Will Health Care Changes Affect Federal Workers?

Federal employees have a lot of choices when picking their health care options. While the choices of plans may be better than most, they are not necessarily the cheapest. How will proposed health care legislation affect the insurance available to federal employees?

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LINDA WERTHEIMER, host:

So, how would the health care bills in Congress impact the Dorsey's coverage? We're joined now by NPR Health Policy Correspondent Julie Rovner. So Julie, it sounds like this family has good coverage already. Would anything change?

JULIE ROVNER: Well, federal worker coverage probably wouldn't change much and the same would be true for most people who work for large companies. And you're right, this family does have pretty good coverage. Among the eight million federal workers and their dependents in the Federal Employee Health Program, are members of Congress and their families. And full disclosure here, I was a federal worker early in my career, so I have belonged to one of these plans too.

WERTHEIMER: So you know how this works on the inside. But don't these federal plans tend to be a little bit expensive?

ROVNER: That's right. They can be. Here's an example. By far, the most popular plan among federal workers is the standard option Blue Cross Blue Shield plan. This year the premiums are $1120 a month for family coverage. Of that, the government pays just under $764 a month. The employee pays the rest. That's just under $357 a month.

In fact, a recent study found a significant number of low paid federal workers can't afford that share of the premium and are, themselves, uninsured. And as you heard in the piece, in order to get more choice, the Dorsey's have pretty significant deductibles and co-pays.

So these plans have not been immune to health care inflation and what federal workers who are covered are hoping for from these bills is pretty much what everybody with insurance is: that changes to the health care system will be made that will slow down those annual increases in premiums and other costs that are basically taking money away that could otherwise be going to their wages. It's as true for the federal government as it is for Bob's Sub Shop.

WERTHEIMER: Still, is it fair to say that the bills would try to make the rest of the insurance marketplace look more like the federal workers' program.

ROVNER: Absolutely it is. You know, the plans available to federal workers may not be any more generous than those for workers in other large companies - in fact, I think they're probably a little bit less generous than a lot of private sector plans - but the Federal Employee Health Program provides lots and lots of choices and good information about those choices in terms of what is and isn't covered, and that's really the model for these exchanges that are envisioned in most of the bills: To give people more choice and more information, and hopefully create more competition between insurance plans.

WERTHEIMER: I have one more question about the teenager we were just hearing from. It won't be too long before she'll be too old to be carried on her mom's insurance. Will she have a problem getting insurance on her own with her preexisting diabetes?

ROVNER: Now under - yes, under the current system she very well may. There are some protections in place if she goes straight from her mom's coverage to, for instance, her own job and that job offers group health coverage, then she will be protected. But if she's got a break in coverage, then she might have a lot of trouble.

Under this plan, under the plans that are kicking around in Congress, she really would be protected. So this will be a big, important thing for everybody like this teenager, who has a preexisting condition - would make it much easier for them to get health insurance.

WERTHEIMER: Thanks very much, NPR's Julie Rovner who covers health policy.

ROVNER: You're very welcome.

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WERTHEIMER: Our series, Are You Covered is produced in partnership with Kaiser Health News, a non-profit news service.

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