Rep. Jackie Speier, D-Calif., expressed concerns about the downsizing effort.

Rep. Jackie Speier, D-Calif., expressed concerns about the downsizing effort. Manuel Balce Ceneta / AP

Military Family Members and Retirees Could Lose Medical Clinic Access under Pentagon Plan

The Defense Department this week published a plan to downsize dozens of military treatment facilities and make many accessible only to active duty troops.

The Defense Department this week announced a plan to “right-size” its network of medical treatment facilities, which will change the services available at individual facilities and, in many cases, eliminate services for military family members and retirees.

As part of an effort to lower costs and focus the Military Health System on “readiness,” Pentagon officials identified 50 facilities in the United States where the department will change what services are available. Although a few locations will provide more services, most will see downsizing. The department currently operates 343 medical facilities within the United States.

In total, 37 facilities will no longer offer services to military family members or retirees, of which five have already begun or completed the move to serving only active duty troops. Of those 37 locations, eight will maintain some amount of non-active duty patients “as necessary” to maintain readiness, officials said.

Under the plan, two facilities would close entirely, while three facilities already are transferring all operations to a different location. In total, the plan could send roughly 200,000 beneficiaries into the care of doctors in the private sector.

In a release announcing the plan, the department said all efforts to offload military family members and retirees onto privatized providers that accept TRICARE will happen slowly, and in some cases over several years.

“The increased demand from the beneficiary population transitioning to local networks is the key driver of [facility] implementation timelines,” officials wrote. “Most [facilities] will need to follow a measured approach by transitioning beneficiary populations gradually to care from commercial providers.”

In a report outlining the plan to Congress, officials examined the health care market surrounding each facility to measure whether private providers could absorb the increased demand of moving families and retirees out of the Military Health System. For instance, average appointment wait times in a given region should not exceed a week for routine care and four weeks for specialty care, while drive time for patients should not exceed 30 minutes to reach a primary care doctor, and specialists should be no further than one hour away.

The department acknowledged that officials must continue to monitor market dynamics and adjust implementation plans as needed.

“During the transition, some local markets may be challenged to absorb the additional [military family] beneficiary demand,” officials wrote. “As demand grows, the expectation is that new entrants to the market will increase network capacity. However, this expectation will be carefully managed during the transition and, if during implementation, local networks are challenged to absorb demand, the department will revise its implementation plan.”

Congress may block the proposal, and it is already receiving a cool reception from some House Democrats. Rep. Jackie Speier, D-Calif., chairwoman of the House Armed Services Subcommittee on Military Personnel, said there should be more study to ensure the private sector can handle the influx of military families and retirees.

“I’m concerned that the DoD, in its haste to cut costs and fund programs and needs unrelated to health care, may be putting our military families and retirees at serious risk, telling approximately 100,000 retirees and 95,000 active duty family members that they will need to use the TRICARE network instead of the [military network] without a sound plan to guarantee that there is adequate capacity to provide the same level of quality health care as they receive now,” Speier said. “During a series of recent visits to military bases and medical facilities throughout the country, the top concern raised was access to health care, changes to the system, and how privatization can and did threaten worse outcomes and higher costs when done without care and consideration.”