The right-wing media have hyped and distorted a decision to keep congressional staffers on their existing health care plan to accuse the Obama administration of acting with the “whims of a dictatorship.”
After the Obama administration agreed to fix a legislative conflict that would have forced congressional staffers off their current health care coverage and into the Affordable Care Act exchanges, the right-wing media accused President Obama of “exempting” Congress from the law. On Fox News' America's Newsroom, co-host Bill Hemmer claimed Obama “personally intervened to make sure that members of Congress and their staffers will not have to live with Obamacare,” later saying the decision “is like the oligarchs.” Fox contributor Monica Crowley said the decision “is like the whims of a dictatorship.” A Wall Street Journal editorial claimed the decision suggests “illegal dispensations for the ruling class, different rules for the hoi polloi.”
But the decision fixed a problem that would have treated congressional employees differently from all other Americans. In the Health Affairs blog, health care expert Timothy Jost explained that “Far from exempting Congress from ACA requirements, as some have reported, the amendment subjects members to a legal requirement that will apply to no other Americans”:
The exchanges are only open to individuals and small employers. No large employers participate in the exchange, at least not yet. There is no provision, therefore for large employers, including the largest -- the United States government -- to pay for exchange coverage. Members of Congress and their staff will generally not be qualified for premium tax credits because they will have income above 400 percent of poverty. Requiring them to pay for coverage out of pocket in after-tax dollars would be unfair and would also make these jobs very unattractive.
In The Washington Post's Wonkblog, Ezra Klein pointed out that, while the media's use of the word “exemption” made it seem as though Congress was creating a unique legislative situation for themselves, “Obamacare would apply to members of Congress and their staffs in the exact same way it applies to employees of The Washington Post, or Politico, or GE, or any other large employer. They wouldn't be any more exempt from the law than I am.”
Jost's post also explained why the legislative fix was necessary. Because the exchanges were meant to provide access to health care for individuals and small businesses, Congress would have no way to pay for their employees' coverage through the law, and because staffers' salaries are generally above the limit for premium subsidies, they would not receive a tax credit to help pay for coverage, essentially creating a unique situation in which staffers would have to pay the full price of their insurance for no reason:
The intent of Congress as to how coverage would be paid for was clear all along, as demonstrated by a 2010 Congressional Research Service report . Congressional coverage would be paid for in the same way coverage for other federal employees is funded -- through the federal Office of Personnel Management. The ACA requires the federal government to “make available” exchange coverage to Congress, and Senator Grassley stated at the time he offered his amendment that its intent was “to require that Members of Congress and congressional staff get their employer-based health insurance through the same exchanges as ... constituents.” It was only a matter of time until OPM clarified this.