No Need for Congress To Reverse 1981 Decision To Deny U.S. Merchant Seamen a Government-Financed Health Care Program

In response to a congressional request, GAO reviewed the rationale for providing medical care to merchant seamen, the methods used to finance it, the reasons for repealing merchant seamen's entitlement to health care at federal facilities by the Omnibus Budget Reconciliation Act, and the arguments for restoring some type of government-financed health care.

GAO found no compelling reason for Congress to provide health care at federal facilities to merchant seamen. Because of improved health conditions, the spread of communicable diseases by merchant seamen is no longer the problem it was in the past. This was the original justification for providing health care to merchant seamen at federal facilities. According to maritime law, shipowners are liable for medical expenses resulting from an illness or injury that occurs while a seaman is in the service of a vessel. In addition, a federal subsidy pays approximately 70 percent of the health care benefits for seamen employed on approximately one-third of the privately owned U.S. vessels in the maritime industry. Further, the federal government provides compensation for merchant seamen's health care during wartime or national emergency when seamen provide services to the government. At other times, seamen likely to be called to aid the defense efforts have access to health care through union health plans. Procedural and administrative questions would have to be addressed before it would be feasible to provide government-financed health care through a program such as the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS). GAO estimated that the annual cost of including merchant seamen and their dependents under the CHAMPUS program would be about $312 million.