FY2010 National Defense Authorization Act: Selected Military Personnel Policy Issues
Congressional research reportNov 10, 2009
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FY2010 National Defense Authorization Act:
Selected Military Personnel Policy Issues
*name redacted*, Coordinator
Analyst in Defense Health Care Policy
*name redacted*
Specialist in Military Manpower Policy
*name redacted*
Specialist in Military Manpower Policy
*name redacted*
Specialist in Military Manpower Policy
November 10, 2009
Congressional Research Service
7-....
www.crs.gov
R40711
CRS Report for Congress
Prepared for Members and Committees of Congress
FY2010 National Defense Authorization Act: Selected Military Personnel Policy Issues
Summary
Military personnel issues typically generate significant interest from many Members of Congress
and their staffs. Ongoing military operations in Iraq and Afghanistan, along with the emerging
operational role of the Reserve Components, further heighten interest in a wide range of military
personnel policies and issues.
The Congressional Research Service (CRS) selected a number of the military personnel issues
considered in deliberations on the House-passed and Senate passed-versions of the National
Defense Authorization Act for FY2010 (P.L. 111-84). This report provides a brief synopsis of
sections that pertain to personnel policy. It includes background information and a discussion of
the issue, along with a table that contains a comparison of the bill (H.R. 2647) passed by the
House on June 25, 2009, the version of this bill passed by Senate on July 23, 2009, and the
version signed into law on October 28, 2009. Where appropriate, other CRS products are
identified to provide more detailed background information and analysis of the issue. For each
issue, a CRS analyst is identified and contact information is provided. Note: some issues were
addressed in the FY2009 National Defense Authorization Act and discussed in CRS Report
RL34590, FY2009 National Defense Authorization Act: Selected Military Personnel Policy
Issues, coordinated by (name redacted), concerning that legislation. Those issues that were
previously considered in CRS Report RL34590 are designated with a “*” in the relevant section
titles of this report.
This report focuses exclusively on the annual defense authorization process. It does not include
appropriations, veterans’ affairs, tax implications of policy choices or any discussion of separately
introduced legislation.
Congressional Research Service
FY2010 National Defense Authorization Act: Selected Military Personnel Policy Issues
Contents
Background ................................................................................................................................1
*Active Duty End Strengths ........................................................................................................2
*Military Pay Raise.....................................................................................................................4
Expansion of Concurrent Receipt ................................................................................................5
Tricare Standard Inpatient Cost-Share .........................................................................................6
Inclusion of Qualifying Service Since September 11, 2001, in Calculating Eligibility for
Early Receipt of Reserve Retired Pay.......................................................................................7
Prohibition on Recruiting or Retaining Individuals Associated with Hate Groups ........................8
Earlier Tricare Prime Eligibility for Certain Reservists .............................................................. 10
Post-Deployment Mental Health Screening ............................................................................... 11
Constructive Eligibility for Tricare Benefits for Individuals Otherwise Ineligible Under
Retroactive Determination of Medicare Part A Entitlement ..................................................... 12
Tricare Coverage for Certain Members of the Retired Reserve Who Are Not Yet Age 60 ........... 13
Chiropractic Health Care for Members on Active Duty.............................................................. 14
Dental Care for Survivors.......................................................................................................... 15
Prohibition on Conversions of Military Medical Positions to Civilian and Dental
Positions ................................................................................................................................ 16
Cooperative Health Care Agreements Between Military Installations and Non-Military
Health Care Systems .............................................................................................................. 17
*Sexual Assault......................................................................................................................... 18
*Government Accountability Office Report on the Progress Made in Implementing
Recommendations to Reduce Domestic Violence in Military Families .................................... 20
*Internship Pilot Program for Military Spouses ......................................................................... 21
Language and Cultural Training ................................................................................................ 22
*Survivor Benefit Plan Offset and Dependency and Indemnity Compensation........................... 23
Supplemental Assistance Allowance.......................................................................................... 24
Retroactive Award of Army Combat Action Badge .................................................................... 25
Civilian Employer-sponsored Health Care for Retired Military Employees ................................ 26
Plan to Increase the Behavioral Health Capabilities of the Department of Defense..................... 27
Suicide Among Members of the Individual Ready Reserve........................................................ 28
Reform and Improvement of the Tricare Program...................................................................... 29
Tables
Table 1. Authorized Active Duty End Strengths ...........................................................................2
Congressional Research Service
FY2010 National Defense Authorization Act: Selected Military Personnel Policy Issues
Contacts
Author Contact Information ...................................................................................................... 31
Congressional Research Service
FY2010 National Defense Authorization Act: Selected Military Personnel Policy Issues
Background
Each year, the Senate and House Armed Services Committees report their respective versions of
the National Defense Authorization Act (NDAA). These bills contain numerous provisions that
affect military personnel, retirees and their family members. Provisions in one version are often
not included in another; are treated differently; or, in certain cases, are identical. Following
passage of these bills by the respective legislative bodies, a Conference Committee is typically
convened to resolve the various differences between the House and Senate versions.
In the course of a typical authorization cycle, congressional staffs receive many constituent
requests for information on provisions contained in the annual NDAA. This report highlights
those personnel-related issues that seem to generate the most intense congressional and
constituent interest, and tracks their status in the FY2010 House and Senate versions of the
NDAA. The National Defense Authorization Act for Fiscal Year 2010 began as H.R. 2647,
introduced in the House on June 2, 2009, reported by the House Committee on Armed Services
on June 18, 2009 (H.Rept. 111-166), and passed by the House on June 25, 2009. In the Senate,
the National Defense Authorization Act for Fiscal Year 2010, S. 1390, was introduced and
reported (S.Rept. 111-35) to the full Senate on July 2, 2009. On July 23, the Senate struck the text
of the House-passed H.R. 2647 and inserted the language of S. 1390 as amended and passed H.R.
2647 by unanimous consent.1 A conference report (H.Rept. 111-288) was filed on October 7. The
conference report was passed by the House on October 8, by the Senate on October 22, and was
signed into law on October 28, 2009 and became P.L. 111-84.
The entries under the headings “House-passed” and “Senate-passed” in the tables on following
pages are based on language in these bills, unless otherwise indicated.
Where appropriate, other CRS products are identified to provide more detailed background
information and analysis of the issue. For each issue, a CRS analyst is identified and contact
information is provided. Note: some issues were addressed in the FY2009 National Defense
Authorization Act and discussed in CRS Report RL34590, FY2009 National Defense
Authorization Act: Selected Military Personnel Policy Issues concerning that legislation. Those
issues that were previously considered are designated with a “*” in the relevant section titles of
this report.
1
Senate, Congressional Record, July 29, 2009, pp. S8287-SS8289.
Congressional Research Service
1
FY2010 National Defense Authorization Act: Selected Military Personnel Policy Issues
*Active Duty End Strengths
Background: The National Defense Authorization Act for Fiscal Year 2008 (P.L. 110-181)
authorized the Army to grow by 65,000 and the Marine Corps by 27,000, to respective end
strengths of 547,400 and 202,000 by FY2012. Successful recruiting efforts, aided by a downturn
in the U.S. economy, enabled the Army and Marine Corps to achieve these new end strength
targets three years earlier than originally projected. Even with these increases, the nation’s armed
forces, especially the Army and Marine Corps, continue to experience high deployment rates.
With relatively stable operations in Iraq and a significant increase in the number of
servicemembers deployed to Afghanistan during 2009, some members of Congress and a number
of observers have recommended a further increase in end strength, especially for the Army.
House-passed
Senate-passed
P.L. 111-84
Section 401 authorizes a total
baseline FY2010 end strength of
1,410,000 including 547,400 for
the Army, 328,800 for the Navy,
202,100 for the Marine Corps,
and 331,700 for the Air Force.
Section 401 of the Senate bill is
virtually identical to Section 401 of the
House bill.
Section 401 authorizes a total baseline
FY2010 end strength of 1,425,000
including 562,400 for the Army,
328,800 for the Navy, 202,100 for the
Marine Corps, and 331,700 for the Air
Force.
Section 403 authorizes, for each
of fiscal years (FYs) 2011 and
2012, an active-duty end strength
for the Army at a number greater
than the number otherwise
authorized by law up to the
FY2010 baseline plus 30,000.
Section 402 of the Senate bill
authorizes the Secretary of Defense
to establish an Army end strength
larger than that established in law for
FYs 2010, 2011 and 2012 up to 30,000
over the 2010 baseline.
Section 403 authorizes the Secretary
of Defense to temporarily increase
the Army’s end strength by 30,000 in
FY 2011 and 2012.
Discussion: With increased concern over the “dwell time” provided to servicemembers between
deployments and the projected end of the Army’s Stop Loss program in January 2010, service end
strengths remain a high visibility issue. Both 2010 national defense authorization bills provide the
same increases to baseline end strength (please see table below) and also allow the Army
temporary increases of 30,000 over the 2010 baseline in each of FYs 2011 and 2012. After the
House and Senate bills were passed, the Administration proposed an additional Army active duty
end strength increase of 15,000. The increase was approved by the Conference Committee and is
reflected in the 562,400 figure above.
Table 1. Authorized Active Duty End Strengths
2008 (P.L. 110-181)
2009 (P.L. 110-417)
2010 (P.L. 111-84)
Baseline Army
525,400
532,400
562,400
Baseline Navy
329,098
326,323
328,800
Baseline Marine Corps
189,000
194,000
202,100
Baseline Air Force
329,563
317,050
331,700
Baseline Subtotal
1,373,061
1,369,773
1,425,000
22,000a
30,000b
Temporary Army
Congressional Research Service
2
FY2010 National Defense Authorization Act: Selected Military Personnel Policy Issues
2008 (P.L. 110-181)
2009 (P.L. 110-417)
2010 (P.L. 111-84)
Temp. Marine Corps
13,000a
0
Temporary Subtotal
35,000
30,000
1,404,773
1,455,000
Grand Total
1,408,061
Note a: Temporary additional authority for 2009 and 2010 provided by Section 403 of P.L. 110-181.
Note b: Temporary additional authority for 2011 and 2012 provided by section 403 of P.L. 111-84.
The Congressional Budget Office (CBO) estimates the cost to DOD of the 2010 baseline increase
to be $31 billion over the FY2010-FY2014 period. CBO further estimates that the 30,000
temporary increase in Army active-duty end strength in FY2011 and FY2012 authorized by
Section 403 will raise costs for salaries and other expenses by roughly $2 billion in FY2011, $4
billion in FY2012, and $2 billion in FY2013.
References: Previously discussed in CRS Report RL34590, FY2009 National Defense
Authorization Act: Selected Military Personnel Policy Issues, coordinated by (name redacted),
page 5. See also CRS Report R40121, U.S. Military Stop Loss Program: Key Questions and
Answers, by (name redacted).
CRS Point of Contact (POC): Charles Henning, x7-.....
Congressional Research Service
3
FY2010 National Defense Authorization Act: Selected Military Personnel Policy Issues
*Military Pay Raise
Background: Ongoing military operations in Iraq and Afghanistan, highlighted by the significant
increase in the number of servicemembers deployed to Afghanistan, continue to focus interest on
the military pay raise. Title 37 U.S.C. 1009 provides a permanent formula for an automatic annual
military pay raise that indexes the raise to the annual increase in the Employment Cost Index
(ECI). The FY2010 President’s Budget request for a 2.9%% military pay raise was consistent
with this formula. However, Congress, in FYs 2004, 2005, 2006, 2008, and 2009 approved the
pay raise as the ECI increase plus 0.5%. The FY2007 pay raise was equal to the ECI.
House-passed
Senate-passed
P.L. 111-84
Section 601 supports a 3.4% (0.5%
above the President’s Budget)
across-the-board pay raise that
would be effective January 1,
2010.
Section 601 also supports a 3.4%
across-the-board pay raise effective
January 1, 2010.
Section 601 provides a 3.4% acrossthe-board pay raise effective January
1, 2010.
Discussion: A military pay raise larger than the permanent formula is not uncommon. In addition
to “across-the-board” pay raises for all military personnel, mid-year, “targeted” pay raises
(targeted at specific grades and longevity) have also been authorized over the past several years.
This year’s proposed legislation includes no mention of targeted pay raises. The Congressional
Budget Office (CBO) estimates the incremental cost of this larger raise would be about $350
million in FY2010 and $2.3 billion over the FY2010-FY2014 period.
Reference: Previously discussed in CRS Report RL34590, FY2009 National Defense
Authorization Act: Selected Military Personnel Policy Issues, coordinated by (name redacted),
page 6. See also CRS Report RL33446, Military Pay and Benefits: Key Questions and Answers,
by (name redacted).
CRS Point of Contact (POC): Charles Henning, x7-.....
Congressional Research Service
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FY2010 National Defense Authorization Act: Selected Military Personnel Policy Issues
Expansion of Concurrent Receipt
Background: “Concurrent receipt” allows some military retirees to receive both military
retirement benefits and disability compensation from the Department of Veterans Affairs (VA).
This practice was forbidden by law until 2004. The first time concurrent receipt legislation was
enacted was in FY2003, and successive legislation since then has extended concurrent receipt to
additional populations and further modified the program. There are two common criteria that
define eligibility for concurrent receipt: (1) all recipients must be military retirees and (2) they
must also be eligible for VA disability compensation. Beyond these common criteria, there are
separate and distinct components: (1) Combat-Related Special Compensation (CRSC) for those
with service-verified combat disabilities and (2) Concurrent Retirement and Disability Payments
(CRDP) for those with service-connected disabilities. A retiree cannot receive both CRSC and
CRDP. At present, all disabled retirees with combat-related disabilities rated at 10% or greater are
eligible for CRSC. However, two groups of retirees with service-connected disabilities are not
currently eligible: (1) Chapter 61 retirees (a reference to the chapter of Title 10 that governs
military disability retirement) who were determined to be unfit for continued military service and
generally due to service-connected (CRDP) disabilities prior to completing 20 years of service,
and (2) longevity retirees (those with 20 or more years of service) who have service-connected
(CRDP) disabilities rated at 40% or less.
The President’s FY2010 Budget request proposed a concurrent receipt expansion similar to that in
H.R. 2647. The House report on the FY2010 NDAA (H.Rept. 111-166) did not initially include
the provision. It was introduced separately as H.R. 2990, which passed the House on June 24,
2009. H.Res. 573, the rule which provided for consideration of H.R. 2647, added the text of H.R.
2990 to the end of H.R. 2647 where it appears as Division D.
House-passed
Senate-passed
P.L. 111-84
Section 121 of Division D includes
a phased expansion of concurrent
receipt eligibility that would
provide CRDP to Chapter 61
military retirees. In 2010 this
would include those with
disabilities rated as either 90 or
100% disabled; in 2011 to those
rated at 70 or 80%; in 2012 to
those rated at 50 or 60%; in 2013
to those rated at 30 or 40%; in
2014 to all Chapter 61 retirees
with a disability rating.
No similar provision.
The House-provision was not
adopted. However, the Joint
Explanatory Statement noted that,
“The Administration’s concurrent
receipt proposal was not included in
this bill as acceptable and specific
offsets were not proposed by the
Administration.”
Discussion: The House version of this proposed expansion of concurrent receipt would have been
effective on January 1, 2010, but was only funded for the first year. Many supporters of
expanding concurrent receipt expressed concern with the House version due to its scope and
implementation.
Reference: CRS Report R40589, Concurrent Receipt: Background and Issues for Congress, by
(name redacted).
CRS Point of Contact (POC): Charles Henning, x7-.....
Congressional Research Service
5
FY2010 National Defense Authorization Act: Selected Military Personnel Policy Issues
Tricare Standard Inpatient Cost-Share
Background: Prior to enactment of P.L. 111-84, 10 U.S.C. 1086(b)(3) required a copayment rate
of 25% of the cost of inpatient care for retirees, “except that in no case may the charges for
inpatient care for a patient exceed $535 per day during the period beginning on April 1, 2006, and
ending on September 30, 2009.” When the exception expired on September 30, 2009, DOD
announced that the per diem rate would again increase to a rate equal to 25% of the cost of
inpatient care. This would have increased the inpatient cost share for retirees younger than 65 and
their family members to $645 a day, or 25% of total hospital charges, whichever was less.
House-passed
Senate-passed
P.L. 111-84
No similar provision.
Section. 706 expressed the sense
of the Senate that in the past, the
Department of Defense has
proposed fee increases on certain
military health care beneficiaries in
order to cover the growing cost of
health care, that the Department
has additional options to constrain
the growth of health care spending,
and that it should consider such
options rather than increasing
certain fees.
Section 709 extends for 1 year
the limitation on charges for
inpatient care in a civilian hospital
under TRICARE Standard.
Discussion: The Conference Committee adopted language to extend the existing freeze on
inpatient copayment increases until September 30, 2010. This will preclude the Tricare Standard
inpatient copay increase for retirees, family members, and survivors under age 65 by $110 per
day, from $535 to $645. DOD did not actually implement the increase prior to enactment of P.L.
111-84 so no beneficiary should have been adversely affected in any way.
References: None.
CRS Point of Contact (POC): Don Jansen, x7-.....
Congressional Research Service
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FY2010 National Defense Authorization Act: Selected Military Personnel Policy Issues
Inclusion of Qualifying Service Since September 11,
2001, in Calculating Eligibility for Early Receipt of
Reserve Retired Pay
Background: Active duty military personnel are eligible for full retirement benefits after 20
creditable years of active duty, regardless of their age. Reservists are also eligible to retire after 20
years of qualifying service, but until recently they could not receive retired pay or access to
retiree health benefits until age 60. The National Defense Authorization Act for FY2008 (P.L.
110-181) contained a provision which permitted certain reservists to draw retired pay as early as
age 50, while maintaining the age for access to the military health care system at 60. This
provision reduced the age for receipt of retired pay for members of the Ready Reserve by three
months for each aggregate of 90 days of specified duty performed. Specified duty includes active
duty under any provision of law referred to in 10 USC 101(a)(13)(B), active duty under 10 USC
12301(d); or active service under 32 USC 502(f) if responding to a national emergency declared
by the President or supported by federal funds. However, the provision only applied to duty
performed after January 28, 2008 (the date of enactment of P.L. 110-181). Some have argued that
this date unfairly excludes service performed prior to that date, particularly service performed
after September 11, 2001, when reservists were heavily used in Iraq, Afghanistan, and other
overseas locations.
House-passed
Senate-passed
P.L. 111-84
No similar provision.
Section 660 of the Senate bill would
amend Section 12731(f)(2)(A) of
Title 10 to include qualifying service
performed since September 11,
2001, in calculating the eligibility of
an individual to receive reserve
retired pay prior to age 60.
No statutory language was included.
However, the conference report
states: “the conferees would
support the provision provided that
acceptable offsets are identified
consistent with budgetary
requirements of both the Senate
and the House of Representatives.”
Discussion: The Senate provision would have expanded the time frame in which qualifying duty
performed by reservists could be counted towards early receipt of retired pay by including any
such duty performed since September 11, 2001. Given the large number of reservists who
performed qualifying duty between September 11, 2001, and January 28, 2008, this would have
significantly increased the number of reservists eligible to receive retired pay prior to age 60. The
Senate provision was not included in the final bill, although the conferees indicated they would
support the provision if sufficient budgetary offsets were identified.
Reference(s): CRS Report RL30802, Reserve Component Personnel Issues: Questions and
Answers, by (name redacted).
CRS Point of Contact (POC): (name redacted) at x7-.... or Charles Henning at x7-.....
Congressional Research Service
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FY2010 National Defense Authorization Act: Selected Military Personnel Policy Issues
Prohibition on Recruiting or Retaining Individuals
Associated with Hate Groups
Background: While the Department of Defense and the Military Services have regulations
prohibiting the recruiting or retention of those who participate in extremist activities, 2 critics have
argued that the military has not effectively enforced these provisions, leading to the infiltration of
violent extremists—including white supremacists—into the armed forces. Defense officials have
stated that racist or extremist behaviors are not tolerated in the military.
House-passed
Senate-passed
P.L. 111-84
Section 524 would amend 10 USC
504 to specify that “A person
associated or affiliated with a group
associated with hate-related violence
against groups or persons or the
United States government, as
determined by the Attorney General
may not be recruited, enlisted, or
retained in the armed forces.” It
prohibits recruiters from enlisting
anyone associated with a hate group.
It also requires the immediate
discharge of military personnel found
to be associated with a hate group,
though it provides an exception for
those who have renounced a
previous association.
No similar provision.
Section 516 requires the Secretary
of Defense, in consultation with the
Attorney General, to submit a
report to the House and Senate
Armed Services Committees on “any
active participation by members of
the Armed Forces in prohibited
activities (as defined by subsection
3.5.8 of Department of Defense
Directive 1325.6)” and “the policies
of the Department of Defense to
prevent individuals who are active
participants in such activities from
enlisting in the Armed Forces.”
Requires the Service Secretaries to
submit an annual report to the
House and Senate Armed Services
Committees on the presence in the
armed forces of persons associated
with hate groups, the actions of the
Secretary to discharge such
members, and the actions of the
Secretary of prevent such persons
from enlisting.
Discussion: The House provision would have statutorily prohibited the recruitment, enlistment,
or retention of individuals who are associated with a “group associated with hate-related
violence” or a “hate group.” These terms were defined to encompass seven meanings, the
broadest of which appears to be “groups or organizations engaged in criminal gang activity
including drug and weapons trafficking and smuggling.” The provision specified the evidence—
such as tattoos, meeting attendance, online activity, and written material—which demonstrated
hate group association. Those already in the military who had renounced a previous affiliation
with a hate group would have been exempted from separation. There was no exemption for those
2
DOD Directive 1325.6, 3.5.8; Army Regulation (AR) 600-20, 4-12; AR 601-210, 4-2(e)(i)(a)(9); Navy Regulations,
Ch. 11, Art. 1167; Navy Recruiting Command Instruction 1130.8H, Vol I, Ch. 1, Sec. 4, p. 4; Air Force Instruction
(AFI) 51-903, 5; AFI 36-2002, Att. 2; Marine Corps Order (MCO) 5370.4B; MCO P1100.72C, 3-85, 3-146 to 148.
Congressional Research Service
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FY2010 National Defense Authorization Act: Selected Military Personnel Policy Issues
seeking to join the military who have renounced a previous affiliation, which could have affected
recruiting in neighborhoods where some form of criminal gang affiliation by teenagers is
relatively common. The final bill does not incorporate the prohibitions of the House provision,
but Section 716 does require a report from the Secretary of Defense on any active participation by
military personnel in supremacist organizations or illegal discriminatory activities, and the
policies in place to prevent such individuals from enlisting in the military.
Reference(s): None.
CRS Point of Contact (POC): (name redacted), x7-.... or Dave Burrelli at x7-.....
Congressional Research Service
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FY2010 National Defense Authorization Act: Selected Military Personnel Policy Issues
Earlier Tricare Prime Eligibility for Certain
Reservists
Background: Since September 11, 2001, the United States has activated hundreds of thousands
of reservists for service in the United States, Afghanistan, Iraq and elsewhere. In response to this,
both Congress and the executive branch have taken a variety of actions to smooth the transition of
reservists from civilian to military status and back. In 2003, Congress provided reservists with
early access to Tricare Prime for reservists for up to 90 days prior to the projected date of
activation if they had received “delayed-effective-date active-duty orders.” “Delayed-effectivedate active-duty orders” were defined as “an order to active duty for a period of more than 30
days in support of a contingency operation under a provision of law referred to in Section
101(a)(13)(B) of [Title 10] that provides for active duty service to begin under such order on a
date after the date of the issuance of the order.”
House-passed
Senate-passed
P.L. 111-84
Section 706 amends 10 USC 1074 to
extend the period of early Tricare
Prime coverage from a maximum of
90 days to a maximum of 180 days
prior to the projected date of
activation if they have received
“delayed-effective- date active-duty
orders” or if they have received
official notification from their Service
Secretary that such orders are
forthcoming.
No similar provision
The House provision was adopted
with a technical change.
Discussion: This provision will extend the period of early Tricare access to as much as 180 days
prior to the projected activation date and provides such access upon “official notification” that
orders are forthcoming. “Official notification” is defined as “a memorandum from the Secretary
concerned that notifies a unit or a member of a reserve component of the armed forces that such
unit or member shall receive a delayed-effective-date active-duty order.”
The Congressional Budget Office (CBO) estimated that this expanded authority will cost about
$92 million in FY2010. In total, CBO estimated that the provision will cost $347 million over the
FY2010-FY2014 period.
Reference(s): CRS Report RL33537, Military Medical Care: Questions and Answers, by (name r
edacted).
CRS Point of Contact (POC): (name redacted), x7-.... or (name redacted), x7-.....
Congressional Research Service
10
FY2010 National Defense Authorization Act: Selected Military Personnel Policy Issues
Post-Deployment Mental Health Screening
Background: Department of Veterans Affairs (VA) researchers have shown that the prevalence of
new mental health diagnoses among OEF/OIF veterans using VA health care increased rapidly
following the Iraq invasion. One recent study reported:
Of 289,328 Iraq and Afghanistan veterans, 106,726(36.9%) received mental health
diagnoses; 62,929 (21.8%) were diagnosed with posttraumatic stress disorder (PTSD) and
50,432 (17.4%) with depression. Adjusted 2-year prevalence rates of PTSD increased 4 to 7
times after the invasion of Iraq. Active duty veterans younger than 25 years had higher rates
of PTSD and alcohol and drug use disorder diagnoses compared with active duty veterans
older than 40 years.3
Addressing these needs has been area of high Congressional concern for several years.
House-passed
Senate-passed
P.L. 111-84
Section 709 would require
DOD to conduct a
demonstration project at
two military installations to
assess the feasibility and
efficacy of providing service
members returning from a
deployment with in-person
mental screenings by a
mental health provider
followed by a telephone
contact from a case
manager at 6, 12, 18, and 24
month intervals.
Section 711 would require the
Secretary of Defense to issue
guidance for the provision of a
person-to-person mental health
assessment for each service
member deployed in connection
with a contingency operation
during the 60-day period prior to
deployment, between 90 and 180
days after return from deployment,
and then again at 6, 12, and 24
month intervals.
Section 708 requires the
Secretary of Defense to issue
guidance for the provision of a
person-to-person mental health
assessment for each service
member deployed in connection
with a contingency during the 60day period before the date of
deployment, between 90 and 180
days after return from
deployment, and then again at 6,
12, and 24 months. The purpose
of the mental health assessments
is to identify post-traumatic stress
disorder, suicidal tendencies, and
other behavioral health
conditions.
Discussion: Based upon deployment statistics and the timing of existing health assessment
requirements, the CBO estimated that Senate Section 711 would result in an additional 150,000
mental health assessments annually for each of the next few years. CBO estimated that the total
additional cost to DOD of Section 711 would be $45 million over the FY2010-FY2014 period. A
cost estimate is not available for House Section 709.
Reference(s): Congressional Budget Office, Cost Estimate for S. 1390, National Defense
Authorization Act for Fiscal Year 2010, as reported by the Senate Committee on Armed Services
on July 2, 2009. July 14, 2009, p. 11, http://www.cbo.gov/ftpdocs/104xx/doc10459/s1390.pdf.
CRS Point of Contact (POC): Don Jansen, x7-.....
3
Karen H. Seal, Thomas J. Metzler, and Kristian S. Gima, et al., “Trends and Risk Factors for Mental Health
Diagnoses Among Iraq and Afghanistan Veterans Using Department of Veterans Affairs Health Care, 2002–2008,”
American Journal of Public Health, July 16, 2009, pp. 1651-1658.
Congressional Research Service
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FY2010 National Defense Authorization Act: Selected Military Personnel Policy Issues
Constructive Eligibility for Tricare Benefits for
Individuals Otherwise Ineligible Under Retroactive
Determination of Medicare Part A Entitlement
Background: 10 U.S.C. 1086(d) provides that a person who is entitled to Medicare Part A
hospital insurance is not eligible for Tricare unless the individual is enrolled in the Medicare Part
B. When a Tricare beneficiary becomes eligible for Medicare, Medicare becomes the primary
payer and Tricare is the secondary payer. Retroactive Medicare eligibility determinations
therefore cause DOD and Medicare to reprocess claims.
House-passed
Senate-passed
P.L. 111-84
No similar provision.
Section 703 would amend 10 USC 1086(d)
to exempt Tricare beneficiaries under the
age of 65 who become Medicare eligible
due to a retroactive disability determination
from the requirement to enroll in Medicare
Part B for the retroactive months of
entitlement to Medicare Part A in order to
maintain Tricare coverage. Tricare would
remain the first payer for any claims filed
during the retroactive months.
The Senate provision
was adopted as
Section 706.
Discussion: CBO estimated that about 1,500 retroactive Medicare determinations are made for
Tricare beneficiaries annually and that on average each determination is retroactive for two
months. CBO estimated that Section 703 would require additional appropriations of about $4
million per year.
Reference(s): Congressional Budget Office, Cost Estimate for S. 1390, National Defense
Authorization Act for Fiscal Year 2010, as reported by the Senate Committee on Armed Services
on July 2, 2009. July 14, 2009, p. 11, http://www.cbo.gov/ftpdocs/104xx/doc10459/s1390.pdf
CRS Point of Contact (POC): Don Jansen, x7-.....
Congressional Research Service
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FY2010 National Defense Authorization Act: Selected Military Personnel Policy Issues
Tricare Coverage for Certain Members of the
Retired Reserve Who Are Not Yet Age 60
Background: Under current law, reserve component members who have completed 20 years of
service but have not yet reached the age of 60 (so called “grey-area” retirees), are not eligible for
Tricare benefits. This has traditionally been the policy because the individuals in this category
were “working-age” and were assumed to be able to obtain health insurance from their civilian
employer.
House-passed
Senate-passed
P.L. 111-84
Section 704 would amend Chapter
55 of Title 10 of the United States
Code by inserting a new section
1076e. The new section would
extend Tricare standard coverage
for certain members of the retired
reserve who are qualified for a nonregular retirement but are not yet
age 60. Eligible members would be
required to pay premiums equal to
the cost of coverage as determined
by the Secretary of Defense on an
appropriate actuarial basis.
Section 701 includes a similar provision.
Similar provision
adopted as Section
704.
Discussion: This provision will extend eligibility for Tricare Standard to members of the Retired
Reserve who are qualified for non-regular retirement but who are not yet age 60, and their
dependents. Eligibility would terminate when the member becomes eligible for Tricare coverage
as a retiree at age 60. Members would be responsible for paying a premium equal to the total cost
of coverage as determined by the Secretary of Defense, based on actual program costs.
The Congressional Budget Office (CBO) estimated the net cost to the government of this new
program will be “insignificant over the long-run.” DOD will incur start-up costs estimated to total
about $15 million over the FY2010-FY2011 period.
Reference(s): Congressional Budget Office, Cost Estimate for H.R. 2647 National Defense
Authorization Act for Fiscal Year 2010, as reported by the House Committee on Armed Services
on June 18, 2009. June 22, 2009. http://www.cbo.gov/ftpdocs/103xx/doc10341/hr2647.pdf
CRS Point of Contact (POC): Don Jansen, x7-.....
Congressional Research Service
13
FY2010 National Defense Authorization Act: Selected Military Personnel Policy Issues
Chiropractic Health Care for Members on Active
Duty
Background: Chiropractic is a health care approach that focuses on the relationship between the
body’s structure—mainly the spine—and its functioning. Although practitioners may use a variety
of treatment approaches, they primarily perform adjustments to the spine or other parts of the
body with the goal of correcting alignment problems and supporting the body’s natural ability to
heal itself. Research to expand the scientific understanding of chiropractic treatment is ongoing.
Section 702 of the Floyd D. Spence National Defense Authorization Act for Fiscal Year 2001
(P.L. 106-398) established the Chiropractic Care Program, replacing the former Chiropractic
Health Care Demonstration Program (CHCDP) that ended in Sept. 1999. Under this new program
60 military clinics and hospitals currently provide chiropractic care to active duty service
members. The current Chiropractic Care Program is only available to active duty service
members at designated military treatment facilities. A service member’s primary care manager
determines if chiropractic care is appropriate. Family members, retirees and their family
members, unremarried former spouses and survivors are not eligible for chiropractic care. They
may be referred to non-chiropractic health care services in the military health system (e.g.,
physical therapy or orthopedics) or may seek chiropractic care in the local community at their
own expense.
House-passed
Senate-passed
P.L. 111-84
Section 702 would require the
Secretary of Defense to provide
chiropractic services and benefits as
a permanent part of the Defense
Health Program, including the
Tricare program for all active duty
service members.
No similar provision.
Section 725 requires the Secretary
of Defense to provide for and report
on clinical trials to be conducted by
the National Institutes of Health or a
similar independent academic
institution to compare the outcomes
of chiropractic treatment, used
either exclusively or as an adjunct to
other treatments, with conventional
treatment, and to assess the effect of
chiropractic treatment on certain
service member groups.
The Secretary would also be
authorized to conduct one or more
demonstration projects to provide
chiropractic services to deployed
members of the uniformed services.
Discussion: The Conference Committee substituted language to provide for additional research
on the outcomes of chiropractic treatment for the House language that would have required
increased chiropractic service availability under Tricare. Under Section 725, clinics currently
providing chiropractic services would continue to do so.
Reference(s): None.
CRS Point of Contact (POC): Don Jansen, x7-.....
Congressional Research Service
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FY2010 National Defense Authorization Act: Selected Military Personnel Policy Issues
Dental Care for Survivors
Background: Under current law (10 U.S.C. 1076a(k)(3)) a dependent enrolled in the Tricare
dental program is no longer eligible for coverage after the end of the three-year period beginning
on the date of the death of the member upon which the dependent’s eligibility was based. Unlike
other survivor eligibility standards, exceptions are not provided for children until they reach age
21 or age 23 if enrolled in college.
House-passed
Senate-passed
P.L. 111-84
Section 703 would amend 10
U.S.C 1076a(k) to extend Tricare
dental benefits to the survivors of
members who die on active duty
until they reach the age of 21, or,
if they are still enrolled in college,
age 23.
Section 702 is similar to the
House provision.
Section 704 would amend 10
U.S.C 1076a(k) to extend
Tricare dental benefits to the
survivors of members who die
on active duty until they reach
the age of 21, or, if they are
still enrolled in college, age 23.
Discussion: This provision is intended to expand survivor eligibility under the Tricare dental
program so that it matches other Tricare survivor eligibility standards. CBO estimated this section
would allow about 7,000 additional survivors to receive dental benefits through the Tricare
program each year, at an annual cost of about $300 per person for an overall cost to DOD of $2
million per year.
Reference(s): Congressional Budget Office, Cost Estimate for H.R. 2647 National Defense
Authorization Act for Fiscal Year 2010, as reported by the House Committee on Armed Services
on June 18, 2009. June 22, 2009. http://www.cbo.gov/ftpdocs/103xx/doc10341/hr2647.pdf
CRS Point of Contact (POC): Don Jansen, x7-.....
Congressional Research Service
15
FY2010 National Defense Authorization Act: Selected Military Personnel Policy Issues
Prohibition on Conversions of Military Medical
Positions to Civilian and Dental Positions
Background: In previous years, the Defense Health Program appropriations request budgeted for
savings to be achieved by converting military medical positions to civilian positions. H.Rept. 111166 states without explanation that such conversions have had an adverse impact on the military
health system. Section 721 of the National Defense Authorization Act for Fiscal Year 2008 (P.L.
110-181) prohibited such conversions and required that any unfilled positions slotted for
conversion be restored to a military position. The Department of Defense budgeted for these
restorations in its 2010 appropriations request.
House-passed
Senate-passed
P.L. 111-84
Section 701 provides that the
Secretary of a military
department may not convert any
military medical or dental position
to a civilian medical or dental
position.
No similar provision.
Section 701 would extend the
current prohibition on the
conversion of military medical
or dental positions in Section
721 of the National Defense
Authorization Act for Fiscal
Year 2008 (P.L. 110-181) until
September 30, 2012.
In the case of any military medical
or dental position that was
converted to a civilian medical or
dental position during the period
beginning on October 1, 2004,
and ending on September 30,
2008, if the position was not filled
by a civilian by September 30,
2008, the Secretary of the military
department concerned must
restore the position to a military
position that may be filled only by
a member of the Armed Forces
who is a health professional.
Discussion: Section 701 of the House-passed bill would have extended a prohibition on
conversions of military medical and dental positions to civilian positions indefinitely. The
provision reenacts Section 721 of the National Defense Authorization Act for Fiscal Year 2008
(P.L. 110-181) but without an end date. The enacted provision extends the Section 721 provision
until September 30, 2012. The Bush Administration had opposed prohibitions on conversions
saying that they would eliminate the flexibility of the Secretary of Defense to use converted
positions to enhance the strength of operating units and would have an adverse impact on all
the services, especially the Army. Previous DOD budgets had recognized annual savings in
excess of $200 million from conversions.
Reference(s): None.
CRS Point of Contact (POC): Don Jansen, x7-.....
Congressional Research Service
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FY2010 National Defense Authorization Act: Selected Military Personnel Policy Issues
Cooperative Health Care Agreements Between
Military Installations and Non-Military Health Care
Systems
Background: Congress has enacted several provisions over the years to allow for the
establishment of cooperative health care arrangements between military installations and local
and regional non-military health care systems. Section 721 of the Ronald W. Reagan National
Defense Authorization Act for Fiscal Year 2005 (P.L. 108-375) required the Secretary of Defense
to conduct a pilot program at two or more installations for the purpose of testing initiatives that
build cooperative health care arrangements and agreements between military installations, and
local and regional non-military health care systems.
Section 707 of the National Defense Authorization Act for Fiscal Year 2008 (P.L. 110-181)
extended the pilot program through 2010 and pushed back the due date for a required final report
describing the results of the program with recommendations for a model health care delivery
system for other military installations until July 1, 2010.
DOD submitted an interim report on the two pilot programs it established under this authority to
Congress on July 30, 2007.4 This report provided an overview of a pilot project at Fort Drum, NY,
and at Yuma, AZ, where there is a Marine Corps facility and an Army proving ground.
House-passed
Senate-passed
P.L. 111-84
Section 705 would
authorize the Secretary of
Defense to establish
cooperative health care
arrangements and
agreements between
military installations and
local and regional nonmilitary health care systems.
No similar provision.
Section 713 would authorize the
Secretary of Defense to establish
cooperative health care
arrangements and agreements
between military installations and
local and regional non-military
health care systems.
Discussion: Cooperative arrangements between DOD and non-military health care systems may
offer opportunities for improved access to care for Tricare beneficiaries and to leverage Federal
health care resources in medically underserved areas by allowing support for hospitals and other
facilities in areas that might not feasibly support both a military health care facility and other
facilities. Unlike previous provisions, Section 713 is not-time limited. The enacted provision does
not authorize health care services at military medical treatment facilities to anyone who is not
otherwise eligible. The enacted provision also requires the Secretary of Defense to report on any
agreement formed.
Reference(s): None.
CRS Point of Contact (POC): Don Jansen, x7-.....
4
Available at:
http://www.tricare.mil/planning/congress/downloads/20070830/2007%20Reports%20to%20Congress/131553Update_to_Congress_on_the_Pilot_Program_for_Health_Care_Delivery_-_Coordinations_-_SIGNED.pdf.
Congressional Research Service
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FY2010 National Defense Authorization Act: Selected Military Personnel Policy Issues
*Sexual Assault
Background: DOD affords the victims of sexual assault the option of confidential reporting of
assaults to specified individuals and services including medical care, counseling and victim
advocacy, without initiating an investigation.
House-passed
Senate-passed
P.L. 111-84
Sec. 592 would require a
Comptroller General report on
the capacity of each military
service to investigate and
adjudicate allegations of sexual
assault, a sexual assault
prevention program developed by
the Secretary of Defense, a
report by the Secretary of
Defense evaluating the availability
of sexual assault forensic
examinations in combat zones,
and collection of statistical
information on the issuance of
military protective orders
involving either the victim or
alleged perpetrator of a sexual
assault.
Section 571would amend the
due date of the report on sexual
assault required by Section
776(e)(1) of the Ronald W.
Reagan National Defense
Authorization Act for Fiscal Year
2005 (P.L. 108-375) to
December 1, 2009.
The House-provision was
adopted as Section 767 with
minor changes.
The House Armed Services
Committee Report (H.Rept. 111116) notes that the committee is
concerned that when a sexual
assault report is made to certain
individuals (e.g. commanders, law
enforcement) by someone other
than the victim, the report may
trigger an investigation regardless
of the victim’s desire for
confidentiality. The committee
directs the Secretary of Defense
to develop a procedure to
provide the victim with
confidentiality in cases where the
assault is reported by someone
other than the victim or other
individuals covered under
confidential reporting. The
Committee also directs the
Secretary to report on the
availability and adequacy of
proper care for victims of sexual
assault.
Discussion: This provision will require by October 28, 2010: (1) a Comptroller General report on
the capacity of each military service to investigate and adjudicate allegations of sexual assault; (2)
a sexual assault prevention program developed by the Secretary of Defense; (3) a report by the
Secretary of Defense evaluating the availability of sexual assault forensic examinations in combat
Congressional Research Service
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FY2010 National Defense Authorization Act: Selected Military Personnel Policy Issues
zones; and (4) a collection of statistical information on the issuance of military protective orders
involving either the victim or alleged perpetrator of a sexual assault.
Reference(s): CRS Report RL34590, FY2009 National Defense Authorization Act: Selected
Military Personnel Policy Issues, coordinated by (name redacted), pp. 15-16.
CRS Point of Contact (POC): (name redacted), x7-.....
Congressional Research Service
19
FY2010 National Defense Authorization Act: Selected Military Personnel Policy Issues
*Government Accountability Office Report on the
Progress Made in Implementing Recommendations
to Reduce Domestic Violence in Military Families
Background: On May 24, 2006, the U.S. Government Accountability Office (GAO) released a
report entitled, “Progress Made in Implementing Recommendations to Reduce Domestic
Violence, but Further Management Action Needed (GAO-06-540).” DOD concurred with many
GAO recommendations in this report, but not all.
House-passed
Senate-passed
P.L. 111-84
Section 582 would require the
Comptroller General to review
and assess the progress of the
Department of Defense in
implementing the
recommendations contained in
GAO report GAO-06-540, and to
submit a report containing the
results of the review and
assessment to the congressional
defense committees.
No similar provision.
The House provision was
adopted as Section 768 with
changes. The Secretary of
Defense, rather than the
Comptroller General, is to
submit the report.
Discussion: Issues affecting military families have been of particular interest to Congress. The
review and assessment of recommendations concerning domestic violence affords both Congress
and the DOD information concerning the status of this issue. Congress had previously tasked
GAO with reporting on this topic. The conference report will require DOD to produce a report on
this issue.
Reference(s): CRS Report RL34590, FY2009 National Defense Authorization Act: Selected
Military Personnel Policy Issues, coordinated by (name redacted), page 21.
CRS Point of Contact (POC): (name redacted), x7-.....
Congressional Research Service
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FY2010 National Defense Authorization Act: Selected Military Personnel Policy Issues
*Internship Pilot Program for Military Spouses
Background: Many military spouses desire and seek employment. Obtaining such employment,
much less a career, is often hampered by frequent moves. It has been suggested that some
employers discriminate against military spouses in the hiring process because of their relatively
high turnover.
House-passed
Senate-passed
P.L. 111-84
Section 581 establishes an
internship pilot program and
reporting requirement for certain
military spouses to obtain federal
employment that could lead to
career portability and
enhancement.
No similar provision.
The House provision was
adopted as Section 764.
Discussion: This provision authorizes the Secretary of Defense to enter into agreements with the
heads of other federal agencies that have established internship programs to reimburse the agency
for costs associated with the first year of employment of an eligible military spouse who is
selected to participate in the agency’s internship program. All spouses would be eligible except
for those that are legally separated, already on active duty, or retired from the military.
Reference(s): CRS Report RL34590, FY2009 National Defense Authorization Act: Selected
Military Personnel Policy Issues, coordinated by (name redacted), page 10.
CRS Point of Contact (POC): (name redacted), x7-.....
Congressional Research Service
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FY2010 National Defense Authorization Act: Selected Military Personnel Policy Issues
Language and Cultural Training
Background: In recent years, both Congress and the Department of Defense have shown
significant interest in increasing the ability of military personnel to operate in foreign countries by
enhancing their cultural knowledge and foreign language proficiency. However, building these
language and cultural skills has proven challenging due to the intensive study required for
mastery and the competing demands of other training and operational requirements for currently
serving personnel.
House-passed
Senate-passed
P.L. 111-84
Section 534 requires the Secretary
of Defense to establish “at least
three Language Training Centers at
accredited universities, senior
military colleges, or similar
institutions of higher education to
create the foundational critical and
strategic language and regional area
expertise....” Members of the armed
forces, including reservists and
ROTC candidates, and DOD civilian
employees are authorized to
participate. Language Training
Centers must be established by
October 1, 2010; program authority
expires on September 30, 2015.
No similar legislative provision.
However, the committee report
(S.Rept. 111-35) included “Cultural
and language proficiency” as an item
of special interest and stated: “...the
committee urges the Department to
consider existing language and
cultural curriculum at universities
and colleges throughout the Nation
as an opportunity to augment
existing Department operated
programs. The committee directs
the Secretary of Defense to submit a
report 180 days after the date of
enactment of this Act on any plans
to leverage these programs in a
manner that compliments the
Department’s organic language and
cultural training programs.” (p. 131)
Section 529 permits the Secretary of
Defense “to establish language
training centers at accredited
universities, senior military colleges,
or other similar institutions of higher
education for purposes of
accelerating the development of
foundational expertise in critical and
strategic languages and regional area
studies....” Members of the armed
forces, including reservists and
ROTC candidates, and DOD civilian
employees are authorized to
participate.
Discussion: Where the House provision would have required the establishment of at least three
language training centers, Section 729 of the final bill simply permits the Secretary of Defense to
establish such centers. Under Section 729, a language training center would have to include the
following: 1) programs to provide that military personnel and DOD civilians who graduate from
the institution of higher education concerned include individuals with beginning through
advanced skills in the languages or area studies covered; 2) programs of language proficiency
training for military personnel and DOD civilians in critical and strategic languages tailored to
meet operational needs; 3) alternative language training delivery systems; 4) programs on critical
and strategic language that can be incorporated into ROTC programs; 5) training and education
programs to expand the pool of qualified instructors in critical and strategic languages and area
studies; 6) program to encourage native and heritage speakers of critical and strategic languages
to serve in the Department of Defense or the Civilian Linguist Reserve Corps. The Language
Training Centers are also authorized to partner with local educational agencies to help develop
critical and strategic language skills among elementary and secondary school students who may
pursue a military career. Section 529 also specifies certain reporting requirements if any language
training centers are established.
Reference(s): None.
CRS Point of Contact (POC): (name redacted), x7-.....
Congressional Research Service
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FY2010 National Defense Authorization Act: Selected Military Personnel Policy Issues
*Survivor Benefit Plan Offset and Dependency and
Indemnity Compensation
Background: A Survivor Benefit Plan (SBP)-eligible spouse who is also eligible for Dependency
and Indemnity Compensation (DIC) will have his or her SBP annuity reduced or offset on a
dollar-for-dollar basis by DIC. Last year, for certain beneficiaries, Congress created a new
survivor indemnity allowance to be paid to survivors of members who are entitled to retired pay,
or would be entitled to reserve component retired pay but for the fact that they (the members)
were not yet 60 years of age, effective October 1, 2008. This amount was $50 a month in FY2009
and increases each year since then by in $10 increments until FY2013; it was later extended to
2017.
House-passed
Senate-passed
P.L. 111-84
No similar provision.
Sec. 652 would repeal the
SBP/DIC offset proactively. This
Senate language prohibits the
recoupment of amounts
refunded to survivors due to the
original offset. Additionally, this
language would repeal the
optional annuity for children by
those affected by this offset.
Provision not adopted.
Discussion: The Senate language would have allowed eligible surviving spouses to receive both
SBP and DIC benefits.
Reference(s): CRS Report RL34590, FY2009 National Defense Authorization Act: Selected
Military Personnel Policy Issues, coordinated by (name redacted), pp. 19-20.
CRS Point of Contact (POC): (name redacted), x7-.....
Congressional Research Service
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FY2010 National Defense Authorization Act: Selected Military Personnel Policy Issues
Supplemental Assistance Allowance
Background: Under P.L. 106-398, Congress established a “Supplemental Subsistence Allowance
for Low-Income Members with Dependents.” This provision was intended to provide an
allowance to military families in lieu of benefits under the Department of Agriculture’s
Supplemental Nutrition Assistance Program (SNAP), commonly known as the Food Stamp
Program. The original amount authorized was up to $500 a month.
House-passed
Senate-passed
P.L. 111-84
No similar provision.
Sec. 603 increases the allowance
amount up to $1,100 a month. In
addition, the Secretary of
Defense is instructed to report
on a plan for eliminating the
need for military families to rely
on SNAP.
Section 602 increases the
allowance to $1,100 a month.
Discussion: The increased allowance will provide additional funds to military families otherwise
eligible for SNAP and recognizes increases in subsistence costs.
Reference(s): None.
CRS Point of Contact (POC): (name redacted), x7-.....
Congressional Research Service
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FY2010 National Defense Authorization Act: Selected Military Personnel Policy Issues
Retroactive Award of Army Combat Action Badge
Background: In World War II, (on October 7, 1943), the Army created the Combat Infantryman
Badge (CID) and the Expert Infantryman Badge (EIB) in recognition of the services and
sacrifices of infantrymen. These badges recognize those, mostly frontline, infantry members who
“saw the face of battle.” These awards were made retroactive to December 6, 1941. Among
Army personnel, these awards are highly coveted. Due to the nature of warfare in Iraq and
Afghanistan, the lack of a discernible front line meant that other Army personnel were exposed
to many of these same services and sacrifices. On May 2, 2005, the Army approved the Combat
Action Badge for members who personally engaged, or were engaged by, the enemy, and not
eligible for the CID or EIB. This award was made retroactive to September 18, 2001, the date
former-President Bush issued a “Declaration of National Emergency by Reason of Certain
Terrorist Attacks.”
House-passed
Senate-passed
P.L. 111-84
Section 575 of the House bill
would allow the Combat Action
Badge to be awarded to eligible
Army personnel for services
between December 7, 1941, the
beginning of U.S. involvement in
World War II, and September 18,
2001.
No similar provision.
Provision not adopted.
Discussion: The House bill would have provided for the retroactive award of the Combat Action
Badge.
Reference(s): None.
CRS POC: (name redacted), x7-.....
Congressional Research Service
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FY2010 National Defense Authorization Act: Selected Military Personnel Policy Issues
Civilian Employer-sponsored Health Care for
Retired Military Employees
Background: Section 707 of the John Warner National Defense Authorization Act for Fiscal Year
2007 (P.L. 109-364, October 17, 2006) amended Chapter 55 of Title 10 United States Code to add
a new section 1097c, prohibiting employers from offering their employees financial or other
incentives such as Tricare supplemental insurance to use Tricare rather than the employer’s group
health plan. The legislation mirrored a similar prohibition applicable to the Medicare program. As
with Medicare, employers can continue to offer “cafeteria benefit plans.” The legislation was
intended to address employer shifting of health-care costs to Tricare. After enactment, many
Tricare beneficiaries no longer were offered Tricare supplements as an employer-sponsored
benefit. Insurance companies that marketed such supplemental plans were also impacted by the
provision. There also is some question as to whether loss of employer-provided Tricare
supplemental insurance may have led Tricare beneficiaries to move from Tricare Standard to
Tricare Prime and the budgetary consequences to the Defense Health Program of such an
enrollment shift. On March 28, 2008, DOD published a proposed rule5 to implement the section
1097c provisions, however, the rule has not yet gone final. On December 31, 2008, DOD
published a notice6 of a proposed information collection that would require each employer that
offers a Tricare supplemental insurance plan to certify that the employer did not provide any
payment for the Tricare supplemental insurance nor receive any direct or indirect consideration
for offering the benefit. An employer offering such a benefit would be required to complete the
certification and to keep it on file for so long as the employer offers the supplemental plan.
House-passed
Senate-passed
P.L. 111-84
No similar provision.
Sec. 705 requires the Comptroller
General to report, no later than
March 31, 2010, on the
implementation of these
requirements with respect to the
relationship between Tricare and
certain civilian employer-sponsored
group health plans.
Section 727 requires the
Secretary of Defense to report
on the implementation of section
1097c of title 10, United States
Code.
The conferees express concern
that the Secretary of Defense has
not yet promulgated
implementing regulations for
section 1097c of title 10, United
States Code, which was effective
on January 1, 2008.
Discussion: Section 727 requires the Secretary of Defense to submit to the armed services
committees a report on the implementation of the requirements of Section 1097c of title 10,
United States Code, relating to the relationship between the Tricare program and employersponsored group health plans no later than March 31, 2010.
Reference(s): None.
CRS Point of Contact (POC): Don Jansen, x7-.....
5
Department of Defense, “Tricare; Relationship between the Tricare Program and Employer-Sponsored Group Health
Plans,” 73 Federal Register 16612, March 28, 2008.
6
Department of Defense, “Proposed Collection; Comment Requst,” 73 Federal Register 80368, December 31, 2008.
Congressional Research Service
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FY2010 National Defense Authorization Act: Selected Military Personnel Policy Issues
Plan to Increase the Behavioral Health Capabilities
of the Department of Defense
Background:. In February 2009, DOD reported to Congress on the status of mental health
provider staffing.7 DOD reported that it had contracted with the Center for Naval Analyses (CNA)
to conduct a validation of a 20+ factor model for evaluating the department’s mental health
provider needs. When released, this report should help determine the nature and extent of any
current shortage of mental health providers. Military mental health providers include
psychiatrists, doctoral-level psychologists, licensed clinical psychologists, and licensed clinical
social workers.
House-passed
Senate-passed
P.L. 111-84
No similar provision.
Section 722 would require the
Secretary of Defense to develop
and implement a plan to
significantly increase the number of
DOD military and civilian
behavioral health personnel.
Section 714 requires the
Secretary of each military
department to increase the
number of active-duty mental
health personnel authorized for
each department; requires the
Secretary of Defense to report
on the appropriate number of
mental health personnel required
to meet mental health care;
requires the Secretary to develop
and implement a plan to
significantly increase the number
of DOD military and civilian
mental health personnel; and
requires the Secretary to assess
establishing one or more military
mental health specialties.
Discussion: The enacted provision requires the service secretaries to increase the number of
active duty mental health personnel authorized by a formula provided in the section. The
Secretary of Defense is also required to submit to the congressional defense committees a report
on the appropriate number of mental health personnel required to meet the mental health care
needs of service members, retirees, and dependents, by October 28, 2010, and to develop and
implement a plan to significantly increase the number of military and civilian mental health
personnel of the Department of Defense by September 30, 2013.
Reference(s): None.
CRS Point of Contact (POC): Don Jansen, x7-.....
7
Assistant Secretary of Defense (Health Affairs), Report to Congress in Response to H.Rept. 110-146 for the National
Defense Authorization Act for Fiscal Year 2008, on Traumatic Brain Injury and H.Rept. 110-279 for Department of
Defense Appropriations Act for Fiscal Year 2008, on Post-Traumatic Stress Disorder, February 10, 2009, pp. 12-14,
http://www.tricare.mil/planning/congress/downloads/PTSD_09.pdf.
Congressional Research Service
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FY2010 National Defense Authorization Act: Selected Military Personnel Policy Issues
Suicide Among Members of the Individual Ready
Reserve
Background: Typically, most service members incur an 8-year military service obligation as part
of their original enlistment contract. Service members typically serve two to four years on active
duty, and then are transferred to the Individual Ready Reserve (IRR) to fulfill the remainder of
their obligation. IRR members generally are required to keep their Services informed of any
change in their medical status that might render them unfit to serve. Many members of the IRR
may have been deployed in contingency operations while on active duty. Some may be recalled to
active duty at a future date. There has been concern that some IRR members do not have access to
appropriate mental health care.
House-passed
Senate-passed
P.L. 111-84
Section 710A would require
a “counseling call” to all IRR
members by appropriately
trained personnel not less
than once every 90 days, as
long as they are in the IRR,
to determine the
“emotional, psychological,
medical, and career needs
and concerns of the
covered member.”
No similar provision.
The provision was not adopted.
Discussion: P.L. 111-84 did adopt a provision (Section 795) that would expand suicide
prevention efforts within the Yellow Ribbon Reintegration Program, a program to provide
community healing and suicide prevention services for National Guard and Reserve members. In
addition, as discussed above in the section titled “Post-Deployment Mental Health Screening,”
Section 708 of P.L. 111-84 requires both pre- and post-deployment person-to-person mental
health assessments for service members.
Reference(s): None.
CRS Point of Contact (POC): Don Jansen, x7-.....
Congressional Research Service
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FY2010 National Defense Authorization Act: Selected Military Personnel Policy Issues
Reform and Improvement of the Tricare Program
Background: S.Rept. 111-35 notes that the Senate Armed Services Committee is aware that “the
cost of the Defense Health Program will be a focus of the 2010 Quadrennial Defense Review and
believes that such focus is appropriate.” Of greater concern to the Committee, however, is that:
...satisfaction with Tricare is declining. Too much attention has been paid to increasing outof-pocket payments by retirees, and not enough to repairing persistent operational problems
that prevent beneficiaries from getting the care that they need, such as the lack of availability
of Tricare providers and cumbersome requirements for preauthorization and referral to
specialty care. Moreover, the fundamental goal of Tricare to maximize use of military
hospitals and clinics is not being achieved, as more and more care is being purchased in the
private sector. Problems with access to care in both military facilities and from civilian
providers needlessly compound the difficulties that military families face during extended
periods of deployment.8
DOD reports customer satisfaction trends in its annual evaluations of the Tricare program.9
House-passed
Senate-passed
P.L. 111-84
Section 713 would require
the Secretary of Defense to
submit a report on the
health care needs of military
family members, and require
the Secretary of the Army
to establish a pilot program
focused on the needs of
military children and
adolescents.
Sec. 559 and 560 would require the
Secretary to develop and
implement a plan to expand to
increase access to mental health
care for family members of the
National Guard and reserve
deployed overseas.
Sec. 721 requires the Secretary of
Defense to submit a report on
the health care needs of military
family members and to undertake
actions to enhance the capability
of the military health system and
improve the Tricare program to
include addressing access issues
for National Guard and reserve
members and their families and
those beneficiaries living in rural
areas.
Sec. 704 directs the Secretary of
Defense, in consultation with the
Secretaries of Health and Human
Services and Homeland Security to
undertake actions to reform and
improve the Tricare program.
The conferees note that private
sector care, which was originally
intended to be and is still
described by the DOD as a
program to fill gaps in the direct
care system, now accounts for
nearly 70% of DOD health care
expenditures.
Discussion: The enacted provision requires the Secretary of Defense to submit a report on the
health care needs of military family members and to undertake actions to enhance the capability
of the military health system and improve the Tricare program, to include addressing access
issues for National Guard and other reserve members and their families and those beneficiaries
living in rural areas. Section 721 also requires the Secretary to submit reports on the progress
made and future plans for improvement of the military health system, including the submission of
8
U.S. Congress, Senate Committee on Armed Services, 111th Cong., 1st Sess., S.Rept. 111-35 (Washington: GPO,
2009), p. 142.
9
Department of Defense, Evaluation of the Tricare Program FY 2009, April 6, 2009, p. 48,
http://www.tricare.mil/planning/congress/downloads/TRICARE%20Program%20Effectiveness%20(FY09).pdf.
Congressional Research Service
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FY2010 National Defense Authorization Act: Selected Military Personnel Policy Issues
a report together with budget materials submitted to Congress in support of the DOD budget for
FY2012.
Reference(s): None.
CRS Point of Contact (POC): Don Jansen, x7-.....
Congressional Research Service
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FY2010 National Defense Authorization Act: Selected Military Personnel Policy Issues
Author Contact Information
(name redacted), Coordinator
Analyst in Defense Health Care Policy
[redacted]@crs.loc.gov, 7-....
(name redacted)
Specialist in Military Manpower Policy
[redacted]@crs.loc.gov, 7-....
(name redacted)
Specialist in Military Manpower Policy
[redacted]@crs.loc.gov, 7-....
(name redacted)
Specialist in Military Manpower Policy
[redacted]@crs.loc.gov, 7-....
Congressional Research Service
31
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