Congress Revokes Administration Discretionary Authority Over TRICARE Pharma Fees

Posted by Jason Van Steenwyk

TRICARE pharmacy co-paysFor years, Congress has granted the Secretary of Defense broad authority to unilaterally set TRICARE premiums and fees itself, rather than seek Congressional approval.

This worked fine for a long time, because previous Administrations did not seek to make major changes and blindside Congress with sudden fee hikes.

No more.

The Obama Administration has repeatedly moved to hike TRICARE premiums – by substantial amounts. For example, last year, TRICARE Pharmacy co-pays increased $2 to $3 dollars. The Obama Administration turned around and attempted to double or triple pharmacy co-pays – to the tune of $21 to $31 per medication.

This is a big deal to those who rely on these medications – particularly TRICARE-For-Life beneficiaries.

Naturally, the prospect of major, sudden TRICARE fee hikes causes angry phone calls and letters to Congressional representatives from veterans, military families, and their powerful lobbying organizations.

This year, Congress said ‘enough,’ and finally tied the Administration’s hands. According to Steve Strobridge, a retired Air Force colonel and Director of Government Relations for the Military Officers Association of America, the Administration had crossed a line and abused its discretional authority.

“In effect, Congress told the Pentagon, “You’ve repeatedly abused the adjustment authority we gave you and show no signs of changing that behavior, so we’re taking your authority away,” explains Strobridge. “Instead, we’re putting a formula in law that will ensure future adjustments are more appropriate and predictable.”

Government Exec magazine describes the proposals, counterproposals, and legislative sponsors in more detail here.

Provisions in the new Defense Authorization Act now tie increases in pharmacy co-payment to increases in retirement pay. Since Congress controls this expense, rather than the Secretary of Defense, Congress therefore took substantial control of the TRICARE fee structure back from the Secretary and put it back with electoral representatives, accountable to the public. 


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2 responses to “Congress Revokes Administration Discretionary Authority Over TRICARE Pharma Fees”

  1. bill parson says:

    If the Gov. has their hands in it, we are doomed.

  2. Alvin Fulcher says:

    Regarding the Post’s December 3rd editorial “Time To Rein In Tricare,” we agree getting it right with defense cuts is critical – out of control deficits and a dangerous rise in the national debt are national security issues. 
    But we can’t agree that Congress should simply raise military retirees’ healthcare costs by $1,000 to $2,000 a year while letting Defense leaders off the hook for health system mismanagement and inefficiencies no civilian company would tolerate.

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