FOR FEBRUARY 17, 2012
Happy Presidents’ Day from TREA
Well, speaking about Presidents, the Administration released its FY2013 proposed budget on Monday. As, expected (heck, as had been previously briefed) the Department of Defense is facing the bulk of the proposed cuts. Military retirees are facing proposed increases in their medical enrollment fees, deductibles and co-pays. We are somewhat surprised by the lack of an immediate reaction from the retiree community about these proposals. Perhaps it is because they are not as terrible as some of the rumors that have been flying around for months. But these are very serious proposals. They could have dramatic effects on your individual budgets. Please read the following article closely. Remembers these are merely proposals; nothing has been passed into law. THIS is the time to contact your members of Congress.
1) DoD Rolls Out Its Proposals for Changes In Retirees’ TRICARE Benefits
In 2012 there was an increase in the yearly enrollment fee for retirees and their families for TRICARE Prime that was passed into law. It is not a surprise that they are proposing further yearly increases in the enrollment fees. But it is slightly surprising that while creating these proposed fees they decided to set up 3 tiers based on a retiree’s retired pay. Below you can see a chart of the Administration’s proposal. As you can see the amount of the proposed fee goes up with the increase in retired pay. When they were talking about this idea a while back, DoD’s idea of tiers was going to be based on a retirees’ total yearly family income (which would have included subsequent jobs, spouses’ incomes, etc) so they clearly backed off that on that idea.
They have also exempted the medically retired and survivors of members of the military who died on active duty from these proposed increases.(That means the wounded warriors and the widows/widowers of those who died on active duty.) So this cuts out the people who the general public cares the most about. And, I am sure DoD believes that will make their proposals much easier to get through Congress.
Please note: When I asked the TMA representatives about survivors whose service member spouse died from service connected injuries, they said did not know. But we bet the answer will be (like last year’s go around) that they are not exempt.
From FY2016 the proposal is that the enrollment fees will go up by the National Medical Cost Index for the infinite future.
They are also proposing a yearly enrollment fee for retirees for TRICARE Standard and TRICARE Extra. At this time there is no yearly enrollment fee. DoD has tried to get this for years and years. If the proposal is adopted it would fundamentally change what the TRICARE Standard benefit is. It would make it just another insurance plan. One should remember that a retiree in TRICARE Standard is already paying 25% of the health care bill (a substantial amount.) Presently a retiree can start to use TRICARE Standard at any time in the year. If he is using a civilian insurance plan that does not cover something that TRICARE Standard does he can use it then. He (or she) always has it in his or her back pocket- so if they decide to leave a job or have an adventure they can use it. When I asked the TMA representative If there would be an open season; if a retiree would need to enroll during that season before using it the answer was again: we don’t know. They promised to get back to us and if we get an answer we will print it immediately. (but all of these gaps will probably be placed where they think they can negotiate.)
Proposed Yearly Enrollment Fee for TRICARE for Life (TFL)
The Administration is proposing that retirees on TFL should pay a yearly enrollment fee! The proposed fees listed below are per person. So a couple would need to multiply these numbers by 2 (just as they have to when paying the monthly Medicare Part B premium.) Again, there are proposed tiers and after FY2016 the increases are based on National Medical Cost Index. When asked what the basis of these numbers were TMA representatives said it was a percentage of the costs of a Medigap policy.
DoD emphasized that the tiers’ income levels will increase based on the COLA so no one will be moved up to a higher tier. But, again, from 2016 on they propose that the increases will be indexed to medical inflation rather than the COLA (remember last year’s fight) so the proposed increases will eat into the retired pay- since the medical index has been much higher than the COLA for the last 25 years.
The Administration’s FY2013 budget also has proposals to change the TRICARE Pharmacy plan and the catastrophic cap.
Proposed TRICARE Pharmacy Co-Pay Changes
The planned pharmacy co-pays are clearly to move beneficiaries to use mail order MTF Pharmacies (when possible) and generic drugs.
These proposals (if adopted as proposed) would apply to all beneficiaries except the active duty. There would still be no fees for the Active Duty’s prescriptions and MTFs would still have no co-pays for everyone.
Please notice that the proposal takes all Tier 3 Non- Formulary drugs (which are covered by TRICARE and should not, I think, be called non formulary) out of the retail stores. When questioned how people could get their first fill of a drug the doctor says they should start right away TMA said that that will be worked on. Also in 5 years all at once mail order generics go from a $0 co-pay to a $9 co-pay. This is the same as the retail generic co-pay. (With a 30 day prescription in retail and up to a 90 day prescription in home delivery.) After they bragged so much last year about having a $0 co-pay. We assume that they think after that length of time everyone will be switched over to home delivery.
Proposed Changes in the Catastrophic Cap
The DoD FY2013 proposed budget also includes changing the absolute limit that a beneficiary needs to pay out of his or her pocket in any single year for TRICARE no matter how much care is provided. They are proposing that the present $3,000 catastrophic cap will be indexed to medical inflation (the National Health Expenditure Index) and the enrollment fees will be excluded in the calculation (Presently enrollment fees are included in the calculation.)
More BRACs and a Military Retirement Commission
The budget also proposes creating 2 additional rounds of BRAC and a “Military Retirement Modernization Commission” that would propose to modernize (read civilianize and cut) the military retirement system and that it would be considered through a BRAC like system. (DoD would make a recommendation to the Commission, after considering that “and other inputs, the Commission would make a recommendation to the President; the President could request changes in the recommendation but not require them; the President chooses whether to send the recommendation to Congress; and Congress must vote up or down the recommendation without changes.)
Over the next five years more than 1 million active-duty personnel are scheduled to join America’s 22 million Veterans. To pay for the healthcare and benefits that they have earned, President Obama has proposed a $140.3 billion budget for the Department of Veterans Affairs for the fiscal year beginning Oct. 1. That is an increase of $13.4 billion dollars, or nearly 11%, over last year’s funding levels.
The President’s proposed budget seeks $52.7 billion for medical care, a 4.1 percent increase over the $50.6 billion approved by Congress for the current fiscal year, and a net increase of $165 million above the advance appropriations level already enacted for FY 2013.
What isn’t currently known is whether VA healthcare funding will be subject to across the board cuts known as sequestration (as called for in the Budget Control Act of 2011). House VA Committee Chairman Jeff Miller (R-FL) has said the Administration is leaving veterans “twisting in the wind” regarding their healthcare funding. Strangely, last year Chairman Miller, along with Senate VA Committee Chairwoman Patty Murray (D-WA) offered up VA funding as part of the sequestration process in order to lessen the impact of budget cuts on the Department of Defense. TREA will keep you informed about what happens.
For the next fiscal year, VA estimates 6.33 million patients will use VA for health care. About 610,000 of those patients will be Veterans of the conflicts in Iraq and Afghanistan. The budget request also would provide:
• $403 million for the gender-specific health care needs of women Veterans, improving their access to services and treatment facilities;
Funding in VA’s major construction account of $396.6 million is provided to continue construction of new medical facilities at Seattle, Dallas, St. Louis and Palo Alto, Calif.
Veterans Job Corps
The 2013 budget proposes $1 billion over five years for a Veterans Job Corps, a new effort to leverage skills Veterans developed in military service for a range of jobs protecting and rebuilding America’s public lands. The initiative would put up to 20,000 Veterans to work on projects to restore America’s lands and resources.
Disability Pay, Pensions
In the next fiscal year, VA projects it will receive about 1,250,000 claims for Veterans disability benefits. This is a 4 percent increase from the 1.2 million projected for this fiscal year.
Shinseki noted that today’s claims from Veterans who served in Iraq and Afghanistan, on average, total 8.5 disabilities per Veteran, a rate nearly double that for claims by Veterans of earlier eras and a substantial increase in the workload for VA employees who administer the benefits system.
By 2013, the budget projects no more than 40 percent of compensation and pension claims will be more than 125 days old, a significant cut from the 60 percent of claims exceeding that mark this year. Other improvements funded by the new budget include:
• A new case-management operating model that moves less complicated claims more quickly through the system;
The proposed VA budget for fiscal year 2013 contains nearly $1.4 billion for programs that prevent or treat homelessness among Veterans. This is an increase of 33 percent, or $333 million, over the 2012 level. The VA has a goal of ending Veteran homelessness by 2015.
In the past year, the number of Veterans homeless on a given night has declined from 76,300 in 2010 to about 67,500 in 2011. By emphasizing rescue and prevention, the budget request envisions driving down the numbers to 35,000 by the end of fiscal year 2013. Some specific efforts funded in the new budget are:
• $21 million to provide 200 coordinators who will help homeless Veterans with disability claims, housing problems, job and vocational opportunities, and problems with the courts;
The Post-9/11 GI Bill will help pay the educational expenses of more than 606,000 Servicemembers, Veterans, family members and survivors during the next fiscal year. Over the past two years, VA has successfully deployed a new IT system to support processing of Post-9/11 GI Bill education claims, and has seen a dramatic improvement in the timeliness and accuracy of its processing program during the same period.
A separate funding increase of nearly $9 million would expand the “VetSuccess on Campus” program from 28 campuses to 80, serving approximately 80,000 Veterans. The program provides outreach and supportive services during their transition from the military to college.
Vocational Rehabilitation and Employment
The budget request for 2013 would provide $233 million, a 14 percent increase over 2012, to administer VA’s vocational rehabilitation and employment program. The increase is focused on expanding services to wounded, ill and injured Servicemembers to ease their transition to the civilian sector. Program participants are expected to increase from 108,000 in 2011 to 130,000 next fiscal year.
Fiscal year 2013 will see $258 million for operation and maintenance of VA’s system of 131 national cemeteries if the budget proposal is accepted. The budget supports the initial implementation of a new policy to establish a national cemetery presence in eight rural areas.
Funding in VA’s Minor Construction budget request would finance $58 million for land acquisition, gravesite expansion and columbaria projects. Also included in the budget request is funding for online mapping of gravesite locations from the IT account.
With a funding request of $46 million, VA will continue its partnership with the states by funding the construction, expansion and improvement of state Veterans cemeteries, while continuing its support to Veterans cemeteries on tribal lands.
The 2013 budget proposal includes $3.3 billion for information technology, a $216 million increase over the current budget. VA operates one of the largest consolidated IT organizations in the world, supporting over 300,000 VA employees and about 10 million Veterans and family members who use VA programs. About 80 percent of the IT budget supports the direct delivery of health care and benefits to Veterans and their families.
IT funding will enable VBA’s transformation to a digital and near paperless environment using the Veterans Benefits Management System, decreasing claims processing times by 50 percent, while VA’s telehealth programs will take advantage of new IT technologies, increasing VA’s ability to provide health care to Veterans in remote locations.
TREA will keep you posted on any updates or criticisms of specific funding proposals as they become available.
Yesterday, February 16, the House of Representatives Guard-Reserve Caucus held its annual caucus breakfast. TREA was a sponsor of the event and President Art Cooper, Legislative Director Larry Madison and Deputy Legislative Director Mike Saunders represented TREA at the event.
The main speaker was David L. McGinnis who currently serves as the acting Assistant Secretary of Defense for Reserve Affairs. In addition, the service chiefs of all the Reserve Components spoke about the needs of their respective branches.
In his remarks, Secretary McGinnis stated that as of today there are 73,951 Guardsmen and Reservists on active duty representing all seven of the Reserve Components serving in various capacities around the world. He also pointed out that all members of the Reserve Components have either enlisted or re-enlisted since September 11, 2001, so they understand what is expected of them with regard to being mobilized and deployed. This is important, according to Mr. McGinnis, because the new strategic guidance issued by the President and the Secretary of Defense places an increased reliance on the Reserve Components.
One of the missions that directly supports the new strategic defense guidance is the National Guard State Partnership Program. Currently there are 63 countries partnered with State National Guards under this program, the purpose of which is to promote national objectives, stability, partner capacity, trust and understanding that will be useful to those countries in the future. “Many of these partnerships have resulted in collaborative working relationships through police and military operational mentoring and liaison teams with our new NATO partners who are part of the effort in Afghanistan,” McGinnis stated.
All of the service chiefs emphasized that trained and ready-to-deploy personnel are the key to a force that is ready and quipped to go whenever and wherever they are called.
Below please find a Press Release from the VA outlining its latest improvement in its Suicide Prevention Line:
Veterans Crisis Line Provides Confidential Help to Veterans and Families
WASHINGTON (Feb. 15, 2012) – The Department of Veterans Affairs is expanding its efforts to prevent suicide through several new initiatives that increase the availability of services for Veterans, Servicemembers and their families.
The new initiatives include a new, free, confidential text-messaging service in the existing Veterans Crisis Line, introduction of toll-free access from Europe, and collaboration with Vets Prevail and Vets4Warriors, two groups providing crisis help to Veterans, Servicemembers and their families.
“Offering text messaging services will help VA reach more Veterans and their friends and families,” said Dr. Janet Kemp, VA’s national mental health director for suicide prevention. “We are working to meet their needs by communicating through multiple channels -- over the phone, through online chat, and now via text, which provides quick, easy access to support. VA wants all Veterans to know that confidential support is only a text message away.”
Since its founding July 2007, VA’s Veterans Crisis Line and the later Chat Service have received 500,000 calls and engaged in 31,000 chats resulting in over 18,000 rescues of Veterans in immediate crisis.
Now, in addition to the Veterans Crisis Line (1-800-273-8255 and Press 1) and online chat (www.VeteransCrisisLine.net), Veterans and Servicemembers in crisis—and their friends and families—may text free of charge to 83-8255 to receive confidential, personal and immediate support. The text service is available, like the Veterans Crisis Line and online chat, 24 hours a day, seven days a week, 365 days a year and connects a user with a specially trained VA professional -- many who are Veterans themselves.
VA’s Veterans Crisis Line continues to add external resources to provide Veterans with additional support. Two of these organizations include Vets Prevail (www.VetsPrevail.org) and Vets4Warriors (www.Vets4Warriors.com).
In December, Vets Prevail launched a chat service that connects Veterans to caring responders who provide information on a wide variety of resources. If the Veteran is in crisis or needs mental health support, the conversation is then seamlessly transferred to a VA Veterans Crisis Line responder.
Vets4Warriors has helped thousands of their peers connect with confidential assistance through a free hotline (1-855-838-8255/1-855-VET-TALK) and online chat (www.Vets4Warriors.com). If a Veteran is in need of professional crisis or mental health support, Vets4Warriors’ responders will transfer the Veteran to a responder at the Veterans Crisis Line.
For more information about VA’s suicide prevention program, visit: http://www.mentalhealth.va.gov/suicide_prevention/
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