Retired Veterans Losing Premium Healthcare Coverage

As the Affordable Care Act or the ACA begins its major implementation, many Americans are still unsure about how the plan affects their current healthcare coverage. In some states, those ineligible for federal subsidies are finding that their insurance costs are going up, if not the premiums directly but in the form of higher deductibles. However, much of the media attention is focused not so much on the plan itself, but the political dogfight that surrounds it.

Which is why partisan blowhard Ed Schultz—a liberal commentator who has adopted the aggressive styles of his conservative radio/television counterparts—yelled at a retired veteran who called into his show that is losing his healthcare, which the caller believes is because of the ACA.  Identified only as Russell, the caller said that he was among the 171,000 military retirees who are losing their healthcare coverage under the federally-run program TRICARE Prime.

However because the call then devolved into a shouting-match, an opportunity was missed to clear up what is a confusing issue. TRICARE is the government health insurance for military members, civilian workers, and their families. TRICARE Prime is a premium plan that offers very comprehensive coverage, more so than other TRICARE plans. On the TRICARE website, it clearly states that TRICARE Prime meets the coverage standards for the ACA, so why would 171,000 people be losing their access to that coverage?

In fact, these retirees are losing their coverage not because of the ACA but because of cost-saving measures put in place by the Department of Defense as early as 2007. These changes, in order to reduce the cost of healthcare for retirees, limit those who are eligible for Prime coverage to those more than 40 miles from a military treatment site or a base that was recently closed by the BRAC.

The rationale is that the government is sending funds to non-military hospitals for those who live too far from a base and use TRICARE Prime, and those are costs that could be cut. Still, legislation passed the House of Representatives that would allow these retirees to keep TRICARE Prime as part of the National Defense Authorization Act for FY2014, but the Senate has yet to vote on it.

Dr. Jonathan Woodson, the Assistant Secretary For Health Affairs at the Pentagon, sent a letter to these veterans to assure they that were not losing their insurance, just merely changing plans. Those who are no longer eligible for TRICARE Prime are able to enroll in TRICARE Standard which is cheaper, but less comprehensive. He also pointed out that some veterans may be eligible to re-enroll in Prime, but it would require waivers acknowledging the increased travel times needed to get both specialty and primary care.

So, Russell—if he lives more than 40 miles from a military hospital—was right, he is going to lose his healthcare coverage. However, he was wrong that the change in his healthcare plan had anything to do with the new healthcare act. For the rest of the 5 million people enrolled in TRICARE, their plans will not change and they meet all the requirements of the ACA as long as they are enrolled in the program. 


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