Lawmakers Propose Self Plus One Option for Federal Health Program

This December 2, 2013 photo shows a woman reading the HealthCare.gov insurance marketplace internet site in Washington, D.C.
National Journal
Kellie Lunney, Government Executive
Kellie Lunney, Government Executive
Dec. 11, 2013, 10:50 a.m.

The bi­par­tis­an budget pro­pos­al an­nounced Tues­day would pave the way for a “self plus one” cov­er­age op­tion un­der the fed­er­al em­ploy­ee health in­sur­ance pro­gram.

A pro­vi­sion in the $85 bil­lion deal un­veiled by Rep. Paul Ry­an, R-Wis., and Sen. Patty Mur­ray, D-Wash., would al­low the Of­fice of Per­son­nel Man­age­ment to “mod­ern­ize” the Fed­er­al Em­ploy­ees Health Be­ne­fits Pro­gram by ex­pand­ing the menu of en­roll­ment op­tions. FE­HBP cur­rently of­fers self-only and fam­ily cov­er­age; en­rollees with spouses and no de­pend­ents must choose the fam­ily plan to re­ceive cov­er­age for their spouse. The Fed­er­al Em­ploy­ees Dent­al and Vis­ion In­sur­ance Pro­gram, or FED­VIP, has had a self plus one op­tion since 2004.

The ad­di­tion of self plus one cov­er­age “would align the FE­HB pro­gram with the com­mer­cial mar­ket and serve to spread costs across dif­fer­ent en­roll­ment types,” a sec­tion-by-sec­tion ana­lys­is of the budget pro­pos­al stated. FE­HBP provides health care be­ne­fits to 8.2 mil­lion fed­er­al em­ploy­ees, re­tir­ees and their de­pend­ents.

The House could vote on the le­gis­la­tion, which par­tially re­peals the se­quester for two years, be­fore it ad­journs on Dec. 13. The bill also would re­quire new ci­vil­ian fed­er­al work­ers and work­ing-age mil­it­ary re­tir­ees to con­trib­ute more to their pen­sions.

Fed­er­al em­ploy­ees and their ad­voc­ates long have com­plained about the lack of a self plus one op­tion in FE­HBP. Em­ploy­ees with spouses and no de­pend­ents have balked at hav­ing to pay more for a fam­ily plan when they don’t have any chil­dren. But it’s not clear a self plus one op­tion would be any cheap­er for en­rollees since that demo­graph­ic — em­ploy­ees with a spouse and no de­pend­ents — tends to be older and more ex­pens­ive to in­sure than a young couple with chil­dren, ac­cord­ing to OPM’s ana­lys­is. The agency has long stud­ied the costs and be­ne­fits of of­fer­ing self plus one.

“The self plus one premi­um would be based on the health cost of this group,” states OPM in its on­line Fre­quently Asked Ques­tions sec­tion. “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. In fact, they might be worse off.” The budget le­gis­la­tion would re­quire OPM to do an ac­tu­ar­ial ana­lys­is of the cost to self plus one be­ne­fi­ciar­ies for the first year of en­roll­ment.

Ex­pand­ing the health cov­er­age op­tions for fed­er­al work­ers has many sup­port­ers, in­clud­ing some em­ploy­ee and re­tir­ee ad­voc­ates and White House of­fi­cials. Pres­id­ent Obama in­cluded a pro­vi­sion to of­fer self plus one in FE­HBP in his fisc­al 2014 budget pro­pos­al. The Na­tion­al Act­ive and Re­tired Fed­er­al Em­ploy­ees As­so­ci­ation and the Fed­er­al Man­agers As­so­ci­ation praised the self plus one pro­vi­sion in the Ry­an-Mur­ray budget pro­pos­al.

“We be­lieve firmly in the prin­ciple of of­fer­ing an equit­able and af­ford­able fed­er­al be­ne­fits pack­age that will best meet the needs of all fed­er­al em­ploy­ees,” said Greg Stan­ford, dir­ect­or of gov­ern­ment and pub­lic af­fairs at the Fed­er­al Man­agers As­so­ci­ation. “Es­tab­lish­ing a self plus one op­tion with­in FE­HBP has been on FMA’s le­gis­lat­ive agenda for sev­er­al years, so we are ap­pre­ci­at­ive that it is in­cluded as part of the budget deal.”

MOST READ
What We're Following See More »
SHARES THEIR LOVE STORY
Bill Clinton Gets Personal in Convention Speech
4 hours ago
THE DETAILS

“In the spring of 1971, I met a girl,” started Bill Clinton. In his speech Tuesday night at the Democratic National Convention, Clinton brought a personal touch, telling parallel stories of his relationship with Hillary Clinton and the work she has done throughout her career. He lauded the Democratic nominee for her career of work, touching on her earliest days of advocacy for children and those with disabilities while in law school, her role as Secretary of State, and her work in raising their daughter, Chelsea. Providing a number of anecdotes throughout the speech, Clinton built to a crescendo, imploring the audience to support his wife for president. "You should elect her, she'll never quit when the going gets tough," he said. "Your children and grandchildren will be grateful."

LOUD “BLACK LIVES MATTER” CHANTS RING OUT
Mothers Of The Movement Endorse Hillary Clinton
6 hours ago
THE DETAILS

A coalition of mothers whose children lost their lives in high profile cases across the country, known as the Mothers Of The Movement, were greeted with deafening chants of "Black Lives Matter" before telling their stories. The mothers of Sandra Bland, Jordan Davis, and Trayvon Martin spoke for the group, soliciting both tears and applause from the crowd. "Hillary Clinton has the compassion and understanding to comfort a grieving mother," said Sybrina Fulton, the mother of Trayvon Martin. "And that's why, in the memory of our children, we are imploring you — all of you — to vote this election day."

SOUTH DAKOTA GIVES HER CLINCHING DELEGATES
Clinton Officially Democratic Nominee for President
8 hours ago
THE DETAILS

With the South Dakota delegation announcing its delegate count, Hillary Rodham Clinton is officially the Democratic nominee for president, surpassing the 2383 delegates needed to clinch the nomination. Clinton is expected to speak at the convention on Thursday night and officially accept the nomination.

THE QUESTION
How Many People Protested in Philly Yesterday?
12 hours ago
THE ANSWER

About 5,500, according to official estimates. "The Monday figures marked a large increase from the protests at the Republican National Convention in Cleveland, where even the largest protests only drew a couple of hundred demonstrators. But it’s a far cry from the 35,000 to 50,000 that Philadelphia city officials initially expected."

Source:
NO BATTLEGROUND STATES LEAN TRUMP
NY Times’ Upshot Gives Clinton 68% Chance to Win
12 hours ago
THE LATEST

Only a day after FiveThirtyEight's Now Cast gave Donald Trump a 57% chance of winning, the New York Times' Upshot fires back with its own analysis that shows Hillary Clinton with a 68% chance to be the next president. Its model "calculates win probabilities for each state," which incorporate recent polls plus "a state's past election results and national polling." Notably, all of the battleground states that "vote like the country as a whole" either lean toward Clinton or are toss-ups. None lean toward Trump.

Source:
×