I
105TH CONGRESS
1ST SESSION
H. R. 2128
To permit Medicare-eligible retired members of the Armed Forces and their
Medicare-eligible dependents to enroll in the Federal Employees Health
Benefits program.
IN THE HOUSE OF REPRESENTATIVES
JULY 9, 1997
Mr. STEARNS introduced the following bill; which was referred to the Commit-
tee on Government Reform and Oversight, and in addition to the Com-
mittee on National Security, for a period to be subsequently determined
by the Speaker, in each case for consideration of such provisions as fall
within the jurisdiction of the committee concerned
A BILL
To permit Medicare-eligible retired members of the Armed
Forces and their Medicare-eligible dependents to enroll
in the Federal Employees Health Benefits program.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. EXPANSION OF FEDERAL EMPLOYEES HEALTH
BENEFITS PROGRAM TO INCLUDE RETIRED
MEMBERS AND DEPENDENTS WHO ARE MEDI-
CARE ELIGIBLE.
(a) FEDERAL EMPLOYEE HEALTH BENEFITS PRO-
GRAM OPTION.—The Secretary of Defense, after consult-
ing with the other administering Secretaries under chapter
55 of title 10, United States Code, shall enter into an
agreement with the Office of Personnel Management
under which certain persons are offered enrollment in a
health benefits plan under chapter 89 of title 5, United
States Code, in lieu of receiving care in treatment facilities
of the uniformed services or through the Civilian Health
and Medical Program of the Uniformed Services or the
TRICARE program. The agreement may provide for en-
rollment limitations if the Office of Personnel Manage-
ment determines that the limitations are necessary to
allow for adequate planning for access for services under
chapter 89 of title 5, United States Code.
(b) ELIGIBLE PERSONS.—(1) The following persons
shall be eligible for enrollment under this section:
(A) A member or former member of the uni-
formed services described in section 1074(b) of title
10, United States Code, who 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.).
(B) A dependent of a person described in sub-
paragraph (A) if the dependent is otherwise eligible
for health care under chapter 55 of title 10, United
States Code and 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.).
(2) Persons described in paragraph (1) shall not be
required to satisfy any eligibility criteria specified in chap-
ter 89 of title 5, United States Code, as a condition for
enrollment in a health benefits plan offered through the
Federal Employee Health Benefits program pursuant to
subsection (a).
(c) CONTRIBUTIONS.—(1) In the case of a person de-
scribed in subsection (b) who enrolls in a health benefits
plan offered through the Federal Employee Health Bene-
fits 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 an enrolled per-
son under this section 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, United States Code.
(d) MANAGEMENT OF PARTICIPATION.—The author-
ity responsible for approving retired or retainer pay or
equivalent pay in the case of a member or former member
shall manage the participation of the member or former
member, and dependents of the member or former mem-
ber, who enroll in a health benefits plan offered through
the Federal Employee Health Benefits program pursuant
to subsection (a). The Office of Personnel Management
shall maintain separate risk pools for persons described
in subsection (b) until such time as the Director of the
Office of Personnel Management determines that complete
inclusion chapter 89 of title 5, United States Code, of per-
sons described in subsection (b) will not adversely affect
Federal employees and annuitants enrolled in health bene-
fits plans under such chapter.
(e) EFFECT OF CANCELLATION.—The cancellation
by a person described in subsection (b) of coverage under
the Federal Employee Health Benefits program shall be
irrevocable for purposes of this section.
(f) REPORTING REQUIREMENTS.—Not later than No-
vember 1 of each year, the Secretary of Defense and the
Director of the Office of Personnel Management shall
jointly submit a report to Congress describing the provi-
sion of health care services to persons under this section
during the preceding fiscal year. The report shall address
or contain the following:
(1) The number of persons 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 persons receiving health care through the
health care system of the uniformed services.
(2) The out-of-pocket cost to enrollees under
such health benefits plans.
(3) The cost to the Government (including the
Department of Defense, the Department of Trans-
portation, and the Department of Health and
Human Services) of providing care under such
health benefits plans.
(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 enrollees under alternative health care options
available to the administering Secretaries.
(5) The effect of this section on the cost, ac-
cess, and utilization rates of other health care op-
tions under the health care system of the uniformed
services.
(g) TIME FOR OPTION.—The Secretary of Defense
shall begin to offer the health benefits option under sub-
section (a) not later than October 1, 1997.
(h) 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), re-
spectively; and
(B) by inserting after subsection (c) the
following new subsection:
‘‘(d) An individual whom the Secretary of Defense de-
termines is an eligible person under the special authority
provided to the Secretary may enroll in a health benefits
plan under this chapter in accordance with the agreement
between the Secretary and the Office and applicable regu-
lations under this chapter.’’;
(2) in section 8906(b)—
(A) in paragraph (1), by striking ‘‘para-
graphs (2) and (3)’’ and inserting in lieu there-
of ‘‘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 in accord-
ance with the agreement between the Secretary and the
Office.’’; and
(3) in section 8906(g)—
(A) in paragraph (1), by striking ‘‘para-
graph (2)’’ and inserting in lieu thereof ‘‘para-
graphs (2) and (3)’’; and
(B) by adding at the end the following new
paragraph:
‘‘(3) The Government contribution described in sub-
section (b)(4) for beneficiaries who enroll in accordance
with section 8905(d) of this title shall be paid in accord-
ance with the agreement between the Secretary and the
Office.’’.
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