washingtonscene \\ COLA News //
COLA in the Hole Falling gasoline prices have caused the FY 2016 COLA to start in the hole. For the month of October, the Consumer Price Index decreased 0.8 percent from the FY 2015 base- line. Follow the trends at www.moaa.org/cola.
by civilian employer plans (as measured by the Hay Group, one of the most re- spected surveyors of benefit programs). Fact 8: Congress’ multiple recent
adjustments to TRICARE pharmacy co- payments have been relatively arbitrary, driven in part by the need to raise more revenue to pay for other programs. Fact 9: The 2016 $10 retail pharmacy
copayment for generic drugs is more than twice the $4 copayment Wal-Mart charges people with no insurance for most common generics. What can we conclude from these facts? Conclusion 1: DoD consistently proj-
ects large cost increases that don’t materialize. If they’ve been consistently bad at making past projections, why should we give much weight to their current projections? Conclusion 2: If past misprojections formed the entire basis for pushing more costs to beneficiaries, one has to question the validity of continuing that argument. Conclusion 3: If you believe the mili- tary health care benefit should be at the very top tier — the gold standard that ex- ceeds private-sector plans in recognition of currently serving and career members’ and families’ decades of service and sacrifice — then pharmacy copayments already are plenty high. Conclusion 4: If the main area of cost
increases has been in care delivered through military hospital and clinics rather than care obtained from civilian providers, then maybe, just maybe, the focus of future cost-containment efforts should be on DoD’s inefficient manage- ment of those in-house programs rather than simply blaming beneficiaries for cost problems they’re not causing. Conclusion 5: One of the pillars of any health care reform effort should be an explicit acknowledgement of the sig- nificant, pre-paid and in-kind premium
38 MILITARY OFFICER JANUARY 2016
value of servicemembers’ and their fami- lies’ decades of service to their country.
Priced Out of T
TRICARE? 2016 TRICARE Young Adult fees are up 47 percent.
RICARE Young Adult (TYA) beneficiaries will see a steep rise in their premiums next year.
TRICARE provides coverage for depen- dents up to age 21 (or 23 for full-time students) of active duty servicemembers and retirees. After that, TYA allows qualified adult children to purchase TRI- CARE coverage until age 26, consistent with other health plans. Beginning Jan. 1, premiums will in-
crease to $306 monthly for TYA Prime and $228 monthly for TYA Standard. Why are costs spiking 26 to 47 percent? The TYA program is required to charge
its young-adult beneficiaries premiums that cover the full government cost of their individual coverage. DoD originally had to rely on estimates
when establishing premium costs. Now that the program has been up and running, it has several years of actual costs to set premiums based on real health care usage. The cost of the TYA program is spread
over a small beneficiary group of approxi- mately 45,000 enrollees. This is the big difference between the military TYA program and other civilian in- surance programs that cover young adults. Most civilian plans spread their young adult costs over their entire enrolled popu- lation, so every insured person, regardless of age, pays a small amount more. MOAA questions the affordability of this benefit for military families, especially those with more than one child in this age