Final NDAA Would Halt Military Medical Billet Reductions

Final NDAA Would Halt Military Medical Billet Reductions
Photo by Steve Pivnick/Air Force

After leading the charge on the military medical billet reduction issue, MOAA was gratified to see the fiscal year 2020 NDAA conference report includes a provision halting these manpower cuts until DoD and the services demonstrate they have addressed all readiness and beneficiary care impacts via reviews and analyses as well as mitigation and outreach plans.


The NDAA passed the House on Dec. 11, and while it still requires passage in the Senate and President Donald Trump’ signature, we are one step closer to suspending billet reductions. Without MOAA’s leadership and the excellent efforts of our military and veteran service organization partners in The Military Coalition, medical billet cuts may have moved forward until it was too late to avoid critical gaps in operational requirements and beneficiary health care services.


[TAKE ACTION: Ask Your Senator to Support the 2020 NDAA]


Plans for cutting approximately 18,000 medical billets were first revealed last March in the Department of Defense FY2020 Budget proposal. MOAA spent the next several months raising concerns about medical readiness and beneficiary care with senior officials in the Defense Health Agency (DHA), the Services’ medical departments and on Capitol Hill, where we met with professional staff from the House and Senate Armed Services Committees as well as dozens of member offices. MOAA members also massively mobilized and sent more than 23,000 letters sending a clear message of concern and the need for legislative action.



Lt. Gen. Ronald Place, USA, head of the Defense Health Agency, speaks with Karen Ruedisueli, MOAA's director of government relations for health affairs, and MOAA President and CEO Lt. Gen. Dana Atkins, USAF (Ret).


Section 719 in the NDAA includes MOAA’s recommendations for detailed analyses, metrics and mitigation plans before any reduction or realignment of medical personnel. Specifically, the provision prohibits DoD and the Services from reducing medical end strength authorizations until they complete:


1. A review of medical manpower requirements of each military department under all national defense strategy scenarios.

2. An analysis of affected billets together with mitigation plans to address potential gaps in health care services.


3. Metrics to determine TRICARE network adequacy; and


4. Outreach plans for affected beneficiaries, including transition plans for continuity of health care services.


The inclusion of Sec. 719 in the FY20 NDAA follows the first ever Military Health System Reform hearing since Congress passed the bulk of reform legislation with the FY17 NDAA. In a show of bipartisan support for service members, military retirees and their families, HASC Personnel Subcommittee Chairwoman Rep. Jackie Speier and Ranking Member Rep. Trent Kelly put the spotlight on numerous MHS Reform concerns. Testifying before the HASC panel were senior leaders from across DoD responsible for MHS Reform implementation, including the Assistant Secretary of Defense for Health Affairs, the Services Surgeons General, the Joint Staff Surgeon, and the DHA Director. We were gratified both Speier and Kelly demanded answers from DoD on a host of concerns MOAA has raised over the past several months.


In her opening remarks, Speier summed up the surprise many advocates felt when they first heard about proposed medical billet reductions: “I was baffled as to why this request was submitted when the Services and the Joint Staff had not completed the analysis of the operational requirements for supporting combatant commanders…It appeared to me that this proposal prioritized cost cutting over operational needs and common sense.”


Kelly echoed MOAA’s fears that DoD has not conducted sufficient analysis on the availability of civilian care in the TRICARE network when he said, “I believe the department may be viewing this as a cost savings exercise when the actual purpose is to improve efficiency and health care quality. It is crucial that prior to any reduction in MTF services that DoD fully understand the civilian network capability to absorb those patients.”


The day after testifying at the MHS Reform Hearing, Lt. Gen. Ronald Place, DHA Director, visited MOAA’s offices to meet with MOAA President and CEO, Lt. Gen. Dana Atkins, and members of our government relations and senior leadership teams. They discussed DHA and MOAA key priorities and challenges, as well as MOAA’s concerns about MHS Reform. The meeting solidified our collaborative relationship and set the stage for working together to achieve our mutual goal of quality health care for our service members, military retirees and their families.


The FY20 NDAA provision halting medical billet cuts is not the end of the fight. MOAA’s work last year engaged many members of Congress on the MHS Reform issue and provides a solid foundation for a robust 2020 engagement strategy on this and many other MHS reform related issues. If you have any questions or concerns about MHS Reform, please send them to

Related Content

About the Author

Karen Ruedisueli
Karen Ruedisueli

Ruedisueli is MOAA’s Director of Government Relations for Health Affairs and also serves as co-chair of The Military Coalition’s (TMC) Health Care Committee. She spent six years with the National Military Family Association, advocating for families of the uniformed services with a focus on health care and military caregivers.