Federal Employee Health Benefits Program Fast Facts

  • The budget deal announced at the end of 2013 that will avoid sequestration for two years included the establishment of a “self plus one” option for the Federal Employee Health Benefits Program (FEHBP).
  • The “self plus one” option was part of a package of changes to federal employee healthcare that the administration proposed in its FY ’14 budget proposal.  The package included changes in the method for procuring prescription drugs, charging higher premiums for those with certain health risks (those who smoke or suffer from obesity), adding regional Preferred Provider Programs (PPO’s), and making improving coverage for domestic partners.  
  • All of the changes in the administration’s package would have winners and losers; some employees would pay more and some would pay less.  AFGE opposes charging premiums based on health status because it is discriminatory.  AFGE opposes regional PPOs, in part because it would undermine the nationwide plans.  In order to compete, Blue Cross/Blue Shield, the most popular FEHBP plan, would likely discontinue its nationwide service.
  • Last year, the House Republican budget applied the Bowles-Simpson plan to end the practice of the government paying a percentage of FEHBP’s premium and replace this with a voucher.  The voucher would have been adjusted annually by the rate of GDP growth, not premium growth.  Over the next 20 years, such a plan would result in federal employees paying 80% of premiums, compared to an average of 30% today.
  • FEHBP began to offer coverage of Applied Behavioral Analysis (ABA), the most effective treatment for autism, in 2012.  Unfortunately, the Office of Personnel Management has refused to require plans to offer ABA, instead merely permitting it.  As a result, the majority of plans still do not offer ABA and it is not even available in all states.  OPM must require coverage of ABA in FEHBP.

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