Are Members of Congress and Their Personal Staffs Required to Purchase Their Health Insurance Plans through the Obamacare Health Insurance Exchanges? – YES

“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.”

“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.”

“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].”

“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’).”