09.13.17

Rounds Urges Support of His Amendment to Shield Military Retirees From Costly Prescription Drug Copay Increases

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WASHINGTON—U.S. Senator Mike Rounds (R-S.D.), a member of the Senate Armed Services Committee, today delivered remarks on the Senate floor in support of an amendment he introduced to the National Defense Authorization Act (NDAA) currently being debated on the Senate floor.

“I fully support improving care for beneficiaries of the military health system,” said Rounds in his speech. “However, increased TRICARE pharmacy copays must be carefully considered to make certain that they do not disproportionately impact one part of the beneficiary population. Unfortunately that would be the case for South Dakota and other largely rural states with large military retiree populations that live too far from Military Treatment Facilities to draw free prescriptions available there.”

 

Rounds’ amendment would change a provision in the current NDAA bill that raises prescription drug copays under the TRICARE program for military retirees and their families who get their prescription drugs from a retail pharmacy or through mail order, while those who obtain them from a Military Treatment Facility continue to get them for free. Under Rounds’ amendment, military retirees and their families who live more than 40 miles from a Military Treatment Facility would be exempt from the proposed higher copays.

Rounds’ remarks, as prepared for delivery:

Mr. President, as the Senate considers the National Defense Authorization Act, the NDAA, I rise today to discuss a simple amendment in support of my constituents who are military retirees as well as those in many other states. 

 

These retirees may be disproportionately and unfairly impacted by increases in TRICARE prescription drug copay increases in the bill we are considering today.

 

Specifically, provisions in this bill will increase cost-sharing amounts for the TRICARE pharmacy benefits program for years 2018 through 2026.

 

The rationale for the increases in the bill we are considering today is that the savings generated from pharmaceutical cost-share increases can be used to improve health outcomes and the experience of care for beneficiaries of the military health system.

 

I fully support improving care for beneficiaries of the military health system. 

 

However, increased TRICARE pharmacy copays must be carefully considered to make certain that they do not disproportionately impact one part of the beneficiary population. 

 

Unfortunately that would be the case for South Dakota and other largely rural states with large military retiree populations that live too far from Military Treatment Facilities to draw free prescriptions available there. 

 

Instead, these military retirees and their families are compelled to use the TRICARE mail order system OR retail pharmacies, and in both cases, they would have to pay higher copays. 

 

For example, the copay for a generic drug ordered through the TRICARE mail order system will increase by $10 in Fiscal Year 2018. 

 

While this does not seem like a lot of money, these costs can add up rapidly if a military retiree and his or her family members are required to make multiple copays for multiple prescriptions.

 

Simply put – our military retirees who live more than 40 miles away from a Military Treatment Facility should not be unfairly forced to pay higher copays on prescription drugs just because of where they choose to live.

 

Under my amendment, we would take a step back. 

 

The amendment would freeze copay increases for TRICARE retirees and their families living more than 40 miles from a Military Treatment Facility. 

 

Additionally, the amendment would require the Department of Defense, DOD, to assess the financial impact of the higher copays on these beneficiaries. 

 

The 40 mile figure was chosen carefully. 

 

Forty miles is a distance used by both DOD and the Department of Veterans Affairs, the VA, as a boundary for reasonable access to a health care facility. 

 

DOD’s TRICARE Prime program, in which care is primarily delivered through a Military Treatment Facility, is available to individuals who reside within Prime Service Areas or PSAs. 

 

PSAs are locations that are within 40 miles of a Military Treatment Facility. 

 

Similarly, the VA Choice program, which allows veterans access to health care in local communities rather than waiting for a VA appointment or traveling to a VA facility, is available to those whose residence is more than 40 miles driving distance from the closest VA medical facility.

 

My amendment would also set a deadline of 60 days after enactment, for a DOD report on the financial impact of the copay increases on military retirees and their families.    

 

With the information provided by DOD, Congress can then rationally assess the impact of the copay increases on beneficiaries who live distant from Military Treatment Facilities and incorporate appropriate provisions in future legislation.

 

I appreciate this opportunity to discuss my amendment, which would rectify this unintended effect on military retirees and their families.

 

Thank you, Mr. President, I yield the floor.

 

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