The drumbeat for increased spending on military and veterans healthcare services got louder last week on Capitol Hill.
At the urging of Defense Department officials, several congressional committees are trying to add nearly $500 million to the department's fiscal 1997 healthcare budget to avoid cutbacks in military hospital care to retirees and family members of active-duty military personnel. The Department of Veterans Affairs, meanwhile, says it could be forced to close dozens of hospitals if its funding doesn't increase over budgeted levels during the next seven years.
The congressional committees with jurisdiction over defense spending want to increase the military's healthcare budget to more than $9.8 billion from the less than $9.4 billion the Clinton administration requested. The administration's fiscal 1997 request represented a $482.2 million decrease over the fiscal 1996 budget.
The House National Security Committee's military personnel subcommittee recently voted to authorize $473 million more for healthcare in fiscal 1997 than the administration requested.
Meanwhile, Rep. C.W. Young (R-Fla.), chairman of the House Appropriations Committee's national security subcommittee, said the extra $473 million will be in the 1997 appropriations bill he will draft for the subcommittee.
Members of Congress and beneficiary groups said they feared that if the 1997 healthcare budget is not increased to $9.8 billion, military hospitals and clinics would be forced to deny care to family members of active-duty personnel and retirees. Retirees and family members can be treated at the 120 military hospitals and 500 clinics when space is available. Care to active-duty personnel represented only about 27% of inpatient admissions and 38% of outpatient visits at military healthcare facilities in fiscal 1994.
The first beneficiaries affected by the administration's cutbacks probably would be about 230,000 of the 1 million military retirees and beneficiaries 65 and older who regularly use military healthcare facilities. They are eligible for Medicare but not to enroll in the Tricare managed-care program the Pentagon is implementing nationwide for family members and retirees younger than 65.
If reductions in the military medical budget force hospital and clinic commanders to cut back services to retirees older than 65, however, those retirees will have to rely on Medicare to pay for their healthcare from private-sector providers.
Many of them have not enrolled in Medicare Part B because the military promised to pay for their healthcare upon retirement. Defense Department officials said the Pentagon spends about $1.4 billion a year to care for Medicare-eligible retirees at military facilities.
VA Secretary Jesse Brown, meanwhile, told the House Appropriations Committee's VA subcommittee that a healthcare budget that remains at $16.6 billion a year during the next seven years would force the VA to close 41 of its 173 hospitals, lay off 60,000 of its nearly 200,000 employees and deny care to 1 million of its 2.9 million regular patients. That estimate is based on a VA planning model.
Other VA officials, however, cast doubt on the model's accuracy. Rep. Jerry Lewis (R-Calif.), chairman of the Appropriations Committee VA panel, questioned Brown's use of the data because the administration's budget projections have shown declines in VA healthcare funding, reaching less than $16 billion by fiscal 1999.