Category Archives: Joyce’s Voice

DoD: we’ll protect family programs… “to the extent feasible”

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When you were a child, how hopeful did you feel when you asked your mom for something and she said “we’ll see”? What’s your reaction when you suggest something to your boss to improve your work place and she says “we’ll try”? How encouraged are you when you ask your spouse to do something and they respond “hold that thought”? When you think about the possibility of checking things off your to-do list, how optimistic are you really if you begin your thoughts with “if the planets align…”?

We’ve talked a lot in this blog space about the budget pressures and uncertainties Department of Defense (DoD) and military families face: from the fiscal cliff to sequestration to the debt ceiling and threatened government shutdown. If you’re as concerned as I am about whether the support programs your military family depends on will be around in the future, then you want reassurance from the DoD. Well here it is, folks.

According to a memo released on January 10 by the Deputy Secretary of Defense Ashton Carter, DoD will “to the extent feasible, protect family programs.” Secretary Carter’s memo offers needed guidance to the Service Chiefs and DoD agencies on dealing with those challenges and uncertainties, but it doesn’t give me warm fuzzies about how families will fare in this process.

The Secretary’s memo also lists major program and funding areas and guidance on how agencies should allocate scarce funding. The National Military Family Association appreciates the decision to exempt military personnel funding (generally regarded as pay and allowances) from sequestration. The guidance also provides the good news that war operations and wounded warrior programs will be “fully protected.” We’re not quite sure about what it means that military health care wasn’t mentioned in the memo. Should we be reassured or worried?

While we’re pleased that family support programs are mentioned in the guidance, the “to the extent feasible” language makes us uneasy. Where does “feasible” fall on a DoD priority list? How do we measure the success of DoD’s efforts if they’re only saying they’ll try?

What makes this statement even more alarming is that we also know other recommended actions outlined in the memo will hurt family programs. A civilian hiring freeze, furloughs of civilian employees, cuts to base operating funding, and curtailment of travel and training will decrease the viability of military family support programs that, in some cases, have already been subject to personnel downsizing and funding cuts.

Our Association shares the Secretary’s concern about the damage that will be done if a Fiscal Year Defense Appropriations bill is not enacted. (This will mean DoD must continue to operate under a Continuing Resolution.) We know families understand some programs may need to be scaled back to protect funding for the readiness and support of their service member. But we also know service members say they can better focus on their missions in dangerous places when they know their families have the support they need. They don’t do their jobs just “to the extent feasible”!

DoD must not be forced to cut military family programs to the bone at a time when they are still needed by families supporting service members at war. We will continue to keep an eye on the effect of this budget guidance on support for families and let DoD know if efforts “to the extent feasible” fall short of the mark.

Tell us what’s happening to family support programs in your community. Are people trying to do more with less? Have you or families you know had trouble accessing programs and support services you need?

Joyce RaezerPosted by Joyce Raezer, Executive Director at the National Military Family Association 

One toe over the edge: the Fiscal Cliff and military families

One toe over the ledge: the Fiscal Cliff and military familiesSo we’ve managed not to topple over the cliff, but it looks like we’ll be hanging on the ledge of uncertainty for a few more months. In the wee hours of the New Year, Congress passed a compromise bill to keep the country from heading over the edge. Like any compromise, the bill didn’t please everyone, but it did fix several issues important to military families, including a one-year extension of the Medicare/TRICARE doc fix, which will help protect families’ access to health care. The compromise legislation did not include an increase to the debt ceiling and the Treasury Department estimates it will run out of ways to stay within the current ceiling by late February or early March, right about the time sequestration is now set to start.

And what of those automatic cuts to federal spending, known as sequestration? The best the Congressional leaders and the President could do was to postpone it for two months. That might sound like a good thing, but this delay also means uncertainty about what will or could be cut for military installations, schools that educate military kids, defense contractors, and all other military and community agencies that support military families.

Other provisions included in the compromise bill would:

  • Create a permanent fix for the Alternative Minimum Tax to prevent taxpayers from moving into higher tax brackets simply because of inflation—this fix was needed immediately to keep taxpayers from paying higher taxes on their 2012 income.
  • Permanently extend the Bush-era tax rates for all families earning less than $450,000.
  • Increase the tax rate on capital gains and some estates.
  • Freeze Congressional pay.
  • Extend federal unemployment benefits for one year.
  • Extend provisions in the expiring farm bill by one year. (This means milk prices won’t skyrocket, as you may have seen in the news.)

The compromise bill did not extend the lower payroll tax rate of 4.2% in effect during the past two years through economic stimulus legislation. Therefore, the payroll tax workers pay to support Social Security will immediately return to 6.2%. Workers will see this change in their first paycheck of 2013. Experts estimate that the family earning an average of $50,000 per year will pay an additional $1,000 in payroll taxes this year.

While the New Year’s Congressional action gives the government and taxpayers some breathing room, we’re not out of the woods yet. The temporary delay of the sequestration cuts will combine with other pending budget events to continue the fiscal uncertainty facing our Nation.

The Association appreciates the actions by Congress and the President to provide the fix to Medicare and TRICARE doctors. We remain concerned about the failure to address the potentially devastating sequestration cuts to both civilian and military programs that could have a negative impact on military families. While the delay in sequestration will temporarily protect some needed support services, it also continues the uncertainty, and a military community at war needs certainty that the Nation supports its service. We call on our Nation’s leaders to forge a more permanent solution that will preserve the strength of our service members and their families.

How do you feel about the outcome of the compromise bill and the negotiations surrounding it?

Joyce RaezerPosted by Joyce Raezer, Executive Director at the National Military Family Association

Here We Go Again! Cuts to Medicare/TRICARE Physician Payments Begin January 1 Unless Congress Acts

Here We Go Again! Cuts to Medicare/TRICARE Physician Payments Begin January 1 Unless Congress ActsAttention TRICARE beneficiaries! In two weeks, doctors will face a 26.5% payment cut for care they provide to Medicare and TRICARE patients. The National Military Family Association believes these impending cuts will directly affect military families’ access to timely care because physicians may decide to no longer care for their existing Medicare or TRICARE patients or accept new ones.

Getting a so-called “Doc Fix,” which would end scheduled cuts in Medicare reimbursement rates, is a recurring issue. Congress temporarily stopped the scheduled payment cuts in February 2012 as part of the Middle Class Tax Relief and Job Creation Act of 2012  (P.L. 112-96). Unfortunately, that fix is due to expire on January 1, 2013, which means that without further Congressional action the 26.5% physician payment cut will go into effect. The timing of the expiration also means the issue has been caught up in the negotiations over the pending fiscal cliff. This makes fixing it that more difficult.

By law, TRICARE reimbursement rates must follow the Medicare reimbursement rules. The law does permit TRICARE to make exceptions if necessary to ensure an adequate network of providers or to eliminate a situation of severely impaired access to care. But, the process of making those adjustments can take time and may happen only after TRICARE officials receive enough reports that military families aren’t finding the care they need.

Our research, Views from the Homefront, demonstrated the need for mental health services for military spouses and children. Our military families already experience difficulty gaining access to mental health care in many communities. We cannot afford to lose any mental health providers. After 11+ years of war, the military must be growing our access to mental health care rather than decreasing it.

We’ve been monitoring this issue and raising concerns about the impact not fixing the rates could have on military families. We encourage military families to contact Members of Congress (House and Senate) and tell them how these cuts can affect access to the health care they need. Ask Congress to implement a permanent fix.

What do you think about these potential cuts? Will your family be affected?

Joyce RaezerPosted by Joyce Raezer, Executive Director at the National Military Family Association

Discrimination by uniform: an update on TRICARE and ABA therapy

Discrimination by uniform: an update on TRICARE and ABA therapyFor the first time—ever—Congress is purposely excluding certain members of the Uniformed Services from receiving some health care benefits because of their Service affiliation. Shocked? So are we.

When I speak about who our Association serves, I say that we work to improve the lives of active duty, National Guard and Reserve, retired, and surviving families of members of all seven Uniformed Services. Then I ask the trivia question: “What are the seven Uniformed Services?” In most cases, people easily name the Army, Navy, Marine Corps, Air Force, and Coast Guard, but they’re often stumped on the other two: the Commissioned Corps of the National Oceanic and Atmospheric Administration (NOAA) and the Public Health Service (PHS).

Members of all seven Uniformed Services take the same oath to support our Nation, are paid using the same pay tables, go where our leaders send them, earn the same retirement benefits, and receive the same TRICARE health care coverage. But this equality in benefits for their service that is granted by law is now threatened by the very Congress we ask to protect us.

A little background. Many military families with an autistic child, as well as some with other disabilities, have seen improvement when the child has access to Applied Behavior Analysis (ABA) therapy. Because TRICARE has provided ABA therapy under the ECHO Program, which is open to active duty families only and has an annual cap on costs, many military families have asked Congress to make it a covered TRICARE benefit to remove the cap and be available to retirees as well. They’ve encountered resistance for several reasons, most notably the cost.

The House’s version

In May, the House of Representatives added a provision to its version of the Fiscal Year 2013 National Defense Authorization Act (NDAA) that would make ABA therapy a TRICARE benefit for patients with an Autism Spectrum Disorder diagnosis. Normally, when a benefit is added to TRICARE, it applies to everyone that qualifies medically. In this case, however, the House decided it was acceptable to specifically exclude all  families of three Uniformed Services: the Coast Guard, NOAA, and PHS—a first.

The Senate’s version

On December 4, the Senate approved its version of the NDAA, which also contains a provision adding ABA therapy as a TRICARE benefit. At the request of our Association and others, the Senate provision opens up the therapy to anyone whose doctor believes would be helped. In response to our concerns about the House excluding three of the seven Uniformed Services from the benefit, the Senate included coverage for all active duty Coast Guard, NOAA, and PHS family members. But, it still specifically excludes retiree families of those Service branches.

What’s Needed

I don’t want to diminish the importance of this new TRICARE benefit. I’m glad Members of Congress have recognized the burden military families with a child needing ABA therapy face in finding and paying for the treatment. However, our Association is deeply concerned about the precedent this action by both Houses of Congress sets—and thinks that every military family should be as well.

Members of Congress have a chance to fix this inequity as they meet to create the final version of the NDAA. They must ensure eligibility for TRICARE benefits is determined by the medical needs of the patient, not the type of uniform their service member wears or wore.

How do you feel about these exclusions in the proposed NDAA?

Joyce RaezerPosted by Joyce Raezer, Executive Director at the
National Military Family Association

Election’s Over and the Turkey Leftovers are Gone—Now Get to Work

In the aftermath of the November 6 election results, we posted a congratulatory message to re-elected President Obama and members of the new 113th Congress:

“Congratulations President Obama and members of the new 113th Congress. Our country faces challenging times and there is a lot of work to be done. We’ll make every effort to ensure our elected leaders honor the sacrifices of military families by providing them the Nation’s highest level of care and involvement. The National Military Family Association will continue to work with the President and members of Congress, as we have since 1969, to make sure caring for military families remains a priority.”

In that message, we wanted to emphasize our long history of working with administration officials and Congress. We also felt it important to point out that multiple, important tasks face our elected officials and military families expect these priorities to be addressed.

Our elected officials, starting with the lame duck 112th Congress that returned to town briefly before heading home for Thanksgiving, must work together to pass the FY 2013 National Defense Authorization Act, a tough task given that the Senate did not even bring its version to the floor before Congress recessed to campaign. They must pass a Defense Appropriations Act for FY 2013 rather than force DoD to continue operating under a Continuing Resolution.

Once again, they need to stop a looming payment cut to doctors who take Medicare and TRICARE so that military families don’t have to add whether their doctor will continue to care for them to their worry list.

And our leaders must decide what—if anything—they will do about the approaching Fiscal Cliff.

We are encouraged by the reported progress of post-election meetings between the President, administration officials, and Congressional leaders on addressing the tax and sequestration concerns that if unsolved will lead us off the Fiscal Cliff. Fixing these issues is part of all elected leaders’ job descriptions. When coming up with their solutions, we hope they remember:

  • Our Nation—and our military—are still fighting a war!!
  • Military families depend on both DoD and community safety nets: proposed sequestration cuts to schools and programs like WIC will affect military families, too!
  • Ending deadlock and addressing the issues our Nation faces in a collaborative way should not be regarded by our Nation’s leaders as just a nice campaign promise but an urgent call to action.
  • The national debt is a national security issue and sequestration only reduces that debt by less than 10%–solving the deficit issue will take sacrifice and commitment from all Americans.

Our Association will continue to listen to military families, respond to their questions and concerns, and be their voice to help our elected officials understand the issues most important to them. We offer ourselves as a resource for our Nation’s leaders and also pledge to help military families understand the complex issues facing our Nation.

What do you expect of our Nation’s leaders as they get back to work?

Posted by Joyce Raezer, Executive Director at the
National Military Family Association

Introducing Branching Out

Welcome to the National Military Family Association’s new blog, Branching Out. We are excited to have a new way to connect with you!

As we work on launching this blog, we’re doing just what the name implies – branching out from our usual methods of communication to have a real conversation with you. But ‘branching out’ also reminds us of the military family tree and the wonderful way that we support each other and help each other grow.

This blog will be a place where we can talk about the hot topics of the day—breaking news, updates on issues we all care about, fun military family stories, volunteer highlights, donor spotlights, contests, and more. You name it – we want to blog about it!

But we can’t do it without your help. Tell us what you want to see on this blog – it’s your space! Email, Facebook, or tweet us with your feedback. Comment, start a discussion, or share a post with a friend. When Branching Out launches,  we want it to be your go-to military family blog!

Now that we’ve introduced Branching Out, we’d like to know a little about you. Tell us one or two of the following in a comment:

  • What is your military affiliation?
  • Are you a military spouse, partner, mom, dad, or sibling?
  • What branch of Service are you associated with?
  • What would you like to see in Branching Out in the future?

To stay up to date as we develop Branching Out, sign up for our monthly blog newsletter or subscribe to posts via email on the right.

Posted by Joyce Raezer, Executive Director at the
National Military Family Association