A bicameral bill would create a pilot program to designate pregnancy as a qualifying life event (QLE) under TRICARE, allowing beneficiaries more flexibility in accessing prenatal care – an essential element to positive maternal and infant outcomes.

The Improving Access to Prenatal Care for Military Families Act, introduced in the House by Reps. Terri Sewell (D-Ala.) and Andy Kim (D-N.J.) and in the Senate by Sen. Tammy Duckworth (D-Ill.), continues efforts to include a version of this legislation in the FY 2025 National Defense Authorization Act (NDAA). The House version of the must-pass NDAA includes a TRICARE pregnancy QLE pilot, but the Senate version does not.

[TAKE ACTION: Ask Your Lawmakers to Improve Access to Prenatal Care]

“With access to care challenges in both military treatment facilities and the TRICARE network, beneficiaries must have flexibility to seek vital prenatal care where it is available,” MOAA President and CEO Lt. Gen. Brian T. Kelly, USAF (Ret), said. “The TRICARE Pregnancy Qualifying Life Event Pilot will not only give pregnant beneficiaries the flexibility to change TRICARE plans, but it will also provide visibility on potential maternal care issues within the military health system, leading to better maternal and infant outcomes and improving military family readiness.”

MOAA has advocated for expanded QLEs since the TRICARE annual enrollment requirement was passed into law with military health system (MHS) reforms in the FY 2017 NDAA. Commercial health plans typically do not have a QLE for pregnancy, but TRICARE policy must address the unique nature of the MHS, which integrates care from military treatment facilities (MTF) and the TRICARE network of civilian providers.

Timely access to care has been a longstanding problem in the MHS. Unpredictable demands for care, coupled with mobile patient/provide populations and operational demands on uniformed medical personnel, lead to pockets of access problems. MTFs do not always follow TRICARE’s access to care standards, resulting in long waits for some patients.

A December 2023 DoD memo acknowledged that congressionally directed MHS reforms and U.S. medical workforce volatility magnified these problems, creating a destabilized MHS that does not consistently delivery timely care to beneficiaries. TRICARE policy must have the flexibility to allow pregnant beneficiaries to seek the care they need where it is available – in the MTF or the TRICARE network.

‘Extraordinary Challenges’

“Our military families take on extraordinary challenges each and every day,” Sewell said in a press release announcing the bill. “Accessing quality maternal health care services should not be one of them. This legislation offers greater flexibility to our expectant military families by empowering pregnant military spouses to choose the health care plan that best meets their needs.”

Duckworth said the bill will “help make it easier for our brave servicemembers and military spouses to access the high-quality care they need and deserve as they build their families. It’s the right thing to do, and I’ll do everything I can to make sure this commonsense policy is included in the final defense bill."

Kim, who will join the Senate in the 119th Congress, said the legislation will “give some peace of mind to servicemembers, military spouses, and their growing families. As they continue to be there for us, this designation would help look after them in a time when having the maternal care they need couldn’t be more important.”

MOAA appreciates the leadership of these lawmakers and their efforts to improve access to prenatal care for military families. Please contact your legislators and urge them to support the Improving Access to Prenatal Care for Military Families Act.