H.R. 2193 — FEHB Protection Act of 2025

This section requires the Director of the Office of Personnel Management (OPM) to, not later than six months after enactment, develop a process to disenroll or remove ineligible individuals from the Federal Employees Health Benefits Program (FEHB); not later than one year after enactment, issue regulations and implement a process to verify the veracity of qualifying life events and eligibility of added family members (including during open seasons); and, during the three-year period beginning one year after enactment, conduct with employing offices a comprehensive audit of covered family members using documents such as marriage and birth certificates. The section further requires that any FEHB fraud risk assessment on or after enactment by OPM assess coverage of ineligible individuals. (As background, FEHB provides health insurance to eligible federal employees, retirees, and family members as defined in 5 U.S.C. §8901.)

This section amends federal health benefits funding authorities (5 U.S.C. §8909) to exempt specified Office of Personnel Management (OPM) oversight funds from annual congressional limitations and to establish the following new funding streams from program contributions: (1) For OPM to develop, maintain, and oversee enrollment and eligibility systems for the Federal Employees Health Benefits (FEHB) program and Postal Service Health Benefits Program (PSHB), capped at $36,792,000 in FY2026, increasing annually to $59,844,351 in FY2035 and by 2.2% each year thereafter. (2) $80 million in FY2026, available until expended, for OPM to conduct a required audit under the FEHB Protection Act of 2025 (with authority to transfer funds to employing offices). (3) For OPM's Office of the Inspector General to conduct oversight of FEHB and PSHB activities (including enrollment, eligibility, and required audits), capped at $5,090,278 in FY2026 and increasing by 2.2% each year thereafter.