Health Care Gap Cited for Guard, Reserve

National Guard member Scott Jones, 34, and his wife, Melissa

hide captionNational Guard member Scott Jones, 34, and his wife, Melissa, sit with their dog outside their trailer home in Columbus, Miss.

Marisa Penaloza, NPR
Scott and Melissa Jones spent their honeymoon at Wal-Mart

hide captionScott and Melissa Jones spent their honeymoon at Wal-Mart — not buying, just looking. Deployment would have boosted Scott's income by as much as $30,000 over his civilian salary and provided full family health insurance for his six children.

Courtesy of the Jones family

Revising Tricare

This position paper on Tricare, the military medical system, was prepared by the National Guard Association of the United States. The group is lobbying Congress for full coverage for Guard members and reservists from the moment they enlist.

The American fighting force in Iraq includes 49,000 citizen soldiers from Reserve and National Guard units. But thousands of others stay home, declared unfit for duty due to inadequate health care before they're mobilized.

Among them is Scott Jones, 34, of Columbus, Miss. A 14-year National Guard tank crewman, Jones is desperate to serve in Iraq, because he'd double his civilian income as a handyman and get full family health insurance — leaving him, his wife and their six children better off than before.

But Jones' two mobilizations went awry when Army doctors at Camp Shelby in Mississippi found him unfit for duty, citing depression and a gum disease that leads to rotten teeth.

Jones lost his civilian job when he received his orders for Iraq, despite a federal law designed to prevent that. At the same time, his wife gave up her job at McDonald's to get treatment for cancer. Jones was told he could be deployed once he got his dental problems addressed, but there was little money for rent and food, let alone major dental work. The family was evicted.

Though Jones' case is extreme, it illustrates a larger problem, says Ret. Brig. Gen. Stephen Koper, president of the National Guard Association, a private advocacy group.

"Among our lowest enlisted grades, 40 percent do not have any kind of health insurance," Koper says. "They're not as healthy as they might be… they are dependent on their own devices to get health care, and in many cases they don't get it at all."

Seven percent of Guard members and reservists arrive for duty medically unfit, a statistic that troubles Tom Hall, assistant secretary of defense for reserve affairs, who acknowledges that "medical readiness is a problem."

But Hall says providing full military medical insurance for Guard members and reservists as soon as they enlist would cost billions of dollars.

"Will you and I as a taxpayer have an enormous bill that will not allow us to properly do other things like modernize and buy equipment? It could be a tradeoff," Hall says.

NPR's Marisa Penaloza produced this report.

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