Tom Cole

From the office of:

Tom Cole

Sending Office: Honorable Tom Cole
Sent By:

Become a Cosponsor of H.R. 6148,
The TRICARE ECHO Improvement Act

Supported By: Tricare for Kids Coalition, Children’s Hospital Association, Military Officers Association of America, National Military Family Association, Fleet Reserve Association

Cosponsors: Gaetz, Haaland


Dear Colleague,

We invite you to become a cosponsor of H.R. 6148, the TRICARE ECHO Improvement Act. This important legislation would provide military families with special needs dependents equitable access to supports and services commonly covered by states’ Medicaid programs.

Many states operate Home and Community-Based Services (HCBS) waivers to expand Medicaid coverage to special needs individuals. These waivers provide coverage for long-term care services and supports at home or in a community setting. Because Medicaid is
a state residency-based program, military families encounter difficulties accessing these waivers. The 2015 Military Compensation and Retirement Commission concluded “access to HCBS waiver benefits is a substantial issue for military families…Service members
are required to reapply for benefits each time they move to a new state. Many Service members encounter waiting lists that exceed their time assigned to a location.”

To address this issue, Congress created the TRICARE Extended Care Health Option (ECHO) program in 2001 to serve as an alternative to HCBS waivers. However, the covered services are not comparable to what most states offer. The 2015 Commission concluded “ECHO
benefits, as currently implemented, are not robust enough to replace state waiver programs.”

The TRICARE ECHO Improvement Act recognizes military families deserve an effective, robust ECHO program. As such, it aligns ECHO’s coverage of services with what is widely offered among the states:

  1. Increases hours of covered respite care. Respite care is short-term care for a patient to provide rest for the patient’s primary caregiver. ECHO currently covers only 16 hours per month while states, on average, cover 60 hours. This legislation
    would increase ECHO coverage to 50 hours monthly. It also codifies recently revised regulations that respite care may be offered regardless of whether the eligible dependent receives another ECHO benefit.
  2. Provides coverage of residence and vehicle adaptations. Most states with HCBS waivers cover medically necessary alterations to residences and vehicles to reduce the disabling effects of a person’s qualifying medical condition. The ECHO
    program, however, does not. This legislation would extend its suite of covered benefits to include such adaptations.
  3. Codifies existing coverage of durable equipment. Under current regulations, ECHO may cover service and modification of durable equipment and assistive technology devices, as well as training in use, to ensure equipment is fully functional
    and matches the physical needs of the user.

Our military families sacrifice much in service to their country. Forgoing necessary medical supports and services for special needs family members should not be part of that sacrifice. If you would like to become a cosponsor of this legislation, please
contact Shane Hand with Congressman Cole ( or Dominque Wardell with Congresswoman Luria (



Tom Cole                                                                                          Elaine Luria

MEMBER OF CONGRESS                                                              MEMBER OF CONGRESS

Related Legislative Issues

Selected legislative information: Armed Services, Family Issues, HealthCare, Veterans

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