Seeking a Second Opinion on Change in Health Care

He said the concern about the surgical benefit change "is justified, and we have reexamined the benefit design for 2009." Although he said he was working with OPM on alternatives, Kichak's testimony indicated that probably fits more in the category of wishful thinking than stone, cold reality.

Gammarino's testimony did not go into details about possible alternatives, though he did say that he could "administer the benefit in a way that is consistent with other services that are covered out-of-network. The alternative will not result in an increase in our premiums."

One possibility is aligning the surgical option with the way other out-of-network services are paid -- 70 percent by the Blues, 30 percent by the patient. Another is cutting back on the long list of things considered surgical procedures.

Despite Kichak's firm defense of the status quo, the agency still could be dragged kicking and screaming to make adjustments.

Rep. Danny K. Davis (D-Ill.) made it clear that as chairman of the panel that deals with many OPM issues, he wants the agency to at least consider extending Open Season.

Beyond the hearing, he has other tools to pressure OPM to make concessions to the legion of angry feds.

In an interview after the session, he spoke of issuing a "public call" to increase pressure on OPM and later did that through a news release urging an extended Open Season.

But a longer Open Season would only give more people more time to become angry over the changes.

In contrast to Gammarino's flexible posture, Del. Eleanor Holmes Norton (D-D.C.) said Kichak acted like a bureaucrat who could see only one solution to a problem.

In an interview, Norton encouraged Kichak to think "like the best bureaucrats do, think of alternatives then . . . decide what are the best alternatives."

You can find a webcast of the hearing and copies of testimony here: http://federalworkforce.oversight.house.gov/story.asp?ID=2280

Contact Joe Davidson at federaldiary@washpost.com.