This post has been updated.
In the months since Rep. Gabrielle Giffords, D-Ariz., sustained a gunshot wound to the head, her difficult path to recovery has been helped by a comprehensive brain injury treatment paid for by the government under federal worker’s compensation.
As the Daily Beast reports, a “central component” of Giffords’ therapy regimen is cognitive rehabilitation therapy, a costly medical treatment designed to retrain the brain to do basic tasks.
Such treatment, as we noted in January, may be available to Giffords, but it is out of reach for thousands of U.S. troops whose health coverage doesn’t include it. The Pentagon’s health care program, Tricare, has refused to cover it but does cover certain types of therapy—such as speech and occupational therapy—which can be a part of cognitive rehabilitation therapy. Tricare officials have said that scientific evidence does not justify providing it comprehensively to troops.
In January, we called Rep. Giffords' office to ask whether she’d ever taken a position on expanding such coverage to troops with brain injuries. We never received an answer.
But in a letter to Health and Human Services Secretary Kathleen Sebelius this month, Giffords’ office has taken a stance. Pia Carusone, her chief of staff, asked the Obama administration to remedy the inequities in access to quality brain injury rehabilitation.
“Most military service members and other Americans who have sustained TBIs lack access to the same high standard of care,” Carusone wrote. (Read the full letter.) “It is imperative that all Americans with TBI have access to the same full continuum of medical treatment that Congresswoman Giffords has been so fortunate to receive.”
Under the health care law passed last year, the U.S. Department of Health and Human Services is tasked with deciding which health benefits are essential and must be provided by Medicaid and by insurers participating in insurance exchanges come 2014. Giffords’ office urged the department to define comprehensive brain injury rehabilitation as one such essential benefit.
Even if Sebelius and her staff take that advice, it’s unclear whether that will extend coverage for American troops. According to a report by the Congressional Research Service [PDF] released last year, the health care reform law “does not affect TRICARE administration, health care benefits, eligibility, or cost to beneficiaries.”
Given this, we’ve asked Giffords’ press office whether the staff would also support having Tricare expand benefits specifically for servicemembers. We’ll update when we hear back.
Update, 4/21: A spokesman for Rep. Giffords acknowledged that including comprehensive rehabilitation treatment in the essential benefits package wouldn't extend benefits for U.S. troops covered by Tricare. The letter is "a first step," spokesman Mark Kimble told me. "Our office is working on the military side of the issue as well."
