A proposal to shift 9 million Tricare beneficiaries to civilian health plans may have been rejected last month by Congress and President Obama, but some military advocates are pressing for a test-run of the plan, called Tricare Choice, for National Guard and rReserve members.
The Reserve Officers Association has drafted a proposal to create a "Tricare Reserve Choice" program that would allow rReserve component personnel and their families to choose a commercial health plan.
While activated, the troops would get medical care from U.S. military providers, but their families would be able to keep, and receive care through, their private health plan.
Reservists now have access to Tricare Reserve Select, a premium-based plan that allows them to see any physician who accepts Tricare.
But when rReserve forces are called up for an extended period, they are covered the same as active-duty personnel, receiving care from the military while their families can use Tricare Prime or Standard without paying any premiums.
Jeff Phillips, ROA executive director, said that arrangement forces families to choose between continuing to see the same provider or saving money.
A Tricare Reserve Choice program, Phillips said, could lower costs and allow Guard and Reserve families to continue receiving health care and coverage without interruption.
"The basic problems [with Tricare Reserve Select] are the disruption that occurs to civilians and their families when they leave their civilian plan and go to Tricare," Phillips said. "There's a continuity-of-care concern as well as a financial cost to that option."
Under Tricare Reserve Choice, reservists would choose from a selection of plans, pay a cost-share of the premiums and any co-payments required under the selected plan.
When called to active duty, they would receive a basic allowance for health care to cover the cost for their families, which would stay with their chosen plan.
ROA proposes that the program also be available to members of the Individual Ready Reserve, who currently cannot buy Tricare Reserve Select, and "gray area retirees," who have left the drilling reserve but are under age 60 and not yet eligible for military retirement pay and benefits.
Those retirees can purchase health care coverage through the Tricare Retired Reserve program, but they pay 100 percent of the premiums.
"[Grey area retirees] are actually still part of the mobilization picture," Phillips argued. "They should be included. Replacing their plan with Tricare Reserve Choice would give them continuity and affordability."
While it is unclear how much money the proposal would save rReserve component families, the Military Compensation and Retirement Modernization Commission said that under its Tricare Choice Reserve proposal, families could expect to pay about 25 percent of their premiums, compared with the 28 percent they pay now.
The House Armed Services Committee in April elected not to include the commission's recommendation to overhaul Tricare in its version of the fiscal 2016 defense authorization bill.
Committee members did not rule out future Tricare reform, but said they were unable to complete a review of the commission's proposal that they believe must happen before it is included in any legislation.
The Senate has not yet finalized its version of the 2016 defense bill, but Sen. Lindsey Graham, R-S.C., who chairs the Senate Armed Services Committee's personnel panel, has expressed interest in the proposal and said he supports a pilot program to test whether it would work.
"Here's my bias: If I were trying to run a health care company, the last people I'd pick would be the Department of Defense," Graham said.
In a statement released April 30 by the White House, President Obama said military health care reform is needed, and promised to "work with the commission and members of Congress … to develop additional reform proposals" as part of the fiscal 2017 budget process.
According to Phillips, Guard and rReserve advocacy groups are looking at how the program could work for Guard members as well.
Those who have expressed interest in a Tricare Choice Reserve demonstration project include the Fleet Reserve Association, the National Guard Association of the United States and the Enlisted Association of the National Guard of the United States, among others.
Retired Maj. Gen Gus Hargett, NGAUS president, said he thinks the program could work, but he has concerns about its cost.
"Right now, not every member of the Guard can afford health care, and along with maintaining military readiness, one of our top priorities is to see every member of the Guard and their families are able to afford health insurance," Hargett said.
In an April interview with Military Times, compensation commission member and former congressman Steve Buyer said Tricare Reserve Choice could be a "first step" in implementing Tricare Choice for all military family members, retirees and their families.
He said he expects to see Tricare Reserve Choice proposed as part of the fiscal 2017 budget process.
"I understand when something like this [recommendation] comes out, people want it to chill a little bit. But the reserve components have stepped forward to say, 'We like Tricare Choice.' They are asking for it," Buyer said.
Patricia Kime is a senior writer covering military and veterans health care, medicine and personnel issues.
