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Senator Warren and Representative Castro Reintroduce the Financial Relief for Civilians Treated at Military Hospitals Act

Government and Politics

December 1, 2022


“Civilians who are transported to MTFs for emergency care - often with no control over where they are taken - face burdensome healthcare costs and debt when they are uninsured, the MTF is not covered under their insurance, or they have high co-pays or deductibles.”

Washington, D.C. — United States Senator Elizabeth Warren (D-Mass.) and Representative Joaquin Castro (D-Texas) introduced the Financial Relief for Civilians Treated at Military Hospitals Act, legislation that would ensure that Military Treatment Facilities (MTFs) run by the Department of Defense (DoD) can continue to enhance military readiness without racking up huge bills for civilians receiving emergency medical care.

Civilians often go to MTFs when they need lifesaving emergency medical care or when the MTF has a unique ability to treat the patient. Treating these patients enables military medical personnel to train together during emergency care and enhances DoD’s medical readiness. MTFs also build relationships with nearby communities. If civilians are uninsured or the MTF does not accept their insurance they can quickly face significant medical debts and aggressive debt collection tactics.

“Unexpected medical emergencies should not leave people drowning in debt,” said Senator Warren. “The Financial Relief for Civilians Treated at Military Hospitals Act would ensure that civilians in need of life saving care at military treatment facilities can do so without the fear of taking on overwhelming financial burdens.”

“For years, civilian patients treated at Brooke Army Medical Center in San Antonio have faced sky-high medical bills for lifesaving trauma care,” said Congressman Castro. “Domestic military hospitals are designed to train military medical personnel for the battlefield, and the federal government should cover their operating costs. The Financial Relief for Civilians Treated at Military Hospitals Act would erase millions of dollars in prior civilian debt and prevent military hospitals from charging for emergency care going forward.”

Senator Warren and Representative Castro added provisions to the National Defense Authorization Act for fiscal year 2021 to expand DoD’s authority to waive medical debt when civilians are unable to pay for the care provided and that care enhances the knowledge, skills, and abilities of military healthcare providers. In July 2022, a report completed by the Government Accountability Office (GAO) found that military hospitals do not “consistently use or communicate options for financial relief for civilian emergency patients.”

The report also found that DoD failed to accurately track debts collected from civilians. Two thirds of the civilian emergency patients who received treatment did not have insurance, leaving them highly vulnerable to massive medical bills. Of the 26,696 civilian medical debt cases GAO reviewed, only .1% had their debt reduced.

The Financial Relief for Civilians Treated at Military Hospitals Act would eliminate previous debts for medical services rendered to civilians at MTFs who are not covered under TRICARE and prohibits an MTF from charging a civilian or their private insurance, Medicare, or Medicaid for any emergency medical treatment.

Senator Warren has long fought to ensure affordable access to healthcare for all and that the government’s aggressive debt collection practices don’t unfairly target patients:

    In August 2022, Senator Warren and Representative Castro (D-Texas) sent a letter to Secretary of Defense Lloyd Austin raising concerns that the Department of Defense (DoD) may be misleading or misinforming civilians about debt they incur when they receive emergency medical care at military health care facilities, and calling for improved billing practices to protect patients.

    The FY 2021 National Defense Authorization Act (NDAA) included Senator Warren's provision, based on the Financial Relief for Civilians Treated at Military Hospitals Act, to give DoD the authority to waive medical debt when the civilian is unable to pay the costs of the care provided and the care enhances the knowledge, skills, and abilities of military healthcare providers.

    Senator Warren originally introduced the Financial Relief for Civilians Treated at Military Hospitals Act in June 2020.

    In January 2020, Senator Warren sent a letter to DoD and the Treasury Department requesting information about the collection of military hospital debt from low-income, civilian patients.

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