Health Care Coverage For Members Of Congress

November 22, 2010 1:39 pm ET

While many congressional Republicans support the repeal of the Affordable Care Act (ACA), members of Congress are the beneficiaries of the Federal Employee Health Benefits (FEHB) program, a generous federally subsidized health care plan. Last week, Republican Congressman-elect Andy Harris — an anesthesiologist from Maryland who campaigned on repealing the ACA — complained that members of Congress are ineligible to enroll in the FEHB program until the first of February. Even as Harris supports denying millions of Americans access to affordable and quality health care, he's upset that his federal health benefits — which became the model for state health insurance exchange networks provided for in the ACA — aren't available on the first day that he walks into Congress.

Rhetoric Vs. Reality: GOP Congressman-Elect's Hypocrisy On Health Care Reform

Rhetoric:

GOP Congressman-Elect Who Supports Repealing Health Care Reform "Demand[ed] To Know Why His Government-Subsidized Health Care Plan ... Takes A Month To Kick In." According to Politico: "A conservative Maryland physician elected to Congress on an anti-Obamacare platform surprised fellow freshmen at a Monday orientation session by demanding to know why his government-subsidized health care plan takes a month to kick in. Republican Andy Harris, an anesthesiologist who defeated freshman Democrat Frank Kratovil on Maryland's Eastern Shore, reacted incredulously when informed that federal law mandated that his government-subsidized health care policy would take effect on Feb. 1 — 28 days after his Jan. 3rd swearing-in. 'He stood up and asked the two ladies who were answering questions why it had to take so long, what he would do without 28 days of health care,' said a congressional staffer who saw the exchange." [Politico, 11/15/10]

  • Harris Lamented That "This Is The Only Employer That I've Ever Worked For Where You Don't Get Coverage The First Day You Are Employed." Harris' spokeswoman told Politico that Harris had also said during the exchange: "This is the only employer that I've ever worked for where you don't get coverage the first day you are employed." [Politico, 11/15/10]
  • Harris Openly Wondered "If He Could Purchase Insurance From The Government To Cover The [Health Care Coverage] Gap." According to a congressional aide, Harris followed up with another question about the health benefits available to newly elected members of Congress, asking "if he could purchase insurance from the government to cover the gap." [Politico, 11/15/10]

Reality:

Harris Is Eligible To Enroll In A Federally Administered COBRA Program To Sustain Health Coverage. According to the Department of Labor's guide to COBRA, "many employees and their families who would lose group health coverage because of serious life events are able to continue their coverage under the employer's group health plan, at least for limited periods of time." FoxNews.com explained that as an anesthesiologist and Maryland state senator, Harris "has the choice of going on a temporary Cobra plan through his position at Johns Hopkins Medical Center or keeping his state health benefits." [Department of Labor, September 2006; FoxNews.com, 11/17/10]

  • Baltimore Sun: Not Knowing About COBRA May Make A Politician Look "Out Of Touch." The Baltimore Sun explained that Harris' apparent ignorance of COBRA invites charges of aloofness: "An existing federal program, under a 1985 law known as COBRA, permits Americans to maintain coverage after leaving a job. Millions of people are familiar with COBRA, including those who lost jobs in the recession. For a politician, knowing facts of everyday life — such as the price of a gallon of milk or the way to obtain insurance between jobs — is a form of protection against the charge of being out of touch." [Baltimore Sun, 11/16/10]

Seventy-Four Percent Of New Employees Who Are Offered Health Insurance "Face A Waiting Period" And "The Average Waiting Period ... Is 2.2 Months." Although Harris' current employer, Johns Hopkins Hospital, offers health insurance on the first day of employment, the Kaiser Family Foundation explained: "Seventy-four percent of covered workers face a waiting period before coverage is available. ... The average waiting period among covered workers who face a waiting period is 2.2 months. Thirty-one percent of covered workers face a waiting period of 3 months or more." [Baltimore Sun, 11/18/10; Kaiser Family Foundation, September 2010, internal citation deleted for clarity]

Harris Campaigned On Repealing The Affordable Care Act...

Harris Campaigned Against The Affordable Care Act And Said "The Obama-Pelosi-Hoyer Agenda Threatens To Pull The Plug On America's Long-Term Health." According to Politico, the Harris campaign released a press statement in October 2010 that said: "Dr. Harris understands that the Obama-Pelosi-Hoyer agenda threatens to pull the plug on America's long-term health. ... In Washington, I will never vote to raise taxes, I will fight to repeal health-care reform, and I will work to balance the budget." [Politico, 11/15/10]

In A 2009 Op-Ed, Harris Slammed "Tone-Deaf" Politicians That Ignore "Patients And Their Health Care Providers." In a 2009 open editorial to The Daily Times of Salisbury, MD, Harris wrote: "If there is any message that has come from the last few weeks of town hall meetings throughout the country, it is that the American public is unhappy with how health care reform is being approached by Congress. As the only physician in the Maryland state Senate, I know how legislatures approach health care issues. Politicians are usually tone-deaf to those who know the most about the issue: patients and their health care providers." [The Daily Times, 9/17/09]

After Criticizing The Federal Government For Not Mandating That Federal Health Benefits Be Made Available On The First Day Of Employment, Harris Decried The Individual Mandate. Following the exchange between Harris and a House orientation staffer about the Federal Employees Health Benefits (FEHB) program, FoxNews.com reported: 

"The best solution would be for the federal government to say, 'Yes, we do provide coverage and it's from day one,'" [Andy Harris] said. 

The "irony is that here the federal government requires that all these employers provide" coverage, and yet the federal government doesn't provide it for his own, he said. "It should be changed so that the federal government should cover you from the first day you're employed."

But that doesn't mean Harris thinks a public option is the solution to temporary gaps in coverage for Americans transitioning between jobs. 

"I'm opposed to Obamacare. I'm opposed to a mandate of any kind on health insurance. This was purely about a technical question."

[FoxNews.com, 11/17/10]

Congressional Health Care Benefits

By 2014, members of Congress and their staffs will no longer be eligible for the Federal Employees Health Benefits (FEHB) program and must enroll in a health insurance policy made available through the Affordable Care Act. The Affordable Care Act establishes state-based health insurance exchange networks — modeled after the FEHB program — that will empower consumers to competitively select their health insurance plan.

The ACA's State Health Exchanges Will Give All Americans The Same Amount Of Choice That Federal Employees Enjoy When Choosing Their Health Care Plans. Currently, members of Congress are eligible to enroll in the Federal Employees Health Benefits (FEHB) program, which offers "a choice of 10 healthcare plans that provide access to a national network of doctors, as well as several HMOs that serve each member's home state." By 2014, the Affordable Care Act will create competitive health insurance exchange networks that "will make purchasing health insurance easier by providing eligible consumers and businesses with 'one-stop-shopping' where they can compare and purchase health insurance coverage." [Los Angeles Times, 8/2/09; U.S. Department of Health and Human Services, accessed 11/17/10]

FactCheck.Org: Members Of Congress And Their Staffs Are Not "Exempt" From The Affordable Care Act. From FactCheck.org: "Are members of Congress and their staffs 'exempt' from the law? No. House and Senate members must obtain coverage just like everybody else." [FactCheck.org, 4/19/10, emphasis original]

In 2014, Members Of Congress Will No Longer Be Eligible To Enroll In The Federal Employees Health Benefits Program. The Affordable Care Act "takes House and Senate members and their staff workers out of the [Federal Employees Health Benefits program], and forces them to obtain coverage through the new state-run insurance exchanges that will be set up in 2014. In the exchanges, private insurance companies will compete for the business of millions of currently uninsured Americans, those who already buy their own coverage and many small-business owners. These exchanges are modeled on the FEHB, and could turn out to offer a more limited selection of policies." [FactCheck.org, 4/19/10]

  • The Affordable Care Act Mandates That Members Of Congress And Their Staffs "Enroll Only In Health Plans Created Under This Act." The non-partisan Congressional Research Service explained that under the Affordable Care Act: "Members of Congress and their staff can enroll only in health plans created under this Act or offered through an exchange. This provision applies only to those congressional staff who are full- and part-time employees employed by the official office of a Member of Congress." [Congressional Research Service, 4/15/10]

Members Of Congress And Their Staffs Are Required By Law To Enroll In Health Insurance Policies Established Through The Affordable Care Act. According to Section 1312 in the Affordable Care Act, members of Congress and their staffs must enroll in health insurance plans that were established through the law:

(D) MEMBERS OF CONGRESS IN THE EXCHANGE.-

(i) REQUIREMENT.-Notwithstanding any other provision of law, after the effective date of this subtitle, 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 (or an amendment made by this Act).

(ii) DEFINITIONS.-In this section:

(I) MEMBER OF CONGRESS.-The term ''Member of Congress'' means any member of the House of Representatives or the Senate.

(II) CONGRESSIONAL STAFF.-The term ''congressional staff'' means all full-time and parttime employees employed by the official office of a Member of Congress, whether in Washington, DC or outside of Washington, DC.

  [Affordable Care Act, Section 1312, 3/23/10]

During The Health Care Debate, Republicans Repeatedly Demanded That Members Of Congress Be Forced To Enroll In Health Care Reform.

In 2009, A Bipartisan Coalition Of Senators Co-Sponsored Senator Coburn's Amendment To Force All Members Of Congress To Enroll In A Public Option. Although the public option provision was eventually stripped from the Affordable Care Act, in 2009 Sen. Tom Coburn (R-OK) sponsored an amendment that would have prohibited members of Congress from enrolling in the Federal Employees Health Benefits (FEHB) program and required that they join the public option. The amendment was co-sponsored by three Republicans and seven Democrats. [Congressional Record, 11/21/09; S. Amdt. 2789 to H.R. 3590, Thomas.gov, accessed 11/18/10]

In 2010, Senator Grassley Introduced An Amendment That Would Have Compelled Executive And Congressional Staff To Enroll In The State Health Exchanges. Prior to passage of the Affordable Care Act, Sen. Chuck Grassley (R-IA) offered an amendment "[t]o make sure the President, Cabinet Members, all White House Senior staff and Congressional Committee and Leadership Staff are purchasing health insurance through the health insurance exchanges established by the Patient Protection and Affordable Care Act." The amendment failed by a vote of 43 to 56. [Congressional Record, 3/23/10; S. Amdt. 3564 to H.R. 4872, Vote 69, 3/24/10]

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