Perseverance has paid off for veterans and military retirees.
Repeating past congressional action, the Senate Finance Committee earlier this monthJune approved legislation that would allow veterans, military retirees and military family members to receive Medicare-funded treatment at some veterans and military healthcare facilities.
The provisions would put the federal hospitals in competition with some private-sector providers.
Two separate amendments to the Medicare reform provisions of the comprehensive Senate budget and spending package would allow for demonstrations of this arrangement, called Medicare "subvention," at Department of Veterans Affairs and Defense Department facilities.
It's not the first time a congressional committee has approved subvention pilots. But if this subvention proposal stays in the final Senate budget package, it will be as close to becoming law as it ever has been.
The subvention provisions will have to survive budget negotiations between leaders of the Senate and House, which so far has not signed off on a subvention package.
Jay Bapple, associate legislative counsel for the National Association for Uniformed Services, a group representing military retirees, applauded the new legislation. "We believe the veterans and military retirees have earned the right to spend their Medicare dollars wherever they want, including military treatment facilities, including VA hospitals," he said.
Today, Medicare-eligible military retirees can receive free treatment at base hospitals and clinics when space is available. They cannot, however, take part in the military's health insurance program for under-65 retirees and their families.
But with downsizing of the armed forces and the closings of bases and their healthcare facilities, beneficiaries 65 and older are finding it more difficult to seek treatment at military facilities, forcing them to seek care at private-sector hospitals and clinics.
Meanwhile, many did not enroll in Medicare Part B because they expected to be able to receive treatment at the military hospitals. When base hospitals close and beneficiaries must seek Medicare-funded physician care from the private sector, they must pay a steep 10% surcharge on their Part B premium for each year beyond their initial eligibility.
In fact, allowing military retirees to enroll late without penalty was the House's one step to assist military retirees.
In approving the traditional subvention project, the Senate Finance Committee spurned another Republican proposal that would have allowed Medicare-eligible military retirees to join Medicare risk HMOs and seek treatment at military facilities, which would be able to join the HMO networks.
But that plan only would have worked for bases and retirees in areas where risk HMOs operate, and it would not have allowed the military bases to increase personnel with the increased money from the HMOs.