January 24, 2023

Senator Warren Asks Answers After DoD-Affiliated Civilians and Contractors in Japan Lose Access to Health Care at U.S. Naval Hospital Yokosuka

“Providing the best possible services to support service members and civilians deployed overseas enhances readiness, retention, and morale.” “It is unclear whether DHA has provided civilians the support and advice they need to transition to receiving care through telehealth and at off-base locations.”

Text of Letter (PDF)

Washington, D.C. — United States Senator Elizabeth Warren (D-Mass.) sent a letter to the Department of Defense (DoD), raising concerns about the decision to stop providing care to civilians at U.S. Naval Hospital Yokosuka. Senator Warren is raising questions about what services are being provided to help support the transition of care and when space to provide care to civilians might open up again.

In September 2022, the U.S. Naval Hospital Yokosuka announced it would cease to provide care to DoD contractors and other civilians, leaving around 4,000 individuals uncertain about their access to healthcare. It is also not clear whether or not the Defense Health Agency (DHA) has provided these individuals with the proper support and advice needed to transition their healthcare to an off-base location.

“Civilians have expressed concerns they will lose access to prescriptions and be unable to independently navigate Japan’s healthcare system without DoD’s assistance,” wrote Senator Warren. “They also express concern that Japanese healthcare facilities and providers will be able to turn them away if they do not have sufficient resources, including language support, to treat these American civilians.”

In December 2022, Congress passed the National Defense Authorization Act (NDAA) for Fiscal Year 2023, requiring the Secretary of Defense to “notify Congress in advance if there is a modification to ‘the scope of medical care provided at a military medical treatment facility, or the beneficiary population served at the facility.’” 

“These provisions went into effect when President Biden signed the NDAA on December 23, 2022, and given the changes put in place at the Yokosuka facility, I expect to receive this formal notice and this transition plan as rapidly as possible so that affected civilians receive the support they need after this loss of care,” concluded Senator Warren.

Senator Warren is asking that all questions about what steps DHA is taking to help smooth the transition and support civilian shortfalls be answered no later than February 6, 2023.

Senator Warren has long worked to ensure affordable access to healthcare for all:

  • In August 2022, Senator Warren and Representative Castro (D-Texas) sent a letter to Secretary of Defense Lloyd Austin raising concerns that the Department of Defense (DoD) may be misleading or misinforming civilians about debt they incur when they receive emergency medical care at military health care facilities, and calling for improved billing practices to protect patients.
  • The FY 2021 National Defense Authorization Act (NDAA) included Senator Warren's provision, based on the Financial Relief for Civilians Treated at Military Hospitals Act, to give DoD the authority to waive medical debt when the civilian is unable to pay the costs of the care provided and the care enhances the knowledge, skills, and abilities of military healthcare providers.
  • Senator Warren originally introduced the Financial Relief for Civilians Treated at Military Hospitals Act in June 2020 and reintroduced the legislation with Representative Castro in December 2022.
  • In January 2020, Senator Warren sent a letter to DoD and the Treasury Department requesting information about the collection of military hospital debt from low-income, civilian patients.