Bill Details
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This bill would make two main changes to federal health insurance rules. First, it would let people skip the health coverage requirement if they live in a county where fewer than two insurance companies offer plans on the health insurance marketplace. Second, it would require members of Congress, congressional staff, and certain executive branch political appointees to follow the same marketplace health insurance rules as other people, with some limits on government help paying for that coverage.
- People living in counties with very limited marketplace choices would be exempt from the rule that generally requires individuals to keep health coverage.
- The bill says insurance companies that are treated as one company under tax rules would count as one issuer when deciding whether a county has fewer than two issuers.
- Members of Congress, congressional staff, the President, the Vice President, and certain political appointees would be covered under the same exchange-based health insurance system.
- The bill would stop the government from paying the usual federal employee health contribution for those officials and would limit their tax credits and cost-sharing help to the same level available to similar private citizens.
Official Summaries
Protection from Obamacare Mandates and Congressional Equity Act
This bill alters provisions relating to the requirement to maintain minimum essential health care coverage (i.e., the individual mandate), as well as provisions relating to health care coverage for certain executive branch and congressional employees.
Specifically, the bill exempts individuals from the requirement to maintain minimum essential health care coverage if they reside in a county where fewer than two health insurers offer insurance on the health insurance exchange. Under current law, there is no penalty for failing to maintain minimum essential health care coverage.
The bill also requires certain executive branch and congressional employees to participate in health insurance exchanges. Under current law, Members of Congress and their designated staff are required to obtain coverage through health insurance exchanges, rather than the Federal Employee Health Benefits (FEHB) Program. Current regulations authorize government contributions toward such coverage and require Members of Congress to designate which members of their staff are required to obtain coverage through an exchange.
The bill requires all congressional staff, including employees of congressional committees and leadership offices, to obtain coverage through an exchange. The bill also prohibits Members of Congress from having the discretion to determine which of their employees are eligible to enroll through an exchange. Further, the President, Vice President, and executive branch political appointees must also obtain coverage through exchanges, rather than FEHB. The government is prohibited from contributing to or subsidizing the health insurance coverage of the officials and employees subject to this requirement, including Members of Congress and their staff.
Current Full Text
[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 127 Introduced in House (IH)]
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119th CONGRESS
1st Session
H. R. 127
To amend the Internal Revenue Code of 1986 to provide an exemption to
the individual mandate to maintain health coverage for individuals
residing in counties with fewer than 2 health insurance issuers
offering plans on an Exchange; to require Members of Congress and
congressional staff to abide by the Patient Protection and Affordable
Care Act with respect to health insurance coverage; and for other
purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
January 3, 2025
Mr. Biggs of Arizona introduced the following bill; which was referred
to the Committee on Ways and Means, and in addition to the Committees
on Energy and Commerce, House Administration, and Oversight and
Government Reform, for a period to be subsequently determined by the
Speaker, in each case for consideration of such provisions as fall
within the jurisdiction of the committee concerned
_______________________________________________________________________
A BILL
To amend the Internal Revenue Code of 1986 to provide an exemption to
the individual mandate to maintain health coverage for individuals
residing in counties with fewer than 2 health insurance issuers
offering plans on an Exchange; to require Members of Congress and
congressional staff to abide by the Patient Protection and Affordable
Care Act with respect to health insurance coverage; and for other
purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Protection from Obamacare Mandates
and Congressional Equity Act''.
SEC. 2. MODIFICATIONS TO EXEMPTION FROM REQUIREMENT TO MAINTAIN HEALTH
COVERAGE.
(a) Exemption for Individuals in Areas With Fewer Than 2 Issuers
Offering Plans on an Exchange.--Section 5000A(e) of the Internal
Revenue Code of 1986 is amended by adding at the end the following new
paragraph:
``(6) Individuals in areas with fewer than 2 issuers
offering plans on an exchange.--
``(A) In general.--Any applicable individual for
any period during a calendar year if there are fewer
than 2 health insurance issuers offering qualified
health plans on an Exchange for such period in the
county in which the applicable individual resides.
``(B) Aggregation rules.--For purposes of
subparagraph (A), all health insurance issuers treated
as a single employer under subsection (a) or (b) of
section 52, or subsection (m) or (o) of section 414,
shall be treated as a single health insurance
issuer.''.
(b) Effective Date.--The amendments made by this section shall
apply to months beginning after the date of the enactment of this Act.
SEC. 3. HEALTH INSURANCE COVERAGE FOR CERTAIN CONGRESSIONAL STAFF AND
MEMBERS OF THE EXECUTIVE BRANCH.
Section 1312(d)(3)(D) of the Patient Protection and Affordable Care
Act (42 U.S.C. 18032(d)(3)(D)) is amended--
(1) by striking the subparagraph heading and inserting the
following:
``(D) Members of congress, congressional staff, and
political appointees in the exchange.--'';
(2) in clause (i), in the matter preceding subclause (I)--
(A) by striking ``and congressional staff with''
and inserting ``, congressional staff, the President,
the Vice President, and political appointees with'';
and
(B) by striking ``or congressional staff shall''
and inserting ``, congressional staff, the President,
the Vice President, or a political appointee shall'';
(3) in clause (ii)--
(A) in subclause (II), by inserting after
``Congress,'' the following: ``of a committee of
Congress, or of a leadership office of Congress,''; and
(B) by adding at the end the following:
``(III) Political appointee.--The
term `political appointee' means any
individual who--
``(aa) is employed in a
position described under
sections 5312 through 5316 of
title 5, United States Code
(relating to the Executive
Schedule);
``(bb) is a limited term
appointee, limited emergency
appointee, or noncareer
appointee in the Senior
Executive Service, as defined
under paragraphs (5), (6), and
(7), respectively, of section
3132(a) of title 5, United
States Code; or
``(cc) is employed in a
position in the executive
branch of the Government of a
confidential or policy-
determining character under
schedule C of subpart C of part
213 of title 5 of the Code of
Federal Regulations.''; and
(4) by adding at the end the following:
``(iii) Government contribution.--No
Government contribution under section 8906 of
title 5, United States Code, shall be provided
on behalf of an individual who is a Member of
Congress, a congressional staff member, the
President, the Vice President, or a political
appointee for coverage under this paragraph.
``(iv) Limitation on amount of tax credit
or cost sharing.--An individual enrolling in
health insurance coverage pursuant to this
paragraph shall not be eligible to receive a
tax credit under section 36B of the Internal
Revenue Code of 1986 or reduced cost sharing
under section 1402 of this Act in an amount
that exceeds the total amount for which a
similarly situated individual (who is not so
enrolled) would be entitled to receive under
such sections.
``(v) Limitation on discretion for
designation of staff.--Notwithstanding any
other provision of law, a Member of Congress
shall not have discretion in determinations
with respect to which employees employed by the
office of such Member are eligible to enroll
for coverage through an Exchange.
``(vi) Clarification.--The terms `small
employer' (as defined under section 1304(b)(2))
and `qualified employers' (as defined under
subsection (f)) do not include the Congress,
with respect to enrollments in an Exchange and
a SHOP Exchange.''.
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