Members of Congress and their staff choose a gold-level healthcare plan through the open marketplace. According to Snopes, Congress members pay approximately 28 percent of their annual healthcare premiums through pre-tax payroll deductions and receive federal subsidies that cover 72 percent of the cost of premiums.
They also get special "free or low-cost" healthcare benefits not offered through healthcare plans on the open market. Snopes reports that members of Congress can pay an unspecified annual fee in order to receive treatment from the Office of the Attending Physician for routine examinations, consultations and certain diagnostic tests. Additionally, members can get free medical outpatient care at military facilities in the D.C. area.
Ocasio-Cortez reported annual earnings of $26,581 in 2017 when she was living in the Parkchester neighborhood of the Bronx. Based on the Kaiser Family Foundation (KFF) Health Insurance Marketplace Calculator, she would pay roughly $160 per month — about $1,922 per year — for a silver plan if she still lived in the Bronx and was making the same amount in 2019.
According to the Congressional Research Service, "the compensation for most Senators, Representatives, Delegates and the Resident Commissioner from Puerto Rico is $174,000." If Ocasio-Cortez's estimate is accurate, members of Congress are paying less than $80 a month — about $960 per year — for top-notch healthcare.
According to the KFF, Americans paid an average of $5,714 in annual premiums in 2017.
Paul Ginsburg, director of the USC-Brookings Schaeffer Initiative for Health Policy, tells CNBC Make It that it is possible that individual members of Congress could be paying roughly this amount for their health coverage. But he but maintains that it's difficult to directly compare the coverage of an individual, like Ocasio-Cortez, and a congressperson. He pointed to New York's history of particularly high premiums as one reason she might have been paying so much when she was a waitress.
Still, her comments highlight important issues related to health care affordability in the U.S.
A recent survey of over 2,000 adults conducted by Harris Poll revealed that 54 percent of Americans have delayed getting healthcare for themselves and 10 percent of Americans with children under the age of 18 have delayed getting care for a dependent in the past year because of costs.