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PolitiFact Florida | St. Petersburg Times
Sorting out the truth in state politics

PolitiFact: Health plans for Congress same as all federal employees

Skeptical constituents of U.S. Rep. Steve Southerland, R-Panama City, recently peppered the freshman member of Congress with questions about the perks of being in elected office.

Among the things they wondered about — health insurance for members of Congress.

Is it free? Is it cheaper? Is it better than other federal workers?

No, Southerland said, his plan is "no different than any other federal employee's in the United States government."

PolitiFact Florida wondered if Southerland was right.

The federal government is the nation's largest employer with more than 2 million employees. That makes its health care program, the Federal Employees Health Benefits Program, the largest employer-sponsored health insurance program.

About 8 million people — including most active federal employees, 1.9 million federal retirees, their spouses and children — obtain private health insurance through enrollment in the federal program. This setup offers many different plans through an insurance exchange and is overseen by the U.S. Office of Personnel Management.

In 2011, the program offered 207 total plan options, including fee-for-service plans, HMOs and high-deductible health insurance plan options with a tax-advantaged account. The plans cover a variety of services, including hospital visits, surgeries, mental health, prescription drugs, emergency care and "catastrophic" benefits. An employee's plan selection is limited to providers near his or her home.

The most popular plan is offered by Blue Cross Blue Shield and covers 62 percent of federal employees and retirees. This year, the biweekly employee premium contribution for individual and family plans under standard Blue Cross Blue Shield coverage would cost $199.20. Blue Cross Blue Shield basic coverage would cost $122.53.

Taxpayers pick up about 75 percent of the premium, and employees contribute the rest, according to the Office of Personnel Management.

It's a process very similar to private industry practice, but private employers generally contribute more toward employees' plans, according to a 2007 study by the Congressional Research Service about congressional health benefits. And federal employees have a wider plan selection than private-sector employees, said Pete Sepp, spokesman for the National Taxpayers Union, a nonprofit organization that scrutinizes government and taxes. "They can buy into HMOs, straight insurance, health savings accounts, all kinds of options," Sepp said. "Whereas in the private sector with a given company, you may only have a handful."

So all federal employees get a pretty good deal — in fact David Williams, president of Taxpayers Protection Alliance, said the federal health insurance plan is "one of the most generous" in the country.

But do members of Congress have a better one?

No, experts we talked to said.

The same buffet of plans is available to federal government workers and members of Congress. They pick the plan that is best for them, and they pay the same price. In short, there is no discount for members of Congress, or their staffs.

But, members of Congress do have two optional health perks that not all other federal employees enjoy.

One is use of the Office of the Attending Physician, a low-profile Navy clinic on the Capitol's first floor that offers basic medical services to members, Hill staffers and sickness-stricken tourists. Members can opt to regularly access the clinic for services such as X-rays, flu shots and physical therapy at an annual fee of $503.

The other is access to medical and emergency treatment at military hospitals. There's no charge for outpatient care at Bethesda Naval Hospital.

Southerland, who entered office in January, said in an interview with PolitiFact Florida he did not know about either service. "I've not needed a doctor since I've been there," he said.

Southerland said his health insurance plan is no different from "any other federal employee's" in the country. The key here is his use of the phrase "health insurance plan." He doesn't get a discount, or free coverage, just because he is a member of Congress. So we rate this claim True.

The statement

"The health insurance plan that (members of Congress) have is no different than any other federal employee's in the United States government."

U.S. Rep. Steve Southerland, Aug. 24, in comments to Tallahassee residents

The ruling

Politifact ruling: True

The key here is his use of the phrase "health insurance plan." While Southerland does get some extra health care benefits as a result of being a member of Congress, his choice of insurance plans is the same as every federal employee using the Federal Employees Health Benefits Program. We rate this claim True.

PolitiFact: Health plans for Congress same as all federal employees 09/04/11 [Last modified: Sunday, September 4, 2011 9:08pm]

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