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Women’s Health Care in DOD Unchanged by Supreme Court Decision > U.S. Department of Defense > Defense Department News

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While last month’s Supreme Court opinion in Dobbs v. Jackson Women’s Health Organization means each state now makes its own laws regarding abortion services, the health care that the Defense Department provides to service members has not changed, the undersecretary of defense for personnel and readiness said. 

“Service members can receive the same reproductive health care after Dobbs as they did before the ruling,” Gil Cisneros testified today before the House Armed Services Committee. “Consistent with long-existing federal law, ‘covered abortions’ — those cases that involve rape, incest or where the life of the mother would be endangered — will continue to be authorized to use federal funds and facilities. There is no interruption to this care.” 

Travel policies related to health care also remain, Cisneros said. If a service member must travel to obtain a covered abortion, she may do so on official status and will not be charged leave. 

While the department will continue to be able to provide to service members the same level of health care it has always provided, Cisneros said the department is aware that the Dobbs decision will change available options for some service members when it comes to abortions that are not covered under department policy. Based on laws that may be in effect in the state where a service member is stationed, abortion services may not be available. 

“Service members are now having to navigate additional challenges to access essential women’s health care services,” he said. “Service members and their families, who were previously able to make very personal decisions about when to have a family, may now face greater burdens depending on where they’re stationed.” 

Cisneros told lawmakers that the DOD continues to review its personnel and medical polices as a result of the Dobbs decision. 

“We understand the very personal nature of how the court decision impacts families,” he said. “We are being very deliberate in analyzing Dobbs with both focus and compassion. We want to make sure we get this right because it impacts access to essential women’s health care and reproductive care.” 

Another aspect of reproductive health care that lawmakers were interested in concerned the availability of contraception within the military health care system. Seileen Mullen, the acting secretary of defense for health affairs, testified that until recently DOD had contraceptive clinics set up at 18 military treatment facilities across the department. Now, she said, the plan is to have those clinics at all military treatment facilities across the department. 

“We have expanded where we have military treatment contraceptive clinics — walk-in clinics,” she said. “A woman or man could come up, get counseling, and decide what contraceptives they need that day.” 

Cisneros said the department is changing policy on one form of contraception in particular — the intrauterine device, or IUD — to make it available to more service members. 

“We are currently updating our policies so that service members and their families will be able to receive those IUDs through the TRICARE health care system without having to pay a copay, which is currently the thing right now,” he said. “We’re changing our policy, updating it, so that the copay will be eliminated with that.” 

Mullen also told lawmakers that the department will soon release results of a survey on women’s reproductive health conducted by the RAND Corporation, which reveals a lack of knowledge among service members regarding contraceptive options. 

“It’s the first time that has been done in 30 years,” Mullen said. “It’s given us quite a bit of information … includ[ing that there’s] a lack of education about women’s options around contraceptives, which are free in our MTFs. All active-duty service members get free contraceptives within the MTFs and in our retail pharmacies.” 

Right now, Mullen said, there is a small copay for active-duty service members to get contraceptives, but congressional legislation might change that — making contraception totally free to service members and their families. 

“We also … have an app called ‘Decide and Be Ready’ that men and women can use to go through their contraceptive options to decide what’s best for them,” she said. “We also have those walk-in clinics that are … being expanded this year, as well. But … it’s sort of astonishing how our young men and women really don’t fully know of what their reproductive rights and health care consists of, and we need to do a better job.”

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VA’s $16 billion health records overhaul may be scrapped if fixes aren’t made

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House lawmakers warned that they may kill off the Department of Veterans Affairs costly and complicated electronic health records modernization effort unless officials can show significant progress in coming months.

Administrators “have to fundamentally improve,” said Rep. Mike Bost, R-Illinois, ranking member of the House Veterans’ Affairs Committee, during a hearing on the topic Wednesday. “If we don’t see major progress by early next year, when VA says they intend to roll [the effort] out to larger sites, we will have to seriously consider pulling the plug.”

“I hope the situation can somehow be turned around. But everyone involved in this needs to understand that the consequences are real, and that there are no blank checks.”

The criticism from House members came amid the second tense hearing for VA health records officials in the past week.

On July 20, members of the Senate Veterans’ Affairs Committee grilled department leaders over new delays in the 10-year modernization effort and reports that the $16 billion price tag could more than triple in coming years.

Just a few days earlier, the VA Inspector General’s office released a new report detailing 149 cases of patient harm caused by the implementation of the new Oracle Cerner Millennium records software over a nine-month period at the department’s hospital in Spokane, Washington.

A flaw in the system sent about 11,000 orders to an unknown and unchecked file, where requests for items such as appointments or blood tests went unanswered. In at least two cases, the lost files caused “major harm” to patients.

The health records overhaul was announced by then-President Donald Trump in 2017 as a way to bring veterans health records onto the same system as the military, providing troops with a lifelong medical file.

But the effort has been beset by problems for the past few years. The new software has been deployed to sites in Ohio and Washington, but additional planned rollouts for 2022 have been delayed until 2023 amid the mounting concerns.

In testimony Wednesday, Dr. Terry Adirim, director of the Electronic Health Record Modernization Integration Office, pushed back on the cost overrun estimates, saying they are based on the assumption putting the system in place will take more than 10 years.

“We are still in the process of planning for a 10-year deployment and we should have a schedule out sometime in the fall,” she said. “However, there have been delays, and so it’s reasonable to expect that it could go beyond that, and we are doing that kind of contingency planning.”

Lawmakers called the situation troubling.

Bost said he intends to draft legislation protecting patients and taxpayers from the program spiraling out of control.

If Republicans win control of the House in the November election, he likely will take over as chairman of the committee and would wield considerable legislative power on the issue.

Current committee Chairman Mark Takano, D-California, said he still believes that the department must upgrade its records system but “I will not sit idly by and allow this program to endanger veterans.”

Rep. Matt Rosendale, R-Montana, called the system “fully dysfunctional” and said he believes it is “not safe or suitable to roll out anywhere else.”

Other panel members said they will work with VA officials to “hold program officials accountable,” which could mean reprimands and dismissals in coming months.

VA officials have promised overhauls to the training programs to better prepare staff for future deployments. Leaders at Oracle Cerner have said publicly they are committed to fixing past problems with the system.

Leo covers Congress, Veterans Affairs and the White House for Military Times. He has covered Washington, D.C. since 2004, focusing on military personnel and veterans policies. His work has earned numerous honors, including a 2009 Polk award, a 2010 National Headliner Award, the IAVA Leadership in Journalism award and the VFW News Media award.

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