ROA's testimony to veterans affairs committee

During the last week of September, the House Committee on Veterans Affairs invited ROA National President MG Robert Smith to present ROA's testimony on the status of seamless transition between the Department of Defense (DoD) and the Department of Veteran Affairs. Highlights of this testimony follow. General Smith noted that traditionally, only veteran service organizations (VSOs) testify before this committee. Consequently, other veterans could be overlooked without ROA's testimony:

"The seamless transition in health care involves Military Treatment Facilities (MTFs) and Veterans Health Administration (VHA) hospitals, but also involves the TRICARE System. With every discharged veteran being offered two years of medical coverage by VHA, if TRICARE coverage fails to support returning Guardsmen and Reservists, they will turn to the VHA hospitals for health care....

"The Community Based Health Care Organization (CBHCO) program was created to assist National Guard and Army Reserve servicemembers injured in the line of duty to return to their homes where they will continue to receive care locally, and remain attached to a unit, while they are evaluated for return to duty, medical release or medical board. This program integrates the Medical Evaluation and Physical Evaluation Board process into the CBHCO." (See "To Their Health, page 51.)

The FY05 National Defense Authorization Act (NDAA) made a number of health coverage permanent improvements for Reserve Component (RC) members to TRICARE. The problem is the Uniformed Services Employment and Reemployment Act (USERRA) and the Servicemembers' Civil Relief Act (SCRA) have not been updated to match these health-care enhancements.

"Initial TRICARE health coverage [is a benefit for] up to 90 days prior to activation for servicemembers who receive a 'delayed-effective-date' order for contingency operations.... If RC members have their orders cancelled after enrolling in the initial TRICARE coverage, and they also have cancelled their employer's health insurance, they are at risk" as they no longer have USERRA protection.

"Currently DoD Health Affairs is recommending that the RC member maintain dual insurance coverage, which increases premium costs to the servicemember and complicates claim reimbursement as TRICARE becomes a secondary payer. A better solution is to change USERRA to include needed protections.

"Transitional Assistance Management Program (TAMP) provides 180 days' health-care coverage as a transition to civilian life....

"TRICARE Reserve Select (TRS) is a health plan offered to [demobilizing] RC members ... [who] have served continuously on active duty for 90 days or more.... A one-year mobilization could qualify an RC member for four years of health care.

"Servicemembers' Civil Relief Act provides for the reinstatement of any individual health insurance upon termination or release from service.... The reinstatement of the health insurance is not subject to exclusions or a waiting period if the medical condition in question arose before or during the period of service, but the servicemember must apply for the reinstatement of the health insurance within 120 days after termination or release from military service.

"The Uniformed Services Employment and Reemployment Rights Act (USERRA) assures immediate reinstatement of health care by the employer only at the time when the RC member returns to employment. If the RC member continues on TAMP health care, or chooses to use the TRICARE Reserve Select coverage, the employer could decline reinstatement of health care to the Reservist when the government plan expires, requiring him or her to wait until the next open registration period, which could be months in the future....

"If a member utilizes transitional health care over 120 days for an individual health insurance, or declines the employer's plan on the day of re-employment to continue on TRS, the demobilized servicemember may loose his or her USERRA or SCRA protection for a continuation of health-care coverage. Should a waiting period exceed 63 days, pre-existing conditions of the member or family may not be covered.

"Changes to USERRA and SCRA need to be made. If TRICARE benefits aren't protected under USERRA and SCRA, members may only provide health-care plans for family members, and turn to the Veterans Health Administration for their personal health-care coverage. At a time when the VHA system is taxed by high demand, and health-care costs are increasing, TRICARE benefits as well as military and VA medical coverage should be optimized."

CAPT Marshall Hanson, USNR (Ret.)

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