Disabled workers could be left out of long-term care program, union says

Disabled federal workers could be excluded from the federal government's new long-term care insurance program, according to a local branch of the American Federation of Government Employees.

In an April 9 letter to AFGE Legislative Director Beth Moten, Jerry Doyle, vice president of AFGE Local 252 at the Education Department, raised concerns that the Office of Personnel Management may impose eligibility restrictions that would make some federal workers with disabilities ineligible for the long-term care program. AFGE represents 600,000 federal employees.

In passing the 2000 Long-Term Care Security Act, Congress authorized OPM to offer long-term care coverage to federal employees and their spouses, children and other close relatives at discounted group rates. Federal workers, active-duty military personnel and both civilian and military retirees are all eligible for the benefit. In December, OPM selected Long Term Care Partners (LTC), a joint venture with Metropolitan Life and John Hancock insurance companies, for a seven-year contract to run the program. An early enrollment period began two weeks ago.

To sign up for the insurance, federal employees, postal employees, military personnel and their spouses must answer seven questions about their pre-existing medical conditions. Retirees; their spouses; retirees' surviving spouses; the parents, parents-in-law or step-parents of federal employees or military personnel; and the adult children of federal employees, postal workers, military personnel or retirees must answer up to 22 questions about their medical history. Applicants who answer "yes" to any of those questions are ineligible for federal long-term care coverage.

"Federal employees who check these boxes will be back at square one where the rights of individuals with disabilities to be treated fairly, equitably and with equal access, is violated unduly, conferring enormous benefit only to those lucky enough to get the insurance," Doyle wrote. "It would seem that the OPM would negotiate a contract with the providers that there should be no 'pre-existing' requirements that question employees about their health status, the same as contractual arrangements between OPM and health insurance providers."

During a Senate Special Committee on Aging hearing Wednesday, Chairman John Breaux, D-La., expressed similar concerns.

"How close are we to adverse risk selection if you're only going to insure people who are healthy?," Breaux asked witnesses, who included OPM's assistant director for long-term care, Frank Titus, and LTC Chief Executive Officer Paul Forte.

Forte testified that the federal long-term care program is not intended for people who already need care or will need care immediately after enrolling in the program. Adding those people to the program would significantly raise program rates, he said.

"We are accepting people who are reasonably healthy," Forte said, adding that people who are not healthy may be eligible for other coverage the company offers.

But Doyle said that position panders "to the underwriters' freewheeling, entrepreneurial culture… with emphasis on 'profit and loss' rather than on health care protection for federal workers with disabilities."

Doyle has asked the national arm of the AFGE to investigate the long-term care program's enrollment requirements.

"It would be judicious for the national AFGE to monitor this matter closely to ensure that no federal worker is left behind in his or her access to the benefits of the Long-Term Care insurance program," he wrote.

For more details about the federal long-term care program, see the April 11 issue of Pay and Benefits Watch.