Yesterday I explained why the Republican House Amendment to "delay Obamacare" (actually, just the individual mandate) would be impossible from a practical standpoint. I am not under any illusions that the people who created it were actually trying to implement something practical or realistic. They don't care that millions of people have been waiting 3.5 years since the ACA became law to be able to enroll in guaranteed issue individual health insurance. They don't care that millions of uninsured Americans will finally be able to afford health to purchase their own health insurance thanks to the subsidies in the marketplaces/exchanges. Their priority is to get rid of the ACA, and it appears that they consider the shutdown of the federal government to be acceptable collateral damage in their fight. Their goal is not really to delay the law, but to derail it entirely - they know full well that delaying the individual mandate would throw the whole law into a tailspin.
But there's another part of the House Amendment to H.J. Res. 59 that is also worth talking about, since it goes hand in hand with an ACA myth that just won't die. So before we go any further, I want to clarify:
Congress is not exempt from the ACA. The President and Vice-President are not exempt from the ACA. Political Appointees are not exempt from the ACA. Being "exempt from the ACA" or "exempt from Obamacare" doesn't really mean anything anyway. The talk show hosts who perpetuate this myth are deliberately trying to obfuscate an aspect of the ACA that actually penalizes Congress.
They talk about how this amendment gets rid of "special treatment" for Congress. If you consider losing your employer-sponsored health
insurance to be "special treatment," then I guess that's true. The amendment basically lays out provisions to make sure that the President, Vice President, political appointees, Congress and congressional staffers must purchase health insurance in the marketplaces (exchanges) and
strips them of any contributions from the government to help pay for their policies.
To briefly summarize the history of this fight, back in 2010 Republican Senator Chuck Grassley felt that "
we [in Congress] need to go into the exchange so that we would have to go through the same red tape as every other citizen." This is sort of a warm-fuzzy statement if you just take it at face value.
But in truth, it's ridiculous, because the majority of US citizens are not going to be using the exchanges. Most people will continue to get their health insurance from their employers or from the government (Medicare, Medicaid, VA).
Federal government employees get their health insurance from the Federal Employees Health Benefits Plan (FEHB). Just like almost every very large employer, the federal government provides health insurance benefits to its workers and pays a large portion of the premiums. The benefits are one of the ways that the government is able to recruit talented employees.
The marketplaces/exchanges were created in order to help people who are uninsured or who purchase their own individual health insurance (because they are self employed or work for a company that doesn't provide benefits). Federal government employees do not fall into this category by any stretch of the imagination. So it has always seemed ridiculous to me that the Grassley Amendment was added in the first place. But it was.
Although the original amendment didn't include a provision for Congress et al to keep their employer contributions (the amount that the government already pays towards their FEHB policies) and use them towards individual health insurance in the marketplaces, it also did not require the government to stop contributing to their health insurance premiums. The Office of Personnel Management (OPM) issued a proposed ruling in August that allowed the government to continue to fund Congressional health insurance after the switch is made from FEHB to the exchanges. Then at the end of September, OPM issued a final ruling which states that
"OPM has clarified that Members of Congress and designated congressional staff must enroll in an appropriate Small Business Health Options Program (SHOP) as determined by the Director in order to receive a Government contribution."
This is what they came up with in order to work around an amendment that never made sense in the first place. The OPM ruling doesn't really make a whole lot of sense either, since the
SHOP marketplaces in 2014 are designed for businesses with up to 50 employees - not exactly the definition of the federal government's employment roster. But the SHOP markeplaces are set up to allow employers to contribute to
their employees' health insurance premiums, so it works on that level.
And now the House Amendment to H.J. Res. 59 would remove that allowance. It states that "
No government contribution under section 8906 of title 5, United States Code, shall be provided on behalf of an individual who is a Member of Congress, congressional staff, the President, Vice President, or a political appointee for coverage under this subparagraph." The basic effect of this would be to strip these government employees of their employer-sponsored health insurance benefits, even though these benefits are part of what helps keep the government competitive with other big companies in the labor market. Keep in mind that we're not just talking about highly paid lawmakers... congressional staffers are included. These are regular people with jobs that probably aren't all that glamorous. And now House Republicans want to strip them of their employer-sponsored health insurance benefits?
Interestingly enough, Senator Grassley has said that he didn't intend for lawmakers to lose the money that the federal government contributes towards their health insurance coverage (just like any other large employer would). And yet, here we are.
Overall, the House Amendment to H.J. Res. 59 is a mess. It makes no sense, and lawmakers who voted against it should be commended. It's only seven pages long, so take a look at it yourself if you're curious. As I mentioned in yesterday's post, there are much more productive, sensible ways that Speaker Boehner and his colleagues could go about changing the law, if they're so inclined. They're throwing a Hail Mary here, because they know that once the marketplaces are running smoothly and people get used to guaranteed issue health insurance and subsidies to help pay for it, the ACA will probably be a pretty popular law. An amendment that attempts to hobble the law under the guise of "delaying" it is disingenuous. The American people deserve better than this.
Colorado Health Insurance Insider
months (this was to prevent employers from dropping their group health insurance in favor of an HRA and individual policies). There are a lot more details about the whole saga in the two posts I linked to at beginning, but that's the story in a nutshell.
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