Whether you had insurance before the passage of the Affordable Care Act (ACA), also called Obamacare, or you went uninsured, chances are the implementation of healthcare reform has had some impact on you. Some health insurance companies folded while others had to amend their policies to come into compliance with new laws concerning standards for minimum essential coverage. Some people had to subsequently change insurance carriers or policies and lost their grandfathered plans. As for federal employees, the law only really affected some.
In 1960, the Federal Employees Health Benefits Program (FEHBP) was established. Much like other employer-sponsored benefits, this program provided federal workers with access to a number of health insurance options at a discounted rate. Under this program, the government paid as much as 75% of premiums for federal employees. In addition, the FEHBP allowed for federal employees to continue receiving these health insurance benefits, including policies and government subsidies, even after retirement, rather than having to switch over to another policy or Medicare, as most Americans do.
It should come as no surprise, then, that most federal workers elected to keep their current healthcare plans rather than make the switch to Obamacare. Since the policies provided under the FEHBP were already compliant with standards for minimum essential coverage, there was no need to change these plans. So long as federal employees are enrolled in the FEHBP, they will not have to pay penalties for failure to carry acceptable health insurance.
However, this does not apply to Congress. Specific language was added to the ACA mandating that all members of Congress and their staffers would have to apply for health insurance through the healthcare marketplace. They were, however, allowed to use the small business marketplace rather than the regular state exchange for individuals and families. There has been some contention about the fairness of this move because SHOP, the platform for small businesses to provide affordable group health insurance for employees, is intended for use by businesses with fewer than 50 employees. Congress has roughly 12,000. However, it has been argued that each member of Congress and their staff constitute a small business.
In addition, this concession has allowed members of Congress and their staffers to continue receiving government subsidies, just as employees in private sector businesses have a portion of their benefits paid by an employer. In other words, they are getting the best of both worlds. Not only are they allowed to behave like small businesses, but they gain the benefits of being part of a much larger company, so to speak. It is from this juxtaposition that the outcry of cheating the system has stemmed.
As for how the transition to Obamacare has affected federal employees, the changes have largely mirrored the experience for the average American. Those who were able to maintain coverage saw few changes to their coverage and costs. As for members of Congress specifically, the enrollment venue certainly changed, as did access to specific healthcare insurance plans, but coverage and cost may not have been affected as much as one might suspect.
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