Congress Passes and President Signs ACA-Backed Legislation Ordering Pentagon to Accelerate Chiropractic Care for America's Military

On November 24, 2003, President Bush signed into law the National Defense Authorization Act for Fiscal Year 2004 (HR 1588). This legislation authorizes the U.S. Defense Department's range of military activities, military construction programs and the defense activities of the Department of Energy. Also, the legislation prescribes personnel strength levels for the Armed Forces and establishes policies and priorities for military health programs, including the chiropractic care benefit Congress approved in 2000 for active duty military service personnel.

HR 1588 contains an ACA-backed provision (Section 711) that orders the Pentagon to move more quickly to make chiropractic care available to our troops. The legislation – now the law of the land -- accelerates implementation of the chiropractic care benefit for America's active duty soldiers, sailors, airmen and marines and sets October 1, 2005 as the new target date for implementation, a full year earlier than what was originally called for by Congress.

Congressman Ed Schrock (R-VA), a member of the Armed Services Committee, played a leadership role in including this directive and accompanying report language calling for a $6 million increase in funding for chiropractic care programs in the DoD budget. The Armed Services Committee Chairman, Rep. Duncan Hunter (R-CA), and a key subcommittee chairman, Rep.John McHugh (R-NY), strongly supported the chiropractic benefits acceleration and cited it as one of four key improvements in the military health program contained in HR 1588. Although a chiropractic provision was not originally included in the Senate version of the bill, a successful ACA and ACC lobbying effort targeting House-Senate conferees – backed by the grassroots involvement of ACA and SACA members -- ensured that the pro-chiropractic language was included in the final bill and signed by the President. Senator Jim Talent (R-MO), a pro-chiropractic leader in the Senate, also fought hard for inclusion of Section 711 and the favorable report language

In addition to the statutory directive to the Defense Department to move faster to get chiropractic care to our troops, the legislation seeks to correct specific deficiencies in the overall implementation of the chiropractic care benefit for active duty personnel. Earlier this year, the Senate approved report language seeking to strengthen the role of the department's Chiropractic Oversight Advisory Committee, increase the accessibility of the chiropractic benefit to cover 45 military health sites around the U.S. by next September and safeguard the status of DCs in the military health system.

Here are the relevant statutory and report language sections of HR 1588:

Statutory Provision -- HR 1588 SEC. 711. ACCELERATION OF IMPLEMENTATION OF CHIROPRACTIC HEALTH CARE FOR MEMBERS ON ACTIVE DUTY.
The Secretary of Defense shall accelerate the implementation of the plan required by section 702 of the Floyd D. Spence National Defense Authorization Act for Fiscal Year 2001 (Public Law 106-398; 114 Stat. 1654A-173) (relating to chiropractic health care services and benefits), with a goal of completing implementation of the plan by October 1, 2005.


Conference Report Language -- House Report 108-354 SUBTITLE B--OTHER BENEFITS IMPROVEMENTS
Acceleration of implementation of chiropractic health care for members on active duty (sec. 711)
The House bill contained a provision (sec. 706) that would require the Secretary of Defense to accelerate the implementation of the program, required by section 702 of the Floyd D. Spence National Defense Authorization Act for Fiscal Year 2001 (Public Law 106-398), to provide chiropractic health care services and benefits to active duty members by one year.

The Senate amendment contained no similar provision.
The Senate recedes.


Report Language -- House Report 108-106 ACCELERATION OF IMPLEMENTATION OF CHIROPRACTIC HEALTH CARE FOR MEMBERS ON ACTIVE DUTY
This section would require the Secretary of Defense to accelerate the availability of chiropractic health care services and benefits through medical treatment facilities within the Defense Health Program (DHP) to members on active duty. The committee authorizes funds to be appropriated for the DHP above the budget request in the amount of $6.0 million for this purpose.


Senate Report Language -- Senate Report 108-046 ITEMS OF SPECIAL INTEREST
Chiropractic health care
The committee is concerned about effective implementation of the chiropractic health care program in the Department of Defense (DOD). The committee understands that the Chiropractic Oversight Advisory Committee, which was created to provide advice to the Secretary of Defense on the development and implementation of this program, has not met in over a year. The committee encourages the DOD to continue to seek the advice and expertise of the Chiropractic Oversight Advisory Committee as implementation of the chiropractic health care program continues throughout the military health care system.

The committee encourages the Department to accelerate the number of military treatment facilities that provide chiropractic care to active duty service members. Accordingly, the committee directs that the Department provide the chiropractic benefit at no fewer than 45 sites by the end of fiscal year 2004. The Department should make information readily available to members of the military departments concerning access to chiropractic services.

Further, every effort should be made by the Department to recognize chiropractors as the health care professionals that they are. The committee recommends that chiropractors, given their extensive medical training, should report to a physician rather than a physician's assistant or other specialty practitioner.