FY2021 National Defense Authorization Act: Selected Personnel and Health Care Issues

June 4, 2021 R46810

FY2021 National Defense Authorization Act:
June 4, 2021
Selected Personnel and Health Care Issues
Alan Ott, Coordinator
The National Defense Authorization Act (NDAA) authorizes appropriations for a wide range of
Analyst in Defense and
national security programs and activities within the Department of Defense (DOD) and other
Intelligence Personnel
executive agencies. Congress typically includes organizational reform, new or modified defense
Policy
policies, and directed reports or studies among the legislation’s provisions.

Kristy N. Kamarck
For FY2021, the House-passed (H.R. 6395) and Senate-passed (S. 4049) bills sought to
Specialist in Military
implement or supplement various categories of personnel and health care matters related to
Manpower
servicemembers, maritime personnel, servicemember families, and DOD civilian employees.

Certain provisions address annual authorizations of military personnel end-strengths, others
affect existing program authorities, and some are novel personnel and healthcare programs. The
Lawrence Kapp
legislative process for these two bills culminated on January 1, 2021, when the FY2021 NDAA
Specialist in Military
Personnel Policy
became P.L. 116-283 after Congress voted to override a Presidential veto.

The active duty military personnel end-strengths authorized in the FY2021 NDAA are 485,900
Bryce H. P. Mendez
for the Army, 347,800 for the Navy, 181,200 for the Marine Corps, and 333,475 for the Air Force
Analyst in Defense Health
(inclusive of the Space Force). The FY2021 NDAA authorizes a 3.0% increase in military basic
Care Policy
pay, consistent with the Administration’s FY2021 budget request and the House and Senate-

passed NDAA bills.
Barbara Salazar Torreon
Senior Research Librarian
The FY2021 NDAA included several provisions that seek to enhance oversight of diversity and

inclusion issues in DOD and establish various initiatives meant to improve diversity and
inclusion in DOD. Military justice and criminal investigations matters in the FY2021 NDAA
Hibbah Kaileh
Research Assistant
focus on sex-related offenses and protecting military family members.

Several provisions in the FY2021 NDAA address military family matters, such as family

readiness, military spouse education and employment, military childcare programs, and military
parental leave.
The FY2021 NDAA includes a number of provisions that delay or clarify certain congressionally directed or DOD-initiated
reform efforts for military health system administration. There are also provisions meant to enhance Congress’s
understanding of DOD’s health care billing practices and provide authority to waive certain billing requirements. Other
provisions in the FY2021 NDAA address mental health issues affecting servicemembers, veterans, and family members.
There are eight general mental health assessment, funding, and reporting provisions, two substance abuse-related provisions,
three suicide-related provisions, and nine reserve component-related provisions.
A significant difference in both NDAA bills from prior versions is the inclusion of COVID-19 specific provisions. These
address personnel, health care, and public health issues that arose during DOD operations supporting the national response to
the COVID-19 pandemic. The various provisions are intended to:
 Authorize hazardous duty pay for military personnel responding to the pandemic.
 Grant constructive retirement credit for certain reservists unable to complete required annual training.
 Require a report to Congress on how full-time National Guard pandemic response duty is determined.
 Require quarantine housing for National Guard members upon completion of pandemic response duty.
 Direct a study on financial hardships among servicemembers during the COVID-19 pandemic.
 Establish a military health systems review panel to examine the system’s response to COVID-19.
 Require a strategy for DOD pandemic response and preparedness and a related health system study.
 Require a registry of TRICARE beneficiaries diagnosed with COVID-19 and a related report to Congress.
 Require DOD to print information for distributed pandemic materials in languages other than English.
 Extend health care eligibility for certain National Guard members after full-time pandemic response duty.
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Introduction
The United States Constitution grants authority to Congress and the President to provide for the
common defense of the nation. All Department of Defense (DOD) policy, activities, and
operations originate from this shared authority. DOD implements legislative and presidential
delegated authority through orders, directives, regulations, and instructions, or similar
administrative acts.
Congress exercises its national defense authority through DOD primarily, but also through the
intelligence community and other executive agencies with national security functions.1 Congress
gives the Secretary of Defense military authority through statutes that prescribe specific duties
and responsibilities or authorize the general authority needed to conduct national defense affairs.
The House and Senate armed services committees (HASC and SASC) traditionally consider fiscal
year (FY) national defense authorization act (NDAA) bills annually. Table 1 lists certain
legislative actions for the FY2021 House-passed (H.R. 6395) and Senate-passed (S. 4049) bills.
Specific provisions in the NDAA bills are often similar or identical in both versions of the
authorization bills. Alternatively, provisions can be included in one version, but not the other, or
be in both in substantively dissimilar forms.
At some point after passage of each chamber’s authorization bill, the House and Senate usually
form a conference committee to resolve the differences between the two chambers. Should the
conference committee resolve differences, the committee would issue a conference report for
each chamber to consider.
Table 1. House and Senate Passed FY2021 NDAA Bills
Selected Legislative Actions
H.R. 6395
Date of Action
S. 4049
Date of Action
P.L. 116-283
01/01/2021
Received in the House
08/07/2020
Senate passed over veto
01/01/2021
Passed in the Senate
07/23/2020
House passed over veto
12/28/2020
Reported by the SASC
06/24/2020
Vetoed by President
12/23/2020
Presented to President
12/11/2020
Passed in the Senate
11/16/2020
Received in the Senate
08/04/2020
Passed in the House
07/21/2020
Reported by the HASC
07/09/2020
Source: H.R. 6395 actions at https://www.congress.gov/bil /116th-congress/house-bil /6395/actions; S. 4049
actions at https://www.congress.gov/bil /116th-congress/senate-bil /4049/actions.

1 The Constitution provides that Congress shall have power to: provide for the common defense; declare war; raise and
support armies; provide and maintain a navy; make rules for the government and regulation of the land and naval
forces; provide for calling forth the militia; provide for organizing, arming, and disciplining the militia, and for
governing such part of them as may be employed in the service of the United States; and make all laws which shall be
necessary and proper for carrying into execution the foregoing powers, and all other powers vested by this constitution
in the government of the United States, or in any department or officer thereof (Article I). See also CRS In Focus
IF11566, Congress, Civilian Control of the Military, and Nonpartisanship, by Kathleen J. McInnis.
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An NDAA contains provisions that affect individuals who are serving in the Armed Forces, and
their families, as well as those who are retired from military service and those who are employed
in DOD. This CRS report considers selected personnel and health care provisions that were
proposed in the authorization bills and examines those selected provisions that Congress enacted
into law (P.L. 116-283). The report’s analysis and information is presented in five general topic
sections that contain specific subsections with selected personnel or health care issues. A
subsection’s author and CRS point of contact are identified and, if available, CRS products that
are relevant to these specific issues are noted.
Military Personnel
The HASC and SASC have jurisdiction over DOD policy and programs addressed in the FY2021
NDAA that are related to military personnel, retirement, and compensation, including Coast
Guard personnel.2 They also oversee military justice matters that are part of the Act’s Uniform
Code of Military Justice (UCMJ) provisions.
Active Duty Authorized Strength
Background. The term "authorized strength" means the largest number of servicemembers
authorized to be in an armed force, a component, a branch, a grade, or any other category of the
armed forces.3 The armed forces are the Army, Navy, Air Force, Marine Corps, Space Force, and
Coast Guard.4 Congress authorizes such numbers each fiscal year for the end-strength of the
armed forces, except the Coast Guard (See “Coast Guard Active Duty Authorized Strength”
below).5 The term “end strength” means the active duty personnel to be paid from funds
appropriated for active-duty personnel, to include certain members of the Selected Reserve and
National Guard serving on active duty. Such authorizations generally do not include the number
of servicemembers in the Selected Reserve or National Guard that may be mobilized or
federalized for active duty. Authorized active component end-strengths for the FY2020 NDAA,
FY2021 President's Budget, and FY2021 NDAA are shown in Table 2.
After the withdrawal of U.S. forces from Iraq in 2011 and drawdown of forces from Afghanistan
beginning in 2012, Congress began to reverse the trend of increasing end-strength levels that
began in 2001. However, Congress halted further reductions in Army and Marine Corps end-
strength in FY2017, providing slight end-strength increases for both Services that year. In
FY2018 and FY2019, Congress again provided slight end-strength increases for the Marine
Corps, while providing a more substantial increase for the Army. Though the Army did not reach
its authorized end-strength of 483,500 in FY2018 or its authorized end-strength of 487,500 in
FY2019, primarily due to missing its recruiting goals for enlisted personnel. End-strength for the
Air Force generally declined from 2004 to 2015, but increased from 2016 to 2019. End-strength
for the Navy declined from 2002 to 2012, increased in 2013 and remained essentially stable
through 2017; it increased again in 2018 and 2019.

2 U.S. Senate, Document 113-18, Standing Rules of the Senate, January 24, 2013, p. 20; U.S. House of Representatives,
Rules of the House of Representatives, January 11, 2019, p. 6; RCP 116-25, Rules Adopted by the Committees of the
House of Representatives of the United States, 116th Congress, 2019-2020, p. 37.
3 10 U.S.C. §101(b)(11).
4 10 U.S.C. §101(a)(4).
5 10 U.S.C. §115.
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FY2021 National Defense Authorization Act: Selected Issues

Coast Guard Active Duty Authorized Strength6
Military personnel authorizations for the Coast Guard reserve are included in the selected reserve end-strength
provisions of the NDAA each fiscal year, but the authorizations for the Coast Guard’s active duty personnel
typically are not included. The FY2021 NDAA does however contain a separate Coast Guard authorization act
that approves an active duty end-strength of 44,500 in the Coast Guard (Elijah E. Cummings Coast Guard
Authorization Act of 2020 (P.L. 116-283, §8102)).
Table 2. Active Duty End Strength
FY2020 NDAA, FY2021 Budget Request, and FY2021 NDAA
Service
FY2020
FY2021
FY2021
NDAA
NDAA
Budget Request
NDAA
Difference
Army
480,000
485,900
485,900
5,900
Navy
340,500
347,800
347,800
7,300
Marine Corps
186,200
184,100
181,200
-5,000
Air Force
332,800
333,700
333,475
675
Total
1,339,500
1,351,500
1,348,375
8,875
Source: CRS Analysis.

Active Duty Authorized Strength Sectional Analysis
House-Passed H.R. 6395
Senate-Passed S. 4049
P.L. 116-283
Sec. 401 would authorize a total
Sec. 401 would authorize a total
Sec. 401 authorizes a total FY2021
FY2021 active duty end-strength of
FY2021 active duty end-strength of
active duty end-strength of
1,351,500 including
1,345,205 including
1,348,375 including
485,900 for the Army
485,000 for the Army

485,900 for the Army
347,800 for the Navy
346,730 for the Navy

347,800 for the Navy
184,100 for the Marine Corps
180,000 for the Marine Corps

181,200 for the Marine Corps
327,266 for the Air Force
333,475 for the Air Force

333,475 for the Air Force
6,434 for the Space Force
Discussion. The Administration’s FY2021 budget requested end-strengths of 485,900 for the
Army, 347,800 for the Navy, and 184,100 for the Marine Corps. In comparison to FY2020
authorized end-strengths, these requests represented increases for the Army (+5,900) and Navy
(+7,300), and a decrease for the Marine Corps (-2,100).
The House-passed bill sought end-strengths that are identical to the Administration request for the
Army, Navy, and Marine Corps. The Senate-passed bill sought end-strengths that are lower than
the Administration request for the Army (-900 compared to the Administration request), Navy (-
1,070), and Marine Corps (-4,100).
In the FY2020 NDAA, Congress authorized the establishment of the United States Space Force, a
new armed force within the Department of the Air Force.7 The Department of the Air Force

6 Established in 1915, the Coast Guard is a military service in the Department of Homeland Security (DHS) and a
branch of the armed forces of the United States. If directed by the President, or by Congress through a declaration of
war, the Coast Guard transfers from DHS to the Department of Defense (DOD) and operates as a service in the Navy.
7 P.L. 116-92, §§951-961.
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FY2021 National Defense Authorization Act: Selected Issues

currently assigns personnel to the Space Force, but in the future it will “will finalize the process
by which personnel will be formally and permanently ‘transferred’ into the U.S. Space Force.
Transfer describes the process whereby a military member is ‘sworn into’ a different branch of
Service. Enlisted members take a new Oath of Enlistment, and Officers are provided a new
Commission.
The Administration’s budget request proposed a total end-strength of 333,700 for the Air Force,
of which 6,434 was allocated for the Space Force:
The Fiscal Year 2021 President’s Budget supports an increase of 900 Airmen to the all-
volunteer force, increasing the total from 332,800 authorized in the FY 2020 National
Defense Authorization Act to 333,700 requested in FY 2021 … Inclusive of the 333,700
end strength, 6,434 military personnel are assigned and/or transferred to the operational
United States Space Force.8
The House-passed version would have required separate end-strength authorizations for the Air
Force (327,266) and Space Force (6,434), which together equal the Administration’s request for
the Air Force (333,700). The Senate-passed provision would have authorized an Air Force end-
strength (333,475) which is slightly lower than the Administration request (-225).
The Senate-passed version would have provided lower total end-strengths than the Administration
request. The committee report that accompanied the bill described these reductions in the context
of how the COVID-19 pandemic affected military recruiting and retention. It then noted:
Many of the assumptions utilized in determining the military’s fiscal year 2021 end
strength request are no longer accurate…. Therefore, the committee has taken a cautious
approach to the end strength authorization for active forces. This provision would authorize
end strength levels within existing variance authority for the Army, Navy, and Air Force.
Based on detailed modelling conducted by the Marine Corps, the committee would further
reduce Marine Corps end strength by 4,100 compared to the budget request. The committee
emphasizes that this provision does not signal a lack of support for the military’s end
strength goals. If conditions improve throughout the summer and fall of 2020, the
committee would support restoring end strength to the requested level.9
The FY2021 NDAA authorizes end-strengths of 485,900 for the Army, 347,800 for the Navy,
181,200 for the Marine Corps, and 333,475 for the Air Force (inclusive of the Space Force). The
FY2021 NDAA conference report noted “The conferees expect the Department of the Air Force
to submit a formal request and justification for [U.S. Space Force] end strength to the
congressional defense committees as part of the President’s Department of Defense budget
request for fiscal year 2022.”
References: See CRS Report R46107, FY2020 National Defense Authorization Act: Selected
Military Personnel Issues, coordinated by Bryce H. P. Mendez and similar reports from earlier
years. Enacted figures for FY2020 found in P.L. 116-92.
CRS Points of Contact: Lawrence Kapp and Alan Ott (Coast Guard).

8 Department of the Air Force, Fiscal Year (FY) 2021 Budget Estimate, Military Personnel Appropriation, 2020, p. 6,
at
https://www.saffm.hq.af.mil/Portals/84/documents/FY21/MILPER_/FY21%20Air%20Force%20Military%20Personnel
_1.pdf?ver=2020-02-10-091310-847.
9 S.Rept. 116-236, pp. 189-90.
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Selected Reserve Authorized Strength10
Background. The overall authorized end-strength of the Selected Reserves has declined by 7.6%
since 2001 (874,664 in FY2001 versus 807,800 in FY2020). Authorized Selected Reserve end-
strengths for the FY2020 NDAA, FY2021 President's Budget, and FY2021 NDAA are shown in
Table 3. During this period, changes in authorized strength by reserve component were as
follows: Navy Reserve (-29,900), Army Reserve (-15,800), Army National Guard (-14,526), Air
Force Reserve (-4,258), Marine Corps Reserve (-1,058), Coast Guard Reserve (-1,000) and Air
National Guard (-322).
Table 3. Selected Reserve End-Strength
FY2020 NDAA, FY2021 Budget Request, and FY2021 NDAA
Reserve Component
FY2020
FY2021
FY2021
NDAA
NDAA
Budget Request
NDAA
Difference
Army National Guard
336,000
336,500
336,500
500
Army Reserve
189,500
189,800
189,800
300
Navy Reserve
59,000
58,800
58,800
-200
Marine Corps Reserve
38,500
38,500
38,500
0
Air National Guard
107,700
108,100
108,100
400
Air Force Reserve
70,100
70,300
70,300
200
Coast Guard Reserve
7,000
7,000
7,000
0
Total
807,800
809,000
809,000
1,200
Source: CRS Analysis.

Selected Reserve Authorized Strength Sectional Analysis
House-Passed H.R. 6395
Senate-Passed S. 4049
P.L. 116-283
Sec. 411 would authorize a total
Sec. 411 would authorize a total
Sec. 411 authorizes a total FY2020
FY2020 Selected Reserve end-
FY2020 Selected Reserve end-
Selected Reserve end- strength of
strength of 809,000 including:
strength of 809,000 including:
809,000 including:
Army National Guard: 336,500
Army National Guard: 336,500
Army National Guard: 336,500
Army Reserve: 189,800
Army Reserve: 189,800

Army Reserve: 189,800
Navy Reserve: 58,800
Navy Reserve: 58,800

Navy Reserve: 58,800
Marine Corps Reserve: 38,500
Marine Corps Reserve: 38,500

Marine Corps Reserve: 38,500
Air National Guard: 108,100
Air National Guard: 108,100

Air National Guard: 108,100
Air Force Reserve: 70,300
Air Force Reserve: 70,300

Air Force Reserve: 70,300
Coast Guard Reserve: 7,000
Coast Guard Reserve: 7,000

Coast Guard Reserve: 7,000
Discussion. The Administration’s FY2021 budget requested end-strengths of 336,500 for the
Army National Guard, 189,800 for the Army Reserve, 58,800 for the Navy Reserve, 38,500 for

10 The Selected Reserves encompass those units and individuals designated as so essential to initial wartime missions
that they have priority over all other Reserves. Members of the Selected Reserve are generally required to perform one
weekend of training each month and two weeks of training each year, for which they receive pay and benefits. Some
members of the Selected Reserve perform considerably more military duty than this, while others may only be required
to perform the two weeks of annual training each year or other combinations of time. Members of the Selected Reserve
can be involuntarily ordered to active duty under all of the principal statutes for reserve activation.
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the Marine Corps Reserve, 108,100 for the Air National Guard, 70,300 for the Air Force Reserve,
and 7,000 for the Coast Guard Reserve.
In comparison to FY2020 authorized end-strengths, these requests represented increases for the
Army National Guard (+500), Air National Guard (+400), Army Reserve (+300), and Air Force
Reserve (+200), a decrease for the Navy Reserve (-200), and no change for the Marine Corps
Reserve and Coast Guard Reserve.
The Administration request and the House-passed and Senate-passed bills for Selected Reserve
end-strengths were identical. The FY2021 NDAA authorizes these end-strength levels.
References: See CRS Report R46107, FY2020 National Defense Authorization Act: Selected
Military Personnel Issues, coordinated by Bryce H. P. Mendez and similar reports from earlier
years. Enacted figures for FY2020 found in P.L. 116-92. For more on the Reserve Component see
CRS Report RL30802, Reserve Component Personnel Issues: Questions and Answers, by
Lawrence Kapp and Barbara Salazar Torreon, and CRS In Focus IF10540, Defense Primer:
Reserve Forces, by Lawrence Kapp.
CRS Points of Contact: Lawrence Kapp and Alan Ott (Coast Guard).
Military Pay Raise
Background. Congress has a long-standing interest in military pay raises, as they impact the
overall cost of military personnel and recruitment and retention of high-quality personnel serving
in the all-volunteer military. Section 1009 of Title 37, U.S. Code, codifies the formula for an
automatic annual increase in basic pay indexed to the annual increase in the Employment Cost
Index (ECI). The statutory formula stipulates that the increase in basic pay for 2021 will be 3.0%
unless either (1) Congress passes a law to provide otherwise; or (2) the President specifies an
alternative pay adjustment under subsection (e) of 37 U.S.C. §1009. Increases in basic pay are
typically effective at the start of the calendar year, rather than the fiscal year.
The FY2021 President’s Budget requested a 3.0% military pay raise, equal to the amount from
the statutory formula.
Military Pay Raise Sectional Analysis
House-Passed H.R. 6395
Senate-Passed S. 4049
P.L. 116-283
Sec. 601 specifies that basic pay
wil increase by 3.0% on January 1,
No similar provision
Sec. 601 increases basic pay by
2021.
3.0% on January 1, 2021.
Discussion. Section 601 of the House-passed bill directs a 3.0% increase in basic pay. The
Senate-passed bill does not contain a provision specifying an increase in basic pay, leaving in
place the 3.0% automatic adjustment provided by 37 U.S.C. §1009. The FY2021 NDAA adopts
the House provision’s 3.0% increase in basic pay.
References: See in CRS Report R46107, FY2020 National Defense Authorization Act: Selected
Military Personnel Issues, coordinated by Bryce H. P. Mendez and similar reports from earlier
years. For an explanation of the pay raise process and historical increases, see CRS In Focus
IF10260, Defense Primer: Military Pay Raise, by Lawrence Kapp. For additional information on
military pay, see CRS Report RL33446, Military Pay: Key Questions and Answers, by Lawrence
Kapp and Barbara Salazar Torreon.
CRS Points of Contact: Lawrence Kapp and Alan Ott (Coast Guard).
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Diversity and Inclusion (D&I)
Background. In the FY2009 NDAA, Congress authorized the creation of the Military Leadership
Diversity Commission (MLDC).11 Following that effort, in 2012, DOD developed and issued a
five-year Diversity and Inclusion Strategic Plan for 2012-2017.12 In the FY2020 NDAA,
Congress required DOD to update and implement its strategic plan.13 Since 2009, several DOD
policy shifts have expanded career opportunities for women in submarine and ground combat
roles, and have altered conditions for service of transgender servicemembers. The implementation
of these policies and the DOD’s integration of demographically diverse groups remains an area of
congressional interest and oversight.
D&I Sectional Analysis
House-Passed H.R. 6395
Senate Passed S. 4049
P.L. 116-283
Sec. 571 would amend diversity
and inclusion reporting
requirements under 10 U.S.C. §113
to include strategic
metrics/benchmarks.
Sec. 551 adopts elements of several
Sec. 572 would establish a
House provisions and Senate Section
statutory requirement for a DOD
520 under a consolidated D&I
Diversity and Inclusion Advisory
initiative. It requires DOD to produce
Council under 10 U.S.C. §186.
Sec. 520 would require DOD to
report to Congress on the findings annual, publicly available D&I reports
Sec. 575 would require an annual
of a recently created defense board that include certain standardized
report on demographics of officers
and advisory committee for
reporting criteria and metrics. It also
appointed to certain grades.
diversity issues.
requires coordination across the
Sec. 1785 would require the
military department. It also requires
military departments to share best
annual meetings between the
practices and lessons learned in the
Secretaries of the military departments
integration of minority groups.
to assess progress toward D&I goals.
Sec. 1786 would require DOD
policy to define and eliminate
conscious and unconscious gender
bias.
Sec. 503 adopts the House provision,
Sec. 502 would require DOD to
amending 10 U.S.C. §612(a)(1), 10
ensure diversity in the membership
No similar provision
U.S.C. §573(b), and 10 U.S.C.
of selection boards.
§14102(b).
Sec 524 adopts the House provision
Sec. 503 would require DOD to
and requires DOD to submit a report
redact personally identifiable
No similar provision
to Congress with recommendations
information in promotion boards.
on further redactions that could
eliminate bias in the selection process.
Sec. 912 would establish the
Sec. 913 adopts the House provision
positions of Chief Diversity Officer
for a DOD Chief Diversity Officer and
No similar provision
for DOD and each military
includes certain qualifications for the
department under 10 U.S.C. §146.
position. It requires the military
departments and the commandant of

11 P.L. 110-417.
12 DOD, Diversity and Inclusion Strategic Plan, 2012-2017, at
https://diversity.defense.gov/Portals/51/Documents/DoD_Diversity_Strategic_Plan_%20final_as%20of%2019%20Apr
%2012%5B1%5D.pdf
13 P.L. 116-92 §555.
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House-Passed H.R. 6395
Senate Passed S. 4049
P.L. 116-283
the Coast Guard to appoint senior
advisors for D&I.
Sec. 554 creates the position of
Sec. 573 would establish an office
Deputy Inspector General for
of the Special Inspector General for
No similar provision
oversight of D&I programs and policies
Racial and Ethnic Disparities in the
in the Armed Forces and requires
Armed Forces.
tracking and reporting of supremacist,
extremist, and criminal gang activity.
Sec. 518 would authorize a 5-year
pilot program in connection with
Sec. 519 adopts the House provision
Senior Reserve Officers’ Training
and includes an authority for the
Corps (SROTC) units at
Sec. 546 is a similar provision to
Secretary of Homeland Security to
Historically Black Col eges and
House Sec. 518.
oversee financial assistance for flight
Universities and Minority Serving
training for members of the Coast
Institutions including financial
Guard Col ege Student Pre-
assistance for flight training.
Commissioning Initiative Program.
Sec. 577 would require a report
Sec. 557 adopts the Senate provision
evaluating barriers to minority
Sec. 519 is a similar provision to
and requires a report by a federal y
participation in certain units of the
House Sec. 577.
funded research division by July 1,
Armed Forces.
2022.
Sec. 571 adopts the House provision
Sec. 554 would require DOD to
under 10 U.S.C. §626 with a goal of
establish a mentoring and career
No similar provision
having diversity in the officer corps
counseling program for officers.
reflect the diversity of each armed
force as a whole. This provision also
includes the Coast Guard.
Sec. 579 would require a DOD
Sec. 555 adopts the House provision
plan to prevent discrimination and
with an amendment requiring a policy
reduce negative career impacts for
No similar provision
to be developed and briefed to the
pregnant servicemembers and
Armed Services Committees within
DOD civilians.
180 days of enactment.
Sec. 541 would require certain
No similar provision
training on religious
Sec. 556 adopts the Senate provision.
accommodations.
Sec. 576 would require DOD to
Sec. 5516 would require DOD to
develop and report on plans to
submit and implementation plan for Not adopted (elements adopted in
increase female and minority
Government Accountability Office other provisions).
representation in the Armed
(GAO) recommendations on female
Forces.
recruitment and retention.
Sec. 574 would require DOD to
Sec. 5586 is a similar provision to
include workplace survey questions
House Section 574 and would
about racist, xenophobic, anti-
require DOD to include workplace Sec. 553 adopts the Senate provision.
Semitic, supremacist, or extremist
survey questions about racist, anti-
activity.
Semitic, or supremacist, activity.
Sec. 519D adopts the House
Sec. 520 would require a study on
provision with an amendment to study
SROTC and JROTC recruitment
No similar provision
also whether JROTC participants are
and advancement and correlations
more likely to join the military than
with race/ethnicity.
non-participants.
Sec. 1710G would require a
No similar provision
Sec. 558 requires a GAO report that
report from each service academy
examines equal opportunity claims and
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House-Passed H.R. 6395
Senate Passed S. 4049
P.L. 116-283
on command climate, equal
command climate surveys at the
opportunity claims and minority
service academies over a 2-year
inclusion in education and
period.
extracurricular activities.
Discussion. The House and Senate bills included several provisions that sought to enhance
oversight of diversity and inclusion issues in DOD. In June and July 2020, then-Secretary of
Defense Mark Esper announced several initiatives aiming to improve diversity and inclusion in
DOD.14 One of these initiatives was to establish a medium-term Defense Board on Diversity and
Inclusion, and a long-term Defense Advisory Committee on Diversity and Inclusion in the Armed
Services “to provide an independent and enduring review and assessment.” Section 551 of the
FY2021 NDAA consolidates several provisions from the House and Senate bills to create
reporting requirements on the advisory committee’s structure and findings and to prohibit the
dissolution of the committee without congressional notification. Section 551 also seeks to
standardize D&I metrics, data collection, methodology, and reporting across the armed forces and
Coast Guard and requires certain reports to be publicly available after delivery to Congress.
Metrics constructed under this authority are prohibited from being used to establish diversity-
based quotas or undermining merit-based processes. In addition, the provision requires DOD
policies to “define conscious and unconscious bias and provide guidance to eliminate such bias.”
The provision requires plans and policies to address D&I barriers across the military lifecycle
starting with recruitment and accession and requires annual meetings of senior leadership across
the departments to provide a forum to assess progress towards D&I goals and share advice.
Secretary Esper’s July memo ordered a review of policies with respect to promotion boards and
selection processes including provisions for diversity in promotion and selection board panels15
and removal of pictures and references to race, ethnicity, and gender in promotion packets. The
final enacted bill adopts two provisions of the House bill that affect how DOD conducts
promotion and selection boards. Section 503 amends promotion statutes to ensure that boards
“represent the diversity of the armed forces to the extent practicable.” Section 524 requires the
redaction of official photos from selection board materials. Part of the justification behind the
removal of pictures and, perhaps, other personally identifiable information is the belief that it will
reduce the impact of unconscious bias that can affect promotion board decisions.16

14 Memorandum from Mark Esper, Secretary of Defense, Actions for Improving Diversity and Inclusion in the
Department of Defense, June 19, 2020, at https://media.defense.gov/2020/Jun/22/2002319394/-1/-1/1/ACTIONS-FOR-
IMPROVING-DIVERSITY-AND-INCLUSION-IN-THE-DOD.PDF. Memorandum from Mark Esper, Secretary of
Defense, Immediate Actions to Address Diversity, Inclusion, and Equal Opportunity in the Military Services, July 14,
2020, at https://media.defense.gov/2020/Jul/15/2002457268/-1/-
1/1/Immediate_Actions_to_Address_Diversity_Inclusion_Equal_Opportunity_in_Military_Services.pdf
15 Covered promotion boards are those for active and reserve officers. The legislation also defines selection boards as
any board “used with respect to the promotion, education, or command assignments of members of the Armed Forces
that is not covered by the amendments made by this section.”
16 Unconscious bias, implicit bias, or implicit social cognition refers to the assumptions or social stereotypes that
individuals form about certain groups of people that are shaped by experience and culture, but held outside the
individual’s conscious awareness. Implicit bias has been associated with unintentional discriminatory behavior towards
individuals based on race, sex, or other physical attributes. Anthony G. Greenwald and Linda Hamilton Kriegert,
“Implicit Bias: Scientific Foundations (Section VIII),” California Law Review, vol. 94, no. 4 (July 2006). Jeff Schogol,
“Army removes indicators of race and gender in soldier promotions in an effort to fight bias,” Task and Purpose, June
26, 2020.
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The final enacted bill could raise the prominence of diversity and inclusion issues in the Armed
Forces by its establishment of several new positions. Section 913 establishes the position of Chief
Diversity Officer for DOD, reporting directly to the Secretary of Defense and fourth in the DOD
order of precedence, which makes this office senior to the Secretaries of the military departments.
It also establishes Chief Diversity Officers for each of the military departments and the Coast
Guard. Section 554 of the final enacted bill also establishes a Deputy Inspector General position
for oversight and audit of D&I programs and supremacist, extremist, and criminal gang activity of
a member of the Armed Forces. Previously the DOD Office for Diversity, Equity, and Inclusion
(ODEI), under the Office of the Secretary of Defense for Personnel and Readiness, was the
primary office responsible for developing and implementing diversity and equal opportunity
policies and programs.17
The final enacted bill (Section 519) adopts similar provisions from the House and Senate bills
(Sections 518 and 546) to authorize five-year pilot programs with Historically Black Colleges and
Universities (HBCUs) and Minority Serving Institutions.18 The purpose of these pilot programs
would be to (1) reduce barriers to participation in Senior Reserve Officer Training Corps
(SROTC) activities for covered institutions and (2) provide financial assistance for flight training
for participants in SROTC and the Coast Guard Student Pre-Commissioning Initiative (CSPI). A
2014 RAND Corporation report on diversity in the Air Force found that “There is a lack of
racial/ethnic minorities and women in rated career fields—including pilot, navigator, air battle
manager, combat systems officer, and flight surgeon—which have the highest promotion and
retention rates.”19 Financial assistance or increased emphasis on flight training programs at
HBCUs and MSIs might be one way to encourage minority selection of aviation occupations.
Other data and studies have shown that minorities are underrepresented in certain career fields
(like combat and special operations occupations).20
Section 577 of the House bill and Section 519 of the Senate bill are similar provisions to require
further study of racial and gender barriers to selection and participation in designated career
fields. The final enacted bill (Section 557) adopts the Senate provision requiring a report titled
‘‘Study on Reducing Barriers to Minority Participation in Elite Units in the Armed Services.’’21
Section 571 of the final enacted bill requires DOD to establish mentoring and career counseling
programs with the explicit goal of having the officer corps in each branch of the service reflect
the diversity of the service as a whole. This provision also includes the Coast Guard.

17 See https://diversity.defense.gov/ODMEO-Leadership/.
18 These covered institutions are, as per P.L. 116-92, §292, “a part B institution (as that term is defined in section
322(2) of the Higher Education Act of 1965 (20 U.S.C. §1061(2)); or any other institution of higher education (as that
term is defined in section 101 of such Act (20 U.S.C. §1001)) at which not less than 50 percent of the total student
enrollment consists of students from ethnic groups that are underrepresented in the fields of science and engineering.”
19 Nelson Lim, Improving Demographic Diversity in the U.S. Air Force Officer Corps, RAND Corporation, p. xviii, at
https://www.rand.org/content/dam/rand/pubs/research_reports/RR400/RR495/RAND_RR495.pdf.
20 CNA for the Office of the Under Secretary of Defense for Personnel and Readiness, Population Representation in
the Military Services, Table B-20. Active Component Enlisted Members, FY18: by Occupational Area, Service, Race,
and Gender, 2018, at https://www.cna.org/pop-rep/2018/appendixb/b_20.html. Margaret Harrell et al., Barriers to
Minority Participation in Special Operations Forces, RAND Corporation, 1999, at
https://www.rand.org/pubs/monograph_reports/MR1042.html.
21 The bill requires a review of recommendations 1999 RAND Corporation report entitled “Barriers to Minority
Participation in Special Operations Forces.” The Senate version of the bill also included a 2018 RAND report entitled
“Understanding Demographic Differences in Undergraduate Pilot Training Attrition.” While the final enacted bill does
not include a reference to this report, it does require the review to include pilot and navigator occupational specialties.
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Department of Defense policies prohibit unlawful employment discrimination based on sex (to
include pregnancy) for DOD civilian employees, but do not explicitly list pregnancy as a
condition subject to sex-based discrimination against servicemembers.22 In July 2020, Secretary
of Defense Mark Esper announced that DOD would be releasing a new policy to prohibit
pregnancy-based discrimination against servicemembers. Section 579 of the House bill requires
DOD to develop a plan to safeguard pregnant servicemembers and DOD civilians from
discrimination and to provide mechanisms to ensure that their careers are not harmed by
pregnancy and childbirth. The final enacted bill adopts this provision (Section 555) and requires
DOD to brief the Armed Services Committees on the policy.
Section 541 of the Senate bill requires training for commanders, chaplains, judge advocates, and
others as recognized by the Secretary on religious accommodations for servicemembers. This
follows a recommendation in the Senate Report to accompany the FY2018 NDAA.23 The final
enacted bill adopts this provision.
Other provisions adopted in the final enacted bill require DOD to conduct specific surveys or
studies. Section 553 requires workplace equal opportunity surveys to include questions about
“racist, anti-Semitic, or supremacist conduct.” Section 519D requires a study on recruitment and
career outcomes for Junior Reserve Officer Training Corps (JROTC) and SROTC participants.
Finally, Section 558 requires a GAO study that examines equal opportunity and command climate
surveys at the service academies.
References: See CRS Report R44321, Diversity, Inclusion, and Equal Opportunity in the Armed
Services: Background and Issues for Congress, by Kristy N. Kamarck; CRS In Focus IF11235,
Defense Primer: Senior Reserve Officer Training Corps, by Kristy N. Kamarck; CRS In Focus
IF11313, Defense Primer: Junior Reserve Officers’ Training Corps (JROTC), by Kristy N.
Kamarck; and CRS Report R46107, FY2020 National Defense Authorization Act: Selected
Military Personnel Issues, coordinated by Bryce H. P. Mendez.
Point of Contact: Kristy N. Kamarck.
Sexual Assault and Harassment in the Military
Background: Over the past decade, sex-related misconduct in the military, such as sexual assault
and sexual harassment, has generated persistent congressional and media attention. Congress has
(1) required additional study, data collection, and reporting to determine the scope of the issue;
(2) expanded protections and support services for victims; (3) made substantial changes to the
military justice system; and (4) taken other actions to enhance sexual assault prevention and
response (SAPR). Specified sex-related offenses are crimes under the Uniform Code of Military
Justice (UCMJ) and subject to prosecution by court-martial.24

22 DoD Directive 1020.02E; Cyrus Salazar, Updates on DoD Directives and DoD Instructions: Pregnancy
Discrimination, Diversity and Inclusion, and Equal Opportunity, DOD Office of Diversity, Equity, and Inclusion,
Presentation to the Defense Advisory Committee on Women in the Services, September 2020, at
https://dacowits.defense.gov/Portals/48/Documents/General%20Documents/RFI%20Docs/Sept2020/ODEI%20RFI%2
06.pdf?ver=2020-08-31-123612-570.
23 S.Rept. 115-125 states “The committee urges the Department, in consultation with commanders, chaplains, and judge
advocates, to ensure that appropriate training on religious liberty is conducted at all levels of command on the
requirements of the law, and to that end the committee directs the Secretary, in consultation with the Chief of Chaplains
for the Army, Navy, and Air Force, to develop curriculum and implement training concerning religious liberty in
accordance with the law. Recipients of this training should include commanders, chaplains, and judge advocates.
24 10 U.S.C. §1044e(h). A sex-related offense means any violation of article 120, 120b, 120c, or 130 of the UCMJ; or
an attempt to commit such offense, as punishable under article 80.
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Sexual Assault and Harassment in the Military Sectional Analysis
House-Passed H.R. 6395
Senate-Passed S. 4049
P.L. 116-283
Reporting and Accountability
Sec. 543 would add additional
areas of review for the Defense
Sec. 527 is an identical provision
Advisory Committee for the
to House Sec. 543.
Sec. 533 adopts this provision.
Prevention of Sexual Misconduct

(DAC-PSM).
Sec. 528 would require the DAC-
No similar provision
PSM to include additional matters in Sec. 534 adopts the Senate provision.
its report to Congress.
Sec. 522 would extend DAC-PSM
No similar provision
oversight to the Coast Guard
Sec. 535 adopts the Senate provision.
Academy.
Sec. 525 would require a DOD
strategy for holding leadership
No similar provision
accountable for discharging the
Sec. 539B adopts the Senate
sexual harassment policies and
provision.
programs.
Sec. 544 would modify data-
reporting requirements on victims
of sexual assault for the Defense
Advisory Committee on
No similar provision
Sec. 536 adopts the House provision.
Investigation, Prosecution, and
Defense of Sexual Assault in the
Armed Forces (DAC-IPAD).
Sec. 549 would add a question
regarding prosecutions of sexual
No similar provision
Not adopted
assault to current workplace and
gender relations surveys.
Sec. 550A would require an
annual report to defense
Sec. 539C adopts the House
committees on the status of sex-
No similar provision
provision.
related offense investigations.
Sec. 530 would require briefing
Sec. 594 would require a report
the defense committees on
on the feasibility of placing
placement of members of the
Sec. 539F adopts the Senate
servicemembers into a non-rated
Armed Forces into a non-rated
provision and requires a briefing within
period when they are in an
period when they are in an
270 days of enactment.
academic status and are victims of
academic status and are victims of
sexual assault.
sexual assault.
Sec. 550B would require a report
on sexual abuse and harassment of
recruits during medical
No similar provision
Not adopted
examinations prior to entry into
the Armed Force.
Victim Services and Support
Sec. 548 would require a safe-to-
report policy applicable across the
Sec. 526 is an identical provision
Sec. 539A adopts this provision.
Armed Forces.
to House Sec. 548.
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House-Passed H.R. 6395
Senate-Passed S. 4049
P.L. 116-283
Sec. 521 would extend the time
required for expedited decisions in
No similar provision
connection with applications for
Sec. 531 adopts the Senate provision.
change of station or unit transfer of
members who are victims of sexual
assault or related offenses.
Sec. 546 would require the
Secretaries of Defense and
Veterans Affairs to develop and
No similar provision
Sec. 538 adopts the House provision.
implement a standard of
coordinated care for survivors of
sexual trauma.
Sec. 539 adopts the House provision
Sec. 547 would require a policy on Sec. 529 is a similar provision to with amendments to minimize
separation of victim and accused at
House Sec. 547.
prejudicial impact, and to also apply to
military service academies.
the U.S. Coast Guard Academy.
Sec. 524 would require a
No similar provision
congressional briefing on Special
Sec. 539E adopts the Senate
Victims’ Counsel program
provision.
Sec. 523 would require a survey
and report on ability of Sexual
No similar provision
Assault Response Coordinators and Sec. 539D adopts the Senate
Sexual Assault Prevention and
provision.
Response Victim Advocates to
perform duties.
Sec. 550C would require the
Sec. 532 allows for confidential
Secretary of Defense to prescribe
reporting of sexual harassment,
regulations establishing a process by
requires DOD to develop a plan for
which a member of the Armed
access to confidential reports to
Forces may confidentially allege a
No similar provision
identify serial harassers, and requires
complaint of sexual harassment to
DOD to report sexual harassment
an individual outside the immediate
complaints to Congressional
chain of command.
committees every two years.
Discussion: The following discussion comprises two topic areas, (1) Reporting and
Accountability, and (2) Victim Services and Support. Other provisions that affect military judicial
processes as they relate to sexual assault are discussed in the following section, “Military Justice
and Criminal Investigations.”
Reporting and Accountability. Congress, in the FY2020 NDAA, required the establishment of a
Defense Advisory Committee for the Prevention of Sexual Misconduct (DAC-PSM) with
expertise in areas such as organizational culture, suicide prevention, implementation science, and
the continuum of harm.25 Identical provisions in the House and Senate bills (Sections 543 and
527) require expanding the committee’s scope for assessment by including the contractor work
force and adding the authority to commission formal research. The final enacted bill adopts this
change. The final enacted bill also adopts in Section 535, language from Senate Sections 522, and

25 DOD defines continuum of harm as a range of interconnected, inappropriate behaviors that are connected to the
occurrence of sexual assault and that support an environment that tolerates these behaviors. For more information, see,
GAO, Sexual Violence: Actions Needed to Improve DOD's Efforts to Address the Continuum of Unwanted Sexual
Behaviors, GAO-18-33, December 18, 2017, at https://www.gao.gov/products/GAO-18-33.
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528 that amend the committee’s specified oversight of “each military service academy” to clarify
that its oversight includes the U.S. Coast Guard Academy (USCGA).26 Additional areas of DAC-
PSM study and reporting under Sections 533, 534, and 535 include a review of evidence-based
sexual assault prevention assessments in workplaces and institutions of higher education, an
assessment of SAPR training in professional military education (PME), and feasibility studies for
preventing sexual assault focused on recruit screening and end-of-service interviews. Section 534
of the final enacted bill specifically requires an examination of reporting databases to ascertain
whether the level of anonymization is sufficient to both protect victim privacy and provide
military leaders with adequate information.
In the FY2015 NDAA, Congress called for the establishment of a 20-member Defense Advisory
Committee on Investigation, Prosecution, and Defense of Sexual Assault in the Armed Forces
(DAC-IPAD).27 In the FY2019 NDAA, Congress required the DAC-IPAD to collect data on
accusations of collateral misconduct against victims of sexual assault.28 Section 536 of the final
enacted bill adopts a House provision that amends this provision to require data collection on
victims of a sexual offense (vice assault) who are suspected (vice accused) of a collateral offense.
It also requires standardized data collection by the military services to support this requirement.
DOD’s Sexual Assault Prevention and Response Office (SAPRO) oversees sexual assault
prevention policy and produces congressionally mandated surveys and annual reports on sexual
assault prevalence, incidents, response actions, and administrative or judicial outcomes.29 Section
549 of the House bill would have added a question to the DOD workplace gender relations
surveys and focus groups to ascertain whether servicemembers would be more willing to report a
sexual assault if prosecution decisions were made by lawyers instead of military commanders.30
This provision was not adopted in the final enacted bill. Section 550B of the House bill, which
would have required a DOD report on sexual assaults that happened during military recruit
medical examinations, also was not adopted; however, the committee report directed DOD to
brief the Armed Services Committees on information related to this population. Section 539C
adopts Section 550A of the House bill, which adds an annual reporting requirement for the status
of sexual assault investigations to include reasons for investigations that are longer than 180 days
in duration. DOD currently collects and reports data on the number of investigations pending and
completed, and the time interval from report of investigation to judge advocate general
recommendations.31
Victim Support and Services. Both the House and Senate bills included the requirement for
development of a safe-to-report policy (House Section 548 and Senate Section 526). This policy,
which has been implemented in various forms at the military service academies, is intended to
remove disincentives for alleged victims to report sexual assault incidents by protecting cadets

26 There are five service academies. The remaining institution, the U.S. Merchant Marine Academy (USMMA), is not
subject to the specified oversight of DAC-PSM. See
https://www.oig.dot.gov/sites/default/files/USMMA%20SAPR%20Final%20Report.pdf
27 P.L. 113-291, §546. See https://dacipad.whs.mil/.
28 P.L. 115-232, §547; 10 U.S.C. §1561 note.
29 Congress required annual reports in P.L. 111-383, §1631; 10 U.S.C. §1561 note. Workplace and gender relations
surveys are required by 10 U.S.C. §481. DOD SAPRO surveys and reports can be found at
https://www.sapr.mil/reports.
30 For more on prosecution decisions in military sexual assault cases, see CRS Report R44944, Military Sexual Assault:
A Framework for Congressional Oversight, by Kristy N. Kamarck and Barbara Salazar Torreon.
31 DOD, Department of Defense Fiscal Year 2019 Annual Report on Sexual Assault in the Military, April 28, 2020, p.
1, and Appendix C: Metrics and Non-Metrics, p. 33.
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FY2021 National Defense Authorization Act: Selected Issues

and midshipmen from punishment for minor collateral misconduct violations that might be
uncovered during an investigation.32 A similar provision was proposed in the FY2020 NDAA, but
was not adopted.33 Survey data suggest that collateral misconduct (e.g., underage drinking) by the
victim may reduce reporting of sexual assault. According to active duty survey data for 2018,
34% of women and 26% of men who experienced a sexual assault did not report the assault
because they “thought they might get in trouble for something they had done or would get labeled
a troublemaker.”34 The final enacted bill adopted the Senate provision under Section 539A.
In the FY2011 NDAA, Congress added a provision that required the Secretary concerned to
provide timely consideration of an application for permanent change of station or change of duty
assignment by a victim of sexual assault or related offense.35 Under this superseded expedited
transfer policy, the commanding officer was required to make a decision within 72 hours of the
submission of an application. Section 531 of the final enacted bill adopts a Senate provision that
extends this decision making timeline to five calendar days.
The FY2020 NDAA provided for the ability of a military service academy cadet or midshipmen
who is the victim of an alleged sexual assault to request a transfer to a different service academy
or Senior Reserve Officer Training Corps (SROTC) unit.36 Provisions in the House (§547) and
Senate (§529) bills would require the Secretary of Defense to prescribe policies to minimize
contact between the alleged victim and any offenders during academic and professional activities
at the service academies. The Senate bill would expand this requirement to all DOD degree-
granting institutions and the Coast Guard Academy.37 Section 539 of the final enacted bill adopts
the House provision with amendments to include the Coast Guard Academy and to minimize
“prejudicial impact.”
In recent years, Congress has made several reforms to the Special Victim Counsel (SVC)
program. An SVC is a judge advocate or civilian attorney who meets special training
requirements and provides legal assistance to victims of sexual assault throughout the military
justice process.38 Section 524 of the Senate bill requires a congressional briefing on SVC staffing
and caseloads under additional responsibilities imposed by the FY2020 NDAA.39 Another
provision in the Senate bill (Section 523) requires a survey and report on the ability of Sexual
Assault Response Coordinators (SARCs) and Sexual Assault Prevention and Response Victim
Advocates (SAPR-VAs) to perform duties.40 Areas of assessment include access for these support

32 Minor collateral offenses are defined in Section 527 of the Senate bill as, “(1) Improper use and possession of
alcohol; (2) Consensual intimate behavior, including adultery or fraternization; (3) Presence in off-limits areas; and (4)
Other misconduct specified in the regulations promulgated.” The U.S. Air Force Academy began implementing a safe-
to-report policy in Academic Program Year (APY) 2017-18 and modeled it after a similar Naval Academy policy.
Annual Report on Sexual Harassment and Violence at the Military Service Academies (MSAs) for Academic Program
Year (APY) 2017-2018, Appendix C: United States Air Force Academy, January 25, 2019, p. 4.
33 See discussion in CRS Report R46107, FY2020 National Defense Authorization Act: Selected Military Personnel
Issues, coordinated by Bryce H. P. Mendez.
34 DOD Office of People Analytics, 2018 Workplace and Gender Relations Survey of Active Duty Members, Overview
Report, May 2019, pp. 35-36, at
https://www.sapr.mil/sites/default/files/Annex_1_2018_WGRA_Overview_Report.pdf. CRS has not been able to find
DOD data on the number of reports of sexual assault that occur following a misconduct offense.
35 P.L. 112-81, §582, codified in 10 U.S.C §673.
36 P.L. 116-92, §555.
37 Other degree granting institutions would include, for example, the War Colleges, and Navy Postgraduate School.
38 10 U.S.C. §§1044, 1044e, and 1565b.
39 P.L. 116-92, §548.
40 SARCs are servicemembers or civilian DOD employees appointed by an installation commander or other appropriate
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FY2021 National Defense Authorization Act: Selected Issues

staff to resources and other assistance, perceptions of retaliation, and responsiveness of
commanders. Both of these provisions were adopted in the final enacted bill.
In 2005, DOD instituted a restricted reporting option for sexual assault victims. This option is
intended to help victims receive needed support services while maintaining a certain level of
privacy. When a victim chooses to make a restricted report, he or she discloses the incident to
specified officials and may then gain confidential access to medical health, mental health, and
victim advocacy services. Incident data is then reported by the official to SAPRO for inclusion in
DOD sexual assault statistics. Section 550C of the House bill requires DOD to provide a similar
confidential reporting process for those who experience sexual harassment. This provision also
requires DOD to develop mechanisms for tracking and reporting confidential complaints in
annual reports to Congress. Section 532 of the final enacted bill adopts this provision with some
amendments to make reports to Congress a biennial requirement and for DOD to develop a plan
for using confidential reports to identify serial harassers.
References: See CRS Report R44944, Military Sexual Assault: A Framework for Congressional
Oversight, by Kristy N. Kamarck and Barbara Salazar Torreon and CRS Report R46097, Military
Families and Intimate Partner Violence: Background and Issues for Congress, by Kristy N.
Kamarck, Alan Ott, and Lisa N. Sacco.
Point of Contact: Kristy N. Kamarck.
Military Justice and Criminal Investigations
Background. The UCMJ Act of 1950 established a unitary military justice system for the armed
forces.41 Among other matters, it standardized servicemember rights and protections at courts-
martial that are similar to rights provided in civilian criminal courts. The Act also made
significant changes in trial procedure and appellate review. Under the Act, as amended, there is a
Court of Criminal Appeals (CCA) in each military service and a Court of Appeals for the Armed
Forces (CAAF).42 The CCA is composed of military and civilian judges appointed by the Judge
Advocate General of the military service, and the CAAF is composed of five civilian judges
appointed by the President for a specific term.43
Certain judgments by a court-martial are automatically appealed to the CCA, while other appeals
are mandated by a service’s Judge Advocate General. An accused may appeal judgments not
subject to automatic or mandated reviews.44 If the CCA affirms the findings of a court-martial,
appeals to the CAAF are at the discretion of the accused, except an affirmed conviction that
imposes a death sentence, which is automatically appealed.45 In lieu of a CAAF review, or after
CAAF review, the accused may also seek review by the U.S. Supreme Court.46

appointment authority. The SARC serves as a single point of contact for coordinating and documenting sexual assault
response and victim care and reports directly to the installation commander. A SAPR-VA is a volunteer servicemember
or DOD civilian employee who reports directly to the SARC. The SAPR-VA facilitates care and provides referrals and
non-clinical support to adult victims of sexual assault.
41 P.L. 81-506.
42 10 U.S.C. §§866 (Art. 66), 941 (Art. 41).
43 10 U.S.C. §942 (Art. 42).
44 10 U.S.C. §866 (Art. 66).
45 10 U.S.C. §867 (Art. 67).
46 10 U.S.C. §867a (Art. 67a).
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Criminal investigations in the armed forces must be expressly authorized in law. Military
commanders may investigate UCMJ offenses within their command, but a service’s military
criminal investigation organization (MCIO) typically investigates serious offenses under the
UCMJ and Title 18 of the U.S. Code.47 The MCIOs in DOD are the Naval Criminal Investigative
Service (NCIS), Army Criminal Investigation Command (CID), and Air Force Office of Special
Investigations (OSI).48 The Coast Guard Investigative Service (CGIS) is also a MCIO, and its
jurisdiction extends to enforcement of certain maritime laws and coastwise trade laws.49
Military Justice and Criminal Investigations Sectional Analysis
House-Passed H.R. 6395
Senate-Passed S. 4049
P.L. 116-283
Military Justice
Sec. 531 would create a derivative
offense of violent extremism if
other UCMJ offenses are
No similar provision
Not adopted
committed against a government or
protected group of persons.
Sec. 532 would require the
Sec. 543 adopts both provisions by
preservation of all general and
Sec. 533 is similar to House Sec.
adding the 15 year rule as a new
special court-martial records for 15
532.
subsection to UCMJ Art. 140a.
years, regardless of outcome.
Sec. 540K would provide notice to
victims of post-trial filings that
Sec. 531 is similar to House Sec.
Sec. 541 adopts both provisions by
could unseal their private or
540K.
adding the victim notice
privileged private information, or
requirement to UCMJ Art. 6b.
cause release of the accused.
Sec. 540J would modify current
CCA weight of evidence factual
Sec. 532 is similar to House Sec.
Sec. 542 adopts the House
sufficiency review that applies to
540J, but it would require the
provision by adding the factual
the accused and the government, by court’s judges to have 12 or more
sufficiency review and judge
limiting its application to whether
years of experience of military or
qualification requirement to UCMJ
the government’s evidence was
civilian criminal trial experience, but Art. 66, but a Senate amendment
factually sufficient. It would also
this requirement could be waived
adds a CAAF review to UCMJ Art.
require the court’s judges to have
under certain conditions.
67 of any CCA findings of factual
12 or more years of experience
insufficiency.
practicing law.
Sec. 540G would prohibit anyone
who may serve as a court-martial
No similar provision
Not adopted
member from receiving any briefing
on the same court-martial.
Sec. 534 would require a GAO
report on status of assessments and Sec 547 adopts the Senate
No similar provision
recommendations related to racial,
provision with initial briefing due to
ethnic, and gender disparities in the
HASC and SASC by May 1, 2021.
military justice system.

47 Department of Defense, Instruction 5505.03, Initiation of Investigations by Defense Criminal Investigative
Organizations, March 24, 2011. A serious offense is an offense punishable by more than one year in prison or a
punitive discharge.
48 14 U.S.C. §§522-525; 10 U.S.C. §§7377, 8750, 9377; Department of Defense, Instruction 5505.16, Investigations by
DoD Components, June 23, 2017.
49 Ibid. Officers and members of the Coast Guard are authorized to enforce Chapter 551 of Title 46.
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House-Passed H.R. 6395
Senate-Passed S. 4049
P.L. 116-283
Sec. 541 would create an
attorney-client evidentiary privilege
for a special victim counsel and
No similar provision
Not adopted
client.
Sec. 550 would establish a pilot
program on prosecution of special
victim offenses committed by
No similar provision
Not adopted
attendees of military service
academies.
Criminal Investigations
Sec. 537 would require DOD to
Sec. 554 adopts the House
col ect and maintain data on all
provision by amalgamating it with
types of dissident and protest
No similar provision
House Section 573
investigations that are referred for
(See D&I
section above).
disposition.
Sec. 540F would require DOD to
enter judicial proceeding data into
Sec. 544 adopts the House
the National Instant Criminal
No similar provision
provision with a Senate amendment
Background Check System within
that defines the term judicial
three days of the proceeding’s
proceeding.
completion.
Sec. 542 would provide a
mechanism for military judges and
magistrates to issue military court
No similar provision
Not adopted
protective orders that could be
enforced by civilian authorities.
Sec. 586 would make the standard
Sec. 545 adopts the Senate
of review for expunging or
provision with establishment and
No similar provision
correcting personally identifying
implementation, and an
information in the Department of
accompanying report, required by
Defense Central Index of
October 1, 2021.
Investigations (DCII) less restrictive.
Discussion. Successive NDAAs have required a wide range of reforms for administrative and
military justice matters. These reforms tend to focus on sex-related offenses and protecting
military family members, but targeting violent extremism is an additional area of congressional
interest.
Military Justice. The House bill (Section 531) would have created a UCMJ punitive article that
criminalizes violent extremism, but Congress did not adopt it. However, the committee conferees
commented that they believed a UCMJ punitive article to prohibit such conduct may be
appropriate to deter and prosecute such servicemembers.
The House (Section 532) and Senate (Section 533) bills amend Article 940a of the UCMJ to
require the preservation of court-martial records. Section 543 of the final enacted bill amends 10
U.S.C. §940a to require the Secretary of Defense to establish agency-wide uniform standards and
criteria for preserving special and general court-martial records, regardless of outcome, for not
less than 15 years.
The House (Section 540K) and Senate (Section 531) bills amends Article 6 of the UCMJ to
provide victims notice of certain court-martial matters. Section 541 of the final enacted bill
amends 10 U.S.C. §806b to require victims to receive reasonable, accurate, and timely notice of a
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post-trial motion, filing, or hearing that may address the finding or sentence of a court-martial
with respect to the accused, unseal privileged or private information of the victim, or result in the
release of the accused.
The House (Section 540J) bill amends Article 66 of the UCMJ to require certain qualifications for
appellate judges and to limit when a CCA may determine that a court-martial judgment is
incorrect in fact. The Senate bill would have amended the provision to require a CAAF review of
any CCA decision that a judgment is incorrect in fact. Section 542 of the final enacted bill
amended 10 U.S.C. §866 to limit CCA review to matters of law, unless the accused meets the
requirements for requesting a factual sufficiency review. Additionally, under the amendment any
commissioned officer or civilian assigned as an appellate military judge to a CCA shall have not
fewer than 12 years of experience in the practice of law before such assignment. Section 542 also
amended 10 U.S.C. §867 to require the CAAF to review any decision by a CCA finding that a
court-martial judgment is incorrect in fact, and it must annually provide a report that includes an
analysis of such decisions.
The House bill (Section 541) would have amended 10 U.S.C. §1044e to define providing legal
advice by a Special Victims’ Counsel (SVC) to the victim as the relationship between an attorney
and a client, but the final enacted bill did not adopt this provision. The committee conferees noted
their view that the relationship between a Special Victims’ Counsel and an alleged victim in the
provision of legal advice and assistance is that of an attorney and a client and is afforded the same
privilege as every other attorney-client relationship.
Criminal Investigations. The House bill (Section 537) requires the Secretary of Defense to
develop and implement a process to track criminal and administrative investigations, and their
findings and disposition, with respect to servicemember conduct that is prohibited under DOD
Instruction 1325.06 (Handling Dissident and Protest Activities Among Members of the Armed
Forces). This section also requires the Secretary to submit a report on the implemented process to
the HASC and SASC not later than December 1 of each year, beginning after the date of the
enactment of the provision. Congress amalgamated this requirement with a similar provision
related to diversity and inclusion and adopted it as part of Section 554 of the FY2021 NDAA.
This section also establishes a new deputy inspector general position in the DOD Office of the
Inspector General with responsibility for these two areas of oversight (Inspector General
Oversight of Diversity and Inclusion in Department of Defense; Supremacist, Extremist, or
Criminal Gang Activity in the Armed Forces). Section 554 also establishes specific reporting
requirements for diversity and inclusion in DOD and supremacist, extremist, or criminal gang
activity in the armed forces.
The House bill (Section 540F) requires DOD to submit to the National Instant Criminal
Background Check System information that would disqualify the accused in a UCMJ judicial
proceeding related to domestic violence from possessing or receiving a firearm. The final enacted
bill adopts this requirement and adds a provision that defines the term ‘judicial proceeding’ as a
hearing (1) of which the person received actual notice and (2) at which the person had an
opportunity to participate with counsel.
The House bill (Section 542) would have authorized military magistrates and military judges to
issue a Military Court Protective Order. The order would have been enforceable by civilian courts
and law enforcement officers. Such orders are meant to protect a victim of an alleged sex or
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domestic violence offense, or a family member or associate of the victim, from a person subject
to the UCMJ. Congress did not adopt this provision.50
The Senate bill (Section 586) addresses the Defense Central Index of Investigations (DCII) title
and index correction or expungement process.51 Section 585 of the final enacted bill adopts this
provision which changes the current standard of review to allow greater probability that a titled
and indexed servicemember who was never criminally prosecuted or administratively disciplined
for the titled offense could have personally identifying information in the DCII expunged or
corrected. The provision also requires that not later than October 1, 2021, the Secretary of
Defense shall submit to the HASC and SASC a report on the actions taken under Section 545,
including a comprehensive description of the policy and process developed and implemented to
carry out the section’s requirements.
References: See CRS Insight IN11484, Analysis of Military Court Protective Order Provision in
H.R. 6395, by Alan Ott; CRS Report R46503, Military Courts-Martial Under the Military Justice
Act of 2016, by Jennifer K. Elsea and Jonathan M. Gaffney; and CRS Report R45970, Gun
Control: National Instant Criminal Background Check System (NICS) Operations and Related
Legislation, by William J. Krouse.
Points of Contact: Alan Ott and Kristy N. Kamarck (Sex-Related Offenses).
Military Personnel Programs
The HASC and SASC have jurisdiction over the broad area of DOD policy and programs related
to military personnel that are addressed in the FY2021 NDAA. This area includes matters
associated with military families, such as DOD schools and DOD assistance programs that focus
on military family members.52
Military Awards, Honors, and Decorations
Background. The DOD awards and decorations program recognizes with personal military
decorations servicemembers who perform qualifying acts of valor, non-combat heroism, or
meritorious service or achievement. The program also recognizes with related DOD-wide service
medals qualifying participation in a military campaign or expedition, or other significant military
operation. No such award or decoration may be presented to an individual whose subsequent
service was not honorable.
Military Awards, Honors, and Decorations Sectional Analysis
House-Passed H.R. 6395
Senate-Passed S. 4049
P.L. 116-283
Medal of Honor (MOH)

50 For more analysis, see CRS Insight IN11484, Analysis of Military Court Protective Order Provision in H.R. 6395, by
Alan Ott.
51 Department of Defense, Instruction 5505.07, Titling and Indexing In Criminal Investigations, February 28, 2018.
52 U.S. Senate, Document 113-18, Standing Rules of the Senate, January 24, 2013, p. 20; U.S. House of
Representatives, Rules of the House of Representatives, January 11, 2019, p. 6; RCP 116-25, Rules Adopted by the
Committees of the House of Representatives of the United States, 116th Congress, 2019-2020, p. 37.
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House-Passed H.R. 6395
Senate-Passed S. 4049
P.L. 116-283
Sec. 1778 would extend the time
Sec. 561 extends the time from
from five to seven years to review
five to six years to review World
World War I valor awards for
No similar provision
War I valor awards for certain
certain veterans for a possible
veterans for a possible upgrade to
upgrade to the MOH.
the MOH.
Service Medals
Sec. 562 authorizes the President
to award certain medals: (a) DSC
to Ramiro F. Olivo; (b) the MOH to
No similar provision

Ralph Puckett, Jr.; (c) MOH to
Dwight M. Birdwell; (d) MOH to
Alwyn C. Cashe; (e) MOH to Earl
D. Plumlee.
Sec. 581 would require the
Sec. 563 requires a feasibility study
Secretary of Defense to establish
No similar provision
on the establishment of service
the Atomic Veterans Service Medal.
medal for radiation-exposed
veterans.
Sec. 583 would allow for eligible
veterans of Operation End Sweep
No similar provision
Not adopted
to be awarded the Vietnam Service
Medal.
Honors
Sec. 552 would authorize the
Sec. 523 authorizes the honorary
Secretary of Defense to make
promotion whether or not
No similar provision
honorary promotions including
posthumous, of a former member
posthumous promotion of a former
or retired member of the Armed
member or retired member of the
Forces.
Armed Forces.
Eligibility and Presentation
Sec. 551 would require the award
or presentation of decorations
favorably recommended fol owing
No similar provision
determination on the merits of
Not adopted
proposals for decorations not
previously submitted in a timely
fashion.
Sec. 525 would require the
Secretaries of Defense and
Veterans Affairs to prepare
No similar provision
Not adopted
guidelines with respect to veterans’
benefits under Title 38, U.S. Code,
Discussion.
Medal of Honor. The Medal of Honor (MOH) is the highest award for valor “above and beyond
the call of duty” that may be bestowed on a U.S. servicemember. Reluctance on the part of
reviewing officials to award the MOH retroactively or to upgrade other awards is generally based
on concern for maintaining the integrity of the MOH and the awards process. This reluctance has
led many observers to believe that the system of awarding the MOH is overly restrictive and that
certain individuals are denied earned medals. As a result, DOD periodically reviews inquiries by
Members of Congress and reevaluates its historical records. Systematic reviews began in the
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1990s for World War II records. During World War II, Black units remained segregated and their
units’ and individuals' valorous actions, along with others, may be unacknowledged or
insufficiently acknowledged. Subsequent record reviews of Jewish, Hispanic, Asian, and Pacific
Islander servicemembers’ records from World War II, Korea and Vietnam53 resulted in the award
of 24 MOHs in 2014.54
Section 584 of the FY2020 NDAA (P.L. 116-92) requires the review of military records of certain
Asian, Jewish, Hispanic, Native American, and African American war veterans from World War I
who were recommended for the MOH or were the recipients of the Distinguished Service Cross,
Navy Cross, or French Croix de Guerre with Palm. Only four soldiers from any of the above
groups, one Hispanic (Private David Barkley Cantu) and three Jewish veterans (First Sergeant
Sydney Gumpertz, First Sergeant Benjamin Kaufman, and Sergeant William Sawelson), were
awarded Medals of Honor at the conclusion of World War I. In April 1991, President George
H.W. Bush awarded the MOH posthumously to Corporal Freddie Stowers, the first Black
recipient from World War I, after the Army's review of his military records. Some critics maintain
that other acts of heroism worthy of the highest military honor may have been overlooked or
downgraded due to racism.
Section 561 of the FY2021 NDAA extends the period of review for certain medals from World
War I by one year amending section 584(f) of the FY2020 NDAA. Section 1778 of the House-
passed version would have amended Section 584(f) of the NDAA for FY2020 (P.L. 116-92) by
extending by two years the period of review for valor medals from World War I that may be
upgraded to the MOH. This would have expanded the time available for veterans to seek review
and allowed more time to collect evidence for a review. The Senate-version has no similar
provision.
Section 562 of the FY2021 NDAA authorizes the President to make certain awards,
notwithstanding the time limitations specified in Section 7274 of Title 10, United States Code.
Section 562 bestows: (a) the Army Distinguished Service Cross (DSC) to Ramiro F. Olivo for
acts of valor during the Vietnam War; (b) the MOH to Ralph Puckett, Jr. for acts of valor during
the Korean War; (c) the MOH to Dwight M. Birdwell for acts of valor during the Vietnam War;
(d) the MOH to Alwyn C. Cashe for acts of valor during Operation Iraqi Freedom; and (e) MOH
to Earl D. Plumlee for acts for valor during Operation Enduring Freedom.
Service Medals. Section 581 of the House-passed version would have required the Secretary to
Defense to design and produce a new military service medal known as the ‘‘Atomic Veterans
Service Medal’’ to honor retired and former servicemembers who are radiation-exposed veterans
as defined in Section 1112(c)(3) of Title 38, U.S. Code. This provision would have recognized the
veterans who witnessed the Trinity detonation in New Mexico55 and the more than 225,000 who
participated in later nuclear development and testing.56 The Senate-passed version had no similar
provision. The FY2021 NDAA, in Section 563, requires the Secretary of Defense to conduct a
feasibility study on establishing a service medal for award to radiation-exposed veterans as

53 The NDAA for FY2002 (P.L. 107-107, §552) called for a review of Jewish and Hispanic veteran war records from
WWII, the Korean War, and the Vietnam War to ensure those deserving the Medal of Honor were not denied because
of prejudice. During the review, records of several soldiers of neither Jewish faith nor Hispanic descent were also found
to meet criteria worthy of the Medal of Honor. The 2002 act was amended to allow these soldiers to be honored with
the upgrade. As a result of the review, 24 recipients were honored in 2014.
54 Army, “Valor 24 Recipients,” March 18, 2014, at https://www.army.mil/medalofhonor/valor24/.
55 The White House, “Presidential Message on the 75th Anniversary of the Trinity Nuclear Test,” July 16, 2020.
56 Patricia Kime, “Lawmakers Want Medals, Not Certificates, to Honor Veterans Involved in Nuclear Testing,”
Militray.com, July 16, 2020, at https://www.military.com/daily-news/2020/07/16/lawmakers-want-medals-not-
certificates-honor-veterans-involved-nuclear-testing.html.
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defined in Section 1112 of Title 38, 24 United States Code. This provision requires the Secretary
of Defense to hold at least one meeting with representatives of organizations that advocate for
radiation-exposed veterans (including leadership of the National Association of Atomic Veterans,
Inc.) to discuss the study and to work on steps towards a mutually agreeable and timely
recognition of these radiation-exposed veterans.
Section 583 of the House-passed version would have allowed veterans who participated in
Operation End Sweep to apply for and receive the Vietnam Service Medal. Operation End Sweep
was the mine sweep of Haiphong Harbor, Vietnam, during the conflict’s ceasefire. On January 27,
1973, U.S. and North Vietnamese officials signed a protocol to the Paris agreement that called for
the United States to neutralize the mines that the Navy had dropped in North Vietnam's coastal
and inland waterways.57 The operation to retrieve or destroy the mines found in the harbor began
on February 6, 1973. It ended on June 17, 1973.58 The Senate-passed version had no similar
provision and the FY2021 NDAA did not adopt the House provision.
Section 551 of the Senate-passed version would have required the Secretary of Defense to submit
a report on the regulations and procedures for awarding medals or other commendations to
handlers of military working dogs (MWDs) as required by Section 582 of the FY2019 NDAA
(P.L. 115-232). The report would have been due no later than 90 days after enactment of this Act.
The House-passed version had no similar provision and the Senate receded during conference.
The FY2021 NDAA instead directs the Secretary of Defense to provide a briefing, not later than
90 days after the date of the enactment of this Act, to the Committees on Armed Services of the
House and Senate on the regulations and procedures to award medals or other commendations to
handlers of MWDs.
Honors. Section 552 of the Senate-passed version would have amended Chapter 80 of Title 10,
U.S. Code, by authorizing the Secretary of Defense to make honorary promotions, including
posthumous promotion of a former member or retired member of the Armed Forces, to any grade
not exceeding the grade of major general or rear admiral (upper half). The Secretary of Defense
would have been required to notify the Armed Services Committees of the House and Senate at
least 60 days prior to making an honorary promotion. This section would also have amended
Section 1563 of Title 10, U.S. Code, requiring that all promotions made using this authority
would be honorary with no effect on pay, retired pay, or other benefits. The House-passed version
had no similar provision. The FY2021 NDAA includes a similar provision in Section 523 that
amends Section 1563 of Title 10, United States Code, to require that all promotions made using
this authority be honorary, whether or not posthumous, with no effect on pay, retired pay, or other
benefits. The Secretary of Defense is required to notify the Armed Services Committees of the
House and Senate and the requesting Member of Congress, if applicable, of such a decision at
least 60 days prior to making an honorary promotion, including a detailed rationale for the
determination.
Eligibility and Presentation. Section 525 of the House-passed version would have amended
Section 528 of the FY2020 NDAA to require the Secretary of Defense to consult with the
Secretary of Veterans Affairs in preparing guidelines with respect to veterans’ benefits under Title

57 Edward J. Marolda, “U.S. Mining and Mine Clearance in North Vietnam,” U.S. Naval History and Heritage
Command, June 15, 2020, at https://www.history.navy.mil/research/library/online-reading-room/title-list-
alphabetically/u/u-s-mining-and-mine-clearance-in-north-vietnam.html.
58 U.S. Naval Institute Archives, “February 6, 1973: Navy Task Force 78 Begins Operation End Sweep,” Naval History
Blog, posted on February 7, 2013, at https://www.navalhistory.org/2013/02/07/february-6-1973-navy-task-force-78-
begins-operation-end-sweep,
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38, U.S. Code, for which eligibility determination depends on the use of DOD service records.
The Senate-passed version had no similar provision. The House-passed version was not adopted.
Section 551 of the Senate-passed version would have authorized a Secretary of a military
department to present an award or decoration, following the favorable review of a request by a
Member of Congress, after a 60-day period for congressional review. This provision would have
amended Section 1130 of Title 10, U.S. Code, and eliminated the current requirement for
legislation to waive the statute of limitation for award of a medal or decoration. According to the
Congressional Budget Office (CBO), enacting Section 551 would have resulted in provision of
awards that would not occur under current law, like the MOH that requires legislation for awards
more than five years after the date of the act of valor.59 CBO estimates that an additional five
living individuals would have received the Medal of Honor over the 2021-2030 period under
Section 551. CBO estimates that associated payments for these five monthly pensions would have
increased direct spending by less than $500,000 in each year, and by $3 million over the 2021-
2030 period.60 The House-passed version had no similar provision. The FY2021 NDAA did not
adopt the Senate provision. Instead the conferees noted in their Joint Explanatory Statement the
importance of congressional oversight of the process of authorizing time limitation waivers; and
especially any waiver for potential Medals of Honor be addressed by Congress in the NDAA.61
The conferees also directed the Secretary of Defense to brief the Armed Services Committees no
later than March 31, 2021, on mechanisms by which the process could be made more effective.62
References: See the “Medal of Honor” section of CRS Report R44577, FY2017 National
Defense Authorization Act: Selected Military Personnel Issues, by Kristy N. Kamarck et al. and
similar reports from earlier years; and CRS Report 95-519, Medal of Honor: History and Issues,
by Barbara Salazar Torreon.
CRS Point of Contact: Barbara Salazar Torreon.
Military Family Matters
Background. There are approximately 2.1 million members of the Armed Forces across the
active and reserve components with an additional 2.6 million dependents (i.e., family members,
typically spouses and/or children).63 The military provides a number of quality of life programs
and services for military families as part of a servicemember's total compensation and benefits
package. Programs include family-life, career, and financial counseling; childcare services and
support; and other Morale, Welfare, and Recreation (MWR) activities. The general motivation for
providing these benefits is to improve the recruitment, retention, and readiness of military
servicemembers.
Military Family Matters Sectional Analysis
House-Passed H.R. 6395
Senate-Passed S. 4049
P.L. 116-283
Family Readiness

59 CBO, “S. 4049, the National Defense Authorization Act for Fiscal Year 2021,” as reported by the Senate Committee
on Armed Services on June 23, 2020, updated July 1, 2020, p. 6 at https://www.cbo.gov/system/files/2020-07/56462-
S4049.pdf.
60 Ibid.
61 Joint Explanatory Statement of the Committee of Conference, PDF p. 152, December 12, 2020, at
https://docs.house.gov/billsthisweek/20201207/116hrpt617-JointExplanatoryStatement.pdf.
62 Ibid.
63 DOD, Demographics: Profile of the Military Community, 2018, pp. 127 and 149.
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House-Passed H.R. 6395
Senate-Passed S. 4049
P.L. 116-283
Sec. 581 adopts the House provision
Sec. 561 would require DOD to
develop family readiness:
and requires DOD to act on
definitions, a communication
No similar provision
recommendations from the National
strategy, and report to Congress.
Academies of Science, Engineering and
Medicine.
Military Spouse Education and Employment
Sec. 564 would expand eligibility
Sec. 577 is a similar provision to
for financial assistance under the My House Section 564 that also
includes financial assistance for the
Career Advancement Account
Subject Standardized Tests of the
(MyCAA) program to continuing
Defense Activity for Non-
Sec. 586 adopts the Senate provision.
education courses and national
Traditional Education Support
testing (including Col ege Level
Division of the Department of
Examination Program tests)
Defense).’
Sec. 574 would clarify eligibility
Sec. 615 would expand
requirements for reimbursement of
reimbursable State licensure and
military spouse licensing costs
certification costs for a military
pursuant to a permanent change of Sec. 622 adopts the Senate provision.
spouse arising from relocation
station and would shift the
under 37 U.S.C. §476.
authority to 37 U.S.C. §453.
Sec. 570D would require DOD to
Sec 587 adopts the House provision
evaluate partner criteria for the
No similar provision
and requires an additional report
Military Spouse Employment
within one year of implementation of
Program (MSEP).
any program changes.
Sec. 625 would require a DOD
Sec. 628 requires a DOD study on
study on the feasibility of thrift
No similar provision
the feasibility of thrift savings plan
savings plan (TSP) contributions by
(TSP) contributions by military spouses
military spouses.
to the account of the servicemember.
Military Childcare
Sec. 563 would expand the
Sec. 589 requires DOD to establish a
authority for DOD to provide
pilot program for providing financial
financial assistance to certain in-
No similar provision
assistance to certain in-home childcare
home childcare providers.
providers.
Sec. 621 would expand the fee
Sec. 629 requires a GAO report on
assistance authority to provide for
the implications of expanding the fee
survivors of servicemembers who
No similar provision
assistance program to survivors of
die in the line of duty.
servicemembers who die in the line of
duty or active duty for training.
Sec. 626 requires the Secretary of
Sec. 623 would require DOD to
Defense to develop and implement a
review the amount of the fee
No similar provision
method to calculate fee assistance for
assistance subsidy for childcare
childcare and youth program service
services.
providers, based on local variations in
cost for childcare services.
Sec. 624 would provide priority
Sec. 576 would require several
Sec. 627 provides priority for certain
for certain military family housing to initiatives with respect to military
military family housing to
servicemembers whose spouse
childcare programs to include,
servicemembers whose spouse agrees
agrees to provide family home day

center fee matters;
to provide family home day care
care services.

services for at least one year.

fee assistance program;
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House-Passed H.R. 6395
Senate-Passed S. 4049
P.L. 116-283

increasing childcare workforce; Sec. 585 adopts the Senate provision
and
with some amendments to allow for

assessment of capacity at high- child development center discounts for
demand installations
families with 2 or more children and to
require reports on high-demand
installations.
Sec. 588 requires the Secretary of
Sec. 565 would require a feasibility
Defense to provide childcare to
determination for providing 24-
servicemembers or DOD civilian
hour childcare to DOD
Sec. 1067 is a similar provision to employees while working a rotating
servicemembers and employees
House Sec. 565.
shift at a military installation, if
who work on rotating shifts.
determined feasible after completing a
study and reporting to Armed Services
committees.
Sec. 571 would delineate
responsibility for allocation of
No similar provision
certain funds for military child
Sec. 584 adopts the Senate provision.
development programs.
Division H, Title II, Subtitle C,
§§9301 - 9309—Access to
No similar provision
Secs. 8231 – 8239 adopts these
Childcare for Coast Guard Families
provisions with some amendments.
Parental Leave
Sec. 566 would allow for
continuation of paid parental leave
No similar provision
Not adopted
upon death of a child.
Sec. 606 would provide
compensation and credit for retired
pay purposes for maternity leave
Sec. 603 is an identical provision
Sec. 602 adopts this provision.
taken by members of the reserve
to House Sec. 606.
components.
Discussion. The following discussion comprises four topic areas.
 Family readiness.
 Military spouse education and employment.
 Military childcare programs.
 Military parental leave.
Family Readiness. In 2019, two reports were published that issued recommendations for
improving the welfare of military families; the DOD Inspector General report, Fiscal Year 2020
Top DOD Management Challenges; and the National Academies of Science, Engineering and
Medicine (NASEM) report, Strengthening the Military Family Readiness System for a Changing
American Society.64 Section 561 of the House bill requires DOD to develop a concept of family

64 DODIG, Fiscal Year 2020 Top DOD Management Challenges, Challenge 3: Ensuring the Welfare and Well-Being
of Military Servicemembers, October 15, 2019, at https://media.defense.gov/2019/Nov/04/2002205654/-1/-
1/1/DEPARTMENT%20OF%20DEFENSE%20OFFICE%20OF%20INSPECTOR%20GENERAL%20FISCAL%20Y
EAR%202020%20TOP%20MANAGEMENT%20CHALLENGES.PDF. National Academies of Sciences,
Engineering, and Medicine, Strengthening the Military Family Readiness System for a Changing American Society,
2019, at https://www.nap.edu/catalog/25380/strengthening-the-military-family-readiness-system-for-a-changing-
american-society.
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readiness including definitions, a communication strategy, and a report to Congress on the
feasibility of implementing other recommendations made by the published reports. Section 581 of
the final enacted bill adopts the House provision and also requires DOD to act on the NASEM’s
recommendations.
Military Spouse Education and Employment. Recognizing that the transient and unpredictable
nature of a career in military service can impose unique burdens on military spouses, Congress
has authorized several initiatives to provide support for military spouses’ education, employment,
and career development. One of these programs is DOD's My Career Advancement Account
(MyCAA) Scholarship Program. MyCAA provides up to $4,000 in non-taxable scholarship funds
to eligible military spouses for licensure and certification programs.65 The House and Senate bills
for the FY2021 NDAA have similar provisions (Sections 564 and 577 respectively) that allow
military spouses to use these funds for continuing education courses or certain national tests for
credit towards an eligible degree program. Section 586 of the final enacted bill adopts the Senate
provision.
Varied interstate licensing requirements may impose additional financial burdens on working
spouses of military servicemembers who are typically faced with military permanent change of
station (PCS) moves every two to three years. The FY2018 NDAA first authorized the
reimbursement of qualified relicensing costs for military spouses as part of travel and
transportation allowances associated with a PCS move from one state to another.66 In the FY2020
NDAA, Congress raised the maximum reimbursement to $1,000, required the Secretary of
Defense to analyze whether that amount is sufficient to cover average relicensing costs, and
extended the sunset date for the authorization from December 31, 2021, to December 31, 2024.67
Section 615 of the House bill would have expanded qualified relicensing costs to include the
costs of continuing education courses. Section 574 of the Senate bill expands the FY2018
authority to allow for reimbursement in additional cases where a PCS move or permanent change
of assignment occurs “between duty stations located in separate jurisdictions with unique
licensing or certification requirements and authorities.” Section 622 of the final enacted bill
adopts the Senate provision.
In the FY2002 NDAA, Congress directed DOD to partner with the United States Chamber of
Commerce and with private-sector employers to enhance private employment opportunities for
military spouses.68 The Military Spouse Employment Partnership (MSEP) is one such DOD effort
to build these partnerships.69 The centerpiece of MSEP is a web-based job search and recruitment
platform. Participating employers are subject to a screening process and must commit to certain
actions to support military spouses. Section 570D of the House bill would require DOD to review
the criteria for participation with an eye on expanding the number of participating local small
businesses, companies that employ telework, software and coding companies, and educational
institutions. This provision would also require a report to Congress on certain metrics following
the implementation of program changes. Section 587 of the final enacted bill adopts the House

65 Funds are distributed to the qualified institution providing the education or training. Eligible military spouses are
those whose servicemember spouse is a junior officer (O-1 and O-2), warrant officer (W-1 and W-2), or enlisted
servicemember (E-1 through E-9).
66 P.L. 115-91, §556.
67 P.L. 116-92, §577.
68 P.L. 107-107, §571.
69 For more on MSEP, see https://msepjobs.militaryonesource.mil/msep/.
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provision and requires an additional report to Congress within one year of implementation of any
program changes.
Finally, due to frequent PCS moves, military spouses may not spend enough time with a single
employer to qualify for vesting in employer contributions to retirement savings plans (e.g., 401k).
Section 625 of the House bill would have required a study to determine the feasibility of allowing
military spouse contributions or transfers to the Thrift Savings Plan (TSP). Military
servicemembers and federal employees are authorized to contribute to the TSP, and the
government provides matching contributions for those who are eligible.70 A provision in the final
enacted bill (Section 628) requires a DOD study on the feasibility of TSP contributions by
military spouses to the account of the servicemember.
Military Childcare. DOD operates the largest employer-sponsored childcare program in the
United States, serving approximately 200,000 children of uniformed servicemembers and DOD
civilians and employing over 23,000 childcare workers, at an annual cost of over $1 billion.
Subsidized care is provided at child development centers (CDCs) and family homes on military
installations. Eligible families receive financial assistance for qualified care centers off-
installation under the fee assistance program.71
Section 563 of the House bill would have expanded the fee assistance authority and allow DOD
to provide financial assistance to military families for certain in-home childcare providers
including nannies, babysitters, and au pairs. The final enacted bill (Section 589) requires DOD to
establish a pilot program for providing financial assistance to certain in-home childcare providers.
In the FY2020 NDAA, Congress extended eligibility for fee assistance to survivors of
servicemembers who die in combat-related incidents in the line of duty.72 Section 621 of the
House bill would have removed the requirement that the servicemember’s line-of-duty death was
combat-related. The final enacted bill (Section 629) does not authorize this change, but rather
requires a GAO report to examine the issue.
Section 623 of the House bill would have required DOD to review the amount of the fee
assistance subsidy for childcare services, taking into account local cost of living and childcare
costs, waitlists at installation CDCs, and the availability of childcare providers on the base and in
the civilian community. Section 626 of the final enacted bill requires the Secretary of Defense to
develop and implement a method to calculate fee assistance for childcare and youth program
service providers, based on local variations in cost for childcare services.
DOD also subsidizes certified home-based childcare services, called Family Care Centers
(FCCs), for children between the ages of 4 weeks through 12 years on military installations.
Section 624 of the House bill would have given priority for installation family housing to a
servicemember whose spouse is willing to establish an FCC. Section 576 of the Senate bill would
also have required DOD to explore incentives for military spouses to establish FCCs in their
homes. Section 627 of the final enacted bill adopts the House provision allowing Service
Secretaries to give priority for military family housing to spouses who agree to provide family
home day care services for at least one year.

70 See CRS Report RL34751, Military Retirement: Background and Recent Developments, by Kristy N. Kamarck and
CRS Report RL30387, Federal Employees’ Retirement System: The Role of the Thrift Savings Plan, by Katelin P.
Isaacs.
71 The fee assistance program is authorized under 10 U.S.C. §1798.
72 P.L. 116-92, §624.
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In February 2020, DOD announced changes to the priority and waitlist system for installation-
based childcare services to provide a higher priority for military families over DOD civilians.73
Section 576 of the Senate bill would have also required liberal use of hardship waivers for CDC
fees and family discounts for additional children. It would have sought to standardize fee
assistance programs across the military departments and expressed a preference for the Army fee
assistance program model.74 In terms of childcare employees, Senate Section 576 would have
authorized the Service Secretaries to provide certain incentives to encourage recruitment and
retention of the childcare workforce (e.g., education benefits and wellness/fitness programs).
Finally, this provision would have required an assessment of installations that exhibit an “extreme
imbalance between demand for and availability of childcare” with recommendations to Congress
on ways to address these imbalances. Section 585 of the final enacted bill adopts some elements
of Section 576 of the Senate bill by amending 10 U.S.C. §1793 to authorize DOD to provide
discounts to families with two or more children in CDC care. It also requires reports to Congress
on installations with an “extreme imbalance” between demand for childcare and availability.
While the conference did not adopt other elements of Senate Section 576, the report to
accompany the bill noted,
The conferees note that existing authorities allow for the liberal issuance of hardship
waivers regarding childcare fees and encourage the Department of Defense to continue
offering flexible childcare options for servicemembers and their families. Additionally, the
conferees strongly encourage the Department to utilize enhanced marketing and
recruitment techniques to hire qualified childcare employees, and provide competitive
benefits in order to retain them.75
Some military positions require frequent shiftwork. At times this creates challenges for military
families in finding childcare services for irregular hours. Similar provisions in the House and
Senate bills require DOD to determine the feasibility of making 24-hour childcare available to
DOD servicemembers and employees who work on rotating shifts. The final enacted bill adopted
this provision under Section 588 and requires DOD to implement the policy if feasible.
Section 1791 of Title 10, United States Code, is the authority for using appropriated funds for
military childcare programs. Section 584 of the final enacted bill adopts Section 571 of the Senate
bill and amends this statute to give the Secretary of Defense the responsibility for allocating funds
and to prohibit delegation of this responsibility to the military services. The Senate Committee
report to accompany the bill states,
The committee remains concerned about the Department of Defense’s plans to transfer
funds to the military services to provide childcare fee assistance as part of the Defense-
Wide Review.76 The committee believes that military family childcare should remain
among the Department’s highest priorities and transferring resources to the military
services would degrade standardization of the program and hinder oversight capabilities of
the Office of the Secretary of Defense.77

73 Secretary of Defense Memorandum, Policy Change Concerning Priorities for Department of Defense Child Care,
February 21, 2020, at https://media.defense.gov/2020/Mar/09/2002261354/-1/-
1/1/POLICY_CHANGE_CONCERNING_PRIORITIES_FOR_DEPARTMENT_OF_DEFENSE_CHILD_CARE_PR
OGRAMS.PDF.
74 See https://www.childcareaware.org/fee-assistancerespite/military-families/army/.
75 H.Rept. 116-617, pdf. p. 130.
76 DOD, FY2021 Defense Wide Review, January 2020.
77 S.Rept. 116-236, p. 207.
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The final enacted bill adopts Division H, Title II, Subtitle C of the House Bill, which addresses
childcare issues for U.S. Coast Guard personnel and their families. Several provisions under this
section seek to provide parity with DOD childcare programs, through surveys, studies, and pilot
programs.
Military Parental Leave. The FY2017 NDAA authorized up to 12 weeks of parental leave
(including up to six weeks convalescent leave) for the primary caregiver in connection with the
birth of a child.78 It also authorized six weeks of leave for a primary caregiver in the case of an
adoption of a child. Under this legislation, secondary caregivers can take up to 21 days of leave in
connection with a birth or adoption. Section 566 of the House bill would have allowed the
member to take the full parental leave even if the child dies prior to the end of the previously
approved leave period. This provision was not adopted; however, the committee report noted that,
Commanders are entrusted with the responsibility of taking care of their troops, which
would include ensuring they have the ability to take leave to deal with the pain caused by
the death of a child. If it becomes clear that commanders are not performing as expected,
the conferees remain open to considering future legislation in this area.
Sections 606 of the House bill and 603 of the Senate bill are identical provisions that allow
military reservists on maternity leave to continue to receive credit towards military retirement.
This provision was adopted in the final enacted bill.
References: See CRS Report R46498, Military Spouse Employment, by Kristy N. Kamarck,
Barbara L. Schwemle, and Sofia Plagakis; CRS Report R45288, Military Child Development
Program: Background and Issues, by Kristy N. Kamarck; and CRS Report RL34751, Military
Retirement: Background and Recent Developments, by Kristy N. Kamarck.
Point of Contact: Kristy N. Kamarck.
COVID-19 Personnel Program Provisions
Background. Throughout 2020, DOD responded to many requests for Defense Support of
Civilian Authorities (DSCA) as part of its role in the federal response to COVID-19. Several
requirements for new or modified personnel programs or authorities arose in relation to the
military units and personnel providing this support. Soldier and family personnel programs and
benefits requirements were also affected by COVID-19 support activities, to include COVID-19
testing and treatment, education services for military dependents, requirements for special pays,
and delayed entitlements or other benefits.79
COVID-19 Personnel Program Provisions Sectional Analysis
House-Passed H.R. 6395
Senate-Passed S. 4049
P.L. 116-283
Military Pay and Retirement

78 P.L. 114-328, §521; 10 U.S.C. §701. Convalescent leave is a type of medical leave that is typically approved by a
physician.
79 See Amy Bushatz, “Will Troops Continue to Receive Special Pays Amid the Pandemic? It Depends,” Military.com,
April 9, 2020, at https://www.military.com/daily-news/2020/04/09/will-troops-continue-receive-special-pays-amid-
pandemic-it-depends.html; and DOD, “Fact Sheet: COVID-19 Military Personnel, Pay, and Benefits Policy –
Supplement 1,” April 9, 2020, at
https://www.whs.mil/Portals/75/Coronavirus/DoD%20Military%20Pay%20%20Personnel%20Benefits%20FAQ_SUP
%201.pdf?ver=2020-04-09-134841-657.
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House-Passed H.R. 6395
Senate-Passed S. 4049
P.L. 116-283
Sec. 602 would direct the Service
Secretaries to issue hazardous duty
No similar provision
pay for members of the Armed
Not adopted
Forces performing in response to
the COVID-19 pandemic.
Sec. 516 adopts Senate Sec. 621
with an amendment that amends
Sections 12732 and 12733 of Title
10, United States Code, to
authorize the Secretary of Defense,
or the Secretary of Homeland
Security with respect to the Coast
Sec. 514 would grant constructive
Guard, to provide points for
credit towards retirements for a
reserve retirement purposes if a
member of the Reserve
reserve servicemember is
Components who cannot complete
Sec. 621 is similar to House Sec.
prevented from participating in
minimum annual training
514.
required dril s or training during the
requirements due to the COVID-19
emergency period beginning on
pandemic.
March 1, 2020, which coincides
with the COVID-19 pandemic. The
provision also requires the
Secretary of Defense to provide a
report to the Committees on
Armed Services of the Senate and
the House of Representatives on
the use of this authority.
Other Personnel-Related Provisions
Sec. 519 would require the DOD
to submit a report to Congress on
how the Secretary of Defense
determined the authorization of
No similar provision
Sec. 519A adopts House Sec. 519
ful -time National Guard duty in
with a technical amendment.
response to the COVID-19
pandemic.
Sec. 517 adopts House Sec. 520B
Sec. 520B would require DOD to
with an amendment that authorizes
provide quarantine housing for
the Secretary of Defense to provide
National Guard members upon
at least 14 days of housing for
completion of active service in
No similar provision
members of the Reserve
response to the COVID-19
Component ordered to active
pandemic.
service in response to the COVID-
19 national emergency.
Sec. 596 would direct the
Secretary of Defense to conduct a
study on financial hardships among
No similar provision
Sec. 597 adopts House Sec. 596
servicemembers during the
with a technical amendment.
COVID-19 pandemic.
Discussion. The selected provisions discussed below relate to COVID-19 specific military
personnel issues and programs. Selected provisions related to COVID-19 specific Defense Health
Care and Public Health issues and programs are discussed separately.
Military Pay and Retirement. Section 602 of the Senate bill would have directed Service
Secretaries to issue hazardous duty pay to certain servicemembers performing duty in response to
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the COVID-19 pandemic between January 1, 2020, and December 31, 2020. The provision would
have required DOD to issue regulations specifying the eligibility criteria for hazardous duty pay,
which would have been no less than $150 per month. In addition, the Senate would have
expressed its sense that DOD should provide hazardous duty pay to certain health care providers
and support staff who treat COVID-19 patients. The provision was not adopted.
House Section 514 would have authorized the Secretary of Defense to approve constructive credit
for certain Reserve servicemembers who were not able to complete minimum annual training
requirements due to cancellation or other extenuating circumstance resulting from the COVID-19
pandemic. The provision would have required DOD to submit a report to Congress, no later than
one year after the COVID-19 national emergency ends, that includes the number of
servicemembers granted constructive credit and recommendations on whether such authority
should be made permanent.80 Senate Section 621 would have amended 10 U.S.C. §§12732 and
12733 to authorize retirement points to reserve servicemembers if they were prevented from
performing inactive duty training (i.e., drill periods) due to certain travel or duty restrictions
during a “covered emergency period.”81 The final enacted bill contains Section 516, which
requires the military services to credit the following to eligible servicemembers, not to exceed 35
points in a one-year period:
 one point for each day of active service; or
 one point for each drill or period of equivalent instruction.
Other Personnel-Related Provisions. Section 519 of the House bill requires DOD to submit a
report to the congressional defense committees, no later than 90 days after enactment, on how the
Secretary of Defense determined to authorize full-time National Guard duty to respond to the
COVID-19 pandemic. The report is to include: how many requests were received from states and
the outcomes (i.e., approved or denied), the length of time to adjudicate each request, a
description of cost considerations (if any), reasoning for denied requests, a description of any
process differences (compared with pre-COVID-19 requests), and recommendations to improve
the request process. Section 519A of the final enacted bill adopts this provision with a technical
amendment.
House Section 520B requires the Secretary of Defense to provide at least 14 days of quarantine
housing for National Guard personnel completing active service in response to the COVID-19
pandemic. The final enacted bill’s provision expands this eligibility to all members of the Reserve
Component.
House Section 596 was incorporated into the final enacted bill with a technical amendment as
Section 597. It directs DOD to conduct a study and submit a report to Congress, no later than 120
days after enactment, on financial hardships among servicemembers during the COVID-19
pandemic. The study is to review the financial impact to servicemembers relating to stop
movement orders; loss of spousal income, hazardous duty incentive pay, educational benefits, and
drill and exercise pay; cancelled deployments; and other financial stressors. In conducting the
study, the provision also requires DOD to consult with the Consumer Financial Protection Bureau
and Department of Homeland Security (with regard to the members of the Coast Guard).
References: See CRS Insight IN11273, COVID-19: The Basics of Domestic Defense Response,
coordinated by Michael J. Vassalotti; CRS In Focus IF10335, DOD Domestic School System:

80 The “COVID-19 national emergency” refers to the period in the President’s Proclamation on Declaring a National
Emergency Concerning the Novel Coronavirus Disease (COVID-19) Outbreak, March 13, 2020.
81 The “covered emergency period” would begin on March 1, 2020, and end 60 days after the applicable travel or duty
restriction is lifted.
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Background and Issues, by Kristy N. Kamarck; and CRS Report RL33446, Military Pay: Key
Questions and Answers, by Lawrence Kapp and Barbara Salazar Torreon.
Points of Contact: Hibbah Kaileh, Kristy N. Kamarck, and Lawrence Kapp.
Maritime and Civilian Personnel
Besides its military personnel portfolio, HASC and SASC jurisdiction includes the policy and
programs for DOD civilian personnel and related authorities that are addressed in the FY2021
NDAA.82 Such jurisdiction also covers the national security aspects of maritime policy and
merchant marine personnel.83 Among other areas, the committees’ maritime oversight includes
the FY2021 NDAA provisions for the funding and operations of the U.S. Merchant Marine
Academy (USMMA) (a component of the Maritime Administration (MARAD), which is in the
Department of Transportation (DOT)).84 Such oversight extends to the Act’s provisions for the six
federally supported state maritime academies (SMAs) (See Table 4).
Merchant Mariners
Background. The USMMA at Kings Point, New York, is a federal service academy with an
approximate enrollment of 1,000 cadets and 40 preparatory school students.85 The cadets are also
midshipmen in the Navy Reserve.86 The Academy prepares students to be merchant marine
officers (licensed mariners) for maritime service and strategic sealift officers for military
service.87 Admission to USMMA is through a competitive process and congressional nomination
is required.88 Tuition and many other expenses are paid by the federal government, but unlike at
all other service academies, USMMA students are responsible for some attendance expenses.89

82 U.S. Senate, Document 113-18, Standing Rules of the Senate, January 24, 2013, p. 20.
83 U.S. House of Representatives, Rules of the House of Representatives, January 11, 2019, p. 6; RCP 116-25, Rules
Adopted by the Committees of the House of Representatives of the United States, 116th Congress, 2019-2020, p. 37.
Specific national security areas of maritime policy under HASC jurisdiction include cabotage, cargo preference,
financial assistance for the construction and operation of vessels, and maintenance of the U.S. shipbuilding and ship
repair industrial base.
84 The Merchant Marine Act of 1936 created the United States Maritime Commission (MARCOM) and among other
matters, required the establishment of a federal merchant marine officer training program. USMMA began operations
in January 1942 and was formally established in September 1943. The shore based officer training program at USMMA
evolved from the ship based U.S. Merchant Marine Cadet Corps program established in 1938. The United States
Maritime Service (USMS) administered both programs. MARCOM created USMS in 1938 as a uniformed service
responsible for federal merchant marine training programs. USMS continues in this role today, but now under the
control and direction of MARAD. Although USMS members still wear a nautical military uniform and have a
commissioned officer rank structure identical to Coast Guard officer rank, it is now part of the federal civil service and
is no longer defined as a uniformed service (See 46 U.S.C. §51701; 10 U.S.C. §101(a)(5)).
85 46 U.S.C. §§51301, 51303; Department of Transportation, Maritime Administration CFO Directive – 16, Version 4,
March 30, 2020, p. 5. The Academy is a four year college accredited by the Middle States Commission on Higher
Education and confers the degree of Bachelor of Science, see
https://nces.ed.gov/collegenavigator/?q=merchant+marine&s=all&id=197027#enrolmt.
86 46 U.S.C. §51311. USMMA cadets are required by law to apply for midshipman status in the Navy Reserve.
87 46 C.F.R. §310.52; U.S. Navy, Program Authorization 221, Reserve Component (RC) Designator 1665 (Strategic
Sealift Officer (SSO)) direct commission officer (DCO) program, June 2019.
88 46 U.S.C. §51302. Nomination and competitive appointment of cadets.
89 46 U.S.C. §51314. Limitation on charges and fees for attendance.
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USMMA cadets must meet certain requirements to graduate. These requirements include
successfully completing the school’s academic program, accumulating at least 360 days of sea-
time serving aboard sealift or merchant vessels, and passing the U.S. Coast Guard examination
for a merchant marine deck or engineer officer’s license.90 Academy graduates incur a federal
service obligation that is fulfilled by concurrent military reserve service for eight years and
merchant mariner licensure for six years. Alternatively, they can fulfill it by spending five years
serving on active duty in any uniformed service or working for the federal government in a
civilian maritime role.91
FY2020 NDAA Independent Study of USMMA92
The FY2020 NDAA requires the National Academy of Public Administration (NAPA) to conduct a comprehensive
assessment of USMMA systems, training, facilities, infrastructure, information technology, and stakeholder
engagement (the COVID-19 Pandemic has delayed the assessment). NAPA’s study is meant to identify needs and
opportunities for modernization to help USMMA keep pace with more modern campuses. NAPA is also required
to develop an action plan for USMMA with specific recommendations for systemic changes and improvements.
Admission to SMAs is governed by state and institutional policy. Students at SMAs are
responsible for all tuition and expenses, but if eligible, they can receive federal student aid or
scholarships that may be available at their institution. ROTC scholarships are not offered at
SMAs, but MARAD’s competitive Student Incentive Payment (SIP) program is an alternative
source of federal funding that may be available to eligible students. SIP participants at SMAs can
receive $8,000 of tuition assistance per year for a total of $32,000 over four years.93 Upon
graduation, SIP recipients incur the same service obligation as USMMA graduates, concurrent
military reserve service for eight years and merchant mariner licensure for six years.
The Strategic Sealift Midshipman Program (SSMP) is a Navy education and training program
conducted by the Department of Naval Science at USMMA and the SMAs.94 The SSMP’s
principal purpose is to qualify participants for service in the Navy’s Strategic Sealift Officer
Program (SSOP).95 All USMMA cadets participate in SSMP and participation in SSMP at SMAs
is mandatory for SIP recipients and elective for other students. Successful program participants
may receive a U.S. Navy Reserve officer commission as a strategic sealift officer (SSO) with the
rank of ensign. The Navy Reserve assigns SSOs to the Strategic Sealift Readiness Group (SSRG),
which is part of the Navy’s Individual Ready Reserve (IRR).
Table 4. Post-Secondary Maritime Institutions
Federal and State Academies
Institution
Location
Established
U.S. Merchant Marine Academy
Kings Point, New York
1942
State University of New York Maritime Col ege New York City (The Bronx), New York
1874
Massachusetts Maritime Academy
Buzzards Bay, Massachusetts
1891

90 U.S. Merchant Marine Academy, Course Catalog, 2019-2020, pp. 37-38.
91 46 U.S.C. §51306.
92 P.L. 116-92, §3513.
93 46 U.S.C. §51509.
94 U.S. Navy, NSTC M-1533.2C, United States Naval Reserve, Administration and Management Annex, Appendix R,
Strategic Sealift Midshipmen Program, CH-2, January 2019.
95 Department of the Navy, OPNAV Instruction 1534.lE, Strategic Sealift Officer Program, 1 Dec 2017.
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Institution
Location
Established
California State University Maritime Academy
Vallejo, California
1929
Maine Maritime Academy
Castine, Maine
1941
Texas A&M Maritime Academy
Galveston, Texas
1962
Great Lakes Maritime Academy
Traverse City, Michigan
1969
Source: See https://www.usmma.edu/; https://www.sunymaritime.edu/; https://www.maritime.edu/;
https://www.csum.edu/; https://mainemaritime.edu/; https://www.tamug.edu/corps/;
https://www.nmc.edu/maritime/.
The NDAA generally includes DOT funding authorizations for USMMA and SMAs. The FY2021
authorization amounts are compared to the FY2020 amounts in Table 5. For USMMA, the
FY2021 NDAA authorized $85,441,000. Approximately 93.5% of this authorization is for
operations and maintenance and 6.5% is available until expended for capital asset management.
The FY2021 NDAA authorized $50,780,000 for the six SMAs and their training ships.
Approximately 80% of this authorization is for several types of training ship expenses and the
remaining 20% is for SMAs operations and student programs.
Table 5. FY2020 and FY2021 MARAD Funding Authorizations
Education and Training Programs
Program
FY 2020
FY 2021
NDAA
NDAA
NDAA
Difference
U.S. Merchant Marine Academy
Academy Operations
77,944,000
79,941,000
1,997,000
Capital Asset Management
18,000,000
5,500,000
(12,500,000)
Subtotal
95,944,000
85,441,000
(10,503,000)
State Maritime Academies
SMAs Training Vessels Maintenance
30,080,000
30,500,000
420,000
SMAs Training Ship Sharing Offset
8,000,000
8,080,000
80,000
Academy Operations
6,000,000
6,000,000
0
Training Ship Fuel Assistance
3,800,000
3,800,000
0
Student Incentive Payment Program
2,400,000
2,400,000
0
Subtotal
50,280,000
50,780,000
500,000
Total
146,224,000
136,221,000
(10,003,000)
Source: P.L. 116-92, §3501; P.L. 116-283, §3501.
Maritime Personnel Sectional Analysis
House-Passed H.R. 6395
Senate-Passed S. 4049
P.L. 116-283
Sec. 3507 would establish the
Elijah E. Cummings Merchant
Mariner Career Training Loan
Sec. 3508 adopts parts of the
Program and authorize the
No similar provision
House provision, but in lieu of a
designation of certain training
program, requires a program study
establishments as a Maritime
and report.
Training Institution.
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House-Passed H.R. 6395
Senate-Passed S. 4049
P.L. 116-283
Sec. 3510 would require vessel
operator beneficiaries of certain
national security programs to take
Sec. 3506 adopts the House
No similar provision
on at least two USMMA cadets per
provision.
vessel for their sea-time duty.
Sec. 3510A expresses a sense of
Sec. 3503 adopts the sense of
Congress that the USMMA
Congress and adds the term
superintendent should be a
No similar provision
merchant marine and certain
graduate of the Academy who
merchant marine positions to the
possesses certain qualifications.
qualifications for superintendent.
Sec. 3510B would require the
MARAD Administrator to publish
information online regarding the
status or employment of USMMA
No similar provision
Sec. 3509 adopts the House
graduates, as well as SIP program
provision.
participation and federal service
obligation information for graduates
of SMAs.
Discussion. It is the policy of the United States that its Navy and merchant marine work closely
together to promote the maximum integration of its sea power forces.96 The Secretary of
Transportation is required to provide education and training for the operation of the merchant
marine as a naval and military auxiliary in time of war or national emergency.97 The Secretary of
the Navy is required to ensure that naval officer training and naval science education programs
for the operation of merchant vessels as a naval and military auxiliary are available at the
USMMA and SMAs.98
The House bill (Section 3507) would have amended Title 46 of the U.S. Code by adding a new
section establishing the Elijah E. Cummings Merchant Mariner Career Training Loan Program in
DOT, but the final enacted bill did not adopt this provision. Instead, it directed MARAD to
develop a merchant mariner recruitment, training, and retention strategic plan and to produce a
study and report on financial assistance for training merchant mariners.
The House bill (Section 3510) was adopted by Section 3506 of the final enacted bill and amends
Title 46 of the U.S. Code to require certain vessel operators to carry USMMA cadets for their sea
duty. Pursuant to 46 U.S.C. §51307(b), as amended in the final enacted bill, operators of a vessel
participating in the maritime programs specified in Chapters 531, 532, and 534 of Title 46 of the
U.S. Code are required to carry two USMMA cadets, if available, on each program vessel.
Since its establishment in 1942, USMMA has had 13 superintendents. Less than half served in the
merchant marine and less than a third graduated from the Academy (See Table 6). Section 3503
of the FY2021 NDAA expresses a sense of Congress that due to the unique mission of USMMA,
it is highly desirable that its superintendent be a USMMA graduate in good standing who has
attained certain merchant marine licensure.99 The House bill (Section 3510A) was adopted by
Section 3503 of the final enacted bill and amends Title 46 of the U.S. Code by adding this sense
of Congress to the qualifications for superintendent. Under 46 USC §51301(c), as amended in the

96 46 U.S.C. §51101.
97 46 U.S.C. §51103.
98 46 U.S.C. §51104.
99 46 U.S.C. §7101.
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final enacted bill, USMAA graduation and captain, chief mate, or chief engineer licensure in the
merchant marine are now among the express superintendent qualifications.
Table 6. Career and Training Backgrounds of USMMA Superintendents
Maritime, Military, and Education Information
13 USMMA Superintendents Appointed from 1942 to 2021
Merchant
Armed Forces Service
Mariner
Navy
Coast Guard
Marine Corps
Army
6 out of 13
9
2
1
1
Post-Secondary Education
USMMA
USNA
USCGA
USMA
Other Schools
4
3
2
1
3
Source: Jeffery L. Cruikshank, Chloe G. Kline, In Peace and War: A History of the U.S. Merchant Marine Academy at
Kings Point (New Jersey: John Wiley & Sons, Inc., 2008); Email to CRS from Office of the Superintendent, U.S.
Merchant Marine Academy, Kings Point, New York, December 2, 2020.
Notes: USNA denotes U.S. Naval Academy; USCGA, U.S. Coast Guard Academy; and USMA, U.S. Military
Academy.
Section 3509 of the FY2021 NDAA requires the MARAD Administrator to make available on a
public website, not later than January 1, 2022, information regarding the number of USMMA and
SMAs graduates for the preceding five years, who are employed in, or whose status qualifies
under, the following categories: unknown, non-maritime, maritime afloat, maritime ashore,
graduate studies, and the armed forces of the United States.
This section also requires information on the public website regarding the number of students at
SMAs who are receiving SIP program funds, or have received such funds in the preceding five
years. Likewise, the number of SMAs students who graduated with a federal service obligation,
and the number who did not, is required on the website, to include the number of SMAs students
who received partial SIP program payments and graduated without a federal service obligation.
References: See CRS Insight IN11416, Maritime Administration’s Ready Reserve Sealift Fleet,
by John Frittelli.
Point of Contact: Alan Ott.
Defense Civilians
Background. The civil service consists of three categories: competitive service, excepted service,
and senior executive service (SES). The competitive service is the primary and largest civil
service category. The other categories are excluded from it by statute, the President, or the Office
of Personnel Management (OPM). The excepted service is the next largest category, and its
selection procedures differ from the ones used in the competitive service. The smallest category is
the SES—less than one percent of the civil service. Selection for the SES is based on an OPM-
regulated merit staffing procedure and qualifications review board (QRB). The stated purpose of
the QRB is to verify and certify an SES aspirant’s executive core qualifications (ECQs).
DOD may employ defense civilians consistent with its yearly appropriation for direct hire
employees. They fill positions that do not require military personnel. The majority of defense
civilians is in the competitive service (82%). Most civil service appointments in DOD are made
under Title 5 of the U.S. Code. The remaining appointments typically are made for specialized
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workforces, such as cyber, acquisition, and intelligence, under Title 10 of the U.S. Code. Defense
civilians perform federal functions under the supervision of a servicemember or another defense
civilian. Defense civilians may exercise management or supervisory authority over
servicemembers when authorized, but they do not have command or military justice authority
over them.
There are two common methods for enumerating civil servants: full-time equivalent (FTE) and
on-board personnel (OBP). The executive branch typically uses FTE in budget documents and
OBP in data reports. A FTE unit equals one work year (2,080 hours) and an OBP unit equals one
employee. The FTE method quantifies employment as the number of hours worked at the end of a
fiscal year, irrespective of the number of employees. The OBP method quantifies employment as
the number of actual employees working on the last day of any quarter in a fiscal year, regardless
of their part or full-time status.
Table 7. Defense Civilian FTE and OBP Units
U.S. Direct Hire and Foreign Direct Hire Civilian Employees
DOD Component
FTE – FY2020
OBP – 30 Sep 2020
Defense
217,300
113,640
Army
180,800
252,247
Navy
207,000
225,284
Air Force
169,800
172,857
Total
774,900
764,028
Source: DOD Budget Overview for FY2021, p. 2-8, available at
https://comptrol er.defense.gov/Portals/45/Documents/defbudget/fy2021/fy2021_Budget_Request_Overview_Bo
ok.pdf (accessed March 16, 2021); Defense Manpower and Data Center (DMDC), Number of Military and DoD
Appropriated Fund (APF) Civilian Personnel Permanently Assigned, As of September 30, 2020, at
https://dwp.dmdc.osd.mil/dwp/app/dod-data-reports/workforce-reports (accessed March 16, 2021)
Notes: FTE numbers were rounded by source. Navy numbers includes Marine Corps employees.
Civilian Personnel Sectional Analysis
House-Passed H.R. 6395
Senate-Passed S. 4049
P.L. 116-283
Sec. 516 would allow the
Sec. 518 adopts the House
establishment of a pilot program to
provision subject to a Senate
extend state job placement
No similar provision
amendment for a 50% federal and
programs to members of the
50% state cost share, with a report
Selected Reserve.
required not later than Mar 1, 2022
Sec. 911 would prohibit civilian
workforce reductions without
appropriate analysis of the impacts
of such reductions on workload,
Sec. 912 adopts the House
military force structure, lethality,
No similar provision
provision.
readiness, operational effectiveness,
stress on the military force, and
ful y burdened costs.
Sec. 1102 would prohibit DOD
from excluding col ective bargaining
No similar provision
Not adopted
rights by defunding any such action.
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House-Passed H.R. 6395
Senate-Passed S. 4049
P.L. 116-283
Sec. 1106 would extend the
authority of the Secretary of
Defense to appoint up to 50 senior
Sec. 1118 adopts the Senate
No similar provision
executives per year without board
provision.
certification from the Office of
Personnel Management.
Sec. 1107 would include Defense
Security Cooperation University
Sec. 1107 adopts the House
and Institute of Security
Governance civilian faculty in
Provision with commentary and a
No similar provision
existing authorities for
March 1, 2021, briefing
compensation at DOD academic
requirement.
institutions.
Sec. 1108 would waive the
requirement that retired or
Sec. 1108 adopts the House
separated servicemembers wait 180 Sec. 1108 is similar to House Sec.
provision subject to a Senate
days before fil ing civilian positions
1108.
amendment that such positions are
for any industrial base facility if
at the GS-13 level and below.
there is shortage of applicants.
Sec. 1109 would create an
alternative work schedule
Sec. 1110A is similar to House
Sec. 1109 adopts both provisions.
demonstration project for certain
Sec. 1109.
Navy firefighters.
Sec. 1107 would authorize DOD
to establish a pilot program offering
higher compensation than normally
Sec. 1119 adopts the Senate
No similar provision
allowed for limited numbers of
provision
positions requiring extremely high
levels of experience managing
complex organizations.
Discussion. It is DOD policy to use civilian employees in all positions that do not require military
incumbents for reasons of law, training, security, discipline, rotation, or combat readiness, or that
do not require a military background for successful performance of the duties involved.100 In
carrying out their responsibilities for civilian personnel management, DOD managers are
governed by DOD policy and the merit system principles in Title 5 of the U.S. Code.101
The House bill (Section 516) allows DOD to establish a pilot program for states to establish or
expand job placement programs and related employment services for members of the Selected
Reserve. Section 518 of the FY2021 NDAA adopts the provision subject to a cost share provision
and authorizes the Secretary of Defense to carry out a pilot program to enhance the efforts of
DOD to provide job placement assistance and related employment services directly to members
of the National Guard and Reserves in reserve active-status. If the pilot program is established,
the Secretary, in coordination with the Chief of the National Guard Bureau, shall submit to the
HASC and SASC a report describing the results of the pilot program not later than March 1,
2022.
The House bill (Section 911) prohibits the Secretary of Defense from reducing the civilian
workforce unless the DOD assesses the impact of such an action based on a number of factors

100 Department of Defense, Directive 1400.05, DOD Policy for Civilian Personnel, §3, January 12, 2005.
101 5 U.S.C. §2301(b).
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specified in the provision. Section 912 of the FY2021 NDAA adopts this provision. Pursuant to
10 U.S.C. §129a, as amended, the Secretary may not reduce the DOD civilian workforce unless
the Secretary conducts an appropriate analysis of the impacts of such reductions on workload,
military force structure, lethality, readiness, operational effectiveness, stress on the military force,
and fully burdened costs.
The Senate bill (Section 1106) would have extended the sunset provision of Section 1109 of the
FY2019 NDAA. Section 1118 of the FY2021 NDAA allows DOD to appoint no more than fifty
SES appointments per year under Title 5 of the U.S. Code without certification by an Office of
Personnel Management (OPM) senior executive service (SES) qualification review board for
three years beyond August 13, 2020.
The House bill (Section 1107) expands the list of covered institutions for which DOD may
establish administratively determined positions. Section 1107 of the FY2021 NDAA adopts this
provision. Under 10 U.S.C. §1595, as amended, the Defense Security Cooperation University and
Defense Institute for Security Governance are added to the list of covered institutions employing
civilian faculty.
The House bill (Section 1108) would have allowed servicemembers to accept a civil service
appointment to specified positions within 180 days of retiring or separating. Section 1108 of the
FY2021 NDAA authorizes the Secretary of Defense to appoint retired servicemembers to DOD
positions classified at or below GS-13, or an equivalent level under another pay plan, in the
competitive service at certain defense industrial base facilities that have been certified by the
Secretary of the military department concerned as lacking sufficient numbers of potential
applicants.
The House bill (Section 1109) authorizes an alternative work schedule demonstration project for
certain Navy fire fighters. Section 1109 of the FY2021 NDAA adopts this provision and requires
the Commander, Navy Region Mid-Atlantic to establish and carry out a fire fighters alternative
work schedule demonstration project for the Navy Region Mid-Atlantic Fire and Emergency
Services. The demonstration project is to be established not later than 180 days after January 1,
2021, and to exist for a period of not less than five years.
The Senate bill (Section 1107) authorizes DOD to establish a pilot program offering higher
compensation than normally allowed by the executive schedule for a limited number of positions.
Section 1119 of the FY2021 NDAA allows the Secretary of Defense to carry out a pilot program
to assess the feasibility and advisability of using the enhanced pay authority. The enhancement
would increase the rate of basic pay for certain agency level executive positions to attract and
retain executives with certain skills and abilities.
References: See CRS In Focus IF11510, Defense Primer: Department of Defense Civilian
Employees, by Alan Ott and CRS Report R45635, Categories of Federal Civil Service
Employment: A Snapshot, by Jon O. Shimabukuro and Jennifer A. Staman
Point of Contact: Alan Ott.
Defense Health Care and Public Health
The HASC and SASC have jurisdiction over military health care, the Defense Health Agency and
the Defense Health Program, as well as the DOD Retiree Health Care Fund and the Armed Forces
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Retirement Home.102 DOD health care and related veterans’ health matters are a significant
portion of the FY2021 NDAA and various provisions address a wide range of health care and
public health issues.
Military Health System Administration
Background. DOD operates a health care delivery system that serves approximately 9.6 million
beneficiaries.103 The Military Health System (MHS) administers the TRICARE program, which
offers health care services at military treatment facilities (MTFs) or through participating civilian
health care providers.104 Historically, the military services have administered the MTFs, while the
Defense Health Agency105 (DHA) administered the private sector care program of TRICARE.
DHA describes itself as a combat support agency that enables the Army, Navy, and Air Force
medical services to provide a medically ready force and ready medical force to combatant
commands in both peacetime and wartime.106
In 2016, Congress found that the organizational structure of the MHS could be streamlined to
sustain the “medical readiness of the Armed Forces, improve beneficiaries’ access to care and the
experience of care, improve health outcomes, and lower the total management cost.”107
Subsequently, Congress directed numerous reforms for the MHS, including:
 transfer of administration and management of MTFs from each respective service
surgeon general to the DHA Director;
 reorganization of DHA’s internal structure; and
 redesignation of the service surgeons general as principal advisor for their
respective military service and as service chief medical advisor to the DHA.108
Congress also directed DOD to implement most reforms no later than September 30, 2021. On
October 25, 2019, the military services transferred the administration and management of their
U.S.-based MTFs to the DHA.109 The military services are to continue to administer their
overseas MTFs until transfer to the DHA in 2020-2021.110
Military Health System Administration Sectional Analysis
House-Passed H.R. 6395
Senate-Passed S. 4049
P.L. 116-283
Organizational Management

102 U.S. Senate, Document 113-18, Standing Rules of the Senate, January 24, 2013, p. 20 U.S. House of
Representatives, Rules of the House of Representatives, January 11, 2019, p. 6; RCP 116-25, Rules Adopted by the
Committees of the House of Representatives of the United States, 116th Congress, 2019-2020, p. 37.
103 DOD, Evaluation of the TRICARE Program: Fiscal Year 2020 Report to Congress, June 9, 2020, p. 21.
104 For more on TRICARE, see CRS In Focus IF10530, Defense Primer: Military Health System, by Bryce H. P.
Mendez.
105 Prior to the creation of the Defense Health Agency (DHA) in 2013, the TRICARE Management Activity (TMA)
was the DOD organization that administered the TRICARE program.
106 For more on the DHA, see https://health.mil/About-MHS/OASDHA/Defense-Health-Agency.
107 H.Rept. 114-840, p. 1066.
108 10 U.S.C. §1073c; and Sections 711 and 712 of the John S. McCain NDAA for FY 2019 (P.L. 115-232). See also
Deputy Secretary of Defense Memorandum, Continuing Implementation of the Reform of the Military Health System,
October 25, 2019, at https://go.usa.gov/x7GQS.
109 Deputy Secretary of Defense Memorandum, Continuing Implementation of the Reform of the Military Health
System, October 25, 2019.
110 Ibid.
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House-Passed H.R. 6395
Senate-Passed S. 4049
P.L. 116-283
Sec. 714 would amend 10 U.S.C.
§1093c(e) by extending to
Sec. 721 is a similar provision to
September 30, 2025, the deadline
House Sec. 714 that would extend
for the Defense Health Agency
the deadline to September 30,
Not adopted. Deadline remains
(DHA) to establish subordinate
2024; and amends Sec. 737 of the
September 30, 2022.
entities that consolidate certain
FY2020 NDAA to clarify the
Research and Development
preservation of certain Department
activities and Public Health
of the Army medical resources.
activities.
Sec. 716 would amend Section
Sec. 718 adopts House Sec. 716
703(d) of the FY2019 NDAA (P.L.
with an amendment that requires
115-232) by establishing a notice-
the Secretary of Defense to certify
and-wait process and revising the
No similar provision
to the congressional defense
elements of the implementation
committees that beneficiaries wil
plan for restructure or realignment
be able to access health care
of military treatment facilities
services if an MTF is restructured
(MTFs).
or realigned.
Sec. 719 would amend 10 U.S.C.
§1073d by requiring the
No similar provision
Not adopted
maintenance of certain MTFs at U.S.
military service academies.
Sec. 722 would amend Section
713(c) of the FY2019 NDAA (P.L.
Sec. 711 adopts Senate Sec. 722
115-232) to delay the transition of
with an amendment that replaces
No similar provision
the TRICARE Dental Program to
the originally proposed provision
the Federal Employees Dental and
with a provision that repeals the
Vision Insurance Program (FEDVIP)
administration of TRICARE Dental
to January 1, 2023.
Program benefits through FEDVIP.
Sec. 742 would amend 10 U.S.C.
§2113a(b) to add the Defense
Health Agency Director as an ex-
No similar provision
officio member of the Uniformed
Sec. 715 adopts Senate Sec. 742.
Services University of the Health
Sciences (USUHS) Board of
Regents.
Military Medical Personnel
Sec. 715 would amend Section 719
Sec. 717 adopts House Sec. 715
of the FY2019 NDAA (P.L. 115-
with an amendment to prohibit any
232) by extending certain
No similar provision
military medical end-strength
limitations on changes to the
reductions within 180 days after
military medical end-strength for a
enactment.
one-year period after enactment.
Civilian Partnerships
Sec. 731 would amend Section 740
of the FY2020 NDAA (P.L. 116-92)
Sec. 741 adopts Senate Sec. 744
to require DOD to conduct a pilot
Sec. 744 is a similar provision to
with an amendment to require
program, no later than 180 days
House Sec. 731 that would require
DOD to submit an initial report to
after enactment, using military-
a pilot program no later than
Congress within 180 days after the
civilian partnerships to enhance
September 30, 2021.
pilot program commences and a
interoperability and medical surge
final report within 180 days after
capabilities of the National Disaster
the pilot program is completed.
Medical System.
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Discussion. The House and Senate bills include a number of provisions to delay or clarify certain
congressionally directed or DOD-initiated reform efforts.
Organizational Management. In 2018, Congress directed DOD to consolidate most of its
medical research and public health programs under the DHA by September 30, 2022.111 Section
714 of the House bill would have extended to September 30, 2025, the deadline for DHA to
establish a formal research and development entity and public health entity, comprised of service-
administered organizations. Section 721 of the Senate bill would have extended the deadline to
September 30, 2024. The FY2021 NDAA adopts neither House Section 714 nor Senate Section
721.
On February 19, 2020, DOD submitted its plan to restructure selected MTFs as required by
Section 703(d) of the FY2017 NDAA (P.L. 114-328).112 The plan identifies 50 MTFs for
restructuring over the next several years, with 43 slated for downsizing, one for capability
enhancements, one for recapitalization, and five for closure.113 Section 716 of the House bill
modifies the requirements for DOD’s implementation plan to restructure its MTFs. Such
modifications include a discussion on local health care capacity and quality in the case of a
reduction of DOD services. The provision also establishes a “notice and wait” period (i.e., after
the implementation plan is resubmitted to Congress and one year after enactment) before DOD
can proceed with MTF restructuring. Section 718 of the FY2021 NDAA adopts this provision
with an amendment requiring the Secretary of Defense to certify to the congressional defense
committees that beneficiaries will be able to access health care services if an MTF is restructured
or realigned. The amendment also revises the notice and wait period to the later of 180 days after
(1) DOD submits its implementation plan and certification, or (2) the enactment of the FY2021
NDAA.
Section 719 of the House bill would have required DOD to maintain MTFs at the Service
Academies if no civilian health care facilities within five miles have the following medical
capabilities: emergency care; orthopedics; general surgery; ear, nose, and throat services;
gynecology; ophthalmology; inpatient care; and any other services deemed necessary by a
respective Service Academy Superintendent.114 The FY2021 NDAA did not adopt this provision.
The FY2019 NDAA directed the transition of DOD’s voluntary dental benefit for family
members and military reservists from the TRICARE Dental Program to the Office of Personnel
Management’s Federal Employees Dental and Vision Insurance Program (FEDVIP) by January 1,
2022.115 Section 723 of the Senate bill would have extend the deadline for DOD to transition to
FEDVIP to January 1, 2023. Section 711 of the FY2021 NDAA replaces the originally proposed

111 P.L. 114-328, §711.
112 DOD, Restructuring and Realignment of Military Medical Treatment Facilities, February 19, 2020, at
https://health.mil/About-MHS/OASDHA/Defense-Health-Agency/Congressional-Relations/Restructuring-and-
Realignment-of-Military-Medical-Treatment-Facilities.
113 For an overview of DOD’s plan, see CRS In Focus IF11458, Military Health System Reform: Military Treatment
Facilities, by Bryce H. P. Mendez.
114 In this section, the term "Service Academies" refers to those specified in 10 U.S.C. §341: the United States Military
Academy, United States Naval Academy, and United States Air Force Academy. DOD does not administer health care
services at the remaining two federal service academies (i.e., U.S. Coast Guard Academy and U.S. Merchant Marine
Academy). Those academies’ respective parent organizations administer their health services program.
115 P.L. 115-232 §713(c). For more on the TRICARE Dental Program, see
https://tricare.mil/CoveredServices/Dental/TDP. For more on the Federal Employee Dental and Vision Insurance
Program (FEDVIP), see https://www.benefeds.com/education-support/dental-vision.
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provision with an amendment that repeals 5 U.S.C. §8951(8) and 10 U.S.C. §1076a(b), no longer
requiring DOD to provide its TRICARE Dental Program through FEDVIP.116
With regard to the administration and management of the Uniformed Services University of the
Health Sciences (USUHS), a Board of Regents is statutorily required to advise the Secretary of
Defense on the university’s academic and administrative matters.117 Currently, the Board includes
15 members: nine voting members (civilians not currently affiliated with DOD), and six ex-
officio (non-voting) members that include the Secretary of Defense, USUHS President, and the
surgeons general of the uniformed services, or their designees.118 Section 742 of the Senate bill
amends 10 U.S.C. §2113a(b) to add the DHA Director as an ex-officio member of the USUHS
Board of Regents. Section 715 of the FY2021 NDAA adopts this provision.
Military Medical Personnel. DOD’s budget request for FY2021 includes a proposal to reduce its
active duty medical force by 9.6% (7,422 personnel) in order to maintain a workforce that is
“appropriately sized and scoped to meet NDS [National Defense Strategy] requirements as well
as allow the MHS to optimize operational training and beneficiary care delivery.”119 Compared to
FY2020 levels, the Navy would have the largest reduction in medical personnel (-12.5%),
followed by the Army (-12.0), and the Air Force (-4.6%).120 To mitigate potential impacts on
beneficiary care resulting from active duty medical force reductions, the Assistant Secretary of
Defense for Health Affairs has directed the DHA to work with the military departments on
alternatives to access health care (i.e., MTF care provided by civil servant employees and
contractors, expansion of the TRICARE network, partnerships with local civilian health
systems).121
In the FY2020 NDAA, Congress enacted limitations on DOD’s ability to reduce or realign its
active duty medical force until certain reviews, analyses, measurements, and outreach actions are
completed.122 However, the law did provide certain exceptions to proceed with force reductions,
such as historically vacant, nonclinical, and headquarters-assigned positions.123 Section 715 of the
House bill prohibits active duty medical force reductions for one year after enactment. After one
year, DOD is able to reduce or realign positions after meeting the requirements established in the

116 5 U.S.C. §8951(8) defines certain TRICARE beneficiaries as being eligible individuals for FEDVIP. 10 U.S.C.
§1076a(b) directs the Secretary of the Defense to administer the TRICARE Dental Program through FEDVIP.
117 10 U.S.C. §2113a. For more on the Uniformed Services University of the Health Sciences (USUHS), see CRS In
Focus IF11385, The Uniformed Services University of the Health Sciences, by Bryce H. P. Mendez.
118 The surgeons general of the uniformed services include the Army Surgeon General, Navy Surgeon General, Air
Force Surgeon General, and the U.S. Coast Guard Director of Health, Safety, and Work-Life.
119 119 DOD, Defense Health Program Fiscal Year (FY) 2021 Budget Estimates, Jan 31, 2020, p. DHP-1, at
https://comptroller.defense.gov/Portals/45/Documents/defbudget/fy2021/budget_justification/pdfs/09_Defense_Health
_Program/Vol_I_Sec_9_PB-11A_Personnel_Summary_DHP_PB21.pdf; and DOD, Defense Budget Overview, Feb
2020, p. 2-5.
120 DOD, Defense Health Program Fiscal Year (FY) 2021 Budget Estimates, January 31, 2020, p. DHP-1. For an
overview of DOD’s FY2020 proposal to reduce or realign the active duty medical force, see CRS Insight IN11115,
DOD’s Proposal to Reduce Military Medical End Strength, by Bryce H. P. Mendez and CRS Report WPD00015,
Reductions in the Military Medical Workforce, by Bryce H. P. Mendez.
121 U.S. Congress, House Committee on Appropriations, Subcommittee on Defense, Defense Health Program (DHP),
prepared by Mr. Thomas McCaffery and Lieutenant General Ronald Place, 116th Cong., 2nd sess., March 5, 2020, pp.
5-6, at https://docs.house.gov/meetings/AP/AP02/20200305/110625/HHRG-116-AP02-Wstate-McCafferyT-
20200305.pdf.
122 P.L. 116-92, §719.
123 Ibid.
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FY2020 NDAA.124 Section 717 of the FY2021 NDAA adopts this provision with an amendment
prohibiting any military medical end-strength reductions or realignment within 180 days after
enactment.
Civilian Partnerships. The MHS states that its “success depends on building strong partnerships
with the civilian health care sector.”125 As a high-priority initiative, the MHS maintains numerous
partnerships with civilian health care organizations, academic institutions, and research entities to
enhance or supplement military medical readiness and deliver the health entitlements authorized
in Chapter 55 of Title 10, U.S. Code.126 Both bills include provisions to revise existing DOD
authorities to conduct a voluntary pilot program to improve medical surge capabilities of the
National Disaster Medical System and interoperability with certain civilian health care
organizations and other federal agencies.127 Section 740 of the House bill would have required
DOD to conduct a pilot program within 180 days after enactment. Section 744 of the Senate bill
requires DOD to conduct a pilot program no later than September 30, 2021. Section 741 of the
FY2021 NDAA adopts Senate Section 744 with an amendment requiring DOD to submit an
initial report to Congress within 180 days after the pilot program commences and a final report
within 180 days after the pilot program is completed.
References: See CRS Report R46107, FY2020 National Defense Authorization Act: Selected
Military Personnel Issues, coordinated by Bryce H. P. Mendez; CRS In Focus IF11273, Military
Health System Reform, by Bryce H. P. Mendez; CRS In Focus IF11458, Military Health System
Reform: Military Treatment Facilities, by Bryce H. P. Mendez; and CRS Insight IN11115, DOD’s
Proposal to Reduce Military Medical End Strength, by Bryce H. P. Mendez.
CRS Point of Contact: Bryce H. P. Mendez.
Military Treatment Facility Billing
Background. In certain situations, military treatment facilities (MTFs) may provide care to non-
beneficiaries (i.e., civilians). Typically, limited MTF care is available to DOD civil service
employees or others through partnerships with civilian health care organizations, graduate
medical education or clinical skills sustainment programs, the Secretarial Designee program,128 or
emergency medical care providers. When MTF care is provided to non-beneficiaries, DOD is
required to charge certain fees to those individuals (or their insurers). The fees, also referred to as
“reasonable charges,” are to represent the “costs, as determined by the Secretary [of Defense], of
trauma and other medical care provided to such civilians.”129 DOD is also required to collect such
reasonable charges from non-beneficiaries (less any third-party payments) in accordance with
general federal debt collection statutes and regulations.130 Procedures in the Code of Federal

124 Ibid.
125 MHS, “Initiatives and Areas of Impact,” accessed August 30, 2020, at https://www.health.mil/About-MHS/MHS-
Initiatives.
126 Ibid.
127 P.L. 116-92, §740.
128 The Secretarial Designee program allows the Secretary of Defense, Service Secretaries, or their designees, to
authorized limited MTF care for non-beneficiaries. For more on the Secretarial Designee program, see DOD
Instruction 6025.23, Health Care Eligibility Under the Secretarial Designee Program and Related Special Authorities,
updated May 28, 2020, at https://www.esd.whs.mil/Portals/54/Documents/DD/issuances/dodi/602523p.pdf?ver=2019-
03-22-095347-850.
129 10 U.S.C. §1079b and 32 C.F.R. § 220.8.
130 31 U.S.C. §3711 and Parts 900-904 of Title 31, Code of Federal Regulations (Federal Claims Collection Standards).
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Regulations (C.F.R.) require prompt and “aggressive” action to collect any debt owed to the
United States Government, including the transfer of delinquent debt (i.e., 180 days past due) to
the Department of the Treasury for further adjudication and collection efforts.131 The Treasury
Department can, and does, use a wide range of collection activities (e.g., debt collection services,
credit agency reporting, wage garnishment, or litigation) that may occur more rapidly than in the
private health care market.132
In several Government Accountability Office (GAO) and DOD Inspector General Reports, MTFs
were found to have longstanding billing challenges that often resulted in low debt collection
rates.133 In recent years, Congress has authorized DOD to expand the provision of limited MTF
care to civilians in an effort to sustain DOD’s graduate medical education programs and support
clinical skills sustainment for military health care providers.134 As MTFs establish additional
clinical training and readiness programs and opt to see more non-beneficiaries, surprise billing
and low debt collection rates may be an ongoing challenge for DOD.135
Military Treatment Facility Billing Sectional Analysis
House-Passed H.R. 6395
Senate-Passed S. 4049
P.L. 116-283
Billing Non-Beneficiaries
Sec. 705 would amend 10 U.S.C.
§1079b to allow DOD to waive
Sec. 703 is an identical provision
certain fees charged to civilian
Sec. 702 adopts House Sec. 705.
to House Section 705.
patients for emergency medical care
received at MTFs.
Sec. 751 would require the
Comptrol er General to assess
No similar provision
DOD’s provision of emergency
Sec. 749 adopts Senate Sec. 751.
medical care to non-beneficiaries in
military treatment facilities.
Billing Beneficiaries
Sec. 752 would require the
Sec. 758 adopts Senate Sec. 752
No similar provision
Comptrol er General to assess
with an amendment that omits the
TRICARE and military treatment
“Findings” and “Sense of Congress”
facility bil ing practices.
paragraphs.

131 Ibid. 32 C.F.R. §901.1 requires federal agencies to “aggressively collect all debts arising out of activities of, or
referred or transferred for collection services to, that agency.”
132 31 C.F.R. §901.1 and Department of the Treasury, “Debt Collection Legal Authorities Quick Reference Charts,”
accessed March 29, 2021, at https://www.fiscal.treasury.gov/dms/resources/debt-collection-legal-auth-qrc.html.
133 See U.S. Government Accountability Office, Military Treatment Facilities: Improvements Needed to Increase DOD
Third-Party Collections, GAO-04-322R, February 20, 2004, at https://www.gao.gov/products/GAO-04-322R; DOD
Inspector General, Audit of DoD’s Management of the Third Party Collection Program for Medical Claims, DODIG-
2019-108, September 16, 2019, at https://media.defense.gov/2019/Sep/18/2002184083/-1/-1/1/DODIG-2019-108.PDF;
DOD Inspector General, Follow-up of Delinquent Medical Service Account Audits, DODIG-2019-038, at
https://media.defense.gov/2018/Dec/21/2002075273/-1/-1/1/DODIG-2019-038.PDF; and DOD Inspector General,
Delinquent Medical Service Accounts at Naval Medical Center Portsmouth Need Additional Management Oversight,
March 4, 2015, at https://media.defense.gov/2015/Mar/04/2001713473/-1/-1/1/DODIG-2015-087.pdf.
134 For example, Section 717 of the FY2017 NDAA (P.L. 114-328) authorized DOD to evaluate and treat veterans and
civilians in MTFs in order to support the readiness of military medical providers.
135 Surprise billing refers to a situation in which a consumer is “unknowingly, and potentially unavoidably, treated by a
provider outside the consumer’s health insurance plan network, and as a result, unexpectedly receives a larger bill than
he or she would have received if the provider had been in the plan network.” For more on surprise billing, see CRS
Report R46116, Surprise Billing in Private Health Insurance: Overview and Federal Policy Considerations, by Ryan J.
Rosso, Noah D. Isserman, and Wen W. Shen.
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Discussion. The House and Senate bills include several provisions to enhance Congress’s
understanding of DOD’s health care billing practices and a proposed authority to waive certain
billing requirements.
Billing Non-Beneficiaries. Section 705 of the House bill and Section 703 of the Senate bill are
identical provisions to amend 10 U.S.C. §1079b by authorizing DOD MTFs to waive certain fees
when MTF care is provided to non-beneficiaries. The provisions allow a fee waiver if after third-
party collections (i.e., health insurance payments) are received, the patient is unable to pay any
outstanding balance or charges, and, if the care provided “enhanced the medical readiness” of
DOD’s health care providers. Section 702 of the FY2021 NDAA adopts this provision.
Section 751 of the Senate bill requires the Comptroller General to assess, no later than one year
after enactment, DOD’s provision of MTF emergency medical care to non-beneficiaries from
October 1, 2015, to September 30, 2020. A report to Congress is required, no later than 180 days
after the completed assessment. The report is to include an assessment of DOD’s debt recovery
processes, total fees charged and collected, debt collected through wage garnishments and other
means, waivers issued for outstanding debt, debt transferred to the Department of the Treasury,
demographic data of non-beneficiaries that received MTF care, and other information that may be
appropriate. Section 749 of the FY2021 NDAA adopts this provision.
Billing Beneficiaries. Section 752 of the Senate bill requires the Comptroller General to assess
and report to Congress, no later than one year after enactment, on DOD’s health care billing
practices, including the implementation status of previous DOD Inspector General
recommendations to improve third-party collections, and how third-party liability claims are
adjudicated.136 Section 758 of the FY2021 NDAA adopts this provision with an amendment that
omits the “Findings” and “Sense of Congress” paragraph of the Senate provision.
References: See DOD, Pilot Program on Increased Third-Party Collection Reimbursements in
Military Medical Treatment Facilities; DOD Instruction 6015, Foreign Military Personnel Care
and Uniform Business Offices in Military Treatment Facilities, February 23, 2015; and Defense
Health Agency Procedural Manual 6015.01, Military Medical Treatment (MTF) Uniform Business
Office (UBO) Operations, October 24, 2017.
CRS Point of Contact: Bryce H. P. Mendez.
Mental Health
Background. Congress has a long history of funding and authorizing numerous DOD,
Department of Veterans Affairs (VA), and Substance Abuse and Mental Health Services
Administration (SAMHSA) mental health programs and services that support servicemembers,
veterans, and their families.137 DOD administers or funds approximately 200 mental health
programs that offer education, awareness, and prevention efforts; clinical treatment; nonclinical
support and counseling services; and research and development.138

136 Previous DOD Inspector General recommendations are those included in the reports listed in footnote Error! B
ookmark not defined..
137 The term mental health used in this report is used synonymously with behavioral health and psychological health.
138 DOD, Report on Improvements in the Identification and Treatment of Mental Health Conditions and Traumatic
Brain Injury Among Members of the Armed Forces, October 2017, p. 1, at https://health.mil/About-
MHS/OASDHA/Defense-Health-Agency/Congressional-Relations/Reports-to-Congress/Signed-in-2017. The various
DOD entities that administer mental health programs include (but are not limited to) the Defense Health Agency,
personnel and medical departments of the military services, National Guard Bureau, the Office of the Under Secretary
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DOD has estimated that, from 2007 to 2016, 853,060 active duty servicemembers were newly
diagnosed with at least one mental health disorder.139 Military reservists140 also experience similar
mental health issues with additional stressors that may not be as prevalent among active duty
servicemembers.141 In a 2014 DOD health-related behaviors survey of reserve component
personnel, 9.3% of reservists experienced “high anxiety,” 4.8% reported “high depression,” and
3.7% reported an attempted suicide during their lifetime.142
DOD has made numerous efforts to address the wide range of mental health issues, however
opportunities for improvement have been highlighted by the GAO,143 DOD Inspector General,144
and other observers of military and veterans’ health.145
Mental Health Sectional Analysis
House-Passed H.R. 6395
Senate-Passed S. 4049
P.L. 116-283
General Mental Health
Sec. 701 would amend 10 U.S.C.
§1074m to require mental health
assessments for servicemembers
No similar provision
Not adopted
who have participated in certain
combat support activities.

of Defense for Personnel and Readiness, Uniformed Services University of the Health Sciences, state National Guard
offices, and the Combatant Commands.
139 Stahlman, Shauna, "Mental Health Disorders and Mental Health Problems, Active Component, U.S. Armed Forces,
2007-2016," Medical Surveillance Monthly Report, vol. 25, no. 3 (March 2018), p. 4, at https://health.mil/Reference-
Center/Reports/2018/01/01/Medical-Surveillance-Monthly-Report-Volume-25-Number-3. These mental health issues
included adjustment disorders (27.9%), depressive disorders (16.8%), anxiety disorders (14.9%), “other” mental health
disorders (14.6%), alcohol-related disorders (9.9%), post-traumatic stress disorder (PTSD; 8.3%), substance abuse
disorders (3.3%), personality disorders (2.2%), bipolar disorders (1.2%), psychotic disorder (0.7%), and schizophrenia
(0.2%).
140 The term military reservists used throughout this section refers to the members of the reserve components of the
Armed Forces (i.e., Army Reserve, Navy Reserve, Marine Corps Reserve, Air Force Reserve, Coast Guard Reserves,
Army National Guard, and Air National Guard). For more on the reserve components, see CRS In Focus IF10540,
Defense Primer: Reserve Forces, by Lawrence Kapp.
141 Defense Health Agency, 2014 Health related Behaviors Survey of Reserve Component Personnel, Total Reserve
Component Executive Summary Report, 2015, pp. 13-15, at https://www.health.mil/Reference-
Center/Reports/2016/05/08/2014-Total-Reserve-Component-Report. Such stressors may include, for example, “Change
in my work load,” “Conflicts between my military responsibilities and my family/personal responsibilities,” “Being
away from my family, and friends,” and “Insufficient training.”
142 Ibid, p. 21.
143 See U.S. Government Accountability Office (GAO), Human Capital: Additional Actions Needed to Enhance DOD's
Efforts to Address Mental Health Care Stigma, GAO-16-404, April 18, 2016, at
https://www.gao.gov/assets/680/676633.pdf; GAO, Defense Health Care: DOD Is Meeting Most Mental Health Care
Access Standards, but It Needs a Standard for Follow-up Appointments, GAO-16-416, April 28, 2016, at
https://www.gao.gov/assets/680/676851.pdf; and GAO, Department of Defense: Eating Disorders in the Military,
GAO-20-611R, August 7, 2020, at https://www.gao.gov/assets/710/708697.pdf.
144 See DOD Inspector General, Evaluation of Access to Mental Health Care in the Department of Defense, August 10,
2020, at https://media.defense.gov/2020/Aug/12/2002475605/-1/-1/1/DODIG-2020-112_REDACTED.PDF.
145 See Joie D. Acosta, et al., Cross-Agency Evaluation of DoD, VA, and HHS Mental Health Public Awareness
Campaigns, RAND Corporation, Santa Monica, CA, 2020, at
https://www.rand.org/pubs/research_reports/RR1612.html; National Academy of Medicine, Preventing Psychological
Disorders in Service Members and their Families, 2014, at https://www.nap.edu/catalog/18597/preventing-
psychological-disorders-in-service-members-and-their-families-an; and DOD, VA, and Department of Health and
Human Services, Interagency Task Force on Military and Veterans Mental Health, 2016 Annual Report, November
2016, at https://www.mentalhealth.va.gov/docs/ITF_2016_Annual_Report_November_2016.pdf.
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House-Passed H.R. 6395
Senate-Passed S. 4049
P.L. 116-283
Sec. 702 would amend 10 U.S.C.
§1090a to establish an additional
process by which a commanding
No similar provision
Not adopted
officer or supervisor confidentially
refers a servicemember for a
mental health evaluation.
Sec. 749 would require the
Sec. 750 would require the DOD
Comptrol er General to submit a
Sec. 754 adopts Senate Sec. 749
to submit a report to Congress, no
report to Congress, no later than
with an amendment that
later than 180 days after enactment, one year after enactment, on
incorporates the report elements in
on the provision of pregnancy-
prenatal and postpartum mental
House Sec. 750.
related mental health care.
health conditions of
servicemembers and their families.
Sec. 535 would require the Judge
Advocates General of the Army,
Marine Corps, Navy, and Air Force
No similar provision
to brief the House and Senate
Sec. 546 adopts Senate Sec. 535.
armed services committees on the
provision of mental health support
for vicarious trauma in certain
military justice system personnel.
Post-Traumatic Stress Disorder
Not adopted The conferees direct
Sec. 736 would direct the
the Secretary of Defense to brief
Secretary of Defense to award
the House and Senate armed
grants for col aborative research
No similar provision
services committees, within 180
between the United States and
days after enactment, on certain
Israel on post-traumatic stress
military health research
disorder (PTSD).
col aboration between the United
States and Israel.
Sec. 750D would authorize an
increase of $2.5 mil ion for the
Defense Health Program account
No similar provision
Not adopted
for PTSD-related healthcare
activities.
Substance Abuse
Sec. 717 would require the
Secretary of Defense to establish a
policy and tracking system that
Sec. 719 adopts House Sec. 717
monitors and prohibits over-
with an amendment expanding the
prescription of opioids in
No similar provision
elements required in the DOD
accordance with certain federal
policy to prevent opioid
clinical practice and prescription
prescription abuse.
guidelines.
Sec. 726 would require the
Secretary of Defense and Secretary
of Veterans Affairs to conduct a
study and provide a report to
Congress on substance use
No similar provision
Not adopted
disorder trends before and after
the COVID-19 public health
emergency among military and
veteran populations.
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House-Passed H.R. 6395
Senate-Passed S. 4049
P.L. 116-283
Suicide
Sec. 732 would amend Section
741(a)(2) of the FY2020 NDAA
(P.L. 116-92) to include additional
No similar provision
Sec. 742 adopts House Sec. 732.
data elements in DOD’s annual
report to Congress on suicide
among servicemembers.
Sec. 745 would direct the
Comptrol er General to assess and
submit a report to Congress on
Sec. 747 is a similar provision to
DOD’s suicide prevention policies,
House Sec. 745.
Sec. 752 adopts House Sec. 745.
programs, and processes at remote
military installations outside of the
contiguous United States.
Mental Health Care for Reservists
Sec. 746 would require the
Sec. 736 adopts Senate Sec. 746
Comptrol er General to conduct a
with an amendment that modifies
study and submit a report to
the study to include the provision
No similar provision
Congress, no later than one year
of mental health care to all
after enactment, on the provision of servicemembers during the
mental health care to members of
COVID-19 pandemic.
the Reserve Component.
Sec. 752 would amend 38 U.S.C.
§1712A to authorize the VA to
provide of readjustment counseling
Sec. 762 is a similar provision to
Sec. 762 adopts House Sec. 752.
and certain outpatient care for
House Sec. 752.
military reservists with certain
mental health issues.
Sec. 753 would add a new section
to Chapter 17, Subchapter VIII,
Title 38 of the U.S. Code,
Sec. 763 is a similar provision to
authorizing the provision of VA
House Sec. 753.
Sec. 763 adopts House Sec. 753.
mental health services for military
reservists.
Sec. 754 would amend 38 U.S.C.
§1720F to authorize the provision
of services offered by VA suicide
Sec. 764 is a similar provision to
Sec. 764 adopts House Sec. 754.
prevention programs to military
House Sec. 754.
reservists.
Sec. 755 would require the VA
Secretary to submit a report to
Congress, no later than one year
after enactment, on certain health
Sec. 765 is a similar provision to
care trends resulting from
House Sec. 755.
Sec. 765 adopts House Sec. 755.
expanded mental health care
eligibility to military reservists.
Discussion. The House and Senate bills include provisions to address mental health issues
affecting servicemembers, veterans, and family members. There are eight general mental health
assessment, funding, and reporting provisions, two substance abuse-related provisions, three
suicide-related provisions, and nine reserve component-related provisions.
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General Mental Health. Section 701 of the House bill would have amended 10 U.S.C. §1074m
to require mental health assessments for servicemembers participating in certain warfighting
activities that had a “direct and immediate impact on a combat operation or other military
operation,” but were not necessarily deployed in support of a contingency operation. House
Section 702 would have amended 10 U.S.C. §1090a by establishing a new process that triggers a
command-directed mental health evaluation. The new process would have allowed a
servicemember to disclose a certain phrase, which then initiates an automatic, confidential
referral for an evaluation. The FY2021 NDAA adopts neither House Section 701 nor 702.
Both the House and Senate bills include a provision on pregnancy-related mental health. House
Section 750 would have required DOD to submit a report to Congress, no later than 180 days
after enactment, on the availability of certain mental health services for pre-natal and post-partum
depression and mood disorders, mental health utilization, access barriers, and options to address
such barriers. Senate Section 749 requires the Comptroller General to conduct a study and submit
a report to Congress, no later than one year after enactment, on pre-natal and post-partum
depression, anxiety, obsessive-compulsive disorder, psychosis, and other relevant mood disorders
among TRICARE beneficiaries. The study would include a demographic assessment of the
population, a comparison of trends between TRICARE beneficiaries and the general U.S.
population, the availability of mental health care services, and the effects of certain biases in the
provision of such care. Section 754 of the FY2021 NDAA adopts Senate Section 749 with an
amendment that incorporates the report elements specified in House Section 750.
Section 535 of the Senate bill requires the Judge Advocates General of the military services to
brief the House and Senate armed services committees, no later than 180 days after enactment, on
the provision of mental health support for vicarious trauma to certain military justice system
personnel (i.e., trial, defense, and special victims’ counsel, and military investigative staff).146 The
briefing is to include an overview of mental health services available, screening tools, an
assessment of mechanisms to eliminate or reduce mental health stigma, and other related
elements. Section 546 of the FY2021 NDAA adopts this provision.
Post-Traumatic Stress Disorder. The House bill included two provisions covering PTSD-focused
programming. Section 736 of the House bill would have established a new DOD grant program,
in coordination with the Secretary of Veterans Affairs and the Secretary of State, focusing on
PTSD collaborative research between the United States and Israel. The grant program would have
been administered in accordance with the 1972 agreement on the United States-Israel Binational
Science Foundation and would have been terminated seven years after the first award was
issued.147 A report to Congress would have been required 180 days after the completion of any
project funded by the grant program. The FY2021 NDAA does not adopt this provision.
However, the conferees direct DOD to brief the House and Senate armed services committees on
current military medical research collaboration between the United States and Israel.148 The
briefing is to include a description of research on trauma care, infectious disease surveillance and
treatment, PTSD, and traumatic brain injury.
House Section 750D would have authorized a $2.5 million increase in Defense Health Program
funding for PTSD-related care or research activities. The increase in funding would have been

146 Vicarious trauma (VT) is the “cognitive, emotional, social, and behavioral changes that may occur while working
with traumatized individuals.” For more on VT, see VA, “PTSD: National Center for PTSD,” accessed September 2,
2020, at https://www.ptsd.va.gov/professional/treat/care/toolkits/provider/workingWithTraumaSurvivors.asp; and
147 For more on the United States-Israel Binational Science Foundation (BSF) and other cooperative agreements with
Israel, see CRS Report RL33222, U.S. Foreign Aid to Israel, by Jeremy M. Sharp; and U.S.-Israel Binational Science
Foundation, “About the BSF,” accessed September 2, 2020, at https://www.bsf.org.il/about/.
148 See p. 1674 of H.Rept. 116-617.
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offset from the Defense-Wide Operation and Maintenance account. The FY2021 NDAA does not
adopt this provision.
Substance Abuse. Section 717 of the House bill requires the Secretary of Defense to establish a
policy that prohibits the over-prescription of opioids through mandatory use of clinical practice
and prescription guidelines issued by the U.S. Centers for Disease Control and Prevention and the
Food and Drug Administration. The provision also requires the Secretary of Defense to establish
a tracking system to monitor compliance with such guidelines and other opioid prescribing
controls. Section 719 of the FY2021 NDAA adopts this provision with an amendment that
expands the required elements included in DOD’s policy to prevent opioid prescription abuse.
Section 726 of the House bill would have directed the Secretary of Defense and Secretary of
Veterans Affairs to conduct a study on substance use or abuse trends among servicemembers and
veterans during the COVID-19 pandemic. The study would have included analyses of opioid or
illicit substance overdoses and deaths; alcohol use disorders; suicides; information resources
disseminated by DOD, VA, SAMHSA and the National Institutes of Health; health care
utilization; and an identification of substance abuse improvement areas for future pandemic
response scenarios. The provision also would have required two reports to Congress that include:
(1) a description and status update of the study, no later than 120 days after the COVID-19 public
health emergency ends; and (2) the results of the study, no later than two years after the COVID-
19 public health emergency ends.149 The FY2021 NDAA does not adopt this provision.
Suicide. Section 732 of the House bill amends Section 741(a)(2) of the FY2020 NDAA (P.L. 116-
92) by adding new data elements to the annual DOD report to Congress on suicide among
servicemembers. The new elements include: (1) the number of suicides, attempted suicides, and
cases of suicidal ideation during the year after a deployment in support of a contingency
operation; and (2) the number of suicides in which a servicemember was prescribed a medication
for mental health issue during the year before his/her death. Section 742 of the FY2021 NDAA
adopts this provision.
Section 745 of the House bill and Section 747 of the Senate bill are identical provisions that
require the Comptroller General to review DOD’s suicide prevention efforts for servicemembers
assigned to certain remote military installations located outside of the contiguous United States.
The review elements include: relevant DOD policies, suicide prevention programs administered
on military installations, mental health screenings, procedures for responding to an attempted or
completed suicide, data collection standards, availability of suicide prevention information
(including information from indigenous populations and graduate research programs), and other
relevant items. Preliminary results of the review are to be briefed to the HASC and SASC no later
than October 1, 2021, with a final report due to Congress no later than March 1, 2022. Section
752 of the FY2021 NDAA adopts the House provision.
Mental Health Care for Military Reservists. Section 746 of the Senate bill directs the
Comptroller General to conduct a study and submit a report to Congress, no later than one year
after enactment, on all federal, state, and private mental health programs that offer services to
members of the Reserve Components (i.e. federal reserves and National Guard). The study is to
describe gaps and barriers to accessing such programs, DOD mental health screening
requirements, and recommendations to “strengthen the reintegration” of reservists. Section 736 of

149 The COVID-19 public health emergency refers to the public health emergency declaration issued by the Secretary of
Health and Human Services on January 27, 2020. For more on the declaration, see
https://www.phe.gov/emergency/news/healthactions/phe/Pages/2019-nCoV.aspx.
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the FY2021 NDAA adopts this provision with an amendment that modifies the study to include
the provision of mental health care to all servicemembers during the COVID-19 pandemic.
Both the House and Senate bills include provisions organized under the Care and Readiness
Enhancement for Reservists Act of 2020, which was incorporated as a separate subtitle within the
House-passed and Senate-passed NDAAs for FY2021.150 House Section 752 and Senate Section
762 are identical provisions to amend 38 U.S.C. §1712A to authorize VA readjustment counseling
services for military reservists with mental health issues.151 Section 762 of the FY2021 NDAA
adopts the House provision.
House Section 753 and Senate Section 763 are identical provisions to amend Chapter 17,
Subchapter VIII of Title 38, U.S. Code, to authorize further VA mental health services for military
reservists, including outpatient or inpatient care at VA health care facilities.152 Section 763 of the
FY2021 NDAA adopts the House provision.
House Section 754 and Senate Section 764 are identical provisions to amend 38 U.S.C. §1720F to
make military reservists eligible for VA suicide prevention services.153 Section 764 of the FY2021
NDAA adopts the House provision.
House Section 755 and Senate Section 765 are identical provisions that direct the Secretary of
Veterans Affairs to submit a report to Congress, no later than one year after enactment, assessing
any changes in VA mental health services utilization by military reservists and any challenges to
providing such services. Section 765 of the FY2021 NDAA adopts the House provision.
References: See CRS In Focus IF10951, Substance Abuse Prevention, Treatment, and Research
Efforts in the Military, by Bryce H. P. Mendez; CRS Insight IN11164, Suicide Rates and Risk
Factors for the National Guard, by Kristy N. Kamarck, Bryce H. P. Mendez, and Xavier L.
Arriaga; and CRS In Focus IF10876, Military Suicide Prevention and Response, by Kristy N.
Kamarck.
CRS Point of Contact: Bryce H. P. Mendez.
Environmental and Occupational Health Concerns
Background: DOD policies require protection from occupational illness or accidental death and
injury.154 DOD’s occupational and environmental health programs typically require military and

150 The Care and Readiness Enhancement (CARE) for Reservists Act of 2020 was incorporated into the House version
of the FY2021 NDAA through the House Armed Services Committee mark-up process. The CARE for Reservists Act
of 2020 was incorporated in the Senate version of the FY2021 NDAA by S.Amdt. 1968.
151 Readjustment counseling is a range of psychosocial services designed to support individuals through a “successful
transition from military to civilian life,” and is typically offered at VA Vet Centers. For more on Vet Centers and
readjustment counseling, see CRS In Focus IF11378, Veterans Health Administration: Behavioral Health Services, by
Victoria R. Green; and Department of Veterans Affairs (VA), “Vet Centers (Readjustment Counseling),” accessed
September 2, 2020, at https://www.vetcenter.va.gov/Vet_Center_Services.asp.
152 For more on VA mental health services, see Ibid; and VA, “Mental Health,” accessed September 2, 2020, at
https://www.mentalhealth.va.gov/index.asp.
153 For more on VA suicide prevention services, see https://www.mentalhealth.va.gov/suicide_prevention/.
154 See DOD Instruction 6055.01, DoD Safety and Occupational Health (SOH) Program, updated July 14, 2020, at
https://www.esd.whs.mil/Portals/54/Documents/DD/issuances/dodi/605501p.pdf?ver=2018-11-19-110543-180; DOD
Instruction 6055.05, Occupational and Environmental Health (OEH), updated August 31, 2018, at
https://www.esd.whs.mil/Portals/54/Documents/DD/issuances/dodi/605505p.pdf?ver=2019-04-04-095234-197; DOD
Directive 6200.04, Force Health Protection, updated April 23, 2007, at
https://www.esd.whs.mil/Portals/54/Documents/DD/issuances/dodd/620004p.pdf; DOD Instruction 6055.12, Hearing
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civilian personnel to receive exposure or injury prevention education for specific tasks or
occupations. Exposure assessment, operational risk management, personal protective equipment,
and medical prophylactics or treatment training may also be required.155
DOD policies also require exposure assessments and screenings for certain hazardous substances
or potentially harmful environments, such as lead, hexavalent chromium, cadmium, open air burn
pits, radiation, blast pressure injuries, and noise.156 DOD primarily documents exposures in the
Defense Occupational and Environmental Health Readiness System (DOEHRS), an electronic
“information management system for longitudinal exposure recordkeeping and reporting.”157
DOD epidemiologists, public health practitioners, and occupational safety experts use DOEHRS
data to conduct medical surveillance, inform future prevention measures, and develop improved
personnel protective equipment. DOD medical personnel can use DOEHRS data when
evaluating, diagnosing, or treating patients exposed to a hazardous substance or environment. In
addition to DOEHRS, DOD can also document certain exposures in legacy electronic health
record systems, paper medical records, or the individual longitudinal exposure record (ILER).158
The VA also uses DOD’s exposure data when considering service connection for a veteran’s
claim for disability compensation, or providing ongoing medical care.159
While DOD’s occupational and environmental health programs screen, document, and track
servicemember or civilian employee exposure to certain substances, all potentially hazardous
substances or occupational exposures are not covered under these programs.
Environmental and Occupational Health Concerns Sectional Analysis
House-Passed H.R. 6395
Senate-Passed S. 4049
P.L. 116-283
General Exposure Tracking and Documentation
Sec. 753 would require the
Sec. 9105 adopts Senate Sec. 753
Secretary of Veterans Affairs to
with an amendment to remove the
No similar provision
provide veterans read-only access
requirement for Secretary of
to their information archived in the
Veterans Affairs to consult with
Individual Longitudinal Exposure
DOD.
Record.

Conservation Program (HCP), August 14, 2019, at
https://www.esd.whs.mil/Portals/54/Documents/DD/issuances/dodi/605512p.pdf?ver=2019-08-14-073309-537; and
DOD Instruction 6055.20, Assessment of Significant Long-Term Health Risks From Past Environmental Exposures On
Military Installations, updated June 10, 2019, at
https://www.esd.whs.mil/Portals/54/Documents/DD/issuances/dodi/605520p.pdf?ver=2019-06-10-110814-890.
155 Ibid.
156 Ibid.
157 DOD Instruction 6055.05, Occupational and Environmental Health (OEH), updated August 31, 2018, p. 17, at
https://www.esd.whs.mil/Portals/54/Documents/DD/issuances/dodi/605505p.pdf?ver=2019-04-04-095234-197. For
more on DOEHRS, see https://www.health.mil/Military-Health-Topics/Technology/Clinical-Support/Centralized-
Credentials-Quality-Assurance-System/Decision-Support/Defense-Occupational-and-Environmental-Health-Readiness-
System-Industrial-Hygiene.
158 The individual longitudinal exposure record (ILER) is a web-based application that displays consolidated
occupational and environmental exposure data for servicemembers and veterans. When fully implemented, the ILER is
intended to be a “complete record of a service member’s Occupational and Environmental Health (OEH). The ILER is
also intended to provide DOD and VA clinicians, claims adjudicators, and benefits advisors a single point of access to
exposure-related records. For more on ILER, see https://health.mil/Reference-Center/Fact-Sheets/2020/06/23/ILER.
159 For more on presumptive service connection and veterans disability compensation, see VA, “Disability
Compensation,” Fact Sheet, February 2015, at
https://www.va.gov/TRIBALGOVERNMENT/docs/Presumption_Fact_Sheet.pdf; and CRS Report R44837, Benefits
for Service-Disabled Veterans, coordinated by Heather M. Salazar.
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House-Passed H.R. 6395
Senate-Passed S. 4049
P.L. 116-283
Sec. 1046 would require the
Sec. 1082 is a similar provision to
Defense Health Agency to develop
House Sec. 1046 that also requires
a tracking system of servicemember an assessment of servicemembers
injuries incurred in/during the use
during any post-deployment health
Sec. 1091 adopts Senate Sec.
of newest generation personal
assessment, for injuries in
1082.
protective equipment, and to assess
connection with il -fitting or
for such injuries during the annual
malfunctioning personal protective
periodic health assessment.
equipment.
Burn Pit and Airborne Hazards Exposure
Sec. 724 would require the
Sec. 735 adopts House Sec. 724
Secretary of Veterans Affairs to
with an amendment requiring
assess servicemembers or veterans
Secretary of Veterans Affairs to
who have tested positive for certain
evaluate, prior to conducting an
viral infections for previous
initial health assessment, whether a
(potential) exposure to “toxic
No similar provision
airborne chemicals or other
veteran had been stationed at a
airborne contaminants” during
location where open burn pits were
military service and enrol such
used or was exposed to toxic
individuals in the Airborne Hazards
airborne chemicals or
and Open Burn Pit Registry.
contaminants.
Not adopted The conference
committee directs DOD to brief
the House and Senate armed
Sec. 757 would require the
services committees, within 180
Secretary of Defense to submit a
days after enactment, on (1)
report to Congress on the status of
No similar provision
research and study efforts relating
all research efforts relating to the
to the health effects of burn pits,
health effects of burn pit exposure.
and (2) a description of the training
provided to DOD medical
providers on the potential adverse
health effects of burn pits.
Sec. 758 would require DOD
medical providers to receive
training on the potential health
No similar provision
Not adopted
effects of burn pit exposure.
Sec. 759 would require the
Secretary of Defense to include a
question in the post-deployment
health assessment regarding
No similar provision
Sec. 721 adopts House Sec. 759.
servicemember exposure to burn
pits.
Sec. 760 would amend Section
201(c)(2) of the Dignified Burial and
Other Veterans’ Benefits
Improvement Act of 2012 (P.L. 112-
260) by adding Egypt and Syria as
additional locations where
No similar provision
Not adopted
servicemembers or veterans may
have been exposed to burn pits and
therefore may be enrol ed in the
open burn pit registry.
Per- and Polyfluoroalkyl Substances Exposure
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House-Passed H.R. 6395
Senate-Passed S. 4049
P.L. 116-283
Sec. 703 would require the
Secretary of Defense to screen and
test servicemembers during certain
assessments for exposure to Per-
No similar provision
Not adopted
and Polyfluoroalkyl substances
(PFAS).
Sec. 339 would authorize a funding
increase of $5 mil ion for a study on Sec. 322 is a similar provision to
PFAS contamination in drinking
water directed in Section 316 of the House Sec. 339.
Sec. 337 adopts House Sec. 339.
FY2018 NDAA (P.L. 115-91).
Other Exposures
Sec. 742 would require the
Secretary of Defense to conduct a
study and submit a report to
Congress, no later than 180 days
after enactment, on toxin exposure
No similar provision
Sec. 751 adopts House Sec. 742.
of servicemembers who deployed
to Karshi-Khanabad Air Base,
Uzbekistan, between October 1,
2001, and December 31, 2005.
Sec. 743 would require the DOD
Sec. 748 adopts Senate Sec. 748
Inspector General to audit, within
with an amendment to also require
90 days after enactment, the
Sec. 748 is a similar provision to
the DOD Inspector General to
medical conditions of certain
House Sec. 743.
audit the military health hazard
individuals and their association
identification process established in
with potential adverse exposures in
Section 3053 of the FY2020 NDAA
privatized military housing.
(P.L. 116-92).
Sec. 754 would require the
Secretary of Defense, in
consultation with the National
No similar provision
Institutes of Health, to study and
Sec. 750 adopts Senate Sec. 754.
submit a report to Congress on the
incidence of cancer among military
aviators and aviation support
personnel.
Sec. 1090B would amend 38
U.S.C. §1116(a)(2) by adding
Parkinsonism, Bladder Cancer, and
Hypothyroidism to the list of
Sec. 9109 adopts Senate Sec.
No similar provision
diseases associated with certain
1090B.
exposure to herbicide agents with
presumptive service connection for
veterans who served in the
Republic of Vietnam.
Discussion. The House and Senate bills include provisions to address DOD’s requirements and
processes for documenting and collecting information from medical surveillance on certain at-
risk individuals or those exposed to certain occupational or environmental hazards.
General Exposure Tracking and Documentation. Section 753 of the Senate bill requires the
Secretary of Veterans Affairs, in consultation with the Secretary of Defense, to provide veterans
access to ILER documentation in a read-only format. Section 9105 of the FY2021 NDAA adopts
this provision.
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Section 1046 of the House bill would have required the Service Secretaries to submit a report to
Congress, no later than January 31, 2021, detailing their respective developments and fielding of
“newest generations of personal protective equipment [PPE].” The provision would have also
required DOD to:
 maintain a data system to document injuries associated with the use of such PPE,
which could include the use of DOEHRS;
 submit a report to Congress, no later than January 31, 2025, on the prevalence of
preventable injuries resulting from ill-fitting or malfunctioning PPE; and
 include at least one question on the annual periodic health assessment (PHA)
relating to servicemember injuries resulting from ill-fitting or malfunctioning
PPE.160
Section 1082 of the Senate bill is a similar provision that requires DOD to brief the House and
Senate armed services committees, instead of providing a report, on the prevalence of preventable
injuries resulting from ill-fitting or malfunctioning PPE. The Senate bill also requires DOD to
include at least one question in the post-deployment health assessment relating to servicemember
injuries resulting from ill-fitting or malfunctioning PPE. Section 1091 of the FY2021 NDAA
adopts Senate Section 1082.
Burn Pit and Airborne Hazards Exposure. DOD defines an open-air burn pit as “an area that is
designated for disposing of solid waste by burning in the outdoor air at a contingency.”161 Use of
burn pits is a DOD waste disposal practice used during military contingency operations in certain
overseas military locations (e.g., Iraq and Afghanistan). Congress has enacted numerous
provisions to reduce the use of open-air burn pits and study the health effects of burn pit exposure
among servicemembers and veterans.162
The House bill includes five provisions related to burn pit and airborne hazards exposure; the
Senate bill includes one related provision (see discussion on Senate Section 754 below). Section
724 of the House bill requires the Secretary of Defense and Secretary of Veterans Affairs to
evaluate servicemembers and veterans who have tested positive for a federally declared pandemic
virus (e.g., SARS-CoV-2) for previous exposure to an open-air burn pit or airborne hazards.
Based on this evaluation, the provision requires DOD or VA to enroll the individual in the
Airborne Hazards and Open Burn Pit Registry.163 The provision also requires the Secretary of
Veterans Affairs to conduct a study on the health impacts from certain pandemic viruses on
servicemembers and veterans exposed to open-air burn pits and airborne hazards. Section 735 of
the FY2021 NDAA adopts this provision with an amendment that requires the Secretary of
Veterans Affairs to evaluate, prior to conducting an initial health assessment, whether a veteran

160 A periodic health assessment (PHA) is an annual screening of “overall health and medical readiness status of each
Service member.” For more on the PHA, see DOD Instruction, Individual Medical Readiness (IMR), updated May 12,
2020, p. 9, at https://www.esd.whs.mil/Portals/54/Documents/DD/issuances/dodi/602519p.pdf?ver=2020-05-12-
110321-523.
161 DOD Instruction 4515.19, Use of Open-Air Burn Pits in Contingency Operations, p. 14, at
https://www.esd.whs.mil/Portals/54/Documents/DD/issuances/dodi/471519p.pdf?ver=2018-11-14-103736-647.
162 See CRS Congressional Distribution Memorandum, Disposal of Wastes in Open Burn Pits During U.S. Military
Contingency Operations in Iraq and Afghanistan, by David M. Bearden, Don J. Jansen, Sidath V. Panangala, and Jerry
H. Yen. This CRS memorandum is available upon request.
163 The Department of Veterans Affairs administers the Airborne Hazards and Open Burn Pit Registry to allow eligible
servicemembers and veterans to document their exposures and report health concerns through an online survey. For
more on the Registry, see https://www.publichealth.va.gov/exposures/burnpits/registry.asp.
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had been stationed at a location where open burn pits were used or was exposed to toxic airborne
chemicals or contaminants.
Section 757 of the House version would have required the Secretary of Defense to submit a report
to the House and Senate armed services committees on the status of all current research projects
studying the health effects of burn pits. Section 758 of the House version would have required the
DOD health care providers to receive training on the potential health effects of burn pits. The
FY2021 NDAA does not adopt House Sections 757 or 758. However, the conferees direct DOD
to brief the House and Senate armed services committees, within 180 days after enactment, on (1)
research and study efforts relating to the health effects of burn pits, and (2) a description of the
training provided to DOD medical providers on the potential adverse health effects of burn pits.164
Section 759 of the House version directs DOD to include an “independent and conspicuous
question” regarding a servicemember’s exposure to open-air burn pits in the post-deployment
health assessment. Section 721 of the FY2021 NDAA adopts this provision. Section 760 of the
House version would have added Egypt and Syria to the list of locations in which exposure to
open-air burn pits would deem a servicemember eligible for the Airborne Hazards and Open Burn
Pit Registry. The FY2021 NDAA does not adopt this provision.
Per- and Polyfluoroalkyl Substances (PFAS) Exposure. PFAS refers to a large group of
synthesized chemical compounds used in a variety of commercial, industrial, and military
settings. Examples of PFAS use include food packaging, nonstick coatings for certain cookware,
stain-resistant fabrics, and certain types of fire-fighting foam.165 Various federal departments and
agencies have initiated studies, including one directed by the FY2018 NDAA, to evaluate
potential health effects associated with exposures to PFAS-contaminated water sources.166 As
Congress considered concerns of certain populations (i.e., firefighters) that may be at-risk for
increased exposure to PFAS, the FY2020 NDAA established an annual blood-testing requirement
to determine and document potential exposure to PFAS among DOD firefighters.167
Section 703 of the House bill would have required the Secretary of Defense to screen
servicemembers and document potential PFAS exposure during the annual PHA, pre/post-
deployment health assessments, and the servicemember’s separation health and physical
examination.168 Servicemembers with a potential PFAS exposure would have been entitled to
follow-on blood testing and further documentation of their health status in the DOD health
record. The FY2021 NDAA does not adopt this provision.

164 See p. 1680 of H.Rept. 116-617.
165 For more on PFAS, see CRS Report R45986, Federal Role in Responding to Potential Risks of Per- and
Polyfluoroalkyl Substances (PFAS), coordinated by David M. Bearden.
166 Ibid and P.L. 115-91 §316. For more on the PFAS study directed by the FY2018 NDAA, see
https://www.atsdr.cdc.gov/news/displaynews.asp?PRid=2664.
167 P.L. 116-92 §707. The annual blood-testing requirement was to have taken effect on October 1, 2020.
168 A separation health and physical examination (SHPE) is an assessment of medical history, service-related medical
concerns, and current health status that is conducted when a servicemember transitions from military service. The
SHPE is also used concurrently as a VA disability examination. For more on the SHPE, see DOD Instruction 6040.46,
The Separation History and Physical Examination (SHPE) for the DoD Separation Health Assessment (SHA) Program,
April 14, 2016, at https://www.esd.whs.mil/Portals/54/Documents/DD/issuances/dodi/604046p.pdf. Deployment health
assessments are health screenings that occur before, during, and after deployment to “monitor, assess, and prevent
disease and injury” and document and reduce occupational and environmental risks and exposures. For more on
deployment health assessments, see DOD Instruction 6490.03, Deployment Health, June 19, 2019, at
https://www.esd.whs.mil/Portals/54/Documents/DD/issuances/dodi/649003p.pdf?ver=2019-06-19-134540-850.
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Section 339 of the House bill and Section 322 of the Senate bill authorizes a $5 million increase
for the PFAS study directed by the FY2018 NDAA. Section 337 of the FY2021 NDAA adopts
House Section 339.
Other Exposures. Section 742 of the House bill requires DOD to conduct a study and submit a
report to Congress, no later than 180 days after enactment, on servicemember exposures to toxic
substances at the Karshi-Khanabad Air Base (also referred to as “K2”), Uzbekistan, during
October 1, 2001, to December 31, 2005. Section 751 of the FY2021 NDAA adopts this provision.
Section 743 of the House bill and Section 748 of the Senate bill are similar provisions that direct
the DOD Inspector General to audit, no later than 90 days after enactment, the association of
medical conditions of servicemembers or their families with adverse exposures to “unsafe or
unhealthy” military housing units.169 The provisions require DOD to submit a report to the House
and Senate armed services committees on their audit results, no later than one year after the audit
begins. Section 748 of the FY2021 NDAA adopts Senate section 748 with an amendment also
requiring the DOD Inspector General to audit the military housing health hazard identification
process established in section 3053 of the FY2020 NDAA (P.L. 116-92).
Section 754 of the Senate bill directs DOD, in conjunction with the National Institutes of Health
(including the National Cancer Institute), to conduct a study of cancer incidence among the
military aviation community (i.e., aviators and aviation support personnel). The provision
requires DOD to conduct a study to determine, and submit a report to Congress, no later than one
year after enactment, with a determination as to whether cancer incidence is higher for the
military aviation community than the general population (age-adjusted). If DOD determines that
the military aviation community has a higher cancer incidence, a second report to Congress is
required, no later than one year after the first report was submitted, describing the environmental
and occupational risks of the community, community and occupational demographics, and other
elements relating to cancer risks. Section 750 of the FY2021 NDAA adopts this provision.
Section 1090B of the Senate bill amends 38 U.S.C. §1116(a)(2) by adding parkinsonism, bladder
cancer, and hypothyroidism to the list of conditions with presumptive service-connection, for
certain veterans potentially exposed to certain herbicide agents (e.g., Agent Orange) in Vietnam
and being considered for disability compensation and other veterans benefits.170 Section 9109 of
the FY2021 NDAA adopts this provision.
References: See CRS Report R46107, FY2020 National Defense Authorization Act: Selected
Military Personnel Issues, coordinated by Bryce H. P. Mendez; CRS Report R45986, Federal
Role in Responding to Potential Risks of Per- and Polyfluoroalkyl Substances (PFAS),
coordinated by David M. Bearden; and CRS In Focus IF11368, Expansion of Benefits to Blue
Water Navy Vietnam Veterans, by Heather M. Salazar.
CRS Point of Contact: Bryce H. P. Mendez.
COVID-19 Healthcare and Public Health Provisions
Background. As DOD continues to conduct support operations for the federal government
response to COVID-19, as it has done so throughout 2020, concerns have arisen over its capacity

169 For more on military housing, see CRS Report WPD00024, The Basics of Military Housing, by G. James Herrera
and Patrick A. Garvey.
170 For more on disability compensation, see footnote Error! Bookmark not defined.. For more on veterans’ exposure t
o Agent Orange, see CRS In Focus IF11368, Expansion of Benefits to Blue Water Navy Vietnam Veterans, by Heather
M. Salazar and CRS Report R43790, Veterans Exposed to Agent Orange: Legislative History, Litigation, and Current
Issues, by Sidath Viranga Panangala and Daniel T. Shedd.
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to support a public health crisis such as global pandemic and to provide healthcare to those
servicemembers responding to the crisis. These concerns and other matters are more visible in the
House-passed bill’s various health-related COVID-19 provisions.
COVID-19 Healthcare and Public Health Provisions Sectional Analysis
House-Passed H.R. 6395
Senate-Passed S. 4049
P.L. 116-283
Sec. 721 would require the
Secretary of Defense to establish a
“COVID-19 Military Health Systems
Review Panel” to review the
No similar provision
Sec. 731 adopts House Sec. 721.
response of the military health
system to COVID-19.
Sec. 722 would require the
Secretary of Defense to develop a
Sec. 732 adopts House Sec. 722,
strategy for pandemic preparedness
with an amendment to remove the
and response, as well as conduct a
No similar provision
requirement for the DOD
Inspector General to report on
study on the response of the
fraud, waste, and abuse of any
Military Health System to COVID-
COVID-19 funds.
19, to be submitted by June 1, 2021.
Sec. 723 would require the
Secretary of Defense to establish
and maintain a registry of TRICARE
Sec. 734 adopts House Sec. 723,
beneficiaries who have been
with an amendment to require
DOD to establish the registry by
diagnosed with COVID-19. This
No similar provision
June 1, 2021, and include only
section would also require the
beneficiaries diagnosed with, or
Secretary to submit to the
treated for COVID-19 at an MTF.
Committees on Armed Services a
report on establishing the registry.
Sec. 725 would require DOD to
make general distribution COVID-
19 pandemic materials available in
No similar provision
Not adopted
languages other than English.
Sec. 520A would extend health
care eligibility for the Transitional
Assistance Management Program to
certain National Guard members
Sec. 705 is a similar provision to
Sec. 733 adopts House Sec. 520A
separating from active service in
House Sec. 520A.
and Senate Sec. 705.
support of the COVID-19
pandemic.
Discussion. The selected provisions discussed below relate to COVID-19 specific Defense Health
Care and Public Health issues and programs. Selected provisions related to COVID-19 specific
military personnel issues and programs are discussed separately.
Section 721 of the House bill requires the Secretary of Defense to establish a “COVID-19
Military Health System Review Panel” to review the MHS response to the COVID-19 pandemic,
examine its effects on DOD’s health programs, and develop recommendations for administrative
or congressional consideration. The panel is to be chaired by the Uniformed Services University
of the Health Sciences (USUHS) President and would be composed of various MHS senior
leaders.171 The panel is required to submit a report to Congress on its findings, no later than June

171 MHS senior leaders include those comprising the Senior Military Medical Action Council (SMMAC). For more on
the SMMAC, see p. 3 of CRS Report R45399, Military Medical Care: Frequently Asked Questions, by Bryce H. P.
Mendez.
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1, 2021, at which time the panel is to terminate. Section 731 of the FY2021 NDAA adopts this
provision.
House Section 722 directs the Secretary of Defense to develop a pandemic preparedness and
response strategy. The strategy is to identify and discuss the following elements in preparation for
a pandemic response:
 necessary training, readiness activities, equipment requirements, and logistics
functions;
 DOD health surveillance capabilities, including infectious disease prevention
efforts and investments in overseas public health laboratories; and
 infectious disease prevention efforts in the domestic setting, including DOD’s
role with the National Disaster Medical System (NDMS) and other federal public
health capabilities.
The provision also requires DOD to study the MHS response to the COVID-19 pandemic. DOD
would have been directed to submit two reports to Congress; (1) a report to Congress, no later
than June 1, 2021, that includes its pandemic response strategy, study findings, and relevant
recommendations; and (2) a DOD Inspector General (DODIG) assessment of any waste, fraud,
and abuse discovered under invocation of the Defense Production Act during the COVID-19
pandemic.172 Section 732 of the FY2021 NDAA adopts this provision with an amendment that
removes the requirement for a DODIG assessment.
House Section 723 would have directed the Secretary of Defense to establish a registry of
TRICARE beneficiaries diagnosed with COVID-19. The registry would have included
demographic data of the affected population, symptoms experienced and treatments received,
certain past medical history data, and any relevant inputs from the Airborne Hazards and Open
Burn Pit Registry.173 The provision would also have required DOD to submit a report to
Congress, no later than 180 days after enactment, that discusses their implementation plan, costs,
administrative details to maintaining the registry, and recommended legislative changes that may
be necessary. Section 734 of the FY2021 NDAA adopts this provision with an amendment to
require DOD to establish the registry by June 1, 2021, and include only those beneficiaries
diagnosed with, or being treated for COVID-19 at an MTF.
House Section 725 would have required DOD to translate and make available any general
distribution DOD materials on COVID-19 in the following languages: Arabic, Cambodian,
Chinese, French, Greek, Haitian Creole, Hindi, Italian, Japanese, Korean, Laotian, Polish,
Portuguese, Russian, Spanish, Tagalog, Thai, Urdu, and Vietnamese. The FY2021 NDAA does
not adopt this provision.
Section 520A of the House bill and Section 705 of the Senate bill requires DOD to extend
eligibility for the Transitional Assistance Management Program (TAMP) to National Guard
members transitioning from full-time, state active duty orders in support of the COVID-19
pandemic.174 Section 733 of the FY2021 NDAA adopts both provisions.

172 For more on the Defense Production Act, see CRS Insight IN11231, The Defense Production Act (DPA) and
COVID-19: Key Authorities and Policy Considerations, by Michael H. Cecire and Heidi M. Peters.
173 For more on the Airborne Hazards and Open Burn Pit Registry, see discussion on “Burn Pit and Airborne Hazards”
in “Environmental and Occupational Health Concerns.”
174 The Transitional Assistance Management Program (TAMP) provides 180 days of premium-free coverage for
TRICARE Prime or TRICARE Select after the sponsors transition or separation. Beneficiaries are eligible for TAMP if
their sponsor is subject to certain transitional events, such as involuntary separation under honorable conditions,
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References: See CRS Report R46481, COVID-19 Testing: Frequently Asked Questions,
coordinated by Amanda K. Sarata and Elayne J. Heisler; and CRS Report R46316, Health Care
Provisions in the Families First Coronavirus Response Act, P.L. 116-127, coordinated by Sarah A.
Lister and Paulette C. Morgan.
CRS Points of Contact: Hibbah Kaileh and Bryce H. P. Mendez.
Defense Activities and Installations
Other military activities over which the HASC and SASC have jurisdiction include the many
DOD-operated retail stores for food, personal goods, and household items—exchanges and
commissaries—which servicemembers generally consider among the most significant benefits
after healthcare and retirement.175 Both committees also oversee all aspects of installations,
reservations, and other establishments in DOD and the Military Departments. The FY2021
NDAA includes several provisions that directly impact the various DOD retail activities and
provisions that address historical designations of military installations.
Defense Exchange and Commissary Stores
Background. Over the past several years, Congress has addressed reforming the Defense
Commissary Agency (DeCA) system, requiring several reports and studies that examined
consolidating the three military exchanges (Army & Air Force Exchange Service (AAFES), the
Marine Corps Exchange (MCX), the Navy Exchange Service Command (NEXCOM)) with the
commissary agency. Recent reform proposals have sought to reduce DeCA's reliance on
appropriated funds without compromising patrons’ commissary benefits and to avoid reducing the
revenue generated by DOD’s military exchanges. The DOD’s military exchanges are non-
appropriated fund (NAF) entities whose revenues also fund morale, welfare, and recreation
(MWR) facilities on military installations. However, 10 U.S.C. §2482 prohibits the Defense
Department from undertaking consolidation without new legislation. Section 633 of the FY2020
NDAA (P.L. 116-92) required the Government Accountability Office (GAO) to review DOD’s
business case analysis (pricing, sales, measuring customer savings, timetable for consolidation,
etc.) before merging the various resale entities into a single entity. On April 30, 2020, GAO
released its report and made four recommendations.176 Among these was that DOD reassess its
cost-savings estimates and provide more information on the military services’ reactions to the
business case analysis, both of which GAO analysts said were omitted from the Pentagon’s report
to Congress.177 In FY2020, Congress authorized $1.0 billion for DeCA to operate 236

demobilizing member of the Reserve Component, sole survivorship discharge, or transition from the Active
Component to the Reserve Component. For more information about TAMP, see https://tricare.mil/tamp. For more on
the use of state active duty orders authorized under 32 U.S.C. §502(f) during the COVID-19 pandemic, see CRS In
Focus IF11483, The National Guard and the COVID-19 Pandemic Response, by Alan Ott.
175 U.S. Senate, Document 113-18, Standing Rules of the Senate, January 24, 2013, p. 20; U.S. House of
Representatives, Rules of the House of Representatives, January 11, 2019, p. 6; RCP 116-25, Rules Adopted by the
Committees of the House of Representatives of the United States, 116th Congress, 2019-2020, p. 37.
176 GAO, Commissaries and Exchanges: DOD and Congress Need More Reliable Information on Expected Savings
and Costs of Consolidating the Defense Resale Organizations, GAO-20-418: April 30, 2020, Recommendations at
https://www.gao.gov/products/GAO-20-418?mobile_opt_out=1#summary_recommend.
177 GAO-20-418, p. 17; and Patricia Kime “DoD Miscalculated Savings of Proposed Commissary-Exchange Merger,
Watchdog Says,” Military.com, May 4, 2020, at https://www.military.com/daily-news/2020/05/04/dod-miscalculated-
savings-proposed-commissary-exchange-merger-watchdog-says.html.
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commissary stores on military installations worldwide, employing a workforce of over 12,000
civilian full-time equivalents.178
Defense Exchange and Commissary Stores Sectional Analysis
House-Passed H.R. 6395
Senate-Passed S. 4049
P.L. 116-283
Sec. 629 requires a report by the
Comptrol er General of the United
States on implications of expansion
of authority to provide financial
assistance to civilian providers of
Sec. 629 would extend
child care services or youth
commissary and exchange benefits
program services for survivors of
for surviving remarried spouses
members of the Armed Forces who
with dependent children of a
No similar provision
die in the line of duty.
member of the Armed Forces who
Sec. 629A requires a report by
dies while on active duty or certain
the Secretary of Defense on the
reserve duty.
extension of commissary and
exchange benefits for surviving
remarried spouses with dependent
children of servicemembers who
die while on active duty or certain
reserve duty.
Sec. 631 provides base responders
Sec. 631would provide base
with the use of commissary stores
responders with essential needs and
No similar provision
and MWR facilities by amending
dining access.
Chapter 54 of Title 10, U.S. Code
by adding a new Section 1066.
Sec. 632 would provide first
responder access to mobile
No similar provision
Sec. 632 adopts Section 632 of
exchanges.
the House Bil .
Sec. 633 would update business
Sec 633 adopts Sec. 633 of the
case analysis for consolidation of
No similar provision
House Bil .
the Defense Resale System.
Sec. 381 would clarify food
Sec. 639 clarifies food ingredient
No similar provision
ingredient requirements for food or requirements for food or beverages
beverages provided by DOD.
provided by the DOD.
Discussion. Section 629 of the House-passed version would have extended commissary and
exchange benefits for surviving remarried spouses with dependent children of a servicemember
who dies while on active duty or certain types of reserve duty. Currently, widowed spouses with
dependent children who remarry no longer have commissary and exchange privileges. This
provision would have eliminated the administrative burden on a surviving remarried spouse or
dependent child, including any requirement for a remarried spouse to apply as a personal agent
for continued access to military installations in accompaniment of a dependent child. The Senate-
passed S. 4049 had no provision. The FY2021 NDAA Section 629 requires the Comptroller
General to submit a report within a year of enactment on the implications of expansion of the
authority under Section 1798 of Title 10, U.S. Code, to provide financial assistance to civilian
providers of child care services or youth program services for survivors of members of the Armed
Forces who die in the line of duty, without regard to whether such deaths occurred in combat-

178 DOD Office of the Under Secretary of Defense (Comptroller) Chief Financial Officer, Defense Budget Overview
Fiscal Year 2020 Budget Request, February 2020, p. 2-7 (PDF p.28), Figure 2.2 Military Family Support Programs at
https://comptroller.defense.gov/Portals/45/Documents/defbudget/fy2021/fy2021_Budget_Request_Overview_Book.pdf
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related incidents. Elements of this report are to include data on the number of servicemembers
who died in the line of duty; dependents who would be eligible for these services; the availability
of these services; and the estimated cost of expanding these services.
The FY2021 NDAA Section 629A also requires the Secretary of Defense, in consultation with the
Secretary of Homeland Security, to submit a report by March 1, 2021, to the Committees on
Armed Services of the House and Senate on the DOD’s procedures for an eligible remarried
spouse to obtain access to a military installation to use a commissary store or MWR facilities to
the same extent as a non-remarried spouse.
House Section 631 would have provided protective services civilian employees (security guards,
firefighters, police and emergency management) located at a military installation access to dining
and essential needs by charging them a user fee to purchase merchandise at a commissary store or
MWR retail facility. Currently, these civilian employees are not allowed access to these facilities.
Section 631 of the FY2021 NDAA adds a new Section 1066 to Chapter 54 of Title 10, U.S. Code
that authorizes DOD to permit protective services employees to purchase food and hygiene items
at a commissary or MWR retail facility on military installations.
House Section 632 provides first responders, as defined in Section 2 of the Homeland Security
Act of 2002 (P.L. 107-296; 6 U.S.C. §101), access to mobile commissary or exchange stores
when deployed to an area covered by a declaration of a major disaster or emergency.179 The
FY2021 NDAA adopted this House provision authorizing the Secretary of Defense to allow
emergency responders to use a mobile commissary or exchange store deployed to an area
declared as a major disaster or emergency under the Robert T. Stafford Disaster Relief and
Emergency Assistance Act (42 U.S.C. §5170).
Section 633 of the House-passed version requires DOD to conduct a new business case analysis
(BCA) incorporating the recommendations made by GAO in its April 2020 report. This provision
requires additional comments from the military services to better inform the House and Senate
Armed Services Committees. It requires a review of all consolidation perspectives before DOD
can move forward with any possible reform efforts.180 There are no similar provisions in the
Senate-passed version of these House provisions. Section 633 of the FY2021 NDAA adopts this
House provision and requires the Secretary of Defense to submit the updated BCA to the
Committees on Armed Services of the House and Senate by June 1, 2021. In addition, this
provision prohibits any action on consolidation until the Armed Service committees notify the
Secretary of Defense in writing of receipt and acceptance of the updated analysis.
Section 381 of the Senate-passed bill would have required the Secretary of Defense to publish in
the Federal Register a notice of a preliminary rule, statement, or “proposed action” regarding the
limitation or prohibition of any food or beverage ingredient in military food service, military
medical foods, commissary food, or commissary food service. The Secretary would have been
required to provide opportunity for public comment before making any final determination. There
is no similar House provision. The FY2021 NDAA includes a similar provision in Section 369
that food ingredient requirements for food and beverages provided by DOD be published in the
Federal Register before making any final rule, It also includes a waiver for military operations or
for the response to a national emergency declared by the President under the National
Emergencies Act (50 U.S.C. §§1601 et seq.), a medical emergency, or a pandemic as well as any

179 Major disaster or emergency defined under section 401 of the Robert T. Stafford Disaster Relief and Emergency
Assistance Act (42 U.S.C. §5170).
180 Eryn Wagnon. “House NDAA Would Require New Case Study on Commissary-Exchange Consolidation,” MOAA,
July 1, 2020, at https://www.moaa.org/content/publications-and-media/news-articles/2020-news-
articles/advocacy/house-ndaa-would-require-new-case-study-on-commissary-exchange-consolidation/.
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recalls by the Food and Drug Administration (FDA) of certain ingredients that may be harmful
for human consumption.
References: See CRS In Focus IF11089, Defense Primer: Military Commissaries and
Exchanges, by Kristy N. Kamarck and Barbara Salazar Torreon.
CRS Point of Contact: Barbara Salazar Torreon.
Names and Symbols Linked to Confederate States
Background. On July 17, 2020, then-Secretary of Defense Mark Esper provided guidance to
defense senior leaders and commanders on the public display or depiction of flags in the
Department of Defense that omits the Confederate flag.181 Some Members of Congress have
expressed interest in renaming military installations named for leaders of the former Confederate
States of America (C.S.A., Confederacy) but the DOD does not have a review process to
reevaluate the naming of specific installations. Instead, each military department has its own
naming convention. The Trump Administration strongly objected to renaming such military
installations.182 President Trump vetoed the enrolled NDAA bill, in part because it contained a
provision to changes the current names.
Names and Symbols Linked to Confederate States Sectional Analysis
House-Passed H.R. 6395
Senate-Passed S. 4049
P.L. 116-283
Sec. 1749 would prohibit the
display of the Confederate battle
No similar provision
Not adopted
flag on DOD property.
Sec. 2829 would require the Army
to remove the names of
Sec. 377 would require the DOD
Sec. 370 requires the DOD to
to establish a commission to
implement a plan by a commission
Confederate States of America
conduct a two-year study of CSA
established by the Secretary of
(CSA) military leaders from all
commemoratives with the intention Defense to remove and replace
installations and authorize the
of removing and replacing
Confederate names from DOD
Secretary of Defense to establish an Confederate names within three
assets within three years of
advisory panel to rename them
years of enactment.
enactment.
within 1 year of enactment.
Discussion. Section 1749 of the House-passed bill would have prohibited display of the
Confederate battle flag from “DOD property” defined as all installations, workplaces, common
access areas; barracks, military housing, naval vessels, aircraft, government vehicles, hangars,
streets, DOD schools, commissaries and exchanges, etc. Exceptions would have included DOD
exhibits that are educational or historical displays in which the Confederate battle flag is not the
main focus; a State flag that incorporates the Confederate battle flag; a State-issued license plate
with a depiction of the Confederate battle flag; or a grave site of a Confederate soldier. Some
contended that this provision was unnecessary following the release of the Secretary of Defense’s

181 “Secretary of Defense Dr. Mark T. Esper Guidance on Public Display or Depiction of Flags in the Department of
Defense,” DOD News, July 17, 2020, at
https://www.defense.gov/Newsroom/Releases/Release/Article/2278101/secretary-of-defense-dr-mark-t-esper-guidance-
on-public-display-or-depiction-of/.
182 The White House, “Presidential Veto Message to the House of Representatives for H.R. 6395,” December 23, 2020,
at https://trumpwhitehouse.archives.gov/briefings-statements/presidential-veto-message-house-representatives-h-r-
6395/; and Leo Shane III, “Trump vows bases named for Confederate leaders ‘will not be changing,’” Military Times,
July 24, 2020, at https://www.militarytimes.com/news/pentagon-congress/2020/07/24/trump-vows-bases-named-for-
confederate-leaders-will-not-be-changing/.
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flag guidance memorandum on July 16, 2020, which prohibits the Confederate battle flag by its
omission from a list of authorized flags.183 The Senate-passed version had no similar provision.
The House provision was not adopted.
Section 2829 of the House-passed version would have required the Army to remove the names on
all installations named for Confederate military leaders within one year of enactment.
Section 377 of the Senate-passed version would have required the establishment of a commission
to study the issue of CSA commemoratives including flags, statues, memorials and monuments
with the intention of removing Confederate names from DOD property within three years of
enactment. Viewpoints from local communities affected by the name changes would also have
been considered by the commission to make the final determination. Confederate grave markers
in military cemeteries would have been exempt. This provision did not cover Department of
Veterans Affairs (VA) cemeteries or state cemeteries receiving funding from the VA’s National
Cemetery Administration (NCA). The Senate-passed version would have authorized $2 million
for the commission’s work from the Army’s Operations and Maintenance budget.
Section 370 of the FY2021 NDAA contains a provision that requires the DOD to implement a
plan by a commission established by the Secretary of Defense to conduct a study of CSA
commemoratives with the intention of removing and replacing Confederate names from DOD
assets within three years of enactment. The eight commission members shall comprise four
appointed by the Secretary of Defense; one appointed by the Chair of the Senate Armed Services
Committee; one appointed by the Ranking Member of the Senate Armed Services Committee;
one appointed by the Chair of the House Armed Services Committee; and one appointed by the
Ranking Member of the House Armed Services Committee.184 The commission shall brief its
findings to the Armed Services Committees after compiling a list of assets to be removed or
renamed; determining costs associated with the removal or renaming of assets; and establishing
criteria and requirements used to nominate and rename these assets. DOD assets are defined in
this section as “any base, installation, street, building, facility, aircraft, ship, plane, weapon,
equipment, or any other property owned or controlled by the Defense Department.” This includes
a review of monuments but excludes grave markers. The commission will be expected to further
define what constitutes a grave marker. Section 370 authorizes $2 million for the commission’s
work from the Army’s Operations and Maintenance budget for FY2021.
Proponents of renaming the installations contend that there are diverse, noteworthy deceased
military leaders from more recent conflicts who demonstrated selfless service and sacrifice,
including Medal of Honor recipients, who would be more appropriate for such an honor.
Opponents of renaming these installations cite the bureaucracy of creating a new review process

183 Secretary of Defense, “Public Display or Depiction of Flags in the Department of Defense,” Memorandum, July 16,
2020, at https://media.defense.gov/2020/Jul/17/2002458783/-1/-1/1/200717-FLAG-MEMO-DTD-200716-
FINAL.PDF.
184 During the final days of the Trump Administration, then Acting Secretary of Defense Chris Miller announced the
names of four appointments to the Commission. DOD News, January 8, 2021, at “Department of Defense Announces
New Appointments,” at https://www.defense.gov/Newsroom/Releases/Release/Article/2466980/department-of-
defense-announces-new-appointments/. However, under the Biden Administration on February 12, 2021, Secretary of
Defense Lloyd Austin appointed four new commissioners. See “Statement by Secretary of Defense Lloyd J. Austin III
on the Department's Representatives to the Congressionally-Mandated Commission on the Naming of Items in the
Department of Defense That Commemorate the Confederate States of America,” DOD News Release, February 12,
2021, at https://www.defense.gov/Newsroom/Releases/Release/Article/2502459/statement-by-secretary-of-defense-
lloyd-j-austin-iii-on-the-departments-represe/. See CRS Insight IN10756, Confederate Names and Military
Installations, by Barbara Salazar Torreon, for more information.
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and the difficulty of satisfying the various viewpoints over which names (if any) would be
selected as subjects of contention.
References: See CRS Insight IN10756, Confederate Names and Military Installations, by
Barbara Salazar Torreon; CRS Report R44959, Confederate Symbols: Relation to Federal Lands
and Programs, coordinated by Laura B. Comay, in the section on the “Department of Defense;”
and CRS Report RS22478, Navy Ship Names: Background for Congress, by Ronald O'Rourke, in
the section, “Ships Named for the Confederacy or Confederate Officers.”
Point of Contact: Barbara Salazar Torreon.

Author Information

Alan Ott, Coordinator
Bryce H. P. Mendez
Analyst in Defense and Intelligence Personnel
Analyst in Defense Health Care Policy
Policy

Kristy N. Kamarck
Barbara Salazar Torreon
Specialist in Military Manpower
Senior Research Librarian

Lawrence Kapp
Hibbah Kaileh
Specialist in Military Personnel Policy
Research Assistant

Disclaimer
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under the direction of Congress. Information in a CRS Report should not be relied upon for purposes other
than public understanding of information that has been provided by CRS to Members of Congress in
connection with CRS’s institutional role. CRS Reports, as a work of the United States Government, are not
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