OPINION:
Kaitlyn Samuels is not a household name. More people should be aware of her story, though, because she represents a growing number of military families that are being left in the cold by the Department of Defense and its military health insurance provider, Tricare.
The teenage daughter of a Navy captain, Kaitlyn suffers from cerebral palsy, scoliosis, autism and epilepsy. Without physical therapy, Kaitlyn’s spine will curve to a degree that will fatally collapse her lungs. The severity of her condition rendered traditional physical therapy conducted on a ball or a bench useless. It was unclear what steps could be taken to arrest or at least slow her decline.
In an act of desperation, Kaitlyn’s doctors hit upon a novel solution and tried conducting her physical therapy on a horse. Miraculously, it worked. But after six years of covering this therapy — which is less expensive than the traditional physical therapy it replaced — Tricare changed its mind and began denying her coverage. It also demanded the family pay back a year of physical therapy costs. Tricare argued that the use of a horse as a therapy tool was experimental and unproven, despite the clear evidence of its effectiveness with Kaitlyn.
After two years of appeals, the Samuels family finally had their day in court. They thought they’d won: The court recommended the Defense Department grant Kaitlyn her benefits. Victory was fleeting, however. The Pentagon sent the Samuels a letter disregarding the judge’s recommendation and once more denying coverage. It sounds unbelievable, but it’s true.
It’s not just Kaitlyn. There are growing numbers of special-needs children and wounded warriors who, to our country’s great shame, are increasingly being denied coverage for basic physical therapy.
Last month, H.R. 1705, Kaitlyn’s Law, was introduced as a bill to amend the U.S. Code to provide for certain forms of physical therapy under Tricare. We proudly support the legislation, which is sponsored by the Samuels’ congressman, Rep. Michael C. Burgess, a Texas Republican and physician.
As Iraq and Afghanistan war veterans, we understand the critical role Tricare plays in providing health care for service members and their families. Particularly when serving overseas, Tricare is often a family’s only health care option. Special-needs families — in which a soldier’s spouse often cannot work because he or she must stay home to care for a child with acute medical problems — can be even more reliant upon a creditable and properly functioning Tricare system.
This is not a spending bill, nor does it expand health care service. It merely serves to enforce the provision in the existing statute confirming coverage for therapy that is medically necessary and proven to work.
Kaitlyn’s Law will clarify the physical therapy tools Tricare must cover in order to prevent the irresponsible mismanagement of benefits already available. It will ensure health care decisions for veterans and their families are made by doctors and patients, not by Washington bureaucrats without medical training or specific knowledge of the case.
It’s important to ensure that the health care program serving uniformed service members, retirees and their loved ones works, and isn’t just lip service. The Samuels family and many others are counting on Washington to affirm the solemn promises the federal government makes to the men and women who volunteer to serve and defend our country.
Members of Congress who want to see that military health care is being responsibly managed should join together to pass this simple, smart, straightforward bill. If you want to support our troops, support Kaitlyn’s Law.
Rep. Tom Cotton is an Arkansas Republican; Josh Mandel, a Republican, is Ohio state treasurer; and Pete Hegseth is CEO of Concerned Veterans for America.
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