[Congressional Record Volume 144, Number 44 (Tuesday, April 21, 1998)]
[Senate]
[Pages S3359-S3361]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. THURMOND (for himself and Mr. Coverdell):
  S. 1963, 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; to the Committee on 
Governmental Affairs.


                 THE MILITARY HEALTH CARE FAIRNESS ACT

  Mr. THURMOND. Mr. President, I rise today to introduce the Military 
Health Care Fairness Act. A companion measure, H.R. 3613, was recently 
introduced in the House of Representatives by Congressman J.C. Watts 
and 38 cosponsors. I am pleased to have Senator Coverdell as an 
original cosponsor of this measure.

  Mr. President, this bill allows those military retirees over the age 
of sixty-five to sign up for the Federal Employees Health Benefits 
program (FEHBP) so that they may have another option for health care 
coverage. It is estimated that approximately 1.3 million retirees, 
dependents, and survivors meet this criteria. However, it is doubtful 
that all of them will sign up for the FEHBP.
  The recent base closures and realignments have limited the number of 
places where some retirees can receive health care. By joining the 
FEHBP, health care choices will increase. The FEHBP will probably be 
desirable to those retirees that do not have prescription drug plans or 
want to limit catastrophic out-of-pocket cost. Further, the retiree is 
not excluded from using the traditional military medical treatment 
facilities on a space available basis. When a retiree, under the FEHBP, 
uses a military facility, the health care plan reimburses the military 
for the cost of treatment.
  Mr. President, during the first year of this program the costs will 
be capped at $100 million. This amount increases $100 million per year 
for five years to cap the costs at $500 million per year. The costs to 
the individual should be the same as to any other federal employee in a 
given geographical area. In order to determine the actual premiums, the 
health plans will be required to establish a separate risk pool to 
determine whether the military group's risk characteristics such as 
age, gender, and care-use affect the other federal employees' premiums. 
While I realize that some might say the costs of this measure are high, 
something must be done to give health care coverage to those retirees 
that do not have adequate coverage under the current military health 
care system. The many men and women who have given so much to protect 
our Country by serving in the military are to be commended for their 
sacrifices and we should acknowledge this by giving them adequate 
health care choices.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                S. 1963

       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 ``Military Health Care 
     Fairness 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, eligible 
     beneficiaries described in subsection (b) shall be afforded 
     an opportunity to enroll in any health benefits plan under 
     the Federal Employee Health Benefits program under chapter 89 
     of title 5, United States Code, offering 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').

[[Page S3360]]

       ``(2) The Secretary of Defense and the other administering 
     Secretaries shall jointly 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 a covered beneficiary who is 
     a military retiree (except a military retiree retired under 
     chapter 1223 of this title), a dependent of such a retiree 
     described in section 1072(2)(B) or (C), or a dependent 
     described in section 1072(2)(A), (D), or (I) of such a 
     retiree who enrolls in an FEHBP plan, who,--
       ``(A) is not guaranteed access under TRICARE to health care 
     that is comparable to the health care benefits provided under 
     the service benefit plan offered under the Federal Employee 
     Health Benefits program;
       ``(B) is eligible to enroll in the TRICARE program but is 
     not enrolled because of the location of the beneficiary, a 
     limitation on the total enrollment, or any other reason; or
       ``(C) is entitled to hospital insurance benefits under part 
     A of title XVIII of the Social Security Act (42 U.S.C. 1395c 
     et seq.).
       ``(2) In addition to the eligibility requirements described 
     in paragraph (1), during the first two years that covered 
     beneficiaries are offered the opportunity to enroll in an 
     FEHBP plan under subsection (a), eligible beneficiaries shall 
     be limited to--
       ``(A) except as provided in subparagraph (B), military 
     retirees 65 years of age or older; and
       ``(B) military retirees retired under chapter 61 of this 
     title.
       ``(3) An eligible beneficiary 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.
       ``(c) Priority of Enrollment.--(1) Eligible beneficiaries 
     shall be permitted to enroll in an FEHBP plan based on the 
     order in which such beneficiaries apply to enroll in the 
     plan.
       ``(2) The Secretary shall maintain a list of eligible 
     beneficiaries who apply to enroll in an FEHBP plan, but whom 
     the Secretary is not able to enroll because of the lack of 
     available funds to carry out this section.
       ``(d) Period of Enrollment.--The Secretary shall provide a 
     period of enrollment for eligible beneficiaries in an FEHBP 
     plan for a period of 90 days--
       ``(A) before implementation of the program described in 
     subsection (a); and
       ``(B) each subsequent year thereafter.
       ``(e) Term of Enrollment.--(1) The minimum period of 
     enrollment in an FEHBP plan shall be three years.
       ``(2) A beneficiary who elects to enroll in an FEHBP plan, 
     and who subsequently discontinues enrollment in the plan 
     before the end of the period described in paragraph (1), 
     shall not be eligible to reenroll in the plan.
       ``(f) Receipt of Care in MTF.--(1) An eligible beneficiary 
     enrolled in an FEHBP plan may receive care at a military 
     medical treatment facility subject to the availability of 
     space in such facility, except that the plan shall reimburse 
     the facility for the cost of such treatment. The plan may 
     adjust beneficiary copayments so that receipt of such care at 
     a military medical treatment facility results in no 
     additional costs to the plan, as compared with the costs that 
     would have been incurred if care had been received from a 
     provider in the plan.
       ``(g) Contributions.--(1) Contributions shall be made for 
     an enrollment of an eligible beneficiary in a plan of the 
     Federal Employee Health Benefits program 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 the Secretary under section 8906 of title 
     5 for an enrolled eligible beneficiary if the beneficiary 
     were an employee of the Secretary.
       ``(3) Each eligible beneficiary enrolled in an FEHBP plan 
     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 same health benefits plan 
     under chapter 89 of title 5.
       ``(h) Management of Participation.--The Director of the 
     Office of Personnel Management shall manage the participation 
     of an eligible beneficiary in a health benefits plan of the 
     Federal Employee Health Benefits program pursuant to an 
     enrollment under this section. The Director shall maintain 
     separate risk pools for participating eligible beneficiaries 
     until such time as the Director determines that inclusion of 
     participating eligible beneficiaries under chapter 89 of 
     title 5 will not adversely affect Federal employees and 
     annuitants enrolled in health benefits plans under such 
     chapter.
       ``(i) Reporting Requirements.--(1) Not later than November 
     1 of each year, the Secretary of Defense and the Director of 
     the Office of Personnel Management shall jointly submit to 
     Congress a report describing the provision of health care 
     services to enrollees under this section during the preceding 
     fiscal year. The report shall address or contain the 
     following:
       ``(A) The number of eligible beneficiaries who are 
     participating in health benefits plans of the Federal 
     Employee Health Benefits program pursuant to an enrollment 
     under this section, 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 eligible beneficiaries use the 
     health care services available to the beneficiaries under 
     health benefits plans pursuant to enrollments under this 
     section.
       ``(C) The cost to enrollees for health care under such 
     health benefits 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 eligible 
     beneficiaries pursuant to enrollments in such health benefits 
     plans under this section.
       ``(E) A comparison of the costs determined under paragraphs 
     (C) and (D) and the costs that would otherwise have been 
     incurred by the United States and enrollees 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.
       ``(2) Not later than the date that is four years after the 
     date of enactment of the National Defense Authorization Act 
     for fiscal year 1999, the Secretary of Defense shall submit 
     to Congress a report describing--
       ``(A) whether the Secretary recommends that a health care 
     option for retired covered beneficiaries equivalent to the 
     option described in subsection (a) be permanently offered to 
     such beneficiaries; and
       ``(B) the estimated costs of offering such an option.''.
       (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 Secretary of Defense 
     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 the 
     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(g) 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(g) of 
     title 10.''.
       (c) Implementation.--The Secretary of Defense--
       (1) 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 the date that is 6 months 
     after the date of the enactment of this Act; and
       (2) shall continue to offer such option through the year 
     2003, and to provide care to eligible covered beneficiaries 
     under such section through the year 2005.
       (d) Funding From Authorized Appropriations.--Of the funds 
     authorized to be appropriated for the Department of Defense 
     for military personnel for fiscal years 1999 through 2005, 
     amounts shall be available for carrying out section 1079b of 
     title 10, United States Code (as added by subsection (a)), as 
     follows
       (1) For fiscal year 1999, $100,000,000.
       (2) For fiscal year 2000, $200,000,000.
       (3) For fiscal year 2001, $300,000,000.
       (4) For fiscal year 2002, $400,000,000.
       (5) For fiscal year 2003, $500,000,000.
       (6) For each of fiscal years 2004 and 2005, such sums as 
     are necessary.

  Mr. COVERDELL. Mr. President, today I am proud to join my esteemed 
colleague, Senator Thurmond, in introducing legislation that will 
address a growing crisis our nation's military retirees now face. These 
soldiers who all served so valiantly for our country now find it 
increasingly difficult to access the lifetime health care promised to 
them in exchange for 20 years of service. As a veteran myself, I 
believe that the government must honor the promises which the country 
made to those men and women who have served so faithfully in defense of 
the United States. America's veterans fulfilled

[[Page S3361]]

their part of the bargain--now the government has a responsibility to 
do likewise. The legislation we introduce today is a Senate companion 
to House legislation introduced by Representative J.C. Watts. 
Congressman Watts has put a great deal of effort and leadership into 
this issue and I applaud his efforts.
  Military retirees are the only Federal Government personnel who have 
been prevented from using their employer-provided health care once they 
reach Medicare-eligible age. In the past, Medicare-eligible retirees 
have received health care in military treatment facilities on a ``space 
available'' basis. However, cutbacks in health care funding, force 
reductions and base closures are forcing many Medicare-eligible 
retirees out of the military medical system. The legislation we have 
introduced today would correct this inequity by giving all military 
retirees health care coverage equal to our FEHBP health plan or the 
option to enroll in FEHBP. As you know, Mr. President, FEHBP is the 
same plan in which you, I, and all our colleagues and staff in the 
Congress, have the option of enrolling. FEHBP is a successfully 
administered health benefits plan. The least we can do is offer to our 
nation's military retirees the same choices in health care as are 
available to us. I dare say they deserve it.
  This legislation would do more than allow access to FEHBP to 
retirees. It would also allow retirees experiencing difficulties with 
the TRICARE/CHAMPUS health plans. Due to TRICARE/CHAMPUS reimbursement 
rates, which are 15 percent below Medicare reimbursement rates, many 
doctors do not participate in TRICARE/CHAMPUS. When a military hospital 
has no space available for a military retiree, the retiree is referred 
to a private facility. If a private facility does not accept TRICARE/
CHAMPUS, the retiree is left waiting for available space in a military 
hospital. This is unjust. Under this legislation, military retirees who 
cannot receive under TRICARE/CHAMPUS the same level of care provided 
under FEHBP have the option of enrolling in FEHBP. Again, Mr. 
President, these are the same options available to us as federal 
employees.
  Mr. President, the Congress understands the need to fix the military 
health care system. Just last year in the 1998 Defense Authorization 
Act, this body recognized through an amendment I proudly cosponsored, 
the moral obligation we have incurred to provide health care to members 
and former members of the Armed Forces who are entitled to retired or 
retainer pay. This is a huge undertaking and important considerations 
such as the cost of such an endeavor must be made. While this 
legislation places caps on annual spending, providing those with 
funding concerns concrete numbers which to work, I firmly believe we 
can ill-afford not to honor the promises our nation made to these men 
and women.
  Mr. President, this nation has long stood by the men and women who 
have fought for, and secured, our country's freedom. Without these 
soldiers America would not stand today as the world's example of 
democracy and cornerstone of freedom. We owe it to our nation, to our 
nation's military retirees and to ourselves to make the small sacrifice 
that passage of this bill would require.
                                 ______