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Defense bill includes private health insurance test program

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The Senate is debating a must-pass defense funding package that could create a commercial health insurance pilot program for military reservists.

The military reservist health coverage pilot program provision is part of the current version of S. 2943, the National Defense Authorization Act for Fiscal Year 2017 bill.

The current version of the bill, which was passed by the House last week and could reach the Senate floor this week, is a 3,076-page conference report.

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Congressional leaders use conference reports to hammer out compromises between the House version of a bill and the Senate version.

The Senate version of the bill included a provision that would let the U.S. Department of Defense work with the U.S. Office of Personnel Management to develop a new health benefits program for reservists and reservists’ family members that would pay for health care services provided at military treatment facilities.

Normally, reservists would pay 28 percent of the premiums plus cost-sharing amounts.

If a reservist was activated and received military health benefits, the plan would waive the premium and cost-sharing requirements for the family members. The family members could keep their coverage and stick with their same health care providers.

The House version of the provision would have asked the Defense Department to study options for creating a new kind of health benefits program for reservists and to report back to Congress within 180 days.

The current version, described in Section 712 in the conference report, lets the Defense Department work with the OPM to create a five-year pilot program.

Section 712 states that the pilot program should offer reservists “a variety of national and regional health benefits plans” that are comparable to commercial plans and “do not contain unnecessary restrictions.”

The plans would have to cap the enrollees’ out-of-pocket expenses.

The section calls for the OPM to set up an insurer contracting process similar to OPM’s Federal Employees Health Benefit Plan contracting process. 


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