2026 Open Season Exchange: OPM’s Shane Stevens on big-picture plans for FEHB, PSHB
Participants in both the Federal Employees Health Benefits and Postal Service Health Benefits programs may have more incentive than usual to take advantage of Open Season, as premium costs continue to surge in yet another year of double-digit percentage increases.
For 2026, FEHB premiums are rising by an average of 12.3% for enrollees, while those in PSHB will see their premium costs rise by an average of 11.3%. It comes after premiums increased by about 13.5% and 11.1% for FEHB and PSHB respectively in 2025.
Shane Stevens, associate director of healthcare and insurance at the Office of Personnel Management, acknowledged what he said was a “frustrating environment” for insurance enrollees who are facing continually rising premium costs.
“Health care costs have become somewhat unsustainable,” Stevens said during Federal News Network’s 2026 Open Season Exchange. “I’ve watched employees have to get second jobs to get insurance and cover it. I’ve watched where they’ve reduced the amount of coverage in order to afford it. In some cases, they’ve gone completely without insurance.”
Combating federal health insurance premium cost increases
To try to combat rising premiums costs, Stevens said OPM’s strategy will revolve around reducing “fraud, waste and abuse” in the government’s insurance programs.
“We have a fiduciary responsibility to the taxpayers, to our plan participants, the retirees, the current federal workers. Yet we have very little insight into what we’re actually spending this coming year,” he said. “We’re working very hard to try and get all of this information, all of this data, to be able to make good decisions, which will help us to detect fraud, waste, abuse and overpayments.”
OPM is also on a one-year deadline to implement recently added requirements from the One Big, Beautiful Bill Act. One provision of the reconciliation bill, called the FEHB Protection Act, requires OPM to create a system for verifying the eligibility of FEHB enrollees. The bill also directs OPM to include eligibility audits in any fraud risk assessments of the program.
The push in Congress came after the Government Accountability Office in 2022 found that OPM may be spending up to $1 billion annually on ineligible FEHB enrollees. Removing ineligible members, however, would reduce costs to the government but not necessarily lower premiums for beneficiaries directly.
“If we get the data and the information we need, I’m convinced that we could save approximately 7% to 8% per year,” Stevens estimated.
Addressing staff needs, other challenges within OPM
OPM’s insurance programs are facing other major challenges as well. The platform for the PSHB program in particular is at risk of an operational failure, according to OPM’s inspector general office. An OIG report over the summer found that staffing shortages at OPM this year, coupled with funding issues, may negatively impact enrollees’ experience or ability to change enrollments during Open Season.
On top of that, GAO recently reported that the staffing shortages at OPM are hindering the agency’s ability to address risks of fraud in the FEHB program.
When asked how OPM has responded to the watchdog’s concerns, “We do believe our staff can work effectively through everything,” Stevens said, adding, “In the short run, we’ve improved our systems and our processes to where we’re not concerned about delays or challenges.”
Stevens added that he plans to roll out more artificial intelligence tools for participants to use in the enrollment process for future years of Open Season.
Emulating the ‘Make America Healthy Again’ agenda
In addition to addressing fraud and saving costs, Stevens also described his goal of shifting the government’s insurance programs toward what he described as a “well care model,” as opposed to what he describes currently as a “sick care model.”
“We want to move more toward a holistic approach and something to where we’re not doing a pharmaceutical-first type of intervention, or where we have faith-based behavioral health care to where they can give true solutions,” he said.
“If we get healthier and we start making better health decisions, then we’re going to be able to reduce the costs, the premiums,” Stevens added.
It’s not yet entirely clear what OPM may change in the FEHB or PSHB programs based on the big-picture priorities Stevens outlined during the interview.
But for 2026, OPM already made one distinct change: Carriers were required to end coverage of all gender-affirming care, in line with an executive order from President Donald Trump earlier this year.
Enrollees who are mid-treatment for gender-affirming care can still continue receiving coverage, according to OPM’s new requirements, but the definition of “mid-treatment” is determined individually by each health carrier. Federal health plan experts have recommended that those impacted by OPM’s change check their carrier’s plan brochure for more details.
Going forward though, Stevens also expressed interest in reconsidering coverage of GLP-1 medications, a class of drugs that are prescribed to treat diabetes and obesity.
“We want to look at utilizing these as a tool for weight loss or for treatment of diabetes,” Stevens said. “However, we don’t want it to be viewed as the end-all be-all of, ‘this is going to save me.’”
Currently, OPM requires all carriers to cover at least one type of GLP-1 for enrollees, prescribed for weight loss. It’s a requirement that health care experts have said is a positive development and ahead of the curve compared with the private sector.
But Stevens said he wants to encourage physical exercise and nutrition over GLP-1s, through the government’s insurance programs. That type of change, he said, may also lead to some cost savings.
“I want to try and move away from that, move more to incentivizing providers to have good health outcomes for their patients versus prescribed medications,” he said.
Stevens’ approach for what he sees for the future of FEHB and PSHB mirrors goals of the Trump administration’s larger push toward the “Make America Healthy Again” agenda.
Stevens, for instance, discussed what he views as a “broken” health care system that focuses on prescriptions first — emulating a sentiment that Health and Human Services Secretary Robert F. Kennedy Jr. has expressed and that has influenced some of the Trump administration’s major health initiatives.
RFK’s MAHA report from May outlined contentious views on vaccines, the nation’s food supply, pesticides and prescription drugs. The HHS report, parts of which have received strong criticism, additionally includes increased scrutiny of childhood vaccines and “fear-based” views on farming chemicals, while also blaming ultra-processed foods for unhealthy Americans.
“We truly have a secretary of health that’s fighting for the real overall well-being of health. We have a president that truly cares about it, and then we have a lot of appointees that are trying to make a big difference,” Stevens said. “It’s a massive shift in the paradigm of how we look at health care — really looking at outcomes versus prescriptions and a lot of the things that have made us an unhealthy population.”
Encouraging Open Season action
In the immediate term, Stevens encouraged participants in FEHB and PSHB over the next several weeks to take advantage of Open Season. Participants have until the enrollment window closes on Dec. 10 to spend time looking at plan brochures and comparing various insurance options that are available to them.
The push to take action during Open Season comes as relatively few insurance enrollees end up selecting a different plan each year.
“Change is tough, change is scary, and a lot of times I think people would just rather stick with their current plan and do the same, regardless of how much it could cost them more,” Stevens said. “It will surprise a lot of people in seeing that if they were to shift over to a different type of plan that they could save a substantial amount of money.”
For measuring this year’s Open Season success, Stevens said he will be looking for any potential shifts in the statistic that just 5% of enrollees change their plans each year.
“We encourage everybody to take the time — I’m talking maybe an hour of your time — to jump in and look at the different tools that we’ve created and make sure that you’re picking the plan that’s best for you,” he said. “We’ll take all of that in and see what we can do to improve our systems and processes to make it even better next year.”
Discover more articles and videos now on our 2026 Open Season Exchange event page.
The post 2026 Open Season Exchange: OPM’s Shane Stevens on big-picture plans for FEHB, PSHB first appeared on Federal News Network.

© Federal News Network

