Keep Our Promise to America's Military Retirees Act - Directs the Secretary of Defense to enter into an agreement with the Office of Personnel Management to provide Federal Employees Health Benefits (FEHB) coverage to the following eligible beneficiaries: (1) a member or former member entitled to military retired or retainer pay; (2) an unremarried former spouse who was married to a member for at least 20 years, during which such member performed at least 20 years of retirement-creditable military service; (3) a dependent of a deceased qualifying member or former member; (4) a dependent of a living member or former member; and (5) a family member.
Directs the Secretary to reimburse such eligible persons for pharmacy benefits received from a pharmacy that is not a TRICARE (Department of Defense managed health care plan) network pharmacy in the same manner as the Secretary would reimburse such person for such benefits received from a TRICARE network pharmacy. Requires such persons, in order to receive such reimbursement, to submit a certification from their physician stating that the person does not have access to a TRICARE network pharmacy due to physical or medical constraints.
Amends title XVIII (Medicare) of the Social Security Act to waive the monthly part B premium (Supplementary Medical Insurance Benefits for the Aged and Disabled) with respect to: (1) an individual who is entitled to military retired or retainer pay based upon service that began before December 7, 1956; and (2) the spouse, widow, or widower of such individuals.
[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[S. 407 Introduced in Senate (IS)]
109th CONGRESS
1st Session
S. 407
To restore health care coverage to retired members of the uniformed
services, and for other purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
February 16, 2005
Mr. Johnson introduced the following bill; which was read twice and
referred to the Committee on Armed Services
_______________________________________________________________________
A BILL
To restore health care coverage to retired members of the uniformed
services, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Keep Our Promise to America's
Military Retirees Act''.
SEC. 2. FINDINGS.
Congress finds the following:
(1) No statutory health care program existed for members of
the uniformed services who entered service prior to December 7,
1956, and retired after serving a minimum of 20 years.
(2) Recruiters, re-enlistment counselors, and officers at
all levels of the uniformed services, and other government
officials, as agents of the United States Government, used
recruiting tactics that allowed members who entered the
uniformed services prior to December 7, 1956, to believe they
would be entitled to fully paid lifetime health care upon
retirement.
(3) In the United States Court of Appeals for the Federal
Circuit decision of November 18, 2002, in Schism v. United
States (No. 99-1402), the Court said: ``Accordingly, we must
affirm the district court's judgment and can do no more than
hope Congress will make good on the promises recruiters made in
good faith to plaintiffs and others of the World War II and
Korean War era--from 1941 to 1956, when Congress enacted its
first health care insurance act for military members, excluding
older retirees. . . . We cannot readily imagine more
sympathetic plaintiffs than the retired officers of the World
War II and Korean War era involved in this case. They served
their country for at least 20 years with the understanding that
when they retired they and their dependents would receive full
free health care for life. The promise of such health care was
made in good faith and relied upon. Again, however, because no
authority existed to make such promises in the first place, and
because Congress has never ratified or acquiesced to this
promise, we have no alternative but to uphold the judgment
against the retirees' breach-of-contract claim. . . . Perhaps
Congress will consider using its legal power to address the
moral claims raised by Schism and Reinlie on their own behalf,
and indirectly for other affected retirees.''.
(4) Only the United States Congress can make good on the
promises recruiters made in good faith to plaintiffs and others
of the World War II and Korean War era.
(5) Statutes enacted in 1956 allowed those who entered
service on or after December 7, 1956, and retired after serving
a minimum of 20 years or by reason of a service-connected
disability to medical and dental care in any facility of the
uniformed services, subject to the availability of space and
facilities and the capabilities of the medical and dental
staff.
(6) Recruiters, re-enlistment counselors, and officers at
all levels of the uniformed services, and other government
officials, as agents of the United States Government, continued
to allow members who entered the uniformed services to believe
they would be entitled to fully paid lifetime health care upon
retirement, despite enactment of statutes in 1956, subsequent
statutes, and the issuance of regulations that defined and
limited the availability of medical care to retired members of
the uniformed services.
(7) After 4 rounds of base closures between 1988 and 1995
and further drawdowns of remaining military medical treatment
facilities, access to ``space available'' health care in a
military medical treatment facility is difficult or virtually
nonexistent for many military retirees.
(8) The failure to provide adequate health care upon
retirement is preventing the retired members of the uniformed
services from recommending, without reservation, that young men
and women make a career of any military service.
(9) Although provisions in the Floyd D. Spence National
Defense Authorization Act for Fiscal Year 2001 (as enacted into
law by Public Law 106-398) extended coverage under the TRICARE
program to medicare eligible military retirees age 65 and
older, those provisions did not address the health care needs
of military retirees under the age of 65.
(10) The United States should make good on the promises
recruiters made in good faith in the World War II and Korean
War era and reestablish high quality health care for all
retired members of the uniformed services.
SEC. 3. COVERAGE OF MILITARY RETIREES UNDER THE FEDERAL EMPLOYEES
HEALTH BENEFITS PROGRAM.
(a) Coverage for Retirees and Dependents.--(1) Section 1108 of
title 10, United States Code, is amended to read as follows:
``Sec. 1108. Health care coverage through Federal Employees Health
Benefits program
``(a) FEHBP Option.--The Secretary of Defense, after consulting
with the other administering Secretaries, shall enter into an agreement
with the Office of Personnel Management to provide coverage to eligible
beneficiaries described in subsection (b) under the health benefits
plans offered through the Federal Employees Health Benefits program
under chapter 89 of title 5.
``(b) Eligible Beneficiaries; Coverage.--(1) An eligible
beneficiary under this subsection is--
``(A) a member or former member of the uniformed services
described in section 1074(b) of this title;
``(B) an individual who is an unremarried former spouse of
a member or former member described in section 1072(2)(F) or
1072(2)(G);
``(C) an individual who is--
``(i) a dependent of a deceased member or former
member described in section 1076(b) or 1076(a)(2)(B) of
this title or of a member who died while on active duty
for a period of more than 30 days; and
``(ii) a member of family as defined in section
8901(5) of title 5; or
``(D) an individual who is--
``(i) a dependent of a living member or former
member described in section 1076(b)(1) of this title;
and
``(ii) a member of family as defined in section
8901(5) of title 5.
``(2) Eligible beneficiaries may enroll in a Federal Employees
Health Benefit plan under chapter 89 of title 5 under this section for
self-only coverage or for self and family coverage which includes any
dependent of the member or former member who is a family member for
purposes of such chapter.
``(3) A person eligible for coverage under this subsection shall
not be required to satisfy any eligibility criteria specified in
chapter 89 of title 5 (except as provided in paragraph (1)(C) or
(1)(D)) as a condition for enrollment in health benefits plans offered
through the Federal Employees Health Benefits program under this
section.
``(4) For purposes of determining whether an individual is a member
of family under paragraph (5) of section 8901 of title 5 for purposes
of paragraph (1)(C) or (1)(D), a member or former member described in
section 1076(b) or 1076(a)(2)(B) of this title shall be deemed to be an
employee under such section.
``(5) An eligible beneficiary who enrolls in the Federal Employees
Health Benefits program under this section shall not be eligible to
receive health care under section 1086 or section 1097. Such a
beneficiary may continue to receive health care in a military medical
treatment facility, in which case the treatment facility shall be
reimbursed by the Federal Employees Health Benefits program for health
care services or drugs received by the beneficiary.
``(c) Change of Health Benefits Plan.--An eligible beneficiary
enrolled in a Federal Employees Health Benefits plan under this section
may change health benefits plans and coverage in the same manner as any
other Federal Employees Health Benefits program beneficiary may change
such plans.
``(d) Government Contributions.--The amount of the Government
contribution for an eligible beneficiary who enrolls in a health
benefits plan under chapter 89 of title 5 in accordance with this
section may not exceed the amount of the Government contribution which
would be payable if the electing beneficiary were an employee (as
defined for purposes of such chapter) enrolled in the same health
benefits plan and level of benefits.
``(e) Separate Risk Pools.--The Director of the Office of Personnel
Management shall require health benefits plans under chapter 89 of
title 5 to maintain a separate risk pool for purposes of establishing
premium rates for eligible beneficiaries who enroll in such a plan in
accordance with this section.
``(f) Reimbursement for Expenses for Health Care Services Normally
Provided by the Department of Defense Under TRICARE Standard.--The
Secretary of Defense shall develop and implement a system to reimburse
an eligible beneficiary who enrolls in a health benefits plan under
chapter 89 of title 5 in accordance with this section for health care
costs incurred by the beneficiary that are not paid under the health
benefits plan but would have been paid by the Department of Defense
under TRICARE Standard.''.
(2) The item relating to section 1108 at the beginning of such
chapter is amended to read as follows:
``1108. Health care coverage through Federal Employees Health Benefits
program.''.
(b) Effective Date.--The amendments made by this section shall take
effect on October 1, 2005.
SEC. 4. REIMBURSEMENT FOR TRICARE PHARMACY BENEFITS AT TRICARE NETWORK
PHARMACY LEVELS TO CERTAIN MILITARY RETIREES AND
DEPENDENTS IN HARDSHIP CASES.
(a) In General.--In the case of an eligible person who has a
certification described in subsection (b), the Secretary shall
reimburse such person for pharmacy benefits received from a pharmacy
that is not a TRICARE network pharmacy in the same manner and in the
same amounts as the Secretary would reimburse such person for such
benefits received from pharmacy that is a TRICARE network pharmacy.
(b) Certification.--The certification referred to in subsection (a)
is a certification from an eligible person's physician--
(1) stating that the person does not have access to a
TRICARE network pharmacy due to physical or medical
constraints; and
(2) meeting such other criteria as the Secretary of Defense
considers appropriate.
(c) Eligible Person.--In this section, an eligible person is an
eligible beneficiary as described in section 1108(b) of title 10,
United States Code who has another insurance plan or program that
provides primary coverage for health benefits.
SEC. 5. WAIVER OF MEDICARE PART B PREMIUM FOR CERTAIN MILITARY
RETIREES.
(a) In General.--Section 1839 of the Social Security Act (42 U.S.C.
1395r) is amended--
(1) in subsection (a)(2), by striking ``The monthly
premium'' and inserting ``Except as provided in subsection (j),
the monthly premium''; and
(2) by adding at the end the following new subsection:
``(j)(1) The amount of the monthly premium for an eligible
individual enrolled under this part is equal to $0.
``(2) For purposes of paragraph (1), the term `eligible individual'
means--
``(A) an individual who is entitled to retired or retainer
pay based upon service in the uniformed services (as defined in
section 101 of title 10, United States Code) that began before
December 7, 1956;
``(B) the spouse (as determined under section 7703 of the
Internal Revenue Code of 1986) of an individual described in
subparagraph (A); and
``(C) the widow or widower, as the case may be, of an
individual described in subparagraph (A).
``(3) With respect to years beginning after the date of the
enactment of this subsection, the monthly premium rate calculated under
subsection (a)(3) for individuals enrolled under this part who are not
eligible individuals under this subsection shall be determined without
regard to benefits and administrative costs attributable to such
eligible individuals during such years.''.
(b) Conforming Amendment.--Section 1839(i) of the Social Security
Act (42 U.S.C. 1395r(i)) is amended by adding at the end the following
new paragraph:
``(7) Inapplicability to certain military retirees.--This
subsection shall not apply to eligible individuals (as defined
in subsection (j)(2)).''.
(c) Effective Date.--(1) The amendments made by this section shall
apply to premiums for months beginning with January 2005.
(2) The Secretary of Health and Human Services shall use the rebate
methodology established pursuant to section 625(a)(2) of the Medicare
Prescription Drug, Improvement, and Modernization Act of 2003 (Public
Law 108-173, 117 Stat. 2318) to provide rebates to eligible individuals
(as defined in subsection (j)(2) of section 1839 of the Social Security
Act, as added by subsection (a)) of any premium or premium penalty paid
under such section for months beginning on or after January 1, 2005.
<all>
Introduced in Senate
Read twice and referred to the Committee on Armed Services.
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