Is Congress Exempt from the ACA?

Aug 21 2013

Published by at 10:01 am under Current Events

The controversial Patient Protection and Affordable Care Act (ACA) was signed into law by President Obama on March 23, 2010, and most of the law was upheld as constitutional by the Supreme Court on June 28th 2012. The ACA reforms America’s healthcare system in several different ways. Much of the controversy surrounding the ACA is due to mandates that require individuals to purchase health insurance, because of the tax penalty imposed for not complying. Keep in mind, there are several groups of people who are not subject to this provision, including: families whose income is below the threshold for filing a tax return, individuals who are opposed to acceptance of benefits from a health insurance policy, people who are insured for the entire year through Medicare and/or TRICARE, those receiving employer provided insurance, and a few others. Most individuals that do not fall into one of these specified groups are subject to the mandate provision.

When the ACA was before Congress, Senator Grassley (R-Iowa), a strong opponent of the bill, suggested an amendment that would impose the exchange system on Congress and their staffs, in an effort to deter support. Supporters of the bill, however, actually ended up welcoming the amendment, using it as a message that if the ACA was good for the rest of America, it was good enough for them as well.

Before the ACA was enacted, most individuals who worked on Capitol Hill were eligible for the same health insurance as federal civilians, and they paid the same premiums. They were able to enroll in any of the insurance programs offered under the federal employee health insurance program. The overall cost of their insurance was subsidized by the federal government. This system is analogous to many other employer subsidized health insurance plans, that the general employed public is familiar with, and frequently takes advantage of. With the ACA, and Senator Grassley’s amendment, Congress members, and their staff, have to leave the federal employee health insurance program and fully participate in the exchange system under the ACA. What wasn’t initially foreseen with the Senator’s amendment was that it did not take into consideration the current employer (i.e. federal government) healthcare premium contribution system. And so in lies the root of what led to the rumor and uproar that Congress was trying to spare itself from the ACA.

In April of 2013, Politico ran a story titled, “Lawmakers, aids may get Obamacare exemption.” The article was interpreted by many to mean that Congress was trying to get out of participating in the insurance exchange provision of the ACA because their staffers were threatening to leave if forced into this provision without the employer contribution benefit. This started a landslide of stories that Congress was trying to wiggle free from the ACA because it was too unaffordable and unfair:

In a nutshell, a number of congressmen and staffers, according to The Politico, are threatening to quit or retire because they can’t afford their premiums under Obamacare! So the same people who gave us this monstrosity, the same people who didn’t have the guts to vote against this monstrosity, are now bellyaching that they can’t afford it. Source

[W]hen it comes to ObamaCare, liberal elites are more than happy to see themselves and their allies protected from the consequences of that grand social experiment. Source

If Congress, acting at the behest of President Obama, was going to shove this unpopular idea down the throats of an unwilling nation, those involved in making the law were going to have to live with it the same as the rest of the country. But three years later and with only six months to go before this provision goes into effect, it appears a new bipartisan consensus has emerged in the Congress about the misnamed Affordable Care Act: they want no part of it. Source

Basically, most of this controversy has to do with a glitch in the ACA language that had not explicitly allowed the federal government from subsidizing, or paying into, their Capitol Hill employees’ insurance plans. This would mean that Congress and their staff members would be responsible for paying their entire premiums. If the Office of Personnel Management (OPM) had not intervened on August 8 of this year, congressional staff would have been penalized by losing those employer healthcare contributions. To prevent this occurrence, the OPM states that individuals who are forced out of the federal employee health insurance program will continue to receive their employer contribution toward their health insurance, comparable to what they are currently receiving under the federal employee health insurance program. Additionally, it should be noted that although there will be tax credits available for some ACA plan enrollees to help pay their premiums, congressional staffers and members will not have this option.

The bottom line of this overly blown out of proportion story, is that Congress members and staffers are still using the ACA exchange system, and they will now be able to continue to receive similar employer healthcare contributions.

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