Jane Dotson
Health insurance for politicians is a highly debated topic. In the United States, members of Congress do not receive free health insurance for life, despite popular belief. They are required by law to purchase health insurance through the exchanges offered by the Affordable Care Act (ACA) or Obamacare. They choose a gold-level ACA plan and receive federal subsidies that cover 72% of the cost of premiums, paying the remaining 28% through pre-tax payroll deductions. They also have access to free or low-cost care through the Office of the Attending Physician and free outpatient care at military facilities in the DC area.
| Characteristics | Values |
|---|---|
| Do members of Congress get free health insurance? | No, members of Congress do not get free health insurance. |
| What type of health insurance do members of Congress have? | Members of Congress must choose a Gold-level Obamacare policy. |
| What percentage of health insurance costs do members of Congress pay? | Members of Congress pay approximately 28% of their annual healthcare premiums through pre-tax payroll deductions. |
| What type of health insurance did members of Congress have before the Affordable Care Act? | Before the Affordable Care Act, members of Congress were covered by the Federal Employees Health Benefits Program (FEHBP). |
| Can members of Congress return to their pre-Affordable Care Act health insurance? | If the Affordable Care Act is repealed, members of Congress can return to the FEHBP. |
| Do members of Congress have access to any other health benefits? | Members of Congress have access to free or low-cost care through the Office of the Attending Physician and free medical outpatient care at military facilities in the D.C. area. They are also eligible for cafeteria plans and Flex 125 savings plans to help pay for healthcare expenses with pre-tax dollars. |
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What You'll Learn
Members of Congress pay 28% of their health insurance costs
Members of Congress and Their Health Insurance
Despite rumours to the contrary, members of Congress do not receive free health insurance for life. They are, in fact, mandated by law to purchase their health insurance through the exchanges offered by the Affordable Care Act (ACA), also known as Obamacare. They choose a gold-level ACA policy and receive federal subsidies that cover 72% of the cost of the premiums. This means that members of Congress pay approximately 28% of their annual healthcare premiums through pre-tax payroll deductions.
Before the ACA was passed, members of Congress were subject to the Federal Employees Health Benefits Program (FEHBP), which provides insurance to federal employees and postal workers. However, the ACA included a provision that required members of Congress to obtain their health insurance through ACA exchanges. As a result, members of Congress now purchase their insurance through the District of Columbia's Small Business Health Options Program (SHOP) exchange, also known as DC Health Link.
It is worth noting that members of Congress have access to additional benefits that the average citizen does not. For example, they have access to free or low-cost care through the Office of the Attending Physician and free medical outpatient care at military facilities in the Washington, D.C. area. They are also eligible to set aside a portion of their salary in Flex 125 savings plans to help pay for healthcare and childcare expenses with pre-tax dollars.
In summary, while members of Congress do not receive free health insurance, they do benefit from federal subsidies that cover a significant portion of their healthcare costs. They also have access to additional benefits that may reduce their overall healthcare expenses.
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They do not receive free healthcare
Despite persistent rumours to the contrary, members of Congress do not receive free healthcare. Before the Affordable Care Act (ACA), members of Congress were covered by the Federal Employees Health Benefits Program (FEHBP), which was available to federal employees and postal workers. However, since the ACA was introduced, members of Congress have been required to obtain their health insurance through ACA exchanges. They must choose a gold-level Obamacare policy, which is the same level of insurance offered to the general public.
Members of Congress receive federal subsidies that cover 72% of the cost of their premiums. This is below average for single-person coverage, as the average American worker pays 17% of their total premium, compared to the 28% paid by members of Congress. These subsidies are only available for gold plans, even though the DC SHOP offers plans at every medal level.
Members of Congress also have access to free or low-cost care through the Office of the Attending Physician, as well as free medical outpatient care at military facilities in the D.C. area. They are also eligible to set salary aside in Flex 125 savings plans, which help them pay for healthcare and childcare expenses with pre-tax dollars. They can also enrol in health savings accounts if they enrol in high-deductible health plans.
If the ACA were to be repealed, members of Congress would be able to return to the FEHBP. They would still enjoy many of the ACA's protections, such as coverage for pre-existing conditions and dependents under 26.
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They have access to free or low-cost care at military facilities
In the United States, members of Congress and their staff pay about 28% of their annual healthcare premiums through pre-tax payroll deductions. They also have access to free or low-cost medical care at military facilities in the Washington, D.C. area. This includes free outpatient care.
Prior to the Affordable Care Act (ACA), members of Congress were covered by the Federal Employees Health Benefits Program (FEHBP). This federal plan was reportedly well-liked by legislators. Should the ACA be repealed, Congress members would likely return to this plan. Under FEHBP, members of Congress would pay the same percentage of their healthcare costs as they do now. They would not receive free health insurance.
The rising cost of health insurance in the United States has placed a burden on employers, who are increasingly unable to cover the full cost of their employees' health insurance. This has resulted in fewer people receiving fully-covered health insurance from their employers.
Despite the protections offered by the ACA, about 25 to 30 million Americans still lack health insurance coverage. This is due to the complex and fragmented nature of the US health insurance system, which includes Medicare, Medicaid, and employer-sponsored insurance.
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They can purchase FEHBP insurance after leaving politics
In the United States, members of Congress are required by law to purchase their health insurance through the exchanges offered by the Affordable Care Act (ACA), also known as Obamacare. Before the ACA was passed, members of Congress received the same healthcare insurance benefits as any other federal employee through the Federal Employees Health Benefits Program (FEHBP).
Under FEHBP plans, no one could be refused or charged more for a pre-existing condition, and dependents under 26 were covered. Federal subsidies for insurance under FEHBP remain stable at 72%, so members of Congress pay around 28% of their annual healthcare premiums through pre-tax payroll deductions.
Upon leaving politics, members of Congress may purchase FEHBP insurance if they are otherwise eligible for retirement. This means that politicians can still enjoy the benefits of FEHBP after their political career, including coverage for pre-existing conditions and dependents under 26.
It is important to note that members of Congress do not receive free healthcare. They pay 100% of any premiums for long-term care insurance with after-tax dollars. However, there are two areas where members of Congress can receive free or low-cost healthcare that the average citizen cannot access. Firstly, they have access to the Office of the Attending Physician, where they can receive limited care for routine examinations, consultations, and certain diagnostic tests for an annual fee. Secondly, in the Capital region only, they may receive free medical outpatient care at military facilities. If they require inpatient care or are outside the Capital region, they must pay 100% of the full cost of military healthcare.
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They have access to the Office of the Attending Physician
Members of Congress and their staff have access to "free or low-cost care" through the Office of the Attending Physician (OAP). The OAP was established by congressional resolution in 1928 to meet the medical needs of Members of Congress. The first Attending Physician, Dr. George Calver, served the Congress for approximately 37 years.
The OAP provides members of Congress with physicals and routine examinations, on-site X-rays and lab work, physical therapy, and referrals to medical specialists from military hospitals and private medical practices. When specialists are needed, they are brought to the Capitol, often at no charge to members of Congress. Members of Congress do not pay for the individual services they receive at the OAP, nor do they submit claims through their federal employee health insurance.
The Attending Physician is also tasked with emergency care for staff, security personnel, and dignitaries, and the implementation of the environmental health, public health, and occupational health programs of the Capitol Hill region. They are involved in security planning and work with the Architect of the Capitol, the Senate Sergeant at Arms, the House Sergeant at Arms, and the United States Capitol Police.
The OAP played a central role in the response to the 2001 anthrax attacks on Senator Tom Daschle's Senate office, with former Attending Physician Rear Admiral Dr. John Eisold and his staff taking nasal swabs from the nearly 6,000 staff, employees, and visitors potentially exposed to the harmful bacteria. Dr. Eisold and his team also provided initial treatment to Senator Tim Johnson when he suffered an intracerebral bleed caused by a cerebral arteriovenous malformation.
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Frequently asked questions
No, members of Congress do not get free health insurance for life. They are required by law to purchase their health insurance through the exchanges offered by the Affordable Care Act (ACA), also known as Obamacare.
Politicians in the US choose from the same selection of plans that regular Americans do. They choose from DC Healthlink's Small Business Health Options Program (SHOP), which offers plans at every medal level. However, they can only receive employer contributions if they purchase insurance at the gold tier.
Politicians have access to free or low-cost care through the Office of the Attending Physician and free medical outpatient care at military facilities in the DC area. They also have access to cafeteria plans, which allow them to establish a flexible spending arrangement (FSA) to cover their medical expenses with pre-tax dollars.
