Answering health-care reform questions

Many questions have surfaced regarding the newly passed health-care reform bill. Representatives from The American Legion answered a handful of the commonly-asked questions that were submitted to national headquarters. Their answers can be found below.

Q: I am retired from the Army after serving for 25 years. In a year and a half I will switch from TRICARE to Medicare. Will I have any health care at that point? I am a Vietnam veteran, and I know where the cuts will hit first. Will I be able to afford health care after increases in costs? I am on a fixed income.

A: When you reach 65 years of age, you are no longer eligible for TRICARE, but if you are enrolled in Medicare Part A and Part B, you can enroll in TRICARE for Life, which serves as your Medicare supplemental insurance.

The recently passed national health-care reform legislation will be enacted over the next four years; therefore, I cannot tell you what the cost of Medicare Part A or Part B may be at that time, or if the requirements for enrollment in TRICARE for Life will remain the same.

However, you can rest assured that The American Legion will be fully engaged in monitoring the implementation of the national health-care reform in order to protect servicemembers, veterans and their families.

Q: What is your estimation of the effect of the over half-trillion-dollar cut to Medicare? With TRICARE for Life as the promised "free" medical care for life that I earned for 34 years of active-duty service, I can't understand how TFL, tied directly to Medicare, is not going to be seriously affected by the new health-care bill's cuts to Medicare. Where is the protection for my benefits

And I have an adjunct question - still related to Medicare and TFL - about the status of the "doctor fix" problem with Medicare. In addition to the overwhelming cut in total Medicare funding, this perversion will reduce payments by 21 percent to the remaining doctors who will accept Medicare/TRICARE for Life, if one is fortunate enough to find any after the new health-care cuts. I understand that Rep. Ike Skelton (D-Miss.) is working on something that may address this second problem. I certainly hope so. What is the Legion doing to help promote that effort?

A: The anticipated $500 billion in cuts to Medicare is supposed to come primarily from curtailing "fraud, waste and abuse" in current billing practices. These proposed savings are not supposed to come from medical services.

When TRICARE was introduced, all Medicare-eligible DoD beneficiaries were prohibited from enrolling in the new TRICARE programs. After a year of aggressive lobbying by The American Legion and others, Congress created TRICARE for Life based on the current Medicare enrollment. Under federal law, if a TRICARE beneficiary is entitled to Medicare because of age, disability or end-stage renal disease (ESRD), the beneficiary must enroll and pay the monthly Medicare Part B premium in order to remain TRICARE-eligible. Active-duty family members entitled to Medicare aren't required to purchase Part B until the active-duty sponsor retires.

The current law does not specifically address TRICARE or TRICARE for Life; therefore, specific changes will have to be enacted by Congress and the Obama administration. TRICARE, the health insurance for military servicemembers, retirees and the families of both, is under the control of DoD and governed by a different section of the United States Code (Title 10), so it will not be affected in any way by the new health-reform legislation. The anticipated 21-percent reduction in the Medicare reimbursement rate dates back several years, before the national health-care reform debate began. The American Legion has been successful in delaying such reductions. The American Legion disagrees with this concept because of its possible impact on the number of health-care professionals who will continue to participate in TRICARE or TRICARE for Life programs.

If you read Skelton's statement, he believes TRICARE and TRICARE for Life are already protected, but introduces the bill to reassure military retirees and their family members enrolled in TRICARE for Life that it would not be adversely impacted by enactment of the Senate's version of the legislation - which is now public law.

According to Defense Secretary Robert Gates, the TRICARE military health plan meets the standards set by the health-care reform bill. Calling their health and well-being his highest priority, Gates reassured servicemembers and their families that the legislation won't have a negative effect on TRICARE, which already meets the bill's quality and minimum-benefit standards. According to Gates, this was clarified by a vote in the House of Representatives (March 20), and is expected to be re-affirmed by the Senate. President Obama and Gates are committed to seeing that the troops, retirees and their families will continue to receive the best-quality health care.

Q: I understand that there is a gap between TRICARE, which covers dependent children not in college to 18 and children to 22 who are in college, and the required insurance, up to 26, that the HCR demands. Do you know how this will be addressed?

A: Just today a bill was introduced to address that very issue. We have not had time to pore over the legislation, but the press release from Rep. Martin Heinrich (D-N.M.) states that he has introduced H.R. 4923, the TRICARE Dependent Coverage Extension Act, a bill that would increase the maximum age to 26 at which our troops and military retirees are allowed to provide health coverage to their dependent children.

"Our brave men and women in uniform sacrifice so much for our country, and it is our duty to make sure that they have access to quality, affordable health care," Heinrich said. "Because of the new health-reform bill passed by Congress, Americans who receive health insurance through a group plan will soon be able to provide coverage to dependent children up to 26 - our military health coverage must meet that same standard and be nothing less."

Heinrich introduced this legislation following the enactment of the Patient Protection and Affordable Care Act, the sweeping health-care overhaul that will allow all American citizens the opportunity to gain access to quality, affordable health care. Under the new system, individuals with private health insurance will now be able to provide coverage to their dependent children up to 26.

Q: Could you please let me know if the e-mail I keep receiving is accurate. It states that if approved by Congress, the first assault wave would hit in 2011, and would hit hard. It would initiate cost sharing to require retirees to pay the first $525 of medical costs, and 50 percent of the next $4,725, for a first-year cost of $2,888 per person. It would be indexed to increase with inflation. A reason given for this action (for PR effect) is "overuse" by retirees. Those of you covered by TFL will want to pay attention.

A: We get this question more than any other, and it is an incorrect reading of a document put out by the OMB. For more info on why this is false, you can read this piece at Factcheck and for a good explanation of how this particular urban legend was started, read what Martin Guerre had to say over at The American Legion's Burn Pit.