Fedweek

The FEHB program would not be directly affected by the first version of a bill unveiled this week by House leaders to repeal and replace the Affordable Care Act (“Obamacare”), although many changes could lie ahead. Republican leaders are hoping to move the measure through Congress by mid-April using a process known as reconciliation, which requires only a simple majority vote in the Senate rather than the 60-vote hurdle that normally applies if opponents of a bill insist on it. However, Senate passage under even that process is far from guaranteed, as the bill is currently written–the same applies even to the House. The FEHB law long predates the ACA and already barred plans from denying coverage due to an enrollee’s pre-existing health condition. The major direct impact was extending coverage of children up to age 26 rather than the prior age 22 cutoff and removing restrictions such as requirement that they be unmarried. The draft bill would leave that policy change in place and even if it were to be repealed generally, it is now part of the FEHB’s own rules that operate independently. The other main impact of the ACA on the FEHB applied to only a tiny part of the FEHB population: it made members of Congress and certain of their staff members ineligible for the FEHB, although OPM later decided they could continue receiving an employer contribution comparable to what the government pays in the FEHB if they enrolled in a specific ACA plan. Any substantial changes to the FEHB enacted this year most likely would occur in the annual budget process that is just about to begin, where proposals such as shifting more of the cost onto enrollees could resurface.