Sen. Jeff Merkley on Republicans’ efforts to repeal and delay

Sen. Jeff Merkley, the junior Democrat from Oregon, takes a dim view of his Republican colleagues’ strategy to immediately repeal the Affordable Care Act — but delay the effective date.

Republicans don’t want the “the millions hurt by repeal to be hurt before the next election, so they push it beyond that,” Merkley said in a sit-down interview with the Business Journal at his Washington, D.C. Senate office.

“That way, they can fulfill their promise to their base, but not actually do it for several years, so they don’t suffer a big backlash in the next election. When people are afraid of how citizens will react, it tells you millions of people will be hurt.”

President-elect Donald Trump repeatedly promised to repeal Obamacare, something Republicans in Congress tried dozens of times to no avail with President Obama in office. Now Republicans plan to proceed shortly after inauguration day, using budget reconciliation. That way, they could revoke parts of the health law with a simple majority, thus avoiding a Senate filibuster.

More than 20 million Americans have gained coverage under the ACA, mostly through the Medicaid expansion and the rest through the health exchanges. In Oregon, more than 400,000 people were added to the Medicaid roles, while another 135,000 signed up for commercial plans via the exchange. The uninsured rate dropped to about 5 percent from 14 percent before the ACA, making Oregon “one of the most successful states in the country,” Merkley noted.

Still, the law has experienced major bumps, as private insurers have exited the health exchanges, in Oregon and around the country, and rates have increased by double digits. Premium tax credits, however, have insulated most consumers who buy their own insurance, including 95,000 Oregonians.

Merkley worries that if Congress passes a repeal early next year but it doesn’t take effect for three years, the uncertainty could lead to more insurers bailing out of the exchange. He also expressed concern about the future of Medicare. Rep. Tom Price, a Georgia Republican who is Trump’s pick for secretary of the Department of Health and Human Services, supports privatizing Medicare by converting it into a voucher program.

“Seniors of modest means soon wouldn’t be able to afford what Medicare current provides. It would be breaking a promise. It’s been a central promise of the working social contract in America, which is under assault,” Merkley said.

During his town hall meetings all over Oregon, constituents decried the ACA as a “government takeover” of health care. But once he broke it down, they would voice support for various aspects of the law, including the exchange marketplace, consumer protection rules on pre-existing conditions and premium support, he said.

“The families it helped tremendously are rural families that didn’t have access to health care before,” Merkley said. “This is traditional red territory, so it’s not a program that benefited blue families but not red. It’s been tremendously powerful in rural areas, including the funding for rural health clinics.”

Merkley, the only senator who backed Sen. Bernie Sanders’ presidential bid, co-sponsored a resolution with the Vermont Independent and several Democratic senators that would have created a public option, or Medicare-like insurance plan.

That effort, which began in September, now looks to be dead in the water.

“A public option would be very helpful for driving down the cost of health care, but at this point, that’s not shared by the majority of the House and Senate,” Merkley said.