washingtonscene All Medicare enrollees will see an an-

nual deductible increase to $166 from the current $147. Without the budget deal, it would have been $233. In essence, anyone receiving a Social Security check who already was paying $104.90 in monthly premiums in 2015 and who won’t exceed the income level shown on page 35 will keep paying the same $104.90 a month in 2016. The in- come thresholds for 2016 are based on the adjusted gross income from your 2014 federal tax return, because that’s the lat- est verifiable income figure the govern- ment has for you. Those below the income threshold

who aren’t receiving Social Security checks or who will enroll in Part B for the first time in 2016 will pay a monthly pre- mium of $122. Because Medicare is a need-based entitlement program, the government subsidizes less and less of the Medicare premium as income rises.

Health Costs D

Spiraling? Are military health care costs really out of control?

efense leaders have com- plained for years about “spiral- ing military health costs,” and their

main proposals have centered on foisting more costs onto health care beneficiaries. Congress has acted on those concerns

by raising TRICARE Prime enrollment fees 23 percent since 2011, doubling or tripling most TRICARE pharmacy copayments over that period, and requiring annual inflation-based fee hikes going forward. The president’s budget projections

still show military health care costs growing in the outyears.

36 MILITARY OFFICER JANUARY 2016 Armed Services Committee leaders

say they intend major action next year to reform military health coverage and that “increased fees will be a necessary part of this reform.” But looking at the facts, rather than the rhetoric, about health care costs will be crucial in that effort. Fact 1: Every year, the Pentagon budget

forecasts significant cost increases for future years. Fact 2: For the past five years, those

projections have proven false, as overall DoD health care costs (as reflected in an- nual Pentagon reports to Congress) have stayed flat. Fact 3: DoD fee-hike proposals, in the main, have targeted beneficiaries who receive their care outside of military hospitals. Fact 4: For the past five years, these

“purchased care” costs have remained flat (other than a $1.5 billion anomaly for FY 2015 that DoD has acknowledged was a one-time oversight failure on com- pounded medications that now has been brought under control). Fact 5: DoD costs for TRICARE For Life (TFL) (i.e., annual Pentagon deposits to the TFL trust fund, which cover both care and medications) have declined dra- matically, from $10.8 billion in FY 2010 to $6.6 billion for FY 2016, as older retirees’ actual health care costs haven’t proven as high as defense actuaries had expected. Fact 6: Virtually the only elements of the DoD health care budget that have been increasing over the past five years are care delivered in military facilities (over which the Pentagon has the most control and which mainly reflects mili- tary readiness needs) and pharmacy costs for non-Medicare-eligibles. Fact 7: At current levels, TRICARE pharmacy copayments are at about the 50th percentile of copayments charged