<P> Prior to 2014, members of Congress and their staff had access to essentially the same health benefits as federal civil servants; they could voluntarily enroll in the Federal Employees Health Benefits Program (FEHBP), an employer - sponsored health insurance program, and were eligible to participate in other programs, such as the Federal Flexible Spending Account Program (FSAFEDS). </P> <P> However, Section 1312 (d) (3) (D) of the Patient Protection and Affordable Care Act (ACA) provided that the only health plans that the federal government can make available to members of Congress and certain congressional staff are those created under the ACA or offered through a health care exchange . The Office of Personnel Management promulgated a final rule to comply with Section 1312 (d) (3) (D). Under the rule, effective January 1, 2014, members and designated staff are no longer able to purchase FEHBP plans as active employees . However, if members enroll in a health plan offered through a Small Business Health Options Program (SHOP) exchange, they remain eligible for an employer contribution toward coverage, and members and designated staff who are eligible for retirement may enroll in a FEHBP plan upon retirement . </P> <P> The ACA and the final rule do not affect members' or staffers' eligibility for Medicare benefits . The ACA and the final rule also do not affect members' and staffers' eligibility for other health benefits related to federal employment, so current members and staff are eligible to participate in FSAFEDS (which has three options within the program), the Federal Employees Dental and Vision Insurance Program, and the Federal Long Term Care Insurance Program . </P> <P> There is an Office of the Attending Physician at the U.S. Capitol, which current members may seek health care from for an annual fee . The attending physician provides routine exams, consultations, and certain diagnostics, and may write prescriptions (although it does not dispense them). The office does not provide vision or dental care . </P>

Who makes the rules for each house of congress