RALEIGH — Health policy experts say President Donald Trump could rekindle Obamacare repeal efforts by killing the handouts insulating Congress from the program’s costs.
Critics say an executive action by former President Barack Obama is the issue. He directed the Office of Personnel Management to declare Congress a small business, letting Congress and its 13,000 employees skirt the law forcing members and workers to buy policies on Obamacare’s individual health insurance exchange.
Instead, they participate in the small business exchange intended only for companies with 50 or fewer employees. Members of Congress and their staffs receive subsidies covering up to three-fourths of their premium costs. Those subsidies aren’t available on the individual exchange.
“If Obamacare is so great, why isn’t Congress abiding by its rules? Rescinding the carve-out would expose Congress to the actual cost of Obamacare,” said Katherine Restrepo, health care policy analyst at the John Locke Foundation. “It’s certainly a way to move the ball on meaningful health care reform.”
Carolina Journal queried the 13 members of North Carolina’s congressional delegation and both U.S. senators for their positions on the congressional subsidies. Only three responded.
U.S. Rep. Virginia Foxx, R-5th District, said asserting that Congress receives a special subsidy to purchase Obamacare plans “is frankly absurd.”
Members of Congress and their staffs receive the same employer premium contributions that other federal employees receive, and that mirrors what most private-sector workers enjoy through employment-based health benefits, Foxx said.
“[Republicans are] solely responsible for forcing members of Congress and their staff onto the Obamacare exchanges” to ensure they received no special treatment, Foxx said.
Acknowledging frustrations over “the seemingly glacial pace” of repeal and replacement, Foxx said she voted more than 70 times to partially or fully repeal Obamacare.
“When President Obama first granted the special Obamacare subsidy in 2013, I was one of the first members of Congress to reject it,” said U.S. Rep. Robert Pittenger, R-9th District.
He co-sponsored the No Obamacare Subsidies for Congress Act that year. This year he helped to introduce and pass a bill to close a loophole that inadvertently gave members special consideration on health care.
Pittenger said the Senate “must be bold enough to take the same vote they took many times under President Obama [to repeal Obamacare]. We need to govern, not grandstand.”
U.S. Rep. Mark Walker, R-6th District, chairman of the influential Republican Study Committee, this year co-sponsored the American Health Care Act. It would have removed the congressional exemption from Obamacare.
On Nov. 14 Walker introduced an amendment to the House tax reform bill to eliminate the individual mandate. The mandate levies a financial penalty on those who don’t buy insurance. Spokesman Jack Minor said Walker hopes that amendment sparks renewed repeal efforts.
“We think members of Congress should have the same health care as the American people,” Minor said. Though unsure of the legal aspects of Trump rescinding the congressional exemption, he said Walker supports any measures that lead to repeal.
Skyrocketing Obamacare premiums, high co-pays and deductibles are “hurting the lower and middle class, specifically, in North Carolina,” Minor said. Terminating the individual mandate would give swift relief to those who can’t afford either Obamacare policies or the fine.
“Every Republican in Congress made a promise” to repeal Obamacare, Minor said. “It’s time for them to keep it.”
The Obama administration’s action was illegal, said Naomi Lopez Bauman, director of health care policy at the Arizona-based Goldwater Institute. But he did it to entice Congress to keep the law in place. Trump could push Congress to act if he directed OPM to move the elected officials into the same exchanges their constituents must maneuver, she said.
Congress and its employees receive “very generous benefits, and they don’t pay that much for them compared to what most people have to pay,” Lopez Bauman said. “Why should they get to live under different rules?”
Officials at 40 organizations signed a letter sent to Trump dated July 21 demanding he end the “fraud of instructing Congress to masquerade as a small business.”
Thomas Miller, a resident fellow at the Washington, D.C-based American Enterprise Institute, is skeptical. Miller, who teaches a class at Duke University School of Law, said if Trump took that action Congress simply would figure out another way to maintain the benefit.
“The idea that members of Congress are hypocrites is not a new revelation. The idea that they try to exempt themselves from the laws that apply to other people is not a new development,” Miller said.
It might be reprehensible, but Congress breaks the laws it passes all the time and gets away with it, Miller said.
“[Conservatives] need to convince people that we have a better approach to health care that does a better job. We failed to do that,” Miller said. If voters are angry, then they should elect new representatives to create a better health care system.