Ten Miles Square

Blog

April 25, 2013 12:00 PM Members of Congress Still Don’t Understand How Obamacare Works

By Aaron Carroll

There was an awesome article in Politico yesterday on how certain members of Congress are trying to come up with a plan to exempt themselves and their aides from Obamacare. Specifically, they appear to be panicking about a provision that says they need to go to the exchanges to buy their insurance.

I’m going to ignore the political implications of these negotiations, which are horrific. If they, themselves, don’t want to be under Obamacare, then how can politicians ask anyone else to be? But what concerns me even more is the fact that the arguments they are using don’t make any sense. It’s as if they don’t understand the law at all. Take this, for example:

Sen. Richard Burr (R-N.C.) said if OPM decides that the federal government doesn’t pick up “the 75 percent that they have been, then put yourself in the position of a lot of entry-level staff people who make $25,000 a year, and all of a sudden, they have a $7,000 a year health care tab? That would be devastating.”

Wow. It sure would be – if that were possible. But it took all of 5 seconds for me to go to the Kaiser reform calculator and plug in some numbers. I made up a 30-year-old single staffer, said he makes $25,000, and was looking for a single person plan. I found out that in 2014, such a plan will likely cost $3440. But this person actually makes only 217% of the poverty line (nice, Congress!) so he would qualify for a significant subsidy. Therefore, the cost to him would be only $1714. That’s not even close to the apocryphal $7000. And that’s if the federal government refused to pay for a staffer’s insurance at all! That’s not what we’re discussing here.

But perhaps Sen. Burr is worried that this staffer might be supporting a whole family, and that once again the federal government will completely stiff him. Let’s rerun the numbers for a family plan. Now that $25,000 salary would qualify the staffer for Medicaid (again, nice Congress!), because for a family of four that salary is barely over the poverty line. While this staffer would likely not have qualified before the expansion, he would now, so his insurance is free. Of course, in some states (like Sen. Burr’s North Carolina), there will be no Medicaid expansion. But that’s not because of Obamacare, that’s because some states are unwilling to implement it fully.

But all of this is almost besides the point. There’s nothing in the law that prevents Congress from paying for the insurance, and they will. Congress covers most of the cost of insurance now, just like tons of employers, and they will continue to do so in the future. This is only a change in purchasing venue for the plans. I don’t know whether the legislators interviewed for this story don’t understand the law, or are purposely making up facts about it for political gain. I also don’t know which of those two options is worse.

[Originally posted at The Incidental Economist]

Back to Home page

Aaron Carroll ,MD, is an associate professor of Pediatrics and the associate director of Children’s Health Services Research at Indiana University School of Medicine.

Comments

  • mdindy on April 25, 2013 2:41 PM:

    It's always seemed to me that explainability is one of the biggest weaknesses of Obamacare. I doubt that more than one in a thousand people can explain it beyond its broad outlines.

  • Sgt. Gym Bunny on April 25, 2013 3:16 PM:

    There’s nothing in the law that prevents Congress from paying for the insurance, and they will.

    Unless the GOP Congress Critters find a way to prevent Congress from paying for the insurance. Just like the GOP are refusing to implement the Medicaid expansions at the state level. They're a pretty damn cynical bunch, so I wouldn't put it past them. Throwing sand in the gears then blaming the mechanic...

  • boatboy_srq on April 25, 2013 3:45 PM:

    Sen. Richard Burr (R-N.C.) said if OPM decides that the federal government doesn’t pick up “the 75 percent that they have been, then put yourself in the position of a lot of entry-level staff people who make $25,000 a year, and all of a sudden, they have a $7,000 a year health care tab? That would be devastating.”

    Why yes, Senator, the federal government will be prohibited from paying the bulk of its employees' healthcare premiums. Just like repealing DOMA will require all "traditional marriages" to be immediately and irrevocably annulled, and require all hetersexuals to get gay-married within 6 months.

    /snark

    I'm beginning to wonder whether election to Congress is an automatic disqualifier for any other career besides lobbyist.

  • Fake Irishman on April 25, 2013 5:59 PM:

    The odd thing is that I believe this provision was introduced as by GOP members of the Senate HELP committee to get a cheap talking point when they expected the Dems to vote it down -- but Tom Harkin and Sherrod Brown thought it was a great idea and voted in favor -- and the provision stayed in through all the negotiations. Burr literally has no one but his own party to blame

  • westomoon on April 26, 2013 9:43 AM:

    Oh, why should this surprise us?

    We learned yesterday that senior members of both parties had no idea how the sequester -- which they enacted and have been playing chicken ever since -- with would work in practice. Not only have they apparently never read it, they haven't even bothered to let one of those $25K a year staffers explain it to them.

    They are amazed and horrified that air traffic has been affected. Maybe if they'd passed an appropriations bill since 2008, they'd have remembered that the FAA is part of the Federal government...