Lawmakers in Washington, D.C., are once again causing a stir regarding President Obama’s health care overhaul with the announcement that congressional leaders from both parties are discussing whether or not to exempt lawmakers and Capitol Hill aides from the insurance exchanges they are mandated to join as part of the Affordable Care Act.
Despite misinformation floating around on social media, the discussions are not about excluding lawmakers altogether from Obamacare in its entirety. Instead, the meetings have concerned excluding lawmakers from certain provisions of the Affordable Care Act, such as the requirement to obtain health insurance through an insurance exchange by the president’s signature legislation.
Senate Majority Leader Harry Reid (D-Nev.), House Speaker John Boehner (R-Ohio), the Obama administration and other top lawmakers have been part of the high-level, confidential talks that have taken place over the past few months.
Part of the confusion of what is being discussed may be related to constant GOP attacks on the legislation, like when a Boehner spokesperson, Michael Steel, released this statement:
“The speaker’s objective is to spare the entire country from the ravages of the president’s health care law. He is approached daily by American citizens, including members of Congress and staff, who want to be freed from its mandates. If the speaker has the opportunity to save anyone from Obamacare, he will.”
The reason why lawmakers are engaging in these talks is because, according to the law’s wording, Congress and staffers may be responsible to cover 100 percent of their premiums until 2017.
Why?
When negotiations were still underway on the Affordable Care Act, Sen. Chuck Grassley (R-Iowa) — a vocal critic of Obamacare — proposed an amendment that forced all members of Congress and their staffs to use the exchanges instead of receiving coverage through the Federal Employee Health Benefits Program. According to Washington Post columnist Ezra Klein, this was a tactic by the Republican Party to embarrass Democrats, who in the end added the amendment to the law.
Legal jargon
This is how the current law is written:
“The 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 — (I) created under this Act (or an amendment made by this Act); or (II) offered through an Exchange established under this Act (or an amendment made by this Act).”
Based on the language of the bill, the federal government is considered a large employer since it employs more than 100 people. Under the legislation, large employers are not allowed into the insurance exchanges until 2017 — and that’s if a state allows them to participate in the exchange.
Being that the federal government is the largest employer in the U.S., anyone working for Congress could suddenly have a lot more health care expenses than anticipated. But the key word is may, as the Office of Personnel Management (OPM) — the agency that manages the federal government’s benefits — has not yet made a ruling about the interpretation of the law.
According to the Congressional Research Service — Congress’ in-house think tank — the government legally can help with premium costs.
“While it does not appear that the contribution must be similar to the contribution provided under [the Federal Employee Health Benefits Package (FEHBP)],” CRS writes in a 2010 report. “… It seems the section may provide the authority for the federal government to make a contribution to the health insurance premiums of Members of Congress and congressional staff. Under FEHBP … the government’s share of premiums is set at 72 percent of the weighted average premium of all plans in the program, not to exceed 75 percent of any given plan’s premium.”
Lawmakers respond
Rep. Henry Waxman (D-Calif.), who was a key architect of the Affordable Care Act, says there is confusion about the content of the law, explaining that the federal government will still subsidize and provide health care plans at no additional cost to lawmakers and congressional aides.
“I think the law is pretty clear,” Waxman said. “Members and their staffs should get their health insurance through the exchange; the federal government will offer them health insurance coverage that they obtained through the exchanges because we want to get the same health care coverage everybody else has available to them.”
Similarly, a staffer said that “even if OPM rules against us, it’s inaccurate to imply that any talks are aimed at exempting federal employees from routine mandates of [the Affordable Care Act] since any talks are about resolving the unique bind that the Grassley amendment puts federal employees in.”
Not every lawmaker agrees, however.
Sen. Richard Burr (R-N.C.) is another critic of Obamacare. He said that the provision has the potential to be devastating to entry-level staff. “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?
“And that makes up probably about 30 percent of the folks that work on the Senate side. Probably a larger portion on the House side. It would drastically change whether kids would have the ability to come up here out of college.”
Burr said he has no problem with Congress being under the same guidelines as the rest of the country, because:
“I think if this is going to be a disaster — which I think it’s going to be — we ought to enjoy it together with our constituents.”
Aides in lawmakers’ personal offices must obtain health care through the exchanges, but not committee staff. Lawmakers and aides older than 65 are covered by Medicare.