What now?

July 18, 2017

Dear Friends,

There’s no doubt that Republican efforts to dismantle the Affordable Care Act and the protections it provides have collapsed because of the unprecedented energy and outrage we’ve seen across the country. This temporary victory is encouraging, but the fight isn’t over. Republicans need to abandon their disingenuous and destructive efforts to undermine the progress we’ve made, and Congress needs to work together to expand health care coverage and lower costs.

There are several ways we can improve our health care system:

  • Establishing a single-payer health care system (or Medicare-for-all) would provide truly universal coverage for all Americans.
  • Allowing younger individuals to buy into Medicare or Medicaid would expand high-quality coverage to more Americans, while providing competition to bring down costs. 
  • Creating a public option – either run by the states or the federal government – would also expand coverage while competing with private insurance plans.
  • Giving states more flexibility to expand Medicaid past 133% of the federal poverty line would insure individuals who currently fall into a coverage gap – those who make too much to qualify for Medicaid, but too little to qualify for a subsidy to purchase coverage on the exchange.

Expanding coverage is only one piece of the puzzle. We can do more to address rising health care costs. The market has seen rising premiums. Republican sabotage of the Affordable Care Act is causing further uncertainty, prompting some insurers to leave the exchanges all together. We need to implement reforms that bring down health care costs and incentivize plans and consumers to stay in the marketplace, including:

  • Allowing Medicare to negotiate drug prices.
  • Giving plans the flexibility to lower or remove out-of-pocket costs for patients with chronic illness.
  • Investing in primary care and community health centers to give patients greater low-cost access to preventive care and mental health services that ultimately save trips to emergency rooms and prevent more expensive, acute conditions.
  • Making sure the right care is delivered in the right setting, to the right person by reducing fraud, unnecessary tests and procedures, and respecting patient care choices. 
  • Encouraging innovative health care. I’m working on legislation to allow kidney disease patients to get primary care and other services they need at the same time they receive dialysis. This would prevent multiple visits to multiple providers at multiple locations – improving care while saving valuable time and costs for patients and providers.
  • Investing in telehealth to give rural patients and hospitals access to specialists and additional care options, for a fraction of the cost.
  • Stabilizing the insurance markets by offering subsidies to plans with high-cost enrollees, or that enter markets where there is either zero or one-plan options.

These are steps we should take now to help all Americans get the health care they need. If Republicans actually wanted to improve our health care system – rather than score political points – they would join us. 


Earl Blumenauer

Member of Congress