WASHINGTON – Census Bureau employee John Walsh spent the past week wading through federal health insurance plans, trying to figure out which was the best for him before today’s open season deadline.
He ended up sticking with his current plan, BlueCross BlueShield.
“My grandfather used to work for the federal government and said it (BlueCross BlueShield) was the way to go,” said Walsh, 24. “I talked with people who had Kaiser and Aetna, and a lot of the plans will not cover certain things.”
Union officials said Walsh’s experience was typical of tens of thousands of federal workers in Maryland who faced a “bewildering” array of health plans whose only constant was an average 11 percent increase in premiums.
“The variety is bewildering,” said Jacque Simon, public policy director for the American Federation of Government Employees. “Multiply the cell phone plan problems by 200 and you’ve got the Federal Employees Health Benefits Program.
But where the union sees a “complete mess” in the federal employee health benefits plans, the Office of Personnel Management sees a strength.
“Choice is a hallmark of the FEHB,” said one OPM official. “We make plenty of information available. Bottom line, though, people have to evaluate it themselves.
“The fact that we offer so much choice is the way to go,” she said.
And private-sector workers, who can expect to see health insurance premiums rise 15 or 20 percent this year, said the feds have nothing to complain about.
“I don’t understand what they think is missing,” said Bob Hunter, director of insurance for the Consumer Federation of America.
“They have options that are very rich and comparable to ones in the private sector for cheaper,” said Hunter, a former insurance administrator for the Department of Housing and Urban Development. “Even within certain plans, they have high and low options, single and family options. I just don’t understand exactly why they’re complaining.”
Hunter said the family and other high-end plans available in the federal program offer coverage equal to if not better than private sector plans.
But Walsh, 24, said the plans are limited in their coverage, and most do not offer dental or optical coverage.
“They offer different things to different people in different plans,” he said. “It’s very specialized.”
The limited coverage makes it difficult to choose a plan that will provide a safety net in case of an emergency, said Colleen Kelley, president of the National Treasury Employees Union.
“Some plans have special provisions for emergencies, but they have to agree that it’s an emergency,” Kelley said. “On the one hand, employees can choose (a plan) every year, but what happens during that year, who knows? You need a crystal ball.
“You would think that with 1.8 million employees, you could identify a plan or two to cover everyone,” Kelley said. “You could have everyone balancing each other out. Instead they’ve created these pools that don’t cover enough.”
Unions said they have no say in the Federal Employee Health Benefits Program and can only negotiate the percentage of premiums paid by certain financial agencies, like the Securities and Exchange Commission.
They are also upset that, while their premiums are not jumping as sharply as private-sector premiums, the government will not pay more than 75 percent of the premium. In the private sector, by contrast, employers typically cover 80 percent of the premium, Kelley said.
Walsh, who went through college without any health care coverage, said he is happy to have any coverage now. But he still sees room for improvement.
“I run and work out every day to improve my health and I pay as much as people who smoke a pack of cigarettes a day,” he said. “And because I’m healthy I won’t be going to the hospital as often and I won’t be taking advantage of the benefits. It doesn’t balance right. I get the shaft.”