U.S. Sen. Ron Wyden's 818th town hall meeting was almost an hour old Saturday night before he got to Topic A now before the Senate. The Oregon Democrat minced no words about the legislation passed by House Republicans to reshape health care without the insurance coverage required by President Barack Obama's signature law.
"My view is that the House bill would slam Oregon with a tsunami of suffering that would plunge thousands of Oregonians into debt and anguish," Wyden told hundreds cheering him on at Liberty High School in Hillsboro.
"I want you to know I will do everything in my power, night and day, to derail that House bill. That's what Oregonians have been asking me to do."
But even though he is the top Democrat on the Senate Finance Committee — which writes tax legislation, including how the major federal health programs are funded — Wyden said he will need to build a coalition to support his efforts.
Among such supporters, he said, are older people — Wyden's first job in the 1970s was as executive director of the Grey Panthers advocacy group — as well as people with disabilities and children with special needs.
"My hope is that we can come out of the gate early, in terms of showing the flaws in this bill, so that Senate Republicans will reject it," he said.
The House passed it 217-213, with no Democrat in favor. The Senate has 52 Republicans, 46 Democrats and two independents who vote with Democrats.
Two people in the audience pressed Wyden on how he would ensure coverage for those with disabilities.
"I was pleased with his answers," said Debra May of Aloha, who was speaking for a friend with disabilities. "I am hoping the House bill gets slammed in the Senate."
Kassiane Asasumasu of Portland had a different take.
"I would like to have heard more action items on what he plans to do," she said. "But he tried."
It was Wyden's second town hall this year in Washington County. The first was at the Hillsboro Civic Center a few days before Republican Donald Trump was sworn in as president on Jan. 20.
Since he was elected a U.S. senator in January 1996, Wyden pledged annual town hall meetings in all of Oregon's 36 counties. He said he may step up the number this year.
"This is really different," Wyden said. "The stakes are so high."
A long list
Wyden is particularly concerned about how the House bill treats pre-existing conditions but he objects to many other provisions as well, including:
n A cumulative reduction of $800 billion in Medicaid, a joint federal-state program most widely known for providing health insurance to low-income people but which also supports nursing home care of people who must spend down their assets.
"These are people who did everything right," Wyden said. "They taught our kids, fought our wars, always volunteered in the community. And guess what: Getting older in America is not cheap — and they ran out of money."
n Schools now can be classified as medical providers, which allows them to receive federal reimbursement for services to children with special needs. The House bill would let states exclude schools.
"These kids do not have lobbies or political action committees," he said. "Medicaid is a real lifeline for them."
n People ages 55-64, just before they are eligible for Medicare, could be charged more than younger people for coverage — someone age 64 up to five times more than someone age 18 — and older middle-class people would get less federal subsidy in the form of tax credits to pay for insurance.
"It's an age tax, plain and simple," Wyden said. "And it is wrong."
n Two taxes under the 2010 law would be eliminated for individuals earning more than $200,000 and couples earning more than $250,000. They now pay an increased Medicare tax of .9 percent, and an additional tax of 3.8 percent on investment income.
The bill also would roll back taxes on medical devices, indoor tanning, prescription drugs and health insurance products.
"We're going to go back to the days when health care was for the healthy and wealthy," he said.
n Insurers could reinstate lifetime limits on benefit amounts paid out. Wyden said this could affect 160 million Americans with employer-sponsored coverage.
"If you have cancer, you can bust the cap in a hurry," he said.
Almost from the moment he returned from Washington, D.C., Wyden said, he was urged to resist the House bill at meetings in Medford and Merlin — in two Southern Oregon counties Trump won, even though Democrat Hillary Clinton carried the state.
Most of those two counties are in Oregon's 2nd District, whose Republican representative, Greg Walden, voted for the bill.
"I cannot express in words the fear I have seen in the past couple of days," Wyden said.
He quoted one Senate Republican — Louisiana's Bill Cassidy, a physician by training — as saying a final version would have to pass a "Jimmy Kimmel test," referring to the late-night comedian, who made an on-air appeal to Congress to protect people with serious continuing ailments such as the heart condition of his infant son.
The 2010 law is known as the Affordable Care Act and unofficially as "Obamacare." It bars insurers from denying coverage or charging more to people with pre-existing medical conditions.
A recent Washington Post-ABC survey found that seven of every 10 respondents favored all 50 states barring insurers from charging people more based on health history.
The House bill would let states seek waivers from that requirement if they had alternatives to help those most at risk — and also from "essential benefits" such as maternity care, mental health and prescription medications.
"I do not care how much money they promised," Wyden said.
Many in the audience wore stickers that read, "Being human is a pre-existing condition," "Life is a pre-existing condition," and "I am a pre-existing condition."
Wyden was the chief sponsor of a bipartisan alternative known as the Healthy Americans Act, portions of which were made part of the 2010 law that passed with only Democratic votes.
"We did not get all we wanted, but we got an airtight provision, loophole-free protection, for the millions of people who were previously discriminated against for a pre-existing condition," he said. "The House bill takes away that guarantee. Don't let anybody tell you otherwise."