Paul Sanchez
Members of Congress and their staff pay around 28% of their annual healthcare premiums through pre-tax payroll deductions, with the Federal Employees Health Benefits Program (FEHBP) covering the rest. They also 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. Upon retirement, members of Congress can participate in the Federal Employee Retirement System (FERS), which provides a monthly retirement annuity based on age, years of federal service, and highest three consecutive years of salary. They can also contribute to the Thrift Savings Plan (TSP), similar to a 401(k) plan, and receive basic life insurance coverage through the Federal Employees' Group Life Insurance (FEGLI) Program.
| Characteristics | Values |
|---|---|
| Percentage of healthcare premiums paid by members of Congress | 28% |
| Cost of healthcare for a 21-year-old making $25,000/year under Obamacare | $282/month |
| Subsidized cost of healthcare for the above individual under Obamacare | $142/month |
| Federal subsidies for insurance under FEHBP | 72% |
| Dental Insurance | Available |
| Vision Insurance | Available |
| Pre-tax dollars for eligible health and dependent care expenses | Available |
| Federal Employees' Group Life Insurance (FEGLI) Program | Available |
| Federal Employees Health Benefits Program (FEHBP) | Available |
Explore related products
What You'll Learn
Members of Congress pay 28% of healthcare premiums
Members of Congress pay approximately 28% of their annual healthcare premiums through pre-tax payroll deductions. They also have access to free or low-cost medical care through various avenues. For example, they can access free outpatient care at military facilities in the D.C. area and receive care through the Office of the Attending Physician.
The Federal Employees Health Benefits Program (FEHBP) is a federal plan that covers members of Congress. Federal subsidies for insurance under FEHBP remain stable at 72%, meaning that members of Congress pay 28% of their costs. While legislators do not pay much for healthcare coverage, they do not receive it for free.
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). Given Congress's location in Washington, D.C., members of Congress and designated staff purchase health insurance through the DC SHOP, also known as the DC Health Link Small Business Market.
Medical Associates Insurance: North Carolina Coverage Explained
You may want to see also
Explore related products
Federal Employees Health Benefits Program (FEHBP)
The Federal Employees Health Benefits Program (FEHBP) is a system of "managed competition" that provides health benefits to civilian government employees and annuitants of the United States government. The program was established by an Act of Congress in 1959 and began covering employees on July 1, 1960.
FEHBP is the largest employer-sponsored health benefits program of its kind, covering about 8 million federal employees, retirees, and their dependents. The government contributes 72% of the weighted average premium of all plans, not exceeding 75% for any one plan. Federal subsidies for insurance under FEHBP have remained stable at 72%, so members of Congress pay the same percentage of their costs as they did under their previous plans.
The program allows insurance companies, employee associations, and labor unions to market health insurance plans to governmental employees. Local plans have easy access to participation, but the entry of new national plans is prohibited. The federal government sets minimal standards that insurance companies must meet to participate in the program, resulting in numerous competing insurance plans available to federal employees.
There are three broad types of plans available on the FEHBP: fee-for-service and preferred provider organization (PPO), usually offered in combination; health maintenance organizations (HMOs); and high-deductible health plans and other consumer-driven plans. The number of plan offerings varies depending on the county, with a median of 24 plans available in 2015, including 19 nationwide and 5 HMOs offered in specific geographic areas.
Travel Medical Insurance: Understanding the Cost of Coverage
You may want to see also
Explore related products
Federal Employees' Group Life Insurance (FEGLI)
The Federal Employees' Group Life Insurance (FEGLI) Program is the largest group life insurance programme in the world, covering over 4 million federal employees, retirees, and their families. The programme was established on 29 August 1954 and is underwritten by several private insurance companies, with the Office of Federal Employees' Group Life Insurance (OFEGLI), a unit of the Metropolitan Life Insurance Company, serving as the administrative office.
FEGLI provides basic coverage for employees, with options for additional coverage. The cost of basic insurance is based on an employee's annual salary, with the CBO sharing the cost. The cost of additional coverage, or Option C insurance, depends on an employee's age and the number of multiples elected. Premiums increase with age, and employees will pay the premiums for their new age group after their birthday.
FEGLI allows employees to assign their insurance to another person, firm, or trust, although the employee continues to pay the premiums. This can be particularly useful in the case of viatical settlement companies, which provide terminally ill employees with an influx of cash to finance medical care. Employees with a life expectancy of no more than 9 months may also cash in their basic life insurance.
There are no regularly scheduled open enrolment periods for FEGLI. Employees can elect, increase, or change coverage at any time, except when they have assigned their coverage. Open seasons are only held when specifically scheduled by the OPM.
Navigating Life Without Medical Insurance: A Survival Guide
You may want to see also
Explore related products
Democrats call for retirement of members over 70
Members of Congress 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 also have access to the Federal Employees Health Benefits Program (FEHBP), although federal subsidies for insurance under FEHBP would mean that members of Congress would still pay around 28% of their annual healthcare premiums.
Despite this, there is a divide in the Democratic Party between younger Democrats and the party's oldest members of Congress, who are mostly running for reelection in 2026. Younger Democrats are pushing to sideline the 70- and 80-year-olds, who they say hold too much sway over the party. This debate has been brought to the fore by the forthcoming book "Original Sin" by CNN's Jake Tapper and Axios' Alex Thompson, which details former President Biden's deterioration as he sought reelection in 2024 at the age of 81.
Some party activists want to take the political keys away from state and local officeholders at a certain age, pointing to several examples where leaders held onto power long past their prime, including Senator Feinstein, who died in office at the age of 90 in 2023, and former President Biden. However, older lawmakers' refusals to step aside could lead to potentially dozens of contested primaries. Some older Democrats believe that the influence and institutional knowledge they have accrued over decades shouldn't be so easily discarded.
For example, Rep. John Larson (D-Conn.), 76, who froze up during a House floor speech in February due to a partial seizure, intends to run for reelection. Rep. Dwight Evans (D-Pa.), 70, who suffered a stroke last May that forced him to miss House votes for the rest of the year, is also running again. Only Reps. Jan Schakowsky (D-Ill.), 80, and Gerry Connolly (D-Va.), 75, have said they are retiring, with Connolly also stepping down as the ranking member of the Oversight Committee as he battles esophageal cancer. House Speaker Emerita Nancy Pelosi (D-Calif.), 85, has not yet said whether she will run for reelection in 2026.
Sharing Medical Information: Insurance Company Access
You may want to see also
Explore related products
House Republicans propose Medicaid cuts
House Republicans have proposed Medicaid cuts as part of a legislative package aiming to achieve at least $1.5 trillion in savings, primarily to cover the costs of preserving the 2017 tax breaks, which are set to expire at the end of the year. The Energy and Commerce Committee, led by Rep. Brett Guthrie, has been tasked with finding $880 billion in savings, largely through cuts to Medicaid.
The proposed legislation includes various measures to reduce Medicaid spending. Firstly, it would cut the 5% boost in Medicaid funding implemented during the COVID-19 pandemic. Additionally, it would prohibit federal funding to states for immigrants who have not provided proof of citizenship. The legislation also includes a freeze on the "provider tax" used by some states to help fund their Medicaid programs. Republicans argue that this tax leads to higher payments from the federal government and creates abuse in the system.
Democrats have strongly opposed these proposed cuts, arguing that they will result in millions of Americans losing their healthcare coverage. A preliminary estimate from the nonpartisan Congressional Budget Office supports this claim, projecting a reduction of 8.6 million people with healthcare over the next decade. Democrats have also characterized the cuts as an attempt to repeal Obamacare, which would negatively impact access to healthcare, particularly for seniors and vulnerable communities.
While Republicans acknowledge the need for savings, they defend their proposal by emphasizing their focus on ensuring the program is administered efficiently to those who truly qualify. They attribute the savings to addressing "waste, fraud, and abuse" in the system and believe that new work and eligibility requirements will help achieve these goals. The proposed cuts have caused divisions within the Republican Party, with more than a dozen House Republicans expressing their opposition to cuts in healthcare safety net programs.
It is important to note that members of Congress and their staff have access to healthcare benefits through various programs. They participate in the Federal Employees Health Benefits Program (FEHBP), where they pay approximately 28% of their annual healthcare premiums through pre-tax payroll deductions. Additionally, they can utilize free or low-cost care through the Office of the Attending Physician and military medical outpatient facilities in the Washington, D.C., area.
Comparing Medical Insurance: What You Need to Know
You may want to see also
Frequently asked questions
Members of Congress have access to the Federal Employees Health Benefits Program (FEHBP). They pay approximately 28% of their annual healthcare premiums through pre-tax payroll deductions and 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.
Retirement is a growing trend among Democrats in Congress, with some calling for every Democrat in Congress over the age of 70 to retire. However, there is resistance to this idea, with some senior lawmakers viewing Congress as a lifetime appointment. When a member of Congress retires, their seat becomes open, and their party may react with disappointment or even panic as open seats are harder to defend.
Former Congress members can participate in the Federal Employee Retirement System (FERS), which provides a monthly retirement annuity based on age, years of federal service, and highest three consecutive years of salary. They can also contribute to the Thrift Savings Plan (TSP), similar to a 401(k) plan, and receive matching funds from the agency. Additionally, they have access to the Federal Employees' Group Life Insurance (FEGLI) Program, which provides basic coverage based on their annual salary, with options for additional coverage.
![Medicare and Social Security: [5 in 1] Maximize Your Retirement Benefits, Secure Medical Coverage and Quality Healthcare | Proven Strategies to Protect Your Financial Future Avoiding Costly Mistakes](https://m.media-amazon.com/images/I/71sRJGiWeQL._AC_UL320_.jpg)
