Despite a good-faith effort by Congress and the White House, the proposed group-rate long-term care insurance program for active-duty and retired members of the federal family isn't likely to start before mid-2001--at the earliest.
Earlier this year, it appeared that both sides might compromise on the major sticking point: the number of plans participating in what would be the nation's biggest long-term care group program.
Lack of progress on long-term care insurance is bad news for many federal workers and retirees. But it should serve as a reality check for many people who assume incorrectly that the program is a done deal and might be offered as early as next year.
All parties agree it will be at least 18 months--once a long-term care program is signed into law--before anybody can sign up for it. Meanwhile, House Republican leaders and the White House remain deadlocked over the number of plans and options to be offered.
Republicans, who first proposed the idea of a federal long-term care program, insist that the potentially lucrative federal program be open to a large number of insurance plans. They would like to see civil servants, military personnel and retirees from both the civil service and military offered from two to six plan choices with various options and premiums offered by each plan.
Democrats insist that open competition might draw too many plans into the program. They fear a confusing array of options would work against the best interests of lower-income workers and retirees. They prefer a one-plan-fits-all approach that would share risks and, they feel, get the best level of benefits and premiums for the most people. Although the potential pool of people eligible under a federal-military family plan is about 22 million, experts believe that only about 6 percent of the eligible people would sign up initially for the program.
Insurance companies are eager to get into a federal program. About 6 million Americans now have long-term care policies. Most bought them as individuals and pay age-based premiums. Benefits range from $100 to $175 a day, paid over a period of years or for life. Many plans have a waiting period before benefits begin. The longer the waiting period (and the lower the benefit), the lower the premium.
Republicans and Democrats agree that Uncle Sam would collect premiums (for a modest fee) and that employees, retirees and other covered family members would pay the entire cost of the premium. They agree that premiums would be based on age at the time of purchase.
Unions and retirees groups have agreed to the buyer-pay-all provision--for now. But once any long-term program is in effect, pressure will begin to mount to have the government pay a part of the premium. Insurers would love that. It would all but guarantee that more workers and retirees would enroll in the program because premiums--for them--would be less.
The government now pays 72 percent of the total amount of health insurance premiums for the average worker and retiree. That remains constant even as premiums go up each year. In 1999, federal health premiums rose 9.5 percent. In January 2000, they will increase an average of 9.3 percent. But the government's percentage share remains the same.
Under the federal program, federal civilian and military personnel, spouses, parents and parents-in-law would be eligible. So would retirees and spouses.
The National Association of Retired Federal Employees is warning members that not everyone will be eligible for guaranteed coverage. NARFE says, "Persons with an immediate or likely need for long-term care are unlikely to meet medical underwriting standards that are developed for the new program."
NARFE is assuring members that it will work with the Office of Personnel Management to ensure that "the annuitant underwriting standards are less burdensome than those offered to mature and older Americans in the private sector."
At 9 a.m. tomorrow on WUST radio (1120 AM), Larry Schneider, a disability insurance specialist, will explain the difference between long-term disability and long-term care coverage and tell why he believes most federal workers need both kinds of coverage.
EEO at the FBI
At 10. a.m. tomorrow on WUST, Kathy Koch, who heads the FBI Office of Equal Employment Opportunity Affairs, will discuss how the program works at the largest federal law enforcement agency.
Mike Causey's e-mail address is email@example.com