For U.S. Sen. Mark Pryor and his likely Republican challenger, U.S. Rep. Tom Cotton, the Patient Protection and Affordable Care Act isn’t just shaping the political debate, it’s forcing them and most of their congressional colleagues to find new health insurance.
Because Obamacare spelled the end of the traditional congressional insurance program, members of the Arkansas congressional delegation have pursued a half-dozen paths to purchase personal health insurance.
The Affordable Care Act ended the employer contribution provided to members of Congress and their staff members under the federal government’s insurance plan. The contribution ranged from 66 percent to 75 percent of the cost of coverage in most cases. An exemption was later passed to allow for that contribution if members signed up for insurance on the Washington, D.C., healthcare exchange.
Only two Arkansas congressional members did that. Republicans Sen. John Boozman and Rep. Rick Crawford, of Arkansas’ 1st Congressional District, agreed to enroll along with their office staff members in the D.C. exchange.
The other four congressional lawmakers, including Pryor and Cotton, chose other options and forfeited the employer contribution.
Pryor, who is a cancer survivor, has a pre-existing condition that used to make it hard for him to find affordable coverage. Now, insurers must provide insurance without screening for previous medical ailments, according to regulations under the Affordable Care Act.
The two-term senator signed up for coverage through the Arkansas healthcare exchange, one of many exchanges set up by individual states to help connect people with local insurance providers. Pryor said during an interview at his Little Rock campaign headquarters that he chose the state exchange so he’d have the same experience as thousands of his constituents.
“I thought it was the right thing to do to have the same experience that other Arkansans did. I wanted to make it real for me,” he said. “My medical history never came into play on the exchange. I think for a lot of people that is going to be the difference that allows them to have insurance when they couldn’t find coverage before.”
Almost 18 years ago, Pryor, who was in his 30s at the time, got a house call from his doctor that would change his life.
Pryor had noticed a small bump on his Achilles tendon while playing basketball and sought medical care. After treating it as a tendon tear with no results, the doctor did a biopsy. The tests showed that the bump was a sign of clear-cell sarcoma, a rare cancer that carried a likelihood of losing a limb and a high rate of fatality.
His doctor recommended an oncologist who specialized in treating cancer of the arms and legs. Pryor still carries the expert’s business card, which has the words “limb salvage” printed on the bottom.
A 13-hour, experimental surgery that removed his Achilles tendon and replaced it with a tendon from his abdomen saved his life and his leg. After radiation therapy and years of remission checks, the senator said he is finally at a point where his every other year checkups don’t make him anxious.
Pryor opted to cover both of his college-aged children on the gold level Blue Cross and Blue Shield insurance plan, which costs about $866 per month and has a $1,000 deductible, he said. His old federal health insurance plan cost about $1,200 per month,before the federal contribution.
“When you’re fighting for your life, you don’t need to be fighting with the insurance company,” he said. “I chose this plan because if my children ever need it, I want the coverage to be there.”
Cotton, who is in a different demographic of health insurance shoppers, chose a grandfathered private insurance plan that will last through the end of 2014 - when, like all other grandfathered plans, it will be canceled under the Affordable Care Act.
The first-term congressman is young, healthy and his insurance rates would have soared if he had signed up for insurance on the exchanges this year, he said. The high rates help subsidize older people and those with pre-existing conditions.
“I looked at plans on the exchange when I could get access to the information, and the deductible would have been twice as high as my deductible in the private plan I purchased on the private market,” he said, during a telephone interview from his D.C. office. “My premium would have been three-and-a-half times as high under the exchange. The kind of value you can get on the private market is much more affordable.”
Cotton took screen shots of some of the website glitches he encountered on the federal exchange at the beginning of October and posted them to his blog and Twitter account. Conversely, he said, it took 30 minutes to choose a plan, enroll and submit his first insurance payment on a private site.
Other people in Cotton’s age group - he’s 36 - have been hard to attract to the exchanges. Of the more than 12,500 people who had signed up for insurance through the Arkansas exchange as of the end of 2013, less than 15 percent were between the ages of 35 and 44.
Cotton’s D.C. staff took note of the congressman’s choice, and while he didn’t mandate that any of them opt out of the D.C. exchange and forgo the federal employer contribution, several have. He said his office has set aside part of its budget - which is paid by the federal government - to reimburse the federal government for its contributions to those employees’ health accounts.
In addition to Pryor and Cotton, U.S. Rep. Tim Griffin, R-Ark., who is a lieutenant colonel in the U.S. Army Reserve, re-enrolled at the beginning of the year in Tricare Reserve Select, military benefits for which he pays a monthly fee, a spokesman confirmed.
A spokesman for U.S. Rep. Steve Womack, said the 3rd Congressional District Republican is going to be covered under a plan held by his wife, Terri, who receives health insurance through her employer.
Front Section, Pages 1 on 02/10/2014