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Groups ask why Senate uses a small-group ACA exchange

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Members of Congress and their aides should get their health coverage from the Affordable Care Act exchange, not through the small-group division at the District of Columbia, several groups opposed to the ACA say.

The Washington-based Council for Citizens Against Government Waste, representatives from eight other groups that oppose the ACA, and a health policy analyst who opposes the law are still trying to make that case.

The Senate Select Committee on Ethics recently rejected the groups’ complaint. The committee ruled that members of Congress and aides can continue to get their health benefits from the Small Business Health Options Program unit at DC Health Link, the District of Columbia’s locally run ACA exchange, the council says.

Related: HHS officials face their customers

An ACA provision requires lawmakers and aides to get their coverage from the exchange system. Officials at the U.S. Office of Personnel Management ruled before the ACA exchange system started up that the best way for lawmakers and aides to get covered would be through the D.C. SHOP unit.

OPM, members of Congress, and D.C. exchange managers have not disclosed how many lawmakers or aides D.C. SHOP plans cover.

If, for example, Senate Majority Leader Mitch McConnell or Sen. Harry Reid (D-Nev.), the minority leader, want employer-sponsored health coverage, the ordinary way for them to get their coverage would be through DC Health Link.

At least one lawmaker, Dr. Michael Burgess (R-Texas), said in December 2015 that he had declined SHOP coverage and was getting his coverage from the Texas individual exchange.

The ACA opponents that oppose congressional use of the D.C. exchange system also oppose the idea of lawmakers and aides getting the normal health coverage employer contribution from the federal government. The Council for Citizens Against Government Waste and its allies want lawmakers and their aides to pay the exchange plan premiums with their own money and any ACA premium subsidy money they can get.

This year, the D.C. SHOP exchange division may also offer more coverage options than many counties’ individual exchange programs.

D.C. regulators recently they said they expect the same four carriers that sell SHOP coverage this year to sell SHOP coverage in the district next year, and for the number of SHOP coverage options to increase to 151, from 136. 


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