In January, the Military Compensation and Retirement Modernization Commission proposed replacing the triple-option Tricare benefit with a menu of commercial insurance options, similar to those offered to federal civilians, but with a break on premiums except for working-age retirees.

As the military community studied those details, the Obama administration released its latest defense budget, which continued a pattern adopted during the George W. Bush administration of proposing hefty Tricare fee increases, particularly for younger and nondisabled retirees.

After months of consideration, Congress rejected both paths for the 9.5 million military health care beneficiaries. Instead, the big legislative lift for 2015 was an overhaul of military retirement for future generations.

Now eyeing 2016, the chairmen of the House and Senate armed services committees promise to begin to reform the $50 billion military health system. Their staffs have begun doing groundwork.

Rep. Mac Thornberry, R-Texas, chairman of the House committee, said reforms will begin with the commission’s findings on weaknesses and inefficiencies in the system.

In his first year as chairman, Thornberry not only tackled retirement but took first steps to overhaul the defense acquisition system. He suggested health reform, like fixing acquisition, might occur in stages.

“I don’t know that we’re going to come in with some sweeping package and overhaul the whole system,” Thornberry said. “I want to be careful that we don’t do unintended damage.”

Thornberry said he will rely on the military health care expertise of personnel subcommittee chairman Rep. Joe Heck, R-Nev., a career Army Reserve physician who “lives and works in that system.”

What Thornberry knows is that problems with access and quality of care vary by location, with rural areas particularly challenged. He also has met “at least some Tricare providers who believe they can provide significantly better service if they can bring some of what they’re doing in the private sector into Tricare. That’s something we want to explore.”

On whether beneficiaries should pay more for their health benefits, Thornberry said that would be decided as part of a wider reform focus.

“The Pentagon keeps sending over these proposals, year after year, to take more money out of folks’ paychecks, and that’s it,” Thornberry said. “That’s not right. We need to look at the broader Tricare system, see how it might be improved. Perhaps that might involve some higher fees or premiums; I don’t know. But we need to look at it in broader context: the purpose of the military health care system, the role it plays in pay and benefits, in recruitment and retention, over the long term.”

Thornberry said he and Sen. John McCain, R-Ariz., chairman of the Senate Armed Services Committee, “have agreed that Tricare reform will be a major subject of emphasis for us in the coming year.”

The House committee has held a roundtable discussion with the military surgeons general and informal talks with beneficiary organizations. National Military Family Association sponsored a panel discussion on Capitol Hill last week where Thornberry made opening remarks.

Military Officers Association of America is polling its members on health care issues. More beneficiary groups are to testify before Heck’s subcommittee on Thursday. The Military Coalition, an umbrella group of 34 military associations and veterans groups, has prepared principles and goals to consider for health care reform.

Most associations reject the commission’s Tricare Choice Plan as going too far to replace current offerings. However, there’s agreement that continuity of care is a problem for Guard and Reserve members. So, the Reserve Officers Association is urging adoption of the commission’s Tricare Reserve Choice plan if alternative fixes to reserve component health care fail to advance soon.

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