Federal workers and their families enrolled in the nation's biggest company health insurance program (9.2 million people) will pay higher premiums and get less for their money in 1982.
Health insurance premiums for feds jumped from 10 percent to 22 percent this year, and insiders expect substantial premium hikes -- and reduced benefits -- to be announced by Uncle Sam within the next few weeks. The Federal Employees Health Benefits (FEHB) program is a national trend-setter for doctor and hospital costs because of its size and because it carries the government's seal of approval.
Locally it pays a major portion -- depending on the plan and permiums -- of the hospital, doctor and psychiatric bills for nearly half of metro Washington's population.
The government -- through the Office of Personnel Management -- is winding up months-long negotiations over 1982 premiums and benefits with the 120 plus carriers who insure 3.3 million government employes and family members. FEHB plans include the government-wide ones offered by Blue Cross-Blue Shield and Aetna, health maintenance organizations (HMOs), programs limited to workers in certain geographic regions, and those sponsored by various federal and postal unions.
Netotiations are secret, but indications are that there will be a substantial premium jump for 1982, and that many carriers will be allowed to cut back benefits to hold down costs.
In the contract negotiated in late 1979 (for this year), the cost of the government share of the premiums jumped 16.8 percent. The result is that Uncle lSam this year paid an additional $375 million and employe premiums went up $260 million. Government contributions are based, on the average premium cost of the six largest plans in the program. The U.S. Postal Service (thanks to union contracts) pays a larger share of health insurance costs for workers than do other federal agencies.
According to the report of the FEHB for the 1980 fiscal year, the -- government and employe premiums, appropriations and interest -- was $3.4 billion. The cost of operating the plans -- including but not limited to benefits paid out -- was $3.5 billion.
Once the new premiums and health insurance packages are announced -- that should be within the next few weeks -- there will be an "open season" this fall. During that open season period, workers and retirees can change plans, or options within their same plan, looking for the best, most ceonomical deal for themselves and their families.
If there is a big premium jump, accompanied by a drop in the level of benefits, federal workers' friends in Congress (there are some, not many but some) may ask for a shakeup in the program and/or legislation to increase the amount federal agencies pay for their employes' insurance.
One member concerned about the program is Rep. Mary Rose Oakar (D-Ohio). She chairs the compensation and employe benefits subcommittee of the House Post Office Civil lService Committee. On Aug. 26, Oakar got a letter from Office of Personnel Management Director Donal J. Devine, alerting her of an "unexpected development" in the 1982 health insurance negotiations.
Devine said that "it has become apparent that projected premium increases for 1982 -- assuming a current level of benefits -- would be excessively high for most major plans." He said Opm, under the Carter administration, had "underestimated" the cost trends and as a result "a situation has been created which demands immediate action to cover past losses as well as expected inflation levels."
Devine said if the project 1982 increases are not held down, outlays for the FEHB will bust its budget "by several hundred million dollars." Devine said OPM will work to hold down costs but " . . . unfortunately, these changes will undoubtedly include some benefit reductions."
Oakar wrtoe back that private industry is going just the opposite direction, "increasing benefit levels and decreasing" employe costs for health care.