Ask The Advisor: March 2014

Ask The Advisor: March 2014

Is Congress Exempt From Obamacare?

Q:  Can you tell me how Congress is getting their health insurance this year?  Our health plan got canceled and we had to enroll through the federal exchange.  My husband and I now pay $350 per month more in premiums for a lousy plan that only pays 60% of our costs after a $4,000 deductible for each of us.  We are middle income seniors, and didn't qualify for a subsidy, and can't afford a better plan.  Obamacare ruined our perfectly good, lower-costing health insurance.  Congress should be forced to take its own medicine!

A:  When Congress passed the Affordable Care Act, better known as Obamacare, a provision of the law originally required all members of Congress and their staff to enroll in the online health exchanges.  But like many Congressional benefits, the Obamacare experience has not worked the same way for Congress as it has for average Americans.  Michael Memoli of The Los Angeles Times reports "their experience has been significantly better than those of average consumers in several respects, including more generous benefit packages, VIP customer service from insurers, and the same government-subsidized premiums they’ve always enjoyed."

Long before Obamacare ever launched on October 1, 2013, the original provision was causing a high level of anxiety on Capitol Hill.  Concerns grew over whether lawmakers and their staff would lose their taxpayer-subsidized premiums, leaving them to cover 100% of the cost of their own coverage.  Emily Ethridge of the Congressional Quarterly Roll Call reported that there were "reports of congressional leaders of both parties holding secret meeting to try to exempt lawmakers and their staff."  A spokesman for Senate Majority Leader Harry Reid (NV) denied that such conversations were taking place.

But in the months to follow, the provision got watered down.  The federal government's Office of Personnel Management stepped in, issuing formal guidance saying that Members and their staffers could keep their healthcare subsidies — which amount to as much as 75% of the monthly premium— and that some staffers would not have to join the new health exchanges at all.

While most Washington D.C. residents had 34 individual health plans to choose from, Members of Congress had 112 "gold" level plans. Meanwhile, millions of average citizens were unable to access and see meaningful Obamacare plan comparisons for weeks due to the non-functioning federal healthcare exchange and many are still trying to confirm their enrollment with their health plans.

TSCL urges seniors like you who are affected by Obamacare to tell others about your experience.  Is your new coverage a godsend, or should it be "returned to sender?"  Be sure to share your story with the local newspaper or TV news station and send TSCL a copy!


Source: "For Congress, Healthcare Plans Remain A Notch Above," Michael A. Memoli, December 1, 2013.  "Health Insurance Anxiety on Capitol Hill," Emily Ethridge, CQ, Roll Call, April 25, 2013.