- The Washington Times - Monday, August 3, 2009

Experts in benefit programs consider the federal retirement system to be the jewel in the crown when it comes to perks. And nobody in Congress or the administration is looking to make any changes, at least for now.

But when it comes to the second most valuable civil service benefit, no-strings health insurance for life, some benefit-watchers are a tad nervous.

About 9 million people — from 100-year-old former feds to one-day-old infant children of government workers — are covered by the Federal Employee Health Benefits Program. Members of Congress, who are covered by the program, often use it as the model for national health care reform. For good reason.

The program is open to active and former feds, their spouses and dependents and, in some cases, grandchildren and ex-spouses. For workers and retirees, the government pays about 70 cents of every premium dollar. Participants are eligible for more than a dozen plans ranging from local health maintenance organizations to insurers offering nationwide or even worldwide coverage.

Participants can change their plan each year during the November-December open season or if they marry, divorce, have children or move to a different area. Persons eligible for FEHBP cannot be rejected because of age, health or pre-existing conditions. Retirees pay the same premiums as young healthy workers in the same plans. Coverage continues for family members when the primary insured person dies.

President Obama has said more than once that all Americans are entitled to the same kind of coverage he had when he was in the Senate. And recently, after she broke her ankle in a fall, Democratic Sen. Barbara A. Mikulski of Maryland said she wanted everyone to have coverage as good as she and other members of Congress have.

While many congressional staffers will take a well-needed break during August recess, many will stay on to work on details of the health care reform bills being developed by the House and Senate. The president has said he wants a bill he can sign by September.

During the 1990s, the Clinton administration made a major effort to come up with some kind of health care reform. Its model was the FEHBP. While much of the planning was done behind the scenes, various proposals surfaced from time to time.

One proposal envisioned putting uninsured Americans into the FEHBP along with federal workers and retirees. Groups representing feds, managers, executives and retirees quickly circled the wagons. They feared the move would add thousands, perhaps millions of uninsured or uninsurable people to the FEHBP risk pool with a corresponding jump in premiums. Unions won a pledge that none of the plans they sponsored in the FEHBP would have to take outsiders.

The reform effort fizzled, and the Obama administration learned from criticism that the Clinton effort lacked transparency. Now things are much more out in the open. But confusion persists as some of the reform bills run more than 1,000 pages long — that’s more pages than the English translation of “War and Peace,” which at least some people have honestly finished.

Meantime, people are having a hard time understanding some things in the House and Senate draft plans. They don’t know how the plans would work or whether they would affect existing coverage. Some of the people doing the worrying are FEHBP plan members.

Several Web sites targeting current and former feds have zeroed in on language in the proposed Senate health care bill (S. 703) by Sen. Bernard Sanders, Vermont independent. It says, in part, that for “Federal Employees Health Benefits Programs … no benefits shall be made available under chapter 89 of Title 5, U.S. Code, for any part of a coverage period occurring after December 31, 2010.”

When members asked the National Active and Retired Federal Employees Association to comment, it said it is hard to know “how, if at all, the FEHBP benefit plans will change.” NARFE noted that while the proposed national health insurance exchange is modeled after the federal program, “it would not use the FEHBP as a vehicle to deliver health care nor would the FEHBP be opened to nonfederal civilian enrollees.” While things could change, NARFE said, the program appears to be safe from reform-induced changes.

Stay tuned.

Mike Causey’s Federal Report runs Mondays. Contact him at [email protected] or 202/895-5132.

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