II

104TH CONGRESS

2D SESSION S. 1651

To amend title 10, United States Code, to permit covered beneficiaries under

the military health care system who are also entitled to medicare to

enroll in the Federal Employees Health Benefits program.

IN THE SENATE OF THE UNITED STATES

MARCH 28, 1996

Mr. WARNER introduced the following bill; which was read twice and referred

to the Committee on Armed Services

A BILL

To amend title 10, United States Code, to permit covered

beneficiaries under the military health care system who

are also entitled to medicare to enroll in the Federal

Employees Health Benefits program.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,

3 SECTION 1. INCLUSION OF MEDICARE ELIGIBLE COVERED

4 BENEFICIARIES IN FEDERAL EMPLOYEES

5 HEALTH BENEFITS PROGRAM.

6 (a) FEHBP OPTION.—(1) Chapter 55 of title 10,

7 United States Code, is amended by inserting after section

8 1079 the following new section:
2

•S 1651 IS

1 ‘‘§ 1079a. Health care coverage through Federal Em2 ployees Health Benefits program

3 ‘‘(a) FEHBP OPTION.—The Secretary of Defense,

4 after consulting with the other administering Secretaries,

5 shall enter into an agreement with the Office of Personnel

6 Management under which covered beneficiaries described

7 in subsection (b) will be offered an opportunity to enroll

8 in a health benefits plan offered through the Federal Em9 ployee Health Benefits program under chapter 89 of title

10 5, in lieu of receiving care under this chapter in treatment

11 facilities of the uniformed services or through the Civilian

12 Health and Medical Program of the Uniformed Services

13 or the TRICARE program. The agreement may provide

14 for limitations on enrollment of covered beneficiaries in

15 the Federal Employee Health Benefits program if the Of16 fice of Personnel Management determines the limitations

17 are necessary to allow for adequate planning for access

18 for services under Federal Employee Health Benefits pro19 gram.

20 ‘‘(b) ELIGIBLE COVERED BENEFICIARIES.—A cov21 ered beneficiary referred to in subsection (a) is a member

22 or former member of the uniformed services described in

23 section 1074(b) of this title, and any dependents of the

24 member described in section 1076(b) of this title, who is

25 or becomes entitled to hospital insurance benefits under

26 part A of title XVIII of the Social Security Act (42 U.S.C.
3

•S 1651 IS

1 1395c et seq.). The covered beneficiary shall not be re2 quired to satisfy any eligibility criteria specified in chapter

3 89 of title 5 as a condition for enrollment in a health bene4 fits plan offered through the Federal Employee Health

5 Benefits program pursuant to subsection (a).

6 ‘‘(c) CONTRIBUTIONS.—(1) In the case of covered

7 beneficiaries described in subsection (b) who enroll in a

8 health benefits plan offered through the Federal Employee

9 Health Benefits program pursuant to subsection (a), the

10 administering Secretary concerned shall be responsible for

11 Government contributions that the Office of Personnel

12 Management determines are necessary to cover all costs

13 in excess of beneficiary contributions under paragraph (2).

14 ‘‘(2) The contribution required from an enrolled cov15 ered beneficiary shall be equal to the amount that would

16 be withheld from the pay of a similarly situated Federal

17 employee who enrolls in a health benefits plan under chap18 ter 89 of title 5.

19 ‘‘(d) MANAGEMENT OF PARTICIPATION.—The au20 thority responsible for approving retired or retainer pay

21 or equivalent pay in the case of a member or former mem22 ber shall manage the participation of the member or

23 former member, and dependents of the member or former

24 member, who enroll in a health benefits plan offered

25 through the Federal Employee Health Benefits program
4

•S 1651 IS

1 pursuant to subsection (a). The Office of Personnel Man2 agement shall maintain separate risk pools for enrolled

3 covered beneficiaries until such time as the Director of the

4 Office of Personnel Management determines that complete

5 inclusion of enrolled covered beneficiaries under chapter

6 89 of title 5 will not adversely affect Federal employees

7 and annuitants enrolled in health benefits plans under

8 such chapter.

9 ‘‘(e) EFFECT OF CANCELLATION.—The cancellation

10 by a covered beneficiary of coverage under the Federal

11 Employee Health Benefits program shall be irrevocable for

12 purposes of this section.

13 ‘‘(f) REPORTING REQUIREMENTS.—Not later than

14 November 1 of each year, the Secretary of Defense and

15 the Director of the Office of Personnel Management shall

16 jointly submit a report to Congress describing the provi17 sion of health care services to covered beneficiaries under

18 this section during the preceding fiscal year. The report

19 shall address or contain the following:

20 ‘‘(1) The number of covered beneficiaries en21 rolled in health benefits plans offered through the

22 Federal Employee Health Benefits program pursu23 ant to subsection (a), both in terms of total number

24 and as a percentage of all covered beneficiaries re-
5

•S 1651 IS

1 ceiving health care through the health care system

2 of the uniformed services.

3 ‘‘(2) The out-of-pocket cost to enrollees under

4 such health benefits plans.

5 ‘‘(3) The cost to the Government (including the

6 Department of Defense, the Department of Trans7 portation, and the Department of Health and

8 Human Services) of providing care under such

9 health benefits plans.

10 ‘‘(4) A comparison of the costs determined

11 under paragraphs (2) and (3) and the costs that

12 would have otherwise been incurred by the Govern13 ment and enrollees under alternative health care op14 tions available to the administering Secretaries.

15 ‘‘(5) The effect of this section on the cost, ac16 cess, and utilization rates of other health care op17 tions under the health care system of the uniformed

18 services.

19 ‘‘(g) TIME FOR OPTION.—The Secretary of Defense

20 shall begin to offer the health benefits option under sub21 section (a) not later than January 1, 1997.’’.

22 (2) The table of sections at the beginning of such

23 chapter is amended by inserting after the item relating

24 to section 1079 the following new item:

‘‘1079a. Health care coverage through Federal Employees Health Benefits program.’’.
6

•S 1651 IS

1 (b) CONFORMING AMENDMENTS.—Chapter 89 of

2 title 5, United States Code, is amended—

3 (1) in section 8905—

4 (A) by redesignating subsections (d)

5 through (f) as subsections (e) through (g), re6 spectively; and

7 (B) by inserting after subsection (c) the

8 following new subsection:

9 ‘‘(d) An individual whom the Secretary of Defense de10 termines is an eligible covered beneficiary under section

11 1079a(b) of title 10 may enroll in a health benefits plan

12 under this chapter in accordance with the agreement

13 under section 1079a(a) of title 10 between the Secretary

14 and the Office and applicable regulations under this chap15 ter.’’;

16 (2) in section 8906(b)—

17 (A) in paragraph (1), by striking ‘‘para18 graphs (2) and (3)’’ and inserting in lieu there19 of ‘‘paragraphs (2), (3), and (4)’’; and

20 (B) by adding at the end the following new

21 paragraph:

22 ‘‘(4) In the case of individuals who enroll in a health

23 plan in accordance with section 8905(d) of this title, the

24 Government contribution shall be determined under sec25 tion 1079a(c) of title 10.’’; and
7

•S 1651 IS

1 (3) in section 8906(g)—

2 (A) in paragraph (1), by striking ‘‘para3 graph (2)’’ and inserting in lieu thereof ‘‘para4 graphs (2) and (3)’’; and

5 (B) by adding at the end the following new

6 paragraph:

7 ‘‘(3) The Government contribution described in sub8 section (b)(4) for beneficiaries who enroll in accordance

9 with section 8905(d) of this title shall be paid as provided

10 in section 1079a(c) of title 10.’’.

Æ