Healthcare for Our Troops Act

Bill: 117-s-5142
Sponsor: full_name: Sen. Baldwin, Tammy [D-WI]
Introduced: 2022-11-29
Policy area: Armed Forces and National Security
Latest action: action_date: 2022-11-29
text: Read twice and referred to the Committee on Armed Services.

Summaries:
action_date: 2022-11-29
action_desc: Introduced in Senate
text: <p><strong>Healthcare for Our Troops Act</strong></p> <p>This bill addresses TRICARE Reserve Select coverage and eligibility for Selected Reserve members of the Ready Reserve and their families. Among other elements, the bill provides eligibility for TRICARE Reserve Select to Selected Reserve members of the Ready Reserve who are eligible for or enrolled in the Federal Employees Health Benefits Program.</p>

tv_txt: II 117th CONGRESS 2d Session S. 5142 IN THE SENATE OF THE UNITED STATES November 29, 2022 Ms. Baldwin (for herself and Ms. Collins ) 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 eliminate certain health care charges for members of the Selected Reserve eligible for TRICARE Reserve Select, and for other purposes.

1. Short title This Act may be cited as the Healthcare for Our Troops Act . 2. Elimination of certain health care charges for members of the Selected Reserve (a) TRICARE Reserve Select Section 1076d of title 10, United States Code, is amended to read as follows: 1076d. TRICARE program: TRICARE Reserve Select coverage for members of the Selected Reserve (a) Members of Selected Reserve (1) In general A member of the Selected Reserve of the Ready Reserve of a reserve component of the Armed Forces is eligible for health benefits under TRICARE Reserve Select as provided in this section. (2) Termination of coverage Eligibility for TRICARE Reserve Select coverage of a member under this section shall terminate upon the termination of the member's service in the Selected Reserve. (b) TRICARE Reserve Select family coverage (1) In general While a member of a reserve component is covered by TRICARE Reserve Select under this section, the members of the immediate family of such member are eligible for TRICARE Reserve Select family coverage as dependents of the member. (2) Continuation of coverage If a member of a reserve component dies while in a period of coverage under this section, the eligibility of the members of the immediate family of such member for TRICARE Reserve Select family coverage shall continue for six months beyond the date of death of the member. (c) Premiums (1) No premiums for individual coverage A member of a reserve component covered by TRICARE Reserve Select individual coverage shall pay no premium for such coverage. (2) Family coverage (A) In general A member of a reserve component covered by TRICARE Reserve Select under this section shall pay a premium for any member of the immediate family of such member covered under TRICARE Reserve Select family coverage. Such premium shall apply instead of any enrollment fees required under section 1075 of this title. (B) Uniform application The Secretary of Defense shall prescribe for the purposes of this section one premium for TRICARE Reserve Select family coverage of immediate family members of members of the reserve components, that shall apply uniformly to all such immediate family members. (C) Premium amount (i) In general The monthly amount of the premium in effect for a month for TRICARE Reserve Select family coverage under this section shall be the amount equal to 28 percent of the total monthly amount determined on an appropriate actuarial basis as being reasonable for that coverage. (ii) Appropriate actuarial basis The appropriate actuarial basis for purposes of clause (i) for each calendar year after calendar year 2009 shall be determined by utilizing the actual cost of providing benefits under this section to dependents of members of the reserve components during the calendar years preceding such calendar year. (D) Payment of premiums (i) In general The premiums for TRICARE Reserve Select family coverage payable by a member of a reserve component under this subsection may be deducted and withheld from basic pay payable to the member under section 204 of title 37 or from compensation payable to the member under section 206 of such title. (ii) Requirements and procedures The Secretary shall prescribe the requirements and procedures applicable to the payment of premiums under this subsection. (E) Collection of premiums Amounts collected as premiums under this subsection shall be credited to the appropriation available for the Defense Health Program Account under section 1100 of this title, shall be merged with sums in such account that are available for the fiscal year in which collected, and shall be available under subsection (b) of such section for such fiscal year. (d) Cost-Sharing amounts (1) Network individual coverage Except as provided in paragraph (2), a beneficiary covered by TRICARE Reserve Select individual coverage shall pay no charge for any health care service to which the beneficiary is entitled pursuant to such coverage. (2) Out-of-network individual coverage With respect to out-of-network health care services, a beneficiary covered by TRICARE Reserve Select individual coverage shall be subject to the same out-of-network cost-sharing requirements as those to which beneficiaries described in section 1075(c)(1) of this title in the active-duty family member category are subject to for the corresponding year. (3) Family coverage A beneficiary covered by TRICARE Reserve Select family coverage shall be subject to the same cost-sharing requirements as those to which beneficiaries described in section 1075(c)(1) of this title in the active-duty family member category are subject to for the corresponding year. (e) Regulations The Secretary of Defense, in consultation with the other administering Secretaries, shall prescribe regulations for the administration of this section. (f) Definitions In this section: (1) The terms active-duty family member category , network , and out-of-network have the meanings given such terms in section 1075(i) of this title. (2) The term immediate family , with respect to a member of a reserve component, means all of the member’s dependents described in subparagraphs (A), (D), and (I) of section 1072(2) of this title. (3) The term TRICARE Reserve Select means— (A) medical care, excluding dental care, at facilities of the uniformed services to which a dependent described in section 1076(a)(2) of this title is entitled; and (B) health benefits under the TRICARE Select self-managed, preferred provider network option under section 1075 of this title made available to beneficiaries by reason of this section and subject to the cost-sharing requirements set forth in subsection (d). (4) The term TRICARE Reserve Select family coverage means coverage under TRICARE Reserve Select of any members of the immediate family of a member of a reserve component, as described in subsection (b). (5) The term TRICARE Reserve Select individual coverage means coverage under TRICARE Reserve Select of a member of a reserve component, as described in subsection (a). . (b) Conforming amendments to TRICARE Select Paragraph (3) of section 1075(c) of title 10, United States Code, is amended to read as follows: (3) With respect to beneficiaries in the reserve and young adult category— (A) for beneficiaries covered by section 1076e or 1110b of this title, the cost-sharing requirements shall be calculated pursuant to subsection (d)(1) as if the beneficiary were in the active-duty family member category or the retired category, as applicable, except that the premiums calculated pursuant to section 1076e or 1110b of this title shall apply instead of any enrollment fee required under this section; and (B) for beneficiaries covered by section 1076d of this title, the cost-sharing requirements shall be calculated pursuant to subsection (d) of such section. . (c) Applicability This section shall apply with respect to the provision of health care under the TRICARE program beginning on the date that is one year after the date of the enactment of this Act. 3. Forms and study relating to improved coverage for members of the Selected Reserve (a) Forms (1) In general Not later than 180 days after the date of the enactment of this Act, the Secretary of Defense shall develop forms to be used by civilian health care providers under the purchased care component of the TRICARE program for medical care for members of the Selected Reserve of the Ready Reserve of a reserve component of the Armed Forces eligible for TRICARE Reserve Select. (2) Information To include Forms developed under paragraph (1) shall include opportunities for a civilian health care provider to indicate, with respect to a member of the Selected Reserve, the following information: (A) Medical Readiness Classification. (B) Fitness for deployment. (C) Any other information the Secretary determines necessary. (b) Study (1) In general The Secretary of Defense shall conduct a study on— (A) the phasing out of mass medical events and periodic health assessments for members of the Selected Reserve eligible for TRICARE Reserve Select; and (B) the replacement of such events and processes with the new TRICARE Reserve Select coverage model under section 1076d of title 10, United States Code, as amended by section 2(a), and the use of forms by civilian health care providers as specified in subsection (a). (2) Report Not later than 180 days after the date of the enactment of this Act, the Secretary shall submit to the Committee on Armed Services of the Senate and the Committee on Armed Services of the House of Representatives a report containing the findings of the study conducted under paragraph (1). (c) Definitions In this section, the terms TRICARE program and TRICARE Reserve Select have the meanings given those terms in section 1072 of title 10, United States Code.