TRICARE and VA Health Care: Impact of the Patient Protection and Affordable Care Act (PPACA)

Sidath Viranga Panangala
Specialist in Veterans Policy

Don J. Jansen
Analyst in Defense Health Care Policy

The 111th Congress recently passed, and the President signed into law, the Patient Protection and Affordable Care Act (P.L. 111-148; PPACA), as amended by the Health Care and Education Reconciliation Act of 2010 (P.L. 111-152; HCERA). In general, PPACA did not make any significant changes to the Department of Defense (DOD) TRICARE program or to the Department of Veterans Affairs (VA) health care system. However, many have sought clarification as to whether certain provisions in PPACA, such as a mandate for most individuals to have health insurance, or extending dependant coverage up to age 26, would apply to TRICARE and VA health care beneficiaries.

To address some of these concerns, Congress has introduced and/or enacted legislation. The TRICARE Affirmation Act (H.R. 4887; P.L. 111-159), signed into law on April 26, 2010, affirms that TRICARE satisfies the minimum acceptable coverage requirement in PPACA. Similarly H.R. 5014 (presented to the President) would clarify that the Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA), Spina Bifida Health Care Program, and the Children of Women Vietnam Veterans Health Care Program meet the "minimum essential coverage" requirement under PPACA. The House Armed Services Committee reported a bill on May 21, 2010, the National Defense Authorization Act for FY2011 bill (H.R. 5136), that includes a section 702 that would extend dependent coverage under TRICARE until age 26. The provision includes a requirement for the Secretary of Defense to prescribe an actuarially appropriate premium for the extended coverage. Likewise, three proposed measures have been introduced to extend CHAMPVA coverage to eligible dependent children up to age 26: H.R. 5185, H.R. 5206, and S. 3356.

This report addresses key questions concerning how PPACA will likely affect TRICARE and VA health care.


Date of Report: May 27, 2010
Number of Pages: 11
Order Number: R41198
Price: $29.95

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