Tags: Healthcare Reform | obamacare | congress | premiums | illegal

WSJ: Obama's Healthcare Fix for Congress is Illegal

Image: WSJ: Obama's Healthcare Fix for Congress is Illegal

By Dan Weil   |   Monday, 05 Aug 2013 12:07 PM

The Obama administration's decision to change Affordable Care Act rules to avoid curbing benefits of congressional members and their staff is illegal, according to a Wall Street Journal editorial.

Obamacare requires the legislative branch to participate in its insurance exchanges, but it lacks clear rules about the premium contributions the government makes for its employees, the editorial says.

"The fairest reading of the statute as written is that if Democrats thought somebody earning $174,000 [a congressman's salary] didn't deserve an exchange subsidy, then this person doesn't get a subsidy merely because he happens to work in Congress," the editorial says.

That would exclude from coverage 11,000 members of Congress and their staff, who now are part of the Federal Employees Health Benefits Program, the editorial explains.

"Instead, they will get the lower-quality, low-choice 'Medicaid Plus' of the exchanges," it states. "The members … and their better-paid aides also wouldn't qualify for Obamacare subsidies. That means they could be exposed to thousands of dollars a year in out-of-pocket insurance costs."

Not surprisingly, Congress didn't react well to the situation. "Democrats in particular begged the White House for help, claiming the [Democratic] language was merely an unintentional mistake," the editorial says. President Barack Obama promised Democrats a fix last week.

"And now the White House is suspending the law to create a double standard," the editorial says. The Office of Personnel Management is scheduled to release details of the rules this week.

Leaks to the press indicate that Congress will receive extra payments based on the current defined-contribution formula, which covers about 75 percent of the cost of the average insurance plan, the editorial says. Currently that's about $4,900 for individuals and $10,000 for families.

The government simply could write checks to workers, essentially raising their pay. Or it could cover 75 percent of the cost of the Obamacare plan each worker chooses, according to the editorial.

"In any case, the carve-out for Congress creates a two-tier exchange system, one for the great unwashed and another for the politically connected," the editorial says.

"This latest White House night at the improv is also illegal. [The Office of Personnel Management] has no authority to pay for insurance plans that lack [government] contracts, nor does the Affordable Care Act permit either exchange contributions or a unilateral bump in congressional pay in return for less overall compensation."

Congress would have to pass appropriations bills to do that, the editorial says.

"But the White House rejected a legislative fix because Republicans might insist on other changes, and Mr. Obama feared that Democrats would go along because they're looking out for number one."

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