I
119THCONGRESS
1
STSESSION 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
MARCH18, 2025
Mr. G
ROTHMANintroduced 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 Manage-
ment 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 Representa-1
tives of the United States of America in Congress assembled, 2
SECTION 1. SHORT TITLE. 3
This Act may be cited as the ‘‘FEHB Protection Act 4
of 2025’’. 5
SEC. 2. FEHB IMPROVEMENTS. 6
(a) D
EFINITIONS.—In this section: 7
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(1) DIRECTOR.—The term ‘‘Director’’ means 1
the Director of the Office of Personnel Management. 2
(2) E
MPLOYING OFFICE.—The term ‘‘employing 3
office’’ has the meaning given the term in section 4
890.101(a) of title 5, Code of Federal Regulations, 5
or any successor regulation. 6
(3) H
EALTH BENEFITS PLAN ; MEMBER OF 7
FAMILY.—The terms ‘‘health benefits plan’’ and 8
‘‘member of family’’ have the meanings given those 9
terms in section 8901 of title 5, United States Code. 10
(4) O
PEN SEASON.—The term ‘‘open season’’ 11
means an open season described in section 12
890.301(f) of title 5, Code of Federal Regulations, 13
or any successor regulation. 14
(5) P
ROGRAM.—The term ‘‘Program’’ means 15
the health insurance programs carried out under 16
chapter 89 of title 5, United States Code, including 17
the program carried out under section 8903c of that 18
title. 19
(6) Q
UALIFYING LIFE EVENT .—The term 20
‘‘qualifying life event’’ has the meaning given the 21
term in section 892.101 of title 5, Code of Federal 22
Regulations, or any successor regulation. 23
(b) V
ERIFICATIONREQUIREMENTS.—Not later than 24
1 year after the date of the enactment of this Act, the 25
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Director shall issue regulations and implement a process 1
to verify— 2
(1) the veracity of any qualifying life event 3
through which an enrollee in the Program seeks to 4
add a member of family with respect to the enrollee 5
to a health benefits plan under the Program; and 6
(2) that, when an enrollee in the Program seeks 7
to add a member of family with respect to the en-8
rollee to the health benefits plan of the enrollee 9
under the Program, including during any open sea-10
son, the individual so added is a qualifying member 11
of family with respect to the enrollee. 12
(c) F
RAUDRISKASSESSMENT.—In any fraud risk 13
assessment conducted with respect to the Program on or 14
after the date of the enactment of this Act, the Director 15
shall include an assessment of individuals who are enrolled 16
in, or covered under, a health benefits plan under the Pro-17
gram even though those individuals are not eligible to be 18
so enrolled or covered. 19
(d) F
AMILYMEMBERELIGIBILITYVERIFICATION 20
A
UDIT.— 21
(1) I
N GENERAL.—During the 3-year period be-22
ginning 1 year after the date of the enactment of 23
this Act, the Director, in coordination with the head 24
of each employing office, shall conduct a comprehen-25
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sive audit regarding members of family who are cov-1
ered under an enrollment in a health benefits plan 2
under the Program. 3
(2) C
ONTENTS.—In conducting an audit re-4
quired under paragraph (1), the Director, in coordi-5
nation with the head of each employing office, shall 6
review marriage certificates, birth certificates, and 7
other appropriate documents that are necessary to 8
determine eligibility to enroll in a health benefits 9
plan under the Program. 10
(e) D
ISENROLLMENT OR REMOVAL.—Not later than 11
6 months after the date of the enactment of this Act, the 12
Director shall develop a process by which any individual 13
enrolled in, or covered under, a health benefits plan under 14
the Program who is not eligible to be so enrolled or cov-15
ered shall be disenrolled or removed from enrollment in 16
a health benefits plan under the Program. 17
SEC. 3. EARNED BENEFITS AND HEALTHCARE ADMINISTRA-18
TIVE SERVICES ASSOCIATED OVERSIGHT AND 19
AUDIT FUNDING. 20
(a) I
NGENERAL.—Section 8909(a)(2) of title 5, 21
United States Code, is amended by striking ‘‘Congress.’’ 22
and inserting ‘‘Congress, except that the amounts author-23
ized under subsection (b)(2) for the Office shall not be 24
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subject to the limitations that may be specified annually 1
by Congress.’’. 2
(b) O
VERSIGHT.—Section 8909(b) of title 5, United 3
States Code, is amended— 4
(1) by redesignating paragraph (2) as para-5
graph (5); and 6
(2) by inserting after paragraph (1) the fol-7
lowing: 8
‘‘(2) In addition to the funds provided under 9
paragraph (1), amounts of all contributions shall be 10
available for the Office to develop, maintain, and 11
conduct oversight over the enrollment and eligibility 12
systems with respect to benefits under this chapter, 13
including the Postal Service Health Benefits Pro-14
gram under section 8903c. Amounts for the Office 15
under this paragraph shall not be available in excess 16
of the following amounts in the following fiscal 17
years: 18
‘‘(A) In fiscal year 2026, $36,792,000. 19
‘‘(B) In fiscal year 2027, $44,733,161. 20
‘‘(C) In fiscal year 2028, $50,930,778. 21
‘‘(D) In fiscal year 2029, $54,198,238. 22
‘‘(E) In fiscal year 2030, $54,855,425. 23
‘‘(F) In fiscal year 2031, $56,062,244. 24
‘‘(G) In fiscal year 2032, $57,295,613. 25
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‘‘(H) In fiscal year 2033, $58,556,117. 1
‘‘(I) In fiscal year 2034, $59,844,351. 2
‘‘(J) In fiscal year 2035 and each fiscal 3
year thereafter, the amount equal to the dollar 4
limit for the immediately preceding fiscal year, 5
increased by 2.2. percent. 6
‘‘(3) In fiscal year 2026, $80,000,000, to be de-7
rived from all contributions and to remain available 8
until expended, shall be available for the Office to 9
conduct the audit required under section 2(d) of the 10
FEHB Protection Act of 2025. Of such amount, the 11
Office may transfer funds as the Director of the Of-12
fice determines necessary to an employing office (as 13
that term is defined in section 890.101(a) of title 5, 14
Code of Federal Regulations, or any successor regu-15
lation) in order to conduct the required audit. 16
‘‘(4) Amounts of all contributions shall be avail-17
able for the Office of Personnel Management Office 18
of the Inspector General to conduct oversight associ-19
ated with activities under this chapter (including the 20
Postal Service Health Benefits Program under sec-21
tion 8903c), including activities associated with en-22
rollment and eligibility in these programs and any 23
associated audit activities as required under the 24
FEHB Protection Act of 2025. Amounts for the Of-25
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fice of the Inspector General under this paragraph 1
shall not be available in excess of the following 2
amounts in the following fiscal years: 3
‘‘(A) In fiscal year 2026, $5,090,278. 4
‘‘(B) In fiscal year 2027 and each fiscal 5
year thereafter, the amount equal to the dollar 6
limit for the immediately preceding fiscal year, 7
increased by 2.2 percent.’’. 8
Æ
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