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Tuesday, February 26, 2013

Health Benefits for Members of Congress

Ada S. Cornell
Information Research Specialist

Members of Congress and retired Members are eligible for private insurance coverage under the same system as other federal employees, the Federal Employees Health Benefits Program (FEHBP). FEHBP is the largest employer-sponsored health plan in the United States, covering more than 8 million federal employees, retirees, and their families.

Retired federal employees, including retired Members, who meet the minimum enrollment period requirements and who are eligible for an immediate annuity may continue to participate in FEHBP in retirement. Current federal employees, including Members of Congress, may also participate in the Federal Flexible Spending Account Program (FSAFEDS) to set up tax-exempt flexible spending accounts for reimbursement of health care, child care, and elder care expenses not otherwise reimbursed or covered by insurance. Current and retired federal employees, including Members of Congress, may enroll in the Federal Employees Dental and Vision Insurance Program (FEDVIP) for supplemental dental and vision insurance coverage. They may also apply for long-term care coverage under the Federal Long Term Care Insurance Program (FLTCIP).

All federal employees, including Members of Congress, pay the same payroll taxes as other workers for Medicare Part A coverage, and they are eligible to enroll in Medicare Part B, Part C, and Part D. Current Members, unlike other federal employees, are also eligible to receive health care services from the Office of the Attending Physician in the U.S. Capitol and at military hospitals.

The Patient Protection and Affordable Care Act (ACA; P.L. 111-148) requires health insurance exchanges to be established in every state by January 1, 2014. The ACA requires that the only health plans the federal government may make available to Members of Congress and certain congressional staff as a benefit of their federal employment are health plans created under the ACA or offered through health insurance exchanges established under the ACA. The Director of OPM has resolved a lack of clarity in the law as to the effective date of this provision by concluding that this provision will not be effective until the health insurance exchanges become operational. Therefore, this provision does not currently affect Members of Congress or their staffs’ participation in FEHBP. Regulations providing interpretive guidance have not yet been promulgated as of the date of this report.

This report covers health benefits made available to Members of Congress through federal government employment, including FEHBP, dental and vision insurance, flexible spending accounts, long-term care insurance, services at the Office of the Attending Physician and military hospitals, and Medicare. It also offers a comparison of FEHBP to health benefits offered by the private sector and state and local governments and a discussion of the effect of the ACA on Members’ health benefits.

Date of Report: February 12, 2013
Number of Pages: 10
Order Number: RS21982
Price: $29.95

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