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Summary

The primary mission of the military health system, which includes the Defense Department's 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-forservice 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 63 hospitals and 413 clinics serving an eligible population of 9.2 million. It operates worldwide and employs some 44,100 civilians and 89,400 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 estimated $41.6 billion in FY2009 (the latter figure includes $10.4 billion paid to an accrual fund for Medicare eligible retirees). DOD projects total medical spending to grow, perhaps reaching $64 billion in FY2015. As of 2007, active duty military and their dependents made up 44% of Tricare beneficiaries. Thirty-six percent of beneficiaries were retirees under age 65 and their dependents, and 20% were 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 Duncan Hunter National Defense Authorization Act for Fiscal Year 2009 (P.L. 110-417, October 14, 2008), prohibited fee increases proposed in the Bush Administration's 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. Military health care issues are addressed in annual defense authorization and appropriations bills; for additional details and the status of current legislation, see CRS Report RL34473, Defense: FY2009 Authorization and Appropriations, by Pat Towell, Stephen Daggett, and Amy Belasco.

Related Legislation:
• S.2009

Related Reports:
• RL33537

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