U.S. Rep. Kurt Schrader says he's focused on small fixes in health care, such as reducing premiums for those buying individual coverage, instead of a totally government-paid system such as Medicare.
The Oregon Democrat says the time is right to pull together minority Democrats and Republicans, who have failed in efforts to gut President Barack Obama's signature 2010 law despite their majorities in Congress.
The law provides subsidies, in the form of tax credits, to help people pay premiums for individual coverage — but some people do not qualify and their premiums are soaring. President Donald Trump has threatened to drop subsidies, but Schrader said even Republicans are fearful of the consequences.
"There does seem to be a movement of members to come together," said Schrader, who has actively promoted bipartisan cooperation. "We showed our leaders there are members on both sides who actually want to get something done."
Schrader spoke about health care, and more, to a town hall meeting attended by about 150 people Tuesday night (Aug. 1) at the Milwaukie Center.
Schrader is part of a group of about 40 members, equally split between Democrats and Republicans, trying to put forward proposals less controversial than outright repeal, which has mustered little public support.
"I'm just a country veterinarian, but it seems to me that if we put a little bit of certainty back into the system, the (premium) rates will come down and might be sustainable," he said.
Although House and Senate Democratic leaders were dubious about reaching out to Republicans — who suffered most of the political backlash from repeal efforts — Schrader said they now have caught on.
"The first few steps you make are the ones that teach you how to make the rest of the steps," he said. "So I am hopeful that if we can work on this small but critical part of the marketplace, people will still have health care and we will not disenfranchise 20 million Americans."
Afterward, Schrader said more movement is likely after Congress returns from its Labor Day recess. He spoke the day before bipartisan leaders of a Senate committee announced hearings on smaller fixes, but Schrader said he expects a House committee will follow suit.
Schrader sits on the Energy and Commerce Committee, which has authority over health care legislation. Its chairman is Oregon Republican Greg Walden, who said he is open to a new approach. Walden supported and Schrader opposed a repeal-and-replace bill (HR 1628) the House passed May 4 on a party-line vote, but the Senate let die.
Slim chance for single-payer
But Schrader told the audience he would not join Oregon's other House members — Earl Blumenauer, Suzanne Bonamici and Peter DeFazio, all Democrats — in cosponsoring a bill (HR 676) to make the federal government responsible for paying all health care. It is modeled on Medicare, the 50-year-old federal program of health insurance for people 65 and older and for some people with disabilities.
All 116 sponsors are Democrats, and Schrader said there is little chance of such a bill advancing through a Republican Congress. "Democrats are not in charge," he said.
Though federal administrative costs of Medicare are a fraction of those for private insurers, Schrader said, Medicare also requires recipients to pay some premiums. For medical services under Part B, the monthly premium was $134 in 2017 — though some Social Security recipients pay less — and for prescription drugs under Part D, the cost can vary depending on the plan.
Under Medicaid, the federal-state program of health insurance for low-income people known here as the Oregon Health Plan and that covers nearly 1 million Oregonians, Schrader said many recipients do not have to pay at all.
Medicaid expansion under the 2010 law, known as the Affordable Care Act, covered more than 400,000 Oregonians.
"You have to figure out how to take care of people under Medicaid. They now get a better deal under the ACA than they would under Medicare," Schrader said.
"We have to work through that. I do not want to mislead you that is something we could do overnight. It's just not going to happen."
Schrader also said Medicare faces its own financial problems.
According to the 2016 report by government trustees, Medicare's hospital insurance trust fund will be exhausted in 2028, two years earlier than projected in the 2015 report — and Medicare accounted for 15 percent of total federal spending in 2016.
Schrader also said attempts to create a single-payer system have failed in Vermont. California lawmakers are trying, but have yet to grapple with how to pay its estimated $400 billion cost.
Schrader also was challenged on his opposition to a boycott of Israel. Boycott supporters have criticized the current government on its restrictive policies in the Palestinian territories Israel has occupied since the Six-Day War 50 years ago.
"If there are civil rights or free-speech issues, I am open to addressing them," Schrader said. "But I do not want children on campuses around this country being persecuted because they are Jewish."
Not everything raised at the hourlong meeting was contentious.
Taylor Gibson of Milwaukie asked how Congress can help former students, such as her, who are struggling with thousands in loan debt. Despite that, she said, she is managing to pay a mortgage.
Schrader said he has signed on as a cosponsor of one of several bills aimed at allowing refinancing of student loans at the current interest rate of 3.76 percent. Gibson says her loan is at 7 percent.
"Some people in Congress, not me, feel that is going to cost the government money because we will not get as much money from these students who are suffering. Isn't that baloney?" Schrader asked. "Everyone can refinance their car or house or whatever, but they cannot refinance student loans."
Schrader spoke just before a more comprehensive proposal was announced by Bonamici — who sits on the House Education and Workforce Committee — and Oregon Sen. Ron Wyden, the top Democrat on the Finance Committee.
"I was appreciative that he signed onto that bill," Gibson said afterward. "But we need more."