Orlando Harmon
Members of Congress do not receive free healthcare. They are required by law to purchase their health insurance through the exchanges offered by the Affordable Care Act (ACA) or Obamacare. They choose a gold-level Obamacare policy and receive federal subsidies that cover 72% of the cost of the premiums, leaving them to pay the remaining 28%. They also have access to free or low-cost care through the Office of the Attending Physician, as well as free outpatient care at military facilities in the DC area.
| Characteristics | Values |
|---|---|
| Do Congressmen get free health insurance? | No |
| What type of health insurance do they have? | Gold-level Obamacare policy |
| What percentage of the cost do they pay? | 28% |
| What percentage is covered by federal subsidies? | 72% |
| Are there other benefits? | Yes, free or low-cost care through the Office of the Attending Physician and free outpatient care at military facilities in the D.C. area |
| What was the previous insurance program? | Federal Employees Health Benefits Program (FEHBP) |
| What is the current program called? | Small Business Health Options Program (SHOP) |
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What You'll Learn
Congress members pay 28% of their health insurance costs
Members of Congress do not receive free health care. Instead, they must pay for their health insurance through the Affordable Care Act (ACA) exchanges, just like any other employer-provided health care. They are not exempt from the health care law.
Before the ACA, members of Congress received the same healthcare insurance benefits as any other federal employee through the Federal Employees Health Benefits Program (FEHBP). However, since the ACA was implemented, they have been required to obtain their health insurance through ACA exchanges.
Congress members can only obtain employer-subsidized, private coverage through the exchanges established under the ACA. They choose a gold-level Obamacare policy and receive federal subsidies that cover 72% of the cost of the premiums. This means that Congress members pay around 28% of their annual healthcare premiums through pre-tax payroll deductions.
In addition, members of Congress qualify for some medical benefits that ordinary federal workers do not. They are eligible to receive limited medical services from the Office of the Attending Physician of the US Capitol, after paying an annual fee. They can also receive free outpatient care at military facilities in the Capital region, but must pay 100% of the cost if they require inpatient care or are outside of the Capital region.
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They receive federal subsidies for 72% of the cost
Members of Congress do not receive free healthcare. They receive federal subsidies that cover 72% of the cost of premiums. This means that members of Congress pay around 28% of their annual healthcare premiums through pre-tax payroll deductions. This is comparable to the benefits received by employees of large companies.
Before the Affordable Care Act (ACA), members of Congress received the same healthcare insurance benefits as other federal employees through the Federal Employees Health Benefits Program (FEHBP). The FEHBP offers about 300 different private healthcare plans, including five government-wide, fee-for-service plans and many regional health maintenance organisation (HMO) plans, as well as high-deductible, tax-advantaged plans.
The ACA requires members of Congress and designated congressional staff members to obtain their health insurance through ACA exchanges. Specifically, they must purchase insurance through the District of Columbia's Small Business Health Options Program (SHOP) exchange, also known as DC Health Link. This is because Congress is located in Washington, DC.
If the ACA were to be repealed, members of Congress would be able to return to the FEHBP. Federal subsidies for insurance under the FEHBP would remain stable at 72%. Therefore, members of Congress would continue to pay the same percentage of their costs as they currently do.
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They can receive free outpatient care at military facilities
Members of Congress do not receive free health care. They pay for their health insurance through the District of Columbia's Small Business Health Options Program (DC SHOP) exchange, also known as DC Health Link. They choose a gold-level Obamacare policy and receive federal subsidies that cover 72% of the cost of the premiums.
However, members of Congress are eligible to receive free or low-cost outpatient care at military facilities in the Washington, D.C. area. This includes the Walter Reed Army Medical Center and the National Naval Medical Center. If they are outside of the Capital region or require inpatient care, they must pay 100% of the cost of military health care.
The Office of the Attending Physician of the U.S. Capitol also provides limited medical services to members of Congress (but not their families) after the payment of an annual fee. However, these services do not include surgery, dental care, eyeglasses, or prescriptions.
While members of Congress do not receive free health care, they have access to benefits that ordinary federal workers do not. They can choose from a variety of ACA insurance plans and receive employer contributions if they purchase insurance at the gold tier. Overall, they enjoy good health insurance by any standard.
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Congress members have access to 300 private healthcare plans
Members of Congress do not receive free healthcare. They are required by law to purchase their health insurance through the exchanges offered by the Affordable Care Act (ACA). They choose a gold-level Obamacare 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, members of Congress received the same healthcare insurance benefits as any other federal employee through the Federal Employees Health Benefits Program (FEHBP). The FEHBP 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.
In addition, members of Congress qualify for some medical benefits that ordinary federal workers do not. They are eligible to receive limited medical services from the Office of the Attending Physician of the U.S. Capitol, after payment of an annual fee. They can also receive care at military hospitals, with no charge for outpatient care.
The District of Columbia's SHOP health plans and federal employer contributions mean that members of Congress receive benefits similar to those enjoyed by employees of large companies.
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They can choose a gold-level Obamacare policy
Members of Congress do not receive free health care. Instead, they can choose a gold-level Obamacare 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.
The gold-level Obamacare policy is part of the Small Business Health Options Program (SHOP) exchange, also known as the DC Health Link Small Business Market, which is administered by the DC Health Benefit Exchange Authority. This program was established to administer group health benefits to employees of small businesses. Members of Congress are required by law to purchase their health insurance through the exchanges offered by the Affordable Care Act.
In addition to the gold-level Obamacare policy, members of Congress also have access to other medical benefits. They are eligible to receive limited medical services from the Office of the Attending Physician of the U.S. Capitol after paying an annual fee. These services do not include surgery, dental care, eyeglasses, or prescriptions, which must be filled at the member's expense. House and Senate members are also eligible to receive free outpatient care at military hospitals in the Washington, D.C., area, such as Walter Reed Army Medical Center and the National Naval Medical Center. Inpatient care at these facilities is billed at rates set by the Department of Defense.
Prior to the Affordable Care Act, members of Congress received healthcare insurance benefits through the Federal Employees Health Benefits Program (FEHBP). This program offered about 300 different private healthcare plans, including government-wide fee-for-service plans, regional health maintenance organization (HMO) plans, and high-deductible, tax-advantaged plans. All plans included comprehensive coverage for hospital, surgical, physician, mental health, prescription drug, and "catastrophic" expenses. If the Affordable Care Act were to be repealed, members of Congress could return to this program.
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Frequently asked questions
No, members of Congress do not receive free health care. They choose a gold-level Obamacare policy and receive federal subsidies that cover 72% of the cost of the premiums.
Members of Congress can choose from a variety of health insurance plans, including the Federal Employees Health Benefits Program (FEHBP), which offers about 300 different private health care plans, and the Small Business Health Options Program (SHOP), which offers a range of ACA insurance plans at different levels.
Yes, 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 Capital region.
