Members of Congress have good health insurance by any standard, but it’s not free and not reserved only for them – and it’s not government insurance. House and Senate members are allowed to purchase private health insurance offered through the Federal Employees Health Benefits Program, which covers more than 8 million other federal employees, retirees and their families.
It’s not a “single-payer” system where the government acts as the one and only health insurance company. As President Bush’s chief of personnel Kay Coles James said in 2003, while lecturing at the conservative Heritage Foundation, “the FEHB program is not centralized, government-run health care.” It has drawn praise both from conservatives and liberals, including President Obama, who held it up as a model for his own health care proposals.
According to the Congressional Research Service, the FEHBP offers about 300 different private health care plans, including five government-wide, fee-for-service plans and many regional health maintenance organization (HMO) plans, plus high-deductible, tax-advantaged plans. All plans cover hospital, surgical and physician services, and mental health services, prescription drugs and “catastrophic” coverage against very large medical expenses. There are no waiting periods for coverage when new employees are hired, and there are no exclusions for preexisting conditions. The FEHBP negotiates contracts annually with all insurance companies who wish to participate. There is plenty of competition for the business; FEHBP is the largest employer-sponsored health plan in the U.S.
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Like other large employers, the government pays a large share of the cost of coverage. On average, the government pays 72 percent of the premiums for its workers, up to a maximum of 75 percent depending on the policy chosen. For example, the popular Blue Cross and Blue Shield standard fee-for-service family plan carries a total premium of $1,327.80 per month, of which the beneficiary pays $430.04. Washington, D.C.-based employees who prefer an HMO option might choose the Kaiser standard family plan. It carries a total premium of $825.15 per month, of which the employee pays only $206.29.
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http://www.factcheck.org/2009/08/health-care-for-members-of-congress/
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