To direct the Secretary of Defense to establish a pilot program regarding treating pregnancy as a qualifying event for enrollment in TRICARE Select.
- Bill Number
- H.R. 4381
- Origin Chamber
- House
- Congress
- 119th Congress, Session 1
- Policy Area
- Armed Forces and National Security
- Status
- Introduced
- Latest Action
- 2025-07-14: Referred to the House Committee on Armed Services.
- Last Updated
- 2026-06-27T00:33:15Z
AI-Generated Summary
Purpose
The legislation, H.R. 4381, aims to improve healthcare access for military families by establishing a temporary pilot program that allows pregnancy to serve as a "qualifying event" (a life change that triggers eligibility for health plan enrollment) for joining TRICARE Select, a health insurance option under the Department of Defense's TRICARE program.
Key Provisions
- Pilot Program Establishment: The Secretary of Defense must start a five-year pilot program within 180 days of the bill's enactment. Under this program, pregnancy is treated as a qualifying event under existing law (10 U.S.C. § 1099(b)(1)(B)), enabling eligible beneficiaries to enroll in TRICARE Select.
- Initial Briefing: Within one year of enactment, the Secretary must brief congressional committees on the program's status.
- Annual Reporting: Starting one year after the program begins, and annually for the next four years, the Secretary must submit reports to congressional committees. These reports include data on enrollment changes, broken down by:
- Month, starting from January 2027.
- Reasons for the change, such as separation from or return to active duty for service members or their dependents, or specifically due to the pregnancy qualifying event.
- Definitions:
- Covered enrollment change: A switch in health plan election by an eligible beneficiary.
- Eligible beneficiary: Individuals qualified to enroll in TRICARE Select (e.g., certain military members, retirees, and dependents).
- Appropriate congressional committees: Includes the House and Senate Armed Services Committees, plus specific House committees on Transportation and Infrastructure and Energy and Commerce.
- TRICARE Select and TRICARE program are defined per existing law (10 U.S.C. § 1072) as DoD health coverage options.
Significant Changes to Existing Law
- This introduces a new, temporary exception to current TRICARE enrollment rules, which typically limit qualifying events to things like marriage, birth, or changes in duty status. Pregnancy itself is not currently a standalone trigger for mid-year enrollment in TRICARE Select, so the pilot adds this flexibility for the five-year duration without permanently altering the underlying statute.
Potential Impacts
- On Government Agencies: The Department of Defense will need to implement the program, track enrollments, and produce detailed reports, potentially increasing administrative workload and costs for monitoring and data analysis.
- On Citizens: Eligible military beneficiaries (active duty, separated, or retired service members and their dependents) who are pregnant could gain easier, timely access to TRICARE Select coverage, reducing out-of-pocket healthcare expenses during pregnancy. This may improve maternal and infant health outcomes for military families.
- On International Relations: No direct impacts, as the bill focuses on domestic U.S. military health benefits.
Main Stakeholders Affected
- Department of Defense and Secretary of Defense: Responsible for program execution, reporting, and resource allocation.
- Military Personnel and Families: Eligible beneficiaries, particularly pregnant service members and dependents, who benefit from expanded enrollment options.
- Congressional Committees: Receive briefings and reports to oversee the program's effectiveness and decide on future extensions or permanency.
- TRICARE Administrators: Healthcare providers and insurers under the TRICARE system, who may see increased enrollments and claims related to pregnancy care.
Notable Legal, Constitutional, or Political Implications
- Legal: The pilot operates as a targeted amendment to Title 10 of the U.S. Code, allowing experimentation without immediate broad changes; success could lead to permanent legislation. It aligns with federal authority over military benefits but requires precise data collection to evaluate efficacy.
- Constitutional: No apparent conflicts; it supports Congress's enumerated powers to regulate armed forces and provide for their welfare under Article I, Section 8.
- Political: Highlights bipartisan interest in military family support, potentially influencing defense budgets and healthcare policy debates. The reporting requirements ensure accountability, which could spark discussions on expanding qualifying events if the pilot demonstrates positive results for service member retention and family well-being.
This summary was generated by AI and may contain inaccuracies. Refer to the official source document for the authoritative text.
Sponsor
Rep. Sewell, Terri A. [D-AL-7]
Cosponsors (1)
Rep. Haridopolos, Mike [R-FL-8]
Recent Actions
- 2025-07-14: Referred to the House Committee on Armed Services.
- 2025-07-14: Introduced in House
- 2025-07-14: Introduced in House
Bill Versions
- To direct the Secretary of Defense to establish a pilot program regarding treating pregnancy as a qualifying event for enrollment in TRICARE Select. — issued 2025-07-14 — PDF (4 pages)