(This article by MOAA staff originally appeared in the April 2025 issue of Military Officer, a magazine available to all MOAA Premium and Life members. Learn more about the magazine here; learn more about joining MOAA here.) 

 

A military spouse waited several weeks for an appointment with her primary care manager (PCM) to get help for her dislocated shoulder at a military treatment facility, then had another delay before finally starting civilian physical therapy weeks later after a fight to be seen in the network, she told a military spouse group on Facebook.

 

She faced more delays when the orthopedic care provider she needed to see wouldn’t treat her until she had an MRI, and that wasn’t available for at least two more months, the spouse wrote in her message. She said she had been calling continually since her PCM visit to be sent within the network for the MRI, but she was referred from one person to another with no resolution.

 

Out of frustration, the spouse, whose identity information is withheld, sought advice on social media from fellow military spouses about whether she should switch from TRICARE Prime to TRICARE Select as open season approached in November to see if that would improve her care. She asked the spouse group, would Select make it easier to get care, or is this just the way it is everywhere?

 

Delays and lack of transparency in cases like this spouse’s are among the reasons MOAA is fighting hard to improve access to care for beneficiaries, said Karen Ruedisueli, MOAA’s director of Government Relations for health affairs.

 

Health care access is one of the five key priorities for MOAA’s Advocacy in Action campaign for 2025.

 

A focus of the campaign will be MOAA advocates going to Capitol Hill in Washington, D.C., the week of April 7, when MOAA members from across the country will join MOAA staff for a series of events. Visits to congressional offices will be Wednesday, April 9.

 

MOAA members and their networks, whether in Washington or remote and at home, are encouraged to contact their lawmakers, and the military legislative leaders in the lawmakers’ offices, to build momentum for MOAA’s efforts on the priority topics.

 

[ADVOCACY IN ACTION: All the Details on MOAA’s Spring Campaign]

 

Here are this year’s five key advocacy topics, why they matter, and what actions MOAA is asking for:

 

Improve Access to Health Care

Why it matters: DoD and Congress have acknowledged longstanding problems with access to care within the Military Health System (MHS), yet beneficiaries lack a consistent, effective, and well-understood system for reporting access challenges and getting help navigating the MHS.

 

Key facts:

• The new MHS stabilization strategy seeks to recapture 7% of beneficiary care back to military hospitals and clinics that are struggling with staffing challenges.
• TRICARE policy prohibits beneficiaries from changing TRICARE plans to move care to the civilian network except during the annual open enrollment season or after qualifying life events.
• Challenges related to the new TRICARE West Region contract underscore the need for more effective beneficiary assistance with barriers to access.

 

“Military families need help when they encounter barriers to access — whether that’s appointment line phones that go unanswered, failure to refer care to the network when an MTF can’t meet access standards, or gaps in the TRICARE network,” Ruedisueli said.

 

“A digital platform would connect beneficiaries with direct help to navigate the MHS and improve visibility to access challenges so fixable problems can be addressed,” she said. “The need for such a system has never been more obvious.”

 

[ISSUE PAPER: Military Health System Access]

 

 

The ask: MOAA urges Congress to pass legislation establishing an MHS digital access assistance platform to:

• Help military families navigate the MHS by routing their issues to the appropriate contacts for assistance.
• Improve oversight and accountability of the MHS by providing visibility to access problems.
• Ensure fixable systemic MHS barriers to access are addressed.

 

Support Family Caregivers

When Andrea Sawyer’s husband returned from an Iraq deployment in 2007, he wasn’t the same person she had known since they were in high school. Outwardly, he appeared unharmed, but his combat wounds were the kind that aren’t visible.

 

“Because my husband had mental health and TBI [traumatic brain injury] issues, but he appeared physically fine, people did not understand what the issues were,” Sawyer, pictured, told Military Officer in a January interview.

 

During months in the warrior transition unit, it became clear he would be medically retired from service and needed help managing life.

 

She became his caregiver, single-handedly meeting their family’s needs and tending to her husband’s challenging mental and physical health conditions. She gave up her professional career in education to be a full-time family caregiver for her husband while raising their two young sons.

 

“I lost my professional identity, my personal income, and my access to contribute to Social Security and my personal retirement accounts,” she said. “I suffered health issues because I would miss my appointments to take him to his appointments.”

 

She found one of the struggles in caregiving is having to fight for the authority that, by necessity, goes with the role.

 

“I was constantly having to justify my existence to new providers. And in a lot of cases … I had more medical information than they did about some of the conditions that he had,” Sawyer said. “It was a level of frustration that is hard to describe. In the beginning, and even now, I had people challenge my role in communicating for him in a medical setting.”

 

[TAKE ACTION: Ask Your Lawmakers to Honor Veteran Caregivers]

 

 

Sawyer started out with little guidance in filling this role for a veteran who is unlikely to recover, be independent, or hold a job again and has difficulty expressing his health needs. She did research, learned the challenges common to millions of caregivers across the nation, and got involved in advocating for caregivers.

 

Now Sawyer is advocacy director with the Wounded Veteran Family Care Program at the Quality of Life Foundation, working to promote legislation called the Veteran Caregiver Reeducation, Reemployment, and Retirement Act. She, often alongside MOAA, leads informational round tables and testifies on Capitol Hill on what caregivers need to rebuild lives and livelihoods.

 

The legislation would provide a path and allow for funds for caregivers to renew lapsed professional certifications so they can return to the workplace when the time comes. It would also study a pathway for VA paid caregivers, through the Program of Comprehensive Assistance for Family Caregivers, to be able to contribute to Social Security and their own personal retirement accounts if the only income in the home is unearned income (Social Security, DoD combat-related medical retirement, VA disability, and current VA caregiver income).

 

“This bill is absolutely essential to help provide economic security in the later years for those family caregivers, be they related or not, who take on the role of caring for our veterans,” Sawyer said. MOAA also supports the Veteran Caregiver Reeducation, Reemployment, and Retirement Act and its reintroduction in the new Congress.

 

[ISSUE PAPER: Veteran Caregivers]

 

Why it matters: Veteran caregivers provide essential care for aging and disabled veterans, often at the expense of their own financial security, mental health, and career aspirations. These caregivers deserve tangible resources to support their vital role within veterans’ families and communities.

 

Key fact: Nearly 3 out of 4 veteran caregivers — 74% — are caring for veterans age 60 or older, yet their stipends are classified as “unearned income,” preventing contributions to Social Security or retirement accounts.

 

“Veteran caregivers make tremendous sacrifices, often putting their futures on hold to care for those who have served,” said Cmdr. René Campos, USN (Ret), MOAA’s senior director of Government Relations. “They deserve meaningful support to rebuild their careers, plan for retirement, and protect their mental health. We must act to ensure they are not left behind.”

 

[READ MORE: Caregivers Sacrifice for Our Veterans – Now Congress Must Support Them]

 

The ask: MOAA urges Congress to pass the Veteran Caregiver Reeducation, Reemployment, and Retirement Act to:

• Enhance education, employment, and retirement opportunities for caregivers.
• Address the significant economic and emotional challenges they face.
• Empower caregivers to achieve financial security while reducing the government’s long-term economic burden.

 

Expand on ‘Ending the Wait’ Efforts

Why it matters: Veterans exposed to toxins during service face decades-long delays for acknowledgment and care. The current system leaves veterans and their families waiting far too long for the benefits and support they need and have earned.

 

[READ THE REPORT: Ending The Wait for Toxic-Exposed Veterans]

 

 

Key facts:

• Since the end of World War I, the VA has acknowledged 30 types of toxic exposures. Just over half of them (16) resulted in establishing a presumptive condition.
• For all acknowledged exposures, the average time between the first year that veterans were exposed to an acknowledgment from VA is 31.4 years.
• For the subset of 16 toxic exposures that have presumptive conditions, the time from acknowledgment to the establishment of a presumptive, as marked by a concession of exposure, is 2.4 years, on average.
• When looking at the overall timeframe, it takes an average of 34.1 years after the first incidence of military toxic exposure to the establishment of a presumptive.

 

“Thirty-four years is far too long for veterans exposed to toxic substances to wait for acknowledgment and care,” said Jeff Goldberg, MOAA’s director of Government Relations for veteran and retired affairs. “These delays are unacceptable and a failure to uphold our commitment to those who served. Congress must act now to eliminate these barriers and deliver the care toxic-exposed veterans have earned.”

 

[RELATED: The Push for a More Perfect PACT Act]

 

The ask: MOAA urges Congress to pass legislation to:

• Establish a classification system for toxic exposures to fill evidentiary gaps.
• Strengthen the legal frameworks for the presumptive-making process.
• Expand research, monitoring, and oversight to advance scientific understanding of toxic exposures.
• Eliminate legal barriers preventing veterans, families, and survivors from accessing toxic exposure benefits.

 

[TAKE ACTION: Ask Your Lawmakers to Deliver Toxic-Exposed Veterans the Care They've Earned]

 

Keep Focus on Military Housing

Why it matters: Thousands of servicemembers live in substandard barracks plagued by mold, pests, sewage overflows, and broken safety systems. Despite recent legislative action, a $137 billion backlog in deferred maintenance persists, and servicemembers continue to face unsafe and unacceptable conditions. Transparency is essential for accountability and sustaining efforts to improve unaccompanied housing.

 

Key facts:

• Many barracks fail to meet DoD standards for privacy, space, and quality, with health and safety risks reported across installations.
• DoD lacks reliable assessments and funding transparency for unaccompanied housing (UH), hindering oversight and improvements.
• Pest infestations, mold, and sewage issues often leave servicemembers responsible for their own pest control and hazardous material removal, according to the Government Accountability Office.

 

[TAKE ACTION: Ask Congress to Address Hazardous Unaccompanied Housing Conditions]

 

 

“No servicemember should live in barracks plagued by mold, pests, or broken systems,” said Cory Titus, MOAA’s director of Government Relations for currently serving affairs. “These conditions undermine the well-being and dignity of those who serve. Improving unaccompanied housing must remain a priority to ensure servicemembers have safe and healthy places to live,” said Titus, a former Army captain.

 

The ask: MOAA urges Congress to require DoD to:

• Provide transparency on funding for barracks maintenance and improvements.
• Empower lawmakers to identify and address UH challenges in their districts and states.

 

Promote the Military Spouse Hiring Act

Why it matters: Military spouses face a staggering 21% unemployment rate — five times the national average — due to frequent relocations and limited job opportunities near remote installations. This creates financial strain for military families, impacts military readiness, and contributes to servicemember retention challenges.

 

Key facts:

• Military spouses relocate every two to three years, on average, making it challenging to find and maintain consistent employment, even though the spouses are often highly educated and skilled.
• Despite significant investments in addressing this crisis, the more than 20% unemployment rate has persisted for over a decade.
• One approach to addressing this issue that remains untested is incentivizing businesses to hire military spouses. When veteran unemployment spiked, the multipronged approach to solving the problem included adding a target group to the Work Opportunity Tax Credit (WOTC). From 2019 to 2023, more than 630,000 veterans were hired under WOTC, demonstrating the program’s success in reducing employment barriers.
• Financial strain caused by spouse unemployment is a significant factor in servicemembers’ decisions to leave the military.

 

[TAKE ACTION: Ask Your Lawmakers to Support Military Spouses]

 

 

“Military spouses bring unmatched resilience, skills, and dedication to the workforce, but frequent moves make steady employment difficult,” said Jennifer Goodale, MOAA’s director of Government Relations for military family and survivor policy. “A targeted tax credit would encourage employers to hire these talented individuals, providing stability for military families and strengthening the communities where they live.”

 

The ask: MOAA urges Congress to add military spouses as a target group under WOTC to:

• Lower the military spouse unemployment rate.
• Offset hiring and onboarding costs for employers and fill vacant positions with highly skilled workers.
• Increase military family financial stability and improve servicemember retention. MOAA members can help lawmakers and their staffs understand the challenges the military community faces and how vital these reforms will be.

 

Visit MOAA’s Legislative Action Center to contact your elected officials. By reaching out and making a connection, we can collectively send a powerful message to Capitol Hill.