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1 1 (April 10, 2023)

handle is hein.crs/govelft0001 and id is 1 raw text is: Congressional Research Service Informing the legislitive debate since 1914 0 April 10, 2023 FY2024 Budget Request for the Military Health System On March 9, 2023, President Joseph R. Biden submitted his Fiscal Year (FY) 2024 budget request to Congress. Discretionary funding in the Department of Defense (DOD) budget request totals $842.0 billion, including $58.7 billion (7.0%) to fund the Military Health System (MHS), which delivers certain health entitlements under Chapter 55 of Title 10, United States Code, to military personnel, retirees, and their families. The MHS provides health care to 9.6 million beneficiaries in DOD hospitals and clinics-known as military treatmentfacilities (MTFs)-and through civilian health care providers participating in TRICARE, a DOD-administered health insurance-like program. Congress traditionally appropriates discretionary funding for the MHS in several accounts within the annual defense appropriations bill. These accounts include Operation and Maintenance (O&M), Military Personnel (MILPERS), and Military Construction (MILCON). DOD refers to these portions of the budget as the unified medical budget (UMB). The request does not include a proposal to modify statutory TRICARE cost-sharing requirements for beneficiaries. FY2024 MHS Budget Request The FY2024 MHS budget request is 0.5% ($0.3 billion) more than the FY2023 appropriation. Table 1 shows the FY2024 request and previously enacted amounts for the MHS. Defense Health Program (DH P) The DHP, a sub-account under the O&M account, funds the following MHS functions: health care delivery in MTFs; TRICARE; certain medical readiness activities and expeditionary medical capabilities; education and training programs; research, development, test, and evaluation (RDT&E); management and headquarters activities; facilities sustainment; procurement; and civilian and contract personnel. The FY2024 request for the DHP account is $38.4 billion, which is 2.1% ($0.8 billion) below the appropriated amount for FY2023. Table 2 highlights selected programs that DOD intends to create, maintain, expand, reduce, or transfer to other DOD accounts. Military Personnel (MI LPERS) The medical MILPERS account funds military personnel operating the MHS. This funding includes various pay and allowances, such as basic, incentive, and special pays; subsistence allowance; permanent change of station travel; and retirement contributions. DOD requested $9.2 billion for medical MILPERS for FY2024, but does not break out specific costs assigned to the MHS at the budget activity group, program element, or line item level. This request is higher than the FY2023 appropriation, reflecting a 1.8% increase in military medical end-strength (+1,985 positions). Table I. Military Health System Funding, FY2019-FY2024 Request ($ in billions) FY2019 FY2020 FY2021 FY2022 FY2023 FY2024 Enacted Enacted Enacted Enacted Enacted Request O&M (DHP) $34.4 $37.1 $34.1 $37.4 $39.2 $38.4 DHP Operation & Maintenance $31.3 $33.0 $31.1 $34.0 $35.6 $37.1 Research, Development, Testing, and Evaluation $2.2 $3.7 $2.4 $2.6 $3.0 $0.9 Procurement $0.9 $0.5 $0.5 $0.8 $0.6 $0.4 MILPERS $8.4 $8.9 $8.3 $8.5 $8.9 $9.2 MILCON $0.4 $0.3 $0.5 $0.5 $0.6 $0.5 MERHCF Contributions $7.5 $7.8 $8.4 $9.3 $9.7 $10.6 Grand Total $50.7 $51.4 $51.3 $55.7 $58.4 $58.7 Sources: Department of Defense (DOD), Defense Budget Overview, March 2023, p. 4-8; DOD Defense Health Program Fiscal Year (FY) 2024 Budget Estimates, March 2023, p. I; and CRS In Focus IF 12087, FY2023 Budget Request for the Military Health System, by Bryce H. P. Mendez. Notes: Numbers may not add up due to rounding. DHP sub-totals include MHS funding for overseas contingency operations (OCO), direct war costs, or overseas operations costs. The FY2024 request does not include funding that Congress historically adds to the DHP (e.g., unrequested medical research funding). The FY2020 and FY2021 enacted amounts include supplemental funding appropriated from the CARES Act (P.L. 116-136). O&M (DHP) refers to a DOD budget account, whereas DHP Operation & Maintenance refers to a subordinate budget activity. The Medicare-Eligible Retiree Health Care Fund (MERHCF) refers to the accrual contributions that pay for future health care expenses of Medicare-eligible TRICARE beneficiaries.

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