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A Project of The Annenberg Public Policy Center

No ‘Special Subsidy’ for Congress

Republican Rep. Robert Pittenger is misleading his constituents by saying that he will decline the health insurance offered to members of Congress next year because it includes a “special subsidy” from the president that “exempted” Congress from the Affordable Care Act.

Congress isn’t “exempt” from the law. It wasn’t exempt back in 2010, when we first debunked such a claim; nor were lawmakers exempt in May when the bogus bit surfaced again. Three months later, they’re still not exempt. In fact, as we’ve said before, lawmakers and their staffs face additional requirements that other Americans don’t. And the “special subsidy” to which Pittenger refers is simply a premium contribution that his employer, the federal government, has long made to the health insurance policies of its workers.

The Affordable Care Act says that starting in 2014, members of Congress and their staffs can no longer get their health insurance through the Federal Employees Health Benefits Program, as they have in the past. Instead, these federal employees will have to get insurance through the exchanges set up by the Affordable Care Act. Other Americans with work-based insurance aren’t subject to such a requirement. They can continue to get health insurance through their employers. Other federal workers, too, can continue to select health insurance plans through the Federal Employees Health Benefits Program. But not Congress.

Why the unusual requirement for lawmakers and congressional staffers? This provision was added when health care bills were being debated, out of Republican concern that Congress get the same insurance that would be offered to some Americans through this legislation — insurance sold through state-based and federal exchanges. Those exchanges are for individuals who buy their own insurance, including the now uninsured, and small businesses.

Our readers may recall that before this provision was created, there were claims circulating that Congress was “exempt” from the law. This twisted reading of the legislation was based on the fact that originally Congress, like other Americans with work-based insurance or Americans on Medicare and Medicaid, wouldn’t be eligible for the exchanges. In other words, Congress was supposedly “exempt” when members couldn’t participate in the exchanges, and now that they are required to do so, they’re still somehow “exempt” from the law. Neither of these convoluted claims is true.

Pittenger and Huckabee Tell Tales

Pittenger, a freshman representative from North Carolina, explained his stance on Aug. 26 to former Arkansas Gov. Mike Huckabee in a radio interview in which their disregard for the facts was nothing short of absurd. Both the questions from Huckabee and answers from Pittenger were bursting with political mendacity.

Pittenger said he objected to a “special subsidy that Obama’s offering members of Congress to pay for our insurance,” saying this wasn’t “fair.” Huckabee called the “subsidy” a “little break” for Congress that “really exempted them from some of the pain of Obamacare.”

This “break,” however, is nothing more than a continuation of the premium contribution that the federal government has long made to its employees’ health insurance.

Just like other employers, the federal government pays a portion of premiums of the health plans it offers to its workers. There was concern on Capitol Hill this year, however, that the employer contributions wouldn’t be made to the health exchange plans when members of Congress and their staffs made the switch in January 2014 to their new insurance. The relevant provision in the law didn’t address the federal government’s employer contribution, which is currently 72 percent of premiums on average. So no employer contribution would be quite a blow to many congressional workers — just as it would be to other workers who get health insurance through their jobs. (While employer contributions vary from firm to firm, the overall average employer contribution was 82 percent for single insurance plans and 71 percent for family plans in 2013, according to the latest employer survey from the Kaiser Family Foundation and the Health Research & Educational Trust.)

But the Office of Personnel Management, which administers the FEHB Program, issued a proposed rule on Aug. 7 saying that the federal government would be able to continue to make the premium contributions. OPM said the contribution wouldn’t be greater than what is offered under the FEHB Program, and lawmakers and their staffs wouldn’t be eligible for the tax credits that are available to other Americans buying coverage through the exchanges.

In other words, OPM ruled that there would be a continuation of the status quo in terms of the employer premium contribution. But Huckabee and Pittenger offered listeners a distorted view, telling them this was special treatment for Congress and an exemption from the Affordable Care Act. Here’s part of their exchange on “The Mike Huckabee Show”:

Huckabee, Aug. 26: [Pittenger’s] not too happy about a little trick that Congress at least swung by the American people, where they’re going to get a subsidy for their health insurance. Give them a little break, you know, for the members of Congress and the staff. … Robert Pittenger doesn’t want it. …

When the Office of Management and Budget was able to without legislation go ahead and create a subsidy for members of Congress and their staff, it really exempted them from some of the pain of Obamacare. And I think it’s interesting that not everybody in Congress thinks that’s a great idea and you happen to be one of them.

Pittenger: Yes sir, I don’t believe it’s fair at all. Congress should not be exempted from the full impact of Obamacare. It’s not fair and I’m not going to be a part of it. So the next enrollment period, I’m going to voluntarily remove myself from the congressional health plan, decline the special subsidy that Obama’s offering members of Congress to pay for our insurance on the Obamacare exchanges.

Pittenger told Huckabee that starting next year “[l]ike millions of Americans, I will purchase my health care insurance without the aid of federal tax dollars.” Of course, Pittenger is a federal employee who will continue to be paid his salary with tax dollars.

In a Q&A in the Washington Post, reporter Sarah Kliff asked Pittenger why he had a problem with accepting a premium contribution from the federal government, when he had already been receiving one. Pittenger said: “Under our current plan, we’ve been under the law. Next year the subsidy is outside the law. I’m not okay with that. … It’s a matter of principle.”

He told the Post that the accommodation to allow the premium contributions to continue was “ruling by decree” by the president. Obama told Democratic senators that he was involved in finding a solution, according to Politico.

As for where Pittenger will get his insurance, the lawmaker told the Washington Post that he didn’t know what his options were, but “I’ll see what’s most affordable and what is the best plan that I can find.” He noted that he had been on his wife’s plan in the past.

We often say that we can’t predict the future at FactCheck.org, but if Pittenger joins a plan that his wife has, we imagine claims would quickly surface that he was exempting himself from Obamacare. If Pittenger doesn’t have an employer-provided option, he would have to purchase insurance through the exchanges.

More Twists and Turns

In the radio interview, Huckabee referred to concern on Capitol Hill that if the government wasn’t able to continue to contribute to premiums, Congress would lose valuable staffers, who would leave for jobs that offered health benefits. He asked what Pittenger thought of these claims of potential “brain drain.” Pittenger replied: “The congressional staff, they’re going to be receiving the exact same health benefits as every other federal employee.” That’s false.

The provision in the law that requires Congress to get insurance on the exchanges says: “[T]he 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.”

The law says congressional “staff” means “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, a Congressional Research Service report agreed with the author of this provision, Sen. Tom Coburn, that it wouldn’t apply to committee or leadership staff. There’s still some confusion, however, on which staffers will be required to get insurance on the exchanges and which won’t. The OPM ruling said that “[b]ecause there is no existing statutory or regulatory definition of the term ‘official office,’ ” OPM’s rule “proposes that the employing office of the Member of Congress determine whether an employed individual meets the statutory definition.”

Even under that loose rule, at least some congressional staff would, as the health care law says, have to get insurance on the exchanges.

Pittenger told Huckabee that he was supporting a bill that would say “no member of Congress can benefit from a federal subsidy,” and Huckabee offered encouragement for voters to pressure their representatives to also support such legislation.

Huckabee: I would think members of Congress who don’t support the notion of rejecting this special subsidy are probably going to be busted by a lot of the voters who say, “Wait a minute, you guys passed this and you’re now getting an exemption from it that we’re not getting. What’s up?” And I think a lot of town halls are probably filled with people who are shouting and screaming that this is wrong because it’s a double-standard.

We hope not. If folks are complaining about a “special subsidy,” “exemption” or “double-standard” in town halls, they are misinformed.

— Lori Robertson