[Congressional Bills 105th Congress]
[From the U.S. Government Publishing Office]
[S. 224 Introduced in Senate (IS)]







105th CONGRESS
  1st Session
                                 S. 224

To amend title 10, United States Code, to permit covered beneficiaries 
under the military health care system who are also entitled to medicare 
  to enroll in the Federal Employees Health Benefits program; and for 
                            other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                            January 28, 1997

  Mr. Warner 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 covered beneficiaries 
under the military health care system who are also entitled to medicare 
  to enroll in the Federal Employees Health Benefits program; 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. INCLUSION OF MEDICARE ELIGIBLE 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) The Secretary of Defense (after consulting 
with the other administering Secretaries) and the Director of the 
Office of Personnel Management shall enter into an agreement to offer 
eligible covered beneficiaries an opportunity to enroll in a health 
benefits plan offered through the Federal Employee Health Benefits 
program under chapter 89 of title 5. The agreement may provide for 
limitations on enrollment of covered beneficiaries in the Federal 
Employee Health Benefits program if the Director determines that the 
limitations are necessary to allow for adequate planning for access for 
services under Federal Employee Health Benefits program.
    ``(2) A person covered by an enrollment in a health benefits plan 
under paragraph (1) is not eligible to receive care under this chapter 
in facilities of the uniformed services or through the Civilian Health 
and Medical Program of the Uniformed Services or the TRICARE program.
    ``(b) Eligible Covered Beneficiaries.--A covered beneficiary 
referred to in subsection (a) is a member or former member of the 
uniformed services described in section 1074(b) of this title, or any 
dependent of the member described in section 1076(b) of this title, who 
is or becomes entitled to hospital insurance benefits under part A of 
title XVIII of the Social Security Act (42 U.S.C. 1395c et seq.). The 
covered beneficiary shall not be required to satisfy any eligibility 
criteria specified in chapter 89 of title 5 as a condition for 
enrollment in a health benefits plan offered through the Federal 
Employee Health Benefits program pursuant to subsection (a).
    ``(c) Contributions.--(1) In the case of covered beneficiaries 
described in subsection (b) who enroll in a health benefits plan 
offered through the Federal Employee Health Benefits program pursuant 
to subsection (a), the administering Secretary concerned shall be 
responsible for Government contributions that the Office of Personnel 
Management determines are necessary to cover all costs in excess of 
beneficiary contributions under paragraph (2).
    ``(2) The contribution required from an enrolled covered 
beneficiary shall be equal to the amount that would be withheld from 
the pay of a similarly situated Federal employee who enrolls in a 
health benefits plan under chapter 89 of title 5.
    ``(d) Management of Participation.--The authority responsible for 
approving retired or retainer pay or equivalent pay in the case of a 
member or former member shall manage the participation of the member or 
former member, and dependents of the member or former member, who 
enroll in a health benefits plan offered through the Federal Employee 
Health Benefits program pursuant to subsection (a). The Office of 
Personnel Management shall maintain separate risk pools for enrolled 
covered beneficiaries until such time as the Director of the Office of 
Personnel Management determines that complete inclusion of enrolled 
covered beneficiaries under chapter 89 of title 5 would not adversely 
affect Federal employees and annuitants enrolled in health benefits 
plans under such chapter.
    ``(e) Effect of Cancellation.--The cancellation by a covered 
beneficiary of coverage under the Federal Employee Health Benefits 
program shall be irrevocable for purposes of this section.
    ``(f) Reporting Requirements.--Not later than November 1 of each 
year, the Secretary of Defense and the Director of the Office of 
Personnel Management shall jointly submit a report to Congress 
describing the provision of health care services to covered 
beneficiaries under this section during the preceding fiscal year. The 
report shall address or contain the following:
            ``(1) The number of covered beneficiaries enrolled in 
        health benefits plans offered through the Federal Employee 
        Health Benefits program pursuant to subsection (a), both in 
        terms of total number and as a percentage of all covered 
        beneficiaries receiving health care through the health care 
        system of the uniformed services.
            ``(2) The out-of-pocket cost to enrollees under such health 
        benefits plans.
            ``(3) The cost to the Government (including the Department 
        of Defense, the Department of Transportation, and the 
        Department of Health and Human Services) of providing care 
        under such health benefits plans.
            ``(4) A comparison of the costs determined under paragraphs 
        (2) and (3) and the costs that would have otherwise been 
        incurred by the Government and enrollees under alternative 
        health care options available to the administering Secretaries.
            ``(5) The effect of this section on the cost, access, and 
        utilization rates of other health care options under the health 
        care system of the uniformed services.''.
    (2) The table of sections at the beginning of such chapter is 
amended by inserting after the item relating to section 1079a the 
following new item:

``1079b. Health care coverage through Federal Employees Health Benefits 
                            program.''.
    (b) Conforming Amendments.--(1) Section 1072 of title 10, United 
States Code, is amended by adding at the end the following:
            ``(7) The term `TRICARE program' means the managed health 
        care program that is established by the Secretary of Defense 
        under the authority of this chapter, principally section 1097 
        of this title, and includes the competitive selection of 
        contractors to financially underwrite the delivery of health 
        care services under the Civilian Health and Medical Program of 
        the Uniformed Services.''.
    (2) 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 Secretary of Defense determines is an 
eligible covered 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 the Secretary and the Office and with applicable 
regulations under this chapter.''.
    (3) 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(c) 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 beneficiaries who enroll under section 8905(d) of this title shall 
be paid as provided in section 1079b(c) of title 10.''.
    (c) Implementation.--The Secretary of Defense shall offer the 
health benefits option under section 1079b(a) of title 10, United 
States Code (as added by subsection (a)), beginning not later than 
January 1, 1998.
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