{"id":1421,"date":"2013-09-30T06:30:09","date_gmt":"2013-09-30T10:30:09","guid":{"rendered":"http:\/\/www.dougsbriefcase.com\/blog\/?p=1421"},"modified":"2013-10-02T07:06:30","modified_gmt":"2013-10-02T11:06:30","slug":"congress-getting-special-deal-obamacare","status":"publish","type":"post","link":"https:\/\/www.dougsbriefcase.com\/blog\/congress-getting-special-deal-obamacare\/","title":{"rendered":"Congress <span class=\"caps\">IS<\/span> Getting a Special Deal Under Obamacare"},"content":{"rendered":"<p><\/p><div id=\"attachment_1424\" style=\"width: 227px\" class=\"wp-caption alignleft\"><a href=\"https:\/\/i0.wp.com\/www.dougsbriefcase.com\/blog\/wp-content\/uploads\/2013\/09\/Credit-Getty-Images.jpg\"><img data-recalc-dims=\"1\" decoding=\"async\" aria-describedby=\"caption-attachment-1424\" loading=\"lazy\" class=\"size-medium wp-image-1424 \" alt=\"The Obama Administration cut Congress a break when it allowed them to keep their health insurance subsidies.  Will Congress at some point be forced to vote on that special deal? [Credit: Getty Images]\" src=\"https:\/\/i0.wp.com\/www.dougsbriefcase.com\/blog\/wp-content\/uploads\/2013\/09\/Credit-Getty-Images.jpg?resize=217%2C300\" width=\"217\" height=\"300\" srcset=\"https:\/\/i0.wp.com\/www.dougsbriefcase.com\/blog\/wp-content\/uploads\/2013\/09\/Credit-Getty-Images.jpg?resize=217%2C300&amp;ssl=1 217w, https:\/\/i0.wp.com\/www.dougsbriefcase.com\/blog\/wp-content\/uploads\/2013\/09\/Credit-Getty-Images.jpg?w=232&amp;ssl=1 232w\" sizes=\"auto, (max-width: 217px) 100vw, 217px\"><\/a><p id=\"caption-attachment-1424\" class=\"wp-caption-text\">The Oba\u00adma Admin\u00adis\u00adtra\u00adtion cut Con\u00adgress a break when it allowed them to keep their health insur\u00adance sub\u00adsi\u00addies. Will&nbsp;that spe\u00adcial deal prove polit\u00adi\u00adcal\u00adly viable? &nbsp;[Cred\u00adit: Get\u00adty Images]<\/p><\/div><em>[Updat\u00aded Octo\u00adber 1,&nbsp;2013]<\/em>\n<p>The new health care exchanges opened for busi\u00adness today, even as most fed\u00ader\u00adal gov\u00adern\u00adment oper\u00ada\u00adtions shut&nbsp;down.<\/p>\n<p>That result&nbsp;is exact\u00adly the oppo\u00adsite of what House Repub\u00adli\u00adcans intend\u00aded when they set\u00adtled on their strat\u00ade\u00adgy of link\u00ading gov\u00adern\u00adment fund\u00ading with Oba\u00admacare \u201cdefund\u00ading.\u201d They insist\u00aded that their tac\u00adtics would keep the gov\u00adern\u00adment open while stop\u00adping the health law in its tracks, though nei\u00adther Sen\u00adate Democ\u00adrats nor the Pres\u00adi\u00addent seem inclined to go&nbsp;along.<!--more--><\/p>\n<p>Con\u00adgress will find&nbsp;some way to mud\u00addle through. Then&nbsp;what?<\/p>\n<p>In defend\u00ading their \u201cdefund\u00ading\u201d strat\u00ade\u00adgy, con\u00adser\u00adv\u00ada\u00adtives argued that they had to stop Oba\u00admacare before today. Once peo\u00adple began to sign up for sub\u00adsi\u00addized health care cov\u00ader\u00adage, they rea\u00adsoned, the health law would stand for\u00adev\u00ader. For\u00adev\u00ader, it appears, has now&nbsp;begun.<\/p>\n<p>But the law\u2019s harsh\u00adest crit\u00adics will not like\u00adly retire to the side\u00adlines. They will con\u00adtin\u00adue to resist&nbsp;its imple\u00admen\u00adta\u00adtion and work for its repeal. They may also tar\u00adget spe\u00adcif\u00adic pro\u00advi\u00adsions of the law they despise. One such tar\u00adget is sub\u00adsi\u00addized health insur\u00adance cov\u00ader\u00adage for Mem\u00adbers of Con\u00adgress and their staffs.<\/p>\n<p>Con\u00adgres\u00adsion\u00adal employ\u00adees, like oth\u00ader fed\u00ader\u00adal work\u00aders, cur\u00adrent\u00adly par\u00adtic\u00adi\u00adpate in&nbsp;the Fed\u00ader\u00adal Employ\u00adees Health Ben\u00ade\u00adfit plan (<span class=\"caps\">FEHB<\/span>). The health care law requires Con\u00adgres\u00adsion\u00adal employ\u00adees, begin\u00adning Jan\u00adu\u00adary 1, to instead obtain their cov\u00ader\u00adage through health insur\u00adance exchanges (<a title=\"Link to PPACA text\" href=\"http:\/\/www.govtrack.us\/congress\/bills\/111\/hr3590\/text\" target=\"_blank\">1312(d)(3)(D)). <\/a>The plain read\u00ading of this pro\u00advi\u00adsion and accom\u00adpa\u00adny\u00ading law requires them to pay full price for their health care and to relin\u00adquish their gov\u00adern\u00adment sub\u00adsi\u00addies that pick up, on aver\u00adage, 72 per\u00adcent of the cost of their insurance.<\/p>\n<p>But the Office of Per\u00adson\u00adnel Man\u00adage\u00adment (<span class=\"caps\">OPM<\/span>) issued a <a title=\"Link to OPM rule\" href=\"https:\/\/s3.amazonaws.com\/public-inspection.federalregister.gov\/2013-19222.pdf\" target=\"_blank\">rule<\/a>&nbsp;in ear\u00adly August&nbsp;that allows Con\u00adgres\u00adsion\u00adal work\u00aders to keep their gov\u00adern\u00adment sub\u00adsi\u00addies while in the exchanges.<\/p>\n<p>The rule has proven unpop\u00adu\u00adlar with the pub\u00adlic, with one poll find\u00ading that <a title=\"Link to Forbes article citing poll data\" href=\"http:\/\/www.forbes.com\/sites\/carrielukas\/2013\/09\/18\/as-congress-and-its-staffers-try-to-weasel-out-of-obamacare-americans-smell-a-rat\" target=\"_blank\">92 per\u00adcent <\/a>object to their elect\u00aded rep\u00adre\u00adsen\u00adta\u00adtives being giv\u00aden spe\u00adcial treat\u00adment in the exchanges. The provision\u2019s unpop\u00adu\u00adlar\u00adi\u00adty prompt\u00aded David Vit\u00adter (R\u2011<span class=\"caps\">LA<\/span>) to pro\u00adpose an <a title=\"Link to Vitter amendment text\" href=\"http:\/\/thomas.loc.gov\/cgi-bin\/query\/F?r113:1:.\/temp\/~r113hIk20H:e59519:\" target=\"_blank\">amend\u00adment<\/a> to over\u00adturn the <span class=\"caps\">OPM<\/span> rule and require the Pres\u00adi\u00addent, Vice Pres\u00adi\u00addent and polit\u00adi\u00adcal&nbsp;appointees also to&nbsp;pur\u00adchase unsub\u00adsi\u00addized cov\u00ader\u00adage through the exchanges.&nbsp; Vitter\u2019s amend\u00adment was so polit\u00adi\u00adcal\u00adly tox\u00adic that Sen\u00adate Major\u00adi\u00adty Leader Har\u00adry Reid (D\u2011<span class=\"caps\">NV<\/span>) with\u00addrew the under\u00adly\u00ading bill from Sen\u00adate con\u00adsid\u00ader\u00ada\u00adtion to spare his col\u00adleagues from hav\u00ading to vote on&nbsp;Vit\u00adter\u2019s language.<\/p>\n<p>But in the hours before the gov\u00adern\u00adment shut\u00addown, both the House and Sen\u00adate vot\u00aded on a Vit\u00adter-like pro\u00advi\u00adsion.&nbsp;&nbsp;Con\u00adgres\u00adsion\u00adal Democ\u00adrats vot\u00aded over\u00adwhelm\u00ading\u00adly against it, argu\u00ading that a res\u00ado\u00adlu\u00adtion to keep the gov\u00adern\u00adment func\u00adtion\u00ading should not include what they regard as extra\u00adne\u00adous provisions.<\/p>\n<p>They may come to regret that vote, par\u00adtic\u00adu\u00adlar\u00adly as details emerge about secret nego\u00adti\u00ada\u00adtions involv\u00ading Reid, Speak\u00ader Boehn\u00ader and the White House that occurred over the course of months.&nbsp; <a title=\"Link to Politico story\" href=\"http:\/\/www.politico.com\/story\/2013\/10\/john-boehner-hill-obamacare-subsidies-97634.html\" target=\"_blank\">Politi\u00adco<\/a> has unearthed email traf\u00adfic indi\u00adcat\u00ading that <span class=\"caps\">OPM<\/span> ini\u00adtial\u00adly decid\u00aded that Con\u00adgres\u00adsion\u00adal employ\u00adees did\u00adn\u2019t qual\u00adi\u00adfy for sub\u00adsi\u00addies.&nbsp; That stirred rare bipar\u00adti\u00adsan and bicam\u00ader\u00adal efforts to lob\u00adby the White House to reverse the agen\u00adcy\u2019s deci\u00adsion.&nbsp; At one point, Reid and the Speak\u00ader were to meet pri\u00advate\u00adly with the Pres\u00adi\u00addent on the mat\u00adter.&nbsp; All par\u00adties agreed to tell the press that&nbsp;the meet\u00ading con\u00adcerned immi\u00adgra\u00adtion in order to con\u00adceal its true pur\u00adpose.&nbsp; While it nev\u00ader occurred, dis\u00adcus\u00adsions with the White House Chief of Staff even\u00adtu\u00adal\u00adly result\u00aded in&nbsp;<span class=\"caps\">OPM<\/span> revers\u00ading its decision.<\/p>\n<p>An&nbsp;amend\u00adment to undo the deal is like\u00adly to re-emerge in some form in the days ahead. Its crit\u00adics have offered good argu\u00adments and bad for oppos\u00ading it. The bet\u00adter argu\u00adments say that this spe\u00adcial deal is a good thing, since Mem\u00adbers and their aides shouldn\u2019t lose their gov\u00adern\u00adment sub\u00adsi\u00addies based on what the provision\u2019s spon\u00adsor acknowl\u00adedges to be a <a title=\"Link to article with Grassley quote\" href=\"http:\/\/blogs.rollcall.com\/wgdb\/grassley-frustrated-by-fight-over-his-health-care-amendment\/\" target=\"_blank\">poor\u00adly draft\u00aded<\/a> pro\u00advi\u00adsion of law. The poor\u00ader argu\u00adments sug\u00adgest that Con\u00adgress is not get\u00adting a spe\u00adcial deal at all, argu\u00adments that look increas\u00ading\u00adly ridicu\u00adlous in view of the rev\u00ade\u00adla\u00adtions in Politico.<\/p>\n<p>That argu\u00adment nev\u00ader\u00adthe\u00adless per\u00adsists.&nbsp; It was recent\u00adly advanced by Prince\u00adton Uni\u00adver\u00adsi\u00adty Pro\u00adfes\u00adsor Uwe Rein\u00adhardt on&nbsp;a&nbsp;<em>New York Times<\/em>&nbsp;<a title=\"Link to Reinhardt blog\" href=\"http:\/\/economix.blogs.nytimes.com\/2013\/09\/27\/a-health-care-fight-that-punishes-federal-workers\" target=\"_blank\">blog<\/a>.&nbsp; Rein\u00adhardt lays out for his read\u00aders the <a title=\"Link to PPACA text\" href=\"http:\/\/www.govtrack.us\/congress\/bills\/111\/hr3590\/text\" target=\"_blank\">text<\/a> of the pro\u00advi\u00adsion bar\u00adring Con\u00adgres\u00adsion\u00adal employ\u00adees from par\u00adtic\u00adi\u00adpat\u00ading in the&nbsp;<span class=\"caps\">FEHB<\/span>:<\/p>\n<blockquote><p>(D) <span class=\"caps\">MEMBERS<\/span> <span class=\"caps\">OF<\/span> <span class=\"caps\">CONGRESS<\/span> <span class=\"caps\">IN<\/span> <span class=\"caps\">THE<\/span> <span class=\"caps\">EXCHANGE<\/span>.<\/p>\n<p>(i) <span class=\"caps\">REQUIREMENT<\/span>. Notwith\u00adstand\u00ading any oth\u00ader pro\u00advi\u00adsion of law, after the effec\u00adtive date of this sub\u00adti\u00adtle, the only health plans that the Fed\u00ader\u00adal Gov\u00adern\u00adment may make avail\u00adable to mem\u00adbers of Con\u00adgress and con\u00adgres\u00adsion\u00adal staff with respect to their ser\u00advice as a mem\u00adber of Con\u00adgress or con\u00adgres\u00adsion\u00adal staff shall be health plans that&nbsp;are:<\/p>\n<p>(I) cre\u00adat\u00aded under this act (or an amend\u00adment made by this act); or (<span class=\"caps\">II<\/span>) offered through an exchange estab\u00adlished under this act (or an amend\u00adment made by this&nbsp;act).<\/p>\n<p>(ii) <span class=\"caps\">DEFINITIONS<\/span>. In this section:<\/p>\n<p>(I) <span class=\"caps\">MEMBERS<\/span> <span class=\"caps\">OF<\/span> <span class=\"caps\">CONGRESS<\/span>. The term \u201cmem\u00adber of Con\u00adgress\u201d means any mem\u00adber of the House of Rep\u00adre\u00adsen\u00adta\u00adtives or the Senate.<\/p>\n<p>(<span class=\"caps\">II<\/span>) <span class=\"caps\">CONGRESSIONAL<\/span> <span class=\"caps\">STAFF<\/span>. The term \u201ccon\u00adgres\u00adsion\u00adal staff\u201d means all full-time and part-time employ\u00adees employed by the offi\u00adcial office of a mem\u00adber of Con\u00adgress, whether in Wash\u00ading\u00adton, D.C., or out\u00adside Wash\u00ading\u00adton, D.C.<\/p><\/blockquote>\n<p>Rein\u00adhardt&nbsp;<a title=\"Link to Reinhardt blog\" href=\"http:\/\/economix.blogs.nytimes.com\/2013\/09\/27\/a-health-care-fight-that-punishes-federal-workers\" target=\"_blank\">argues<\/a> that the sec\u00adtion itself is silent on whether Con\u00adgres\u00adsion\u00adal employ\u00adees can receive subsidies:<\/p>\n<blockquote><p><span class=\"dquo\">\u201c<\/span>Does it state in the sec\u00adtion that the fed\u00ader\u00adal gov\u00adern\u00adment may not con\u00adtin\u00adue to make the tra\u00addi\u00adtion\u00adal employ\u00ader-pro\u00advid\u00aded con\u00adtri\u00adbu\u00adtions to the tar\u00adget\u00aded employ\u00adees\u2019 health insur\u00adance? As I read this short sec\u00adtion, it says absolute\u00adly noth\u00ading about this&nbsp;issue.\u201d<\/p><\/blockquote>\n<p>Actu\u00adal\u00adly, it says a good deal about the issue:&nbsp;\u201cnotwith\u00adstand\u00ading any oth\u00ader pro\u00advi\u00adsion of law\u201d \u2013&nbsp;in par\u00adtic\u00adu\u00adlar,&nbsp;the law that makes&nbsp;them eli\u00adgi\u00adble&nbsp;for&nbsp;<span class=\"caps\">FEHB<\/span> cov\u00ader\u00adage and sub\u00adsi\u00addies&nbsp;\u2013 Con\u00adgres\u00adsion\u00adal employ\u00adees must look else\u00adwhere for their health cov\u00ader\u00adage. The bur\u00adden is on Pro\u00adfes\u00adsor Rein\u00adhardt to show that Con\u00adgres\u00adsion\u00adal employ\u00adees can both be ban\u00adished from the <span class=\"caps\">FEHB<\/span> and&nbsp;enti\u00adtled to its sub\u00adsi\u00addies. He makes no effort to do that beyond cit\u00ading a <a title=\"Link to CRS paper\" href=\"http:\/\/oneillshare.org\/Public%20Documents\/NHeLP\/crs-on-health-care-fines.pdf\" target=\"_blank\">Con\u00adgres\u00adsion\u00adal Research Ser\u00advice<\/a> paper that is, on close exam\u00adi\u00adna\u00adtion, at best ambigu\u00adous on the subject.<\/p>\n<p>The ques\u00adtion that Pro\u00adfes\u00adsor Rein\u00adhardt side\u00adsteps is the crit\u00adi\u00adcal one: \u201cBy what legal author\u00adi\u00adty can the fed\u00ader\u00adal gov\u00adern\u00adment sub\u00adsi\u00addize indi\u00advid\u00adual cov\u00ader\u00adage that its employ\u00adees obtain through exchanges?\u201d<\/p>\n<p>Oth\u00aders have more direct\u00adly addressed this ques\u00adtion, though&nbsp;not with&nbsp;con\u00advinc\u00ading results. <a title=\"Link to Bagley blog\" href=\"http:\/\/theincidentaleconomist.com\/wordpress\/explaining-the-administrations-proposed-rule-for-the-congressional-staffer-obamacare-fix\/\" target=\"_blank\">Nicholas Bagley<\/a><span class=\"quo\">,<\/span> a Uni\u00adver\u00adsi\u00adty of Michi\u00adgan Law Pro\u00adfes\u00adsor, has writ\u00adten on the Inci\u00adden\u00adtal Econ\u00ado\u00admist blog that the <span class=\"caps\">FEHB<\/span> statute itself allows Con\u00adgres\u00adsion\u00adal employ\u00adees who enroll in cov\u00ader\u00adage through health insur\u00adance exchanges to keep their <span class=\"caps\">FEHB<\/span> sub\u00adsi\u00addies.&nbsp; He cites <a title=\"Link to 5 USC 8901\" href=\"http:\/\/www.law.cornell.edu\/uscode\/text\/5\/8901\" target=\"_blank\">5 <span class=\"caps\">USC<\/span> 8901(6), <\/a>which defines \u201chealth ben\u00ade\u00adfits plan\u201d for pur\u00adpos\u00ades of the <span class=\"caps\">FEHB<\/span>, argu\u00ading that indi\u00advid\u00adual health plans pur\u00adchased through the exchanges meet this def\u00adi\u00adn\u00adi\u00adtion and that Con\u00adgres\u00adsion\u00adal employ\u00adees who enroll in such plans can there\u00adfore receive gov\u00adern\u00adment subsidies.<\/p>\n<p><span class=\"caps\">OPM<\/span>, in its <a title=\"Link to OPM rule\" href=\"https:\/\/s3.amazonaws.com\/public-inspection.federalregister.gov\/2013-19222.pdf\" target=\"_blank\">rule<\/a><span class=\"quo\">,<\/span> made a sim\u00adi\u00adlar assertion.<\/p>\n<blockquote><p><span class=\"dquo\">\u201c<\/span>Although, pur\u00adsuant to its author\u00adi\u00adty under chap\u00adter 89 of title 5, <span class=\"caps\">OPM<\/span> will have no role in \u2018con\u00adtract\u00ading for\u2019 or \u2018approv\u00ading\u2019 health ben\u00ade\u00adfit plans that are offered through the Exchanges, there is no doubt that such plans fit with\u00adin the def\u00adi\u00adn\u00adi\u00adtion of \u2018health ben\u00ade\u00adfit plan\u2019 under 8901(6). \u201d<\/p><\/blockquote>\n<p>Note that the agency acknowl\u00adedges some of the anom\u00adalies in&nbsp;its approach, since the law makes no pro\u00advi\u00adsion for sub\u00adsi\u00addiz\u00ading cov\u00ader\u00adage pro\u00advid\u00aded by plans that <span class=\"caps\">OPM<\/span> has nei\u00adther con\u00adtract\u00aded with nor approved.&nbsp; The&nbsp;legal basis for its deci\u00adsion rests entire\u00adly on its asser\u00adtion that indi\u00advid\u00adual plans sold through exchanges meet the statu\u00adto\u00adry def\u00adi\u00adn\u00adi\u00adtion of \u201chealth ben\u00ade\u00adfit plan.\u201d&nbsp;&nbsp;A care\u00adful&nbsp;read\u00ading of that pro\u00advi\u00adsion leaves no doubt that&nbsp;such plans do <em><strong>not<\/strong><\/em> meet that def\u00adi\u00adn\u00adi\u00adtion. &nbsp;Here is the pro\u00advi\u00adsion <a title=\"Link to 5 USC 8901\" href=\"http:\/\/www.law.cornell.edu\/uscode\/text\/5\/8901\" target=\"_blank\">(5 <span class=\"caps\">USC<\/span> 8901(6)):<\/a><\/p>\n<blockquote><p>&nbsp;\u201c(6) \u2018health ben\u00ade\u00adfits plan\u2019 means a group insur\u00adance pol\u00adi\u00adcy or con\u00adtract, med\u00adical or hos\u00adpi\u00adtal ser\u00advice agree\u00adment, mem\u00adber\u00adship or sub\u00adscrip\u00adtion con\u00adtract, or sim\u00adi\u00adlar group arrange\u00adment pro\u00advid\u00aded by a car\u00adri\u00ader for the pur\u00adpose of pro\u00advid\u00ading, pay\u00ading for, or reim\u00adburs\u00ading expens\u00ades for health services.\u201d<\/p><\/blockquote>\n<p>Note that the def\u00adi\u00adn\u00adi\u00adtion refers to a \u201c<em><strong>group<\/strong><\/em> insur\u00adance pol\u00adi\u00adcy or con\u00adtract\u201d or \u201csim\u00adi\u00adlar <em><strong>group<\/strong><\/em> arrange\u00adment.\u201d Plans sold through the exchanges are <em><strong>indi\u00advid\u00adual<\/strong><\/em> poli\u00adcies. They are not group plans. As such they do not \u2014 and can\u00adnot, absent a change in the law \u2014 meet the def\u00adi\u00adn\u00adi\u00adtion of \u201chealth ben\u00ade\u00adfits plan\u201d and there\u00adfore can\u00adnot be eli\u00adgi\u00adble for subsidies.<\/p>\n<p>Pro\u00advid\u00ading sub\u00adsi\u00addies for indi\u00advid\u00adual plans pur\u00adchased through the exchanges would run afoul of oth\u00ader legal require\u00adments of the <span class=\"caps\">FEHB<\/span> pro\u00adgram. To&nbsp;qual\u00adi\u00adfy as a \u201chealth ben\u00ade\u00adfits plan,\u201d a health insur\u00adance pol\u00adi\u00adcy must be issued by a&nbsp;\u201ccar\u00adri\u00ader.\u201d&nbsp; A \u201ccar\u00adri\u00ader,\u201d is defined as an enti\u00adty that issues \u201cgroup insur\u00adance poli\u00adcies or con\u00adtracts\u201d&nbsp;<a title=\"Link to 5 USC 8901\" href=\"http:\/\/www.law.cornell.edu\/uscode\/text\/5\/8901\" target=\"_blank\">(5 <span class=\"caps\">USC<\/span> 8901(7))<\/a><span class=\"quo\">,<\/span> a def\u00adi\u00adn\u00adi\u00adtion that insur\u00aders sell\u00ading through exchanges do not meet.&nbsp;&nbsp;Sec\u00adtion <a title=\"Link to 5 USC 8903\" href=\"http:\/\/www.law.cornell.edu\/uscode\/text\/5\/8903\" target=\"_blank\">8903<\/a> lists the vari\u00adeties of \u201chealth ben\u00ade\u00adfits plans\u201d for which <span class=\"caps\">OPM<\/span> may con\u00adtract; plans sold through the exchanges do not fall into any of these categories.<\/p>\n<p><a title=\"Link to 5 USC 8906\" href=\"http:\/\/www.law.cornell.edu\/uscode\/text\/5\/8906\" target=\"_blank\">5 <span class=\"caps\">USC<\/span> 8906<\/a> seals the argu\u00adment when it pro\u00advides that the gov\u00adern\u00adment can con\u00adtribute to pre\u00admi\u00adums only for \u201chealth ben\u00ade\u00adfits for an employ\u00adee or annu\u00adi\u00adtant enrolled in a health ben\u00ade\u00adfits plan under this chap\u00adter.\u201d Because of Oba\u00admacare, Con\u00adgres\u00adsion\u00adal employ\u00adees are inel\u00adi\u00adgi\u00adble to enroll in health ben\u00ade\u00adfits plans \u201cunder this chap\u00adter\u201d \u2013 that is, under the <span class=\"caps\">FEHB<\/span>. They there\u00adfore can\u00adnot ben\u00ade\u00adfit from gov\u00adern\u00adment subsidies.<\/p>\n<p><a title=\"Link to 5 USC 8909\" href=\"http:\/\/www.law.cornell.edu\/uscode\/text\/5\/8909\" target=\"_blank\">5 <span class=\"caps\">USC<\/span> 8909<\/a> cre\u00adates a spe\u00adcial fund in the Trea\u00adsury to col\u00adlect and dis\u00adburse pre\u00admi\u00adums and gov\u00adern\u00adment con\u00adtri\u00adbu\u00adtions to health plans.&nbsp; Dis\u00adburse\u00adments from this fund can only be&nbsp;used&nbsp;to cov\u00ader the&nbsp;agen\u00adcy\u2019s admin\u00adis\u00adtra\u00adtive costs and to \u201cmake pay\u00adments to approved health ben\u00ade\u00adfits plans\u201d (5 <span class=\"caps\">USC<\/span> 8909(a)(1)).&nbsp;&nbsp;<a title=\"Link to OPM rule\" href=\"https:\/\/s3.amazonaws.com\/public-inspection.federalregister.gov\/2013-19222.pdf\" target=\"_blank\"><span class=\"caps\">OPM<\/span> acknowl\u00adedged <\/a>in its rule&nbsp;that it has not \u201capproved\u201d health insur\u00adance plans sold through the exchanges.&nbsp; It is there\u00adfore ille\u00adgal for <span class=\"caps\">OPM<\/span> to make pay\u00adments to health plans offered through the exchanges.<\/p>\n<p>In short, OPM\u2019s deci\u00adsion to pro\u00advide&nbsp;a polit\u00adi\u00adcal\u00adly favored class with sub\u00adsi\u00addies for non-group health insur\u00adance cov\u00ader\u00adage is entire\u00adly con\u00adtrary to&nbsp;law.<\/p>\n<p>That <span class=\"caps\">OPM<\/span> bent and twist\u00aded the rules to pro\u00advide Con\u00adgres\u00adsion\u00adal employ\u00adees with these sub\u00adsi\u00addies is abun\u00addant\u00adly clear in oth\u00ader ways. The agency acknowl\u00adedged in its <a title=\"Link to OPM Q&amp;A\" href=\"http:\/\/www.opm.gov\/retirement-services\/publications-forms\/benefits-administration-letters\/2013\/13-204attachment2.pdf\" target=\"_blank\">Q<span class=\"amp\">&amp;<\/span>A doc\u00adu\u00adment <\/a>explain\u00ading the rule that&nbsp;Oba\u00admacare \u201cpro\u00adhibits an employ\u00ader from pro\u00advid\u00ading a qual\u00adi\u00adfied health plan through an Exchange,\u201d the very&nbsp;arrange\u00adment that <span class=\"caps\">OPM<\/span> is sanc\u00adtion\u00ading for Con\u00adgres\u00adsion\u00adal employ\u00adees.&nbsp;&nbsp;<span class=\"caps\">OPM<\/span> sim\u00adply declares that this restric\u00adtion does not apply to the fed\u00ader\u00adal gov\u00adern\u00adment with respect to its Con\u00adgres\u00adsion\u00adal employ\u00adees, again with\u00adout offer\u00ading any legal justification.<\/p>\n<p>More\u00adover, the only sub\u00adsi\u00addies avail\u00adable through the indi\u00advid\u00adual exchanges are income-relat\u00aded.&nbsp; This rule gives Con\u00adgres\u00adsion\u00adal employ\u00adees anoth\u00ader spe\u00adcial excep\u00adtion.&nbsp;&nbsp;Mem\u00adbers of Con\u00adgress earn rough\u00adly four times the income lim\u00adit for exchange sub\u00adsi\u00addies, yet will receive sub\u00adsi\u00addies that will be greater, on aver\u00adage, than those who earn as lit\u00adtle as $34,000 annually.<\/p>\n<p><span class=\"caps\">OPM<\/span> also has to con\u00adtort the sub\u00adsi\u00addies them\u00adselves to make them work in the exchanges. The <span class=\"caps\">FEHB<\/span> uses pure com\u00admu\u00adni\u00adty rat\u00ading \u2013 two employ\u00adees who sign up for the same plan pay the same pre\u00admi\u00adum regard\u00adless of their age. Exchange-rat\u00aded plans, how\u00adev\u00ader, will charge the old\u00adest enrollees pre\u00admi\u00adums that are three times as large as those paid by the youngest enrollees. Will Con\u00adgres\u00adsion\u00adal employ\u00adees be forced to com\u00adply with the 3:1 ratio or will insur\u00aders have to charge them a pure\u00adly com\u00admu\u00adni\u00adty-rat\u00aded pre\u00admi\u00adum? If they com\u00adply with the 3:1 ratio, how will sub\u00adsi\u00addies be com\u00adput\u00aded? Will old\u00ader work\u00aders be forced to pay more for their cov\u00ader\u00adage or will the gov\u00adern\u00adment give them larg\u00ader sub\u00adsi\u00addies than younger employees?<\/p>\n<p>Prac\u00adti\u00adcal prob\u00adlems engen\u00addered by this agency dis\u00adtor\u00adtion abound. <span class=\"caps\">OPM<\/span> deter\u00admines pre\u00admi\u00adum sub\u00adsi\u00addies by com\u00adput\u00ading the \u201cweight\u00aded aver\u00adage of the pre\u00admi\u00adums that will be in effect dur\u00ading the fol\u00adlow\u00ading con\u00adtract year with respect to: (A) enroll\u00adments under this chap\u00adter for self alone; and (B) enroll\u00adments under this chap\u00adter for self and fam\u00adi\u00adly\u201d (<a title=\"Link to 5 USC 8906\" href=\"http:\/\/www.law.cornell.edu\/uscode\/text\/5\/8906\" target=\"_blank\">5 <span class=\"caps\">USC<\/span> 8906<\/a>).&nbsp; Since <span class=\"caps\">OPM<\/span> has no con\u00adtracts with insur\u00aders who sell through the exchanges,&nbsp;those pre\u00admi\u00adums do not fig\u00adure into&nbsp;the \u201cweight\u00aded aver\u00adage\u201d cal\u00adcu\u00adla\u00adtion, ren\u00adder\u00ading the process for deter\u00admin\u00ading sub\u00adsi\u00addies arbi\u00adtrary and uncertain.<\/p>\n<p>And speak\u00ading of con\u00adtracts, <a title=\"Link to 5 USC 8909\" href=\"http:\/\/www.law.cornell.edu\/uscode\/text\/5\/8909 \" target=\"_blank\">5 <span class=\"caps\">USC<\/span> 8909<\/a> pro\u00advides author\u00adi\u00adty for <span class=\"caps\">OPM<\/span> to pay sub\u00adsi\u00addies on behalf of its employ\u00adees to the plans with which it has con\u00adtract\u00aded. Legal prob\u00adlems aside, how, exact\u00adly, will it make month\u00adly pay\u00adments to mul\u00adti\u00adple insur\u00aders scat\u00adtered through\u00adout the coun\u00adtry whose con\u00adtracts are with exchanges and not with <span class=\"caps\">OPM<\/span>?&nbsp; Con\u00adgres\u00adsion\u00adal employ\u00adees&nbsp;do not all work and live&nbsp;in Wash\u00ading\u00adton.&nbsp;&nbsp;Mem\u00adbers main\u00adtain offices and employ staff in every state and Con\u00adgres\u00adsion\u00adal dis\u00adtrict.&nbsp;&nbsp;They will be&nbsp;enrolling in plans offered through vir\u00adtu\u00adal\u00adly every exchange in the coun\u00adtry, cre\u00adat\u00ading a logis\u00adti\u00adcal night\u00admare for an agency that will have to&nbsp;dis\u00adburse pre\u00admi\u00adums and sub\u00adsi\u00addies on a month\u00adly or bi-week\u00adly basis to numer\u00adous plans with which&nbsp;it has&nbsp;no con\u00adtrac\u00adtu\u00adal rela\u00adtion\u00adship.&nbsp;&nbsp;It\u2019s worth not\u00ading&nbsp;that <a title=\"Link to Roll Call piece\" href=\"http:\/\/blogs.rollcall.com\/wgdb\/senators-staff-told-not-to-enroll-in-obamacare-exchanges-yet\/\" target=\"_blank\">Sen\u00adate employ\u00adees have been asked to delay sign\u00ading up <\/a>for plans sold through the exchanges, per\u00adhaps to give <span class=\"caps\">OPM<\/span> and those who admin\u00adis\u00adter employ\u00adee ben\u00ade\u00adfits for Con\u00adgres\u00adsion\u00adal employ\u00adees addi\u00adtion\u00adal time to&nbsp;fig\u00adure all&nbsp;this&nbsp;out.<\/p>\n<p>This is, in short, a spe\u00adcial deal for Con\u00adgres\u00adsion\u00adal employ\u00adees that required a fed\u00ader\u00adal agency to twist the law, bend its reg\u00adu\u00adla\u00adtions, and dis\u00adtort the very nature of the <span class=\"caps\">FEHB<\/span> pro\u00adgram in order to pro\u00advide gov\u00adern\u00adment sub\u00adsi\u00addies to some very pow\u00ader\u00adful and influ\u00aden\u00adtial people.<\/p>\n<p>This offends many people\u2019s sense of fair\u00adness. They expect&nbsp;Mem\u00adbers to abide by the laws they enact. But is it fair to take gov\u00adern\u00adment sub\u00adsi\u00addies away from hard-work\u00ading Con\u00adgres\u00adsion\u00adal employ\u00adees sim\u00adply because of what the provision\u2019s spon\u00adsor, Sen\u00ada\u00adtor Charles Grass\u00adley (R\u2011<span class=\"caps\">IA<\/span>), describes as a \u201c<a title=\"Link to Grassley quote\" href=\"http:\/\/blogs.rollcall.com\/wgdb\/grassley-frustrated-by-fight-over-his-health-care-amendment\/\" target=\"_blank\">draft\u00ading error<\/a>\u201d made by Demo\u00adc\u00adra\u00adt\u00adic aides?&nbsp; His leg\u00adis\u00adla\u00adtion, accord\u00ading to Grass\u00adley, was nev\u00ader meant to take his sub\u00adsidy away.&nbsp; Bob Mof\u00adfit of the Her\u00aditage Foun\u00adda\u00adtion has&nbsp;<a title=\"Link to Moffit paper\" href=\"http:\/\/www.heritage.org\/research\/reports\/2013\/08\/congress-in-the-obamacare-trap-no-easy-escape\" target=\"_blank\">doc\u00adu\u00adment\u00aded<\/a> that the orig\u00adi\u00adnal Grass\u00adley amend\u00adment&nbsp;con\u00adtained a pro\u00advi\u00adsion that explic\u00adit\u00adly pro\u00advid\u00aded the sub\u00adsi\u00addies, as did the House-passed bill.&nbsp; That pro\u00advi\u00adsion was&nbsp;removed from the final Sen\u00adate ver\u00adsion, which even\u00adtu\u00adal\u00adly became law.&nbsp; The&nbsp;exci\u00adsion of the sub\u00adsi\u00addies was&nbsp;evi\u00addent\u00adly inad\u00adver\u00adtent,&nbsp;an error&nbsp;that&nbsp;Grass\u00adley attrib\u00adut\u00ades to&nbsp;aides to&nbsp;Sen\u00ada\u00adtor Reid. &nbsp;Why should&nbsp;Con\u00adgres\u00adsion\u00adal staffers, who work long hours as pub\u00adlic ser\u00advants,&nbsp;for\u00adfeit an impor\u00adtant and val\u00adued ben\u00ade\u00adfit because of slop\u00adpy work\u00adman\u00adship by one of their colleagues?<\/p>\n<p>While I object to the ham-hand\u00aded and extra-legal means that the Admin\u00adis\u00adtra\u00adtion is using to con\u00adtin\u00adue&nbsp;sub\u00adsi\u00addiz\u00ading Con\u00adgres\u00adsion\u00adal health cov\u00ader\u00adage, I agree with the result.&nbsp; I don\u2019t want staffers to have to pay full price for cov\u00ader\u00adage that may well prove infe\u00adri\u00ador to what they now have.&nbsp; Most peo\u00adple who live out\u00adside the Belt\u00adway, though,&nbsp;will not find them&nbsp;or their boss\u00ades to be an espe\u00adcial\u00adly sym\u00adpa\u00adthet\u00adic group. Mil\u00adlions of peo\u00adple&nbsp;may suf\u00adfer mis\u00adfor\u00adtunes as a result of the new health care law, includ\u00ading the loss of employ\u00ader-sub\u00adsi\u00addized cov\u00ader\u00adage. If Con\u00adgress isn\u2019t will\u00ading to spare&nbsp;ordi\u00adnary Amer\u00adi\u00adcans&nbsp;the con\u00adse\u00adquences of&nbsp;its pol\u00adi\u00adcy errors, why should <span class=\"caps\">OPM<\/span> spare Con\u00adgress the con\u00adse\u00adquences of its draft\u00ading errors?<\/p>\n<p>Con\u00adgress&nbsp;should clear all&nbsp;this&nbsp;up by putting the propo\u00adsi\u00adtion to a vote&nbsp;\u2013 this time with\u00adout the com\u00adpli\u00adca\u00adtions of a loom\u00ading gov\u00adern\u00adment shut\u00addown.&nbsp;&nbsp;Such a vote car\u00adries polit\u00adi\u00adcal risk.&nbsp; But it is a risk that is unavoidable.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>[Updat\u00aded Octo\u00adber 1,&nbsp;2013] The new health care exchanges opened for busi\u00adness today, even as most fed\u00ader\u00adal gov\u00adern\u00adment oper\u00ada\u00adtions shut&nbsp;down. That result&nbsp;is exact\u00adly the oppo\u00adsite of what House Repub\u00adli\u00adcans intend\u00aded when they set\u00adtled on their strat\u00ade\u00adgy of link\u00ading gov\u00adern\u00adment fund\u00ading with \u2026 <a href=\"https:\/\/www.dougsbriefcase.com\/blog\/congress-getting-special-deal-obamacare\/\">Con\u00adtin\u00adue read\u00ading <span class=\"meta-nav\">\u2192<\/span><\/a><\/p>\n","protected":false},"author":3,"featured_media":1424,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","wp_typography_post_enhancements_disabled":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_hide_featured_image":false,"_jetpack_featured_image_duplicate_dismissed":0,"_jetpack_feature_clip_id":0,"_jetpack_memberships_contains_paid_content":false,"nfd_image_url":"","nfd_onboarding_generated":"","footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2},"jetpack_post_was_ever_published":false},"categories":[375,482,480,16,124],"tags":[1194,625,624,628,130,1200,117,623,629,627,1188,622,626],"class_list":["post-1421","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-congress","category-government-shutdown","category-government-spending-2","category-health-care","category-obamacare","tag-congress","tag-david-vitter","tag-defund-obamacare","tag-economix","tag-fehb","tag-government-shutdown","tag-harry-reid","tag-health-insurance-exchanges","tag-incidental-economist","tag-nicholas-bagley","tag-obamacare","tag-opm","tag-uwe-reinhardt"],"aioseo_notices":[],"aioseo_head":"\n\t\t<!-- All in One SEO 5.0.5 - aioseo.com -->\n\t<meta name=\"description\" content=\"[Updated October 1, 2013] The new health care exchanges opened for business today, even as most federal government operations shut down. That result is exactly the opposite of what House Republicans intended when they settled on their strategy of linking government funding with Obamacare \u201cdefunding.\u201d They insisted that their tactics would keep the government open while\" \/>\n\t<meta name=\"robots\" content=\"max-image-preview:large\" \/>\n\t<meta name=\"author\" content=\"Doug Badger\"\/>\n\t<link rel=\"canonical\" href=\"https:\/\/www.dougsbriefcase.com\/blog\/congress-getting-special-deal-obamacare\/\" \/>\n\t\t<meta name=\"generator\" content=\"All in One SEO (AIOSEO) 5.0.5\" \/>\n\t\t<meta property=\"og:locale\" content=\"en_US\" \/>\n\t\t<meta property=\"og:site_name\" content=\"Doug&#039;s Brief Case - A brief case for my way of thinking.\" \/>\n\t\t<meta property=\"og:type\" content=\"article\" \/>\n\t\t<meta property=\"og:title\" content=\"Congress IS Getting a Special Deal Under Obamacare - Doug&#039;s Brief Case\" \/>\n\t\t<meta property=\"og:description\" content=\"[Updated October 1, 2013] The new health care exchanges opened for business today, even as most federal government operations shut down. That result is exactly the opposite of what House Republicans intended when they settled on their strategy of linking government funding with Obamacare \u201cdefunding.\u201d They insisted that their tactics would keep the government open while\" \/>\n\t\t<meta property=\"og:url\" content=\"https:\/\/www.dougsbriefcase.com\/blog\/congress-getting-special-deal-obamacare\/\" \/>\n\t\t<meta property=\"article:published_time\" content=\"2013-09-30T10:30:09+00:00\" \/>\n\t\t<meta property=\"article:modified_time\" content=\"2013-10-02T11:06:30+00:00\" \/>\n\t\t<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n\t\t<meta name=\"twitter:title\" content=\"Congress IS Getting a Special Deal Under Obamacare - Doug&#039;s Brief Case\" \/>\n\t\t<meta name=\"twitter:description\" content=\"[Updated October 1, 2013] The new health care exchanges opened for business today, even as most federal government operations shut down. That result is exactly the opposite of what House Republicans intended when they settled on their strategy of linking government funding with Obamacare \u201cdefunding.\u201d They insisted that their tactics would keep the government open while\" \/>\n\t\t<script type=\"application\/ld+json\" class=\"aioseo-schema\">\n\t\t\t{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"BlogPosting\",\"@id\":\"https:\\\/\\\/www.dougsbriefcase.com\\\/blog\\\/congress-getting-special-deal-obamacare\\\/#blogposting\",\"name\":\"Congress IS Getting a Special Deal Under Obamacare - Doug's Brief Case\",\"headline\":\"Congress IS Getting a Special Deal Under Obamacare\",\"author\":{\"@id\":\"https:\\\/\\\/www.dougsbriefcase.com\\\/blog\\\/author\\\/doug-badger\\\/#author\"},\"publisher\":{\"@id\":\"https:\\\/\\\/www.dougsbriefcase.com\\\/blog\\\/#organization\"},\"image\":{\"@type\":\"ImageObject\",\"url\":\"https:\\\/\\\/i0.wp.com\\\/www.dougsbriefcase.com\\\/blog\\\/wp-content\\\/uploads\\\/2013\\\/09\\\/Credit-Getty-Images.jpg?fit=232%2C320&ssl=1\",\"width\":232,\"height\":320,\"caption\":\"The Obama Administration cut Congress a break when it allowed them to keep their health insurance subsidies.  Will Congress at some point be forced to vote on that special deal? 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20:27:54","updated":"2026-10-29 20:27:54","focus_keyword":null,"additional_keywords":null,"truseo_locale":null,"ai":null,"breadcrumb_settings":null,"seo_analyzer_scan_date":null},"aioseo_breadcrumb":"<div class=\"aioseo-breadcrumbs\"><span class=\"aioseo-breadcrumb\">\n\t\t\t<a href=\"https:\/\/www.dougsbriefcase.com\/blog\/\" title=\"Home\">Home<\/a>\n\t\t<\/span><span class=\"aioseo-breadcrumb-separator\">\u00bb<\/span><span class=\"aioseo-breadcrumb\">\n\t\t\t<a href=\"https:\/\/www.dougsbriefcase.com\/blog\/category\/health-care\/\" title=\"Health Care\">Health Care<\/a>\n\t\t<\/span><span class=\"aioseo-breadcrumb-separator\">\u00bb<\/span><span class=\"aioseo-breadcrumb\">\n\t\t\tIS<\/span> Getting a Special Deal Under Obamacare\"&gt;Congress <span class=\"caps\">IS<\/span> Getting a Special Deal Under Obamacare\n\t\t<\/span><\/div>","aioseo_breadcrumb_json":[{"label":"Home","link":"https:\/\/www.dougsbriefcase.com\/blog\/"},{"label":"Health 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