Your health plan: BFF, WDW, WOOT or WTF?

Tuesday - 5/7/2013, 2:00am EDT

Confused about what kind of health plan you, as a federal worker or retiree, will have next year? Will you be in a Maryland or Massachusetts health exchange or the Federal Employees Health Benefits Program?

If so, welcome to Washington's rapidly growing WDW (We Did What?) delayed-reaction club. You can be a member whether you supported or opposed the administration's Affordable Care Act, aka Obamacare.

Now the issue is what impact, if any, the ACA will have on the Federal Employees Health Benefits Program, the nation's biggest, and best employer-supplied health care program. Few Americans know much about the FEHBP except that it is very good program with lots of options — and that the boss pays about 70 percent of the total premium. And the bosses, in this case your elected leaders, are in it too!

There has been lots of reporting on the FEHBP of late. Some of it has been as spot-on as possible, some a tad misleading because this is complicated stuff.

Some of the things that may or may not impact federal workers and politicians are yet to be decided either by Congress and/or the Office of Personnel Management.

Most of the opposition to the ACA came from Republicans who said it would be elitist if Congress stayed in the FEHBP while forcing many non- elected, non-federal workers and employers into mandatory coverage and state health exchanges. They took steps to ensure that members of Congress — and staffers — would be have to leave the FEHBP for state exchanges next January.

Backers of the ACA say it was never intended to cover everyone and was designed for the roughly 15 percent of Americans who don't have or can't get health insurance. That would certainly not include the millions of people who automatically qualify for the FEHBP because they are members of the federal-postal family.

Getting a glimpse of the health care future (as in the year 2014) is not easy because the very complex Affordable Care Act was written and passed relatively quickly. Many of the most important things in it — backers say the best stuff, opponents say the nasty bits — were delayed until next year.

In a worst-case scenario, federal workers in 2014 would lose coverage under the relatively low-cost, cradle-to-grave FEHBP and be forced to get coverage from one of the ACA-mandated state insurance exchanges.

Other potential changes would impact all members of Congress and many (but not all) employees of the House and Senate. As currently written, the ACA requires senators, representatives and many of their staffers to leave the FEHBP and instead go into state-by-state health care exchanges. They could also lose one of the big perks of the FEHBP: The government contribution to their health premiums. Currently, Uncle Sam pays anywhere from 20 to 25 percent of the total premium. Under the pending change, members of Congress and many congressional staffers could lose that benefit. That could be a double blow because in addition to losing the government contribution to their health plan, they would be put in exchanges where premiums are based on the actual risk pool rather than in an employer-based program like the FEHBP.

Senate Majority Leader Harry Reid (D-Nev.) last week denied there have been secret talks on the status of senators, staff and the FEHBP. Others say Congress is working quietly on a plan including one that would move members out of the program, but permit congressional employees (many of them low-paid) to stay in the subsidized FEHBP program.

Stay tuned. This could be a very interesting and educational health insurance open season coming up.


NEARLY USELESS FACTOID

Compiled by Jack Moore

Sigmund Freud, the father of psychoanalysis, had his wife choose his clothes and handkerchiefs everyday and even put toothpaste on his toothbrush for him.

(Source: Slate)


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