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CBO eyes military retirees, vets for health cost cuts
Stars and Stripes ^ | 2 Jan 09 | Tom Philpott

Posted on 01/02/2009 9:06:58 PM PST by GATOR NAVY

A new report from the Congressional Budget Office shows why some military retirees and veterans could face higher out-of-pocket costs if the Obama administration and Congress take bold moves to reform the U.S. health system and to make federal health programs more efficient.

Among 115 “options” presented, though not endorsed, in the CBO report, several focus on raising Tricare out-of-pocket costs for retirees and one targets families. Others would tighten access to VA hospitals and clinics, or raise VA health fees, for veterans with no service-connected conditions.

Working-age military retirees will find here some of those familiar cost-saving ideas endorsed by the Bush administration to raise Tricare fees, co-payments and deductibles for retirees under 62 and their spouses.

But other options are new and, if enacted into law, would raise health costs for Medicare-eligible military retirees and for active duty families. One option suggests having the VA health system disenroll millions of users who have no service-related injuries or ailments.

Every two years, the CBO presents daring options for Congress and the executive branch to weigh in trying to control federal spending. The new report, “Budget Options, Volume 1: Health Care,” is unusual in that it focuses entirely health care, an Obama policy priority, and its arrival is unscheduled.

It’s also significant that the CBO director who led this work was Peter R. Orszag, President-elect Obama’s nominee to be his director of the Office of Management and Budget. OMB is responsible for assembling the president’s annual budget request to Congress. How bold will his economic team be?

“We are going to go through our federal budget, as I promised during the campaign, page by page, line by line, eliminating those programs we don’t need and insisting that those that we do need operate in a sensible, cost-effective way,” Obama said in November as he announced Orszag’s nomination to join his cabinet .

“We’re also going to focus on one of the biggest, long-run challenges that our budget faces, namely the rising cost of health care in both the public and private sectors,” Obama continued. “This is not just a challenge but also an opportunity to improve the health care that Americans rely on, and to bring down the costs that taxpayers, businesses and families have to pay. That is what [OMB] will do in my administration.”

Obama added, “Peter doesn’t need a map to tell him where the bodies are buried in the federal budget. He knows what works and what doesn’t, what’s worth our precious tax dollars and what is not.”

Indeed, in the CBO report’s preface, Orszag gets “special thanks” for having “conceived” the report and being “instrumental in its development.”

Many of its options deal with adjustments to Medicare, Medicaid, private health insurance rules and the Federal Employees Health Benefit Plan for federal civilians. Most ideas are aimed at cutting costs but some would enhance benefits. The 226-page report can be read on line at: www.cbo.gov/ftpdocs/99xx/doc9925/12-18-HealthOptions.pdf

Here are some options that would touch military people and veterans: Tricare for working-age retirees

Fees, co-payments and deductibles would be raised for retirees under 62 to restore the relative costs paid when Tricare began in 1995. Tricare Prime enrollment would be raised to $550 a year for individuals from $230. Retiree families would pay $1,100 versus $460 today. Co-pays for doctor visits would climb to $28 from $12 and users of Tricare Standard and Extra would pay an annual deductible of $350 for an individual and $700 for families. Congress has declined to support such increases for the past three years. Fees for active duty families

Dependents of active duty members enrolled in Tricare Prime, the managed care network, would pay new fees equal to 10 percent of the cost of health services obtained either in military treatment facilities or through civilian network providers. Total out of pocket costs would be capped, however.

To help offset these costs, dependents would receive a $500 non-taxable allowance annually. Those who elect to use alternative health insurance, rather than Tricare, could apply the $500 toward their health insurance premiums, co-payments or deductibles.

CBO estimates these fees would save $7 billion over 10 years and encourage Prime enrollees to “use medical services prudently.” It also would entice more spouses to enroll in employer-provided health plans instead of Tricare. The downside, CBO said, would be financial difficulties for some Prime enrollees despite the cap on out-of-pocket costs. Also, CBO said, spouses induced to rely on employer health plans could see health coverage interrupted during military assignment relocations. Tricare-For-Life fees

The military’s health insurance supplement to Medicare could see higher user costs. Under this option, beneficiaries would pay the first $525 of yearly medical costs plus one half of the next $4,725 of costs charged to Medicare. So the extra out-of-pocket cost for TFL users would be up to $2,887.50 a year. This amount would be indexed to rise with Medicare costs. The change would save $40 billion over 10 years. But CBO said it also could discourage some patients from seeking preventive care or proper management of chronic conditions. So it could negatively affect some patients’ health. Tighten VA enrollment

The VA healthcare system would be directed to disenroll 2.3 million Priority Groups 7 and 8 – individuals who are not poor and have no service-related medical needs. Estimated savings would be $53 billion over 10 years but Medicare spending would rise by $26 billion in the same period as elderly among these vets shifted to Medicare.

CBO said 90 percent of these vets have other health care coverage. But this change could leave up to 10 percent unable to find affordable care.


TOPICS: VetsCoR
KEYWORDS: tricare; va; veterns
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Ouch.
1 posted on 01/02/2009 9:07:00 PM PST by GATOR NAVY
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To: GATOR NAVY
Why don't the pols try cutting their own - and not take their almost $5,000 pay raise this year.

And cut the exorbitant retirement they get.

They have the best percs of anyone in the land. Certainly not “representative’ of us Plebeians out here.

2 posted on 01/02/2009 9:19:17 PM PST by maine-iac7 ("He has the right to criticize who has the heart to help" Lincoln)
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To: maine-iac7

If they were only illegals....


3 posted on 01/02/2009 9:24:42 PM PST by notaliberal
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To: GATOR NAVY
Those B@astards,bleed the military and give free healthcare to D@amn illegals so they can keep fraudulently voting them back in office. I'm so digusted with ALL politicians, I hope they rot in HELL!!!!!!!!!
4 posted on 01/02/2009 9:29:56 PM PST by lula ( Islam IS the Anti-Christ)
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To: GATOR NAVY

What kind of deduction and co pay does congress pay?


5 posted on 01/02/2009 9:58:33 PM PST by CindyDawg (I)
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To: maine-iac7

BUMP!

I am really trying not to type a stream of expletives, but I am muttering them.


6 posted on 01/02/2009 10:06:16 PM PST by Army Air Corps (Four fried chickens and a coke)
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To: lula

We need to get a campaign going on this. What about it.


7 posted on 01/02/2009 10:06:22 PM PST by notaliberal
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To: notaliberal

Ok notaliberal, emailed:
Sean
Rush
Mike G
Mark L

Thanks notaliberal

Crooks in Washington next


8 posted on 01/02/2009 10:31:54 PM PST by notaliberal
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To: GATOR NAVY
To qualify for the VA you can make no more than 30k. Then they have a co-payment of $50.
I use them for tricare just for my eyes. Here is the joke: In Sacramento UCDMC the teaching hospital staffs the VA. The best Dr,s work both places. It doesn,t matter where I go just the gas useage.
9 posted on 01/03/2009 12:25:27 AM PST by Domangart (editor and publisher)
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To: notaliberal

While the Federal Medical Prison Rochester Mn, takes criminals and terrorist(think 9-11 blind cleric) to the Mayo Clinic


10 posted on 01/03/2009 1:32:26 AM PST by Son House (Mr. Øbama, Your Tax Increases Are Decreasing Job Opportunities)
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To: maine-iac7

They need to fight back and demand the same level of treatment/care as the pols receive that Bama promised!


11 posted on 01/03/2009 1:40:39 AM PST by Always Independent
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To: All

BOHICA

Bend Over.. Here it comes again


12 posted on 01/04/2009 9:09:17 PM PST by Kitanis
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To: GATOR NAVY; Army Air Corps; notaliberal; Domangart; Son House; Titan Magroyne
From a related article on Military.com: Vets Eyed For Health Cost Cuts
by Tom Philpott
... other options are new and, if enacted into law, would raise health costs for Medicare-eligible military retirees and for active duty families. One option suggests having the VA health system disenroll millions of current users who have no service-related injuries or ailments.

Tighten VA Enrollment – The VA healthcare system would be directed to disenroll 2.3 million Priority Groups 7 and 8 -- individuals who are not poor and have no service-related medical needs. Estimated savings would be $53 billion over 10 years but Medicare spending would rise by $26 billion in the same period as elderly among these vets shifted to Medicare.


CBO said 90 percent of these vets have other health care coverage. But this change could leave up to 10 percent unable to find affordable care.

It's also significant that the CBO director who led this work was Peter R. Orszag, President-elect Obama's nominee to be his director of the Office of Management and Budget. OMB is responsible for assembling the president's annual budget request to Congress. How bold will his economic team be?

"We are going to go through our federal budget, as I promised during the campaign, page by page, line by line, eliminating those programs we don't need and insisting that those that we do need operate in a sensible, cost-effective way," Obama said in November as he announced Orszag's nomination to join his cabinet .

"We're also going to focus on one of the biggest, long-run challenges that our budget faces, namely the rising cost of health care in both the public and private sectors," Obama continued. "This is not just a challenge but also an opportunity to improve the health care that Americans rely on, and to bring down the costs that taxpayers, businesses and families have to pay. That is what [OMB] will do in my administration."

Obama added, "Peter doesn't need a map to tell him where the bodies are buried in the federal budget. He knows what works and what doesn't, what's worth our precious tax dollars and what is not."

Indeed, in the CBO report's preface, Orszag gets "special thanks" for having "conceived" the report and being "instrumental in its development."


We Are So Screwed!
To comment, e-mail milupdate@aol.com, write to Military Update, P.O. Box 231111, Centreville, VA, 20120-1111 or visit: militaryupdate.com.


13 posted on 01/07/2009 3:17:22 PM PST by Drumbo ("Democracy can withstand anything but democrats." - Jubal Harshaw (Robert A. Heinlein))
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To: Drumbo
I wonder how many of these vets voted for Obama? My husband certainly did not and he is one who will be affected by this. The VA delivers decent care at an affordable price and if these patients are not yet eligible for Medicare, but have private health insurance the VA bills their insurance to help recover some of the costs of their program.

Elections have consequences, as we kept saying all last year.

14 posted on 01/07/2009 3:21:44 PM PST by Arizona Carolyn
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To: lula

Next, they’ll probably try to go after military retirement pay


15 posted on 01/07/2009 3:23:39 PM PST by SIDENET ("It was a different time, you understand." - Wallace "Suitcase" Jefferson)
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To: Arizona Carolyn
two sides of the same publicity-seeking coin

Metaphor Alert!


16 posted on 01/07/2009 3:24:31 PM PST by Revolting cat! (Don't rush to be savage!.)
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To: Arizona Carolyn

Why did #16 end up on this thread? Search me!


17 posted on 01/07/2009 3:25:50 PM PST by Revolting cat! (Don't rush to be savage!.)
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To: Revolting cat!

LOL.


18 posted on 01/07/2009 3:28:52 PM PST by SIDENET ("It was a different time, you understand." - Wallace "Suitcase" Jefferson)
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To: Revolting cat!

~LOL~ had me scratching my head.


19 posted on 01/07/2009 3:34:40 PM PST by Arizona Carolyn
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To: GATOR NAVY; Lil'freeper

One way or another Obama will screw us all.


20 posted on 01/07/2009 3:38:48 PM PST by big'ol_freeper (Gen. George S. Patton to Michael Moore... American Carol: "I really like slapping you.")
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