Confusion Over Insurance Changeover For Congress

Among the Americans whose health insurance arrangements will definitely be changed by the new health care law are members of Congress themselves. The law stipulates that lawmakers and some members of their staffs enroll in new health insurance exchanges. But an apparent drafting error in the law makes it unclear when that transition is supposed to occur.

ROBERT SIEGEL, host:

The new health law probably will not affect the health insurance arrangements of most Americans who get their coverage at work. But one group that will see a change are members of Congress. Lawmakers have specifically required themselves and some of their staff members to purchase coverage through the new health exchanges the law calls for.

But a new memo from the Congressional Research Service says Congress may have inadvertently left itself with no coverage options, at least for a while. Joining us to sort out some of the confusion is NPR health policy correspondent Julie Rovner. Hi, Julie.

JULIE ROVNER: Hi, Robert.

SIEGEL: So, first, a little context here. How do members of Congress get their health insurance now?

ROVNER: Well, both Congress and its staff members get their coverage the same as every other federal worker through the Federal Employees Health Benefits Plan. It is the largest employer provided health plan in the nation. Covers more than eight million workers and their dependents.

SIEGEL: And why did they decide to change that in the new law?

ROVNER: Well, until the mid-1990s, Congress was exempt from most workplace laws for a fairly simple reason that had to do with the constitutional separation of powers. But after a six-year crusade led largely by Iowa Republican Senator Chuck Grassley, Congress in the mid-1990s did figure out how to apply most civil rights and labor laws to itself. And since then, pretty much every workplace law that Congress has passed, it has managed to apply to itself also.

And it was, in fact, Senator Grassley who added the amendment to the health bill to require members of Congress and their staff to drop their federal employee health coverage and buy coverage that will be available in these new health exchanges.

SIEGEL: Grassley, a Republican, was saying if you Democrats think the system is so good for the voters, it ought to be good enough for us.

ROVNER: That's exactly what he said.

SIEGEL: So, it's not all staff members, though, who are covered by his amendment, just some staffers?

ROVNER: Well, that certainly is what it appears to be, just members and the staff who work in their personal offices. It seems not to apply to the people who work for congressional committees. Now, in fact, those are the people who actually wrote the bill. Some people have suggested that's some sort of conspiracy by those staffers who did the bill writing to get out of having to drop their federal employee health insurance.

But there's actually another reason for that and that's because if it included all staff, it would reach a lot of other legislative branch employees whose insurance arrangements Congress didn't feel it wanted to disrupt, like the Capitol police or even staffers for the Congressional Research Service.

SIEGEL: Which brings us to the recent memo from the research service. It seems lawmakers did not specify when this changeover in insurance is supposed to take place and so they asked the research service what it thought.

ROVNER: Well, that's right. And because there's no date, theoretically, at least according to the CRS, it could be interpreted as lawmakers having to drop their coverage right away and move into other plans that would be created by the new law, except that there aren't any other plans created by the new law just yet. And there won't be likely for at least the next couple of years.

SIEGEL: Well, this sent us back to the archives to September 29th of last year. The Senate Finance Committee and Senator Grassley at that time did have a date in mind when his amendment would take effect.

Senator CHUCK GRASSLEY (Republican, Iowa): So, my modified amendment would apply the original intent of my amendment and require that after the year 2013, all members of Congress and staff would have to purchase coverage through state-based exchanges.

SIEGEL: After 2013, a date that evidently somehow didn't make it into the final bill. Does that actually that the members of Congress and their staff should be uninsured because Senator Grassley's date never made it into the final draft?

ROVNER: In a word, no. I don't think any judge would ever interpret that Congress ever intended for that to happen. A judge would obviously see the lack of a date as what it is, which is a mistake. And I think before it ever got to that point, Congress will almost certainly fix it in some kind of a technical change. Although, with this bill, I think you need to mention that even the smallest change is likely to stir up a lot of debate.

SIEGEL: All that would take would be, say, a cloture vote?

ROVNER: Maybe.

SIEGEL: Thanks, Julie.

ROVNER: You're welcome.

SIEGEL: That's NPR health policy correspondent Julie Rovner.

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