3-27-25 grothman’s federal employees health benefits program protection act passes committee

(Washington, D.C.) – Today, Congressman Glenn Grothman’s (R-WI) bill, the Federal Employees Health Benefits Program (FEHB) Protection Act, passed out of the House Committee on Oversight and Government Reform with bipartisan support and now awaits consideration on the House floor.  This legislation will help to stop government waste by strengthening oversight of the FEHB program to ensure eligible federal employees and their dependents receive the benefits they have paid into, while decreasing the number of improper payments.  

“With a renewed focus on government efficiency, now is the time to examine all programs big and small,” said Grothman. “Improper payments are rife within the federal government and on top of being a gross misuse of taxpayer’s money, they can threaten the viability of programs that people who play by the rules depend on. The FEHB Protection Act will cut waste with commonsense changes, like adding eligibility checks and fraud risk assessments. I look forward to this legislation coming before the full House for a vote so we can save taxpayers up to $5.2 billion over the next decade.”

Background

The Federal Employees Health Benefits Program (FEHBP) covers approximately 8.2 million individuals, including 2.2 million federal employees, 1.9 million retirees, and an estimated 4.1 million family members costing approximately $59 billion of combined annual premiums paid by the government and enrollees.  However, a December 2022 Government Accountability Office report raised serious concerns regarding the lack of controls for verifying the eligibility of covered family members in the FEHBP. The lack of controls is costing taxpayers an estimated $250 million to $3 billion annually in fraudulent and improper payments.   To address this challenge, the FEHB Protection Act requires federal agencies to verify that an employee is eligible to add a family member to their FEHBP health coverage plan. This bill also requires the Office of Personnel Management (OPM) to consider coverage of ineligible individuals when conducting FEHBP fraud risk assessments. It further requires a comprehensive audit be conducted of employee family members currently enrolled in the FEHBP—including a review of eligibility verification documentation such as marriage certificates and birth certificates—and requires OPM disenroll or remove from enrollment any ineligible individual found to be receiving FEHBP coverage. Finally, the bill would centralize FEHBP administration, including the enrollment process, at OPM and provide continued oversight funding to the OPM Inspector General in order to prevent such fraud in the future.