Is your health plan on the sick list?

The “What-Was-I-thinking?” decision of Congress to leave the Federal Employee Health Benefits Program next January could have major repercussions down the road for federal workers and retirees. As in higher premiums and reduced benefits and coverage for starters!

The fact that national politicians and their staffs — the people who make the laws and who created the FEHBP — have been key players (and sometimes patients) is a major reason the cradle-to-grave federal program is considered the best in the nation.

Many members of Congress — and their all-important staffers, who do much of the real thinking and heavy-lifting for legislators — had hoped that implementation of the Affordable Care Act (aka Obamacare) would not impact them. Like regular federal and postal workers, members of Congress, staff and family members are currently entitled to FEHBP coverage.

Nobody eligible for the FEHBP (by employment, marriage or birth) can be denied coverage because of age, health, personal life-style or preexisting conditions. Covered individuals pay only 25 to 27 percent of the total premium cost. No matter how old and sick they or family members get, coverage in more than a dozen plans is guaranteed. The government pays the rest and that percentage remains constant each year if premiums go up.

The FEHBP is so good that many savvy people, especially in the Washington area, moved into government toward the end of their careers to work for at least five years to qualify for the federal plan when they retire.

FEHBP premiums are paid on a pre-tax basis and there are a wide range of plans, from global fee-for-service to localized HMOs to chose from. The FEHBP is so good that many private sector types take federal jobs late in their careers to qualify for lifetime FEHBP coverage for themselves and their families.

For rank-and-file federal and postal workers, one of the best things about the FEHBP is that it covers members of Congress. And congressional staff who write laws, including the ones that set up and improved the FEHBP. That is also, perhaps, the primary reason the FEHBP is so good. Congress didn’t set up the excellent program to take care of a bunch of bureaucrats and retired feds. Members of Congress, and staff, are not dumb. And they get sick too. When they write a law improving federal worker benefits — whether it involves health insurance or the retirement plan — they also look out for number one. And then some. But sometimes Congress gets tripped up by its own political machinations. Like now…

Beginning next January, a lot of things will change. House and Senate members who are now happily enrolled in the FEHBP will be required to find new coverage. When the ACA plan was being debated, both sides used FEHBP coverage to advance their cause. One side said it was hypocritical to put ordinary Americans into a new system while members of Congress remained nestled in the FEHBP. The other said, hang-the-FEHBP, we’ll go with the crowd. Now, they are about to do just that.

So what does an FEHBP without politicians mean? It could well mean that in the future politicians will propose cuts, price increases or both for the FEHBP. It could also make it easier for Congress to approve a voucher system for the FEHBP (where you would be given a fixed amount of money to buy your own plan). Or change the system which has federal agencies paying the lion’s share of employee and retiree premiums.

All for the good of the taxpayers now. As of January, 2014, members of Congress will no longer be part of the FEHBP.

NEARLY USELESS FACTOID:

By Julia Ziegler

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