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SUZANNE VENEZIA
MAILING ADDRESS: P.O. BOX 295
COLMAR, PENNSYLVANIA 18915-9998
(215) 390-3126 s.venezia@verizon.net
07/11/2014
Sent Through U.S. First Class Mail with Certificate of Mailing and Email/Fax
OFFICE OF ROBERT P. CASEY
393 RUSSELL SENATE OFFICE BUILDING
WASHINGTON DC 20510
CC: THE WHITE HOUSE
TO THE PRESIDENT OF THE UNITED STATES OF AMERICA
BARACK OBAMA
1600 PENNSYLVANIA AVENUE NW
WASHINGTON, DC 20500
CC: OFFICE OF GOVERNOR TOM CORBETT
ROOM 225
MAIN CAPITOL BUILDING
HARRISBURG, PENNSYLVANIA 17120
CC: ALLYSON Y. SCHWARTZ
REPRESENTATIVE 13TH
CONGRESSIONAL DISTRICT OF PENNSYLANIA
WASHINGTON, DC OFFICE
1227 LONGWORTH HOUSE OFFICE BUILDING
WASHINGTON, DC 20515
Dear Senator Casey,
I am in receipt of your attached letter dated June 11, 2014, in which you claim that the health plans
available to private sector employees under of the Affordable Care Act are similar to the health plans
available to federal employees and to members of Congress and official office staff. Contrary to your
indications, federal government contributions are significantly higher, in terms of percentage and
actual cost contribution, than national averages even for single policies.
Although you indicate, Senator Casey, that you have enrolled in Washington DC’s SHOP, only plan
costs and not specific plan details are currently available online for public access. In any case, it is
important to underline the fact that the OPM (Office of Personnel [Federal] Management) currently
provides healthcare plan contributions exactly as it did in the past:
The formula for Government contributions is the same formula used for other Federal
employees. The Government contribution will equal the lesser of: (1) 72 percent of amounts
OPM determines are the program-wide weighted average of premiums in effect each year, for
Self Only and for Self and Family enrollments, respectively, or (2) 75 percent of the total
premium for the particular plan an enrollee selects. (http://www.opm.gov/healthcare-
insurance/changes-in-health-coverage/eligibility-enrollment/#url=Members-of-CongressStaff)

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Below is an example comparing the contribution of a private sector employee with a congressional
employee for a “silver” plan using the government websites https://www.healthcare.gov/find-
premium-estimates), http://www.opm.gov/healthcare-insurance/changes-in-health-coverage/eligibility-
enrollment/tabs/members-of-congressstaff/ and https://dchealthlink.com/calculator:
Annual Salary from $46,000 to $174,0001
(and beyond)
Private Sector Employee - Age 54 Congressional Employee – Age 54
Employee Contribution: $428/month2
Employee Contribution: $125.75/month 3
Therefore, the cost contribution difference for between the private-sector employee and the
congressional employee, regardless of salaries ranging from $46,000 to $174,000 and beyond, is more
than triple.
Below are some examples of out-of-pocket expenses for “silver” plans at
http://www.opm.gov/healthcare-insurance/healthcare/plan-information and at
http://www.opm.gov/healthcare-insurance/healthcare/plan-information/premiums/2014/nonpostal-
hmo.pdf. (federal employees) and at the HHS Exchange at https://www.healthcare.gov/find-premium-
estimates/ (private-sector employees):
 MRIs : federal plans $ 75.00; HHS Exchange: $250.00;
 Emergency room visits : federal plans $250.00; HHS Exchange: $450.00;
 Hospital stays : federal plans $200.00/day; HHS Exchange: $400.00/day.
The above are just a few examples in some of the silver plans of the overwhelming differences in
effective plan costs for an employee.
Most importantly, however, in my letter to President Obama dated 05/19/2014 also copied to you (to
which you make response in your attached letter dated 06/11/2014), I did not propose that PPACA be
repealed but modified; most importantly, I proposed that all persons have access to the same plans
and that all persons contribute to healthcare costs based on income with no cap on income. This
would mean that an employee with an annual salary of $ 174,000 would pay considerably more for
health care than an employee who makes $46,000/year. This is how the most successful healthcare
programs are sustained today.
It would be plainly untruthful to state that federal, state and local government employees do not have
better access to good affordable healthcare. As a public school teacher, I had access to benefits which
were substantially better and much cheaper than private-sector employees. With the advent of
1
$174,000 is a U.S. Senator’s salary.
2
This calculation was made at https://www.healthcare.gov/find-premium-estimates). I used Montgomery County in
Pennsylvania (my residence), since there was no Washington, DC in the calculator. See Attachment C.
3
This calculation was made at http://www.opm.gov/healthcare-insurance/changes-in-health-coverage/eligibility-
enrollment/tabs/members-of-congressstaff/. See also https://dchealthlink.com/calculator for total cost calculation ($503.00
on $174,000). See Attachments A and B.

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PPACA, the great divide between private and public employee healthcare has perhaps, to some small
extent, been bridged. Unfortunately, however, healthcare costs are rising, and Congress has not
proposed any remedies similar to the ones I outlined in my proposal of May 2014.
On the local level, states like Pennsylvania who have rejected Medicaid expansion, virtually provide
no subsidized healthcare plans for individuals who have little or no earned income4
. Although PPACA
does not require health insurance for those who do not reach the income threshold, these individuals
are effectively left without standard healthcare other than some services offered by local clinics,
funding permitted. This is “beggars’ healthcare”.
It is evident that great inequity persists in our healthcare system; out of economic necessity people are
forced to purchase high deductible plans which negate, through their very existence, the principle of
good preventive healthcare.
At this time, the entity receiving the most benefits from PPACA is the health insurance industry.
While I am pleased that PPACA exists, I am not pleased that there is no talk of modification and that
Congress insists on erroneously claiming that health benefits are more or less the same for employees
in the private and public sector. Time needs to be spent on better understanding healthcare
inequities and on finding solutions to eliminate them.
Thank you, Senator Casey, for providing me with feedback and for the opportunity to review with
you current healthcare plan issues.
Sincerely,
Suzanne Venezia
Enclosures:
- Attachment A : Calculation from https://dchealthlink.com./calculator; Silver Plan $503.00;
- Attachment B: Calculation from http://www.opm.gov/healthcare-insurance/changes-in-health-
coverage/eligibility-enrollment/tabs/members-of-congressstaff/Congressional; Employee
Contribution $125.75;
- Attachment C: Calculation from https://www.healthcare.gov/find-premium-estimates); Private
Employee Contribution: $428.00;
- Attachment D : Letter from Senator Robert Casey dated 06/11/2014 (2 pages).
4
In Pennsylvania in order to quality for subsidized healthcare plans, individuals must be employed for at least 25
hours/week.