December Legislative Update
One of the things difficult in doing a legislative column is that things written about can change before the column is printed. Please take this into consideration when reading not only what is written here but also what is published in other newsletters and magazines you receive. MOAA may, for example, asks us to write or call our Members of Congress concerning specific pieces of legislation yet when contact is made a vote may have already been taken. This is just the manner in which the legislative world works. Additionally, a large number of co-sponsors may seem to be the driving factor in bringing legislation before a subcommittee for a hearing but this is not necessarily true. Bills may be introduced with only one or two co-sponsors while those with lots of them may never get to the floor for a vote. Chairmen drive the train. When funds are involved, money can also be the determinant factor on ultimate approval or disapproval.
Congress, while working on various pieces of legislation, is primarily engrossed in the monumental health care bill. Perhaps by the time you read this a vote will have been taken in either the House or Senate or both. Watch for the impact on any of the forms of Tricare, especially Tricare for Life, and Medicare. The Senate recently voted against a bill to fix the scheduled 21 percent decrease in Medicare payments to physicians effective January 1 on the premise that the cost for it could not be funded. The House, conversely, introduced HR 3961, the Medicare Physician Payment Reform Act of 2009, to repeal the formula previously set by Congress which determines the reimbursement rates. A reduction in Medicare rates will adversely impact TFL payments and, consequently, those who carry this “free” health care plan could find it harder to find doctors and specialists in the civilian community willing to take new Medicare patients. Doctors are not required to take new patients.
Much has already been written about the recently passed National Defense Authorization Act (NDAA), the legislation that tells DoD how it will spend the funds appropriated for it. There are no Tricare increases but the Senate version to repeal the deduction of survivor benefits (DIC) from SBP failed to pass, supposedly due to lack of funds. Those retired under Chapter 61 again lost the battle to phase out the disability offset from retired pay, ostensibly because the Senate did not like how the House had proposed funding it. Money can be found to support some programs but not others, particularly when some affect few people. Budget rules seem to be more politically motivated than publicly motivated. The NDAA does provide a 3.4% cost of living increase for active duty personnel. There is also word that federal civil service personnel and Members of Congress may receive a 2% cost of living increase while those dependent on the annual COLA to help offset increased living costs, military retirees and social security recipients for example, will receive nothing, possibly for the next two years. The President has stated he would like to have social security recipients get another $250.00, as was done under the Stimulus Bill, but Congress asked where that money will come from.
Concerning the issue of increasing Tricare costs, during a congressional hearing in mid-October on projected DoD budget growth a member of the Congressional Research Service addressed the rising costs of a service member and a member of the Congressional Budget Office addressed the increasing pay raises of the active military as causes. Included by the latter was a discussion on rising health care costs and their impact on the DoD budget. A solution might be to increase retiree cost shares because, “It’s hard to get folks to control their utilization (of military health care facilities) when they don’t face a co-payment.” This battle is not over.
In mid-September a third Senate hearing this legislative session was held on the calculations used for compensation for service-connected disabilities. Some studies say that some disabilities are under compensated while others are over compensated and both quality of life and lost earning capacity should be considered in compensation. There is nothing in VA out year strategic planning addressing an internal study to look into compensation changes.