A top advocacy group for service members and military retirees is spending time this spring on Capitol Hill seeking to ward off any discussion of changes to Tricare for Life, to include enrollment fees for the program, which serves as a backstop to Medicare for senior retired personnel.
The Military Officers Association of America, or MOAA, has targeted Tricare for Life, the program used by retirees and military spouses 65 and older, as one of its top focus points this year in response to a Congressional Budget Office report that included program fees among the options for trimming the federal budget deficit.
The Biden administration's proposed fiscal 2025 budget does not include any changes to Tricare for Life. But the Alexandria, Virginia-based group believes this budget cycle was the right time to educate congressional offices on the importance of Tricare for Life for its users, even though it is not yet facing any changes.
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"Absolutely, this is an unconventional issue because there are no current legislative or administration proposals to cut Tricare for Life. However, we wanted to counter the messaging that CBO put out there through their report on ideas for reducing the deficit," said Karen Ruedisueli, MOAA's director of government relations for health affairs, during an interview on Thursday.
Tricare for Life, or TFL, was created in 2001 by Congress to serve as a second payee to Medicare for older military retirees and dependent family members. Before then, retirees were able to be seen on a space-available basis at military treatment facilities, but base realignment and closure decisions, as well as military health-care system downsizing, left many without a military health-care option.
Under Tricare for Life, retirees are required to sign up for and use Medicare Part B, which requires enrollment fees based on income. TFL, which requires no fees, picks up any remaining deductibles and copayment costs.
In its Options for Reducing the Deficit 2023 to 2032 published in late 2022, CBO noted that adding enrollment fees of $575 for an individual or $1,150 for a family could reduce the deficit by $15.6 billion over the decade.
CBO also noted that introducing out-of-pocket requirements for using TFL would cut the deficit by $32.6 billion during that time period.
The TFL line items are among several hundred suggestions explored by CBO in the report to reduce the federal deficit, which exceeded $1.7 trillion in fiscal 2023.
But in the report, CBO analysts stressed that the report does not make any recommendations -- it just simply states options. "Inclusion or exclusion of any particular option does not imply an endorsement or rejection by CBO," the report stated.
Nonetheless, the MOAA wanted to focus on TFL because the concepts put forth in the report are not "unprecedented," Ruedisueli said.
"From fiscal year 2013 to fiscal year 2017, the administration budget request included five consecutive proposals for Tricare for Life enrollment fees, and the conditions that lead to those recommendations, I think, are out there to a certain extent right now," Ruedisueli said. "There's pressure on the [Defense Department] budget. There are rising military health system costs."
Roughly 200 MOAA members spent Wednesday in congressional offices speaking to staff about Tricare for Life and two legislative proposals the organization would like to see passed this year.
Those proposals include a change to troops' Basic Allowance for Housing that would cover 100% of the national average for housing costs rather than 95%, the rate determined in 2015; and passage of the Major Richard Star Act, which would allow medically retired service members to receive their entire retired pay from the DoD, as well as their disability compensation from the Department of Veterans Affairs, without any offsets.
The Biden administration's fiscal 2025 budget request of $7.3 trillion includes $850 billion for the Department of Defense. The budget calls for a 5.2% pay raise for troops and other incentives to bolster junior service members' pay and improve quality of life.
Ruedisueli said the MOAA will continue to educate members of Congress and their staffs on the issues important to their members, especially those that affect all military retirees and career service members.
"It's almost a decade removed from the last kind of tangible threats to [Tricare for Life] benefits," Ruedisueli said. "If a proposal were to surface in the next few years, it wouldn't just be about dollars and cents. Hopefully, they will recall some of the folks that visited them and explain why this benefit is so critical."
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