The President's 2017 Budget proposes five changes to modernize and strengthen the Federal Employees Health Benefits Program (FEHBP): 1) Streamline pharmacy benefit contracting to allow the Office of Personnel Management (OPM) to contract separately for pharmaceutical benefits; 2) Allow OPM to enter into contracts with a greater variety of health plan types; 3) Permit OPM to adjust plan premiums based on wellness program participation and tobacco use; 4) Extend temporary health benefit coverage to infants born to dependent daughters of FEHBP participants for 30 days; and 5) add FEHBP to the list of Federal Health Programs in the Anti- Kickback statute. If enacted and implemented, these changes could be reflected in carrier contracts issued for 2018.Proposals 1), 3) and 5) have been offered for three or four years in a row without Congressional action. These proposals, if enacted, would unnecessarily disrupt a program that is working. For example, the FEHBlog has explained time and again (with links to studies) that separating prescription coverage from medical coverage raises premiums by denying plans the opportunity to coordinate care. If it were such a great idea, why didn't Congress take that approach with the Affordable Care Act plans? TRICARE is structured with separate medical and prescription drug coverage but reformers are urging that TRICARE be restructured to look like the FEHBP. Leave well enough alone.
The FEHBlog will post OPM's budget justification to Congress when it becomes available.