WASHINGTON -- In the battle over health care, no one is immune. Not even federally insured government workers.
As congressional lawmakers prepare to take up health care before the August recess, government worker unions are preparing an all-out lobbying blitz to safeguard the benefits their ranks currently receive.
"The issue is so volatile that no one can predict the outcome," says Robert M. Tobias, president of the National Treasury Employees Union (NTEU).
"We have to pay very close attention to what happens in the Senate, and that's where we're going to be focusing our energies," he said yesterday. "We're working very hard to make sure federal employees are protected."
House and Senate Democratic leaders are trying to open the Federal Employees Health Benefits Program (FEHBP) to the private sector -- a move government worker unions say could produce higher rates and reduce coverage for the nine million federal workers and retirees enrolled in the plan.
While unions do not oppose making the government's plan more accessible to the public, they caution that without extra protections, the influx of new enrollees could limit the benefits currently available in the federal ranks.
So far, union officials say they are encouraged by what House and Senate Democratic leaders have offered. Most federal employee unions expect to focus their lobbying activity in the Senate, where Majority Leader George Mitchell, D-Maine, unveiled his health reform plan yesterday.
While the Senate proposal opens the FEHBP to small business employees and uninsured individuals, it also allows federal workers to seek supplemental benefits in the event reforms leave them with less comprehensive coverage.
The Senate plan "looks very, very good," Mr. Tobias said. "It provides us with the opportunity to . . . create programs to take up the slack if the basic benefit package is less than what is currently available."
Federal worker unions want assurances they will not lose some generous features in the FEHBP.
Blue Cross and most other fee-for-service plans offered under FEHBP provide 100 percent coverage for inpatient hospitalization, 80 percent coverage for prescription drugs (after payment of a $50 deductible) and 100 percent coverage for adult dental care services.
In Maryland, nearly 300,000 people work for the federal government. More than 118,500 retired civil servants reside in the state.
Judy Park, legislative director for the National Association of Retired Federal Employees (NARFE), says government retirees stand to lose the most because they are so dependent on the federal health care plan.
"We want to make sure the plan does not become the insurer of last resort," she says. "Through our grass-roots network, we've been making this point known to every member of Congress."
Last week, in a letter mailed to every member of the Senate, the nation's leading federal worker unions outlined their basic concerns about health care reform and its effects on federal employee coverage. In addition to seeking supplemental payments to keep current federal worker benefits in place, the groups made other demands:
* Restraining premium increases. The groups want to create separate risk pools for nonfederal workers who join the program to insulate government employees from higher costs associated with an expanded FEHBP. The groups also suggest placing strict caps on the amount premiums may rise.
* Limiting private sector enrollment. The unions want nationwide fee-for-service plans operating under FEHBP to remain available only to the federal community.
More than 250 of these locally offered plans provide a set benefit package for a set premium. New enrollees would cause administrative costs and premiums to rise, the groups contend.
* Phasing in nonfederal enrollees gradually. Insurance providers would dramatically raise their rates to protect against the costs of an unknown population if the new enrollees are added all at once, the groups say. This is even more critical if the employer payment is set at 50 percent of the cost of insurance premiums, as the Senate bill specifies.
* Preserving age-adjustment standard. Insurers should not use age as a factor in setting community-rated premiums, the groups say, warning that such adjustment could result in "astronomical" premium increases for federal retirees who are not eligible for Medicare. The Senate bill does not allow insurers to consider age when setting these rates.
The federal government pays an average 72 percent of the health insurance premiums for its federal employees and retirees, the groups wrote in the letter. That formula should be preserved under any health reform plan passed by Congress, the letter states.
The letter was signed by NTEU's Mr. Tobias; NARFE president Charles W. Carter; American Federation of Government Employees president John Sturdivant; and National Federation of Federal Employees president Sheila Velazco.