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OPM hopes to add six new insurers to FEHBP

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The Office of Personnel Management is now negotiating with six health care insurance carriers to add them to the Federal Employees Health Benefits Program, director of health care and insurance John O’Brien said Thursday.

In his keynote speech to the FEHB Carrier Conference, O’Brien said OPM added four new insurance providers last year.

O’Brien also touted OPM’s success at keeping premium increases below 4 percent for the last two years. But he also noted that even small premium increases bite at a time when  federal pay scales are frozen.

“Our low premium growth translates to roughly an additional $400 that federal employees had to pay to maintain their health coverage during that time,” O’Brien said. “That $400 did not come out of a growing salary, but from existing family and personal budgets.”

And O’Brien told the carriers that OPM wants to do more to measure insurers’ performance in FEHBP, decrease hospital readmission rates, properly administer prescription drugs, and decrease obesity.

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Last chance to sign up for FEHBP

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Have you signed up for your health, dental and vision insurance for next year? If not, better act fast — today is the final day of the Federal Employees Health Benefits Program’s open season. The open season — your only window of opportunity to choose your health coverage — began Nov. 12 and ends Dec. 10.

So speak now or forever hold your … health care coverage that may not meet your needs in 2013.

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Report: White House to extend health care to firefighters

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Lauer (photo courtesy of NFFE)

The Denver Post today reported that the White House has decided to allow seasonal federal firefighters to purchase the same health insurance as other federal employees, almost a month after one firefighter’s online petition for benefits went viral.

Most federal employees get health insurance through the Federal Employees Health Benefits Plan. But more than 8,000 seasonal federal firefighters aren’t eligible for FEHBP because they usually work less than six months each year. U.S. Forest Service firefighter John Lauer started an online petition in late May after his friend and fellow firefighter’s son was born prematurely. Because Lauer’s friend had no health insurance, he had to spend $70,000 on his son’s treatments.

The National Federation of Federal Employees heard about Lauer’s petition and began promoting it in mid-June. It soon gathered more than 100,000 signatures and NFFE began talking to the Office of Personnel Management about the problem.

And according to the Denver Post:

On a a recent trip to Colorado Springs, the president was apparently moved by the men and women firefighters he met, senior administration officials said in an interview Tuesday. When he returned to Washington, he told his cabinet that he wanted to “find a solution” for the hundreds of workers toiling in dangerous conditions without the option to buy in to federal insurance.

Administration officials told the Post that OPM will extend the health benefits to firefighters by the end of July.

NFFE just issued a statement lauding the decision.

“No longer do our firefighters have to fear incurring thousands in medical bills if they are injured outside of the job, or if their child gets sick,” NFFE National President William Dougan said. “These brave individuals put their lives on the line every year to protect our homes and communities. I could not be more proud that this new policy returns the favor by giving them the protection they need.”

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Firefighter’s petition for health benefits goes viral

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Lauer (photo courtesy of NFFE)

An online petition to extend federal health care benefits to seasonal wildland firefighters is spreading like … well … wildfire.

John Lauer, a temporary firefighter for the U.S. Forest Service, and thousands of his colleagues aren’t eligible for the Federal Employees Health Benefits Plan because they only work for the government six months out of each year. But those six months are extremely busy — Lauer and other firefighters usually work 16-hour shifts each day — and dangerous.

And when medical misfortune strikes a firefighter’s family, it can be devastating. Lauer said his godson Rudy — the son of a friend and fellow firefighter — was born prematurely. Because Lauer’s friend didn’t have FEHBP health insurance, Rudy’s treatments cost $70,000.

Lauer had enough. He started an online petition on change.org in late May, hoping to get 100,000 signatures and send it to President Obama. The National Federation of Federal Employees, of which Lauer is a member, said it gathered about 700 signatures over the next couple of weeks. On June 13, NFFE heard about the petition and began pushing it to its Forest Service bargaining unit employees.

Interest in the petition exploded. By Friday morning, it crossed the 10,000-signature mark. At the time of this blog’s publication, it had nearly 45,000 signatures.

“I couldn’t stand by quietly anymore and watch my godson’s parents suffer without health insurance,” Lauer said in a NFFE news release. “Stories like this are a dime a dozen for seasonal firefighters. These are some of the bravest, most dedicated people I have ever met. They deserve insurance.”

NFFE said Lauer is currently fighting a fire in Colorado and was unavailable for comment. NFFE said the Forest Service hires between 5,000 and 10,000 seasonal wildland firefighters each year.

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OPM’s Berry: Justice Dept. opinion ties my hands on gay spouses’ health benefits

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Last week we reported that even though lesbian federal employee Karen Golinski won health coverage for her wife — courtesy of a February court ruling — the Office of Personnel Management is still instructing federal agencies to deny the same coverage to all other gay and lesbian feds’ spouses.

Today I asked OPM Director John Berry how his agency can legally extend Federal Employees Health Benefits Program benefits to only one couple, and treat thousands more differently. He said, basically, that the Justice Department’s legal opinion on the Golinski ruling has tied OPM’s hands:

As someone who’s openly gay and has a partner that would love to join the FEHBP program, and I would love to have him be able to join the FEHBP program, because it’s a great program. I look forward to this issue resolving itself, personally. So you can rest assured, I’m watching this issue closely. That being said, it’s the Justice Department that gets to decide what a court ruling allows us to do. And the Justice Department has defined that, how this court ruling, because of the jurisdiction of the court and the direction of the court, it only applies to this one person. That’s what I’ve been told.

I have to do what the Justice Department tells me to do. As a sworn officer, upholding the Constitution, I’m enforcing what the Justice Department’s told me.

Berry pledged to keep pushing to extend health care benefits to gay and lesbian feds’ same-sex partners, and said he hopes Congress will pass a bill granting those rights:

My hope, at the end of the day, is that Congress can act. We’ve had wonderful bipartisan support on this. Sen. [Susan] Collins [R-Maine] has been as strong an advocate as Sen. [Joe] Lieberman [I-Conn.] and Sen. [Daniel] Akaka [D-Hawaii] in the Senate, and we’ve got the same in the House. I think there’s a shot that, even legislatively, we can move forward on this, is my hope. Otherwise, we’ll wait and see what the Justice Department allows us to do, responding to appropriate court action.

However, Senate support for extending same-sex benefits isn’t as bipartisan as Berry suggested. Collins remains the only Republican co-sponsor of S 1910, and no Republicans have signed on to the House version, HR 3485. And with House Republicans dead-set against broadening federal employees’ benefits — gay or straight — I don’t see how same-sex health benefits can possibly pass Congress.

Berry’s comments came a few hours before news broke that President Obama now backs gay marriage.

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OPM: FEHBP must cover lesbian fed’s wife, but no other same-sex spouses

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Karen Golinski, a lesbian federal employee, won a major court victory in February when a federal judge ruled that the government had to extend health benefits to her same-sex wife. But other gay and lesbian feds won’t be able to benefit from Golinski’s victory at this time.

The Office of Personnel Management in March ordered Blue Cross Blue Shield to cover Golinski’s wife, Amy Cunninghis. But today, OPM sent a notice out on its listserv that said the Golinski ruling does not apply to anyone else.

“OPM has been directed by the Department of Justice to continue applying the Defense of Marriage Act (DOMA) to all other situations,” OPM said. “Therefore, if you receive a request to enroll a same-sex spouse, you are still precluded by DOMA from processing the enrollment request or sending it to the [Federal Employees Health Benefits] Plan.”

OPM has been in an awkward position for some time regarding health benefits for same-sex spouses. OPM Director John Berry is gay, and has repeatedly said he thinks gay and lesbian feds’ spouses should be covered. But Section 3 of DOMA prevents the government from legally recognizing same-sex marriages, which bars gay feds’ husbands and wives from FEHBP. The Justice Department last year said it believes DOMA is unconstitutional and it would no longer defend the law. And last July, Justice backed Golinski’s case in a brief that amounted to a mea culpa for the government’s “significant and regrettable” history of persecuting gay and lesbian employees. (Go back and read that blog, and this one for some background on how gay and lesbian feds were treated. It’s pretty startling.)

But even though the Obama administration may want to extend health care to gay and lesbian feds’ spouses, it now seems pretty clear that won’t happen until DOMA is repealed or struck down.

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Health care premiums coming tomorrow

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Here’s a heads up for all of our readers: Tomorrow morning, the Office of Personnel Management is planning to unveil next year’s premiums for the Federal Employees Health Benefits Program. Check back in at FederalTimes.com sometime after 11 a.m. Tuesday for the news on how your health care costs will change in 2012.

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White House: Streamline prescription drug contracting

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The White House has also tucked a proposal into its $3 trillion deficit reduction proposal to overhaul how the government buys prescription drugs for the Federal Employees Health Benefits Program. On page 43 of its report, the administration calls for allowing the Office of Personnel Management to contract directly with pharmacy benefit managers, or PBMs, for prescription drugs. PBMs are companies that negotiate prescription drug prices with pharmaceutical companies on behalf of FEHBP’s insurance providers. But PBMs are not considered subcontractors, and as a result, OPM has little oversight of them and cannot be sure they pass on rebates (of as much as 50 percent of the drugs’ retail cost) to FEHBP enrollees.

The White House says the current “fragmented strategy [using PBMs] does not take full advantage of the combined purchasing power of the nearly eight million enrollees in the FEHB program.” It projects the move would save $1.6 billion over a decade.

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Justice lays out government’s ‘significant and regrettable’ history of anti-gay bias

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The Justice Department on Friday filed a brief siding with a lesbian federal employee who is suing to get health insurance for her wife, and arguing that Section 3 of the Defense of Marriage Act is unconstitutional.

Plaintiff Karen Golinski is an appeals court attorney in California, who legally married her wife in August 2008 and wants her to be covered by the Federal Employees Health Benefits Program. However, since DOMA’s Section 3 defines marriage as between one man and one woman, the federal government is banned from extending full health benefits to same-sex spouses and partners, though the Obama administration and Office of Personnel Management want to change that.

In addition to backing Golinski’s suit and opposing a motion by the House’s Bipartisan Legal Defense Group to dismiss it, Justice’s brief also serves as a mea culpa for the way the government has treated gay and lesbian employees over the last six decades. “The federal government has played a significant and regrettable role in the history of discrimination against gay and lesbian individuals,” Justice said.

  • In 1950, a Senate subcommittee began investigating the government’s employment “of homosexuals and other sexual perverts,” and found that about 1,700 job-seekers were denied employment because of a record of homosexuality “or other sex perversion.”
  • President Eisenhower issued an executive order in 1953 that officially deemed sexual perversion as grounds for investigation and possible dismissal from federal service, throughout the entire federal government. This effectively required all gay people to be fired from their federal jobs, Justice said.
  • Agencies began enforcing those rules zealously, Justice said. The State Department had investigators interrogate male applicants to uncover “any effeminate tendencies or mannerisms,” used polygraphs on people who denied allegations they were gay, and sent inspectors around the world to uncover homosexuals in State’s ranks.
  • The FBI had state and local police officers supply arrest records on “morals charges” — even if someone was never convicted — as well as data on gay bars and other gay hangouts, and press articles on the gay subculture.
  • And the U.S. Postal Service helped the FBI by setting up a watch list of men who subscribed to bodybuilding magazines or exchanged letters with suspected gay men. Once the Postal Service concluded someone was gay, it would track his mail to uncover more suspected gay men.

This all continued until 1975, when the Civil Service Commission — OPM’s predecessor — officially prohibited discrimination based on sexual orientation. “The end result was thousands of men and women forced from their federal jobs based on the suspicion they were gay or lesbian,” Justice wrote.

Metro Weekly, the gay-oriented Washington newspaper that posted the Golinski brief online, called the brief “historic.” “The brief … is the single-most persuasive legal argument ever advanced by the United States government in support of equality for lesbian, gay and bisexual people,” Metro Weekly wrote.

Justice in February announced it had decided Section 3 of DOMA is unconstitutional, and would no longer defend it. The House’s Bipartisan Legal Defense Group soon took up DOMA’s defense, and in June asked the U.S. District Court in California’s northern district to dismiss Golinski’s case.

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OPM wants lower copays, deductibles for wellness activities

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The Office of Personnel Management today asked health insurers to put their money where their mouth is on offering programs to foster health and wellness.

In today’s annual call letter spelling out its priorities, OPM encouraged insurers to offer hard benefits — such as reduced copayments or deductibles — to federal employees if they complete a health risk assessment, follow programs to manage diseases such as diabetes, or engage in other wellness activities. OPM also said it expects insurers to offer programs and cover services that seek to reduce obesity in both children and adults.

As OPM Director John Berry hinted at yesterday, the call letter also asks insurers to submit proposals to pilot test so-called “integrated health care systems.” Those systems are intended to better integrate decision making between doctors and hospitals to find the lowest-cost treatments. The call letter said that under such a system, “overall coordination of care is led by a personal physician with the patient serving as the focal point of all medical activity. These systems have the ability to manage the patient’s continuum of care across different institutional settings, including ambulatory and inpatient hospital care and possibly post-acute care.” OPM said they could lower health care costs by reducing hospital stays and emergency room visits and increasing preventive care.

OPM also expects insurers to look for ways to improve patient safety and treatment outcomes and prevent hospital readmissions, promote generic drugs and reduce pharmacy spending. Insurers are encouraged to submit proposals to reduce racial and ethnic disparities in health status and health care, increase the number of providers who can treat seniors, and offer affinity programs that can cover same-sex domestic partners. Berry said some Federal Employee Health Benefits Program insurers today cover domestic partners and gay or lesbian spouses under affinity programs, but enrollees have to pay the entire premium.

The call letter can be read here.

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