Health Care Happenings

Well, the dreaded time has finally come…what has been chatter and mounting talk about budget cuts and increases in health care fees is here.

No more what if’s.

No more maybe’s.

No more speculation.

The Defense Department put some information about proposed cuts on the table yesterday when the Secretary of Defense, Leon Panetta announced details of his FY2013 budget. 

Though the full details will not be released until February 13 when the President releases his buget to Congress, the targets for significant cuts are clearly in eye sight…

        Uncle Sam wants you to give back money you, and your family have earned through a full career of service and sacrifice

“…Given the significant fiscal constraints that have been imposed on this Department, our approach was to use this as an opportunity to maintain the strongest military in the world, to not hollow out the force, to take a balanced approach by putting everything on the table, and to not break faith with the troops or their families…,” said Panetta.

Retirees, under age 65, will be hit hardest by major increases in health care fees. 

Here’s what the Pentagon wants from YOU (see more details in this week’s MOAA Legislative Update):

• New enrollment fees and additional fee increases for those enrolled in TRICARE by creating a ‘tiered’ approach based on retired rank.  This means-testing will require senior grade retirees to pay more for their health care than junior retirees;
• An enrollment fee for TRICARE for Life beneficiaries 65 and older; and,
• Additional increases in pharmacy co-pays with the goal of increasing the use of generics and the mail order pharmacy.

Should Congress approve the ‘tiered’ approach to health care fees, then that would make military retirees the only group of government retirees to be subject to means-testing  

In other words, the longer and more successfully you serve, the less benefit you earn

So what do you think–Does this break faith with the troops or their families” (SecDef’s words)?

Tell us what you think…And, even more important, tell your legislators what you think about these and other drastic cuts. 

Please send your legislators a MOAA-suggested message and ask them to oppose these dramatic cuts…let MOAA help you communicate with lawmakers to stop these cuts.

Happy New Year?

2012 didn’t start out so Happy

In fact, President Obama and the Secretary of Defense Leon Panetta rolled out their plan to cut defense spending by $450 billion over the next decade.  Maybe you saw MOAA’s report on the plan in last week’s Legislative Update, “Troops-Pay-Healthcare Cuts Coming.”

The plan to target troops, retirees and their families reminds me of the arcade game Wack-a-Mole, only there is nothing fun about this.  The threat of targeting military and retiree benefits for cuts, particularly health care, is nothing new–the difference is reality is less than a month away–then we’ll know more of the ugly details when the President submits his budget to Congress the first week in February.

In announcing his priorities outlined in a ‘Sustaining U.S. Global Leadership: Priorities for the 21st Century Defense,’ the President stated,

“Most importantly, we will keep the faith with our troops, military families and veterans who have borne the burden of a decade of war and who make our military the best in the world.”

In reading the report I noticed a great deal of focus on national security, cost of doing business, economic challenges, rebuilding readiness, reducing manpower costs and reductions in the growth of compensation and health care costs…

It was a rather sterile report, with little mention of military people and their families–the very strength of our national security.

I don’t know about you, but I’m not going to let my military benefits be taken from me so easily–WILL YOU?

The impact of these cuts will be tremendous on my family–and, even more devasting to those with far fewer resources.

There are always unintended consequences in budget cuts like these.

I’m going to do all I can to let my legislators know this is unacceptable–and, I’m going to tell my military friends and their families to use there voice too.  MOAA makes it easy to let your members of Congress know what you think about these cuts and other issues.  We also like to tell your stories.

Silence isn’t good–it just signals to policy and law makers that everything is okay.

But it takes all our stories–all our voices to turn this tide.  Let’s pull the plug so there will be no more WHACKING our military, retirees, veterans, and their families and survivors.

Use your voice and DO SOMETHING FOR YOU, YOUR FAMILY AND OUR MILITARY COMMUNITY–sign up for MOAA Legislative Updates to stay informed and let us help you take action–visit www.moaa.org/email or call MOAA’s Member Service Center at 800-234-MOAA (6622).

So What Will You Do This Year to Stop the Cuts? 

“At our hearing in July I requested that Department of Veterans Affairs (VA) survey their frontline mental health professionals about whether they have sufficient resources to get veterans into treatment…The results that came back were not good.

               Nearly 40%  said they cannot schedule an appointment in their own clinic within the VA mandated 14-day windo

               70% said they did not have adequate staff or space to meet the mental health needs

               46% said the lack of off-hour appointments prevented veterans from accessing care.”

                     Chairman Patty Murray, Senate Committee on Veterans Affairs

    

Yesterday, Chairman Murray held a follow-on hearing to address the VA survey and continue to probe barriers preventing veterans from getting the mental health services in VA Health Administration (VHA) they need and want.

As the hearing progressed, it became clear that there was a disconnect between wait times data being reported by mental health providers and VA Central Office Mental Health Operations officials.

One withness, a Coordinator for Post-traumatic Stress Disorder (PTSD) Services and Evidence Based Psychotherapy at the Wilmington VA Medical Center and a representative for the American Federation of Government Employees, provided dozens of examples of VA employee comments that expressed similar concerns highlighted in the VA survey mentioned above:

• “Social workers at my facility universally feel extremely overworked and overwhelmed…
• She is overbooked every day–her caseload of more than 200 patients, including high risk patients, is simply unrealistic…
• Poor staffing in the general mental health clinic makes it difficult if not impossible to refer veterans for ongoing general mental health services.”

On the other hand, VA officials told the Committee that the Department believes it has unprecedented resources to adquately execute the mission but will continue to aggressively follow the data in order to make good predictions on needed resources and funding.

Additionally, VA’s response to the survey results was to put together an action plan and conduct more focus groups, audits and to implement more policy and guidelines.

MOAA agrees with Chairman Murray and the Committee members.  The issues of access and the barriers that prevent veterans from getting the care they need are not new.  And, they need to be fixed NOW!

Isn’t it time VA stopped playing catch up and start addressing the massive numbers of veterans entering their system and the ones who will soon be coming back from Iraq and Afghanistan.  Or will it take another 10 years to catch up to the challenges that exist in VA now?

We’ve talked about the White House proposal to establish an escalating enrollment fee for TRICARE For Life, but that budget-cutting proposal included several other cutbacks that would affect all Medicare-eligibles, including those on TFL.

The other proposals included:

a. Requiring pre-approval for some kinds of imaging (e.g., MRIs and CT scans), beginning in 2013

b. Further reducing the Part B subsidy levels (that is, further increasing Part B premiums) for the four income categories above $85K, starting in 2017

c. Freezing the income thresholds beyond current freeze expiration (FY19); change would freeze them until 25% of eligibles exceed them

d. Adding $25 to the Medicare deductible for new enrollees in 2017, another $25 for new enrollees in 2019, and another $25 for new enrollees in 2021 (strange system would require Medicare to track four different deductible rates, depending on when beneficiaries became Medicare-eligible

e. Establishing a $100 copay for home health services for new Medicare eligibles starting in 2017, indexed to the growth in average payment

f. Starting in 2017, establishing a Part B premium surcharge (they estimate it would be about 30% of the standard Part B premium) for beneficiaries whose Medicare supplements provide first-dollar coverage (as TFL does) (this would be in addition to any TFL enrollment fee)

It remains to be seen what the Super Committee will do with these and other proposals.

We’ve received additional details on the White House’s recently-announced plan to impose an annual enrollment fee for TRICARE for Life.

We previously reported the proposal would establish a fee of $200 per person, starting in FY2013.

Now we’ve seen the legislative language behind the plan, and it wouldn’t stop there.

For FY2013, the Administration plan would raise the enrollment fee to $295 per person.

For FY2015 and beyond, it would give the Secretary of Defense authority to raise the fee each year based on some index of medical health cost growth. The legislative language and accompanying explanation includes a chart that assumes the enrollment fee would grow at roughly 6% per year.

MOAA opposes any enrollment fee for TFL, and opposes tying any fees to medical inflation….especially one that’s left to the discretion of the Secretary of Defense.

We’ve seen the result of that kind of statutory discretion — the next time there’s a budget crunch, the Secretary has the leeway to change the rules and jack up fees to virtually any level.

The recent budget proposal put forth by the White House has the explicit intention to “Make the military’s healthcare more in line with and like other civilian healthcare plans.”  What exactly does this mean?

It implies that the Military’s plan is too good a benefit and should be put more in line with the average civilian plan such as Blue Cross/Blue Shield, Aetna etc. which the federal government among other corporate entities offer to their employees.  The military will no longer have the EARNED “gold standard”, but will be relegated to the middle of the pack in healthcare plan rankings – as evidenced by achieving parity in pharmacy co-pays for example.

It should be noted that while these drug co-pays do not apply to the active military member, that member is still responsible for higher co-pays for their family.  This particurlarly affects active duty Guard and Reserve families who are mostly assigned away from military facilities.  Additionally, changing retail medications to a percentage of the cost of the medication penalizes the sickest most, for example military children with disabilities and chronic  illnesses.

This move to make “the military more like civilian plans” is inappropriate and fails to distinguish the very radical difference between military and civilian working conditions.  It ignores that fact that military people and their families pay large premiums up-front for their health coverage through decades of service and sacrifice.  Those “healthcare premiums” have been earned and should continue to earn “gold standard” health coverage that is significantly better than typically offered for civilians who do not incur those sacrifices for their country.

The United States military both past, present and future deserve a benefit which should be in the top rung … not the middle rung.