The U.S. Office of Personnel Management is trying to keep the Patient Protection and Affordable Care Act from stripping coverage from members of Congress, their staff members and dependents.
PPACA will require members of Congress and congressional staff members to get their coverage from the PPACA public exchanges starting Jan. 1, but the law contains no provision authorizing the government to help members of Congress and their staff members pay for the coverage.
Some PPACA opponents have suggested those affected would have to pay the full cost of exchange coverage themselves.
Recommended For You
Obama administration officials announced last week that they had come up with a regulatory fix.
OPM officials now have filed draft coverage gap regulations.
In the draft, set to appear in the Federal Register on Thursday, OPM officials say the federal law that authorizes the government to help pay for regular Federal Employees Health Benefits coverage for lawmakers and staff members refers to "health benefits plan under this chapter."
In the past, OPM has never had to clarify the provision, but the agency will now say the provision applies to exchange plans, both for members of Congress and staff, and for retirees, officials said.
The exchange use mandate would affect workers in the office of a member of Congress and not other types of congressional workers. OPM is asking for comments on how it should define "official office."
In many cases, officials said, staff members could go from one type of payroll status to another without being aware of the change.
Today, the federal employees' plan has a "self only" enrollment category and a "self and family" category.
In the exchanges, plans may charge rates based on the actual number of people in a family, officials said.
When lawmakers and staff members start using the exchanges, the government will provide the same self-and-family contribution level for any individual getting coverage for two or more people through the exchange system, officials said.
© 2025 ALM Global, LLC, All Rights Reserved. Request academic re-use from www.copyright.com. All other uses, submit a request to [email protected]. For more information visit Asset & Logo Licensing.
Allison Bell
Allison Bell, a senior reporter at ThinkAdvisor and BenefitsPRO, previously was an associate editor at National Underwriter Life & Health. She has a bachelor's degree in economics from Washington University in St. Louis and a master's degree in journalism from the Medill School of Journalism at Northwestern University. She can be reached through X at @Think_Allison.
