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The same health insurance that members of Congress get

That used to be one of the slogans for health-care reform: Every American should have the same insurance choices that members of Congress have. This obscured, to some degree, that members of Congress don't have very interesting choices: Most of them are covered by BlueCross BlueShield. But it sounded good.

In practice, however, it was hard to achieve, as the Federal Employee Health Benefits Program wasn't set up to insure all Americans. But as Joe Klein points out, Harry Reid is doing the slogan one better: Every member of Congress will now have the same choices ordinary Americans have:

My favorite provision requires that all members of Congress give up their federally-funded health care benefits and join the health care exchanges that will be set up by this bill. This is brilliant politics, addressing the tide of populist anger and fears of incipient socialism. But it also makes an important substantive point. The future of health care reform in this country will depend on how effectively the exchanges -- health insurance super-stores -- are working. If members of Congress have to participate in this system, you can bet they'll insist on an array of choices, similar to the system they currently use, the Federal Employees Health Benefits Plan.

The one caveat to this is that every American doesn't have these choices. Only those few Americans eligible for the exchanges have these choices. So there's more work to be done. But this is good politics and, not incidentally, good policy. Given that the exchanges will largely serve limited to low-income Americans during the first 10 years, this at least assures them one powerful constituency.

By Ezra Klein  |  November 23, 2009; 2:40 PM ET
Categories:  Health Reform  
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Comments

Choice, schmoice. I've always been P.O.ed by this choice argument.

What do you want-- your choice of insurance plan, or your choice of doctor?

If my employer negotiates a plan with an insurance company, chances are he/she is looking as what is in his/her price range. Then the employer make a decision about how much will be the employee's portion. Chances are, as the employee, my choice is to take it or leave it. Can I afford my portion and/or the out-of-pocket expenses? If I do take it, chances are the insurance company is going to tell me who is "in the network".

Now if I could buy into Medicare (I'm 61 and counting the years/days), I'd have my choice of doctor.

If we're taking about a choice of plans, the only choices are: A) what is not covered in the policy; and B) how much does the insured pay out of pocket.

Posted by: jshafham | November 23, 2009 3:12 PM | Report abuse

Like everyone else, I think this is a good policy, but what a sad reflection on what it takes to get our elected representatives to care about the substance of the policy they make as anything other than political currency.

Posted by: bean3 | November 23, 2009 3:36 PM | Report abuse

We'll see whether this provision survives the conference committee.

Posted by: ostap666 | November 23, 2009 3:42 PM | Report abuse

I absolutely support this. If they create no public option, exchanges, etc., at the very least they should buying their health insurance on the open market in their home states. I'm okay with raising their pay $5k and letting them use it. I'm not okay with the riding on their spouse's employer's insurance. At a minimum, they would have to insurance for themselves. Let see how long it is before they start crying about it.

Posted by: just_watching | November 23, 2009 4:12 PM | Report abuse

Reid's bill is actually weaker than Baucus' in that the latter allowed all federal employees to use the exchanges instead of FEHBP.

Making Congressional staffers use the exchanges is going to be a minor annoyance for some, but most of these people are healthy strivers who are holding out for seven-figure K street paydays. It's far different than Joe Average who will have to make painful and lasting tradeoffs to pay for expensive mandatory health insurance.

Posted by: bmull | November 23, 2009 7:52 PM | Report abuse

this is the kind of thing i love about keeping up with your blog ezra, i learn about details that everyone should know about. definitely on board for this provision.

Posted by: schaffermommy | November 24, 2009 6:26 AM | Report abuse

Be aware Medicare is not accepted by all doctors. The 1997 Balanced Budget Act permits doctors to opt out totally and are not bound by the Medicare fee schedule. Patients of these doctors must pay whatever is charged.

Posted by: cwat | November 24, 2009 9:42 AM | Report abuse

So, basically, let's screw all the federal workers who don't work for Congress (which is the vast majority) and who won't ever see a K Street job in their lives. Dump them and every single living federal retiree out of FEHBP and force them to give up the insurance and doctors they've had for decades.

Nice work, Democrats. Don't let the door hit you on the butt as we all vote for Republicans.

Posted by: WashingtonDame | November 24, 2009 11:37 AM | Report abuse

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