This fucking terrifies me.

[ysobelle]

http://kevxml2adsl.verizon.net/_1_2GDUTO1086ZB7O__vzn.dsl/apnws/story.htm?kcfg=apart&sin=D868OMOO0&qcat=usnews&ran=345&passqi=&feed=ap&top=1


Not just that it's happening, but that it's so wildly embraced by so many people.

In other news, I sent an email through the Planned Parenthood site concerning the Catholic health care options that exclude birth control, vasectomies, or abortions. I got an interesting email back immediately, and I thought I'd post it here.

I'm very much open to discussion, especially as I'm not entirely sure what it all means in practical terms. Except that it seems like it could potentially set a chilling precedent.






From: Director@opm.gov (Director, US Office of Personnel Management)
To: Ysobelle@aol.com
Thank you for your recent e-mail concerning plan options within the Federal
Employees Health Benefits (FEHB) Program.



The FEHB Program, created in 1960, is the largest employer-sponsored health
benefits program in the Nation. It is administered by the Office of
Personnel Management (OPM) and is the vehicle for offering health insurance
coverage to some 8 million Federal employees, annuitants and their family
members. The FEHB Program features 19 nationwide fee for service options
and more than 240 geographically-based Health Maintenance Organization (HMO)
options. Each plan must meet a high standard established and maintained by
our team of dedicated professionals. The FEHB program has historically
maintained the distinction of including a wide variety of available options
and free market competition for enrollment that occurs among the FEHB plans
during the annual Open Season. This year that Open Season will take place
from November 8 through December 13 in 2004.



Fundamentally, the men and women of the Federal civil service are wise
enough to make informed decisions regarding healthcare for themselves and
their families based on multiple sources of information and a wide range of
options. During the past three years, important new benefits have been
created for Federal employees and their families, including Long Term Care
Insurance, Flexible Savings Accounts and a new product this year, Health
Savings Accounts (HSA). OPM, and its partners, are very aggressive and
successful in educating employees on new benefits. These new benefits
further allow Federal employees to make the best decisions for their
families by entrusting employees with the appropriate range of benefit
options they need to address their health care needs and personal
preferences and savings goals.



Health Savings Accounts are an important benefit for employees seeking to
better manage their health care while simultaneously accumulating wealth
through savings. For more information on Federal HSAs please check the
questions and answers section of web site at <http://www.opm.gov/hsa>
www.opm.gov/hsa.



Of the more than 240 options available under the Federal Employees Health
Benefits Program, the only option that excludes contraceptive coverage is a
new High Deductible Option of the OSF Health Plan (an HMO in Illinois).
Coverage of contraceptive devices was mandated by the United States Congress
in all FEHB Plans by the FY 1999 Treasury-Postal Appropriations Act.
Importantly, Congress included in that law a "conscience clause" that
allowed plans (and individual health care providers) to exclude
contraceptive coverage if necessary to remain consistent with the tenets of
their beliefs. Before the legislative requirement, 87% of the health plans
offered at least one form of contraceptive coverage and most offered more.
Five health plans were exempted from the requirement at the time coverage
was mandated in 1999 by the Congress, but by 2004, primarily due to
attrition, no plan invoked the exemption. Beginning in 2005, OSF is only
exercising the exemption for its High Deductible Health Plan option;
however, the other option offered by the OSF Plan will continue to provide
contraceptive coverage.



The fact the contraceptive coverage will not be provided in OSF's new High
Deductible Option, while it will continue to be covered in the plan's other
option, will be highlighted in the "How We Change for 2005" page in the OSF
Plan Brochure. The OSF Brochure addresses both options. The importance of
reviewing this page is highlighted in OPM's Open Season materials as well as
on the Brochure's cover page. It is very unlikely that prospective enrollees
will be unaware that contraceptive coverage is not available in the High
Deductible OSF option, but remains universally available in the FEHB
Program. At the same time, prospective enrollees will have the choice of a
plan, albeit one that serves a limited enrollment area, which does not
provide this coverage.



I appreciate your interest in this issue and for taking the time to contact
the Office of Personnel Management regarding your concern about one of the
240 health care options available to Federal employees. Although your letter
addressed only one aspect of the Federal Employees Health Benefits Program,
I encourage you to become more familiar with the entire Federal benefit
structure through <http://www.opm.gov/> www.usajobs.opm.gov. While on this
site I hope you will review the career opportunities Federal service offers.
Our Nation needs qualified civil servants and we encourage all who are
interested to consider making their future contribution to the country
through the United States civil service.



Thank you for your interest in the FEHB Program.




Sincerely,






Kay Coles James


Director





-------------------------------
-- Even though this E-Mail has been scanned and found clean of
-- known viruses, OPM can not guarantee this message is virus free.
-------------------------------
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Comments

[miscelenaclosed.livejournal.com]

but that it's so wildly embraced by so many people.

The only number mentioned comes from Falwell's mouth; not exactly an un-biased source.

Coverage of contraceptive devices was mandated by the United States Congress in all FEHB Plans by the FY 1999 Treasury-Postal Appropriations Act. Importantly, Congress included in that law a "conscience clause" that allowed plans (and individual health care providers) to exclude contraceptive coverage if necessary to remain consistent with the tenets of
their beliefs. (...) by 2004, primarily due to attrition, no plan invoked the exemption. Beginning in 2005, OSF is only exercising the exemption for its High Deductible Health Plan option; however, the other option offered by the OSF Plan will continue to provide contraceptive coverage.

Meaning, as I'm reading it: contraception is big business; no plan/company has both exercised that 'conscience clause' and remained on the roster of plans offered by the FEHB... probably because the masses chose the plans that covered their needs... including contraception.

The people get what the people pay for; and the people put their money toward plans that cover contraception. Few government workers are fundamentalist enough to opt out of an otherwise-advantagous HMO simply because it DID offer contraception.... so here's just no market for a plan that doesn't.

[ysobelle.livejournal.com]

I'm gonna defer to Jenna Lynn below-- happy anniversary, JL!-- cos she knows FAR more about this than I.

But as for Falwell, I wasn't thinking about his view, per se. More that there are enough people in the world who truly agree with his manner of thinking. I mean, a lot of them got Bush elected and voted against gay rights, right?

[miscelenaclosed.livejournal.com]

I wouldn't go that far, myself. Not everyone who voted for Bush "voted against gay rights." There are a number of other ways of looking at it:

First: A full 2/3 of those polled voted FOR government recognition of gay unions as binding civil contracts... but only 1/3 think it ought to be called 'marriage'. I'm not clear on the legal implications of the difference (and maybe the voters weren't either?), but only 1/3rd voted to "protect marriage" per se by casting a ballot for non-recognition of same-sex unions altogether. In addition: that issue was on the ballot in only ten states. Ten states where, I presume, it's a heated issue... heated enough to require a referendum. In other states it's not an issue at all, and gay marriages are being performed. If you've got stats that read differently, I'd be interested in seeing them. I'm not suggesting that I'm any kind of expert here... I'm just repeating what I read.

Secondly: Many voted for Bush for reasons that they would NEVER take so far as Falwell does.

From what I read (and again: I'm far from an expert, so correct me if I've read the numbers wrong) abortion was a deciding factor for many. But not just 'abortion' (the availability of which has a firm majority support in this country...) the particular issue to which people were reacting was specifically partial-birth abortions and I challenge you to find me one person who doesn't find that concept distasteful at best, and who couldn't be reached by a graphic and not-entirely-accurate appeal to prevent that from happening. It's a very emotional issue... and I wouldn't paint everyone who is against partial birth abortion as a rabid fundamentalist... or even against other abortion.

Third: Not everyone who voted for Bush did so for 'faith' reasons: I know two people who said they'd voted for Bush because they felt like it'd be a bad idea to change horses mid-stream in this war... that they may be very unhappy with Bush's war in Iraq, but that Kerry would only make bigger debacle out of it if he stepped in to try to clean it up.

So I guess what I want to say is: don't let the fundies convince you that Bush's reelection is any sort of mandate for them, and more than it was a 'mandate' for Bush. 51% of a vote is FAR from a mandate... and I think it indicates, actually, that the country has a LOT of undecided moderates who just sort of fell slightly one way or the other based on the weather on the 2nd, and slightly more of them fell toward Bush's side.

I firmly believe that if the Kerry-supporters get to work educating the public on various hot-button issues (clearing up the legal implications of "marriage" vs. "civil union", for instance... and understanding that a lot of Democrats are actually against partial-birth-abortion, too...) *and* work to unite a strong bi-partisan constituency against the continuation of the war, things will go very differently than the doom-sayers are predicting for the next four years.

But then, I'm apolitical and generally a-religious as well, remember? So who am I to say? :)

Ugh, do not get me started...

[autumnyte.livejournal.com]

The issue for me is two-fold. First of all, the only plan that allows employees to take advantage of the much touted Heath Savings Account is the Catholic Plan. I think the government should have provided a non faith-based option that allowed people to take advantage of that.

Secondly, I have encountered numerous problems with faith-based medical organizations. Be they health plans, hospitals, or individual providers. For example, people whose employer has contracted with a Catholic Lab (for specimens) can't be seen at Planned Parenthood or any other pro-choice family planning provider. Because the Catholic carriers refuse to work with Planned Parenthood on moral grounds. That's just one example, mind you, but it causes a heck of a problem for patients who just want to come to us for a well-woman exam, only to find out that their insurance prohibits it.

I'm just incredibly concerned by the precedent, personally. To be honest, faith-based initiatives scare the crap out of me. Now there are options for people. But what happens when the options get less and less as the less expensive faith-based options come more into play.

Not to mention, medicine and religion tend to meld together rather poorly, AFIAC.

Re: Ugh, do not get me started...

[ysobelle.livejournal.com]

AFIAC?


And do you mind if I copy your response? We're discussing this on the Wench board.

Re: Ugh, do not get me started...

[autumnyte.livejournal.com]

Sorry, should have been AFAIC (As far as I'm concerned.)

And absolutely, feel free to copy my response and use it as you like.

Where do you live?

[miscelenaclosed.livejournal.com]

I'm just curious: the letter posted above seems to indicate that there aren't *any* currently-offered plans that are opting out of the federal mandate requiring coverage for contraception.... so which 'Catholic Plan' are you citing?

As far as NON-government corporations only offering certain health-care plans, well, we're ALL stuck with whatever benefits our employers offer... which is sometimes nothing at all. Seems to me the best way to get that changed is to approach the HR department and explain the difficulty.

Unless the employer *purposely* contracted with that plan for the 'Catholic' reasons, perhaps they'd be willing to find a different or second option. If not, and enough people in the firm are upset with the option, perhaps fleeing the company plan en masse is a viable option: find a local insurance agent who'll write you a group policy from another HMO/PPO for the employees who are dissatisfied?

If it's a company of any size at all, when the young and generally healthy employees start opting out, the rates are going to go up for the older less-healthy people in the company, and the CFO will notice. I've seen that happen in a company I worked for directly when they merely reduced the amount the company would chip in from 75% to 50%: everyone who could easily change plans (read: no pre-existing conditions) went out and got their own private insurance for less than the 50% they'd have been forced to pay... and the firm ended up paying MORE for FEWER enrollees because the risk-assessment on the remaining (older, not as healthy) employees was much higher.

In any case, the insurance companies only do what makes them money. It's nice to say it's for noble religious reasons, but if that's putting them out of business, it'll change.

Re: Where do you live?

[autumnyte.livejournal.com]

I live in Pennsylvania. And no, I'm not talking about any plans in this area. But the issue is of concern to me because I have no doubt that this is the first of many similar programs.

The "Catholic Plan" I am referencing is the one in Illinois that is being provided by Sisters of the Third Order of St. Francis. President Bush is making a big push to encourage people to choose a new type of insurance, a "health savings account" plan, which allows people to bank pre-tax dollars to pay for their healthcare. This is a new program, as concerns Federal Employees, and the insurance through The OSF is the only way employees can access that plan.

In other words, I have real concern that the benefits of the savings account are being touted so highly that the downside of this health plan might not be fully recognized. Insurance is a difficult thing to wrap one's brain around at times. I deal with people on a daily basis who are shocked to discover that their employer has excluded birth control.

As far as NON-government corporations only offering certain health-care plans, well, we're ALL stuck with whatever benefits our employers offer... which is sometimes nothing at all. Seems to me the best way to get that changed is to approach the HR department and explain the difficulty.

I personally happen to feel that non-coverage of birth control by employers is an issue of sexual discrimination. Almost across the board, these same plans that don't cover birth control for women will cover Viagra for men. But I can certainly see both sides of that issue. I agree that the HR department is the best place to start, although in many companies that doesn't get women too far. Particularly in companies where the percentage of female employees is low.

However, that is a separate issue. My concern with the issue at hand is that government dollars are subsidizing a religion-based insurance plan that conforms to one religion's specific beliefs, and I have major "separation of church and state" issues with that.

In any case, the insurance companies only do what makes them money. It's nice to say it's for noble religious reasons, but if that's putting them out of business, it'll change.

True. Unfortunately, a lot of these Catholic hospitals and insurance companies are building their client base by undercutting their secular competitor's prices. Once they have built up, I can only assume that their prices will rise as well, but at that point it may be too late.

Re: Where do you live?

[maskm.livejournal.com]

"I personally happen to feel that non-coverage of birth control by employers is an issue of sexual discrimination. Almost across the board, these same plans that don't cover birth control for women will cover Viagra for men."

While I personally believe contraception should be given freely to everyone, the bottom line is that *fertility is not an illness*. Impotence, for a man or a woman, is a medical illness.

Re: Where do you live?

[autumnyte.livejournal.com]

True, however, most of these health insurance plans are designed to cover routine and preventative treatments as well as treatment of illness.

Also, although fertility is the primary reason, it isn't the only reason women take estrogen and progestin hormones. What about the many women who use the pill to control severe cramps or irregular periods? What about women who have a concurrent health problem, for whom pregnancy would be a serious health risk? None of this is taken into account under most insurance plans that lack a contraceptive rider.

In any case, as I mentioned above, I can see both sides of that issue. I feel much less strongly about private employers than I do about the government subsidizing a religious program.

Re: Where do you live?

[maskm.livejournal.com]

"True, however, most of these health insurance plans are designed to cover routine and preventative treatments..."

Again, contraceptives are preventing something that's perfectly normal and healthy to occur (in most cases), not something medically necessary to avoid (in most cases). Don't get me wrong, I think contraception should be available but I'm just looking at the underlying logic. I also think insurance companies will save money in the long run by providing contraceptives.

"What about the many women who use the pill to control severe cramps or irregular periods? What about women who have a concurrent health problem, for whom pregnancy would be a serious health risk?"

Then this is clearly treating or preventing an illness and should be covered (by federal regulation if need be) EVEN IF the company does not cover those medications as soley birth control measures.

Re: Where do you live?

[autumnyte.livejournal.com]

Again, contraceptives are preventing something that's perfectly normal and healthy to occur (in most cases), not something medically necessary to avoid (in most cases).

Fair enough.

And you're SO correct about the savings that birth control provides. Maybe that's the best way to convince private employers and insurance companies. A full-term birth (and even abortion, in most cases) costs the insurance company a LOT more than most methods of birth control or sterilization cost.

[maskm.livejournal.com]

Do you really have a problem with Federal employees having the option to choose 1 out of *240* plans that has faith-based guidelines in it? Or am I missing something here?

[miscelenaclosed.livejournal.com]

Well, not all 240 are offered in all areas: the single one that doesn't offer contraception (and it's a high-deductible plan; it may not be limiting coverage for faith-based reasons, but simply because it's a cheaper, limited-coverage plan) is one of two options offered by "an HMO in Illinois".

So government employees in some areas may have only one option... but if all of them offer contraception coverage, I'm not clear on the objection, either.

[maskm.livejournal.com]

Yeah.

"The FEHB Program features 19 nationwide fee for service options..."

If 19 are nationwide, why is one local HMO in Illinois that doesn't cover contraception coverage such an issue?

This is almost seeming like a non-issue to me unless I'm still missing something.

[autumnyte.livejournal.com]

Here's an editorial about the issue that may articulate some of the concerns better than I can.

It's mainly the religious tie-in and the belief that it's only the beginning of a slippery slope that has my back up. That said, I wouldn't argue that it's in any way the most urgent issue currently facing the country. ;-)

[maskm.livejournal.com]

Yeah, it's a LITTLE worrisome. I can't tell if they are getting special $$ from the government for this, but it doesn't SEEM so. That I would oppose.

It's tough. On the other side, what right do we have to tell people they HAVE to offer things they find morally offensive to the people who signed up under them who also believe those things are morally offensive?

I guess it becomes as issue if they become the ONLY supplier in an area.