119-hr2193

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2193 Introduced in House

    (IH) ]

<DOC>

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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