National Defense Authorizaton Act for Fiscal Year 2007

By:  Lindsey Graham
Date: June 14, 2006
Location: Washington, DC



Mr. GRAHAM. Madam President, I will give a little background, if I could, about this subject matter and area of inquiry.

The Department of Defense initiated early on this year, and part of last year, a fairly dramatic increase in TRICARE premiums for military retirees and family members. The TRICARE program is, I think our membership knows, a military health care system for Active-Duty people and also for those who are retired, up to age 65. This is a provision for those 65 who can continue during Medicare eligibility.

The health care part of the military budget is just growing leaps and bounds. Our chairman is sort of the champion of the TRICARE program, and it has been a wonderful program for military members and their families and retirees. But in 2015, it is going to be 12 percent, if nothing changes in the entire military budget. It is on an unsustainable course. We have not had a premium increase since TRICARE's inception.

I will take a back seat to no one in wanting to help the troops, but the best thing we can do is create a benefit that is sustainable and not have to pick between health care benefits and armament and new weapons and all of the operational needs of the military, which are going to be eventually squeezed. In committee, Senator Nelson and myself, along with the chairman and ranking member, said to the Department of Defense: Stop, don't pass go, no fee increases.

We are going to have the GAO and other groups look at ways to save money before you have to ask for fee increases. And, secondly, give us some idea if the Department of Defense numbers are accurate. Are they accurate in terms of the growth explosion in the cost of this program? So we are going to get information to make a good decision and basically put a hold on the fee increases for participation of TRICARE.

That got us into the area of prescription drugs. One of the things that we have done for military members, and retirees in particular, is we have made prescription drugs very affordable and reasonably priced. What we are trying to do to save money is to allow an increase in retail prescription drug costs, which have again been static since the inception of the program, from $3 to $5 for a 30-day prescription for generic drugs, from $9 to $15 for a 30-day prescription of brand drugs. To counter that, we were going to have a zero copayment for those who chose to get their prescriptions filled through the mail. If you had a maintenance prescription, a drug need that would be recurring, and you used the mail system, there would be no copay at all.

What we are trying to do there is get people into purchasing drugs in a way that is cost effective for the military and have some cost increase to keep the program sustainable. That is what this debate is about.

I appreciate the chairman, who has been a great leader in this, working with Senator Lautenberg to try to find a way to get us past 2007.

I will end on this note. This problem is going to get worse. Over time, the military health care footprint within the Department of Defense budget is on an unsustainable course. TRICARE is a great program, but we are going to have to look at ways to make it more efficient, look at cost savings and, eventually, we are going to have to go back to the military community and ask for some increased participation to make this sustainable for the next generation of military retirees and their families. If we don't, we are going to be in a dilemma we would not want to be in as a nation, having to pick between operational needs and health care needs.

As a member of the Guard and Reserve--and I have done some time on active duty--I want to be as generous and as fair with the benefit package as the country can afford, but no benefit can be locked in time without some reevaluation and adjustment. After 2007 passes, we are going to have to start making hard choices. I promise all the Members of this body and those who may be listening to the military community that we are going to do it in a way that is acceptable, humane, rational, and not ask more than people can bear. The idea of trying to have a zero copayment if you would get your prescriptions filled through the mail is a great idea. It will be good for the military members participating in the prescription drug program, and I am convinced--and we will see after this year--that it will save a lot of money, specifically for those drugs recurring in need.

The increases on the generic and brand names through the retail system are appropriate, and we will revisit that issue after this year.

I just want the Members of the body to know that if we don't get ahead of the growth of TRICARE and try to implement changes in a systematic, incremental way, we are going to wind up one day where this body in the next decade is going to have to make some draconian choices. The way to prevent making draconian choices is to phase in changes that the force can accommodate and that will relieve the pressure on TRICARE. It is a wonderful program, and it needs to be on a sustainable footing. Right now it is on an unsustainable path. We will find out more information about how to reform it at the end of this year.

Madam President, I say to the chairman of the committee, I appreciate all the effort he has given to create TRICARE. He worked in a bipartisan manner to create a health care program that has been very valuable to the men and women in the military, their families, and particularly retirees. This program, like every other program at the Federal level, is going to have to be looked at anew in terms of sustainability. I look forward to working with the chairman and others to make it sustainable.


Mr. GRAHAM. Madam President, if I may add, the projections are that the military health care program will be $65 billion in costs by 2015, 12 percent of the DOD's budget. We will be getting a real hard look to see if those moneys are accurate and ways to save money. Madam President, 2007 will be a year in which we look at the true cost component of TRICARE projected out in the future and try to think of ways to make it sustainable, because if the projections are anywhere near accurate, this program becomes unsustainable over time. It is worth saving, and I think anyone in the military would want it to be saved. We are just going to have to be honest with them about the cost. They cannot be locked in time forever.

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