Thread: Congress, Fearing 'Brain Drain,' Seeks to Opt Out of Participating in Obamacare's Exc

Congress, Fearing 'Brain Drain,' Seeks to Opt Out of Participating in Obamacare's Exchanges

http://www.forbes.com/sites/aroy/201...res-exchanges/



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Sen. Chuck Grassley (R., Iowa) authored the Obamacare amendment requiring that members of Congress and their staff participate in the law's insurance exchanges. (Photo credit: Wikipedia)


As Obamacare was winding its way through the Senate in 2009, Sen. Chuck Grassley (R., Iowa) slipped in an amendment requiring that members of Congress, and their staff, enroll in Obamacare’s health insurance exchanges. The idea was simple: that if Congress was going to impose Obamacare upon the country, it should have to experience what it is imposing firsthand. But now, word comes that Congress is quietly seeking to rescind that provision of the law, because members fear that staffers who face higher insurance costs will leave the Hill. The news has sparked outrage from the right and left. Here’s the back story, and why this debate is crucial to the future of market-based health reform.
Sen. Grassley’s original idea was to require all federal employees to enroll in the exchanges, instead of in the Federal Employee Health Benefits Program, where most gain coverage today. Indeed, a previous Senate Finance Committee amendment proposed putting members and staffers on Medicaid. But “fierce opposition from federal employee unions” sank Grassley’s effort, and he had to water his amendment down to only apply to Congress and congressional staff.
Staffers grumble about being stuck on the exchanges
Ever since Obamacare became law, this has been a source of grumbling among the congressional staffers I talk to. One aspect of the Grassley amendment is that it originally appeared to exempt staffers who worked for congressional committees, and congressional leadership, because those staffers didn’t work for specific Members of Congress. (My understanding is that the Office of Personnel Management has since clarified the regulations to include all staff, including committee and leadership.)
There are a couple of legitimate issues for Congress to resolve with this provision, formally known as Section 1312(d)(3)(D) of the Affordable Care Act. First: Will staffers have to buy insurance on the exchanges for themselves with after-tax money, or will the government be able to contribute to these costs with a pre-tax contribution? Second: In the past, the government’s sponsorship of health benefits for members and staffers counted toward retiree benefits. If these individuals are placed on the exchange, will their pensions will be affected?
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According to the Congressional Research Service, Congress’ in-house think tank, the government can indeed contribute to members’ and staffers’ premium costs. “While it does not appear that the contribution must be similar to the contribution provided under FEHBP,” CRS writes in a 2010 report, “it seems the section may provide the authority for the federal government to make a contribution to the health insurance premiums of Members of Congress and congressional staff. Under FEHBP…the government’s share of premiums is set at 72% of the weighted average premium of all plans in the program, not to exceed 75% of any given plan’s premium.”
So Congress should have the authority to fund a comparable portion of the premiums as they do today. Staffers are waiting for a ruling from the Office of Personnel Management on precisely this point.
A bipartisan deal to rescind the provision?
According to John Bresnahan and Jake Sherman of Politico, however, Congress is seeking to wipe out these provisions and put members and staffers back onto FEHBP. “Several proposals have been submitted to the Office of Personnel Management,” they write. “One proposal exempts lawmakers and aides; the other exempts aides alone.”
What’s surprising about the effort to revive the exemption is that it appears to be bipartisan. According to the Politico reporters, talks to change the provision involve both Senate Majority Leader Harry Reid (D., Nev.) and House Speaker John Boehner (R., Ohio). “Everyone has to hold hands on this and jump, or nothing is going to get done,” one source told the reporters. Several of their sources worried about a “brain drain” that would drive talented staffers off the Hill.
One subtle point needs to be made: Large employers in the private sector are not required to put their employees onto the Obamacare exchanges. Given that Congress is a large employer, this isn’t, in the purest technical sense, about subjecting Congress to the same laws it imposes on other large employers. But it is about subjecting Congress to the laws it imposes on those who will have to buy insurance on the exchanges: individuals who don’t get coverage through their employers, and small businesses.
Exchanges are crucial to the future of health reform
While I have many friends who work for Congress, and I wish them well, it is absolutely a good thing that members and staffers are enrolled on the exchange. It is vital for these individuals to experience, first-hand, how Obamacare’s costly mandates and regulations will drive up the price of health insurance. Staffers will, in particular, be affected by Obamacare’s “community rating” provision, which jacks up the cost of insurance for young people. (Most Hill staffers are in their twenties and early thirties.)
If anything, even more federal employees should be required to enroll in the exchanges, especially those at the White House and the Department of Health and Human Services who are writing thousands of pages of exchange regulations. (Indeed, a bill has been proposed that would extend exchange coverage to the President, Vice President, and political appointees.) It’s critical that those who design our laws get to experience them for themselves. I might also throw in the good folks at the Congressional Budget Office, who will get a better sense of how these regulations affect exchange costs and subsidies.
This may seem like a lot of inside baseball. But it’s actually a critical issue. If Obamacare can’t be repealed—and it is my view that repeal is highly unlikely—then the future of market-based health reform goes through the exchanges. Getting private insurance exchanges right is important, if we want to use them to reform Medicare, Medicaid, and our other health-care entitlements. And the best way to make sure that we get the exchanges right is to make sure that the people who write the laws are also living under them.
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UPDATE 1: Sherman and Bresnahan report that House Speaker John Boehner says that this snafu is “Democrats’ problem to solve.”

“The fact that Democratic leaders want to opt themselves out of the Obamacare exchanges shows that Sen. Baucus isn’t the only one who realizes the president’s health care law is a ‘train wreck,’” said Boehner spokesman Michael Steel.
“The speaker would like to see resolution of this problem, along with the other nightmares created by Washington Democrats’ health law, which is why he supports full repeal,” Steel added. “In the meantime, it is Democrats’ problem to solve. He will not sneak any language into bills to solve it for them — and the Democratic leadership knows that.”

UPDATE 2: Harry Reid, in a carefully-worded statement, says there will be “no legislative fix” to exempt members and staffers. That leaves open the possibility for OPM to provide a back-door exemption:

Senator Reid is committed to ensuring that all members of Congress and Congressional staff experience the benefits of the Affordable Care Act in exactly the same way as every other American. He believes that this is the effect of the legislation as written, and that therefore no legislative fix is necessary. There are not now, have never been, nor will there ever be any discussions about exempting members of Congress or Congressional staff from Affordable Care Act provisions that apply to any employees of any other public or private employer offering health care.

UPDATE 3: Chris Jacobs of the Galen Institute offers historical context, and suggests that state legislators who vote to expand Medicaid should be required to enroll in the program:

The Twitterverse exploded with outrage today, following last night’s Politico story indicating that congressional leadership have engaged in secret conversations attempting to craft an Obamacare waiver for Members of Congress and/or their staffs. As with the rest of Obamacare, the problem lies in the botched way the legislation was enacted — drafted in secret, then rammed through Congress on a party-line vote. Harry Reid drafted this particular section of the bill behind closed doors; Senator Grassley later offered an amendment clarifying the provisions, but Democrats defeated it three years ago. (Text of the Grassley amendment available here; my summary of the amendment here; Senate floor vote here). So there’s one important principle at play: Having rammed the bill through while claiming that reading the bill was a waste of time, because we had to act “real fast” and didn’t have two lawyers over two days to understand the legislation, Democrats now want to exempt themselves from the mess they created. As we’ve said before, you break it, you own it.
But there’s another important principle as well regarding Members’ health coverage, and the ongoing state-level debate regarding Obamacare’s expansion of Medicaid: How many state legislators who want to expand Medicaid for others want to go on Medicaid themselves? We know the answer to this question at the federal level — Sen. LeMieux offered a “Medicaid for Members” amendment in March 2010, which received not a single vote from Senate Democrats. (Text of the amendment here; my summary here; Senate floor vote here.) In 2009, Rep. Henry Waxman publicly admitted that “it is highly unlikely that you are going to find millionaires who would like to go on Medicaid.” In other words, Medicaid provides such inferior coverage that millionaires — and wealthy Members of Congress — wouldn’t dream of enrolling in it themselves, but have no qualms about putting low-income individuals on this “insurance.”
So to the original story: The root problem is not that Congress drafted the law sloppily — although that did happen in spades. The problem is that not enough individuals have been exposed to Obamacare’s underlying flaws. Because it’s easy to see how requiring federal and state representatives to go on Medicaid themselves would make many legislators much less enthusiastic about expanding “coverage” under Obamacare.

UPDATE 4: Ezra Klein says that Harry Reid has to hope that OPM gets him out of this jam:

If OPM doesn’t rule as Reid expects, I’ll be surprised to see this get fixed, at least quickly. Republicans view any chaos around Obamacare as a win for them. As of today, they’re telling me that that even extends to chaos caused by a Republican senator’s amendment that mainly effects their health insurance. I don’t think they’ll hold out long on that if it turns out they actually have to shoulder the full cost of their premiums. But it will be tough to preemptively back down too.

Lawmakers, aides may get Obamacare exemption

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The talks involve John Boehner and Harry Reid, among others. | AP Photos




By JOHN BRESNAHAN and JAKE SHERMAN | 4/24/13 9:49 PM EDT
Congressional leaders in both parties are engaged in high-level, confidential talks about exempting lawmakers and Capitol Hill aides from the insurance exchanges they are mandated to join as part of President Barack Obama’s health care overhaul, sources in both parties said.
The talks — which involve Senate Majority Leader Harry Reid (D-Nev.), House Speaker John Boehner (R-Ohio), the Obama administration and other top lawmakers — are extraordinarily sensitive, with both sides acutely aware of the potential for political fallout from giving carve-outs from the hugely controversial law to 535 lawmakers and thousands of their aides. Discussions have stretched out for months, sources said.
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A source close to the talks says: “Everyone has to hold hands on this and jump, or nothing is going to get done.”
Yet if Capitol Hill leaders move forward with the plan, they risk being dubbed hypocrites by their political rivals and the American public. By removing themselves from a key Obamacare component, lawmakers and aides would be held to a different standard than the people who put them in office.
(Also on POLITICO: GOP pulls contentious Obamacare bill)
Democrats, in particular, would take a public hammering as the traditional boosters of Obamacare. Republicans would undoubtedly attempt to shred them over any attempt to escape coverage by it, unless Boehner and Senate Minority Leader Mitch McConnell (R-Ky.) give Democrats cover by backing it.
There is concern in some quarters that the provision requiring lawmakers and staffers to join the exchanges, if it isn’t revised, could lead to a “brain drain” on Capitol Hill, as several sources close to the talks put it.
The problem stems from whether members and aides set to enter the exchanges would have their health insurance premiums subsidized by their employer — in this case, the federal government. If not, aides and lawmakers in both parties fear that staffers — especially low-paid junior aides — could be hit with thousands of dollars in new health care costs, prompting them to seek jobs elsewhere. Older, more senior staffers could also retire or jump to the private sector rather than face a big financial penalty.
(Also on POLITICO: Baucus will continue ACA push)
Plus, lawmakers — especially those with long careers in public service and smaller bank accounts — are also concerned about the hit to their own wallets.
House Minority Whip Steny Hoyer (D-Md.) is worried about the provision. The No. 2 House Democrat has personally raised the issue with Boehner and other party leaders, sources said.
“Mr. Hoyer is looking at this policy, like all other policies in the Affordable Care Act, to ensure they’re being implemented in a way that’s workable for everyone, including members and staff,” said Katie Grant, Hoyer’s communications director.
Several proposals have been submitted to the Office of Personnel Management, which will administer the benefits. One proposal exempts lawmakers and aides; the other exempts aides alone.
When asked about the high-level bipartisan talks, Michael Steel, a Boehner spokesman, said: “The speaker’s objective is to spare the entire country from the ravages of the president’s health care law. He is approached daily by American citizens, including members of Congress and staff, who want to be freed from its mandates. If the speaker has the opportunity to save anyone from Obamacare, he will.”
Reid’s office declined to comment about the bipartisan talks.
However, the idea of exempting lawmakers and aides from the exchanges has its detractors, including Rep. Henry Waxman (D-Calif.), a key Obamacare architect. Waxman thinks there is confusion about the content of the law. The Affordable Care Act, he said, mandates that the federal government will still subsidize and provide health plans obtained in the exchange. There will be no additional cost to lawmakers and Hill aides, he contends.



Read more: http://www.politico.com/story/2013/0...#ixzz2RXLI0prC

http://www.alipac.us/f19/new-intolerable-act-182462/

A source close to the talks says: “Everyone has to hold hands on this and jump, or nothing is going to get done.”

Yet if Capitol Hill leaders move forward with the plan, they risk being dubbed hypocrites by their political rivals and the American public. By removing themselves from a key Obamacare component, lawmakers and aides would be held to a different standard than the people who put them in office.

John Boehner the Corrupt "Sometimes ORANGE" Drunk Snake Oil Salesman has got to be replaced ... he's trying to Out McCain "John "Slim Shady" McCain