Are Members of Congress and Their Personal Staffs Required to Purchase Their Health Insurance Plans through the Obamacare Health Insurance Exchanges? – YES
General Reference (not clearly pro or con)
The Patient Protection and Affordable Care Act, Section 1312, “Consumer Choice,” page 64, signed into law on Mar. 23, 2010, available at the Library of Congress website, states:
“(D) MEMBERS OF CONGRESS IN THE EXCHANGE.
Notwithstanding any other provision of law, after the effective date of this subtitle, 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).
In this section:
(I) MEMBER OF CONGRESS.-The term ‘Member of Congress’ means any member of the House of Representatives or the Senate.
(II) CONGRESSIONAL STAFF.-The term ‘congressional staff’ means all full-time and part-time employees employed by the official office of a Member of Congress, whether in Washington, DC or outside of Washington, DC.”Mar. 23, 2010 - Patient Protection and Affordable Care Act (HR 3590)
[Editor’s Note: On Aug. 7, 2013 the United States Office of Personnel Management (OPM) issued a rule to implement the Obamacare requirement that members of congress and staff employed by the “official office of a Member of Congress” must obtain health insurance plans through the Health Insurance Exchanges beginning on Jan. 1, 2014.
According to an Aug. 28, 2013 article in The Hill, the OPM rule “does not appear to apply to staffers who work in leadership or committee offices.” These staffers may be able to continue to participate in the Federal Employees Health Benefits program (FEHB).
Members of Congress and their personal staff who are required to purchase their health insurance plans through the Obamacare health insurance exchange will continue to receive a government contribution of up to 75% of the cost of their health insurance premium – the same contribution they previously received to help pay the cost of their former health insurance plan under the Federal Employees Health Benefits program (FEHB).]
The United States Office of Personnel Management (OPM) stated the following in its Aug. 7, 2013 “Fact Sheet: Health Insurance Coverage: Members of Congress and Congressional Staff,” available at www.opm.gov:
“The Affordable Care Act includes a provision which requires that Members of Congress and congressional staff employed by the official office of a Member of Congress may only obtain coverage by health plans created under the Act or through coverage offered via an Affordable Insurance Exchange (Exchanges)…
Members of Congress and their staff will no longer be eligible for FEHB [Federal Employees Health Benefits] coverage as of January 1, 2014.
The Act defines ‘congressional staff’ as all full-time and part-time employees employed by the official office of a Member of Congress.
Because there is not an existing statutory or regulatory definition, OPM believes Congress is best able to make the determination as to whether an individual is employed by the ‘official office’ of the Member of Congress…
Members of Congress and their staff who are no longer eligible to enroll in an FEHB health plan will continue to receive a government contribution toward the cost of their premiums for qualified health plans purchased on the Exchanges. This contribution will be based on the government contribution provided for FEHB coverage. OPM will apply the employer contribution amounts up to 75 percent of the total cost of the health plan premium on the Exchange plan premium, the same as for an FEHB health plan premium.”
Rick Newman, columnist for Yahoo! Finance, stated the following in his Oct. 4, 2013 article “That Congressional Exemption From Obamacare? Another Myth,” available at the Yahoo! Finance website:
“Of all the misconceptions surrounding the new health reform law known as Obamacare—and there are many—one of the newest and most infuriating is the idea that Congress made itself ‘exempt’ from a law that puts onerous new burdens on many other Americans. That contention is totally false. In fact, members of Congress, along with their personal staffers, are required to participate in Obamacare, which is a more stringent requirement than employees of many big companies face…
The confusion is understandable. Earlier this year, Congress did, in fact, consider passing legislation that would amount to an exemption, though that never happened…
Up until now, members of Congress, like all federal employees, have been able to select insurance from a government plan…
The government, on average, pays about 75% of the premiums for members of Congress and other federal workers, while workers pay the other 25%. That’s comparable to what big firms kick in for coverage…
With members of Congress and their staffs being forced to buy insurance on the exchanges beginning in 2014, the real question regarding Congress is how the government can continue to offer some sort of health care benefit for those federal employees, the way most big employers do…
The Office of Personnel Management, which is the government’s HR department, finally decided this summer that the government will give Congressional employees a tax-free subsidy roughly equivalent to the value of the benefit they’ve been getting until now. That will help offset the unsubsidized cost of insurance bought through an exchange.”
Patrick Leahy, JD, US Senator (D-VT), in the “Fact vs. Fiction” section of his “Health Care Reform” webpage (accessed Oct. 8, 2012), stated:
“Fiction – Members of Congress are exempt from the health care reform law.
Fact – No one has received a special exemption from the Affordable Care Act. In fact, the health care reform law explicitly includes language regarding the health insurance plans for Members of Congress and their staff.
As a United States Senator, Senator Leahy’s health plan options are the same options offered to all federal employees. Included in the Affordable Care Act, was a provision that requires that ‘the only health plans that the Federal Government may make available to Members of Congress and Congressional staff shall be health plans that are created under this Act or offered through an Exchange established under this Act.’ Members of Congress and their staffs can only purchase health insurance coverage from the health insurance exchanges that are made available for uninsured Americans. The full text of this provision is available on pages 80-81 in section 1312 of the Affordable Care Act.”
Ada S. Cornell, Information Research Specialist for the Congressional Research Service, in a May 3, 2012 report, “Health Benefits for Members of Congress,” available at Representative Henry Waxman’s website, stated:
“The Patient Protection and Affordable Care Act (ACA; P.L. 111-148) requires health benefit exchanges to be established in every state by January 1, 2014. A provision in ACA requires that the only health plans 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, as created by the ACA. The language implies that Members of Congress and certain congressional staff will no longer be eligible to enroll in FEHBP [Federal Employees Health Benefits Program].”
Annie L. Mach, Analyst in Health Care Financing, and Ada S. Cornell, Information Research Specialist for the Congressional Research Service, in a Sep. 19, 2012 report, “Laws Affecting the Federal Employees Health Benefits (FEHB) Program,” available at www.fas.org, stated:
“Patient Protection and Affordable Care Act (P.L. 111-148, as amended), March 23, 2010
Beginning in 2014, Members of Congress and congressional staff may only enroll in health plans created under ACA, or offered through an exchange. Congressional staff, for the purpose of this requirement, will be limited to those part-and full-time employees who are employed by the official office of a Member of Congress (i.e., in a ‘personal office’).”
[Editor’s Note: Based upon a neutral reading of the Patient Protection and Affordable Care Act and bi-partisan third party analysis, this question seems to have a clear and obvious Pro (yes) answer, and ProCon.org has therefore presented the responses in a single column with no opposing perspective.]