Alyssa Lane
Members of Congress in the US have access to health insurance through the Federal Employees Health Benefits Program (FEHBP). This program offers about 300 different private healthcare plans, including high-deductible, tax-advantaged plans. While Congress members are not exempt from the healthcare law, they do qualify for some medical benefits that ordinary federal workers do not. For example, they have access to free or low-cost care through the Office of the Attending Physician and free outpatient medical care at military facilities in the Washington, D.C. area.
| Characteristics | Values |
|---|---|
| Percentage of annual healthcare premiums paid by Congress members | 28% |
| Cost of healthcare premiums for a 21-year-old making $25,000 a year | $282 per month for a silver Obamacare plan |
| Cost of healthcare premiums with subsidies | $142 per month |
| Previous healthcare plan for Congress members | Federal Employees Health Benefits Program (FEHBP) |
| Federal subsidies for insurance under FEHBP | 72% |
| Current healthcare plan for Congress members | Small Business Health Options Program (SHOP) |
| Number of private healthcare plans offered by FEHBP | 300 |
| Annual fee for medical services from the Office of the Attending Physician of the U.S. Capitol | $491 (as of 2007) |
Explore related products
$9.99 $19.99
What You'll Learn
Members of Congress pay 28% of healthcare premiums
Members of Congress pay 28% of their healthcare premiums. This is because federal subsidies for insurance under the Federal Employees Health Benefits Program (FEHBP) cover the remaining 72%. The FEHBP is not a "single-payer" system, but rather offers about 300 different private healthcare plans, including five government-wide, fee-for-service plans and many regional health maintenance organization (HMO) plans, plus high-deductible, tax-advantaged plans.
All plans cover hospital, surgical and physician services, mental health services, prescription drugs, and "catastrophic" coverage against very large medical expenses. Members of Congress are also eligible to receive limited medical services from the Office of the Attending Physician of the U.S. Capitol after paying an annual fee. This fee was $491 in 2007 and does not include surgery, dental care, eyeglasses, or prescriptions.
Additionally, House and Senate members (but not their families) are eligible to receive care at military hospitals, including free outpatient care at Washington, D.C., area hospitals such as Walter Reed Army Medical Center and the National Naval Medical Center. Inpatient care is billed at rates set by the Department of Defense.
Since 2014, members of Congress have been able to obtain employer-subsidized, private coverage through the exchanges established under the Affordable Care Act (ACA). Prior to this, they were covered by private insurance under the same system as all other federal workers.
Travel Insurance: Medical Coverage Explained
You may want to see also
Explore related products
They have access to free or low-cost care
Members of Congress and their staff pay approximately 28% of their annual healthcare premiums through pre-tax payroll deductions. Despite this, they have access to free or low-cost care through various avenues. Firstly, they can receive free or low-cost care through the Office of the Attending Physician, although this does not include surgery, dental care, eyeglasses, or prescription drugs. Secondly, they are eligible for free medical outpatient care at military facilities in the Washington, D.C. area, including Walter Reed Army Medical Center and National Naval Medical Center. Inpatient care at these facilities is billed at rates set by the Department of Defense.
Before 2014, members of Congress were covered by private insurance under the Federal Employees Health Benefits Program (FEHBP), which is not a centralized, government-run healthcare system. The FEHBP offers about 300 different private healthcare plans, including five government-wide, fee-for-service plans, regional health maintenance organization (HMO) plans, and high-deductible, tax-advantaged plans. Federal subsidies for insurance under the FEHBP would remain stable at 72%, so even if members of Congress returned to this plan, they would still pay the same percentage of their costs that they currently do.
Since 2014, members of Congress have been able to obtain employer-subsidized, private coverage through the exchanges established under the Affordable Care Act (ACA). The House of Representatives and Senate offices provide health coverage to members of Congress and designated staff through the Small Business Health Options Program (SHOP), specifically the DC SHOP administered by the DC Health Benefit Exchange Authority.
Chiropractor Visits: Understanding Medical Insurance Coverage
You may want to see also
Explore related products
Congress members can receive care at military hospitals
Members of Congress are subject to the Affordable Care Act, also known as Obamacare. They are not exempt from the healthcare law, despite some false claims to the contrary. They may not participate in the Federal Health Benefits Program (FEHBP), which most federal workers use. Instead, they must use an Obamacare plan unless they receive healthcare through a spouse's or parent's plan or purchase one without a government contribution.
Congress members pay around 28% of their annual healthcare premiums through pre-tax payroll deductions. They also have access to free or low-cost care through the Office of the Attending Physician, which was created in 1928 to address the inadequate medical care available to Congress at the time. This office also provides free medical outpatient care at military facilities in the DC area.
The House of Representatives and Senate offices provide health coverage to members of Congress and designated staff through the Small Business Health Options Program (SHOP). The DC SHOP, or DC Health Link Small Business Market, is the appropriate program from which members of Congress can purchase health insurance to receive a government contribution.
Until 2014, members of Congress were covered by private insurance under the same system as all federal workers. Since then, they have only been able to obtain employer-subsidized private coverage through the exchanges established under the ACA. Congress members are eligible to receive benefits from Medicare, just like every other American paying into the system. They do not receive free travel or personal bodyguards and drivers courtesy of taxpayers' money.
Get Free Medical Insurance in Ohio: A Step-by-Step Guide
You may want to see also
Explore related products
Inpatient care is billed at rates set by the DoD
Members of Congress in the US have access to health insurance through the Federal Employees Health Benefits Program (FEHBP). This program offers about 300 different private healthcare plans, including five government-wide, fee-for-service plans and many regional health maintenance organization (HMO) plans, as well as high-deductible, tax-advantaged plans. Federal subsidies for insurance under FEHBP are stable at 72%, so members of Congress pay approximately 28% of their annual healthcare premiums through pre-tax payroll deductions.
In addition to the FEHBP, members of Congress also qualify for some additional medical benefits that ordinary federal workers do not. For instance, they are eligible to receive limited medical services from the Office of the Attending Physician of the US Capitol after paying an annual fee ($491 in 2007). However, these services do not include surgery, dental care, or eyeglasses, and any prescriptions must be paid for by the member.
House and Senate members are also eligible to receive inpatient care at military hospitals, including the Walter Reed Army Medical Center and National Naval Medical Center in the Washington, DC, area. While outpatient care at these facilities is provided free of charge, inpatient care is billed at rates set by the Department of Defense (DoD).
Since 2014, members of Congress have been able to obtain health insurance through the Small Business Health Options Program (SHOP), specifically the DC Health Link Small Business Market administered by the DC Health Benefit Exchange Authority. This allows them to receive a government contribution towards their health insurance costs.
Health Insurance Beneficiaries: Can They Authorize Medical Treatment?
You may want to see also
Explore related products
Congress members can access 300 private healthcare plans
Members of Congress can access around 300 private healthcare plans through the Federal Employees Health Benefits Program (FEHBP). This is not a "single-payer" system where the government acts as the sole health insurance provider. Instead, the FEHBP offers a variety of private health care plans, including five government-wide, fee-for-service plans, regional health maintenance organization (HMO) plans, and high-deductible, tax-advantaged plans. All plans cover hospital, surgical, physician, mental health, and prescription drug services, as well as protection against very large medical expenses.
While members of Congress have access to these private plans, they still contribute to their health insurance costs. They pay approximately 28% of their annual healthcare premiums through pre-tax payroll deductions. Additionally, they have access to free or low-cost care through the Office of the Attending Physician and free outpatient medical care at military facilities in the Washington, D.C. area. Inpatient care at these military hospitals is billed at rates set by the Department of Defense.
It is important to note that the health insurance options for members of Congress have evolved over time. Before 2014, they were covered by private insurance under the same system as all other federal workers. However, starting in 2014, House and Senate members could only obtain employer-subsidized private coverage through the exchanges established under the Affordable Care Act (ACA).
The specific deductible amounts and plan details for Congress members can be found through the Office of Personnel Management (OPM). The House of Representatives and Senate offices also provide health coverage information and guidance to their members and staff.
Accessing Medical Insurance: Options for Low-Income Citizens
You may want to see also
Frequently asked questions
Members of Congress pay approximately 28% of their annual healthcare premiums through pre-tax payroll deductions. They do not receive free health insurance but qualify for some medical benefits that ordinary federal workers do not.
Congress members are eligible to receive limited medical services from the Office of the Attending Physician of the U.S. Capitol and military hospitals after paying an annual fee. They can also receive free outpatient care at Washington, D.C., area hospitals.
Congress members can obtain employer-subsidized, private coverage through the Affordable Care Act (ACA) exchanges. They previously had access to the Federal Employees Health Benefits Program (FEHBP), which offered about 300 different private healthcare plans, including high-deductible, tax-advantaged plans.
