Uncle Sam's in-house health insurance program--the Federal Employee Health Benefits Program--is the nation's biggest group health program. It covers 9 million current and former federal employees, dependent children, spouses and, in some cases, ex-spouses. Federal workers in the Washington area have 14 plans to choose from.

The government--also known as the taxpayers-- picks up an average of 72 percent of the total premium for federal workers and retirees. The U.S. Postal Service pays an even bigger share of the total premium for its clerks, letter carriers and other active-duty workers. The federal plans make no distinction between the young and old, the healthy and terminally ill. All pay the same premiums in the same plans for the same coverage. Plans offer two options: self-only and family. A family can be husband and wife or a married couple with 36 children.

Many private employers don't insure retirees, or they charge them more or cut their benefits. But the federal program is for life. Some covered retirees and survivors are well over 100. It is the ultimate group plan.

Although everybody in the program enjoys the benefits of a group plan--to some extent or other--some people don't like the way the federal group is defined.

For example, some childless couples resent paying the same premiums as big families. Some gay men and lesbians feel they should have the same right to family coverage as married couples (as outlined in Monday's Federal Diary). Here's some reader reaction:

* Robert H: "If the government is going to provide 'health' coverage for same-sex couples, what next? Life insurance? Survivor annuities? Two same-sex heterosexual friends who share a house? Opposite-sex heterosexual friends who share a house? Singles who are foster parents? A priest (in the military) and his housekeeper? Etc. Etc. The whole idea of beginning with coverage for same-sex couples for health insurance is an absurdity."

* Dan Haney: "The . . . point of family coverage for couples is to provide for the children where one partner is working and the other is caring for the home and children. No children, no coverage, no loss. In same-sex situations, both partners presumably can work, and if one is disabled, the other partner can provide the difference [in benefits and income]. To provide both partners with the opportunity for medical coverage is redundant and, at employer expense, simply permitting a much better lifestyle for the vast majority of gay/lesbian couples than child-raising, married couples. The argument that gay/lesbian workers [subsidize] family plans is flawed since it ignores both the employer contributions and the fastest-growing segment of health care expenses: HIV and AIDS."

* C. King: "If a company offers same-sex equal benefits coverage, how fair is it not to offer the same benefits to a man and woman who live together? What about a father and daughter who live together? If there is no legal marriage, how do you determine what other kind of couple should or should not receive benefits?"

* Michael Dawson: "Try relocating with the federal government when you have a same-sex partner. My agency puts a premium on being mobile when making promotional selections. However, regulations do not recognize same-sex partners, so the cost of relocating the same-sex partner is paid out of pocket. . . .

"My partner of 12 years has put his career on hold and had to change jobs twice so that I could take advantage of promotion opportunities. . . . Not only does he have to find a new job and temporary health coverage with each move, he can't even have his name on the deed to your home. . . . Unmarried straight couples simply have to get married prior to [relocating]. Obviously, same-sex couples don't have that option."

* Mary Kay: "The government has never offered health plan coverage for unmarried couples of the opposite sex, so why would they offer it for couples of the same sex?"

* John Binford: "My heart bleeds for the gay folks who feel discriminated against because the fed health plans don't cover their partner or whatever the PC term is these days. They knew the deal when they chose to work for Uncle, as well as the reasoning and legislation behind it.

"However, this, like most things, is eventually going to be negotiable, and if Uncle finds himself short of people willing to take his deal, then he will eventually broaden the health plan to include gays."

* Rebecca L. Frasure: "Years ago, in a private company, I had family coverage which covered myself, my husband and three kids. My co-worker had family coverage . . . though it only covered her and her husband. Every month, my co-worker would complain that she had to pay the same amount I did. I would retort that my three kids are future taxpayers, and they would be supporting her Social Security and Medicare payments when she is retired and receiving said payments."

Mike Causey's e-mail address is causeym@washpost.com

Wednesday, Nov. 3, 1999