[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2193 Introduced in House (IH)]
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119th CONGRESS
1st Session
H. R. 2193
To require the Director of the Office of Personnel Management to take
certain actions with respect to the health insurance program carried
out under chapter 89 of title 5, United States Code, and for other
purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
March 18, 2025
Mr. Grothman introduced the following bill; which was referred to the
Committee on Oversight and Government Reform
_______________________________________________________________________
A BILL
To require the Director of the Office of Personnel Management to take
certain actions with respect to the health insurance program carried
out under chapter 89 of title 5, United States Code, and for other
purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``FEHB Protection Act of 2025''.
SEC. 2. FEHB IMPROVEMENTS.
(a) Definitions.--In this section:
(1) Director.--The term ``Director'' means the Director of
the Office of Personnel Management.
(2) Employing office.--The term ``employing office'' has
the meaning given the term in section 890.101(a) of title 5,
Code of Federal Regulations, or any successor regulation.
(3) Health benefits plan; member of family.--The terms
``health benefits plan'' and ``member of family'' have the
meanings given those terms in section 8901 of title 5, United
States Code.
(4) Open season.--The term ``open season'' means an open
season described in section 890.301(f) of title 5, Code of
Federal Regulations, or any successor regulation.
(5) Program.--The term ``Program'' means the health
insurance programs carried out under chapter 89 of title 5,
United States Code, including the program carried out under
section 8903c of that title.
(6) Qualifying life event.--The term ``qualifying life
event'' has the meaning given the term in section 892.101 of
title 5, Code of Federal Regulations, or any successor
regulation.
(b) Verification Requirements.--Not later than 1 year after the
date of the enactment of this Act, the Director shall issue regulations
and implement a process to verify--
(1) the veracity of any qualifying life event through which
an enrollee in the Program seeks to add a member of family with
respect to the enrollee to a health benefits plan under the
Program; and
(2) that, when an enrollee in the Program seeks to add a
member of family with respect to the enrollee to the health
benefits plan of the enrollee under the Program, including
during any open season, the individual so added is a qualifying
member of family with respect to the enrollee.
(c) Fraud Risk Assessment.--In any fraud risk assessment conducted
with respect to the Program on or after the date of the enactment of
this Act, the Director shall include an assessment of individuals who
are enrolled in, or covered under, a health benefits plan under the
Program even though those individuals are not eligible to be so
enrolled or covered.
(d) Family Member Eligibility Verification Audit.--
(1) In general.--During the 3-year period beginning 1 year
after the date of the enactment of this Act, the Director, in
coordination with the head of each employing office, shall
conduct a comprehensive audit regarding members of family who
are covered under an enrollment in a health benefits plan under
the Program.
(2) Contents.--In conducting an audit required under
paragraph (1), the Director, in coordination with the head of
each employing office, shall review marriage certificates,
birth certificates, and other appropriate documents that are
necessary to determine eligibility to enroll in a health
benefits plan under the Program.
(e) Disenrollment or Removal.--Not later than 6 months after the
date of the enactment of this Act, the Director shall develop a process
by which any individual enrolled in, or covered under, a health
benefits plan under the Program who is not eligible to be so enrolled
or covered shall be disenrolled or removed from enrollment in a health
benefits plan under the Program.
SEC. 3. EARNED BENEFITS AND HEALTHCARE ADMINISTRATIVE SERVICES
ASSOCIATED OVERSIGHT AND AUDIT FUNDING.
(a) In General.--Section 8909(a)(2) of title 5, United States Code,
is amended by striking ``Congress.'' and inserting ``Congress, except
that the amounts authorized under subsection (b)(2) for the Office
shall not be subject to the limitations that may be specified annually
by Congress.''.
(b) Oversight.--Section 8909(b) of title 5, United States Code, is
amended--
(1) by redesignating paragraph (2) as paragraph (5); and
(2) by inserting after paragraph (1) the following:
``(2) In addition to the funds provided under paragraph
(1), amounts of all contributions shall be available for the
Office to develop, maintain, and conduct oversight over the
enrollment and eligibility systems with respect to benefits
under this chapter, including the Postal Service Health
Benefits Program under section 8903c. Amounts for the Office
under this paragraph shall not be available in excess of the
following amounts in the following fiscal years:
``(A) In fiscal year 2026, $36,792,000.
``(B) In fiscal year 2027, $44,733,161.
``(C) In fiscal year 2028, $50,930,778.
``(D) In fiscal year 2029, $54,198,238.
``(E) In fiscal year 2030, $54,855,425.
``(F) In fiscal year 2031, $56,062,244.
``(G) In fiscal year 2032, $57,295,613.
``(H) In fiscal year 2033, $58,556,117.
``(I) In fiscal year 2034, $59,844,351.
``(J) In fiscal year 2035 and each fiscal year
thereafter, the amount equal to the dollar limit for
the immediately preceding fiscal year, increased by
2.2. percent.
``(3) In fiscal year 2026, $80,000,000, to be derived from
all contributions and to remain available until expended, shall
be available for the Office to conduct the audit required under
section 2(d) of the FEHB Protection Act of 2025. Of such
amount, the Office may transfer funds as the Director of the
Office determines necessary to an employing office (as that
term is defined in section 890.101(a) of title 5, Code of
Federal Regulations, or any successor regulation) in order to
conduct the required audit.
``(4) Amounts of all contributions shall be available for
the Office of Personnel Management Office of the Inspector
General to conduct oversight associated with activities under
this chapter (including the Postal Service Health Benefits
Program under section 8903c), including activities associated
with enrollment and eligibility in these programs and any
associated audit activities as required under the FEHB
Protection Act of 2025. Amounts for the Office of the Inspector
General under this paragraph shall not be available in excess
of the following amounts in the following fiscal years:
``(A) In fiscal year 2026, $5,090,278.
``(B) In fiscal year 2027 and each fiscal year
thereafter, the amount equal to the dollar limit for
the immediately preceding fiscal year, increased by 2.2
percent.''.
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