Mike Tracy will be the first person to tell you there are things that he does not know. At the top of the list is a certain amount of confusion about politics.

"Or maybe it's that they figure by the time they do need help, that someone will have come along and fixed the mess they made? That's kind of what I think. And, in the meantime, we just have to hope for the best."

"I really don't know what to believe," he says. "These people who want to do away with health care, do they really believe that they will never get sick, that they will never need help? Or do they just not care?

"One thing I do know," he says. "I know that my life will not be as comfortable as hers is. And if this new health care repeal passes, I don't know how comfortable hers will be for that much longer."

By "we," the 56-year-old Tracy means himself and his 91-year-old mother, Betty.

Betty is able to live in Laurelhurst because Medicaid helps pay the bill. Mike, who has had his share of medical issues — including a period where his doctor feared a tumor, resulting in expensive tests and ER visits that he had to pay for out of pocket because he had no insurance at the time — had gone years without insurance after leaving his job to care full time for his parents.

The Tracys are sitting in a community room at Laurelhurst Village, a residential facility for seniors in the southeast section of Portland, Oregon. Betty is one of 189 people living at the facility, 89 of whom are on Medicaid.

He is now dependent on coverage for medications, including Nexium, that he takes every day.

Betty and Mike are among the 400,000 Oregonians — and millions of Americans — who were able to get coverage as a result of the Affordable Care Act, which opened Medicaid to people under 65 years old like Mike based on income — or, rather, lack of income.

The bill — named for Republican senators Lindsey Graham of South Carolina and Bill Cassidy of Texas — would end Medicaid as most people have known it for decades, replacing much of it with block grants that would be administered by the states.

If Graham-Cassidy, the latest Republican effort to repeal the Affordable Care Act, were to pass, according to at least one estimate, they would likely lose that insurance. The Center for Budget and Policy Priorities determined that Oregon would lose approximately $3.6 billion — more than any other state in the country.

If the Republicans, as they have said, bring the bill the to a vote this week, they will be voting without having received a full analysis of the bill by the Congressional Budget Office. That office says it will take weeks before it is done. The analysis by the Center for Budget and Policy Priorities says while it can't put an exact number of how many people lose insurance, it will likely be more than 32 million.

Meanwhile, the thing about having states administer programs through block grants is just one aspect that bothers Mike. When health care exchanges were first set up under the ACA, Oregon tried setting up its own exchange — an effort that ended up in court and the state eventually joining the federal exchange.

"There is a system right now," he says. "It may not be perfect, but it is working. Suddenly they want every state to reinvent the wheel? And what if one state sets one standard and another sets one that's more open? People are going to start leaving one state for another, overwhelming the other state.

"What sense does that make?"

Mike has been working full-time taking care of his parents for more than a decade now.

"It started when my dad got sick," he says. "I was working at Horizon Air — I had started there in 1998."

Mike was the airline's supervisor for ground operations at Portland International Airport, which means he was in charge of — among other things — making sure that the planes got to and from the gates and that passengers got on and off the planes.

"And in 2005, my dad was getting sicker, and I was taking more and more days off to take care of him," he says. "Originally my bosses were supportive, understanding. Eventually, though, it was too much and they allowed me to resign."

Mike says that when he had been working, he was very good about investing and saving, and spending wisely. He originally paid to continue insurance after he left Horizon but, as expenses caring for his parents piled up as did the cost of just living day to day, insurance became prohibitive.

The choice was caring for his parents or for himself. It really wasn't a choice.

"I was able to put enough money away to take care of my dad and now my mom," he says. "And myself, I guess, to a certain degree, but by the time I'm where my mom is, as I said, I won't be able to be as comfortable.

"I like to think that I always have a plan. This time, I'm not really sure what it will be."

Mike shows up every morning at Laurelhurst, often showing up at 7:30 and staying until 10 at night.

"I'm here about 90 hours a week," he says. "Not just helping mom but helping others as well. The staff is here great, but there is only so much that they can do. And not every person here has someone who can come in and help them."

Mike says that as a volunteer, while he can't do anything medical, there are many small tasks he can perform for his mom and other residents.

"From getting ice cream to helping get people to and from the dining room, there's a lot I do to help people out," he says. "So many people have no one, and to be able to do something for them is a great reward."

His mom smiles at him.

"He does so much," she says. "He works so hard for so many."

Betty knows about working hard.

"I worked my whole life," she says.

"She worked for 55 years," Mike adds. "She did her part, paid into the system."

But without Mike, it's not clear where she would be now.

"She lived with me for about 10 years," he says. "And I did a pretty good job."

Earlier this year, though, it became too much. Over the past few years, Betty had had a couple of stints in physical rehabilitation facilities that always got her back to where she could go back and stay with her son.

This time, though, she failed rehab, as she points out.

"She wasn't as mobile as she had been," he says. "And there's only so much that I can do."

This is where Medicaid becomes very important. There's a misconception that once people reach a certain age, Medicare takes care of them. It's not the case. It pays a portion of expenses mostly related to rehabilitation facilities.

"Medicare doesn't cover much," Mike says. "Medicaid more, but still not everything."

A place like Laurelhurst, which is better than some, not as fancy as others, still costs a few grand every month. Medicaid covers some — including $60 a month for personal expenses — but not enough, which is why Mike is watching his savings dwindle.

"By the time I am no longer to take care of myself," he says. "If there is no more Medicaid available to me, I'm not quite sure what I will do."

Mike is the youngest of three brothers — one has spent his life at a job and the other has spent his life in the military — and he wonders if his next step might be helping take care of one of them.



"Would I have liked to have been married, to have spent my life at a good job, to have bought a new car once," he wonders. "Of course. But taking care of family, there is nothing more important than that. My mom and dad took care of their parents, they took care of me, then I took care of my dad and now her.

"I don't understand why people don't see how important it is to look after the people around them. It seems so basic yet so incomprehensible to so many."

Betty looks at her son.

"You're a good son," she says. "A good person."

Photo of Mike and Betty Tracy by Colin Miner/Patch

