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A Project of The Annenberg Public Policy Center

Is Congress Exempt from GOP Health Bill?

Q: Does the new GOP health care bill apply to members of Congress and their families?

A: For procedural reasons, the bill passed by House Republicans exempted lawmakers from some of its effects. But a stand-alone bill passed unanimously would do away with that exemption if the legislation becomes law.


Did the House of Representatives exempt members of Congress from the provisions in the American Health Care Act?


A feeling of deja vu came over us here at FactCheck.org as the Republican plan to repeal and replace the Affordable Care Act (aka Obamacare) neared a vote in the House. We heard concerns raised — from Democrats this time — about Republicans moving forward with a bill that had not yet been analyzed by the nonpartisan Congressional Budget Office. That sounded familiar. And of course, the roles were now reversed as Republicans found themselves fending off criticism that they had not even read their own bill.

And then this: Several readers have asked us whether House Republicans were exempting Congress and its staff from the bill they had proposed, and passed. At FactCheck.org this was awfully familiar: We debunked claims for years about Congress exempting itself from Obamacare. The exemption claim wasn’t true.

And it is almost certainly not going to be true this time either.

But the accusation isn’t totally groundless. The American Health Care Act, passed in the House on May 4 along partisan lines, includes an amendment that would allow states to obtain waivers from certain insurance requirements mandated by the Affordable Care Act. States could get waivers to: increase how much insurers can charge based on age, establish their own requirements for essential health benefits that plans must include, and allow insurers to price policies based on health status in some cases. That last waiver, as we have explained, could lead to higher premiums for those with preexisting conditions who don’t maintain continuous coverage. The amendment — penned by New Jersey Rep. Tom MacArthur — specifically exempts Congress and its staff from the effects of such state waivers.

But the reason for that exemption has nothing to do with trying to protect the insurance of members of Congress from the legislation. Rather, it is about trying to ease the passage of the bill. Republicans are seeking to pass the AHCA as a reconciliation bill, which would allow the Senate to pass legislation with a simple majority — 51 votes — rather than a filibuster-proof 60 votes (which would require Democratic help).

As the Committee for a Responsible Federal Budget explained in a blog post, in order to not run afoul of the reconciliation rules, House committees drafting a bill cannot make changes that are the jurisdiction of other committees. Marc Goldwein, senior policy director of CRFB, told us Republicans likely feared a Senate parliamentarian might rule that a proposed insurance change for members of Congress would rightly fall to the Homeland Security and Governmental Affairs Committee — a ruling that could jeopardize the bill’s reconciliation status.

MacArthur told the Philadelphia Inquirer that the exemption for Congress was, as the Inquirer put it, “a technical problem due to Senate rules about the bill’s language.” MacArthur said the problem would be addressed.

Indeed, Republican Rep. Martha McSally of Arizona proposed a stand-alone bill to strike the exemption of Congress from state waiver provisions should the AHCA be enacted into law. From the House floor, McSally said that “due to very arcane Senate procedural rules within the budget reconciliation process,” the MacArthur amendment “does not and cannot apply to members of Congress.”

“I believe that any law we pass [that] applies to our constituents must also apply equally to members of Congress,” McSally said. “Individuals who are stewards of public trust must abide by the rules that they make.”

McSally’s bill passed on May 4 by a 429-0 vote. Unlike a reconciliation bill, the McSally bill would require 60 votes in the Senate to pass.

So there are now two bills that the House sent to the Senate. The AHCA — for esoteric procedural reasons — would exempt members of Congress and their staffs from state waiver provisions. But then there’s a bill that would strike that exemption if the AHCA becomes law. Clearly, based on the unanimous vote for the McSally bill, there is bipartisan agreement that a health care law Congress passes should apply in the same way to members of Congress.


Groppe, Maureen. “Democrats attempt to put brakes on Republican health care bill.” USA Today. 8 Mar 2017.

Rozsa, Matthew. “Some Republicans voted for Trumpcare without even reading the bill.” Salon. 5 May 2017.

Kliff, Sarah. “Republicans exempt their own insurance from their latest health care proposal.” Vox. 3 May 2017.

Robertson, Lori. “Obamacare Myths.” FactCheck.org. 16 Sep. 2013.

Congress.gov. H.R.1628 – American Health Care Act of 2017.

Politico. The MacArthur Amendment to the American Health Care Act.

Committee for a Responsible Federal Budget. Reconciliation 101. 6 Dec 2016.

Committee for a Responsible Federal Budget. The Byrd Rule and Its Effect on Health Reform: A Short Guide. 28 Apr 2017.

Tamari, Jonathan. “South Jersey representative draws spotlight — and heat — in reviving Obamacare repeal.” Philadelphia Inquirer. 26 Apr 2017.

Rep. Martha McSally congressional website. Press release: “House Unanimously Passes McSally Bill Striking AHCA Exemptions for Members of Congress.” 4 May 2017.

Clerk of the House. Final Vote Results for Roll Call 255. HR 2192: To amend the Public Health Service Act to eliminate the non-application of certain State waiver provisions to Members of Congress and congressional staff. 4 May 2017.