The annual National Defense Authorization Act (NDAA) process is still underway. The House and Senate have passed their versions of the FY 2021 bill, and we are waiting to learn when the bill will head into conference to resolve differences between the drafts.

MOAA’s Virtual Storming the Hill and Summer Storm events have focused on provisions in the House NDAA version that help ensure continued beneficiary access to high quality care as military health system (MHS) reform efforts move forward. You can still make your voice heard on those issues, but there are several other important provisions, supported by MOAA, that could lead to improvements in the health care benefit if they are included in the final legislation.

Maternity Care

Both the House and Senate versions require DoD to conduct a demonstration project to evaluate coverage of doulas and expanded coverage of lactation consultants under the TRICARE program. Doulas are trained professionals who provide physical and emotional support during labor, delivery and the early postpartum time.

MOAA supports this effort to provide additional resources to servicemembers and spouses who often deliver without the support of their spouse, family, and friends due to geographic separation. The demonstration will evaluate this coverage expansion in terms of cost, quality of care and impact on maternal and fetal outcomes.

[RELATED: Spouse and Family Resources From MOAA]

Both chambers also included provisions to conduct a study on the availability of prenatal and postpartum mental health care for servicemembers and their dependents. MOAA supports the Senate requirement of a Government Accountability Office (GAO) report on access to mental health care as well as the incidence of prenatal and postpartum mental health conditions among servicemembers and their dependents relative to the civilian population. We recommend the conferees include House language on barriers that prevent active duty servicemembers and spouses from seeking mental health care, and how DoD is addressing those barriers.

Other TRICARE Coverage

Because TRICARE coverage is governed by statute, it is often necessary to pass a law to update TRICARE policy to keep up with evolving technologies and treatment protocols. MOAA supports provisions in the House version of the NDAA that would address TRICARE coverage issues:

• Section 704 includes digital breast tomosynthesis (3D mammography) as a TRICARE-covered benefit for breast cancer screening. The procedure is already covered for diagnostic purposes and as a provisional benefit for screening.
• Section 707 expands eligibility for hearing aids at MTFs to dependents of reserve component members enrolled in TRICARE Reserve Select.
• Section 747 requires DoD to do a report to Congress on the feasibility, efficacy, and cost of expanding coverage for chiropractic care to TRICARE beneficiaries.

MOAA has long advocated to fix this chiropractic coverage gap. While we appreciate that servicemembers have access to chiropractic care in many military treatment facilities, we are concerned beneficiaries face a barrier to accessing chiropractic care given TRICARE’s lack of coverage.

Chiropractic has become a standard of care for pain management, particularly as the opioid epidemic highlights the risks of relying on pharmaceuticals. We are confident a report to Congress will provide additional support for coverage expansion.

[RELATED: TRICARE Users Get Discounts on Chiropractic Care, Gym Memberships in Pilot Program]

While MOAA remains vigilant to protect beneficiaries from disproportionate TRICARE out-of-pocket cost increases, we are also dedicated to ensuring the military health care benefit keeps up with evolving technology and treatment protocols and meets the unique needs of military families.