Pass the Stop Copay Overpay Act
Recommendation
Congress should pass the Stop Copay Overpay Act, which would prohibit the Department of Defense (DOD) from charging TRICARE enrollees a co-pay exceeding a certain rate for an outpatient visit for mental health and substance use disorders (MH/SUD). Specifically, the co-payment amount should not exceed a co-pay charged under the TRICARE program for an outpatient visit for primary care services.[1][2]
Background/summary
Over nine million people use TRICARE to provide for their healthcare needs, which includes coverage for MH/SUD services.[2] Copays under TRICARE have been increasing[3] and are higher than those under the Federal Employee Health Benefits (FEHB) program and some commercial plans.[3] The current lack of parity between copayments for outpatient MH/SUD visits and primary care outpatient visits must be addressed. Discriminatory cost barriers should not be a reason why someone does not receive the MH/SUD care they need.[2] To address reduce these costs on active military families, Congress should pass the Stop Copy Overpay Act.[1][2]
citations
1. Stop Copay Overpay Act. HR. 4824 (Houlahan-Reschenthaler), 117th Congress (2021-2022). Last Accessed August 4, 2023.
2. “Rep. Reschenthaler Introduces Bipartisan Stop Copay Overpay Act to Reduce Health Care Costs for Veterans and Their Families.” Last Updated July 29, 2021.
3. Ruedisueli, Karen. “Mental Health Care: MOAA Works to Rein in TRICARE Costs.” Military Officers Association of America. Last Accessed August 4, 2023.