Washington • They created the law. Now they have to live with it.
And when it comes to the Affordable Care Act, that means higher insurance costs for many members of Congress, yet, for some of their younger staffers, the switch will end up saving them cash.
“Clearly the most significant variable is age. That’s good news for them,” said Rep. Jim Matheson, D-Utah, who blames his 53 years and his need to cover his wife and two children on the spike in his insurance costs. His monthly premiums rose from $434 to $795.
Like all members of Congress, Matheson had previously selected his insurance from plans offered through the Federal Employees Health Benefits Program, which still covers everyone from park rangers in Zion National Park to the chef in the White House.
With such a large federal workforce, the program has a huge risk pool and that meant lower-than-average costs for top-quality insurance. But when Congress passed the Affordable Care Act in 2010, Republicans fought for and won a provision requiring lawmakers and most of their staffers to get their insurance through an exchange, set up to help the uninsured and those who buy insurance on the private marketplace.
The 535 members of Congress and more than 11,000 staffers in Washington, D.C., and home offices throughout the nation had to make a decision by Monday night. The government picked up 75 percent of the cost for those who went through the D.C. Health Link, which included 112 “gold” plans. That’s the equivalent of the federal contribution in the old system.
Lawmakers who bought insurance from a state-based exchange or the federal healthcare.gov, which covers people in Utah, had to pay the full cost. At least 11 senators, including Colorado’s two Democrats, rejected the federal subsidy, according to a Washington Post tally.
Utah’s elected officials appeared to have stuck with the D.C. Health Link and while they were surprised to see how much more it cost them, most thought it made sense for lawmakers to experience the realities of the new health law.
“It is a good exercise for policymakers to experience what the Affordable Care Act set up,” said Matheson, who was one of the few Democrats to vote against that bill and continues to oppose the law.
He likes the idea of the exchanges, an online marketplace where people can compare plans and their costs, calling it “a good market-based way to help consumers make decisions.”
But that doesn’t mean Utah’s lawmakers found it easy to sign up.
The D.C. Health Link, like the federally run healthcare.gov, has had a rough rollout.
The first time Matheson logged on was Nov. 19, and he couldn’t get past the first page. It took a change in browsers — his office found that Google Chrome worked better than others — and some persistence to get through the application process, but when he tried to pick a plan, he got an error message. It took him about a week and the help of someone at a call center to finally pick a Blue Cross Blue Shield plan that was as close to his current coverage as he could get.
Freshman Rep. Chris Stewart, R-Utah, said it took him a month to navigate the troubled site with his wife. Rep. Jason Chaffetz, R-Utah, one of Congress’ most tech-savvy members, got so frustrated that he filled out a paper application. So did Rep. Rob Bishop, R-Utah.
Matheson, Stewart and Chaffetz all have children at home and all of them saw their costs skyrocket.
Not only did Matheson’s premiums rise by $360 per month, but also his deductible nearly tripled from $700 to $2,000, which surprised him.
“With a higher deductible,” he said, “ you would think the premium wouldn’t go up.”
Chaffetz went a different route. He stayed with Blue Cross Blue Shield, but he elected to have a health-savings account, in which he could set aside pre-tax dollars to cover health expenses in the hope that he could roll the money forward if his family had a healthy year.
Still, his premiums for his family of five rose from about $450 per month on his current plan to $665. He has to cover all expenses until he hits his deductible, which is $2,800 for his family. The insurance will pick up the cost of everything else as long as he stays in the provider network, which is the same nationwide list that he enjoys today.
Sen. Orrin Hatch, R-Utah, along with Stewart and Bishop, declined to provide specifics of the plan they picked through the D.C. Health Link. Sen. Mike Lee, R-Utah has yet to release information about his insurance selection.
Hatch, through a spokesman, said his premiums went up a little more than $200 per month and his out-of-pocket maximum doubled to $11,000. Bishop said his premiums would double. Beyond his financial frustration, Bishop wondered how many people would get stymied by the enrollment process.
“I just have empathy for anyone trying to do this process who didn’t have the support I had,” he said. “It is a rigorous and difficult process to get through.”
Anecdotally, Utah’s House members have noticed that staffers who have children have seen their costs rise, while younger, single staffers have said their costs stayed about the same.
Matheson’s press secretary Jessica Gail, who is 28 and single, picked the most comparable plan she could find to the federal plan she has now. Her premiums dropped from $128 per month to about $89 when dental coverage is factored in. She was surprised, but it wasn’t an anomaly. Five other employees in the office also saw their premiums fall, though they now have higher annual deductibles. For Gail, it is $1,500.
Rep. Jim Matheson
Old plan: $434
New plan: $795
Deductible (in network)
Old plan: $700
New plan: $2,000
Out-of-pocket maximum (in network)
Old plan: $7,000
New plan: $7,000
Rep. Jason Chaffetz
Old plan: about $450
New plan: $665
Deductible (in network)
Old plan: $2,500
Nw plan: $2,800
Out-of-pocket maximum (in network)
Old plan: $5,000
New plan: $5,600