Hokanson said.

Part of that effort involves expanding healthcare for guardsmen under VA, including primary care and increasing the availability of mental health care.

The task force has 30 members who have been meeting weekly since last October. It includes members from the National Guard joint surgeon’s office, which is responsible for medical policy, legislative affairs, and manpower and personnel. No date has been set for a formal report on their progress.

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