Candidates Promise to Open up Federal Insurance

By Judith Smelser on Tuesday, November 4, 2003.

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When it comes to health insurance, many people believe that federal employees have one of the best deals around.

Some of the Democratic Presidential candidates have suggested that ordinary Americans should be able buy into the federal health plan.

Others say that plan should be used as a model for a new system to cover people who can't get insurance from their employers.

As part of NHPR's ongoing series on health care, New Hampshire Public Radio's Washington Correspondent Judith Smelser takes a look at the Federal Health plan.

And she finds that some federal employees like their health coverage and others don't.

The Federal Employees Health Benefit Program - FEHB for short - is administered by the massive Office of Personnel Management in Washington, DC.

In that agency, the buzzword when it comes to health care is "choice."

T3 30
"The FEHB has 200 plans that participate."

Nancy Kichack is with OPM's health benefits office.

T3 :44
"Some employers do have multi-choice plans the way we do. I think ours is larger than most folks'."

Those 200 plans are spread out across the country, but in most regions, workers have around fifteen plans to choose from.

They range from health maintenance organizations to the more flexible - fee-for-service programs.

As in many job-based health plans, federal employees must pick up part of the bill for their health insurance.

The amount they pay depends on which plan they choose ï¿½ the better the benefits, the greater the employee contribution.

The average payroll deduction comes to just under 100 dollars a month for a plan that covers just the employee ï¿½ itï¿½s just over 200 for a family plan.

Overall, federal employees seem fairly pleased with their health plans.

But conversations on Capitol Hill suggest that FEHB may not be as deluxe as many outsiders think.

New Hampshire's Second District Congressman, Charles Bass, admits he got better coverage before he became a federal employee.

T2 :16 (20)
"To be honest with you, the health plan that I had before I came to Congress as a small business owner was actually better. It had better dental coverage, the copay was a little bit lower, and there were other benefits which I don't have under the current plan, such as access to fitness centers and preventative maintenance."

Bass says that while the federal program may not be the best there is, it's certainly not bad.

And conversations with a number of Congressional staffers revealed the same kind of ambivalence.

T2 :14 (11)
"When I came here I found out that the health plan does not include dental. It doesn't automatically come with it. When I was in state government, you know, you have dental, you have vision, you have all this stuff that's covered." T4 :18 (08) "It allows you a choice of different providers. I was able to keep all my doctors that I had before I came to work for the government, which was important to me." T8 :13 (09) "I was working at a law firm before I came to the House of Representatives, where the plan covered a lot more vision, dental, than it does today." T6 :12 (09) "I've always been able to get a referral and all the tests and all taht that I always needed. So it was never any problem getting in late-night or urgently or anything."

(FADE IN RIVER SOUND)

The same health program is available to federal employees all over the country - even at this secluded ranger station beside the Androscoggin (an-druh-SKOG-gin) River in the heart of New Hampshire's White Mountains.

George Potuzzo is a District Ranger for the White Mountain National Forest.

Like his compatriots in Washington, DC, he complains about the lack of good dental and vision coverage.

But on the other hand, he appreciates the level of prescription drug coverage he gets.

As far as he's concerned, it's a middle-of-the-road health plan.

9:20 (20)
"It's better than a lot of people have. I have a lot of friends that are self employed, and I see what they have to pay, so I obviously have a much better deal than they do. I also have some friends that are involved in other state or local government - they have much better plans than I do."

As for the very political question of whether a new government-run insurance plan could be modeled on the federal program, Congressman Bass is skeptical.

He says the proposals made by some of the Democratic Presidential contenders are simply new ways of couching an old idea.

4:25 (15)
"What they're really talking about is making a plan available to the general public that is a socialized, federally-financed health care plan. Has nothing to do with federal employees, but they're using it as a model for their version of socialized medicine."

But Ron Pollack from the health care consumer group Familes USA rejects Bassï¿½s argument.

T1 4:44 (20)
"The federal health benefits plan involves numerous different private sector plans. The premiums are collected by those private enitites, the claims are paid by those private entitites, the people who provide the health care services are private doctors and hosptials."

Pollack says allowing people to buy into a large group insurance plan, like the federal program, could make health insurance more affordable for the millions of uninsured Americans.

The Office of Personnel Management is concerned about allowing new people to buy directly into the federal plan.

As for using that plan as a model for other programs ï¿½ the OPMï¿½s Nancy Kichack is noncommittal.

T3 15:59 (07)
ï¿½We think that what weï¿½re doing works well and that other folks should look at it and make their own decision.

For NHPR News, this is JS in Washington.