Congress experiences Obamacare… differently

Washington — Republicans trying to block the Affordable Care Act put a provision in the bill aimed at embarrassing its Democratic supporters by requiring lawmakers and their staff to drop their federal health plans for one purchased on a state exchange.

Republicans said they wanted ACA supporters to “feel the pain” they say other Americans feel when they buy health plans on those exchanges.

But members of Congress and their staffs – even those who work in their home states and not Washington — are having a completely different experience than anyone else who buys insurance on an exchange. In part that’s because the exchanges were created by the ACA to help cover the uninsured and underinsured, not well-insured government workers.

Beginning Nov. 11, when enrollment opened for federal workers, members of Congress and their staffs were required to choose a plan from the District of Columbia exchange, DC Health Link.

They have 112 plans to choose from using the DC Health Link’s offerings for small businesses. Most shoppers on state exchanges have far fewer choices.  Connecticut’s exchange, Access Health CT, offers 26 plans.

Last week, President Obama announced a one-year delay of online enrollment for small businesses looking to buy health coverage through federal Obamacare exchanges. But the District of Columbia exchange and Connecticut’s exchange are able to sign up small businesses.

In addition, if lawmakers and staff want to continue to receive help paying their premiums from the federal government, they must buy a “gold” plan, the most expensive and comprehensive plans on the exchange. Most Americans can afford only the less expensive “bronze” or “silver” plans.

To help buy these gold plans, members of Congress and their staff will continue to receive the employer match they now get under the Federal Employee Health Benefits Program, the plan offered to anyone who works on Capitol Hill and throughout the federal government. The average match is about 70 percent, which means members of Congress and their staffs pay about 30 percent of their premiums. Even with the ACA’s subsidies to Americans with modest incomes, most shoppers on state exchanges aren’t receiving that kind of premium break.

The angry Republican

This has enraged many conservative Republicans, most notably Sen. David Vitter of Louisiana, who argues that the employee contribution spares members of Congress from what the Republicans say is the “unaffordability” of the ACA. Vitter has filibustered nearly every bill considered in the Senate lately, demanding consideration of his amendment that would eliminate the federal contribution that helps lawmakers and their staffers buy health insurance.

“It’s amazing to me, and it makes it very clear how determined they are to protect the political elite in Washington,” Vitter said of Democrats’ opposition to his amendment.

But John Hudak, a fellow at the Brookings Institution, said the Vitter amendment would affect only the most vulnerable on Capitol Hill.

Taking away the federal contribution “hurts junior staffers making $30,000 a year because members of Congress can afford to pay for health care out of their own pockets,” Hudak said.

Connecticut delegation

Sen. Richard Blumenthal, D-Conn., and Rep. John Larson, D-1st District, are unaffected by the provision in the Affordable Care Act aimed at Congress because they are enrolled in Medicare. Rep. Elizabeth Esty, D-5th District, is covered under her husband’s state of Connecticut plan. Daniel Esty is commissioner of the state Department of Energy & Environmental Protection.

The rest of the delegation had not signed up as of last week, but lawmakers must do so by Dec. 9, when their open enrollment ends.  (In Connecticut, the deadline is Dec. 23 to sign up through the exchange for a plan that starts Jan. 1. Those who want to sign up for a plan through the exchange that would go into effect later in 2014 have until March 31 to do so.)

Edmund Skowronek, a spokesman for Larson who works in a 1st District office, said he has “gone on the website and checked the options,” but has not yet selected a plan.

Hudak said Republican criticisms that members of Congress are still exempt from the ACA is unfair. In fact, they are the only ones required to purchase their coverage from an exchange. Everyone else can choose to buy insurance from an exchange — where they may qualify for subsidies or federal help in paying for copays and deductible — or outside the exchange. And the ACA prohibits all other large employers like the federal government from buying insurance for their employees through the exchange.

“Congress is not exempt, it is actually forced to use an exchange in a way those working for other large employers can’t,” Hudak said.

OPM

Conservatives, who insist members of Congress are still “exempt” from the ACA, have focused much of their ire on the Office of Personnel Management, which set up the system for Capital Hill to sign up for health insurance. The OPM determined that the ACA required lawmakers and their staff to sign up on an exchange, but it said nothing about the employer match.

John O’Brien, director of health care at the OPM, said the gold offerings on the DC Health Link’s small business plans were closest to those offered in the Federal Employee Health Benefits Program. The federal program, with its 200-plus plans, will still cover federal civil service workers.

Another difference is that under the FEHBP program, premiums were the same for everyone who chose the same plan. In the exchange, premiums are based in part on a person’s age. That means older members of Congress and congressional staff will pay more than younger ones for the same plan.

DC Health Link has had its share of computer problems, but far fewer glitches than the disaster-prone federal exchange 34 states are using.

Still, House Majority Leader John Boehner, R-Ohio, complained that he could not register for a new health plan.

“Despite multiple attempts, I was unable to get past that point and sign up for a health plan,” Boehner wrote on his official blog. “We’ve got a call into the help desk. Guess I’ll just have to keep trying.”

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