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U.S. Lawmakers and Staff to Keep Health-Premium Subsidy

Photographer: Brendan Hoffman/Bloomberg

The provision was inserted into the health-care overhaul bill in 2009 by U.S. Senator Charles Grassley of Iowa, then the top Republican on the Senate Finance Committee, which drafted the legislation. Close

The provision was inserted into the health-care overhaul bill in 2009 by U.S. Senator... Read More

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Photographer: Brendan Hoffman/Bloomberg

The provision was inserted into the health-care overhaul bill in 2009 by U.S. Senator Charles Grassley of Iowa, then the top Republican on the Senate Finance Committee, which drafted the legislation.

U.S. lawmakers and members of their staffs can keep receiving the federal government’s medical insurance premium subsidy next year after the 2010 health-care law forces them into new insurance exchanges, according to a proposed Obama administration rule issued today.

Starting Jan. 1, members of Congress and their aides must purchase coverage on health-insurance exchanges created by the law and being set up in each state. Ambiguities in the law had raised questions about whether congressional staff members would continue receiving government subsidies of as much as 75 percent of their health-care premiums, as they do under the benefits plan covering all federal employees.

The rule comes as the administration prepares to implement key provisions of the health-care law that have drawn Republican threats to shut down the government unless funding to carry out the programs is withheld.

Lawmakers and staff members purchasing family plans faced the prospect of paying an additional $11,000 a year for medical insurance if the administration determined that they were ineligible for the subsidy.

The rules proposed by the Office of Personnel Management would allow lawmakers and members of their official staffs to keep receiving a premium subsidy. The regulations would enforce a provision of the health-care law that makes lawmakers and those aides ineligible at year’s end to purchase medical insurance through the Federal Employees Health Benefits Program.

“These proposed regulations implement the administrative aspects of switching members of Congress and congressional staff to their new insurance plans -- the same plans available to millions of Americans through the new exchanges,” Jon Foley, OPM’s planning and policy director, said in a statement.

Republican Amendment

The provision was inserted into the health-care overhaul bill in 2009 by Iowa Senator Charles Grassley, then the top Republican on the Senate Finance Committee, which drafted the legislation. Grassley said at the time that members of Congress should be forced to live under the laws that apply to other Americans.

Under the regulations, members of Congress and their staffs will be eligible to purchase insurance on the exchange in the state where they live, OPM said.

The proposed rule attempts to clarify which aides will have to obtain health insurance through the exchanges. Questions arose because the law states that “congressional staff” includes people who work in “the official office” of a member of Congress.

OPM said that “because there is no existing statutory or regulatory definition of the term ‘official office,’” each lawmaker will “determine whether an employed individual meets the statutory definition.” The decision must be made by Oct. 1 every year, OPM said.

Final Authority

Lawmakers will be the “final authority” on whether a staff member who is assigned to perform work for both a legislative committee and the member’s personal office is eligible for the subsidy, the regulation states.

Republican Senator Tom Coburn of Oklahoma has held up Senate confirmation of Katherine Archuleta to be the next OPM director until receiving answers from the agency to his questions about the subsidy.

He said last week that if OPM didn’t provide a satisfactory answer, he was ready to propose legislation that would preserve the premium subsidy for congressional staff. His legislation wouldn’t have covered members of Congress.

“I am not going to punish federal employees because they happen to work for Congress,” Coburn said in an interview last week.

Coburn will lift the hold on Archuleta’s nomination now that OPM has proposed regulations, said an aide, who wasn’t authorized to discuss the matter publicly and spoke on condition of anonymity.

Support Staff

The subsidy provision for purchasing insurance on the exchanges doesn’t apply to support staff or to employees of other legislative-branch offices, such as the Library of Congress, the Architect of the Capitol or the Office of the Senate Sergeant at Arms and Doorkeeper. Those employees remain eligible to purchase health coverage under the federal government’s benefits plan.

The proposed regulation becomes final following a notice and comment period.

To contact the reporter on this story: James Rowley in Washington at jarowley@bloomberg.net

To contact the editor responsible for this story: Katherine Rizzo at krizzo5@bloomberg.net

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