Obamacare Is NOT Similar to Members of Congress’ Health Coverage
Private Choice, Not Bureaucratic Control
Some observers have attempted to compare the health coverage offered to Members of Congress through the Federal Employee Health Benefit Program (FEHBP) and the government-run plan included in Democrat health “reform” legislation. Although FEHBP plans are heavily subsidized by the federal government and may not be a model for comprehensive reform, an analysis shows little commonalities between FEHBP and a government-run health plan:
- All federal employees participating in FEHBP receive their coverage from private plans—no so-called “public option” is necessary to create competition or enhance choice.
- Federal employees are not required to participate in any FEHBP plan, or to enroll in FEHBP at all— unlike the government-run plan, where bureaucrats could enroll individuals solely in the government-run plan. (Section 205(b)(3), pp. 69-70)
- Plans participating in FEHBP have flexibility to determine their own benefits—unlike the government-run plan, where bureaucrats on a new “Health Benefits Advisory Committee” would determine what health coverage all individuals must purchase. (Section 123(b), pp. 28-30)
- In FEHBP, plans negotiate with hospitals and doctors to determine fair reimbursement levels—unlike the government-run plan, where bureaucrats would be able to pay doctors and hospitals as little as they want, while denying physicians the right to appeal the bureaucrats’ decision to any board or court for review. (Section 223(f), pp. 96-97)
- There are no penalties for non-participation in FEHBP—unlike the government-run plan, where under the Democrats’ new regime, individuals would be taxed if they do not buy coverage that meets bureaucrats’ diktats, whether they want (or need) that coverage or not—and whether they can afford that coverage or not. (Section 401, pp. 136-40)
- Because plans within FEHBP operate at arm’s length from the federal government, there is no government pressure for carriers to deny access to life-saving treatments based on cost grounds—unlike a government-run health plan, which would face pressure to deny care to save money. As senior Obama Administration official Sherry Glied has previously written: “Health care waiting lines represent a trade-off between patient costs and capital costs.”
- Perhaps most importantly, no provision in any Democrat bill would transition existing participants in FEHBP into either the new Exchanges or the government-run health plan. Neither Democrat Members nor federal employee unions have demonstrated any desire to join a government-run health plan.
While Members of Congress receive health coverage through FEHBP, this coverage is provided through private plans—and does not include any type of government-run health plan. Moreover, the quality coverage provided to Members of Congress through FEHBP does not include the myriad bureaucratic mandates, regulations, and directives included in the government-run health plan as part of Democrats’ government takeover of health care.