II

105TH CONGRESS

2D SESSION S. 1963

To amend title 10, United States Code, to permit certain beneficiaries of

the military health care system to enroll in Federal employees health

benefits plans.

IN THE SENATE OF THE UNITED STATES

APRIL 21, 1998

Mr. THURMOND (for himself and Mr. COVERDELL) introduced the following

bill; which was read twice and referred to the Committee on Governmental Affairs

A BILL

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

beneficiaries of the military health care system to enroll

in Federal employees health benefits plans.

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

3 SECTION 1. SHORT TITLE.

4 This Act may be cited as the ‘‘Military Health Care

5 Fairness Act’’.
2

•S 1963 IS

1 SEC. 2. INCLUSION OF CERTAIN COVERED BENEFICIARIES

2 IN FEDERAL EMPLOYEES HEALTH BENEFITS

3 PROGRAM.

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

5 United States Code, is amended by inserting after section

6 1079a the following new section:

7 ‘‘§ 1079b. Health care coverage through Federal Em8 ployees Health Benefits program

9 ‘‘(a) FEHBP OPTION.—(1) Subject to the availabil10 ity of funds to carry out this section for a fiscal year, eligi11 ble beneficiaries described in subsection (b) shall be af12 forded an opportunity to enroll in any health benefits plan

13 under the Federal Employee Health Benefits program

14 under chapter 89 of title 5, United States Code, offering

15 medical care comparable to the care authorized by section

16 1077 of this title to be provided under section 1076 of

17 this title (in this section referred to as an ‘FEHBP plan’).

18 ‘‘(2) The Secretary of Defense and the other admin19 istering Secretaries shall jointly enter into an agreement

20 with the Director of the Office of Personnel Management

21 to carry out paragraph (1).

22 ‘‘(b) ELIGIBLE BENEFICIARIES.—(1) An eligible ben23 eficiary referred to in subsection (a) is a covered bene24 ficiary who is a military retiree (except a military retiree

25 retired under chapter 1223 of this title), a dependent of

26 such a retiree described in section 1072(2)(B) or (C), or
3

•S 1963 IS

1 a dependent described in section 1072(2)(A), (D), or (I)

2 of such a retiree who enrolls in an FEHBP plan, who,—

3 ‘‘(A) is not guaranteed access under TRICARE

4 to health care that is comparable to the health care

5 benefits provided under the service benefit plan of6 fered under the Federal Employee Health Benefits

7 program;

8 ‘‘(B) is eligible to enroll in the TRICARE pro9 gram but is not enrolled because of the location of

10 the beneficiary, a limitation on the total enrollment,

11 or any other reason; or

12 ‘‘(C) is entitled to hospital insurance benefits

13 under part A of title XVIII of the Social Security

14 Act (42 U.S.C. 1395c et seq.).

15 ‘‘(2) In addition to the eligibility requirements de16 scribed in paragraph (1), during the first two years that

17 covered beneficiaries are offered the opportunity to enroll

18 in an FEHBP plan under subsection (a), eligible bene19 ficiaries shall be limited to—

20 ‘‘(A) except as provided in subparagraph (B),

21 military retirees 65 years of age or older; and

22 ‘‘(B) military retirees retired under chapter 61

23 of this title.
4

•S 1963 IS

1 ‘‘(3) An eligible beneficiary shall not be required to

2 satisfy any eligibility criteria specified in chapter 89 of

3 title 5 as a condition for enrollment in an FEHBP plan.

4 ‘‘(c) PRIORITY OF ENROLLMENT.—(1) Eligible bene5 ficiaries shall be permitted to enroll in an FEHBP plan

6 based on the order in which such beneficiaries apply to

7 enroll in the plan.

8 ‘‘(2) The Secretary shall maintain a list of eligible

9 beneficiaries who apply to enroll in an FEHBP plan, but

10 whom the Secretary is not able to enroll because of the

11 lack of available funds to carry out this section.

12 ‘‘(d) PERIOD OF ENROLLMENT.—The Secretary shall

13 provide a period of enrollment for eligible beneficiaries in

14 an FEHBP plan for a period of 90 days—

15 ‘‘(1) before implementation of the program de16 scribed in subsection (a); and

17 ‘‘(2) each subsequent year thereafter.

18 ‘‘(e) TERM OF ENROLLMENT.—(1) The minimum pe19 riod of enrollment in an FEHBP plan shall be three years.

20 ‘‘(2) A beneficiary who elects to enroll in an FEHBP

21 plan, and who subsequently discontinues enrollment in the

22 plan before the end of the period described in paragraph

23 (1), shall not be eligible to reenroll in the plan.

24 ‘‘(f) RECEIPT OF CARE IN MTF.—An eligible bene25 ficiary enrolled in an FEHBP plan may receive care at
5

•S 1963 IS

1 a military medical treatment facility subject to the avail2 ability of space in such facility, except that the plan shall

3 reimburse the facility for the cost of such treatment. The

4 plan may adjust beneficiary copayments so that receipt of

5 such care at a military medical treatment facility results

6 in no additional costs to the plan, as compared with the

7 costs that would have been incurred if care had been re8 ceived from a provider in the plan.

9 ‘‘(g) CONTRIBUTIONS.—(1) Contributions shall be

10 made for an enrollment of an eligible beneficiary in a plan

11 of the Federal Employee Health Benefits program under

12 this section as if the beneficiary were an employee of the

13 Federal Government.

14 ‘‘(2) The administering Secretary concerned shall be

15 responsible for the Government contributions that the Di16 rector of the Office of Personnel Management determines

17 would be payable by the Secretary under section 8906 of

18 title 5 for an enrolled eligible beneficiary if the beneficiary

19 were an employee of the Secretary.

20 ‘‘(3) Each eligible beneficiary enrolled in an FEHBP

21 plan shall be required to contribute the amount that would

22 be withheld from the pay of a similarly situated Federal

23 employee who is enrolled in the same health benefits plan

24 under chapter 89 of title 5.
6

•S 1963 IS

1 ‘‘(h) MANAGEMENT OF PARTICIPATION.—The Direc2 tor of the Office of Personnel Management shall manage

3 the participation of an eligible beneficiary in a health ben4 efits plan of the Federal Employee Health Benefits pro5 gram pursuant to an enrollment under this section. The

6 Director shall maintain separate risk pools for participat7 ing eligible beneficiaries until such time as the Director

8 determines that inclusion of participating eligible bene9 ficiaries under chapter 89 of title 5 will not adversely af10 fect Federal employees and annuitants enrolled in health

11 benefits plans under such chapter.

12 ‘‘(i) REPORTING REQUIREMENTS.—(1) Not later

13 than November 1 of each year, the Secretary of Defense

14 and the Director of the Office of Personnel Management

15 shall jointly submit to Congress a report describing the

16 provision of health care services to enrollees under this

17 section during the preceding fiscal year. The report shall

18 address or contain the following:

19 ‘‘(A) The number of eligible beneficiaries who

20 are participating in health benefits plans of the Fed21 eral Employee Health Benefits program pursuant to

22 an enrollment under this section, both in terms of

23 total number and as a percentage of all covered

24 beneficiaries who are receiving health care through

25 the health care system of the uniformed services.
7

•S 1963 IS

1 ‘‘(B) The extent to which eligible beneficiaries

2 use the health care services available to the bene3 ficiaries under health benefits plans pursuant to en4 rollments under this section.

5 ‘‘(C) The cost to enrollees for health care under

6 such health benefits plans.

7 ‘‘(D) The cost to the Department of Defense,

8 the Department of Transportation, the Department

9 of Health and Human Services, and any other de10 partments and agencies of the Federal Government

11 of providing care to eligible beneficiaries pursuant to

12 enrollments in such health benefits plans under this

13 section.

14 ‘‘(E) A comparison of the costs determined

15 under paragraphs (C) and (D) and the costs that

16 would otherwise have been incurred by the United

17 States and enrollees under alternative health care

18 options available to the administering Secretaries.

19 ‘‘(F) The effects of the exercise of authority

20 under this section on the cost, access, and utilization

21 rates of other health care options under the health

22 care system of the uniformed services.

23 ‘‘(2) Not later than the date that is four years after

24 the date of enactment of the National Defense Authoriza-
8

•S 1963 IS

1 tion Act for fiscal year 1999, the Secretary of Defense

2 shall submit to Congress a report describing—

3 ‘‘(A) whether the Secretary recommends that a

4 health care option for retired covered beneficiaries

5 equivalent to the option described in subsection (a)

6 be permanently offered to such beneficiaries; and

7 ‘‘(B) the estimated costs of offering such an op8 tion.’’.

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

10 chapter is amended by inserting after the item relating

11 to section 1079a the following:

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

12 (b) CONFORMING AMENDMENTS.—(1) Section 8905

13 of title 5, United States Code, is amended—

14 (A) by redesignating subsections (d), (e), and

15 (f) as subsections (e), (f), and (g), respectively; and

16 (B) by inserting after subsection (c) the follow17 ing new subsection (d):

18 ‘‘(d) An individual whom the Secretary of Defense de19 termines is an eligible beneficiary under subsection (b) of

20 section 1079b of title 10 may enroll in a health benefits

21 plan under this chapter in accordance with the agreement

22 entered into under subsection (a) of such section between

23 the Secretary and the Office and with applicable regula24 tions under this chapter.’’.
9

•S 1963 IS

1 (2) Section 8906 of title 5, United States Code, is

2 amended—

3 (A) in subsection (b)—

4 (i) in paragraph (1), by striking ‘‘para5 graphs (2) and (3)’’ and inserting in lieu there6 of ‘‘paragraphs (2), (3), and (4)’’; and

7 (ii) by adding at the end the following new

8 paragraph:

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

10 plan under section 8905(d) of this title, the Government

11 contribution shall be determined under section 1079b(g)

12 of title 10.’’; and

13 (B) in subsection (g)—

14 (i) in paragraph (1), by striking ‘‘para15 graph (2)’’ and inserting in lieu thereof ‘‘para16 graphs (2) and (3)’’; and

17 (ii) by adding at the end the following new

18 paragraph:

19 ‘‘(3) The Government contribution described in sub20 section (b)(4) for beneficiaries who enroll under section

21 8905(d) of this title shall be paid as provided in section

22 1079b(g) of title 10.’’.

23 (c) IMPLEMENTATION.—The Secretary of Defense—

24 (1) shall begin to offer the health benefits op25 tion under section 1079b(a) of title 10, United
10

•S 1963 IS

1 States Code (as added by subsection (a)) not later

2 than the date that is 6 months after the date of the

3 enactment of this Act; and

4 (2) shall continue to offer such option through

5 the year 2003, and to provide care to eligible cov6 ered beneficiaries under such section through the

7 year 2005.

8 (d) FUNDING FROM AUTHORIZED APPROPRIA9 TIONS.—Of the funds authorized to be appropriated for

10 the Department of Defense for military personnel for fis11 cal years 1999 through 2005, amounts shall be available

12 for carrying out section 1079b of title 10, United States

13 Code (as added by subsection (a)), as follows:

14 (1) For fiscal year 1999, $100,000,000.

15 (2) For fiscal year 2000, $200,000,000.

16 (3) For fiscal year 2001, $300,000,000.

17 (4) For fiscal year 2002, $400,000,000.

18 (5) For fiscal year 2003, $500,000,000.

19 (6) For each of fiscal years 2004 and 2005,

20 such sums as are necessary.

Æ