Health Care Commitment Act

Summary: Health Care Commitment Act - Amends Federal provisions concerning the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) to direct the Secretary of Defense to enter into an agreement with the Office of Personnel Management (OPM) under which a covered CHAMPUS beneficiary who is also entitled to hospital insurance benefits under Part A of title XVIII (Medicare) of the Social Security Act will be permitted to enroll in a health benefits plan offered through the Federal Employees Health Benefits program in addition to receiving care through a military treatment facility, CHAMPUS, or the TRICARE program.  Outlines provisions concerning:  (1) required contributions for such coverage; and (2) the management of participants in the plan.  Requires the administering Secretaries and the OPM Director to report annually to the Congress describing the provision of health care services to covered beneficiaries under the plan during the preceding fiscal year.  Requires the Secretary of Defense to begin to offer the health benefits option described under this Act no later than January 1, 1998.

SECTION 1. SHORT TITLE.

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

SEC. 2. INCLUSION OF MEDICARE-ELIGIBLE COVERED BENEFICIARIES IN FEDERAL 
              EMPLOYEES HEALTH BENEFITS PROGRAM.

    (a) FEHBP Option.--(1) Chapter 55 of title 10, United States Code, 
is amended by adding at the end the following new section:
``Sec. 1107. Health care coverage through Federal Employees Health 
              Benefits program
    ``(a) FEHBP Option.--The Secretary of Defense, after consulting 
with the other administering Secretaries, shall enter into an agreement 
with the Office of Personnel Management under which a Medicare-eligible 
covered beneficiary described in subsection (b) will be offered an 
opportunity to enroll in a health benefits plan offered through the 
Federal Employee Health Benefits program under chapter 89 of title 5, 
in addition to receiving health care services under this chapter 
through a treatment facility of the uniformed services, the Civilian 
Health and Medical Program of the Uniformed Services, or the TRICARE 
program. The agreement may provide for limitations on enrollment of 
Medicare-eligible covered beneficiaries in the Federal Employee Health 
Benefits program if the Office of Personnel Management determines the 
limitations are necessary to allow for adequate planning for access for 
services under the Federal Employee Health Benefits program.
    ``(b) Medicare-Eligible Covered Beneficiary Described.--A Medicare-
eligible covered beneficiary referred to in subsection (a) is a covered 
beneficiary under this chapter who for any reason is or becomes 
entitled to hospital insurance benefits under part A of title XVIII of 
the Social Security Act (42 U.S.C. 1395c et seq.). The covered 
beneficiary shall not be required to satisfy any eligibility criteria 
specified in chapter 89 of title 5 as a condition for enrollment in a 
health benefits plan offered through the Federal Employee Health 
Benefits program pursuant to subsection (a).
    ``(c) Continued Participation in Uniformed Services Health 
System.--A Medicare-eligible covered beneficiary who enrolls in a 
health benefits plan offered through the Federal Employee Health 
Benefits program pursuant to subsection (a) may continue, after such 
enrollment, to receive health care services through a treatment 
facility of the uniformed services, the Civilian Health and Medical 
Program of the Uniformed Services, or the TRICARE program. Section 1095 
of this title, relating to collection from third-party payers, shall 
apply with respect to the costs of health care services incurred by the 
United States on behalf of an enrolled covered beneficiary through a 
treatment facility of the uniformed services, the Civilian Health and 
Medical Program of the Uniformed Services, or the TRICARE program.
    ``(d) Contributions.--(1) In the case of a Medicare-eligible 
covered beneficiary who enrolls in a health benefits plan offered 
through the Federal Employee Health Benefits program pursuant to 
subsection (a), the administering Secretary concerned shall be 
responsible for Government contributions that the Office of Personnel 
Management determines are necessary to cover all costs in excess of 
beneficiary contributions under paragraph (2).
    ``(2) The contribution required from the enrolled covered 
beneficiary shall be equal to the amount that would be withheld from 
the pay of a similarly situated Federal employee who enrolls in a 
health benefits plan under chapter 89 of title 5.
    ``(e) Management of Participation.--If the enrolled covered 
beneficiary is a member or former member of the uniformed services 
described in section 1074(b) of this title, the authority responsible 
for approving retired or retainer pay or equivalent pay for the member 
or former member shall manage the participation of the enrolled member 
or former member in a health benefits plan offered through the Federal 
Employee Health Benefits program pursuant to subsection (a). If the 
enrolled covered beneficiary is a dependent of a member or 
former member, the authority that is, or would be, responsible for 
approving retired or retainer pay or equivalent pay for the member or 
former member shall manage the participation of the enrolled dependent 
in a health benefits plan offered through the Federal Employee Health 
Benefits program under subsection (a). The Office of Personnel 
Management shall maintain separate risk pools for enrolled covered 
beneficiaries until such time as the Director of the Office of 
Personnel Management determines that complete inclusion of enrolled 
covered beneficiaries under chapter 89 of title 5 will not adversely 
affect Federal employees and annuitants enrolled in health benefits 
plans under such chapter.
    ``(f) Effect of Cancellation.--The cancellation by a Medicare-
eligible covered beneficiary of coverage under the Federal Employee 
Health Benefits program shall be irrevocable for purposes of this 
section.
    ``(g) Reporting Requirements.--Not later than November 1 of each 
year, the administering Secretaries and the Director of the Office of 
Personnel Management shall jointly submit a report to Congress 
describing the provision of health care services to Medicare-eligible 
covered beneficiaries under this section during the preceding fiscal 
year. The report shall address or contain the following:
            ``(1) The number of Medicare-eligible covered beneficiaries 
        enrolled in health benefits plans offered through the Federal 
        Employee Health Benefits program pursuant to subsection (a), 
        both in terms of total number and as a percentage of all 
        Medicare-eligible covered beneficiaries receiving health care 
        through the health care system of the uniformed services.
            ``(2) The out-of-pocket cost to enrolled covered 
        beneficiaries under such health benefits plans.
            ``(3) The cost to the Government (including the Department 
        of Defense, the Department of Transportation, and the 
        Department of Health and Human Services) of providing care 
        under such health benefits plans as a result of this section.
            ``(4) A comparison of the costs determined under paragraphs 
        (2) and (3) and the costs that would have otherwise been 
        incurred by the Government and enrolled covered beneficiaries 
        under alternative health care options available to the 
        administering Secretaries.
            ``(5) The effect of this section on the cost, access, and 
        utilization rates of other health care options under the health 
        care system of the uniformed services.
    ``(h) Time for Option.--The Secretary of Defense shall begin to 
offer the health benefits option under subsection (a) not later than 
January 1, 1998.''.
    (2) The table of sections at the beginning of such chapter is 
amended by adding at the end the following new item:

``1107. Health care coverage through Federal Employees Health Benefits 
                            program.''.
    (b) Conforming Amendments.--Chapter 89 of title 5, United States 
Code, is amended--
            (1) in section 8905--
                    (A) by redesignating subsections (d) through (f) as 
                subsections (e) through (g), respectively; and
                    (B) by inserting after subsection (c) the following 
                new subsection:
    ``(d) An individual whom an administering Secretary described in 
section 1073 of title 10 determines is a medicare-eligible covered 
beneficiary under subsection (b) of section 1107 of such title 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 of Defense and the Office and in accordance with 
applicable regulations under this chapter.'';
            (2) in section 8906(b)--
                    (A) in paragraph (1), by striking ``paragraphs (2) 
                and (3)'' and inserting in lieu thereof ``paragraphs 
                (2), (3), and (4)''; and
                    (B) by adding at the end the following new 
                paragraph:
    ``(4) In the case of individuals who enroll in a health plan in 
accordance with section 8905(d) of this title, the Government 
contribution shall be determined under section 1107(d) of title 10.''; 
and
            (3) in section 8906(g)--
                    (A) in paragraph (1), by striking ``paragraph (2)'' 
                and inserting in lieu thereof ``paragraphs (2) and 
                (3)''; and
                    (B) by adding at the end the following new 
                paragraph:
    ``(3) The Government contribution described in subsection (b)(4) 
for beneficiaries who enroll in accordance with section 8905(d) of this 
title shall be paid as provided in section 1107(d) of title 10.''.