Health care reform: Where do Oregon lawmakers stand?

Local members of Congress are in the thick of the national debate over health insurance reform. Congress is considering legislation to end health insurance industry abuses, slow down health insurance cost increases and cut down on the number of Americans who are uninsured. Five members of Oregon’s seven-member congressional delegation serve on House or Senate committees with jurisdiction over health reform bills. 

As a member of the House Ways and Means Committee, Rep. Earl Blumenauer (D-Ore.) was able to pass an end-of-life-consultation amendment to the House version of the Affordable Health Choices Act. Blumenauer’s amendment was based on an earlier bill he introduced with a Republican co-sponsor, Congressman Charles Boustany of Louisiana. It would allow Medicare to cover the costs of patients voluntarily meeting with doctors to discuss end-of-life preferences. In that discussion, the doctor would talk about things like living wills and advance medical directives — which record the patient’s wishes to receive or not receive life-sustaining care once they become incapacitated and unable to communicate their wishes. Some conservative media figures pointed to that provision to suggest that the government would be encouraging euthanasia; resigned Alaska Gov. Sarah Palin went further, claiming that government “death panels” would be deciding whether citizens deserve to live. But nothing in the bill bears any resemblance to those claims.

In the U.S. Senate, Jeff Merkley (D-Ore.) — a member of the Health Education Labor and Pensions Committee — succeeded in passing two amendments to a Senate version of the health insurance reform bill. One expanded small-business access to a proposed government regulated health insurance exchange, and the other would give breast-feeding mothers workplace breaks and a private space to pump milk for their infants. Prior to the small business amendment, the bill proposed that small businesses of up to 10 employees be allowed to purchase insurance on the exchange (which would have a public health insurance option among the offerings). Merkley succeeded in amending that to businesses with up to 50 employees. The nursing mothers’ amend- ment is similar to state legislation Merkley helped pass when he was speaker of the Oregon House of Representatives.

Meanwhile, Sen. Ron Wyden (D-Oregon) serves on the Senate Finance Committee, which is also considering health insurance reform proposals. Wyden has been targeted by the labor-supported group Health Care for America Now because he is one of 15 Senate Democrats who have not pledged support for a public health insurance option. Wyden is pushing his own bill, the Healthy Americans Act, which would eliminate employer-sponsored health insurance and require all Americans to buy individual policies from private health insurance companies. While 14 senators have signed on as nominal co-sponsors to Wyden’s bill (including Merkley and Washington Democrat Maria Cantwell), it’s not clear that any elements that are unique to the Wyden bill are gaining traction in either chamber of Congress. Unions in particular have opposed the Wyden bill, and several unions have paid for radio ads in Oregon critical of it.

Rep. David Wu (D-Ore.) voted for the version of the bill that passed a committee he serves on —the Committee on Education and Labor. Greg Walden (R-Ore.) voted against the version that passed the Committee on Energy and Commerce.

Rep. Peter DeFazio (D-Ore.) doesn’t serve on any of the House committees that will look at health reform bills, but he supports the legislation and was one of about 60 House Democrats who signed a letter committing to vote against any health insurance bill that does not contain a public health insurance option.

Blumenauer also signed that letter, though spokesperson Erin Allweiss clarified that Blumenauer will look at whatever bill is passed before making a decision on how to vote.

Kurt Schrader (D-Ore.) isn’t on any of the committees either, but told the Oregonian editorial board Aug. 20 that he’s prepared to vote against the health care bill unless Democratic leaders find ways to substantially rein in its anticipated costs. Schrader objected to the fact that the bill would provide health care subsidies for families with incomes up to 400 percent of the poverty line — about $88,000 for a family of four. He suggested that be lowered to 300 percent or 250 percent. Also, the provision in the House bill that limits maximum annual out-of-pocket cost to $5,000 per person could be doubled to reduce the cost, he said. And he seemed to prefer nonprofit co-ops as an alternative to a public health insurance option. In 2004, Schrader inherited a fortune from his grandfather, a Pfizer executive.

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