[Congressional Record Volume 147, Number 89 (Monday, June 25, 2001)]
[Senate]
[Pages S6863-S6864]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Ms. COLLINS (for herself and Ms. Landrieu):
  S. 1096. A bill to eliminate the requirement that certain covered 
beneficiaries under chapter 55 of title 10, United States Code, obtain 
a nonavailability-of-health-care statement with respect to obstetrics 
and gynecological care related to a pregnancy; to the Committee on 
Armed Services.
  Ms. COLLINS. Mr. President, I rise today to introduce the Military 
Spouse Physician Choice Act of 2001. This legislation amends the 
Civilian Health and Medical Program of the Uniformed Services, CHAMPUS, 
to eliminate the requirement that a military dependent obtain a 
nonavailability statement, NAS, or a waiver from a commanding officer 
of a military treatment facility, in order to receive maternity care 
from a civilian doctor. I am pleased that my colleague Senator Landrieu 
is joining me in introducing this legislation.
  This legislation, which is a companion to H.R. 1511, introduced in 
the House by Representatives Jim Ryun and Susan Davis, will eliminate 
the requirement for TRICARE Standard maternity patients to obtain 
military nonavailability statements before seeing other doctors. Under 
current policy, Standard patients who live within 40 miles of a 
military medical facility must obtain a NAS from the facility commander 
before receiving pregnancy care from a civilian physician.
  Over 53 percent of our Nation's active service personnel today are 
married. Maintaining a high quality of life for these men and women in 
uniform must include the best possible health care for their spouses. 
While the services may recruit men and women to serve in our military 
forces, the reality is that we retain families to protect our Nation. 
It is therefore critical that all military spouses receive the health 
care services they signed up for.
  Currently, a military dependent has two options under the military's 
health care system. All military personnel and 84 percent of military 
dependents enroll in TRICARE Prime, which is the military's version of 
an HMO. Prime provides quality care, usually at a military treatment 
facility on the post or base. However, some dependents choose to enroll 
in the military's fee-for-service plans, called TRICARE Standard and 
Extra. These dependents voluntarily accept higher copayments and 
deductibles in return for the promise of freedom to choose their own 
doctor.
  Unfortunately, the promises in the enrollment brochure do not apply 
in all circumstances. Currently, a woman who chooses a civilian doctor 
through TRICARE Standard or Extra is forced to change doctors and 
return to the military treatment facility when she becomes pregnant. 
The only way for her to continue using her own doctor is to receive 
special permission from the commanding officer of that military 
treatment facility. The result is a bureaucratic nightmare.
  This situation is a concern for military dependents across the 
country. It represents a break in continuity of care that compromises 
the invaluable relationship between a woman and her doctor. A woman who 
has a trusted relationship with her civilian ob/gyn is required to 
change to a doctor at the military treatment facility due to an 
unnecessary regulation that can, and should, be fixed.
  Military families deserve better treatment. Many of them consistently 
pay higher premiums and accept higher out-of-pocket costs in exchange 
for an active role in controlling their health care decisions. It 
should not take a military order to allow a woman to stay with her 
regular doctor for prenatal, delivery and postnatal care. This is why 
Senator Landrieu and I are introducing legislation to cut through this 
burdensome red tape. The Military Spouse Physician Choice Act would 
eliminate the need for women to get special permission to receive the 
continuity of care they were promised.
  Over the past few years, Congress has made several positive changes 
to military health care services. We have given our military personnel 
the ability to choose the health care option that is right for each of 
their families. We have enabled our military treatment facilities to 
maintain a high level of excellence, making them the choice of most 
military dependents. It only follows that a pregnant spouse should be 
able to choose to utilize that treatment facility but not be mandated 
to do so.
  If we want to continue to recruit and retain quality people for our 
armed services, we need to show them that they and their families will 
be treated fairly when making health care decisions.
  I am very pleased that the Military Coalition, a consortium of 
nationally prominent uniformed services and veterans organizations 
representing more than 5.5 million members plus their families, has 
endorsed this legislation. The Retired Officers Association, TROA, has 
as well because the current policy denies TRICARE Standard 
beneficiaries one of the most important principles of quality health 
care, continuity of care by a provider of their choice.

[[Page S6864]]

  I urge all Members of the Senate to join me and Senator Landrieu in 
support of the Military Spouse Physician Choice Act.
  I ask consent that the text of the bill be printed in the Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                S. 1096

       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 Spouse Physician 
     Choice Act''.

     SEC. 2. ELIMINATION OF REQUIREMENT TO OBTAIN NONAVAILABILITY-
                   OF-HEALTH-CARE STATEMENT IN CASES OF PREGNANCY.

       (a) Elimination of Requirement.--Section 1080(b) of title 
     10, United States Code, is amended by striking the second 
     sentence.
       (b) Expansion of Nonavailability Statement Waiver 
     Authority.--Section 721 of the Floyd D. Spence National 
     Defense Authorization Act for Fiscal Year 2001 (as enacted by 
     Public Law 106-398; 114 Stat. 1654A-446) is amended--
       (1) in subsection (a), by inserting ``, or with respect to 
     obstetrics and gynecological care related to the pregnancy of 
     such a beneficiary who is enrolled in TRICARE Extra,'' after 
     ``TRICARE Standard''; and
       (2) in subsection (c)--
       (A) by redesignating paragraphs (1) through (3) as 
     subparagraphs (A) through (C), respectively;
       (B) by inserting ``(1)'' after ``(c) Exceptions.--''; and
       (C) by adding at the end the following new paragraph:
       ``(2) Paragraph (1) shall not apply in the case of 
     obstetrics and gynecological care related to the pregnancy of 
     a covered beneficiary.''.

  Ms. LANDRIEU. Mr. President, I rise today to introduce the Military 
Spouse Physician Choice Act of 2001 with my distinguished colleague, 
the junior Senator from Maine. This legislation amends the Civilian 
Health and Medical Program of the Uniformed Services, CHAMPUS, to 
restore equity to the families of our servicemembers. Simply put, this 
bill would delete the requirement for a servicemember's spouse to 
obtain a non-availability statement from the commanding officer of the 
nearest military treatment facility in order to receive maternity care 
from a civilian doctor.
  Under current legislation, military dependents choosing to enroll and 
pay for TRICARE Standard, the program in which enrollees accept higher 
co-payments in exchange for the option of choosing their own doctors, 
are still required to obtain a military non-availability statement 
before seeing their choice of civilian physician. This practice 
continues despite the fact they are already paying for just that 
option. Our bill eliminates the requirement for maternity patients 
enrolled in TRICARE Standard to get that non-availability statement 
before being seen by the civilian physician of their choice for all 
maternity care throughout the pregnancy.
  I am committed to the quality of life of the men and women in uniform 
who sacrifice to serve their Nation. All too often we forget that 
families and their treatment are key to the quality of life and 
retention of those servicemenbers. Our military and their families 
deserve better treatment than what they receive today. If they choose 
to accept the higher costs of TRICARE Standard in exchange for greater 
control over their healthcare choices, then they should have that 
control over all healthcare choices. Pregnancy should not force a 
spouse to get permission from the military to receive her prenatal, 
delivery, and postnatal care from the same doctor who she paid to see 
prior to the pregnancy. Anything less is fundamentally unfair and is 
something none of us would accept from any medical plan in the civilian 
community.
  This body has worked hard to improve military healthcare for our 
servicemembers, their families and retirees. With the creation of 
TRICARE, we gave them control over their medical treatment by allowing 
them to pay additional costs out of pocket in exchange for greater 
flexibility, the same choice anyone outside of the military has the 
opportunity to make. If we want to continue to recruit and retain the 
best and brightest people our Nation has, we owe them equitable 
treatment. Any other course is a disservice to them and disrespectful 
of the choices and financial commitments they have made to the military 
healthcare system. I urge my colleagues to support this bill and send a 
message to our military: You and your families will be treated fairly 
and with respect when making healthcare decisions. The Military 
Coalition representing more than 5.5 million servicemembers and their 
families supports this legislation. So does The Retired Officers' 
Association, TROA. Fellow members of the Senate, support of this bill 
should be common sense for all of us. This bill should pass unanimously 
because it does what is right, what is fair, and keeps faith with our 
military.
  I am proud to cosponsor this legislation with Senator Collins and 
urge all of you to join us in supporting the Military Spouse Physician 
Choice Act.
                                 ______