SC Congressmen Shop for Health Coverage

9:27 PM, Dec 10, 2013   |    comments
Lindsey Graham (left), Tim Scott (Getty Images)
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By Mary Orndorff Troyan, Gannett Washington Bureau

WASHINGTON - South Carolina's senators have purchased health insurance from marketplaces set up under the Affordable Care Act and have opted not to continue receiving federal help to pay for their coverage.

The 2010 law bars members of Congress from remaining insured by the Federal Employees Health Benefit Program, which covers federal employees. As a result, the lawmakers had to find private coverage on one of the online exchanges or find alternate insurance. Their deadline for making a decision was Monday night.

Republican Sen. Lindsey Graham enrolled in a private plan through HealthCare.gov, the federal online marketplace that serves South Carolina and 35 other states. Republican Sen. Tim Scott enrolled through DC Health Link, the marketplace set up by the District of Columbia.

How the Affordable Care Act affects members of Congress and their staffs has been a source of controversy over the last three years. Rather than exempt them from the law, as some have claimed, Congress intentionally made sure the law would affect lawmakers and their aides even more directly. It requires them to give up their coverage under the Federal Employees Health Benefit Program and to shop for coverage on the marketplaces.

In the past, the Federal Employees Health Benefit Program subsidized the cost of the lawmakers' coverage, the same way large companies pay most of the cost of their workers' insurance. The Affordable Care Act didn't specify that lawmakers would have to give up that employer contribution when they purchased insurance through the marketplace, but conservatives have tried several times to eliminate it. Those efforts have failed. Now, some members are giving up the subsidy voluntarily.

Graham and Scott, both unmarried, have declined to continue receiving the employer contribution, which covers about 75 percent of each federal employee's insurance premium.

"I don't think members of Congress should get a special deal," Graham said in a statement announcing his decision.

A Washington Post survey found several members of Congress - Republicans and Democrats - have rejected the employer contribution. Most members have purchased coverage through one of the online marketplaces, but several are covered under their spouse's insurance plan, Medicare, or another private or public plan.

Rep. Trey Gowdy, R-Spartanburg, will remain on his spouse's insurance plan, according to his spokeswoman.

Rep. Jeff Duncan, R-Laurens, purchased coverage through DC Health Link last week and will receive the employer contribution, his spokesman said. Duncan said his premiums, deductibles and annual out-of-pocket costs all have increased, and he was able to choose a plan that does not include coverage for abortions.

Rep. Mick Mulvaney, R-Indian Land, said purchasing a plan through the DC Health Link was "not a pleasant experience" because his premiums are higher and he was unable to confirm whether all of his family's doctors participate in the new plan. Like Graham and Scott, Mulvaney is rejecting the employer contribution.

Rep. Mark Sanford, R-Charleston, and Rep. James Clyburn, D-Columbia, also purchased coverage through the DC exchange and are accepting the employer contribution.

Some members of Congress believe the Affordable Care Act allows their staffs to remain on the Federal Employees Health Benefit Program. But spokesmen for Graham, Scott, Gowdy, Duncan, Mulvaney, Sanford and Clyburn said their office employees who were on that plan will buy insurance through the DC exchange or seek alternatives.

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