In the world of military healthcare, the promise of a lifetime of care can be a powerful recruiting tool. But when that promise is broken, the consequences can be devastating. This is the story of Guy Shoemaker, a retired Army sergeant first class who was diagnosed with throat cancer and relied on the military's healthcare program, TRICARE, for his treatment. What started as a smooth journey through the healthcare system took a sharp turn when TRICARE transitioned to a new contractor, TriWest Healthcare Alliance, and Shoemaker's experience became a microcosm of the larger issues plaguing the military's healthcare program.
A Broken Promise
For over a decade, Shoemaker pitched military service to potential recruits, touting the promise of healthcare for life. When he needed it, he turned to TRICARE, which covered the chemotherapy, radiation, and follow-up care that helped him regain his ability to eat and speak. But when TRICARE transitioned to TriWest, his experience took a turn for the worse. Suddenly, tens of thousands of dollars in previously approved claims were overturned, and money that had been paid to providers was clawed back. Shoemaker, who had stopped going in for his regular therapy appointments due to the financial strain, found himself in a dire situation.
The Larger Issues
Shoemaker's case is not an isolated incident. Since the transition to TriWest, there have been reports of pregnant women and new mothers having their care disrupted, veterans receiving massive bills for previously approved and paid claims, and providers going months without reimbursement. In February 2025, the Defense Health Agency, which oversees TRICARE, acknowledged that challenges had cropped up nationwide since the transition. But a year later, problems persist, and the situation raises questions about whether TriWest was prepared to take on the more than 4 million members and how the Defense Health Agency has worked to resolve the situation.
The Defense Health Agency's Role
Two sources with direct knowledge of the transition from Health Net to TriWest claimed that after TriWest was awarded the $65 billion contract, the Defense Health Agency was repeatedly warned that it wasn’t ready to take on the work. The sources claimed staffing was insufficient and that staff members were poorly trained, and that an inability to handle the massive volume of patient and provider data jeopardized coverage for millions. The Defense Health Agency did not provide adequate oversight of the transition, and by early December 2024, it was still unclear whether TriWest would have the staffing and training in place before the takeover.
The Human Cost
The human cost of these issues is profound. Shoemaker, who had to stop going in for regular therapy sessions due to the financial strain, found himself in a dire situation. His cancer treatment led to scarring that thickened the muscles in his throat and made swallowing difficult. He carries a cup with him because his salivary glands have dried up, creating mucus and phlegm in his throat, and he undergoes periodic dilations to expand his throat. If he loses his ability to swallow, he risks aspiration, which can lead to pneumonia and be deadly.
The Way Forward
The ongoing issues with TRICARE and TriWest raise important questions about the future of military healthcare. How can we ensure that the promise of healthcare for life is not just a recruiting tool but a reality for those who serve? How can we prevent similar issues from arising in the future? These are questions that need to be answered, and the answers will shape the future of military healthcare.
In my opinion, the Defense Health Agency needs to take a more proactive approach to oversight and ensure that contractors like TriWest are adequately prepared to take on the work. The human cost of these issues is too high, and we cannot afford to have more people like Guy Shoemaker suffer because of a broken promise. It's time for the Defense Health Agency to step up and ensure that military healthcare is a true promise that is kept.
