The government's promise of lifetime health care for the military's men and women is suddenly a little less sacrosanct as Congress looks to slash trillion-dollar-plus deficits.
It's a reflection of Washington's newfound embrace of fiscal austerity and the Pentagon's push to cut health care costs that have skyrocketed from $19 billion in 2001 to $53 billion.
The numbers are daunting for a military focused on building and arming an all-volunteer force for war. The Pentagon is providing health care coverage for 3.3 million active duty personnel and their dependents and 5.5 million retirees, eligible dependents and surviving spouses.
Retirees outnumber the active duty, 2.3 million to 1.4 million.
Combined with the billions in retirement pay, it's no surprise that Defense Secretary Leon Panetta recently said personnel costs have put the Pentagon "on an unsustainable course."
Yet the resistance to health care changes is fierce.
Powerful veterans groups and retired generals are mobilizing to fight any changes, arguing that Americans who were willing to die for their country should be treated differently than the average worker. The American Legion has sent a letter to every member of the House and Senate pleading with them to spare health care benefits. The Veterans of Foreign Wars has urged its 2 million members, their families and friends to contact lawmakers and deliver the same message.
The two groups were unnerved when both parties' leaders on the Senate Armed Services Committee -- Carl Levin, D-Mich., and John McCain, R-Ariz. -- recommended that the special deficit-cutting supercommittee look at raising enrollment fees and imposing restrictions on the military's health care program, known as TRICARE. Current military members would be grandfathered in.
McCain and Levin also favored creating a commission to look at military retirement benefits and make recommendations for changes.
"Any changes to TRICARE that put the burden back on the beneficiaries is not supported by the American Legion," said Peter Gaytan, the group's executive director. He wondered about future benefits for his 19-year-old nephew who heads to Afghanistan in December.
The willingness in Congress to consider cost-cutting changes to the military's entitlement programs is shared by other senators, from members of the Armed Services panel to budget-conscious lawmakers in both the Republican and Democratic ranks such as Sens. Tom Coburn, R-Okla., and Mark Warner, D-Va.
"I think we have to look at whether savings can be achieved, but we have to keep our promise to people who were recruited based on those benefits, and we also ought to look at whether there's ways to improve the benefit structure," Sen. Susan Collins, R-Maine, said in an interview last week.
That prospect has Joe Davis, a spokesman for the Veterans of Foreign Wars, fearful of the next step.
"All our worries are starting to come to fruition," Davis said.
The debt accord reached this past summer between President Barack Obama and congressional Republicans set in motion some $450 billion worth of cuts in projected defense spending over 10 years. It's a reality check for the Defense Department, whose budget has nearly doubled to some $700 billion in the 10 years since the Sept. 11 terror attack.
That amount doesn't include the trillion-plus spent on the wars in Iraq and Afghanistan. The 12-member, bipartisan supercommittee has a mandate to come up with at least $1.2 trillion in cuts by Nov. 23. If it fails to produce a plan or Congress rejects its proposal, automatic, across-the-board cuts of $1.2 trillion kick in, half of it from defense spending.
Panetta said $600 billion more in cuts over the next decade atop the $450 billion in cuts passed this summer would represent a "doomsday" for the nation's military. Republicans and Democrats have echoed his apocalyptic warning. In their separate letters to the supercommittee, Levin and McCain said they reject any deeper cuts in overall defense spending beyond the 10-year, $450 billion cuts.
Determined to avoid spending reductions that would hit troop numbers, aircraft, ships and weapons, Levin, McCain and other lawmakers are urging budget-cutters to scrutinize the military entitlement programs.
"I think they may be facing reality and want to soften the blow some," said former Rep. Ike Skelton, D-Mo., who served as House Armed Services chairman. "They're both very responsible when it comes to the troops."
Levin and McCain support establishing an annual enrollment fee for TRICARE for Life, the health care program that now has no fee for participation. Obama had proposed an initial annual fee of $200.
Levin said future increases in fees should be tied to the same index used to determine hikes in the TRICARE Prime program, which has the lowest out-of-pocked expenses. McCain also urged the supercommittee to consider restricting working-age military retirees and their dependents from enrolling in TRICARE Prime. The retirees could still enroll in other TRICARE programs. McCain pointed out that the Congressional Budget Office has estimated that such a move would save $111 billion over 10 years.
Active-duty personnel still would be enrolled in the program automatically.
In the House, lawmakers are less inclined to make any changes in health care benefits. Rep. Howard "Buck" McKeon, R-Calif., chairman of the House Armed Services Committee, agreed to a slight increase in TRICARE Prime fees for working-age military retirees. The fees had been unchanged for 11 years at $230 a year for an individual and $460 for a family.
Asked about the recommendations from Levin and McCain to the supercommittee, McKeon's office said the House has already made changes and suggested additional savings come from civilian rather military health care and retirement programs. The House vote to raise the annual TRICARE
Prime fees by $2.50 for individuals and $5 for families.