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Oregon Democrat backs changes at town hall meeting in Milwaukie, but stops short of commitment sought by advocates of a single-payer system of insurance.

PAMPLIN MEDIA GROUP: PETER WONG - U.S. Sen. Ron Wyden, D-Ore., makes a point during a town hall meeting Saturday, Dec. 1, at Rex Putnam High School in Milwaukie. Seated are Principal Ryan Richardson and Matt Utterback, superintendent of North Clackamas schools.U.S. Sen. Ron Wyden coped with a few hecklers Saturday, Nov. 30, during a town hall meeting at Rex Putnam High School in Milwaukie.

The Oregon Democrat responded to a few in the audience of more than a hundred — some of them from the Portland chapter of Democratic Socialists of America — who criticized him for not co-sponsoring legislation to make the federal government the nation's sole payer of health care.

Without dismissing advocates of a single-payer system, Wyden said he wants to pursue other steps that might be politically possible in the next Congress — where Democrats have secured a slim majority in the House, but lost two seats in a Senate that remains under Republican control.

"There are a lot of pieces to this puzzle," he told the audience. "If we were starting over … nobody would say we ought to do what we are doing now. The question is how to get there from here, where everybody in America gets good-quality, affordable coverage."

Among Wyden's proposals, all of which he offered in the current Congress ending this month:

• A requirement for more disclosure by pharmacy benefit managers, whose job is to negotiate rebates with drug manufacturers and to manage costs and complex specialized medications.

"We don't know what they are doing for themselves or for you, but it isn't good," Wyden said about the lack of information about drug rebates.

• A requirement for drug manufacturers to document big price increases for medications. "If a drug company wants to raise its prices, it ought to publicly justify them," he said.

• Authority for Medicare, the federal program of health insurance for people 65 and older, to negotiate drug prices. Republican majorities in Congress denied such authority in 2003 when they approved prescription drug coverage under Medicare.

Although Wyden has received campaign contributions from the health-care industry in the past, he said, "The Big PhRMA lobby is opposing all three of these things," a reference to the Pharmaceutical Research and Manufacturers Association, which represents the drug-makers.

Wyden is the top Democrat on the Senate Finance Committee, whose authority extends to the major federal programs of Medicare, Medicaid for low-income people, and the Children's Health Insurance Program.

Republican Charles Grassley of Iowa will succeed to the committee chairmanship in the new Congress. He and Wyden released a report three years ago critical of Gilead Sciences, a biotechnology company based in California, for its price increases for hepatitis C medication.

Wyden said afterward he hopes he and Grassley can find common ground, based on that experience.

"The best predictor of the future is to look at the past," he said. "I thought it was important and he was willing to take on some price-gouging. That is what we need."

Meanwhile, single-payer legislation was introduced by independent Sen. Bernie Sanders, who sought the Democratic presidential nomination in 2016, and co-sponsored by 16 Democrats including Oregon's Jeff Merkley. But only one of them sits on the Finance Committee.

Wyden did not mention it, but Democrats lost two seats in the Senate, where Republicans have a 53-47 majority.

Democrats gained 40 seats to win the House for the first time since 2010.

Single-payer advocacy

PAMPLIN MEDIA GROUP: PETER WONG - U.S. Sen. Ron Wyden, D-Ore., after a town hall meeting Saturday, Dec. 1, at Rex Putnam High School in Milwaukie.
Although Saturday's meeting — his third in Clackamas County this year — was not the first where Wyden has faced tough questions about health care, single-payer advocates have been pushing Democrats to make it their cause.

Nico Serra of Portland, a health-care and housing advocate, was not as confrontational when he asked Wyden a question.

"I feel for him because he has to hold a lot of contradictions. We talk about big money in politics and what the people need," Serra said afterward.

"I am hoping we as grassroots leaders can provide the support that he needs to do what he wants to do. To me, it seems he is being tied down by the same problems that are pulling a lot of us back."

Wyden said afterward he isn't bothered by the critics.

"This is a complicated issue. That's why I do these town hall meetings to get everybody's input," he said.

But Wyden also said that employer-sponsored health insurance, which emerged after World War II and still accounts for coverage of 100 million throughout the country, cannot disappear overnight.

Nearly 350,000 Oregonians are enrolled in Medicare Advantage plans that offer coverage in addition to basic hospital and doctor services. Oregon has one of the highest participation rates among its 800,000 Medicare recipients.

"They are going to ask where they are going to go for health care the day it does not exist," Wyden said, if the federal government is the only provider of health insurance under a single-payer system.

Wyden did say he would favor a "public option" for insurance.

Still under attack

PAMPLIN MEDIA GROUP: PETER WONG - U.S. Sen. Ron Wyden, D-Ore., fields questions from a town hall audience Saturday, Dec. 1, at Rex Putnam High School in Milwaukie.Although a House under a Democratic majority is likely to forestall future Republican attempts to repeal the Affordable Care Act — the 2010 health-care overhaul popularly known as Obamacare — Wyden said the law is still under attack.

Republican congressional majorities, in a tax-code overhaul they passed last year without Democratic support, removed a requirement for people to obtain insurance coverage or pay penalties on their income-tax returns. This is known as the "individual mandate," originally a Republican idea.

Republicans have also proposed to convert Medicaid — which Oregon and 35 other states have chosen to expand under the 2010 law — into block grants that may result in future spending cuts.

President Donald Trump also reduced the enrollment period for insurance, plus advertising and assistance for signups, although Oregon filled some of those gaps through state action.

Trump wants to allow states to sell stripped-down plans that offer less coverage for services than the 2010 law requires. Wyden calls them "junk plans."

The Trump administration also sides with states led by Republican attorneys general in their lawsuit challenging the 2010 law's guarantee of insurance coverage without extra cost to people with pre-existing medical conditions. The lawsuit is pending in a federal court in Texas.

"That means America would go backward to the days when health care was for the healthy and wealthy," Wyden said. "So I spend a lot of my time trying to stop people from going backward."

Wyden was the chief sponsor of a bipartisan bill, the Healthy Americans Act, which would have offered universal coverage through a new private insurance system for everyone except Medicare recipients and military personnel. Some of its key provisions, notably the guarantee for pre-existing conditions, did make it into the 2010 law.

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Other issues

U.S. Sen. Ron Wyden offered these comments on other issues:

Climate change: He will propose doing away with 40 current tax breaks for fossil-fuel producers and substitute three to promote energy efficiency, development of alternative sources, and cleaner transportation.

He said a recent federal report contradicts President Donald Trump and other deniers of climate charge.

"What they laid out in the Oregon section alone ought to be a wake-up call to everybody to what this is going to do to the outdoors — the skiing areas, the fish, our wonderful rivers and the like," he said. "So my hope is that we can move from that wake-up call to get serious about the urgency of this challenge."

Immigration: He still believes in the bipartisan approach developed by then President George W. Bush and Sen. Ted Kennedy back in 2006 — and which passed the Senate in 2013, but died without a vote in the House — to strengthen border security without Trump's "preposterous wall." The 10 million undocumented immigrants would be put on a path to citizenship after learning English and paying fines.

"I was for it then. I am for it now," he said. "I think it is the only way we extricate ourselves from this."

Russia investigation: He said it was significant that Michael Cohen, Trump's personal lawyer, pleaded guilty to lying about the extent of discussions involving a Trump Tower project in Moscow during 2016.

"The reason that is so significant is that while Cohen is in effect in Moscow and talking with the Russians about the Moscow hotel deal for Donald Trump, Trump was in America campaigning for president," Wyden said, and calling for better U.S. relations with Russia and President Vladimir Putin.

"What we saw in the plea agreement with Michael Cohen was that what Donald Trump was talking about is not America first, he was talking about Donald Trump's bank account first. It is a big development."

— Peter Wong

Note: Adds brief comments by Wyden on other issues during his town hall meeting.

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