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Sen. Jeff Merkley Headshot

An Imperfect Stride Towards Justice

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Dear Friends,

At 7 am this morning, a short time ago, I voted for the Patient Protection and Affordable Care Act. It passed.

If you are like me, it is hard to respond with uninhibited celebration. It is hard to celebrate when you are mourning. I am mourning the loss of the national public option. I am mourning the infringement on women's constitutional right to choose.

And there is much more about which I am frustrated. The bill does not, for example, adjust the discrimination in Medicare reimbursement rates that afflicts states like Oregon and Minnesota and Iowa. As a consequence, in Oregon it is hard for our Medicare card holders to get in a doctor's door! The bill doesn't address the outrageous prices Americans pay for drugs. The important health care marketplaces established in this bill don't get set up for four long years -- way too long! And I could go on.

But I voted for this bill today because, while there is a lot this bill doesn't do, there is also much that is right and good in this bill. Because of this bill:

* 30 million Americans will gain access to affordable health care.
* 10,000 additional communities will get community health centers.
* A new Health Care Bill of Rights will:
** ban the practice of barring health insurance to citizens with pre-existing conditions;
** ban the practice of dumping policy holders who get sick or injured;
** enable children to stay on their parents' policies through age 25;
** ban discrimination based gender or health histories; and
** ban lifetime coverage caps.
* Insurance purchasing pools (exchanges) will give individuals and small businesses--who have been lambs to the slaughter when trying to buy insurance--access to fair rates.
* Insurance companies must spend at least 80%-85% of premiums on health services (higher than the current national average).
* America will invest far more in prevention and disease management.

These are good things. And there is a lot more. One of my favorites--in part, I confess, because I led the fight for it--is the amendment that guarantees every mother returning to work the privacy and flexibility in break time needed to nurse her child or pump breast milk. Breastfeeding is great for the baby's and the mother's health, and is a big factor in emotional bonding as well. Another good feature is that a host of preventive services will be provided without any fees or co-pays. Yet another is the pilot projects on integrated health care, to expand bundled payment strategies and replace the ever-more-expensive fee-for-service arrangements. There are requirements in this bill that will produce a flood of health information that will help us launch future reforms. This bill does a lot to take on the health care workforce shortages driven by boomer demographics. And this bill opens the door to state-crafted public health plans that could have a huge impact.

And here is a fundamental accomplishment: Because of this bill, health care in the United States of America is no longer a privilege, it is a right.

When I joined the Senate in January this year, I asked Senator Ted Kennedy if he would consider advocating for my membership on the Senate's Health, Education, Labor, and Pensions committee. He did, and I've been honored to serve on his committee and to fight for the goal that was his biggest ambition: affordable, quality health care for every single American. When we gathered with Senator Kennedy in his hide-away office earlier this year to debate strategy, he knew the size of the challenge. At that point, the Democrats didn't have 60 votes in the Senate: Arlen Specter was still a Republican and Al Franken hadn't yet won his seat over Norm Coleman. We didn't know if we would be able to win the Republican votes necessary to end debate and hold a final vote on the bill. We didn't know how we could make the bill deficit neutral. We didn't know how we would overcome the charged issues of immigration and reproductive rights. But we decided to push forward with every ounce of our hearts and minds, sensing that there was a generational opportunity that we had to seize.

Senator Kennedy had served in the Senate for 47 years and had never had the opportunity to vote for universal health care on the floor of the Senate. Due to the road he paved over decades, and the spirit he showed throughout this year until his death, I have had that opportunity after only 12 months in office. I can report to you that a short while ago the U.S. Senate passed a universal health care bill. This bill, for all its shortcomings, will provide affordable, quality health care to virtually all Americans.

That is a big deal. But to secure this victory, we must still come back in January and win passage of amendments proposed by the House or by the Conference Committee. The fight continues.

I hope that all of you in the progressive community will keep mourning the battles that we lost this year on drug prices and single-payer and public option and Medicare. We must draw from our frustration and anger the power to keep organizing and keep fighting so that we can win battles to improve on the work done this year. The fight for justice is never over.

But also take a moment to recognize that the progressive elections you won in Senate races across the country--including mine in Oregon--made a big difference. Without them, we wouldn't have made history this morning - passing legislation containing the Health Care Bill of Rights, the community health centers, the purchasing pools for individuals and small businesses, the investment in prevention and disease management, and the promise that every American is entitled to affordable care. What we have done is take a long stride toward economic and social justice. I think Senator Kennedy would be pleased.

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