New enrollment fees could be ahead for TRICARE

Reforms in the 2017 defense authorization bill add enrollment fees to TRICARE to try to bring down government costs.

Starting in 2018, new members of the military may have to dig deeper into their pockets to pay for  family member medical treatment.

The House Armed Services Committee is proposing some reforms to TRICARE, which insures about 9.5 million active duty, retired and reserve service members in the 2017 defense authorization bill.

Part of those reforms includes adding enrollment fees and fixed dollar copayments for active duty family members and retirees who join the military in 2018 or beyond.

New active duty members would have to pay annual enrollment fees for family members if they join in 2018 or after.

“The goal is to see the changes in structure and function be rolled out and evolve in the next two to four years,” said House Armed Services Military Personnel Subcommittee Chairman Joe Heck (R-Nev.). “Potential increases in enrollment fees and deductibles will be put into place because we will have increased access and increase the product.”

Heck said deductibles and copays will be indexed to the Cost of Living Adjustment.

As for the annual fees, the cost depends what plan members pick. The committee narrowed down the number of plan choices to two.

Beneficiaries can use TRICARE Prime, which is like an HMO and uses military treatment facilities, or they can use TRICARE Preferred, which works like a PPO and offers more treatment choices.

Using that plan, TRICARE Prime will cost an individual $180 and a family $360 annually. Retired beneficiaries will pay $325 for an individual and $650 for a family.

TRICARE Preferred is more expensive. That plan would cost $300 for an individual annually and $600 for a family. Retired users would pay $425 individually and $850 for a family.

Some service member advocate groups think that is too much though.

“That probably sounds minimal compared to what a lot of civilians pay,” said Karen Ruedisueli, deputy director of government relations at the National Military Family Association. “But you have to keep in mind a couple of things. One is that they would be introducing these fees at the same time that the new retirement system is rolling out.”

Ruedisueli said service members will be encouraged to invest in that to get a match from the government.

In addition, the government is cutting Basic Allowance for Housing and has not been able to tie military pay raises to the Employment Cost Index for at least three years, she said.

All those things combined put a burden on the troops. The committee did suggest a raise tied to the ECI, but that will not happen unless the bill becomes law.

To put things in perspective, a new enlisted soldier is paid $1,567 a month.

The reason for the cost hikes is that the government has become increasingly worried about the rising costs of military health care.

A Congressional Budget Office report stated DoD spent $52 billion in health care for service members, retirees and their families in 2012.

“The cost of providing that care has increased rapidly as a share of the defense budget over the past decade, out-pacing growth in the economy, growth in per capita health care spending in the United States and growth in funding for DoD’s base budget,” the report states.

The cost of providing health care to military and their families rose 130 percent from 2000 to 2012, the report states.

The report states expanded benefits, medical costs of wars and the increased use of TRICARE are all causes of the cost increase.

The committee did not venture to guess exactly how much the fees will save the government on health care, but the Obama administration put out a similar, but slightly more ambitious, plan for TRICARE earlier this year.

That plan projected an estimated savings of about $5 billion between 2017 and 2021.

While the enrollment fees may lessen the cost of health care for the government and put some burden on the troops, some lawmakers think more needs to be done to fix the system.

“We are probably not saving the kind of money that might be necessary going forward so that we are certain people are getting the very best care, but at the same time [creating] savings going forward,” House Armed Services Military Personnel Subcommittee Ranking Member Susan Davis (D-Calif.) said. “One we start letting [health care costs] rise too much over the personnel costs overall we are going to be in trouble.”

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