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Summary

The primary mission of the military health system, which includes the Defense Departments hospitals, clinics, and medical personnel, is to maintain the health of military personnel so they can carry out their military missions, and to be prepared to deliver health care during wartime. The military health system also provides health care services through either Department of Defense (DOD) medical facilities, known as military treatment facilities or MTFs as space is available, or, through private health care providers. Known as Tricare, this system of military and private health care offers benefits to active duty personnel and other beneficiaries, including dependents of active duty personnel, military retirees, and dependents of retirees. Tricare beneficiaries can obtain prescription drugs through a pharmacy system that includes MTF pharmacies, network retail pharmacies, non-network retail pharmacies, and the Tricare Mail Order Program (TMOP). Dependents of active duty personnel and retirees and dependents under age 65 can choose to enroll in Tricare Prime (a managed care option), or if they choose not to enroll, they can obtain care through Tricare Standard (a fee-for-service option) or Tricare Extra (preferred-provider option). Retirees who are eligible for Medicare can enroll in Tricare For Life (TFL). The military health system currently includes some 59 inpatient medical facilities and 661 medical and dental clinics serving an eligible population of 9.3 million. It operates worldwide and employs over 51,000 civilian and 131,700 military personnel. Calculating the total cost of military medical spending is complicated by the different categories of funds involved; DOD statistics on total medical spending indicate a growth from $17.5 billion in FY2000 to an enacted level of estimated $43.8 billion in FY2009 (the latter figure includes $10.4 billion paid to an accrual fund for Medicare eligible retirees). The FY2010 Budget requested $47.4 billion total for the unified medical budget of the military health system. DOD projects total medical spending to grow, perhaps reaching $64 billion in FY2015. DOD estimates that active duty military and their dependents will make up 43% of Tricare beneficiaries in 2010. Thirty-five percent of beneficiaries will be retirees under age 65 and their dependents, and 22% will be retirees age 65 and over and their dependents. DOD estimates that care provided to retirees and their dependents will make up over 65% of DOD health care costs by 2015, up from 43% in 1999. The Obama Administration has not proposed increasing Tricare user fees for 2010. Previously, the Duncan Hunter National Defense Authorization Act for Fiscal Year 2009 (P.L. 110-417, October 14, 2008), prohibited fee increases proposed in the Bush Administrations 2009 budget to help address increased defense health care costs. However, this act included measures intended to contain costs through increased use of preventive care services by Tricare beneficiaries. These provisions include waiving copayments for preventive services, and demonstration projects to provide incentives for preventive health care. This report will be updated as new information becomes available.

Related Legislation:
• S.2009

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