Fact check: Trump's odd threat on Congress health care

President Donald Trump says Congress should be paying what the public pays when it comes to "Obamacare." But members of Congress already pretty much do. Here's a look at Trump's claim, and the reality.

Trump's tweet Monday:

The facts

Although Trump's tweet may suggest otherwise, members of Congress and their staff get their health insurance through the Obamacare exchanges. They are required to do so by a provision in the health law itself.

It's something of an anomaly, because other people covered by employer-sponsored health insurance plans were not required by the law to enter the newly created insurance exchanges. But the provision was added under political pressure, to avoid the perception that lawmakers were writing a law for the public that they themselves would be able to avoid.

The 2010 law set up health insurance for members of Congress and their staffs through the District of Columbia health care exchange. Most were kicked out of the Federal Employees Health Benefits Program, which other government workers use.

The federal government pays about 72 percent of lawmakers' premiums, according to the Congressional Research Service. Although employer contributions vary, 72 percent is in line with what other businesses offer their employees, said John Arensmeyer, head of the Small Business Majority.

Not all members of Congress are on the D.C. exchange. Just like other people, some are covered through their spouses' insurance, or through various other means.

Sen. John McCain gets his coverage from the Department of Veterans Affairs as a former Navy pilot, although he is being treated for his recent brain cancer diagnosis at the Mayo Clinic. Sen. Claire McCaskill chooses to forgo the employer contribution and buys her insurance, like other Missourians, from the national Obamacare exchange.

Although Trump's tweet could be read to suggest he plans to do something about what members of Congress pay for their health insurance, it's not clear what that could be. This much is known: He is upset that Republicans could not pass legislation dismantling Obamacare and is holding out the prospect of punishing lawmakers for their failure.

Meantime his negativity about insurance companies raises a different matter entirely.

Although it's not completely clear what Trump is talking about by suggesting Obamacare should "hurt the insurance companies," it could be a reference to an ongoing issue of whether the Trump administration will continue cost-sharing payments to insurers. White House adviser Kellyanne Conway said on "Fox News Sunday" that Trump will make a decision on that this week.

The subsidies, totaling about $7 billion a year, help reduce deductibles and copayments for consumers with modest incomes. President Barack Obama's administration used its rule-making authority to set direct payments to insurers to help offset these costs. Trump inherited the payment structure, but he also has the power to end it.

The payments are the subject of a lawsuit brought by House Republicans over whether the health law specifically included a congressional appropriation for the money, as required under the Constitution. Trump only guaranteed the payments through July.