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Floor Speech

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Mr. MERKLEY. Mr. President, I appreciate the comments from my colleague from Colorado. I don't think it is unique to the States out West, be it Oregon or Colorado or California or Idaho or Nevada or so forth. I think people in every single State care about access to healthcare.

Now, I came to the Senate in 2009, and in that year, we decided to make a major effort to fill in huge holes in our healthcare system. Well, we had Medicaid for the least affluent, but then folks who were just above that, they couldn't afford private insurance; they also didn't qualify for Medicaid, so we created extended Medicaid and made it a State option that covered a lot more people.

And then when you came to the middle class, you had folks who had insurance through their employer but not every employer provided insurance. And so we created the healthcare exchange where you could buy insurance and you could do so with tax credits to help you make the payments so that they were affordable.

Well, that plan was pretty straightforward, but a man named Frank Luntz--he was a pollster and messagemaker for the Republicans--put out a memo. And I was one of the first Members of the Senate to see this memo. It was April of 2009. And the memo said: Whatever the Democrats come up with to improve healthcare, we are going to call it a government takeover because we have done focus groups, and that scares Americans. It makes them dread this.

And it doesn't matter what the policy is, we will call it a government takeover. And I came down here to the floor, at that point my desk was much farther over here, around the corner, and I waved this around and said: Is this what America has come to? Instead of working together to improve the healthcare system, instead, we are so polarized that the minority wants to stop us from improving healthcare, even if it makes sense. And they are going to make up a falsehood and sell it across America.

Well, apparently, that is what America had come to because they did promote that falsehood all across America.

Now back home in Oregon, I have made a commitment to go to a townhall in each of my 36 counties every year, open hour. People can come and share whatever they want.

I am out in Prineville, OR, where, normally, there would be, like, 30 or 50 people at a townhall and about 500 people show up. Why? Because they are terrified of a government takeover of the healthcare system. There was about 200 people inside the room. There are several hundred people outside who can't get in because the room is completely packed. And they are angry. They are very angry.

And one man shouts out and says: Why won't you listen to us and stop this government takeover?

And I said: I will listen to everybody in this room. I will describe major features of the plan, and you all can respond to me: Step forward or step backward. So I said: How about requiring insurance policies to cover pre-existing conditions? Step forward--80 percent of the people in the room raised their hand. Step backwards--about 10 percent. Another 10 percent didn't vote.

I said: How about having preventive tests free because an ounce of prevention is worth a pound of cure? Step forward--80 percent yes.

How about having children on your policy to age 26? Again, 80 percent yes.

How about having a website where you can compare private insurance policies so you can pick the best one for your family? Again, 80 percent yes.

Well, by now, people are looking around the room going: Well, this all sounds pretty good. Of course, they came, and they were very angry.

I said: Let's talk about the economics of this. How about providing tax credits to help middle-class Americans buy insurance from private companies? Again, 80 percent yes. People liked that idea.

How about expanding Medicaid because we have the least affluent in our society who are trapped between just a little too affluent to qualify for Medicaid, but they certainly can't afford private insurance.

Oh, no. That sounds good too.

And so I would say then: Thank you very much for the feedback on the major features of the plan. There is no government takeover in it, but you have all expressed to me your support for many of the features, and that is why I am supporting it.

Well, this was the year 2009. You had a blue trifecta that said: Let's fill in the holes on healthcare, and we went about and did it. And now let's fast forward to 2025. You don't have a blue trifecta; you have a red trifecta. And the red trifecta knows how important health insurance is, so they made some promises. And the promises were: We will not touch your healthcare. We will not force people off insurance. And, in fact, they did exactly the opposite.

In 2009, the House, the Senate, the Oval Office working together to fill in the holes and make sure everybody could get healthcare; 2025, the red trifecta, the Oval Office, Republican leadership in the House and Senate say: We are going to tear down your access to healthcare. And that is what they did in the one big ugly betrayal of a bill voted a few weeks ago right here in this Chamber, tearing down your healthcare. And 15 million Americans are going to lose access to healthcare because of this bill.

Here is the philosophy we saw: Roll out the red carpet for the rich and powerful. Roll out the redtape for the less affluent. Wow. What a horrific strategy to rip healthcare away from 15 million people.

What does that mean to a family when they lose health insurance? Well, I will tell you. It means that they don't go to the doctor. And when they don't go to the doctor, that lump they ignored becomes ravaging breast cancer with horrific consequences for the woman, the family, the children. It means diabetes delayed is diabetes that is much more severe and hard to treat. It means all sorts of risks for the individual and all sorts of consequences for the family and the stress of knowing you have a healthcare condition and you should go to a doctor but you don't go because you can't afford to go.

Or maybe you do buy a policy, but now it is more expensive. Here is what is going to happen on the healthcare exchange in Oregon. The cost is going to go up by 68 percent, an estimated $1,300 per family, because the big ugly betrayal of a bill raised the cost of buying healthcare on the exchange because it didn't extend the premium tax credits that were in the bill previously, that were in the system previously.

Well, that is a shocker. If people spend the money there, it may well be that they don't have the money for their rent, may not have their money to purchase the prescription pills that the doctor they went to said they need to buy, or maybe it is an impact on groceries.

And I will tell you what else happens. With so many people losing Medicaid--in Oregon, the Oregon Health Plan--and in Oregon, the estimate is 150,000 to 200,000 people will lose Medicaid.

Well, now in your rural clinics and hospitals, we have a situation where the revenue that flows to that clinic or hospital drops dramatically.

This is from the Sheps Center for Health Services Research, University of North Carolina--real experts on rural healthcare. And what do they say in this study? They say that more than 300 rural hospitals are at risk of either closing or significantly reducing their services because of the big ugly betrayal of a bill.

Oregon, four rural hospitals or clinics. Almost every state is listed here. Is that really what we want to do? We want to shut down rural healthcare?

And when you shut down a clinic, when you shut down a rural hospital, you aren't just affecting the least affluent who were on the State's Medicaid plan; you are affecting everyone in the community. Every single person loses access to the healthcare when the clinic or hospital shuts down.

We lost, 2 years ago, a maternity care ward in Baker City, OR. Tragic for the community. If you are getting ready to have a child, now you are thinking about the fact, to have it delivered, I have to go at least 70 miles down I-84, and I-84 is often closed in winter due to ice and snow.

Is that the stress? We want to rip healthcare out of our rural community and put on the stress?

And I will tell you what else happens: People simply don't get down the road for the medical treatment that they should be accessing.

So here is the story. This is wrong, so we are going to introduce a bill that reverses this and says: Everything that was ripped out of American healthcare by the big ugly betrayal of a bill, we are going to restore it. And we are going to add in the same tax credits people had access to last year. That way, there won't be a 68 percent increase for people buying healthcare on the exchange on Oregon, a $1,300 increase. That way, the middle class will still be able to afford to buy policies, and the less affluent will still have health insurance so they will get the care that they need, and the rural communities will still have the cash flow to be able to keep their clinics and hospitals open.

That is the right vision, not the vision of: Families lose and billionaires win. That is the whole vision of the big ugly betrayal of a bill. No, but, instead, a better vision. And what is that better vision? Families thrive and billionaires pay their fair share. Let's fight for that vision.

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