FEHBP To Offer Health Plan That Excludes Contraception Coverage
The Bush administration last week announced a new Catholic health care plan for federal employees that specifically excludes payment for contraception, abortion-related services, sterilization procedures and artificial insemination, the New York Times reports. The plan is part of a $1 billion administration initiative that aims to involve religious organizations in all types of federal social programs, according to the Times. It is also a new type of coverage that combines a health savings account with high-deductible coverage and is being "promoted as a centerpiece" of Bush's health care policy, the Times reports.
The health plan is sponsored by OSF HealthCare, a unit of the Sisters of the Third Order of St. Francis, which operates St. Francis Medical Center in Peoria, Ill., and five Roman Catholic hospitals in Illinois and Michigan. Federal employees in 31 Illinois counties can enroll in the plan beginning in November. Although federal workers in Illinois will be able to select from other health care plans that do not have religious-based restrictions, the new OSF plan will be the only plan with an HSA component.
An HSA combines a tax-free savings account that enrollees can use to pay for routine care with a high-deductible health plan that provides coverage only after the annual deductible -- $1,050 for an individual or $2,100 for family coverage -- has been reached. Enrollees will receive a portion of the premium that the government will provide to OSF in their HSAs.
In total, the government will contribute $240.89 per month for individuals and $599 per month for families to the new plan. Monthly premium contributions for employees will be $80.30 for individuals and $199.66 for families. By comparison, federal workers who enroll in a traditional preferred provider plan in Illinois will pay $89.09 per individual and $299.96 per family, according to the Times.
Although the "vast majority" of private health plans currently cover various types of contraceptives, the new OSF plan will not cover contraceptives, according to the Times. However, because the money in an individual health savings account is controlled by plan members, they could use funds from their HSAs to pay for contraceptives, abortions or other reproductive health services not covered by the health plan, the Times reports. Abby Block -- a senior health official in the Office of Personnel Management, which manages the Federal Employees Health Benefits Program -- said the reproductive health care exclusions under the plan will be explained in brochures given to federal employees in Illinois when they choose their 2005 coverage in November.
Twenty-three states currently require health plans to cover contraceptives, 14 of which provide an exemption for employers or insurers that object on religious grounds. A "number" of Catholic health plans have covered various reproductive services in the past -- including contraceptives, vasectomies, tubal ligations and sometimes abortions under Medicaid laws and through a non-Catholic partner, according to the Times. Through a separate third-party provider, enrollees in other OSF plans in Peoria currently have access to contraceptive coverage, but not coverage for abortions.
According to Block, the new plan is the first for federal employees "that has tailored its benefits in line with a set of tenets that are supported by the Catholic Church." It also is the first to be promoted as "faith-based," the Times reports. Numerous federal agencies, including OPM, the Office of Housing and Urban Development, Department of Justice and U.S. Department of Agriculture, have been instructed to pursue opportunities for faith-based programs, according to White House spokesperson Trent Duffy, the Times reports.
Under a 1984 law, all federal employee benefit plans were prohibited from covering abortions, except in cases of rape, incest or danger to a woman's life, according to Block. Although a 1999 law requires that federal plans offer contraceptive coverage, Congress has "repeatedly exempted insurance plans affiliated with Catholic organizations from that provision," according to the Times.
The new plan will "empower" federal employees to exercise greater control over their health care spending, according to Kay Coles James, director of OPM and former spokesperson for the National Right to Life Committee. She added that the plan gives employees "more opportunities to make choices in the private sector." However, critics of the plan have said that it may "grow into a wider phenomenon," according to the Times. Philip Lee, a professor of social medicine at the University of California-San Francisco and former assistant secretary of health under the Clinton administration, asked if the "explicit denial" under the OSF plan could be the first step in "denying federal employees a normal benefit that has been traditional for 30 years?" He added, "Is this simply the opening wedge?"
Frances Kissling, president of Catholics for a Free Choice, said, "I don't think substandard medical care should be offered through the federal government," adding that "when it comes to contraceptives, assisted reproduction and voluntary sterilization, these services are generally covered within our society. These are services that federal employees need." However, OSF spokesperson Jeff Koch said that it was "a good thing for federal employees to have the option" of a health plan that is consistent with Catholic doctrine, the Times reports (Freudenheim, New York Times, 9/25).