Military Health Care Fairness Act

Summary: Military Health Care Fairness Act - Amends the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) to allow certain eligible covered beneficiaries to enroll in any health benefits plan under the Federal Employee Health Benefits Program (FEHB) offering medical care comparable to that offered under CHAMPUS. Includes as an eligible beneficiary a military retiree (with an exception) or dependent who:  (1) is not guaranteed access under TRICARE (a Department of Defense (DOD) managed care program) to health care comparable to health care provided under the FEHB; (2) is eligible to enroll in the TRICARE Program but is not so enrolled because of location, total enrollment limitations, or any other reason; or (3) is entitled to hospital insurance benefits under part A of title XVIII (Medicare) of the Social Security Act.  Limits eligible beneficiaries during the first two years of enrollment to military retirees who are:  (1) 65 years of age or older; or (2) retired or separated due to physical disability. 
States that any eligible beneficiary shall not be required to satisfy any FEHB eligibility criteria as a condition for enrollment. Provides for:  (1) an enrollment period and a three-year minimum enrollment term; (2) authorized treatment in a military medical treatment facility; (3) enrollment contributions; (4) participation management by the Director of the Office of Personnel Management (OPM); and (5) annual reports from the Secretary of Defense and the OPM Director concerning the provision of such care.  Directs the Secretary, within four years after the date of enactment of the National Defense Authorization Act for Fiscal Year 1999, to report to the Congress on whether such health care option should be made permanent and on the estimated costs of such option. 
Directs the Secretary to:  (1) begin to offer such option no later than six months after enactment of this Act; and (2) continue to offer such option through 2003, and to provide care to eligible beneficiaries through 2005. 
Provides program funding for FY 1999 through 2005 from amounts authorized for appropriation to DOD for military personnel.

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Military Health Care Fairness Act''.

SEC. 2. INCLUSION OF CERTAIN COVERED BENEFICIARIES IN FEDERAL EMPLOYEES 
              HEALTH BENEFITS PROGRAM.

    (a) FEHBP Option.--(1) Chapter 55 of title 10, United States Code, 
is amended by inserting after section 1079a the following new section:
``Sec. 1079b. Health care coverage through Federal Employees Health 
              Benefits program
    ``(a) FEHBP Option.--(1) Subject to the availability of funds to 
carry out this section for a fiscal year, eligible beneficiaries 
described in subsection (b) shall be afforded an opportunity to enroll 
in any health benefits plan under the Federal Employee Health Benefits 
program under chapter 89 of title 5, United States Code, offering 
medical care comparable to the care authorized by section 1077 of this 
title to be provided under section 1076 of this title (in this section 
referred to as an `FEHBP plan').
    ``(2) The Secretary of Defense and the other administering 
Secretaries shall jointly enter into an agreement with the Director of 
the Office of Personnel Management to carry out paragraph (1).
    ``(b) Eligible Beneficiaries.--(1) An eligible beneficiary referred 
to in subsection (a) is a covered beneficiary who is a military retiree 
(except a military retiree retired under chapter 1223 of this title), a 
dependent of such a retiree described in section 1072(2)(B) or (C), or 
a dependent described in section 1072(2)(A), (D), or (I) of such a 
retiree who enrolls in an FEHBP plan, who,--
            ``(A) is not guaranteed access under TRICARE to health care 
        that is comparable to the health care benefits provided under 
        the service benefit plan offered under the Federal Employee 
        Health Benefits program;
            ``(B) is eligible to enroll in the TRICARE program but is 
        not enrolled because of the location of the beneficiary, a 
        limitation on the total enrollment, or any other reason; or
            ``(C) is entitled to hospital insurance benefits under part 
        A of title XVIII of the Social Security Act (42 U.S.C. 1395c et 
        seq.).
    ``(2) In addition to the eligibility requirements described in 
paragraph (1), during the first two years that covered beneficiaries 
are offered the opportunity to enroll in an FEHBP plan under subsection 
(a), eligible beneficiaries shall be limited to--
            ``(A) except as provided in subparagraph (B), military 
        retirees 65 years of age or older; and
            ``(B) military retirees retired under chapter 61 of this 
        title.
    ``(3) An eligible beneficiary shall not be required to satisfy any 
eligibility criteria specified in chapter 89 of title 5 as a condition 
for enrollment in an FEHBP plan.
    ``(c) Priorities; List.--(1) Eligible beneficiaries shall be 
permitted to enroll in an FEHBP plan based on the order in which such 
beneficiaries apply to enroll in the plan.
    ``(2) The Secretary shall maintain a list of eligible beneficiaries 
who apply to enroll in an FEHBP plan, but whom the Secretary is not 
able to enroll because of the lack of available funds to carry out this 
section.
    ``(d) Period of Enrollment.--The Secretary shall provide a period 
of enrollment for eligible beneficiaries in an FEHBP plan for a period 
of 90 days--
            ``(A) before implementation of the program described in 
        subsection (a); and
            ``(B) each subsequent year thereafter.
    ``(e) Term of Enrollment.--(1) The minimum period of enrollment in 
an FEHBP plan shall be three years.
    ``(2) A beneficiary who elects to enroll in an FEHBP plan, and who 
subsequently discontinues enrollment in the plan before the end of the 
period described in paragraph (1), shall not be eligible to reenroll in 
the plan.
    ``(f) Receipt of Care in MTF.--(1) An eligible beneficiary enrolled 
in an FEHBP plan may receive care at a military medical treatment 
facility subject to the availability of space in such facility, except 
that the plan shall reimburse the facility for the cost of such 
treatment. The plan may adjust beneficiary copayments so that receipt 
of such care at a military medical treatment facility results in no 
additional costs to the plan, as compared with the costs that would 
have been incurred if care had been received from a provider in the 
plan.
    ``(g) Contributions.--(1) Contributions shall be made for an 
enrollment of an eligible beneficiary in a plan of the Federal Employee 
Health Benefits program under this section as if the beneficiary were 
an employee of the Federal Government.
    ``(2) The administering Secretary concerned shall be responsible 
for the Government contributions that the Director of the Office of 
Personnel Management determines would be payable by the Secretary under 
section 8906 of title 5 for an enrolled eligible beneficiary if the 
beneficiary were an employee of the Secretary.
    ``(3) Each eligible beneficiary enrolled in an FEHBP plan shall be 
required to contribute the amount that would be withheld from the pay 
of a similarly situated Federal employee who is enrolled in the same 
health benefits plan under chapter 89 of title 5.
    ``(h) Management of Participation.--The Director of the Office of 
Personnel Management shall manage the participation of an eligible 
beneficiary in a health benefits plan of the Federal Employee Health 
Benefits program pursuant to an enrollment under this section. The 
Director shall maintain separate risk pools for participating eligible 
beneficiaries until such time as the Director determines that inclusion 
of participating eligible beneficiaries under chapter 89 of title 5 
will not adversely affect Federal employees and annuitants enrolled in 
health benefits plans under such chapter.
    ``(i) Reporting Requirements.--(1) Not later than November 1 of 
each year, the Secretary of Defense and the Director of the Office of 
Personnel Management shall jointly submit to Congress a report 
describing the provision of health care services to enrollees under 
this section during the preceding fiscal year. The report shall address 
or contain the following:
            ``(A) The number of eligible beneficiaries who are 
        participating in health benefits plans of the Federal Employee 
        Health Benefits program pursuant to an enrollment under this 
        section, both in terms of total number and as a percentage of 
        all covered beneficiaries who are receiving health care through 
        the health care system of the uniformed services.
            ``(B) The extent to which eligible beneficiaries use the 
        health care services available to the beneficiaries under 
        health benefits plans pursuant to enrollments under this 
        section.
            ``(C) The cost to enrollees for health care under such 
        health benefits plans.
            ``(D) The cost to the Department of Defense, the Department 
        of Transportation, the Department of Health and Human Services, 
        and any other departments and agencies of the Federal 
        Government of providing care to eligible beneficiaries pursuant 
        to enrollments in such health benefits plans under this 
        section.
            ``(E) A comparison of the costs determined under paragraphs 
        (C) and (D) and the costs that would otherwise have been 
        incurred by the United States and enrollees under alternative 
        health care options available to the administering Secretaries.
            ``(F) The effects of the exercise of authority under this 
        section on the cost, access, and utilization rates of other 
        health care options under the health care system of the 
        uniformed services.
    ``(2) Not later than the date that is four years after the date of 
enactment of the National Defense Authorization Act for fiscal year 
1999, the Secretary of Defense shall submit to Congress a report 
describing--
            ``(A) whether the Secretary recommends that a health care 
        option for retired covered beneficiaries equivalent to the 
        option described in subsection (a) be permanently offered to 
        such beneficiaries; and
            ``(B) the estimated costs of offering such an option.''.
    (2) The table of sections at the beginning of such chapter is 
amended by inserting after the item relating to section 1079a the 
following:

``1079b. Health care coverage through Federal Employees Health Benefits 
                            program.''.
    (b) Conforming Amendments.--(1) Section 8905 of title 5, United 
States Code, is amended--
            (A) by redesignating subsections (d), (e), and (f) as 
        subsections (e), (f), and (g), respectively; and
            (B) by inserting after subsection (c) the following new 
        subsection (d):
    ``(d) An individual whom the Secretary of Defense determines is an 
eligible beneficiary under subsection (b) of section 1079b of title 10 
may enroll in a health benefits plan under this chapter in accordance 
with the agreement entered into under subsection (a) of such section 
between the Secretary and the Office and with applicable regulations 
under this chapter.''.
    (2) Section 8906 of title 5, United States Code, is amended--
            (A) in subsection (b)--
                    (i) in paragraph (1), by striking ``paragraphs (2) 
                and (3)'' and inserting in lieu thereof ``paragraphs 
                (2), (3), and (4)''; and
                    (ii) by adding at the end the following new 
                paragraph:
    ``(4) In the case of individuals who enroll in a health plan under 
section 8905(d) of this title, the Government contribution shall be 
determined under section 1079b(g) of title 10.''; and
            (B) in subsection (g)--
                    (i) in paragraph (1), by striking ``paragraph (2)'' 
                and inserting in lieu thereof ``paragraphs (2) and 
                (3)''; and
                    (ii) by adding at the end the following new 
                paragraph:
    ``(3) The Government contribution described in subsection (b)(4) 
for beneficiaries who enroll under section 8905(d) of this title shall 
be paid as provided in section 1079b(g) of title 10.''.
    (c) Implementation.--The Secretary of Defense--
            (1) shall begin to offer the health benefits option under 
        section 1079b(a) of title 10, United States Code (as added by 
        subsection (a)) not later than the date that is 6 months after 
        the date of the enactment of this Act; and
            (2) shall continue to offer such option through the year 
        2003, and to provide care to eligible covered beneficiaries 
        under such section through the year 2005.
    (d) Authorization of Appropriations.--Out of funds authorized to be 
appropriated for the Department of Defense for military personnel, 
there shall be available to offer the health benefits option under 
section 1079b(a) of title 10, United States Code (as added by 
subsection (a)), the following:
            (1) $100 million for fiscal year 1999.
            (2) $200 million for fiscal year 2000.
            (3) $300 million for fiscal year 2001.
            (4) $400 million for fiscal year 2002.
            (5) $500 million for fiscal year 2003.
            (6) such sums as necessary for fiscal year 2004.
            (7) such sums as necessary for fiscal year 2005.