So, is Congress’ health care plan better than yours? Not really

If you think health care insurance for your U.S. representative or senator is a lot better than yours, think again.
“It’s very similar – it resembles most employer-based options,” said Paul “Buzzy” Mize, a longtime Tupelo insurance businessman.
Tonight, President Barack Obama will lay out his vision for American health care reform to a joint session of Congress.
He, those members of Congress and all full-time federal employees have the same options when they sign up for health insurance.
Their choices include HMOs, PPOs and fee-for-service plans, much like private insurance plans available through American employers.
“I don’t see a lot of differences,” said Mize, a longtime Republican.
What do members of Congress choose?
Rep. Travis Childers, D-Booneville, went with BlueCross/BlueShield. He has its “standard” plan, and is paying about $356 a month for his family of four.
Republican Sens. Thad Cochran of Oxford and Roger Wicker of Tupelo pay the same for their family coverage.
“Members of Congress have a choice of the same insurance plans eligible to all federal employees,” Cochran said. “These plans come from the same providers that cover millions of Americans.”
He also noted that members of Congress aren’t immune to the same price pressures as other Americans. They’re paying more out of pocket each year because of increasing premiums.
“For example, average premiums for FEHBP increased 7 percent last year,” he said.
Dental and vision insurance also is available for added price.
BlueCross is the most popular option with all federal employees, reports the U.S. Office of Personnel Management, which doesn’t track how many members of Congress enroll in individual plans.
BlueCross is a PPO – a preferred provider organization – which offers savings to use certain medical providers for reduced fees.
But a report by consulting firm Watson Wyatt finds that even though the federal plan has lower deductibles and co-pays than the “typical” PPO, it did not rate as well as an average HMO or health maintenance organization.
An HMO is a voluntary group in a geographic area with member physicians financed with fixed, advance payments.
A Kaiser Family Foundation 2008 survey found the average PPO premium for individual coverage was $4,802 a year and for a family $12,937.
The federal plan’s premiums were higher for individuals at $5,386 but lower for families, $12,335.
The government paid 69 percent of that family premium, less than the 73 percent national average for employers.
“They are not Cadillac plans,” said Jon Gabel of the National Opinion Research Center at the University of Chicago in an interview with Time.
“These aren’t the wonderful, exemplary plans … that many people think they are.”
Mize said the BlueCross federal plan features cost-cutting strategies “just like everybody else” with physician networks and wellness emphasis.
However, federal lawmakers have some attractive features not available to the general public.
- They can use taxpayer-subsidized care at Walter Reed Army Medical Center in Washington and the National Naval Medical Center in Bethesda, Md.
- They have their own pharmacy, as well as doctors, nurses and technicians standing by in the U.S. Capitol.
That means they can get a physical or an X-ray without leaving work, but they pay for these services at a monthly rate of about $300 per representative and $600 per senator.
During a recent town hall meeting, President Obama described Congress’ plan as “no better than the janitor that cleans their offices,” saying its deal-making leverage rises from the millions of people who are part of the pool.
“That drives down their costs, and they get a better deal,” he said.

Contact Patsy R. Brumfield at (662) 678-1596 or patsy.brumfield@djournal.com.

CORRECTION: Rep. Travis Childers, D-Booneville, pays $356 per month for health insurance to cover himself and his daughter, not for full family coverage, as incorrectly reported in Wednesday’s Daily Journal. His wife and son have a separate policy.

Patsy R. Brumfied/NEMS Daily Journal