Archived Issue: July/August 2007

Authorization Bills Move Forward With Key NAUS Issues

House Approves the Armed Services Committee FY 2008 NDAA

This year’s House consideration of the 2008 National Defense Authorization Act (H.R. 1585) was an amazing spectacle of legislative coordination to witness. It was a special partnership of work and many of our NAUS goals are included in this bill.

Unlike the old days, more than a decade ago, when, for instance, Rep. Les Aspin (D-MI) was chairman of the Armed Services Committee (1985-1992), the NDAA was completed as a collective effort in full bipartisan partnership. In those days, it often took a week and sometimes longer to move the defense bill through the House and on to the Senate.

Under the leadership of Chairman Ike Skelton (D-MO) and Ranking Member Duncan Hunter (R-CA), the House Armed Services Committee approved its version of H.R. 1585 with full approval, 58 to 0, of that Committee. And when the House considered the bill, it was discussed in one day and decided the next on a 327 to 27 vote.

As Journal readers know, the annual National Defense Authorization Act (NDAA) provides the authorization levels that our servicemembers need. It contains provisions that are important to our troops in the field, to our national security and to our military retirees, their dependents and survivors.

The fiscal year 2008 NDAA provides authorization for $648.6 billion to support our brave men and women in uniform and sets Defense Department military policies and plans for the budget year that will begin on October 1, 2007.

To the credit of this Armed Services Committee, NAUS is extremely pleased to see our number one goal approved by the Committee, the rejection of the Pentagon’s plan to steeply increase TRICARE fees and pharmacy co-pays. Blocking the DoD outrageous plan is a NAUS top goal, and we applaud the Armed Services Committee’s responsible and respectful action.

We are also pleased to see the House Committee approve Chairman Skelton’s across-the-board 3.5 percent pay raise for military members. The increase is a half percent higher than the general civilian wage increase that the administration requested. It helps fulfill a congressional commitment to close the gap in pay between the uniformed services and private sector, which was as large as 14 percent in 1999 and will stand at 3.4 percent with the approval of this raise.

The Committee’s bill would also take new ground to expand eligibility of Combat Related Special Compensation (CRSC) to medically retired servicemembers (Chapter 61), provided they served for at least 15 years and have at least a 60 percent disability rating.

Regarding this matter, our NAUS goal is to push through an improved concurrent receipt policy for all medically retired servicemembers, regardless of length of service or disability rating. However, we see the House action as a small step in the right direction. It is only the first step if NAUS and our partners in The Military Coalition and The Alliance continue our efforts to better recognize those who never had a chance to meet the 20-year threshold for retirement because of medical conditions or illnesses.

Another element of the House measure would transfer authority of the Selected Reserve Montgomery G.I. Bill from DoD to VA. This action reflects a NAUS-goal to move the Guard/Reserve MGIB program from the darkness of Pentagon jurisdiction to the light of Veterans Affairs. The expectation is that under the jurisdiction of House and Senate Veterans’ Affairs Committees the program would receive better attention rather than neglect.

The bill also includes the entire Wounded Warrior Assistance Act, which addresses many of the problems identified earlier this year at Walter Reed Army Medical Center. Further, it seeks to reform the various administrative processes of the disability evaluation program, in an effort to restore confidence in the program while simultaneously working to achieve a more seamless transition of servicemembers from DoD to VA.

Calling attention to the morale of the troops, Rep. Vito Fossella (R-NY) added an amendment to the bill that authorizes free mailing privileges for family members of our troops in harm’s way in Iraq and Afghanistan. The special assistance package would allow families to send a letter or care package free of postage once every other month to loved ones in combat zones.

Regarding the Fossella mail amendment, it was almost two years ago when the 42nd ID (Rainbow) was deployed and in Iraq, that a soldier’s family member complained to NAUS about the high cost of postage to soldiers there. It occurred at a Family Readiness Group meeting in Troy, NY, and NAUS Regional Vice President Tom Quinlan was in attendance. Tom and the Rainbow Chapter in New York took up the issue, and it has since gone through several transformations and with a great deal of help from countless others made its way to this stage of development.

As an aside, appropriate at this point, we appreciate the dedicated work of our New York organization and highlight its commitment to this issue. Not only has Rep. Fossella taken the issue to this point, Senator Hillary Clinton has introduced an identical measure in the Senate. And NAUS is working with the Senator in anticipation that she will work to amend the Senate version of the NDAA when it comes to the floor. With the addition of the amendment to the Senate bill, the likelihood of its success in conference takes a quantum leap forward.

As Rep. Tom Davis (R-VA) said on the House floor when he quoted General Walter Boomer, the commander of the Marines in the first gulf war, a soldier’s best friend, next to his rifle, is the postman. And NAUS agrees, holding a son or daughter’s art project or biting into a homemade cookie or reading a simple letter from back home is always appreciated and means so much to our heroes fighting in Iraq and Afghanistan. We will work to see this through.

The bill also addresses military end strengths. Concerned that the size of the force is not sufficient to meet current demands, House lawmakers recommend end strength levels greater than those DoD requested, proposing to increase the Army by 36,000; the Marine Corps by 9,000; and the Army National Guard by 1,300. Committee members also disagree with a Navy plan to cut approximately 900 medical personnel, moving to restore 490 medical personnel positions. Another provision prohibits any additional conversion of military medical positions to civilian slots DoD-wide.

Overall, the bill looks good at this stage and disappointments are few. It doesn’t contain a couple of key provisions we were looking for like accelerating the SBP paid-up provision or expansion of concurrent receipt to retirees with less than 40 percent disability ratings. But clearly the committee put forth considerable effort to address many of our concerns.

NAUS is deeply disappointed, however, in the ultra-limited reach of the Committee’s recommendation to pay a modest $40 a month to surviving spouses who are adversely affected by the SBP/DIC offset. The effect of this action, if approved, changes the SBP annuity reduction to $1,027 from $1,067. Perhaps we’re missing something, but on first view the Committee’s action gives the word “modest” new meaning. We look for better consideration in the Senate bill and the conference to follow.

Some of the other disappointments include an $800 million reduction in the President’s recommendation for funding a layered ballistic missile defense system capable of intercepting missiles at all stages of flight. With North Korea already testing long-range missile capability and Iran within a decade or less capable of reaching the United States and its allies, slowing the development of a missile defense system is ill advised.

The House bill would also cut $867 million from the Army’s modernization program, the Future Combat Systems, a program designed to integrate the soldier on the ground with a network of weapons, sensors, and information to advance the soldier’s reach and survivability in combat.

Overall, the House bill rightly targets our military’s readiness needs. After five years of war, the readiness of our ground forces, particularly our National Guard and Reserve, are a serious concern. As mentioned, it authorizes an increase in the size of the Army and Marine Corps to reduce the strain on current forces. It addresses many of the problems identified at Walter Reed Army Medical Center to ensure improved treatment of our wounded warriors. And it authorizes funds for personal body armor and up-armored Humvees and Mine Resistant Ambush Protected vehicles, known as MRAPs.

At this writing, there remains opportunity for key issues to be addressed, especially in the Senate. Remember, you play an important part in this process, and we urge you to contact your senators to support S. 935, the Nelson bill to end the offset of Survivor Benefit Plan against the Dependency and Indemnity Compensation payment (SBP/DIC offset). Your calls and letters on issues contained in this bill can directly influence decisions, as a final bill is forged over the next few months. Give your Senators a shout.

Senate Armed Services Committee Approves NDAA for 2008

At this writing, the Senate Committee on Armed Services has approved its National Defense Authorization Act for 2008 (NDAA) and sent it to the full Senate for its consideration and amendment. It is anticipated that the Senate will act on this matter soon, but the schedule remains uncertain due to the possibility of action on other matters that may jam the Senate schedule, such as a second look at the immigration bill or similar measures that may crop up.

Let’s take a look at the Committee’s report and discuss a couple of additions that NAUS would like to see as the bill (S. 1547) comes to the floor for a vote.

As in the House bill, the Senate includes an across-the-board 3.5 percent pay raise next January for military personnel. This increase is a half percentage point greater than the average private sector wage growth, measured by the Employment Cost Index (ECI) and is aimed to close the civilian-military narrowing wage gap.

Similar to the House bill, NAUS is pleased to report that the Senate legislation also rejects the $1.86 billion increase sought by the Pentagon in proposed TRICARE fee and pharmacy copayments. Stopping the tone-deaf, blunt-force approach of the Pentagon is a NAUS commitment. And we will continue to keep a close eye on protecting the promised benefits of quality care and on securing its provision for our retirees, their families and survivors.

Another NAUS-endorsed provision is the authorized payment of combat-related special compensation to service members medically retired for a combat-related disability. The Senate bill treats Chapter 61 retirees – medically retired – quite differently and better than the House bill. The House provides for only those with at least 15 years service and only those with a 60 percent disability or greater. The Senate expands to accept all Chapter 61 retirees whose service was cut short because of combat-related injuries.

As the reader knows, these troops never had the chance to meet the 20-year threshold for regular retirement. They were forced out of the service due to an injury or illness during service. They are given an unfair and outdated choice between retirement pay or VA compensation. The result is an elimination of one or the other. NAUS asks you to help us pass the Senate version for all who have given so much to our country.

The Senate bill also would authorize the use of federal pricing for pharmaceuticals dispensed through the TRICARE retail program. And like the House bill, the Senate would authorize an increase in the end strengths for the Army and Marine Corps of 525,400 and 189,000, up 13,000 for the Army and 9,000 for the Marine Corps.

One of the areas of concern is the provision of Reserve retirement. NAUS and its partners in The Military Coalition and The Alliance have been working for years to upgrade Reserve retirement to make it more like that which is provided to civilian federal workers.

We would like to see the Reserve retirement age dropped to 55 from the current age of 60. The Senate bill takes a step toward a better recognition of our citizen warriors by lowering the retirement age by three months for every 90 days a reservist or National Guard member is on active duty. Unfortunately, the effective date for the change is on the date the bill is signed, thereby shortchanging all who have given so much active time during the past Iraq and Afghanistan wars. We will be working to improve on this provision.

Another area we are pleased to see addressed is the requirement of the Secretary of Defense to establish a Family Readiness Council and develop a comprehensive policy and plans to improve the support for and coordination of family readiness programs. NAUS testified on this issue earlier in the year asking for the enhancement of programs and policies to support marriage and families under the extreme stress of lengthy separation and deployments.

Some of the other areas of NAUS engagement are addressed below for SBP/DIC, mail assistance and keeping our promise to America’s military retirees.

NAUS Political Report

As you know, the Washington political environment has changed greatly since last November’s congressional elections. In many ways, the change has been good and our voice is being heard and our interests are being reflected in the appropriations and authorizations discussions before Congress.

Your legislative team, pictured on the cover, is continuing to work hard to deal with the White House and the Congress. Our mission remains constant. We give bipartisan support to those congressional and executive branch leaders who best support us in obtaining our objectives. We fight for you and stand with those who are key to our issues regardless of party affiliation.

As the first session of the 110th Congress moves past the mid-way point, look to NAUS to keep you informed on voting records, cosponsorship, and related political statements on our issues of the day. NAUS can understand the matters and give you the pulse on Capitol Hill and elsewhere in the nation’s Capitol City. However to be successful to the degree we mean to be, we must ask you to help us gain the attention of Congress and other decision makers at the Department of Defense and elsewhere in the executive branch.

If we are to be successful in winning protection and improvements in military health care, cost-of-living adjustments, and other earned benefits in the present budget cutting and defense rebalancing political culture, we need to work together. NAUS can sound the alarm, but the real power is with you – the constituent and voter. We can discover the intelligence and outline plans of action, but only working together can we win the victory.

As we said many times, protecting your hard earned health care is our number one priority. We have many friends in Congress who understand the sacrifice of service in America’s Armed Forces. However, we have many more who need to receive regular doses of education about not only the monetary expense of war and defense of freedom in this generation, but the costs that incur on the home front to those individuals who served and sacrificed in past generations.

NAUS firmly believes that those of us who have borne the battle and answered the call to arms know what it means to be strong enough to meet the threats we face today and those we may see tomorrow. And we know also the difficulty in asking those in military service to fight for us overseas and then to fight for promised benefits and services once they return to a defended America.

Let there be no doubt that the challenges we face with military health care, veterans compensation benefits, survivor and related issues can only be addressed with adequate resources. We anticipate that those we elect will establish the right priorities to set things straight. Funding for military and veterans health care should not take a back seat to billions of dollars of “backroom” deals that fund thousands of lesser priority programs.

There is still much work to do in seeing that Congress attends to the priorities of the nation and stops abusing military retirees with ever-higher rates for the health care they earned through an arduous military career. For example, what budget priority allows health care for illegal aliens to trump care for former military.

Join with us in working to ensure that our Government never fails to honor and repay the men and women whose bravery won our freedom and prosperity. The price will never be greater than the value we receive from their service.

Keep Our Promise to America’s Military Retirees

Rep. Chris Van Hollen (D-MD) has introduced two new NAUS-endorsed bills to address the promise made to retirees who joined before 1956 that they would get free lifetime medical care in return for a career in the military.

The first Van Hollen bill is the Keeping Faith with the Greatest Generation Military Retirees Act, H.R. 1223. This bill addresses a specific obligation Congress has to military retirees who entered the uniformed services prior to 1956. These service personnel joined the service under one set of rules but retired under a different set of rules that stripped them of health care that had been provided routinely to them.

In 2002, a Federal Appeals Court called on Congress to use its legal authority to address the “moral claims” of this class of military retirees. To answer the promise, H.R. 1223 would waive Medicare Part B Premiums for Military Retirees who entered the uniformed services prior to December 7, 1956, because they entered the service under one set of rules but retired under a different set of rules that stripped them of promised and earned health care.

The second Van Hollen bill is H.R. 1222, the Keep Our Promise to America’s Military Retirees Act. This bill would fulfill a promise to young recruits that quality health care would be available to them when they retired after a career in uniformed service to their country. It would allow military retirees to opt out of the TRICARE military health system and enroll in the Federal Employees Health Benefit Plan (FEHBP) if TRICARE does not provide them adequate health care. It would also maintain access to the military pharmacy benefit for military retirees who opt out of TRICARE and enroll in FEHBP.

We encourage you to contact your member of Congress to cosponsor and support H.R. 1222 and H.R. 1223. These bills would answer the “moral claims” of this class of military retirees for the promises made to serve a military career.

Guam in the NDAA

Another of the NAUS-endorsed provisions contained in the House passed version of H.R. 1585, the National Defense Authorization Act for fiscal year 2008, addresses our concern about medical care for our military retirees and their families who live on Guam.

Under the encouragement of NAUS President Bill Matz, the lead of Representative Madeleine Z. Bordallo and the support of chairman Ike Skelton and ranking member Duncan Hunter, the House bill includes a welcome authorization to provide space-available category 4 level seating priority to retirees requiring specialty care at off-island medical facilities. It also directs DoD to identify the administrative actions needed to be executed in order to provide relief to the affected TRICARE beneficiaries residing in the territories of the United States.

NAUS strongly supports responsive attention to the needs of retirees on Guam who are reliant on the TRICARE system for their health care. Since 2005, military retirees and their dependents referred off island for specialty care have had to pay for medical travel at their own expense. Previously, the Defense Department covered this significant cost, but it has now discontinued its support for travel expenses incurred for medical referrals.

The House provision would greatly assist military retirees and military dependents on Guam. And NAUS agrees. Guam’s retirees requiring specialty care at off-island facilities deserve to have a priority answer to their TRICARE concerns. They earned it. After all, they served one of our country’s most demanding roles; they gave a life’s career in the United States military to keep America safe.

Medicare Physician Payment Reform

As NAUS works to avoid erosion in our military retiree health coverage, another issue tightly related to TRICARE remains high on our political radar and deserving of our lobbying attention.

We have a problem in the Medicare system as to how we reimburse physicians. Since TRICARE provider payments are based on Medicare reimbursement rates, access to care for beneficiaries under TRICARE and TRICARE for Life is directly tied to the Medicare physician payment formula.

Under present law, physician’s Medicare payments in part B of Medicare face a 10-percent scheduled reduction effective Jan. 1, 2008. Physician payment corrections are driven by a flawed formula called the Sustained Growth Rate.

Every year in the recent past, except 2002, Congress has avoided discussion on the Medicare/TRICARE Sustained Growth Rate (SGR). Instead it has come in at the end of the year, days before the scheduled drop in rates, and done something to stop the cut. Last year, instead of reforming the SGR formula, Congress at the eleventh hour decided to pay the same rate as the previous year.

Reforming or repealing the SGR is technical and complex, and in some very important areas confusing. Nevertheless, it’s something we need Congress to take under consideration, understand, debate and fix.

NAUS strongly supports congressional action on the reimbursement for healthcare providers who are paid under the Medicare physician fee schedule. SGR reform would attend to the inherent tension currently in the system. Paying doctors fairly would help stabilize the physician workforce, at least for those doctors who participate in Medicare, and therefore in TRICARE, the military healthcare system.

Without corrective action, rates will fall and fewer providers will take Medicare and TRICARE patients. Avoiding a physician payment cut will help ensure access to care. And for military retirees, the benefits of TRICARE are not worth much if beneficiaries cannot find a doctor when they need one.

NAUS asks you to contact your Senators and Representative and urge them to help keep health care accessible for military retirees and their families. Ask them to help get the Medicare payment policy right. If you are sick, you want a doctor there, willing and able to provide care. After all, that’s what your earned benefit is all about.

Veterans Disability Benefits Commission Receives IOM Report

As requested by the Veterans Disability Benefits Commission, the Institute of Medicine (IOM) released a report on June 7 entitled A 21st Century System for Evaluating Veterans for Disability Benefits.

The IOM report, which examines and recommends improvements in the medical evaluation and disability rating of veterans for the benefits, recommends the Department of Veterans Affairs update the entire Disability Rating Schedule and establish a regular process for keeping it up to date; commission an external advisory committee of medical and other disability experts to assist in the updating process; and, re-examine the current statutory purpose of the disability compensation program (to compensate for average loss of earning capacity) and expand it to include compensation for a veteran’s loss of quality of life.

Though the VA has not yet responded, the report brought heavy criticism from several Veterans Service Organizations (VSOs). The simple fact, VSOs said, is that the VA disability rating schedule is continually reviewed and revisions are regularly made. Suggesting a total revamp of the system is uncalled for, VSOs said, and the report wrongly leads one to believe that the schedule was assembled at the end of World War II and never reopened for review or retooling. Though it dates to the Second World War, the schedule has undergone extensive and reiterative revision.

As NAUS readers know, the Veterans Disability Benefits Commission is chaired by LTG Terry Scott, USA (Ret), and includes NAUS President Bill Matz as one of the 13 Commissioners. It was established by Congress to review benefits going to disabled veterans and the survivors of deceased veterans and is scheduled to make final recommendations to Congress and President George W. Bush this fall. The Institute of Medicine is part of the National Academies, an organization chartered by Congress to advise the government of scientific and technical issues. NAUS looks forward to reading the final report and moving forward with legislation to provide full concurrent receipt for all disabled retired service personnel.

Walter Reed Update

The conditions and situation at Walter Reed Army Medical Center seems to have dropped off the radar screen after all the intense media and Congressional scrutiny of several months ago.

We would like to report that things have improved dramatically.

Dr. S. Ward Casscells, the new Assistant Secretary of Defense for Health has made several visits to the medical center and has reported that through the combined efforts of the new Commander of the Walter Reed Army Medical Center MG Schoomaker, the Army Vice Chief of Staff General Cody and the Walter Reed Staff, vast improvements have been made.

Dr. Casscells reports that repairs to Building 18 are either well underway or complete. NAUS has also heard that all residents of that building have been moved out to better quarters at least until the rehab has been completed.

In dealing with the wounded warriors there has been a drastic increase in the number of case managers to assist these brave men and women through the bureaucratic messes they find themselves in. The Army has stood up their Wounded Warrior Brigade, based upon the Marine Wounded Warrior Barracks at Camp Lejune, to ensure that the needs of the troops and their families are met.

Neither the House nor Senate versions of the 2008 National Defense Authorization Act have called for Walter Reed to remain open beyond 2011 under BRAC plans. Defense Secretary Gates indicated that he concurs with the recommendations made by the independent review group headed by former Army Secretaries Togo West and John Marsh that the medical center should be closed as planned. However they also stressed that Walter Reed should be fully funded until the new facilities on the grounds of Bethesda Naval Medical Center and at Ft. Belvoir, just south of Washington, are fully completed, staffed and ready to go.

Since the BRAC Commission’s 2005 report on closing Walter Reed, NAUS has consistently sought to ensure the facility remained fully functional and fully operational to serve the needs of catastrophically injured soldiers. We just did not see how the closing of this prestigious institution, without the replacement hospitals all ready to go, would happen without some degradation in treatment for the patient community at the medical center. Unfortunately we were correct and the most vulnerable of those patients, the wounded returning for treatment from Afghanistan and Iraq were those most affected. We continue to stress that FULL FUNDING of Walter Reed be maintained until and through the transfer of services and patients to the new facilities. Let us together continue to focus on the needs of our wounded warriors.

Unfortunately, the review of conditions initiated by Dr. Casscells uncovered yet another problem when 4,500 letters and packages were found sitting undelivered in the WRAMC mailroom. As soldiers set out to get the mail back en route, the contract employee who mismanaged the mailroom was fired and procedures were put in place to ensure the problem does not happen again.

Legislation to Honor Fallen Troops Ready for President’s Signature

On Flag Day, June 14, the Senate approved by voice vote legislation to allow governors to fly the national flag at half-staff in honor of those who lose their lives serving our country in the Armed Forces. The House passed the bill by a vote 408 to 4, on May 15. At press time, the bill is being prepared for the President’s signature into law.

The bill, titled The Army Specialist Joseph P. Micks Federal Flag Code Amendment Act of 2007 (H.R. 692), is named after Joseph P. Micks, a soldier from Rapid River, Michigan, killed in Iraq last July at the age of 22. It amends current law to honor the brave men and women who serve in our Armed Forces to the list of persons in whose honor the flag may be flown at half-staff. It would apply to all Federal installations and facilities in the State.

NAUS is pleased to see our country give its respect to our fallen military heroes who made the ultimate sacrifice and their families through this action.

It is a grateful nation that honors the sacrifice of our military. And we commend Rep. Bart Stupak, sponsor of the bill, and our affiliated organization, the Society of Military Widows, for their strong and early endorsement of the bill.

SBP and DIC

NAUS continues to work to change the requirement for a dollar-for-dollar offset of the Survivor Benefit Plan (SBP) against receipt of the Department of Veterans Affairs Dependency and Indemnity Compensation (DIC). The DIC offset affects 61,000 survivors whose husbands purchased SBP annuities to provide for them. And it should be pointed out that in many cases the annuity is eliminated completely.

As readers know, the House version of the National Defense Authorization Act (H.R. 1585) contains a modest reduction of the offset. While the House bill would only reduce the SBP/DIC offset by a mere $40, we also know that this action is the first time the House has taken a formal stand against the $1,067 monthly offset of the SBP annuities.

We believe it is past time to end this unfair offset, and we look to the Senate to take a larger step than the House and move to end this unfair reduction when it takes up the measure later this session. This is the reason we strongly support Sen. Bill Nelson’s (D-FL) legislation (S. 935), and ask you to contact your Senators to cosponsor and support passage of this bill or its inclusion in the fiscal year 2008 NDAA (S. 1547).

Don’t forget that you play an important part in this process, and we urge you to contact your Senators to support S. 935, the Nelson bill to end the SBP/DIC offset. Your calls and letters on issues can directly influence decisions, as a final bill is forged over the next few months.