A couple of weeks ago Roll Call, the U.S. Capitol’s insider news magazine, reminded us that a complicated quirk in budget rules exempted U.S. Senators from their own plan to replace the Affordable Care Act. Although that plan is widely despised, the Republican leader, Mitch McConnell, threatened to call a vote simply to repeal the federal health care law. Any outcome, then, is of no direct impact to Senators because their plan is special, not involved.
The rules keep Senators well-insulated in their own tax-subsidized health insurance plan, a benefit with the thinnest roots to the Affordable Care Act, enabling the legislators to claim, weakly, that they pay into the “same” plan as all federal employees. This is like a Lexus driver saying he rides in a Toyota.
Fearing a citizen backlash against the privilege, Ted Cruz, the Texas Republican and a fierce conservative, crafted a plan to nullify the exemption, but it banged up against complications in the rules. As part of the 2010 Affordable Care Act, members of Congress and many staffers had quietly shifted their health insurance and benefits from the Federal
Employee Health Benefits program to the small business exchange in Washington, D.C. – and under jurisdiction of a separate committee.
The route through another procedural thicket, called “reconciliation instructions,” means that the Senate’s plan must exempt members’ insurance lest it lose its “privileged” status, one that requires only 50 votes for passage. A plan without that status, but including the senators’ insurance, would require 60 votes, a total that is out of reach for proponents of anything like the current Senate health care plan.
Put another way, Senators and House members have no dogs in the current hunt. Their health insurance and benefits are not part of the legislation now so controversial – a Senate plan crafted entirely behind closed doors and one that has had not a minute of public hearing.
We must remember that congressional health care includes extra privileges, such as free outpatient care at the Washington area’s Army and Naval medical centers; they have access to the Office of the Attending Physician at the Capitol, which costs members $500 a year and puts them within shouting distance of highly professional care for everything from routine physical exams to X-rays, CAT scans and surgery.
At more than one town hall meeting on health care – the ones legislators dare to attend – the consistent, long-simmering question on nearly every citizen’s mind, or tongue, is
“Why can’t we have what the Congress has?” Long answer: It’s one thing to subsidize the Federal Employees Health Benefits Program and the small business exchange in Washington and eight million other federal employees. But it is quite another to offer the plan to hundreds of millions more (the rest of us), and extend those extra special Congressional privileges at no cost but our own – an estimated $1 trillion over ten years.
Short answer: Our plan is too expensive to include the rest of you. The grand health care perk – the one that is excluded from the current Senate plan (and was never part of the House plan) – is one big reason that members of congress campaign year-round to keep their jobs.
Think on it the next time legislators speak so earnestly about health care – knights of the realm, sharing our pain.