THE VIRGINIAN-PILOT
Copyright (c) 1996, Landmark Communications, Inc.
DATE: Friday, March 8, 1996 TAG: 9603080546
SECTION: FRONT PAGE: A7 EDITION: FINAL
SOURCE: BY DALE EISMAN, STAFF WRITER
DATELINE: WASHINGTON LENGTH: Medium: 77 lines
Thousands of military retirees, in danger of seeing their health care erode as the Pentagon implements a new insurance system, should be allowed to enroll in the health plan available to federal civilian workers and retirees, a congressional subcommittee was told Thursday.
``If it's good enough for us in the Congress, good enough for federal retirees, it ought to be good enough for military retirees,'' Rep. Jim Moran, a Democrat who represents part of Northern Virginia, told members of the House National Security Committee.
But Dr. Stephen Joseph, assistant secretary of defense for health affairs, warned that permitting Medicare-eligible military retirees to enroll in the federal employee plan - as a bill introduced by Moran proposes - could add up to $1.9 billion annually to the Pentagon's budget.
The military is under orders from Congress to improve health care services but not increase costs to either the government or beneficiaries. The Pentagon spends about $15 billion annually on health care.
The federal employee plan permits federal civilian retirees to choose from among several types of health insurance programs, including fee-for-service plans such as Blue Cross/Blue Shield and health maintanance organizations like Optima.
Though many enlisted in part because they expected they would receive free medical care for life, military retirees can use military hospitals and other facilities only when space is available. That forces many to use the civilian doctors and facilities in the CHAMPUS network, a number that is declining in many areas because of CHAMPUS' low reimbursement rates.
The military is gradually replacing CHAMPUS with Tricare Prime, which works much like a civilian HMO. Tricare Prime charges enrollment fees to eligible retirees and requires small co-payments for services. The plan will come to Hampton Roads in 1997, though a pilot version has been in the area and available to some military members for about three years.
But military retirees over 65 and thus eligible for Medicare are excluded from Tricare Prime. Moran's bill would let them join the federal civilian plan instead and several groups representing military retirees urged the subcommittee to back it.
The groups also urged approval of legislation that would force Medicare to reimburse the Defense Department for the cost of caring for Medicare-eligible military retirees who go to military hospitals and clinics. Those costs are now borne entirely in the Pentagon's budget.
The ``Medicare subvention'' proposal, as it's called, has been bouncing around Congress for several years, gradually picking up steam. Recent additions to its list of supporters include Senate Majority Leader Bob Dole of Kansas, the frontrunner for the Republican presidential nomination.
Joseph told the subcommittee that the Pentagon is considering an experiment with subvention in a limited area. Under that plan, Medicare would pay part of the cost of service provided in military hospitals to retirees who also choose to enroll in Tricare Prime.
Though Tricare Prime's treatment of retirees came under fire in the hearing, Joseph and an independent analyst provided the subcommittee with statistics indicating the new plan is wildly popular among the active-duty members enrolling in it.
In Washington state and Oregon, the first part of the country where the plan has been fully implemented, some 58,000 people enrolled during just its first four months of operation. Pentagon planners had expected only 28,000 would sign up in the program's first year.
Stephen P. Backhus, a General Accounting Office analyst, said that while Tricare Prime appears off to a good start, the Pentagon needs to do a better job gathering data about who is using it.
For example, Backhus said the military is not gathering information about the number of military members who are married to civilians and had been using their spouses' health benefits but are now moving over to take advantage of Tricare Prime. If that number is large, it could add to the military's cost significantly, he said.
KEYWORDS: MILITARY BUDGET DEFENSE BUDGET by CNB