Private insurance realities hit Congress personally

Boehner

The New York Times ran a quietly subversive news story Wednesday about how members of Congress and their aides will receive health coverage under the Office of Personnel Management's new proposed rule interpreting a controversial Obamacare provision.

During the drafting of the Patient Protection and Affordable Care Act, Sen. Charles Grassley (R-Iowa), an opponent of the legislation, insisted that members of Congress and their staffers should have to buy their coverage from the state health insurance exchanges the same way millions of other Americans would get it—rather than getting it through the Federal Employees Health Benefit Program as they do now. It was a commendable idea that few members of Congress probably thought through.

The Times article pointed out that on Jan. 1, House Speaker John Boehner, who's 64, and other older members who aren't yet eligible for Medicare will face a harsh reality experienced by lots of other older Americans who have had to buy their own insurance—significantly higher premiums than those paid by younger people. They may have to pay three times more, which is allowed by the ACA.

On top of that, insurers on the exchange can charge smokers like Boehner up to 50% more than nonsmokers, also allowed by the law.

According to the Kaiser Family Foundation calculator, Boehner and his wife Debbie may have to pay a lot more for their coverage than they pay now. The premium for a couple of their age—at least one of whom a smoker—will be nearly $23,000 a year, according to the calculator. Nearly $5,000 of that premium amount is due to the smoker's surcharge. With the federal government contributing about $11,000 to Boehner's coverage, he may have to pony up about $12,000, probably twice as much as he pays now under the federal employee benefit program.

Under the proposed OPM rule, Boehner and other members and staffers will no longer be eligible for their employer's retiree health benefit program, just like tens of millions of Americans who don't have an employer retiree benefit program. They'll have to supplement their Medicare benefit the same way everyone else does—through private supplemental coverage, which can be quite expensive.

So here's to Grassley, who achieved precisely what he sought to do, exposing the nation's lawmakers to the vicissitudes of the American health insurance system.

At least, though, Boehner and his aging congressional colleagues won't face the peril of not being able to find coverage at all because of their age or medical condition. For that, they can thank Obamacare.

Follow Harris Meyer on Twitter: @MHHmeyer