BILL ANALYSIS                                                                                                                                                                                                    



                                                                  SJR 10
                                                                  Page  1

          Date of Hearing:   August 27, 2008

                       ASSEMBLY COMMITTEE ON VETERANS AFFAIRS
                                  Mary Salas, Chair
             SJR 10 (Committee on Veterans Affairs) - As Introduced:  May  
                                      28, 2009

           SENATE VOTE  :   36-0
           
          SUBJECT  :   Military Health Care.

           SUMMARY  :   request that the President and the Congress of the  
          United States pass H.R. 816 that would prohibit certain  
          increases in fees for military health care.
            
           EXISTING LAW  created established TRICARE as the uniformed  
          services health care program for active duty service members and  
          their families, retired service members and their families,  
          members of the National Guard/Reserve and their families,  
          survivors and other eligible beneficiaries. The uniformed  
          services include the U.S. Army, U.S. Navy, U.S. Air Force, U.S.  
          Marine Corps, U.S. Coast Guard, the Commissioned Corps of the  
          U.S. Public Health Service, and the Commissioned Corps of the  
          National Oceanic and Atmospheric Administration. 

           FISCAL EFFECT  :   None.

           COMMENTS : 

           TRICARE BACKGROUND:   TRICARE replaced the Civilian Health and  
          Medical Program of the Uniformed Services (CHAMPUS) program in  
          1993.  TRICARE's primary objectives are to optimize delivery of  
          health care services in the military's direct care system, which  
          includes Military Treatment Facilities (MTFs), and attain the  
          highest level of patient satisfaction through delivery of a  
          world-class health care benefit. 
            
          TRICARE combines the health care resources of the uniformed  
          services and supplements them with networks of civilian health  
          care professionals, institutions, pharmacies, suppliers and  
          other providers to provide access to high-quality health care  
          services while maintaining the capability to support military  
          operations and the military readiness mission.









                                                                  SJR 10
                                                                  Page  2

          TRICARE is available worldwide and managed regionally in six  
          separate TRICARE regions - TRICARE North, TRICARE South, TRICARE  
          West, TRICARE Europe, TRICARE Pacific and TRICARE Latin America  
          and Canada - jointly by the TRICARE Management Activity (TMA)  
          and TRICARE Regional Offices (TRO). TMA has partnered with  
          civilian managed care support contractors in the North (Health  
          Net Federal Services, LLC), South (Humana Military Healthcare  
          Services) and West (TriWest Healthcare Alliance) to assist TROs  
          and MTF Commanders in operating an integrated health care  
          delivery system. 

           Background on HR 816 of 2009:     

          As introduced on 2/3/2009, the Military Retirees Health Care  
          Protection Act contains congressional intent language that  
          states: 

             1)   the Department of Defense (DOD) and the nation have a  
               committed health benefits obligation to retired military  
               personnel that exceeds the obligation of corporate  
               employers to civilian employees; and 
             2)   DOD has many additional options to constrain the growth  
               of health care spending in ways that do not disadvantage  
               beneficiaries, and should pursue such options rather than  
               seeking large fee increases for beneficiaries. 

          Prohibits:
             1)   an increase after: April 1, 2006, in a premium,  
               deductible, co-payment, or other charge prescribed by the  
               Secretary of Defense for medical and dental health care  
               coverage for military personnel; and 
             2)   an increase after September 30, 2009, in the dollar  
               amount of a cost-sharing requirement under the DOD pharmacy  
               benefits program. 
             3)   charges for DOD inpatient care from exceeding $535 per  
               day; and 
             4)   beginning on January 1, 2009, an increase in premiums  
               under TRICARE (a DOD managed health care program) for  
               certain members of the Selected Reserve. 

          The Congressional Budget Office, a nonpartisan arm of Congress,  
          has compiled a list of 115 options for changes in medical care  
          programs.  These are primarily ways to cut federal funding.  The  
          Senate Budget Committee is considering these changes as it  








                                                                  SJR 10
                                                                  Page  3

          prepares the 2010 federal spending guide.  The options include  
          raising enrollment fees, co-payments and deductibles for  
          military retirees younger than age 65 and their families who use  
          the TRICARE health benefits program; requiring some veterans to  
          pay co-payments when treated for medical issues not related to  
          military service; and a novel idea of allowing active-duty  
          families to pocket money - up to $500 each year - if they don't  
          use health benefits.  Also included is a cost-sharing idea for  
          Medicare-eligible military retirees under which the government  
          would not cover the first $525 of health care costs each year  
          and provide limited reimbursement of the next $4,725 in costs,  
          all in an effort to discourage unnecessary medical treatment.

          The cost of health care has consistently risen, between 2001 and  
          2007 health care premiums for average Americans increased by 78  
          percent.  TRICARE fees have not increased since that program was  
          created in the mid-1990s - despite constant calls by the Defense  
          Department to raise deductibles, co-payments and enrollment fees  
          to cut military health care costs. When taking these facts into  
          account the healthcare cost at TRICARE remain relatively low.

          The Senate Budget Committee does not have the power to increase  
          TRICARE fees or change veterans' health care benefits.  Instead,  
          it exercises its influence by making recommendations on federal  
          spending which includes an annual revenue and spending plan  
          that, if approved by Congress, sets limits for various programs.  
           There has been no information provided to the committee that  
          shows an increase in TRICARE fees has been offered by any member  
          of Congress or the current administration

           REGISTERED SUPPORT / OPPOSITION  :

           Support 
           
          None on file.
           
            Opposition 
           
          None on file.

           Analysis Prepared by  :    Eric Worthen / V. A. / (916) 319-3550