MN03 : A Good Question with a Questionable Answer

Apparently, Congressman Erik Paulsen didn’t get any letters asking him “good questions” last week, because he did not issue a Correspondence Corner posting … but that doesn’t mean that there are not “good questions” that he could have answered… like from Dennis from Eden Prairie who asked WCCO (highlights below) :

Good Question: What Health Benefits Do Members Of Congress Get?

“What’s interesting about it, while most people think Congress gets some cushy deal in terms of healthcare, guess what,” says David Schultz, a professor of political science at Hamline University. “By law, they have to buy their health care through the health care exchanges.”
Members of Congress used to have the plan that’s currently given federal employees called the Federal Employee Health Benefits Program (FEHB). Schultz says that plan is comparable to what a large corporation would offer to its employees.
In 2014, that all changed. When Congress passed the Affordable Care Act, it decided Members of Congress – and their staffs – should be required to get their insurance benefits through the ACA exchanges. Members and their staffs are given the choice of 57 plans through the Washington, D.C. exchanges.
According to the Congressional Research Service, the employer (the government) pays between 72 percent and 75 percent of the premium.
Some Members choose not to take the employer contribution or choose to donate it.
Members of Congress, though, do get some added perks. For an annual fee, Members can go to the Capitol’s Office of Attending Physician for routine care. They can also be treated at Washington, D.C. military facilities for free – as long as it is outpatient care.
For any inpatient care, Members are billed at the full reimbursement rates set by the Department of Defense.

Surely, everyone remembers when the Republican-controlled House shutdown the government (but not the Congressional gym) and some Members said they would be donating their pay during that time period (others like Congressman Paulsen requested that his be put on hold during the shutdown … what happened to the $7,734 held wages is unknown) … so Members could take advantage of the Congressional gym and keep getting paid their $174,000 annual salary, this question that Dennis is asking strickly about healthcare and the subsidies available … leaving the viewers to wonder how many Members “choose not to take the employer contribution or choose to donate it” ?

That’s a real “good question … and as President Reagan preached “trust but verify” the answer may be ONE.

According to House records, Elise Stefanik (R-NY-21) is the only Member listed as donating her subsidized healthcare — roughly $261 per month (Congresswoman Stefanik just turned 33 this week and is engaged to be married this year.)
Which of the 57 Gold-tiered plan choices she picked is unknown … nor what the cost may be for a family plan for someone who would be pushing 60 (the typical Member of Congress.)
But, hey, she does get good press from the Watertown Daily Times for her 2014 campaign pledge … and she did ‘donate” more this year because of healthcare increases (it was roughly $251 per month last year.)

“Gold tier” plans pay 80 percent of in-network expenses for an average population of consumers. Premiums for gold-tier plans are higher but deductibles and out-of-pocket expenses are lower.

Funny thing is that you will hear some Members complain about high deductibles (i.e. over $15,000 a year) however, with 57 plans to choose from, they obviously are making the wrong choice.

Also, let’s remember that the taxpayers are footing the bill for 75% of the insurance policy cost … and if they “donate” their subsidy back, the Member gets a tax deduction as a charitable contribution. It’s a win-win for the Member.

The Office of Attending Physician is a taxpayer-supported perk … Members who opt-in pay an annual fee (in 2015 it was $596 and $611 for 2016) for first aid, immunizations, flu shots, physician referrals, lab work, physical therapy, radiology, electrocardiography and or course, emergency services … and this does not come cheap … the first quarter of the year, the OAP reported $827,563.65 in expenses (which includes providing urgent care to Congressional staffers, Capitol Police officers, visitors and Supreme Court justices as well as Members.)
And if OAP makes a mistake, they can be sued (and you know the taxpayer ends up footing the bill.)

And yes, Members do receive (at no charge) for outpatient care if it is provided in the National Capital Region — which means free treatment at such facilities as Walter Reed National Military Medical Center or the National Naval Medical Center. For inpatient care, Members are billed at full reimbursement based on rates set by the Department of Defense — which could be as low as $18.20.

And, yet Members have other healtchare “perks” available (which require Member contribution) …
Federal Flexible Spending Account Program
Federal Employees Dental and Vision Insurance Program
Federal Long Term Care Insurance Program.

In summary, Dennis from Eden Prairie asked a “good question … and the answer is that Members of Congress have a pretty good benefit … and one they will not lose even if they are successful in repealing ObamaCare.

And shouldn’t we be asking … how can constituents get a choice of 57 Gold-tier plans to choose … now, that’s something we all would like.

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