Skip to content

OPM Details Obamacare Fix for Congress, Staff

It’s official: Members of Congress and congressional staff will keep their health care subsidies under Obamacare, and some staffers won’t have to join the new health exchanges at all.

The Office of Personnel Management issued formal guidance on how lawmakers and staffers can use their federal employee benefits to help pay for health care on the new health exchanges.

“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,” OPM Director of Planning and Policy Jon Foley said in a statement.

But OPM separately noted that, unlike other Americans, Members of Congress and staff will continue to keep their employee subsidies under the plan, claiming a legal loophole written into the law itself. OPM noted that the provision requiring members of Congress and their staff to join the exchanges included the phrase “notwithstanding any other provision of law.” That phrase, per OPM, gives the government license to ignore the other provision of the of the Affordable Care Act “that prohibits an employer from providing a qualified health plan through an Exchange as a benefit under its cafeteria plan.”

In turn, lawmakers and staff will not be eligible for premium tax credits under the plans, and OPM noted that the rule merely maintains benefits lawmakers and staff already have. “The amount of the employer contribution toward their Exchange premiums is no more than would otherwise be made toward coverage under the [Federal Employee Health Benefits] Program,” OPM wrote.

Interestingly, the proposed rule leaves it to individual offices on Capitol Hill to define which employees are deemed to fall under the regulations because the term “official office” of a Member of Congress doesn’t have an existing statutory definition.

As this blog first reported last week, lawmakers and the White House worked out a fix fairly quickly after the issue came up for debate at a Senate Democratic Conference meeting with President Barack Obama.

The original news generated a mixed response. While senators had left for August recess by the time word of the deal circulated, the House was still in town for one more day.

Obama’s comments on the subject at the closed-door meeting were first reported by Politico.