I
105TH CONGRESS
2D SESSION
H. R. 3613
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 HOUSE OF REPRESENTATIVES
MARCH 31, 1998
Mr. WATTS of Oklahoma (for himself, Mr. CUNNINGHAM, Mr. THORNBERRY,
Mr. MICA, Mr. INGLIS of South Carolina, Mr. CANNON, Mr. BARR of
Georgia, Mr. RIGGS, Mr. HANSEN, Mr. GOODE, Mr. NORWOOD, Mr.
HUNTER, Mr. FILNER, Mr. PICKERING, Mr. SESSIONS, Mr. MCCOLLUM,
Mr. METCALF, Mr. GIBBONS, Mr. RYUN, Mr. ENSIGN, Mr. BILBRAY, Mr.
FOX of Pennsylvania, Mr. BOEHLERT, Mrs. EMERSON, Mr. COOK, Mr.
JENKINS, Mr. ENGLISH
of Pennsylvania, Mrs. CHENOWETH, Mr.
PALLONE, Mr. BARTLETT of Maryland, Mr. MCINTYRE, Mr. CONDIT, Mr.
REDMOND, Mrs. LINDA
SMITH
of Washington, Mr. BAKER, Mr.
COSTELLO, Mr. ROYCE, Mr. LOBIONDO, and Ms. GRANGER) introduced
the following bill; which was referred to the Committee on National Secu-
rity, and in addition to the Committee on Government Reform and Over-
sight, 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 amend title 10, United States Code, to permit certain
beneficiaries of the military health care system to enroll
in Federal employees health benefits plans.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
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:
‘‘§ 1079b. Health care coverage through Federal Em-
ployees Health Benefits program
‘‘(a) FEHBP OPTION.—(1) Subject to the availabil-
ity of funds to carry out this section for a fiscal year, eligi-
ble beneficiaries described in subsection (b) shall be af-
forded 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 admin-
istering 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 ben-
eficiary referred to in subsection (a) is a covered bene-
ficiary 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 of-
fered under the Federal Employee Health Benefits
program;
‘‘(B) is eligible to enroll in the TRICARE pro-
gram 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 de-
scribed 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 bene-
ficiaries 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 de-
scribed in subsection (a); and
‘‘(B) each subsequent year thereafter.
‘‘(e) TERM OF ENROLLMENT.—(1) The minimum pe-
riod 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 re-
ceipt 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 Di-
rector 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 Direc-
tor of the Office of Personnel Management shall manage
the participation of an eligible beneficiary in a health ben-
efits plan of the Federal Employee Health Benefits pro-
gram pursuant to an enrollment under this section. The
Director shall maintain separate risk pools for participat-
ing eligible beneficiaries until such time as the Director
determines that inclusion of participating eligible bene-
ficiaries under chapter 89 of title 5 will not adversely af-
fect 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 Fed-
eral 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 bene-
ficiaries under health benefits plans pursuant to en-
rollments 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 de-
partments 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 Authoriza-
tion 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 op-
tion.’’.
(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 pro-
gram.’’.
(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 follow-
ing new subsection (d):
‘‘(d) An individual whom the Secretary of Defense de-
termines 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 regula-
tions under this chapter.’’.
(2) Section 8906 of title 5, United States Code, is
amended—
(A) in subsection (b)—
(i) in paragraph (1), by striking ‘‘para-
graphs (2) and (3)’’ and inserting in lieu there-
of ‘‘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 ‘‘para-
graph (2)’’ and inserting in lieu thereof ‘‘para-
graphs (2) and (3)’’; and
(ii) by adding at the end the following new
paragraph:
‘‘(3) The Government contribution described in sub-
section (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—