More than a dozen Democratic senators are pressing the Office of Personnel Management to withdraw a proposal that would expand OPM’s access to claims-level health data tied to Federal Employees Health Benefits (FEHB) and Postal Service Health Benefits (PSHB) enrollees, warning it could violate federal privacy protections and chill doctor-patient confidentiality.
- Senators said the proposal would collect or require access to “claims-level” data connected to individual FEHB and PSHB participants, according to GovExec — Pay & Benefits.
- Lawmakers warned the approach could conflict with federal privacy laws and long-standing medical confidentiality norms, GovExec — Pay & Benefits reported.
- The senators urged OPM to pull back the proposal rather than proceed under the current framework, citing risks to federal and postal employees’ sensitive health information, according to the report.
- The concerns apply to both FEHB (covering most federal civilian employees and many annuitants) and PSHB (the separate program for Postal Service employees and annuitants), as described by GovExec — Pay & Benefits.
The pushback lands as OPM continues implementing PSHB, a major structural change to how postal employees and retirees receive coverage beginning in 2025, while also overseeing FEHB’s contracting and program integrity efforts.
According to GovExec — Pay & Benefits, senators argued that claims-level data—especially when tied to individuals—can reveal diagnoses, treatments, prescriptions, and other highly sensitive information. They said that even if the stated intent is oversight or cost control, expanding access to individualized claims data raises the risk of improper disclosure and could deter enrollees from seeking care or being candid with providers.
For federal and postal employees, the immediate question is whether OPM will narrow or withdraw the proposal, or proceed and attempt to address lawmakers’ privacy objections through revised policy language, safeguards, or data-handling limitations. Enrollees tracking how FEHB plan choices and benefits compare year to year can also reference the FEHB value guide when evaluating coverage tradeoffs during open season.
GovExec — Pay & Benefits reported that the senators framed their request as a privacy and oversight issue, signaling continued congressional scrutiny of how OPM and participating carriers handle enrollee health information across both FEHB and PSHB.
Source: GovExec — Pay & Benefits