It might look a bit like grandstanding, but Representative Mark Amodei’s (R-NV2) decision about keeping his staff in the Federal Employees Health Benefit Program [RGJ] should help clarify the provisions of the Affordable Care Act.
Click on the FEHB site and you get this information from the Office of Personnel Management:
The FEHB Program can help you and your family meet your health care needs. Federal employees, retirees and their survivors enjoy the widest selection of health plans in the country. You can choose from among Consumer-Driven and High Deductible plans that offer catastrophic risk protection with higher deductibles, health savings/reimbursable accounts and lower premiums, or Fee-for-Service (FFS) plans, and their Preferred Provider Organizations (PPO), or Health Maintenance Organizations (HMO) if you live (or sometimes if you work) within the area serviced by the plan.
Use this site to compare the costs, benefits, and features of different plans. We chose the different benefit categories based on enrollee requests, differences among plans, and simplicity. However, we urge you to consider the total benefit package, in addition to service and cost, and provider availability when choosing a health plan.
And, there you have the core of the health care options available for federal employees. Federal employees may go to the site. Look at the options available from the menu of providers. For Nevada federal employees the list includes policies available from Blue Cross/Blue Shield, GEHA, MHBP, etc. In other words, federal employees have the choice between several types of plans with several types of benefits.
Now, we get to the political salvo: “If Obamacare is so good then why doesn’t Congress sign up for it?”
It can. And this is the point wherein things got confusing — thanks in no small part to the Grassley Amendment. The time line from this USA Today article is helpful:
“During the 2010 debate over the Affordable Care Act, Sen. Chuck Grassley, R-Iowa, proposed an amendment requiring members of Congress and their staffs to purchase health insurance though state exchanges. Democrats, viewing the amendment as a political stunt, co-opted the idea as their own and inserted it into the bill.
But the provision was silent about who would pay for that insurance, or how those payments would be treated. The exchanges were intended for uninsured people who couldn’t get health insurance through their employer or qualify for Medicaid. Those who had access to health benefits meeting minimum coverage levels could still purchase insurance on the exchanges — but without a subsidy and using after-tax income.”
The salient point is that the health care insurance exchanges in the Affordable Care Act, analogous to the offerings of the FEHB site, were intended for those people who did not have employer sponsored insurance, and did not qualify for Medicaid or were ineligible for Medicare. There shouldn’t have been a problem — except for the poorly worded draft of Senator Grassley’s amendment. What the Senator intended was that members of Congress would have the same before tax employer contribution as any other federal employee. What he got was a mess in which there was no subsidy for, or pre-tax benefit, for lawmakers who were the employers.
“(Grassley)…says that was his intent all along. “My goal, regardless of how the amendment was worded … was that we need to go into the exchange so that we would have to go through the same red tape as every other citizen,” he told Roll Call Thursday. But because of what Grassley called a “drafting error,” the amendment left out language that would have explicitly given lawmakers the same before-tax employer contribution as any other federal employee gets. [USAT]
In the midst of this controversy Senator David Vitter (R-LA) introduced a less than helpful amendment to a spending bill which would have required members of Congress to pay the full cost of their health care plans. No subsidies, no pre-tax benefits, essentially tossing Congressional staff members under the next oncoming bus. One GOP staffer was exceedingly candid:
“I’ve been a staffer in a republican Senate office for 8 years. It’s extremely frustrating to have Vitter portray the employer contribution as some sort of exemption from the exchanges. My healthcare costs are already going to sky rocket, but being responsible for 100% of my premiums just isn’t realistic on my salary. I know I’m not the only staffer looking for a job off the hill because I knew this was a possibility. I can only assume the poor staff having to write the amendment language are hopefully throwing death glares at Vitter.” [New Yorker]
No death glares were ultimately necessary, the Vitter Amendment failed. The OPM issued its ruling that “the government would continue to pay the employer contribution for congressional health benefits at the same rate as if members were still on the federal plan.” [USAT] So, members of a Congressional representative’s staff may stay with the plan they selected from the FEHB site, or opt for one from the Affordable Care Act exchange. However, this didn’t prevent Representative Amodei from getting one of the anti-ACA talking points out.
Representative Amodei is worried about “security.”
“In order to create an account, you have to enroll all of your personal data,” Amodei said. “This comes on the heels of what you (reporters) have been writing about accurately – that there is no security for the data. So you are sending your data to a bunch of strange people, 2,500 miles from home just to see if they have any information on what their plan is and how it will affect you.” [RGJ]
Compare this to the second item in the list of Anti-Obamacare Playbook talking points: “Be on the lookout for information in your state about Obamacare scams, data risks, etc.” [NYT] The dig from the Congressman conveniently ignores the fact that when a person goes to the FEHB site to shop for health insurance plans his or her information is sent “to a bunch of strange people, 2,500 miles from home just to see if they have any information on what their plan is and how it will affect you.” Evidently, perfect strangers at FEHB are somehow completely different from those perfect strangers manning ACA centers? We might reverse the question — If it’s not OK to send data to ACA centers in order to shop for health insurance plans which fit the family needs, then why is it OK to send the same data to the FEHB people?
The only real difference between sending information to sign up for a plan offered in the FEHB exchange and the ACA exchange is Representative Amodei’s indefatigable capacity for following the Party Play Book.
In the mean time, Nevadans who do not have employer sponsored health insurance plans, who don’t qualify for Medicaid, and aren’t eligible for Medicare can click over to the Nevada Health Link and see what Anthem, St. Mary’s, Health Plan of Nevada, or Nevada Health Co-Op have available.