Over one million U.S. military service members are members of the National Guard or reserves. These troops are being tested like never before, yet they do not receive the same physical and mental health care coverage provided to their active-duty counterparts, a gap that a recently introduced bipartisan bill seeks to address.

The year 2020 has been called “the year of the Guard,” given nearly continuous activations for domestic missions supporting responses to the COVID-19 pandemic, several natural disasters, civil disturbances and unrest, and Department of Homeland Security activities at the southern border. As a result, 2020 required one of the highest mobilization levels of the National Guard since World War II. This may contribute to an increase in the use of health care benefits, particularly those associated with mental health care.

Referred to as the reserve component, members of the National Guard or reserves represent approximately one-third of all military personnel. The reserve component is strategically important within the U.S. armed forces, serving both international and domestic missions. Approximately one-quarter of U.S. military service members who deployed between 2001 and 2015 were in the reserve component. Reserves serve only on federal missions, while National Guard can be mobilized under state or federal orders.

Despite their essential role in the military, reserve component service members do not receive the same medical benefits as active component service members. Eligibility for military health insurance benefits under TRICARE changes over time based on whether a service member is “activated” for a particular mission and the length of the activation orders. When they are not on active-duty orders, reserve component service members might be covered by insurance provided through an employer or spouse. Thus, in a given year, a reserve component service member can receive health insurance from different types of TRICARE coverage, U.S. Department of Veterans Affairs coverage, and two or more sources of civilian coverage.

Read the full article about health care for National Guard members by Justin Hummer and Kimberly A. Hepner at RAND Corporation.