In the aftermath of last month’s Supreme Court ruling to uphold the Affordable Care Act, Republicans have made it clear that they have no plans to give up their fight to repeal President Barack Obama’s signature health care law. What is often lost in the discussion about Obamacare is how the law will affect members of Congress, who enjoy famously cushy benefits plans administered by the federal government.
We asked around Washington to try and get some answers about how members of Congress stand to benefit/suffer if the law is upheld or repealed— and what we found was a little surprising.
Many of the special benefits afforded in Congress’ federally-administered healthcare plans are actually included in the Obamacare legislation. But while Republicans are ready to repeal those benefits for rank-and-file voters, they aren’t quite willing to give them up for themselves.
Under the Affordable Care Act, members of Congress will no longer be allowed to remain on their current healthcare plans.
Section 1312 of the law spells this out:
“[T]he only health plans that the Federal Government may make available to Members of Congress and congressional staff with respect to their service as a Member of Congress or congressional staff shall be health plans that are, (1) created under this act; or (2) offered through an exchange established under this act.”
The provision was included by Republican Senators Tom Coburn (OK) and David Vitter (LA), two adamant opponents of the healthcare bill, as a way of forcing the then-Democratic-led Congress to reap what it sowed.
According to a 2010 report from the Congressional Research Service, the language of Section 1312 means that, once Obamacare is fully implemented, members of Congress will not be allowed to enroll in healthcare plans administered by the Federal Employee Health Benefits Program, and will instead be required to join the state- and federally-run health insurance exchanges when they are set up in 2014.
The FEHBP plans are actually relatively similar to healthcare plans offered in the private sector, with a few key distinctions:
- Federal employees can choose from 206 different plan options, offering a national network of doctors and a variety of services. Taxpayers pick up 75 per cent of the premium cost. In contrast, about 85 per cent of private-sector companies offer employees only one option for healthcare coverage.
- While the FEHBP plans are run by private insurers, the OPM does set minimum coverage requirements for the plans.
- Insurers offering plans under the FEHBP are prohibited from excluding federal employees and their dependents from coverage based on pre-existing conditions, or from altering rates based on age or gender.
- For an additional fee, members of Congress (but not their dependents) can get care from the on-site Attending Physician, and be treated at military hospitals in the D.C. area.
The Department of Health and Human Services has not yet issued rules on exchanges for members of Congress, so it is impossible to accurately determine the changes to their benefits. (A spokesman from Sen. Coburn’s office told BI that members of Congress will still be able to access care from the Attending Physician and military hospitals.)
But the Affordable Care Act actually requires all health insurance plans to provide many of the benefits already provided by the FEHBP plans, including a minimum standard of coverage, and ban on denying coverage or altering rates based on age, gender, or pre-existing condition.
Although these provisions are popular among Americans, House Republicans have said that they will repeal them, along with the rest the Affordable Care Act. But they aren’t willing to give up their own sweet healthcare deal.
During last week’s House vote to repeal Obamacare, Republicans voted against a measure that would have forced members of Congress to give up their FEHBP plans.
“If Republicans want to take those protections away, then Republicans should lose those protections as well,” Nadeam Eishami, a spokesperson for House Minority Leader Nancy Pelosi (D-CA), told Business Insider. “They twisted themselves into pretzels trying to explain it, but you can’t really explain that to your constituents — it’s hard to tell the mother of a child with diabetes that you are going to take away healthcare for her kid, and at the same time vote to protect your own healthcare.”
A spokesperson for House Majority Leader Eric Cantor (R-VA) would not comment specifically on the amendment.
To be sure, the Democrats’ amendment — like the repeal vote itself — was entirely politically motivated.
“It’s not like we would have voted for repeal if they passed it,” Eishami told Business Insider.
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