WASHINGTON – If Americans remember anything about the 2010 health care law, it might be the president’s refrain that “if you like your health care plan, you can keep your health care plan.”
Everyone, that is, except members of Congress and their staff members.
A provision inserted into the 2010 Affordable Care Act (ACA) made an exception: House and Senate members and their congressional staff must give up their federal coverage Dec. 31.
Instead, they’re required to enroll in plans sold through the new “health exchanges” in their districts or place of residence.
That September 2009 amendment, offered by Republican Sen. Charles E. Grassley of Iowa, sprang from the GOP’s attempts to derail health care reform. Grassley argued politicians should live with their own law, which he opposed. The amendment survived when Democrats pushed the legislation through six months later without a single Republican vote.
Now members of Congress will join the earliest initiates to the ACA.
On Oct. 1, a six-month window opens for uninsured people and small employers to buy coverage through the exchanges. The exchanges are closed to large employers, including the federal government – with the exception for members of Congress and their aides.
With just weeks until open enrollment, lawmakers are about to tangle personally with a law that has been as divisive as any in recent years.
On Wednesday, workers on Capitol Hill got a reminder of the approaching enrollment period when the Office of Personnel Management (OPM) issued proposed rules on how the switch should occur.
As expected, OPM’s guidelines said the federal government’s current insurance contributions will carry over to the exchange plans. That means members and their aides will keep a benefit worth up to 75 percent of premiums, to a maximum of $4,962 this year for one person and $11,049 for a family.
The OPM also proposed a way to settle an ambiguity over exactly which staff members will have to make the switch. The law says the provision applies to employees who work for the members’ offices, both in Washington, D.C., and in their district offices back home.
It was unclear whether that included staff members working through a member’s capacity as a committee chair or caucus leader. The OPM proposed that call should be left to members’ discretion.
What is clear is the GOP’s continued distaste for the health care law.
When Rep. Cathy McMorris Rodgers, R-Wash., was asked through her spokeswoman whether her family planned to shop for coverage in Spokane, she responded: “This is the Democrats’ law, and this is the Democrats’ fix. My proposed solution is to get rid of the entire law.”
All four House Republicans from Washington, including Rep. Dave Reichert, of Auburn, have voted mostly in lockstep to defund and repeal all or parts of the health care law. Nearly 40 such votes have taken place in three years.
Jill Strait, majority communications director for the House Natural Resources Committee, chaired by Republican Rep. Doc Hastings, of Pasco, said the OPM’s guidelines are under review. She said Hastings has not decided whether committee staff members such as herself will have to switch insurers.
Strait then added: “Obamacare is raising costs for families, imposing new taxes, hurting small businesses and the economy, stunting job opportunities for those looking for work, and restricting the health choices and freedoms of Americans.”
Sen. Patty Murray, a Democrat and a stalwart defender of the law, said she welcomes giving up her federal coverage.
“I’m looking forward to enrolling in a marketplace where insurance companies are going to compete to give me the best price and quality,” she said. “It’ll certainly be a whole lot better for many Washington families than when insurance companies called the shots and consumers paid top dollar for plans that could deny them for pre-existing conditions or could put caps on how much care they would cover.”
Murray, who lives in Seattle, plans to enroll with a plan sold in King County.
Most health plans pay for services from doctors and hospitals in other cities, but typically at higher, out-of-network costs.
Jared Leopold, a spokesman for Democratic Sen. Maria Cantwell of Washington, said Cantwell didn’t know whether she will purchase new coverage in Edmonds or her home in Washington, D.C., because the Senate is awaiting final guidance on the exchanges, but was looking forward to it.
He also said it was unclear whether it would be up to Cantwell to make the call on the insurance option for her staff members on the Senate Indian Affairs Committee, which she chairs.
For many Americans who are uninsured or have bare-bones individual coverage, health plans created under the ACA will offer richer benefits closer to what members of Congress and other public or corporate employees enjoy. Mandatory coverage includes, among other benefits, prescription drugs, maternity and newborn care, and mental health and drug and alcohol treatments.
Pushing members of Congress and their staff members off their federal coverage will create several twists. For one thing, health plans under the exchanges are allowed to vary premiums based on age, with the oldest consumers paying up to three times the rate as younger people.
Health plans for federal workers carry the same premiums for each enrollee regardless of age. The average age of a Senate member in this Congress is 62; for House members, it’s 57. Congressional staffers, many in their 20s and 30s, could see insurance costs fall with cheaper rates, unless the government reduces its contributions accordingly. Rep. Jim McDermott, a Washington Democrat and a champion of universal coverage, hopes that firsthand experience with Obamacare might prove enlightening for the law’s opponents.
“I think it’s good to see lawmakers personally invested in this reform,” he said. “Luckily for me, Washington state has been a consistent leader in implementing the health reform legislation and committed to affordable coverage for all, so I am confident that our new system will be a success.”