Bill Overview
Title: Financial Relief for Civilians Treated at Military Hospitals Act
Description: This bill prohibits the Department of Defense (or the military departments) from attempting to collect a debt owed by a civilian not covered under TRICARE for certain emergency medical treatment at a military medical treatment facility. The bill also prohibits a military medical treatment facility from charging any fee for certain emergency medical treatment provided to a civilian who is not covered under TRICARE, or a third-party payer of such civilian (e.g., Medicare).
Sponsors: Rep. Castro, Joaquin [D-TX-20]
Target Audience
Population: Civilians receiving emergency care at military hospitals not covered by TRICARE
Estimated Size: 1500000
- Civilians sometimes need emergency medical treatment and are taken to military hospitals because they're the nearest or most able to provide care.
- Military hospitals traditionally charge civilians for medical care even if those charges pose significant financial difficulties, unless they're covered by a military insurance program such as TRICARE.
- TRICARE doesn't cover non-military personnel typically; hence, a large number of civilians not covered by TRICARE may face out-of-pocket costs at military facilities.
- The bill specifically targets civilians who receive emergency care and are billed by military hospitals; it eliminates these costs for non-TRICARE covered individuals.
- Considering that the US has a very large civilian population, a subset of which could have emergency medical situations each year and be taken to military facilities, the global impact could be significant.
- Millions of civilians live near military installations across the world, and while specifics might vary country to country, there remains a potential for emergency care to be needed and fall under the financial assistance outlined in this legislation.
Reasoning
- The policy affects a specific subset of the civilian population – those who receive emergency care at military facilities and are not covered under TRICARE. However, it does not universally apply to all civilians, as it specifically addresses emergency medical services.
- Not everyone in the US lives near a military base, thus the likelihood of being affected by this policy is higher among individuals living in proximity to such facilities, particularly in emergency situations where the nearest medical facility might be a military hospital.
- The policy could relieve significant financial burdens from individuals who currently might face unpredictable and high medical costs due to emergency treatments. This could improve their wellbeing by reducing stress and financial difficulty.
- A vast majority of the US population utilizes civilian healthcare facilities or are covered by insurance policies that collaborate with civilian institutions, meaning the impact of this policy might be restricted to a relatively smaller group.
- Wellbeing changes resulting from this policy could be measured over a short span if the individuals have recently accessed military healthcare for emergencies and experienced financial relief because of this policy.
- People currently dealing with debts due to past medical bills from military hospitals would benefit greatly from immediate relief once those debts are cancelled, making the policy impact visible even from year one.
Simulated Interviews
Office Manager (Virginia Beach, VA)
Age: 34 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 6/20
Statement of Opinion:
- I'm always worried about unexpected costs, like if one of my kids needs urgent care and the closest hospital is on the base.
- This policy would mean I don't have to worry about getting a bill I can't afford after an emergency visit.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 6 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 7 | 5 |
| Year 20 | 7 | 5 |
Construction Worker (San Diego, CA)
Age: 52 | Gender: male
Wellbeing Before Policy: 4
Duration of Impact: 20.0 years
Commonness: 4/20
Statement of Opinion:
- I had a bad injury before and ended up with a massive debt. It's still hanging over me.
- If I ever need immediate help again, at least this bill won't ruin me financially.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 4 |
| Year 2 | 7 | 4 |
| Year 3 | 7 | 5 |
| Year 5 | 8 | 5 |
| Year 10 | 8 | 5 |
| Year 20 | 9 | 5 |
Retired Teacher (Fayetteville, NC)
Age: 68 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 15.0 years
Commonness: 5/20
Statement of Opinion:
- Navigating Medicare can be complex, adding military charges makes it worse.
- This should eliminate the hassle when I need emergency care there.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 7 | 6 |
| Year 10 | 8 | 6 |
| Year 20 | 8 | 6 |
Truck Driver (Anchorage, AK)
Age: 45 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 5.0 years
Commonness: 3/20
Statement of Opinion:
- I often worry about what would happen if I get hurt on the job far from home.
- Knowing emergency costs are covered saves me a massive worry.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 6 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 7 | 5 |
| Year 20 | 7 | 5 |
Freelance Designer (Honolulu, HI)
Age: 29 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 10.0 years
Commonness: 7/20
Statement of Opinion:
- As a freelancer, I don't have the safety net of health insurance and it's a constant source of stress.
- This policy means I could avoid huge unexpected hospital expenses.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 8 | 6 |
| Year 10 | 8 | 6 |
| Year 20 | 8 | 6 |
Retired Army Officer (Jacksonville, FL)
Age: 75 | Gender: male
Wellbeing Before Policy: 7
Duration of Impact: 7.0 years
Commonness: 4/20
Statement of Opinion:
- I have decent coverage but this policy is a good safety net for emergencies.
- It's a relief for my family to know we're protected in sudden crises.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 7 | 7 |
| Year 3 | 7 | 7 |
| Year 5 | 7 | 7 |
| Year 10 | 7 | 7 |
| Year 20 | 7 | 7 |
Financial Analyst (New York, NY)
Age: 39 | Gender: male
Wellbeing Before Policy: 8
Duration of Impact: 0.0 years
Commonness: 12/20
Statement of Opinion:
- I'm probably not going to be affected directly, but it's good to know the military hospitals won't charge civilians for emergencies.
- It doesn't change much for me because of my location and private plan.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 8 |
| Year 2 | 8 | 8 |
| Year 3 | 8 | 8 |
| Year 5 | 8 | 8 |
| Year 10 | 8 | 8 |
| Year 20 | 8 | 8 |
School Counselor (El Paso, TX)
Age: 56 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 15.0 years
Commonness: 6/20
Statement of Opinion:
- I have a lot of anxiety from my last medical bill owing to emergency care.
- This policy would mean I could recover without the debt burden next time.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 8 | 5 |
| Year 10 | 8 | 5 |
| Year 20 | 9 | 5 |
Graduate Student (Colorado Springs, CO)
Age: 23 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 7/20
Statement of Opinion:
- I'm a student and can't afford surprise medical bills.
- This policy would be a huge relief for my peace of mind living so close to a base.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 7 | 5 |
| Year 20 | 7 | 5 |
Tech Support Specialist (Seattle, WA)
Age: 32 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 5.0 years
Commonness: 5/20
Statement of Opinion:
- I don't live near a military base but travel there for work sometimes.
- If something happened on-site, it's good to know I wouldn't face unexpected bills.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 6 | 6 |
| Year 3 | 6 | 6 |
| Year 5 | 7 | 6 |
| Year 10 | 7 | 6 |
| Year 20 | 7 | 6 |
Cost Estimates
Year 1: $1100000000 (Low: $900000000, High: $1300000000)
Year 2: $1122000000 (Low: $920000000, High: $1330000000)
Year 3: $1144440000 (Low: $938200000, High: $1356600000)
Year 5: $1180448400 (Low: $970042000, High: $1406982000)
Year 10: $1252465352 (Low: $1026530610, High: $1498399268)
Year 100: $18179870754 (Low: $14826507263, High: $21700550385)
Key Considerations
- The policy will result in continuous expenditure for the Department of Defense since it effectively absorbs civilian medical bills previously charged.
- Civilians will no longer face collections from military facilities, potentially improving financial security and access to emergency care for those near military bases.
- Health care costs can be unpredictable; significant variance in the estimates is due to assumptions about the number of civilians treated and the costs they incur.