[Congressional Bills 105th Congress]
[From the U.S. Government Publishing Office]
[S. 2045 Introduced in Senate (IS)]







105th CONGRESS
  2d Session
                                S. 2045

To amend title 10, United States Code, to permit certain beneficiaries 
   of the military health care system to enroll in Federal employees 
             health benefits plans, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                              May 7, 1998

 Mr. Faircloth introduced the following bill; which was read twice and 
              referred to the Committee on Armed Services

_______________________________________________________________________

                                 A BILL


 
To amend title 10, United States Code, to permit certain beneficiaries 
   of the military health care system to enroll in Federal employees 
             health benefits plans, and for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Improved Military Medical Plan 
Act''.

SEC. 2. INCLUSION OF CERTAIN COVERED BENEFICIARIES IN FEDERAL EMPLOYEES 
              HEALTH BENEFITS PROGRAM.

    (a) FEHBP Option.--(1) Chapter 55 of title 10, United States Code, 
is amended by inserting after section 1079a the following new section:
``Sec. 1079b. Health care coverage through Federal Employees Health 
              Benefits program
    ``(a) FEHBP Option.--(1) Subject to the availability of funds to 
carry out this section for a fiscal year and subject to the provisions 
of this section, eligible beneficiaries described in subsection (b) 
shall be afforded an opportunity to enroll in any health benefits plan 
under the Federal Employees Health Benefits program under chapter 89 of 
title 5 that offers medical care comparable to the care authorized by 
section 1077 of this title to be provided under section 1076 of this 
title (in this section referred to as an `FEHBP plan').
    ``(2) The administering Secretaries shall enter into an agreement 
with the Director of the Office of Personnel Management to carry out 
paragraph (1).
    ``(b) Eligible Beneficiaries.--(1) An eligible beneficiary referred 
to in subsection (a) is any member or former member of the uniformed 
services described in section 1074(b) of this title, or any dependents 
of such member or former member described in section 1076(b) of this 
title, who is entitled to benefits under part A of title XVIII of the 
Social Security Act (42 U.S.C. 1395c et seq.).
    ``(2) An eligible beneficiary under this subsection shall not be 
required to satisfy any eligibility criteria specified in chapter 89 of 
title 5 as a condition for enrollment in an FEHBP plan under this 
section.
    ``(c) Areas of Enrollment.--(1)(A) Except as provided in paragraph 
(2), the Director of the Office of Personnel Management shall, in 
consultation with the administering Secretaries, select the areas in 
which eligible beneficiaries must reside in order to be permitted to 
enroll in FEHBP plans under this section. The Director shall select the 
largest number of such areas that is practicable.
    ``(B) The areas selected by the Director under subparagraph (A) 
shall include not less than six regions under the TRICARE program, with 
at least one such region including a site of the medicare subvention 
demonstration project for military retirees under section 1896 of the 
Social Security Act (42 U.S.C. 1395ggg).
    ``(2) Commencing not later than one year after the date of 
submittal of the report required by subsection (j)(2), eligible 
beneficiaries nationwide shall be afforded an opportunity to enroll in 
an FEHBP plan in accordance with this section.
    ``(d) Priorities; List.--(1) Eligible beneficiaries shall be 
permitted to enroll in an FEHBP plan under this section based on the 
order in which such beneficiaries submit to the administering Secretary 
concerned an application to enroll in an FEHBP plan under this section.
    ``(2) Each administering Secretary shall maintain a list of 
eligible beneficiaries who apply to enroll in an FEHBP plan under this 
section, but whom such Secretary is not able to enroll because of the 
lack of available funds to carry out this section.
    ``(3) Eligible beneficiaries who are on a list under paragraph (2) 
at the time of the expansion of opportunities for eligible 
beneficiaries to enroll in FEHBP plans under subsection (c)(2) shall 
resubmit an application under this subsection to be afforded an 
opportunity to enroll in an FEHBP plan under this section.
    ``(e) Period of Enrollment.--The administering Secretaries shall 
provide a period of enrollment for eligible beneficiaries in FEHBP 
plans under this section for a period of 90 days--
            ``(1) before the commencement of the availability of care 
        under such plans under this section; and
            ``(2) for each subsequent year thereafter.
    ``(f) Term of Enrollment.--(1) An eligible beneficiary who elects 
to participate in a plan under the Federal Employees Health Benefits 
program under this section shall participate continuously in such a 
plan (whether in the plan originally elected or another plan) during 
the three-year period beginning on the date of commencement of the 
beneficiary's participation in such a plan under this section.
    ``(2) An eligible beneficiary who discontinues participation in a 
plan under the Federal Employees Health Benefits program under this 
section before the end of the period described in paragraph (1) shall 
not be eligible to reenroll in any plan under the program under this 
section.
    ``(g) Receipt of Care in Military Treatment Facilities.--(1) An 
eligible beneficiary enrolled in an FEHBP plan under this section may 
receive care at a military medical treatment facility subject to the 
availability of space in such facility.
    ``(2) The FEHBP plan concerned shall reimburse a facility for the 
cost of treatment provided under paragraph (1) to an eligible 
beneficiary enrolled in the plan under this section.
    ``(3) An FEHBP plan may adjust the copayments of an eligible 
beneficiary enrolled in the plan under this section so that receipt of 
care by the beneficiary at a military medical treatment facility 
results in no additional costs to the plan when compared with the costs 
the plan would have incurred if the beneficiary had received such care 
from a provider in the plan.
    ``(h) Contributions.--(1) Contributions shall be made for an 
eligible beneficiary who enrolls in an FEHBP plan under this section as 
if the beneficiary were an employee of the Federal Government.
    ``(2) The administering Secretary concerned shall be responsible 
for the Government contributions that the Director of the Office of 
Personnel Management determines would be payable by such Secretary 
under section 8906 of title 5 for an eligible beneficiary who is 
enrolled in an FEHBP plan under this section if the beneficiary were an 
employee of such Secretary.
    ``(3) Each eligible beneficiary enrolled in an FEHBP plan under 
this section shall be required to contribute the amount that would be 
withheld from the pay of a similarly situated Federal employee who is 
enrolled in the plan under chapter 89 of title 5.
    ``(i) Management of Participation.--(1) The Director of the Office 
of Personnel Management shall manage the participation of eligible 
beneficiaries in FEHBP plans under this section.
    ``(2) The Director and the administering Secretaries shall ensure 
(whether through procedures, the establishment of reserve funds, or 
other mechanisms) that inclusion of such participating eligible 
beneficiaries under chapter 89 of title 5 will not have an adverse 
financial effect on Federal employees and annuitants enrolled in health 
benefits plans under such chapter.
    ``(j) Reporting Requirements.--(1) Not later than November 1 each 
year, the administering Secretaries and the Director of the Office of 
Personnel Management shall jointly submit to Congress a report 
describing the provision of health care services to eligible 
beneficiaries who were enrolled in FEHBP plans under this section 
during the preceding fiscal year. The report shall address or contain 
the following:
            ``(A) The number of such eligible beneficiaries, both in 
        terms of total number and as a percentage of all covered 
        beneficiaries who are receiving health care through the health 
        care system of the uniformed services.
            ``(B) The extent to which such eligible beneficiaries used 
        the health care services available to such beneficiaries under 
        such plans.
            ``(C) The cost to such eligible beneficiaries of health 
        care under such plans.
            ``(D) The cost to the Department of Defense, the Department 
        of Transportation, the Department of Health and Human Services, 
        and any other departments and agencies of the Federal 
        Government of providing care to such eligible beneficiaries.
            ``(E) A comparison of the costs determined under paragraphs 
        (C) and (D) with the costs that would otherwise have been 
        incurred by the United States and such eligible beneficiaries 
        under alternative health care options available to the 
        administering Secretaries.
            ``(F) The effects of the exercise of authority under this 
        section on the cost, access, and utilization rates of other 
        health care options under the health care system of the 
        uniformed services.
            ``(G) An assessment, as of the date of the report, whether 
        or not the health care option under the TRICARE program known 
        as TRICARE Standard offers medical care coverage that is 
        substantially similar to the medical care coverage offered 
        under the fee-for-service health benefits plan under the 
        Federal Employees Health Benefits program having the most 
        number of subscribers as of such date, and, if not, whether or 
        not that option is being modified in order to offer such 
        coverage.
    ``(2) Not later than 3 years after the date of enactment of the 
Improved Military Medical Plan Act, the administering Secretaries shall 
jointly submit to Congress a report setting forth--
            ``(A) the assessment of such Secretaries as to the 
        advisability of--
                    ``(i) offering to eligible beneficiaries described 
                in subsection (b)(1) the health care option available 
                under subsection (a) on a permanent basis nationwide; 
                or
                    ``(ii) limiting the availability of that health 
                care option to eligible beneficiaries who are currently 
                enrolled in an FEHBP plan as of the date of the report;
            ``(B) the recommendation of such Secretaries whether--
                    ``(i) to expand the availability of the health care 
                option available under subsection (a) to any member or 
                former member of the uniformed services described in 
                section 1074(b) of this title, or any dependent of such 
                member or former member described in section 1076(b) of 
                this title, without regard to whether such member or 
                former member, or dependent, is entitled to benefits 
                under part A of title XVIII of the Social Security Act; 
                or
                    ``(ii) not to expand the availability of that 
                option in accordance with clause (i) because the 
                TRICARE Standard health care option offers medical care 
                coverage that is substantially similar to the medical 
                care coverage offered under the fee-for-service health 
                benefits plan under the Federal Employees Health 
                Benefits program having the most number of subscribers 
                as of the date of the report; and
            ``(C) the estimated costs of carrying out each assessment 
        under subparagraph (A) and the recommendation under 
        subparagraph (B).
    ``(3)(A) Not later than 6 months after the submittal of the report 
required by paragraph (2), the Comptroller General shall submit to 
Congress an assessment of the recommendation under subparagraph (B) of 
that paragraph.
    ``(B) If the recommendation is not to expand the availability of 
the option referred to in clause (i) of such subparagraph (B) in 
accordance with that clause, the review shall include an evaluation of 
the validity of any comparison made by the administering Secretaries 
for purposes of clause (ii) of such subparagraph (B).''.
    (2) The table of sections at the beginning of such chapter is 
amended by inserting after the item relating to section 1079a the 
following:

``1079b. Health care coverage through Federal Employees Health Benefits 
                            program.''.
    (b) Conforming Amendments.--(1) Section 8905 of title 5, United 
States Code, is amended--
            (A) by redesignating subsections (d), (e), and (f) as 
        subsections (e), (f), and (g), respectively; and
            (B) by inserting after subsection (c) the following new 
        subsection (d):
    ``(d) An individual whom the administering Secretary concerned 
determines is an eligible beneficiary under subsection (b) of section 
1079b of title 10 may enroll in a health benefits plan under this 
chapter in accordance with the agreement entered into under subsection 
(a) of such section between such Secretary and the Office and with 
applicable regulations under this chapter.''.
    (2) Section 8906 of title 5, United States Code, is amended--
            (A) in subsection (b)--
                    (i) in paragraph (1), by striking ``paragraphs (2) 
                and (3)'' and inserting in lieu thereof ``paragraphs 
                (2), (3), and (4)''; and
                    (ii) by adding at the end the following new 
                paragraph:
    ``(4) In the case of individuals who enroll in a health plan under 
section 8905(d) of this title, the Government contribution shall be 
determined under section 1079b(h) of title 10.''; and
            (B) in subsection (g)--
                    (i) in paragraph (1), by striking ``paragraph (2)'' 
                and inserting in lieu thereof ``paragraphs (2) and 
                (3)''; and
                    (ii) by adding at the end the following new 
                paragraph:
    ``(3) The Government contribution described in subsection (b)(4) 
for individuals who enroll under section 8905(d) of this title shall be 
paid as provided in section 1079b(h) of title 10.''.
    (c) Implementation.--The administering Secretaries shall begin to 
offer the health benefits option under section 1079b(a) of title 10, 
United States Code (as added by subsection (a)), not later than 6 
months after the date of enactment of this Act.
    (d) Availability of Funds.--(1) There shall be available to offer 
the health benefits option under section 1079b of title 10, United 
States Code (as added by subsection (a)), amounts as follows:
            (A) $100,000,000 for fiscal year 1999.
            (B) $125,000,000 for fiscal year 2000.
            (C) $150,000,000 for fiscal year 2001.
            (D) $175,000,000 for fiscal year 2002.
            (E) $200,000,000 for fiscal year 2003.
    (2) Amounts available under paragraph (1) for a fiscal year for the 
purpose set forth in that paragraph shall be derived from amounts 
authorized to be appropriated to the Department of Defense, the 
Department of Transportation, and the Department of Health and Human 
Services, respectively, for such fiscal year for payment of personnel 
costs.
    (3) For each fiscal year set forth in paragraph (1), the 
administering Secretaries shall determine the extent to which the funds 
of their respective departments under paragraph (2) shall be utilized 
for the purpose set forth in paragraph (1) within the limitation for 
such fiscal year specified in paragraph (1).
    (e) Plan for Enhancement of TRICARE Standard Option.--Not later 
than 6 months after the date of enactment of this Act, the 
administering Secretaries shall jointly submit to Congress a report 
that sets forth a plan for any enhancements of the health care option 
under the TRICARE program known as TRICARE Standard that the 
administering Secretaries jointly consider necessary so that the 
medical care coverage offered under that option is substantially 
similar to the medical care coverage offered under the fee-for-service 
health benefits plan under the Federal Employees Health Benefits 
program under chapter 89 of title 5, United States Code, that has the 
most number of subscribers as of the date of the report.
    (f) Definitions.--In this section:
            (1) The term ``administering Secretaries'' has the meaning 
        given that term in section 1072(3) of title 10, United States 
        Code.
            (2) The term ``TRICARE program'' has the meaning given that 
        term in section 1072(7) of title 10, United States Code.
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