Air Force Confirms Medical Disqualifications Doubled after New Med-Records System Implemented

On Friday morning, my report detailing the deleterious effect that the Department of Defense’s new health-records system, called Genesis, may have had on recruitment was published. Using firsthand reports from recruiters who deal with the challenges of bringing on the next generation of service members, I walked through the popular theories and took a long look at how the DOD’s health-reporting system, which went live at all recruit-processing centers in 2022, now pulls all applicants’ medication records and what this new system of absolute knowledge might mean compared with the old system of self-reporting. As Frank, one of the recruiters I interviewed, shared, about a third of his applicants had some sort of medical hang-up under the new system. But his was only one recruiting district in one state in one branch (the Navy), so his information was directionally helpful but statistically insufficient to make a strong claim one way or the other.

To complement the recruiters’ anecdotal experiences, I contacted the Marines, Navy, Air Force, and Army earlier in the week — not to mention Leidos (the DOD-contracted provider for Genesis), the U.S. Military Entrance Processing Command, and the Pentagon — but Leidos and the Pentagon replied with “no comment” and an anodyne approval of the new system. Thankfully, on Friday night, the Air Force came through with the numbers.

An Air Force spokesman shared with National Review (emphasis added):

The Health Information Exchange associated with MHS Genesis requires more records to be reviewed as increased initial, potentially disqualifying conditions, are uncovered that entail extended and substantial records requests.

In Fiscal Year 2021, 81 percent of all Air Force applicants going to MEPS [military-entrance processing stations] were qualified on their initial processing visit. In Fiscal Year 2022 (the start of MHS Genesis and Health Information Exchange), this initial qualification rate dropped to 69 percent and ended Fiscal Year 2023 with a 58 percent initial qualification rate.

During the transition to MHS Genesis, the timeline to clear applicants increased until a sufficient number of personnel were added to review and provide final medical determinations. In the last year, enlisted medical waiver decisions have gone from three weeks to three days to initiate evaluations. MHS Genesis continues to ensure we are getting the fittest, most healthy Airmen and Guardians for our missions.

In short, the U.S. Air Force, which before 2023 had met its recruiting goals every year since 1999, experienced a doubling in its initial-medical-rejection rate in the span of two years, and the most significant change during that span had been the incorporation of the Health Information Exchange that’s part of the Genesis records system.

Some back-of-the-napkin math: The Air Force adds about 31,000 airmen every year. Assuming every medically unqualified applicant is permanently rejected (for ease of figures), military-entrance processing stations (MEPS) would have had to process 38,271 airmen to reach the 31,000 figure in 2021. Using the same pool and applying Genesis, only 26,407 would be qualified in 2022 and fewer than 22,198 in 2023. To get 31,000 qualified recruits in 2023, the Air Force would have needed to process 53,448 applicants — 15,000 more than it did in 2021. That’s asking a heck of a lot more from recruiters, MEPS, and the recruiting budget.

As the spokesman notes, the Air Force has instituted a hiring blitz to more quickly make judgments on medical waivers for those who are initially disqualified — excellent. However, as I note in my report, the three days of waiver review are preceded by weeks of preparation, hassling past doctors, and document-chasing conducted by the waiver requester. The Genesis-related surge in waiver-necessitating conditions being uncovered is more work for everyone, and more work for the applicant increases the chances that he’ll go searching for work, school, or something else that doesn’t require a battery of doctors’ appointments.

As I concluded in the report:

To be clear, Genesis offers a long-term upside for veteran care, but until medical standards and waivers are streamlined for recruits (i.e., comport with the reality of American teens), the U.S. military is likely to see continued shortfalls as candidates who previously would have been seen as viable are prevented from joining. Even if a sixth of applicants, rather than a third, as Frank experienced, are now disqualified from service, that’s an unacceptable figure and would go most of the way toward explaining the recruiting downturn that began in 2022.

You can read the whole report (which now includes the Air Force’s statement) here.

Editor’s Note: Story updated to reflect Genesis is provided, rather than developed, by Leidos.