By Debbie Gregory.

The Congressional Budget Office (CBO) periodically issues a volume of options that would decrease federal spending or increase federal revenues. In December, the CBO published its list of 121 options to combat the projected $1 trillion federal deficit this year, among them three suggestions on TRICARE and six that address veterans’ benefits.

In its most recent volume, entitled “Options for Reducing the Deficit: 2019 to 2028”, the CBO suggested raising TRICARE enrollment fees for military retirees, instituting enrollment fees for TRICARE for Life and reducing veterans’ benefits.

The publication marks the fourth time in five years that the CBO has suggested raising TRICARE enrollment fees for working-age retirees and introducing minimum out-of-pocket expenses for those using TRICARE for Life.

In order to save nearly $12 billion, CBO suggested increasing TRICARE enrollment fees, deductibles and co-payments for working-age military retirees.

“Beneficiaries with individual coverage would pay $650 annually to enroll in TRICARE Prime. The annual cost of family enrollment would be $1,300,” the report stated. “All beneficiaries who enroll in TRICARE Select would pay an annual enrollment fee of $485 for individual coverage and $970 for a family.”

The CBO also suggested instituting enrollment fees for TRICARE for Life, the program that serves as supplemental coverage for military retirees on Medicare. Analysts estimated that the Defense Department could save $12 billion between 2021 and 2028.

According to CBO analysts, these options would reduce the financial burden of TRICARE for Life to the DoD in two ways: It would cut the government’s share by the amount of fees collected and indirectly would save money by causing some patients to forgo TRICARE for Life altogether, either by buying a private Medicare supplement or simply going without one.

According to the CBO, the Department of Veterans Affairs also presents several opportunities for cost-savings measures, including tightening up disability compensation requirements and disallowing benefits for arteriosclerotic heart disease, chronic obstructive pulmonary disease, Crohn’s disease, hemorrhoids, multiple sclerosis, osteoarthritis, and uterine fibroids. Additionally, the CBO recommends discontinuing the VA’s individual employability payments, reducing disability benefits to veterans older than 67 who are receiving Social Security payments, and eliminating disability compensation for veterans with disability rates below 30 percent.

The CBO also recommended making VA disability payments taxable income.

To all of the above, we say NO! Veterans have earned their benefits, and those benefits should be off the table.

By Debbie Gregory.

The U.S. military is reportedly finalizing plans to eliminate more than 17,000 uniformed medical professionals, including physicians, dentists, nurses and other healthcare professionals, resulting in a 13 percent cut to its medical workforce.

“Part of this drill is to realign our people to the appropriate level of workload so that their skills, both for battlefield care and for beneficiary care, improve,” said one Defense Department official.

While senior officials discussed the reasons for the cuts, they declined to confirm exact figures, as those numbers will not be made official until the fiscal year 2020 defense budget is approved by the White House, and sent to Congress next month. If both branches approve the budget, the reductions will take effect in fiscal year 2021.

The reduction will allow a deepening of the workload of remaining medical billets at base hospitals and clinics to strengthen medical skills, as well as improving quality of care for beneficiaries, according to defense officials.

The staff cuts are worrisome for patient access, particularly to physicians young families rely on such as pediatricians and obstetricians, according to retired Navy Capt. Kathryn M. Beasley, director of government relations for health issues at the Military Officers Association of America.

“We need to see the final numbers to understand the impact,” she said.

But senior defense officials, who say they collaborated closely with the services on overall staff reduction plans, contend the current force is larger than needed to meet today’s operational missions and is overloaded with skill sets not useful for deployment and delivering of battlefield care.

Defense officials conceded the staff cuts, and refocusing on deployable skills, over time will change the mix of providers delivering care on base, forcing more family care off base and onto Tricare provider networks.

“We will expect to see an increase in certain skill sets [and] a decrease in other skill sets,” said one official. “More trauma surgeons, fewer pediatricians, for example. Those kinds of changes are right at the heart of what Congress has directed us to do.”

By Debbie Gregory.

UnitedHealthcare is in good company as Health Net Federal Services and WellPoint Military Care have joined in on the protest of the awarding of the military contract to manage the Tricare health program.

The contract, called T-2017 and awarded in July, is worth up to $58 billion and oversees private health services for nearly 9.4 million military family members, retirees and active duty personnel.

Health Net Federal Services, which now manages the Tricare North Region and was awarded the contract to manage Tricare’s West region, filed a protest over the Defense Department’s decision to give the East region contract to Humana Government Business.

The Defense Department and the Defense Health Agency said in 2014 that they would shift Tricare from a three-region system—North, South and West—to two coverage areas.

The brand new East region is a consolidation of the North and South regions

The West region contract has a maximum value of $18 billion over six years, while the six-year East region contract is potentially worth $41 billion.

WellPoint Military Care, a division of Anthem Blue Cross and Blue Shield, was created to vie for the lucrative contract.

UnitedHealth Military & Veterans, which manages the Tricare West contract, was the first to file protests over the awards. It was not selected to manage either of the new consolidated regions.

A Pentagon spokesman said the protest will not affect health care services for Tricare beneficiaries, adding that the current contracts will remain in place until all protests are resolved.

The Defense Health Agency has 30 days to respond to the protests. The U.S. Government Accountability Office (GAO) is expected to rule on the bid protest by November 9, 2016.