Where do members of Congress obtain health insurance? Is Congress exempt from Obamacare?

Is Congress required to comply with Obamacare? Yes and no. Following are the facts on the current situation. Congress and it’s staff are eligible for the Federal Employees Health Benefits Program, just like other federal employees. However, the Affordable Care Act requires that Members of Congress and some of their staff must get their coverage through an exchange plan. But what will they pay, 25% of the cost as they do now or are they on their own? There seems to be some disagreement among members of congress … I guess you have to pass a law to find out what’s in it! LOL

Now it’s being reported there are secret (no longer) talks to exempt Congress from this provision. Frankly, this is a stupid provision written by the gutless people who wrote the law. There is no reason why Congress and its staff should not stay in their “employer” plan just as will every other worker with employer-based health benefits.

Who knows if Congress will risk the wrath of voters if they pass an exemption to the law as logical as that may be, but the misinformation machine moves on in any case.

From Politico: Sen. Richard Burr (R-N.C.) said if OPM decides that the federal government doesn’t pick up “the 75 percent that they have been, then put yourself in the position of a lot of entry-level staff people who make $25,000 a year, and all of a sudden, they have a $7,000 a year health care tab? That would be devastating.”

Devastating? What’s devastating is that you don’t know what you are talking about. Put yourself in the position of the average American! Yeah, and it will also be devastating to an entry-level person not employed by Congress who is mandated by law to carry health insurance.

In fact, the estimated total premium for a person age 28 earning $25,000 per year is $3,391 in the exchanges in a medium cost area. The required premium would be $1,726 with the balance a federal tax credit. If the person was married with children, they would be on Medicaid.

From:

Health Benefits for Members of Congress
By Ada S. Cornell
Information Research Specialist
Congressional Research Service February 12, 2013

Members of Congress and retired Members are eligible for private insurance coverage under the same system as other federal employees, the Federal Employees Health Benefits Program (FEHBP). FEHBP is the largest employer-sponsored health plan in the United States, covering more than 8 million federal employees, retirees, and their families.

Retired federal employees, including retired Members, who meet the minimum enrollment period requirements and who are eligible for an immediate annuity may continue to participate in FEHBP in retirement. Current federal employees, including Members of Congress, may also participate in the Federal Flexible Spending Account Program (FSAFEDS) to set up tax-exempt flexible spending accounts for reimbursement of health care, child care, and elder care expenses not otherwise reimbursed or covered by insurance. Current and retired federal employees, including Members of Congress, may enroll in the Federal Employees Dental and Vision Insurance Program (FEDVIP) for supplemental dental and vision insurance coverage. They may also apply for long-term care coverage under the Federal Long Term Care Insurance Program (FLTCIP).

All federal employees, including Members of Congress, pay the same payroll taxes as other workers for Medicare Part A coverage, and they are eligible to enroll in Medicare Part B, Part C, and Part D. Current Members, unlike other federal employees, are also eligible to receive health care services from the Office of the Attending Physician in the U.S. Capitol and at military hospitals.

The Patient Protection and Affordable Care Act (ACA; P.L. 111-148) requires health insurance exchanges to be established in every state by January 1, 2014. The ACA requires that the only health plans the federal government may make available to Members of Congress and certain congressional staff as a benefit of their federal employment are health plans created under the ACA or offered through health insurance exchanges established under the ACA. The Director of OPM has resolved a lack of clarity in the law as to the effective date of this provision by concluding that this provision will not be effective until the health insurance exchanges become operational.

Therefore, this provision does not currently affect Members of Congress or their staffs’ participation in FEHBP. Regulations providing interpretive guidance have not yet been promulgated as of the date of this report.