Why some feds are skeptical of new self-plus-one FEHBP option

Thursday - 12/19/2013, 10:37am EST

Jackie Simon, AFGE's public policy director, on "Your Turn" with Mike Causey

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When it comes to federal employees' health insurance coverage, they are forced into just two options: opt to cover only themselves or choose a one-size-fits-all family plan.

Thanks to the bipartisan budget deal passed by Congress and on its way to the President's desk, though, federal employees will soon have a new choice: "self plus one."

The budget bill amends the law governing the Federal Employees Health Benefits Program (FEHBP) to include the new option. The architects of the budget deal said it would align the federal program with insurance options in the commercial market and help "spread costs across different enrollment types," according to a summary of the bill.

Federal employees have long clamored for the couples-only option, but the Office of Personnel Management, which oversees the FEHBP, has always demurred, citing concerns it would disrupt the risk-sharing inherent in large group plans.

That is, until President Barack Obama recommended a self-plus-one option as part of an FEHBP "modernization plan" included in his 2014 budget proposal.

Now, with the self-plus-one option enshrined in law, at least one federal-employee union finds OPM's recent change of heart "problematic."

AFGE decries 'unknown impact'

"Our concern about is that we don't know the impact," said Jackie Simon, director of public policy for the American Federation of Government Employees, in an interview on Your Turn with Mike Causey. "After being told for so many years — I'm talking decades — that self-plus-one would be more expensive than family, suddenly they've scored savings."

For example, OPM has long maintained that older two-person families and retirees — groups with more expensive health insurance costs compared to younger people with families — would be the most likely to sign up for the new option, which could cause premiums to increase.

"For this reason, it is not clear that adding additional enrollment options to the FEHB Program would result in any significant benefit to those who ask for the change," a frequently-asked-questions section on OPM's website states. "In fact, they might be worse off."

Simon said OPM officials have been "extremely secretive" and "unwilling to share" updated cost-saving estimates or a rationale for why they've changed their longstanding position on self-plus-one coverage.

"They'll say, 'Oh, there are winners and losers,'" Simon said. "Well, we don't know who's going to be the winner, who's going to be the loser and by how much? Then, we look at the score, and we see a savings. When the government's saving that much money, we know employees and retirees are going to be paying more."

In an analysis of the budget deal, the Congressional Budget Office projected that because retirees would be more likely to select the new option, the average costs of their policies would be lower, while the average cost of FEHBP policies for active-duty federal employees would increase.

CBO's analysis of the legislation indicated it would reduce government spending by about $3 billion over 10 years. However, CBO's cost-saving estimate is at odds with an Obama administration estimate which reported the self-plus-one option would cut the deficit by nearly $5.2 billion over the same period.

Federal News Radio has requested comment from OPM.

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