Health

Congress Would Get Better Health Benefits Than the Rest of Us

Courtesy of an exemption they slipped into the latest bill.

by Jesse Hicks
Jul 14 2017, 6:06pm

Just yesterday, Senate Majority Leader Mitch McConnell released the latest proposal to overhaul the Affordable Care Act, hoping that a few tweaks and some generous handouts to waffling Republican senators could secure the necessary votes. With only a few changes, the bill looks very familiar—including a provision that exempts members of Congress and their staff from part of the plan. As you might recall, the House bill did the same a few months ago.

In revising the legislation, Republicans included language allowing insurers to offer plans that don't cover the Affordable Care Act's essential health benefits. Those benefits—including maternity care and mental health services—were required under the ACA so that insurers couldn't offer hollowed-out plans that were insurance in name only. Under the new bill, insurers can do just that, as long as they also offer at least one plan that does cover all the ACA-mandated services.

Vox reports that, thanks to little more than a dozen words of dense language on page 167, members of Congress and their staffs could only be sold plans with full ACA benefits. A Senate Republican tells Vox the language was included to satisfy strict rules about the reconciliation process, the route Republicans are hoping to use to pass the legislation by avoiding a Democratic filibuster. (Though they're still struggling to find the 50 votes.) This was the case with the House bill, too.

Interestingly, the exemption does not protect Congress from another grim reality of the bill: That it doesn't protect people with pre-existing conditions from potentially ruinous premium increases or denied coverage. The expert who alerted Vox's Sarah Kliff to the exemption, Timothy Jost of Washington and Lee University, points out that that means Congress and staff could find themselves with plans that include the essential health benefits (which the exemption requires) and yet also potentially denied coverage because of a pre-existing condition. These two things seems to be at odds with each other. More hopeful, though, is the possibility that the exemption will go away, which is what happened with the House bill.

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