FY2023 NDAA: TRICARE for Reservists

FY2023 NDAA: TRICARE for Reservists

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INSIGHTi

FY2023 NDAA: TRICARE for Reservists
Updated January 12, 2023
Background
Since September 11, 2001, Congress has enacted a number of new or modified benefits tailored for
certain Selected Reserve members (i.e., drilling reservists) and their dependent family members. These
benefits include expanded eligibility for health care benefits offered through the TRICARE program.
Most drilling reservists are eligible to enroll in a premium-based health plan called TRICARE Reserve
Select (TRS).
TRS is structured similarly to TRICARE Select (i.e., a preferred provider option) and is available
worldwide. The beneficiary costs of TRS include monthly premiums, annual deductibles, fixed co-pays
when receiving care from network providers, and a percentage of the allowable charges when receiving
care from a TRICARE-authorized non-network provider. In addition to TRS, drilling reservists and their
dependent family members may be eligible for dental insurance through the TRICARE Dental Program
(TDP) or vision insurance through the Federal Employees Dental and Vision Insurance Program
(FEDVIP).
Reservists (including members of the National Guard) on federal active duty orders for more than 30
consecutive days receive identical health benefits as active duty servicemembers. These benefits include a
premium-free health plan (i.e., TRICARE Prime) and premium-free dental and vision care. Once
activated reservists complete an active duty period, they may be eligible for transitional health benefits as
they return to a reserve status. Table 1 lists the proposed and enacted reserve component-specific health
care provisions included in the Fiscal Year 2023 (FY2023) National Defense Authorization Act (NDAA;
P.L. 117-263).
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Table 1. FY2023 NDAA Legislative Proposals
House-Passed H.R. 7900
Senate Armed Services
Enacted Legislation (P.L. 117-263)
Committee-Reported S. 4543
Section 703 would have amended 10
No similar provision.
Not adopted.
U.S.C. §1076a to establish a new dental
plan under the TRICARE Dental
Program (TDP) that may be offered to
members of the Selected Reserve (i.e.,
dril ing reservists) with no premium or
cost-sharing requirements.
No similar provision.
Section 702 would have amended 10
Section 702 adopts the Senate
U.S.C. §1145 to extend eligibility for
provision with an amendment that
the Transitional Assistance
extends TAMP eligibility to members
Management Program (TAMP) to
of the National Guard who are
members of the National Guard who
transitioning from periods of “active
are transitioning from periods of
service of more than 30 days” ordered
“active service of more than 30 days”
under 32 U.S.C. §502(f) in support of a
ordered under 32 U.S.C. §502(f) in
national emergency declared by the
support of a national emergency
President or by Congress.
declared by the President.
No similar provision.
Section 705 would have authorized the
Section 707 adopts the Senate
Secretary of Defense to conduct a
provision.
study on the feasibility and cost effects
of extending eligibility for TRS and
TDP to all members of the Selected
Reserve, their dependents, and
nondependent children under 26 years
old.
Section 757 would have directed the
No similar provision.
Not adopted.
Government Accountability Office to
conduct a study of the barriers to
reservists accessing services offered
through the Exceptional Family
Member Program and TRICARE’s
Extended Care Health Option.
Section 4501 would have authorized
No similar provision.
Not adopted.
$100 mil ion in FY2023 funding for the
establishment of a new TDP dental
plan.
Source: CRS analysis of H.R. 7900, S. 4543, and P.L. 117-263.
Discussion
Certain military service leaders and military service organizations advocate for an expansion in
TRICARE benefits for reservists to ensure continuity of care when transitioning between active and
reserve status, and to assist with resolving deficient medical readiness requirements. Other observers have
noted potential challenges with DOD’s ability to sustain existing health benefits and increases in
personnel costs associated with the addition or expansion of new benefits to a larger population.
The FY2023 NDAA includes provisions to expand and evaluate the feasibility of expanding eligibility of
certain TRICARE benefits for drilling reservists and their dependent family members.

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Health and Dental Benefits
Section 703 of the House bill would have amended 10 U.S.C. §1076a to establish a new dental plan under
TDP for Selected Reserve members. The new plan would have been administered in a similar manner as
other plans under TDP; however, there would have been no associated premium or cost-sharing
requirements for enrolled reservists. Section 4501 would have authorized $100 million in the FY2023
“In-House Care” line item of the Defense Health Program account for the establishment of the new dental
plan. Both provisions were not adopted.
Section 707 of P.L. 117-263, which adopts Senate Section 705, authorizes the Secretary of Defense to
conduct a study on the feasibility and potential cost effects of expanding eligibility for TRS and TDP to
all Selected Reserve members, their dependent family members, and nondependent children under 26
years old. If the Secretary chooses to conduct the study, elements of the assessment are to include a
discussion of
 cost-shifting between DOD, the Office of Personnel Management’s Federal Employees
Health Benefits Program, Medicaid, and other health insurance payers;
 new costs or cost savings to DOD;
 resources necessary for implementation of expanded benefits; and
 impacts to recruitment and retention of reservists.

Within one year after enactment, the Secretary is required to brief the House and Senate Armed Services
Committees on the study design and provide a report to the committees no later than two years after
enactment.
Section 757 of the House bill would have directed the Government Accountability Office (GAO) to
conduct a study of the barriers to reservists accessing medical and non-medical support services offered
through the Exceptional Family Member Program (EFMP) and the TRICARE’s Extended Care Health
Option (ECHO). The provision would have required GAO, no later than 180 days after enactment, to
conduct the study and provide a report of their findings and recommendations to improve EFMP and
ECHO for reservists. Though the provision was not adopted, the Joint Explanatory Statement directs the
Secretary of Defense to brief the House and Senate Armed Services Committees on the “eligibility of
reserve component members for such programs and to describe how eligible members may access the
services provided by those programs.”
Transitional Health Benefits
Since 1992, Congress has periodically authorized the provision of temporary TRICARE coverage for
servicemembers transitioning from active duty to reserve duty status, or who are involuntarily separated
from active duty under honorable conditions. Congress codified this temporary coverage period, known
as the “Transition Assistance Management Program” (TAMP), in 10 U.S.C. §1145. TAMP provides
premium-free TRICARE Prime or TRICARE Select benefits to an eligible transitioning servicemember
and their dependent family members for up to 180 days after their active duty status ends. In general,
TAMP is available to activated reservists (including members of the National Guard on federal active
duty, also known as Title 10 orders) when separating from a period of more than 30 consecutive days of
active duty service in support of a preplanned mission, contingency operation, or the whole of
government response to the COVID-19 pandemic.
Section 702 of the enacted bill, which adopts Senate Section 702, amends 10 U.S.C. §1145 to extend
TAMP eligibility to National Guard members who are separating from a period of more than 30
consecutive days of full-time National Guard duty. The period of duty must be ordered under 32 U.S.C.
§502(f), federally funded, and in support of a national emergency declared by the President or Congress.

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For more on TRICARE for reservists, see CRS Report R45399, Military Medical Care: Frequently Asked
Questions, and CRS Report R45968, Limits on TRICARE for Reservists: Frequently Asked Questions.

Author Information

Bryce H. P. Mendez

Analyst in Defense Health Care Policy

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