For years, the political dynamic around the incredibly complex health insurance law known as Obamacare was quite simple: Republicans wanted to repeal it, and Democrats sought to defend it at all costs.
Lost in that polarization was the fact that a lot of people, including Oregon's senior U.S. senator, really wanted to fix the Affordable Care Act.
Thanks to Obamacare and the Oregon Health Plan, approximately 95 percent of Oregonians are covered by health care insurance. That's great. But Oregonians who don't qualify for significant federal subsidies have seen huge premium hikes when buying their own coverage under Obamacare, and insurance companies have started pulling out of the federal program after suffering heavy losses. To many, Obamacare looked a lot like a death spiral, where premiums were getting too costly for anyone to afford, leading to even higher premiums the following year. In Oregon, insurers have been dropping out of the individual market, some of them folding entirely, because of a customer base that was sicker and costlier than expected.
In a recent interview with the Portland Tribune editorial board, Sen. Ron Wyden — who proposed his own health care plan that ultimately lost out to the Affordable Care Act — confessed that the current health care plan needed to be changed. The problem, as Wyden sees it, is that Obamacare doesn't attract enough healthy people or enough young people, which makes the insurance pools smaller and filled with people who, quite frankly, need health care the most. Unless the Trump administration figures out how to replace the current health care system with one where the costs are spread more evenly across the population, Obamacare will simply spiral into oblivion — which is where some Republicans want it to go.
However, other Republicans are awakening to the reality that the very working-class people who elected Donald Trump to the presidency are the same ones who are glad to have health care. Sure, they're open to something better, but then who isn't?
The challenging task of repairing Obamacare has fallen largely to another Oregonian: the state's sole Republican representative, Greg Walden, the new chairman of the House Energy and Commerce Committee, where the heavy lifting on health care gets done.
We urge him to preserve the fundamentals of Obamacare while doing what the original law did not: meaningfully curb the costs of health care and focus government support on cost-effective, evidence-based practices rather than fostering the equivalent of an arms race among hospitals and health care providers.
One area has tremendous potential for bipartisan support: reining in out-of-control prescription drug prices. Drug manufacturers have taken advantage of a captive customer base to jack up prices, often with no reasonable basis. Critics of President Trump have said that even if the government is allowed to negotiate on behalf of Medicare, there would be nothing to prevent drug companies from raising prices for everyone else.
Wyden argues that if Trump negotiates lower Medicare prices and they become public, drug companies would have no choice but to provide private insurers with the same prices as Medicare recipients.
Walden, who holds a safe red seat in a blue state that embraced the Affordable Care Act, is in a position to improve it. Wyden, who irked fellow Democrats by once working with current House Speaker Paul Ryan on Medicare reform, could help.
We don't mind if the Affordable Care Act is repealed; just make sure there's something better set to take its place when that happens. We don't care if you call the result TrumpCare, WaldenCare or WydenCare. Just make sure it works.