Lawmakers Want the Pentagon to Waive Tricare Copays on Birth Control Services

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clinical medicine flight commander demonstrates several contraceptive options
A clinical medicine flight commander demonstrates several contraceptive options, such as an intrauterine device, at the 15th MDG’s contraceptive clinic at Joint Base Pearl Harbor-Hickam, Hawaii, May 6, 2021. (U.S. Air Force photo by 2nd Lt. Benjamin Aronson)

House lawmakers are urging the Pentagon to expand access to contraception for military family members and retirees by waiving Tricare copayment charges on appointments for such care and services.

On Thursday, 141 House Democrats sent a letter to Defense Secretary Lloyd Austin asking him to eliminate the copayments for counseling and services related to birth control and long-acting, reversible contraceptives such as implants and shots. They argue it would improve the health and well-being of beneficiaries as well as the military.

The move would bring the Tricare contraception benefit more in line with the Patient Protection and Affordable Care Act, also known as "Obamacare." That law requires private insurance plans to cover preventive services, including all contraceptives approved by the Food and Drug Administration, for their patients, the lawmakers say.

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"These protections do not apply to coverage through Tricare. As a result, military families have fewer rights than those they serve to protect," wrote the lawmakers, who were led by Rep. Jackie Speier, D-Calif., the chair of the House Armed Services personnel panel.

Under current law, spouses and children of an active-duty service member or a retiree enrolled in Tricare Select must make copayments for prescriptions obtained outside a military pharmacy as well as appointments for birth control counseling and for insertion and removal of long-acting contraceptives.

Retirees and family members of retirees enrolled in Tricare Prime face the same charges when they see a Tricare-authorized provider.

By law, Austin cannot waive the copayments for birth control prescriptions for those who obtain their medication via a location other than a military pharmacy. But he does have the ability to waive the copayments for appointments, they say.

"We encourage you to waive contraceptive copays that fall under your authority and continue working with Congress to eliminate all cost sharing for contraception for servicemembers and military families, as gaps will still remain in statute for certain Tricare beneficiaries," they wrote.

Eliminating copayments for prescriptions filled at Tricare retail pharmacies would require legislation, which has been introduced in the House and Senate but has failed in the past to make it into the final defense policy bill, including in fiscal 2022.

The lawmakers noted that the Defense Department itself has supported the proposal.

"The estimated $56 million in avoided pregnancy costs suggests that removing these financial barriers to contraception may mean more freedom of choice with respect to family planning for our beneficiaries," DoD officials wrote in an assessment, according to the letter sent to Austin.

The move would expand patient access to more effective long-term birth control options, the lawmakers said.

A study looking at the Navy's approach at boot camp to sex education and contraception, which includes offering walk-in clinics and access to long-acting reversible contraception methods such as intrauterine devices and hormonal implants, found that the program reduced the service's childbirth rates slightly, related leave by one day and non-deployable time related to birth and recovery by nearly eight days.

More than 470,000 women of child-bearing age are married to active-duty service members, and there are more than 120,000 dependents of troops who are over age 12. While many receive their medical care at military treatment facilities, some choose to use Tricare Select, a program that allows them to see non-military providers.

Roughly 3.1 million retirees under age 65 and their family members use the Tricare health program, roughly half of whom are women, some of child-bearing age.

Lawmakers said the change would improve the lives of women by giving them better control of their family planning decisions and their medical treatment, given that birth control is also used to address conditions like endometriosis, an overgrowth of tissue outside the uterus.

"Prioritizing access to contraception for servicemembers and their dependents is an investment in their health and wellbeing and an investment in the stability of our Armed Forces," they wrote.

A Defense Department official declined to comment on the letter, telling Military.com that the department would respond directly to the lawmakers.

-- Patricia Kime can be reached at Patricia.Kime@Military.com. Follow her on Twitter @patriciakime

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