Get The Facts: "Congress Is Not Exempt From Obamacare"
- Posted on
May 3, 2013
Is it true that there are bills in Congress that would exempt members
and their staffs and families from buying into “Obamacare”?
Congress members and staffers will be required to buy insurance through
the exchanges on Jan. 1. But reportedly there is concern about whether
federal contributions to premiums can continue without a change.
Is it true that there are bills in the House and Senate that will
exempt members and their staff and families from buying into Obamacare?
Several readers have asked us about Congress attempting to exempt itself from the requirements of the Affordable Care Act.
A few said that a Facebook post claimed that President Barack Obama,
Sen. Harry Reid and Democrats in Congress were trying to “get themselves
exempted from Obamacare,” in the words of one reader.
But there is no bill in Congress calling for an exemption from the
health care law. In fact, members of Congress and their staffs face
additional requirements that most Americans don’t have to meet.
Under the health care law, their insurance coverage will have to switch from the Federal Employees Health Benefits Program,
the group of private insurance plans that cover 8 million federal
employees and retirees, to the exchanges created by the law. Those
exchanges are meant for those who buy coverage on their own, the
currently uninsured and small businesses. Members of Congress and their
staffs would be the only employees of a large employer in the exchanges,
which are set to begin offering insurance in January.
So, why is the false “exempt” claim making the Facebook rounds? There
is reportedly concern on Capitol Hill that the Office of Personnel
Management, which administers the Federal Employees Health Benefits
Program, won’t be able to smoothly transition members and their staffs
into an exchange. The concern, as a Roll Call story explained,
was that the government wouldn’t be able to make contributions toward
the federal employees’ premiums, at least at the beginning of 2014. That
would mean employees would pick up the whole tab for their insurance
policies. Right now, the government pays 72 percent of premiums on average.
The “exempt” claims were sparked by a Politico report
on April 24 that said secret talks were being held by lawmakers to
change the requirement to get insurance through the exchanges because of
this concern. The headline on the story said “Lawmakers, aides may get
After the story was published, a spokesman for Sen. Harry Reid said
there hadn’t been any discussions to exempt Congress from “provisions
that apply to any employees of any other public or private employer
offering health care.” And Democratic Rep. Henry Waxman of California
told Politico that lawmakers and their staffs will indeed get insurance
through the exchanges. “[T]he federal government will offer them health
insurance coverage that they obtained through the exchanges because we
want to get the same health care coverage everybody else has available
to them,” he said.
We contacted the Office of Personnel Management and received this
statement from an administration official: “Members of Congress will not
receive anything that is not available to the public. The law doesn’t
allow them to get insurance from FEHB, they are going to get insurance
on the market place, just like uninsured individuals and small
We can’t say what did or didn’t happen in any secret meetings. But we
can say that no bill has been introduced to exempt members of Congress
from the Affordable Care Act — and they were never exempt in the first
place. Even if, hypothetically, Congress were to nullify the provision
requiring members and their staffs to get insurance on the exchanges, it
still wouldn’t amount to an exemption from the law. Lawmakers and
staffers would be subject to the mandate to have health insurance or pay
a fine, just as everyone else is.
The law provides a few exemptions
from the requirement to have insurance, but only for those who earn too
little to file taxes, those with financial hardships, those who can’t
find affordable coverage, and some religious groups that qualify for Social Security exemptions, mainly Mennonite or Amish.
An Old Falsehood
Bogus claims about Congress being “exempt”
date back to early 2010, when different health care bills were still
being debated. Some Republicans claimed that Americans, except for
members of Congress, would be forced into the government-run “public
option” (which wasn’t part of the final bill that became law) or
state-based exchanges (which are part of the law).
As we said previously, members of Congress get private health insurance through the Federal Employees Health Benefits Program,
which actually served as a model for the exchanges. Federal workers
pick from among many health plans. The exchanges would operate in the
same way — like a marketplace for those shopping for private insurance.
But some Republicans pushed the idea that if the exchanges were good
enough for other Americans, they should be good enough for Congress. So,
an amendment by Republican Sen. Chuck Grassley of Iowa was added to the
Senate bill requiring that the federal government offer only health
plans that were part of an exchange to members of Congress and their
staffs. The law’s final language
on this, written by Sen. Tom Coburn, says that: “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.”
Congressional “staff” is defined as “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.” As we reported before,
Coburn said the provision wouldn’t apply to those working for
committees or leadership staff, and a Congressional Research Service
report agreed that could be the case.
In other words, the Affordable Care Act places on lawmakers and their
staffs additional requirements that don’t pertain to other Americans
with work-based insurance.
– Lori Robertson
Update: To Debunked Right Wing Lie Below!
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