Thousands of National Guardsmen around the country are in contact with people who’ve contracted COVID-19. But while the federal government has called on them for frontline assistance in battling the pandemic, it’s not giving them what they need to protect themselves: access to the military’s health insurance.
The approximately 20,000 guardsmen who have been called up to help states around the country deal with the spread of the coronavirus are federalized on what’s called Title 32 status, which puts them in command of their various state governors but with the federal government paying costs.
But according to the National Guard’s advocates and the U.S. governors’ association, the guardsmen are activated on orders that last 30 days. That puts them one single day shy of the requirement allowing the military health insurance system known as TRICARE—think of it as Medicare For All In Uniform—to cover them. Military Times first reported the eligibility shortfall.
It’s an urgent problem for guardsmen now that the pandemic-spurred economic collapse has exposed the folly of the current system of employer-provided health insurance. Some proportion of the guardsmen who may expose themselves to COVID-19 will have lost their jobs, and more surely will in the weeks to come.
If their jobs came with health insurance, they would be qualified to shop on the Obamacare exchanges. But that process can be cumbersome and expensive at a moment when they face unemployment. If they never had job-based insurance, then they’ve lost their income right at the moment they are being asked to risk their own health and what remains of their financial security. Similarly, Guardsmen on orders short of 31 days qualify for an aspect of TRICARE called TRICARE Reserve Select. But that's an optional purchase, and while its premiums are lower than civilian health insurance, Guardsmen will still have to pay.
The lack of TRICARE eligibility puts guardsmen and their families “in a terrible position,” said J. Roy Robinson, a retired one-star general and the president of the National Guard Association of the United States. “These kids are in jeopardy, and it’s wrong.”
Robinson, who served for 33 years as an officer in the Mississippi National Guard, continued: “Leadership at the Pentagon, either knowingly or unknowingly, are putting soldiers and airmen, in my opinion, in harm’s way without them having proper medical coverage.”
On April 1, Sen. Steve Daines (R-MT) asked Trump to ensure federalized guardsmen’s TRICARE eligibility during an “unprecedented situation.”
“During this time, we should do all we can to support the men and women being asked to assist our nation’s response to this pandemic and ensure that they are put on orders long enough to make them eligible for TRICARE,” Daines wrote.
The first U.S. servicemember to die from coronavirus was 57-year-old New Jersey National Guardsman Douglas Linn Hickok, an Army captain. Hickok had not deployed to respond to COVID-19 when he contracted it, but he was preparing to deploy when he grew sick on March 21. He died on March 28.
The Pentagon did not immediately respond to The Daily Beast’s request for comment.
As coronavirus has spread, the Trump administration has faced mounting pressure to expand health insurance coverage options for the broad universe of the uninsured. But it has so far resisted allowing a special enrollment period for Obamacare, claiming that there are other options for those in need to get insurance and that cash assistance from the government could help instead.
The issue is more acute with members of the Guard who are being tasked by the government to help combat the spread of the pandemic. A senior administration official told The Daily Beast that the governors were receiving “full federal funding of the state National Guard”—a separate issue from the guardsmen’s TRICARE access. The official, who would not speak for the record, said that every “request granted is set for a full month,” which confirms the activation period falling just short of TRICARE eligibility.
“We are working with states and the National Guard by continuously monitoring the situation on the ground to determine any Title 32 extension,” the official said. The official would not address why the current orders fall short of the TRICARE eligibility period.
Without TRICARE, warned Robinson, members of the Guard will “have to fall back on their personal health insurance. I hate to say it, but in a lot of those areas, a lot of these guys don't have health insurance.” Robinson lamented that as of Friday, “there is no agreement to fix this.”
“We appreciate the administration’s willingness to take steps to address this need, however, we are concerned that the current orders coming down from the Department have been limited to only 30 days,” said James Nash, a spokesman for the National Governors’ Association. “As you note, service members will not have full federal protections for anything under 31 days. We would encourage the administration to look at this and extend orders.”
Some 24 states and territories are receiving Title 32 funding for their National Guard operations, with other states continuing to submit funding requests, the senior official said.
It’s unclear how many guardsmen are currently operating without health insurance and require TRICARE—let alone how many of their private insurance companies will charge them substantial deductibles for any COVID-19-related treatment they might require as a consequence of their service.
On Friday morning, with no agreement in place to extend the Guard’s orders to ensure TRICARE eligibility, President Trump tweeted, “Thank you @USNationalGuard, keep up the great work!”
-- Sam Stein contributed reporting