As House and Senate Democrats negotiate a final health care reform bill, servicemembers across the nation — and their advocates in Washington, D.C. — remain vigilant for side effects.

The Obama administration and Democratic congressional leaders have tried to reassure military members, retirees and veterans that national health care reform won’t negatively impact them — in fact will help veterans.

Indeed Democrats contend that if the Senate-passed Patient Protection and Affordable Care Act becomes law, many of 16 million veterans not enrolled in VA health care "will have access to quality, affordable health insurance choices through [new] health insurance Exchanges ... and may be eligible for premium tax credits and cost-sharing reductions as well."

A two-page list of reassurances from the Senate Finance Committee can be read online at:

Many military retirees and veterans don’t believe it. Their skepticism is reinforced by statements from Republicans who oppose the president’s health initiative and by scary e-mails including one from a retired brigadier general who wrongly asserts that the Congressional Budget Office already has drafted a bill to eliminate Tricare for Life. It has not.

The House-passed Affordable Health Care for America Act states in Section 311 that "nothing" in the bill "shall be construed as affecting" authority of the Defense or Veterans Affairs departments to provide Tricare or VA health care. The final compromise is almost certain to include this language to protect Tricare and veterans’ health care, Capitol Hill sources said. They will be protected from any excise tax that Senate Democrats want to levy on so-called "Cadillac" health insurance.

Behind the anxiety of many older retirees is the memory of a broken promise over free health care for life, said Joe Barnes, national executive director of the Fleet Reserve Association. That, combined with the endless loop of misinformation on the Internet, has deepened concerns, Barnes said.

Bob Washington, co-chair of the health care committee of The Military Coalition, an umbrella group of service associations, also points to the false report involving CBO. Many older retirees also fear for their Tricare for Life benefits from the spectacle of lawmakers each year having to block an automatic cut in Medicare doctor fees ordered by an earlier Congress.

More anxiety arises because Democrats say they pay for health reform with billions of dollars in Medicare savings, something Republicans contend will put Medicare at risk though most military associations disagree.

But Joyce Raezer, executive director of the National Military Family Association, believes legitimate concerns do remain for the military community. They flow from the plans’ promise to make affordable health insurance available to 31 million Americans who currently are uninsured.

Health reform plans would create health insurance "exchanges" from which individuals and small business will buy coverage. Raezer wants to know what will happen if participating insurance companies try to entice physicians to be part of these plans by paying fees higher than Medicare allows. Tricare fees, by law, are tied to Medicare reimbursement rates.

So Raezer worries that Tricare beneficiaries will see access to civilian providers tighten, particularly access to family physicians who serve as gatekeepers to specialty care. Some primary care doctors already set limits on the number of Tricare and Medicare patient they take on, she said.

"What’s going to happen if reimbursements don’t change for Tricare," Raezer asked.

"Are we’re going to continue to depend on patriotic doctors to take Tricare beneficiaries when all of these other people are jostling for care?" She urges the military community to remain wary.

"Folks hear that the legislation isn’t touching Tricare, isn’t involving VA, and they say, ‘Okay, we’re safe,’ " Raezer said. "I’m relieved that members of Congress don’t want to [pull] Tricare benefits into all of this [and will] let DOD run its health care program. … But I don’t think that’s enough for us to say ‘Don’t worry.’ We still have to watch for unintended consequences."

To comment, send e-mail or write to Military Update, P.O. Box 231111, Centreville, VA, 20120-1111

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