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COL Biff Hadden USA (R)-President of Ft Benning Chapter with Georgia Military Veterans Hall of Fame inductee CAPT (Coach) Vince Dooley

DoD Releases Detailed Plans for Medical Billet Cuts

By: Karen Ruedisueli

SEPTEMBER 22, 2021

DoD Releases Detailed Plans for Medical Billet Cuts

More than 1,600 of the proposed medical billet cuts would take place in the National Capital Region. Here, active duty medical personnel work at a COVID-19 vaccine station in December at Walter Reed National Military Medical Center Bethesda, Md. (Photo by Lisa Ferdinando/Defense Department)

The services plan to cut nearly 13,000 military medical billets using a phased approach through FY 2027, according to a recently released DoD report – a 25% reduction in billet cuts compared with previous proposals.

The report, reflecting MOAA wins from FY 2020 and FY 2021 National Defense Authorization Act (NDAA) legislation, provides the first glimpse at how billet reductions may impact military treatment facilities (MTFs) and uniformed medical providers. It also provides MOAA with insights we can leverage to continue our efforts to halt the billet cuts and ensure continued beneficiary access to care – efforts that continue to be a top priority for the remainder of the FY 2022 NDAA cycle.

MOAA has advocated for enhanced congressional oversight since the medical billet cuts were revealed in the FY 2020 administration budget request. Thanks in large part to efforts from MOAA members who sent thousands of messages to their elected officials, DoD and the services were required to report to Congress on detailed plans and mitigation strategies related to medical billet reductions.

[MOAA IN MILITARY TIMES: New Plan Scales Back Massive Cuts in Military Medical Billets]

MOAA remains concerned about the potential negative impact of medical billet cuts on both operational requirements and beneficiary access to quality care, and will continue to seek a halt to the cuts alongside greater transparency and congressional oversight on mitigation planning.

What’s in the Report

The full report – which includes breakdowns of project cuts by year, installation, occupation code, and service branch – is available online in PDF format. Some details:

  • Planned medical billet cuts have been reduced by 25% from 17,005 (submitted in FY 2020) to 12,801.
  • The Army is responsible for the bulk of the adjustment, with the secretary of the Army deciding to adjust medical billet cuts from 6,935 to 2,948 based on additional analysis. The Army accounts for 95% of the overall DoD medical billet cut reductions.
  • The majority of cuts (71%) are enlisted positions. The other 29% are aimed at officer and warrant officer billets, including 779 physicians and 1,081 nurses.
  • Data by occupational code indicate notable reductions in positions related to clinical care including Behavioral Sciences/Mental Health Services, Biomedical Laboratory Services, Dental Care, Family Practice, Medical/Surgical Nurse, Ophthalmology/Optometry, Pediatrics, Pharmacy, and Radiology, among others.
  • Medical billet cuts will impact 220 different units including hospitals, clinics, medical centers, research organizations, and educational facilities. The National Capital Region (NCR) will take the largest portion of the reductions; 1,603 billet cuts are in NCR MTFs because, as the report states, the ability to hire in this area is greater.
  • All the services report a phased approach to billet reductions, with the preponderance planned for FY 2023 and the totals tapering off through FY 2027.
  • The services plan to replace 56% of the uniformed medical billets with civilian hires and “absorb” 26% of the cuts where remaining staff at a location is assumed to be sufficient to cover current and future health care delivery demands. Of the other cuts, 9% are student positions and don’t require mitigation, per DoD, and 1% will be addressed by sending care to the TRICARE network – according to the report, the network optimization strategy was used sparingly based on limited network adequacy information.

What’s Next

While the report provides some details on medical billet cuts, it raises more questions than answers on mitigation planning and the potential impact on the direct care system, including beneficiary access to care.

Without these answers, it’s unlikely to change the minds of many in Congress who have expressed concerns throughout this process that DoD’s proposed cuts go beyond the military health system (MHS) reform directed in the FY 2017 NDAA. At a December 2019 hearing, for instance, Rep. Jackie Speier (D-Calif.) said it appeared the plan “prioritized cost cutting over operational needs and common sense,” and Rep. Trent Kelly (R-Miss.) said DoD “may be viewing this as a cost-savings exercise when the actual purpose is to improve efficiency and health care quality.”

MOAA has continued to raise concerns about medical billet cuts on the Hill and in meetings and letters to senior DoD leadership throughout this legislative cycle. We appreciate the House Armed Services Committee (HASC) responded to our concerns with a provision in its version of the FY 2022 NDAA that would force DoD to delay any planned cuts for a year after the bill’s passage and require a Government Accountability Office (GAO) assessment of the analyses used to support any reduction of military medical manning.

Please stay tuned for a Call to Action supporting this provision as the NDAA process moves ahead.

Have More Questions About Your Health Care Benefit?

MOAA's 2020-2021 TRICARE Guide answers some commonly asked questions.


Karen Ruedisueli

Karen Ruedisueli

Ruedisueli is MOAA’s Director of Government Relations for Health Affairs and also serves as co-chair of The Military Coalition’s (TMC) Health Care Committee. She spent six years with the National Military Family Association, advocating for families of the uniformed services with a focus on health care and military caregivers.


Here’s How the House and Senate Toxic Exposure Reform Bills Stack Up

By: Cory Titus

JUNE 02, 2021

Here’s How the House and Senate Toxic Exposure Reform Bills Stack Up

Marines dispose of trash in a burn pit in the Khan Neshin district of Afghanistan in 2012. (Photo by Cpl. Alfred V. Lopez/Marine Corps)

Last week, Senate and House Veterans Affairs Committee leadership unveiled omnibus bills to provide comprehensive reforms to benefit those exposed to toxins while in uniformed service.


Sen. Jon Tester (D-Mont.) introduced the Comprehensive and Overdue Support for Troops (COST) of War Act of 2021, followed a day later by the introduction of the Honoring our Promise to Address Comprehensive Toxics (PACT) Act of 2021 by Rep. Mark Takano (D-Calif.).


Both omnibus bills reflect the work of MOAA, notably our grassroots outreach, as well as efforts from other veterans service organizations (VSOs). The legislation includes both bills supported by MOAA’s Advocacy in Action campaign, along with many other MOAA-backed positions.


[TAKE ACTION: Ask Your Lawmaker to Support Comprehensive Toxic Exposure Reform]


Both omnibus bills include:

  • The Toxic Exposure in the American Military (TEAM) Act (S. 927 and H.R. 2127)
  • The Veterans Burn Pits Exposure Recognition Act (S. 437 and H.R. 2436)
  • The addition of Agent Orange presumptives for hypertension and monoclonal gammopathy of undetermined significance, better known as MGUS (S. 810 and H.R. 1972)
  • The recognition of radiation exposure in the Enewetak Atoll and from the 1966 accident in Palomares, Spain (S. 565, H.R. 1585, and H.R. 2580)
  • Improvements to studies and epidemiological reporting for all exposures


[RELATED: VA Will Soon Begin Processing Claims for 3 New Agent Orange Illnesses]


These core consistencies bode well for MOAA’s reform requests. Having both versions include these components mean they are highly likely to stay in the final bill. However, there are differences to be resolved:

  • The House version adds more presumptives, specifically cancers that the Senate version has not included. We expect this will be a key area of negotiation in the coming months.
  • The House version creates health registries for Fort McClellan, Ala., and for Per- and polyfluoroalkyl substances (PFAS) – MOAA supports the creation of these registries.
  • The House version establishes independent scientific review board overseen by the VA, whereas the Senate continues to use the time-tested National Academies of Science, Engineering, and Medicine (NASEM) to review evidence. MOAA believes NASEM should be continued to be used for evaluating toxic exposure conditions.
  • The House version recognizes burn pit use in Yemen, Uzbekistan, and the Philippines whereas the Senate does not. We would encourage Senate to add these locations.


Along with our existing Advocacy in Action bills, MOAA supports both chambers’ omnibus packages. Each bill delivered on our core asks, and that is certainly due to your efforts during Advocacy in Action and prior work on this issue by MOAA. Comprehensive change would not have been on the horizon without the entire community behind it.


MOAA has reviewed both bills, and while the each have areas we believe could be improved before sending to the president, each offer a dramatic step forward in getting these veterans and their families the benefits they deserve.


[GET INVOLVED: Support MOAA's Advocacy in Action Campaign]


Even if you’ve already reached out to your lawmakers regarding MOAA-supported toxic exposure reform legislation, don’t hesitate to reach out again – follow up with staffers or lawmakers and let them know you support their chamber’s omnibus measure. With momentum building in both the House and Senate, now is the time to continue to make your voice heard.


[SEND A TWEET: Support Comprehensive Toxic Exposure Reform #MOAATakesAction]


Cory Titus

Cory Titus

Titus separated from the Army in 2017 as a captain and is MOAA's Director of Veteran Benefits and Guard/Reserve Affairs. He is currently studying social entrepreneurship at George Mason University with a focus on improving military financial education.

Georgia Council of MOAA
Georgia Council of MOAA
Georgia Council of MOAA
Georgia Council of MOAA

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