Health Care

Congressman DeFazio is committed to reining in the escalating costs of health care and prescription drugs and ensuring access to affordable, quality health care for all Oregonians and Americans. 

The skyrocketing costs of health care in the United States are untenable. In fact, Americans pay more for health care, by far, than any other developed country, yet we have the worst health outcomes compared to these other countries. Nearly 1 in 4 Americans—including insured Americans—skip medicine and medical care because of high costs. Congressman DeFazio believes this is absolutely unacceptable.  

The health care system is failing too many people. Too many families are vulnerable to the whims of the insurance and pharmaceutical industries, which in DeFazio’s view are more interested in protecting their billions in profits rather than protecting the health care of hard-working Americans, families, and seniors. Seniors are also vulnerable to the same insurance and pharmaceutical industry tactics, and their Medicare coverage continues to be under threat by ideological attacks. 

Protecting and Improving the Affordable Care Act (ACA) 

The Affordable Care Act dramatically reduced the number of uninsured Oregonians and Americans. Yet ever since its passage, critics have attempted to repeal the ACA without ever providing a suitable replacement. DeFazio has always said the ACA is not perfect, and that there are many aspects of the law that need to be fixed – but he believes the law should be reformed rather than replaced.  

DeFazio strongly believes that repealing the ACA would severely disrupt our country’s health care system and threaten the health and well-being of thousands of Oregonians and millions of Americans across the country. For example, if the ACA were repealed:  

• More than 20 million Americans could lose insurance coverage, including more than 372,000 Oregonians and more than 72,000 in Oregon’s 4th congressional district alone.  
• Over 135 million Americans under age 65 who have pre-existing conditions, including over 300,000 Oregonians in Oregon’s 4th congressional district, could be denied coverage or charged more for coverage.  
• The Medicare Part D coverage gap or ‘donut hole’ – which the ACA closed – could return, meaning the 155,000 seniors in the Oregon’s 4th congressional district who receive Medicare Part D benefits could be subject to an annual copay as high as $2,400. 
• Medicare beneficiaries would likely face higher premiums and pay more for preventive care.  
• Young Americans under the age of 26 who are covered under a parent’s health insurance plan could lose their coverage. 
• Big Pharma and billionaires would receive a windfall of tax cuts while the health and financial security of low- and middle-income Americans would be jeopardized.  

Major Accomplishments  

Expanding Health Care for All 

Rep. DeFazio believes that if we want to increase access to affordable health care, lower insurance premiums, and cut prescription drug costs, we need to explore all available options. While the Affordable Care Act (ACA) dramatically reduced the number of uninsured Americans by the millions, Rep. DeFazio has always maintained that the ACA has been in great need of improvement since day one.  

In Rep. DeFazio’s view, the ACA bill that became law simply did do enough to help all Oregonians and Americans. Rep. DeFazio believes the original ACA bill that passed the House in 2009 was far superior, with national exchanges and a government not-for-profit option. If the final ACA bill hadn’t been watered down by the Senate, Rep. DeFazio believes that this government-run, not-for-profit health plan would have paved the way for providing more comprehensive coverage at lower cost. 

That is why Rep. DeFazio has consistently introduced his own legislation that would establish a government-run not-for-profit plan, expand health care access, and bring down costs.  

Rep. DeFazio has been very vocal about reforming the individual mandate. That’s why soon after the ACA was passed, he proposed a bill that would reform the individual mandate by allowing individuals to opt out of this controversial mandate if they accept the full cost of their own healthcare. 

Ending Health Insurance Industry Price-Gouging 

In 2020, the House of Representatives unanimously passed Rep. DeFazio’s legislation to promote fair competition and rein in the health insurance industry’s price-gouging of consumers. DeFazio’s legislation would repeal an antiquated antitrust exemption which allows insurance companies to conspire with each other to artificially raise health care costs and set market share to increase their profits.  

Today, insurance companies still can—and do—price-gouge consumers and reap massive profits on the backs of seniors, working families, and everyday Americans. In 2019, while an estimated 33 million Americans were uninsured, the health insurance industry raked in $35 billion in profits. That’s obscene. 

Rep. DeFazio successfully fought to include similar provisions to end the insurance industry’s antitrust exemption in the House-passed ACA bill, but the language was stripped by the Senate. Since then, Rep. DeFazio has continued fighting to put an end to this exemption and finally rein in the health insurance industry’s price-gouging. 

As long as this exemption is still on the books, health insurance companies will continue to drive up prices, limit competition, conspire to underpay doctors and hospitals, and overcharge consumers. DeFazio’s legislation will protect consumers and make sure the health insurance industry finally plays by the same rules as virtually every other industry in America. 

Lowering Prescription Drug Costs 

Rep. DeFazio strongly opposes pharmaceutical companies’ price-gouging of prescription drugs, and throughout his time in Congress he has fought to stop Big Pharma’s price-gouging of Oregonians and Americans.  

Skyrocketing prescription drug costs continue to prevent many Oregonians from having the health and financial security they deserve. Despite the fact that billions of U.S. taxpayer dollars are spent every year on the development and distribution of prescription drugs, Americans pay more out-of-pocket for prescription drugs than individuals in any other country.  

Rep. DeFazio believes Americans should not pay to develop a drug only to see it put on the shelves in the U.S. at a much higher price than other nations. That’s why Rep. DeFazio has introduced legislation to end price-gouging on prescription drugs developed with taxpayer-funded research. Under this legislation, federal agencies would secure affordable pricing agreements for taxpayer-funded prescription drugs. 

Medicare Part D and the ‘Donut Hole’ 

Rep. DeFazio has also long fought to protect seniors from pharmaceutical companies’ price-gouging under the Medicare Part D program, which 155,000 seniors in Oregon’s 4th congressional district rely on for prescription drug benefits. 

Rep. DeFazio opposed the House Majority'’s refusal to allow the federal government to negotiate prices for Medicare Part D when the program was created. This omission has allowed drug companies free rein to charge Medicare recipients higher prices – more than anywhere else in the world – resulting in massive handouts of taxpayer dollars to the pharmaceutical industry.  

That’s why Rep. DeFazio has consistently supported legislation to authorize the federal government to negotiate prices for all prescription drugs covered by Medicare Part D. 

Rep. DeFazio has also long opposed the Medicare Part D coverage gap, or ‘donut hole’, which for years resulted in massive out-of-pocket drug costs for many seniors in Oregon. The Affordable Care Act (ACA) gradually lowered donut hole costs for seniors and finally closed it in 2020. DeFazio opposes efforts to repeal the ACA, which if repealed would re-open the donut hole and once again subject seniors to massive out-of-pocket drug costs. 

Protecting Medicare 

As a trained gerontologist, Rep. DeFazio has devoted his career to protecting programs and benefits vital to seniors. Throughout his time in Congress, DeFazio has successfully opposed efforts to privatize Medicare, reduce benefits for seniors, and cut Medicare funding.  

Medicare was created because many seniors could not afford private health insurance. Health care costs were driving seniors and families into financial ruin, often forcing them into poverty.  

Rep. DeFazio is opposed to any plan that brings those days back for current or future retirees, and he believes balancing the budget on the backs of seniors and individuals with most need by cutting Medicare is irresponsible and cruel. 

Improving Access to Care for Medicare Recipients 

Because of an old Medicare reimbursement formula, Oregon used to be one of over a dozen states where doctors and hospitals received Medicare reimbursements at rates far below the national average, despite delivering better health outcomes. Oregon doctors were increasingly unable to take new Medicare patients because reimbursement rates were so low that they lost money on every patient. 

With the leadership of Congressman DeFazio, Congress finally fixed the Medicare geographic disparities formula after decades of trying. Thanks to Congressman DeFazio’s efforts, an agreement was reached to fix the outdated formula and provide a path forward for the future. Because of this effort, Oregon doctors and hospitals received immediate relief for their unfairly low Medicare reimbursement rates, resulting in improved access to heath care for seniors in Southwest Oregon.