Merkley vs. Smith: Oregon U.S. Senate Health Positions Scored on the Evidence-Base Rubric

 

PsyPAC Oct 14, 2026  

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Scorecard

On the overall score, Merkley leads 4.0 to 1.0 out of 5. Merkley is the incumbent and has a deep health record of bills, statements and committee remarks; David Brock Smith is a state senator whose campaign materials say very little on health care, so most of his scores reflect missing evidence rather than a stated opposing policy. Scores (0 to 5) measure how specific and well-sourced each position is, not whether the policy is good. Confidence follows the rubric: High, Medium or Low. The method favors incumbents, because votes and sponsored bills (Tier 1) are the strongest evidence.​[ A ]

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The overall score is the average of the four criterion scores, weighted equally; overall confidence is the lowest of the four criterion confidences. Sub-scores, evidence tiers and sources are in the sections below. Evidence is as of October 14, 2026.

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1. Overall approach to health care

Merkley: 5 (Medium). Smith: 1 (Low). Merkley has a leading bill and consistent statements back to 2017; Smith has no stated position on coverage, the ACA or Medicaid in sources I could open.

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[ B ]

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2. Reproductive rights

Merkley: 4 (Medium). Smith: 2 (Medium). Both have clear abortion records; Merkley’s extends to contraception, while Smith’s rests on one sponsored bill.

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[ C ]

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​​3. Cost of prescription medications

Merkley: 4 (Medium). Smith: 0 (Medium). Merkley’s evidence is a bill and a campaign proposal; nothing was found for Smith.

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[ D ] 

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4. Access to mental wellness programs

Merkley: 3 (Medium). Smith: 1 (Medium). Merkley’s evidence is school-focused; Smith has one campaign phrase.

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​[ E ]

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Gaps, conflicts and caveats

These scores rest on the sources listed below as of October 14, 2026. Bold numbers are 0 to 5 sub-scores for that row; tier numbers refer to the rubric’s evidence tiers.

• Evidence is lopsided by design. Merkley is a three-term incumbent with votes, bills and official releases (Tier 1 and 2); Smith is a state senator running his first federal campaign, and his stated health positions in sources I could open are one phrase on mental health, an abortion bill from 2024 and a rural hospital funding bill. Scores for Smith mean little evidence was found, not that he opposes a position.

• Smith’s campaign site and state record. Smith’s own site could not be opened (davidbrocksmith.com, blocked), the Oregon Secretary of State voters’ pamphlet statements (the fetch failed) or his Oregon legislative bill list. His 2025 and 2026 Oregon votes on health bills were not reviewed. Smith’s campaign positions come from quotations on third-party pages.

• Unverified items I did not score. OnTheIssues records that Smith “supported requiring coverage for all for reproductive health” in July 2017, which would sit oddly with his 2024 abortion bill. The Legiscan roll call for the 2017 Reproductive Health Equity Act (HB 3391) shows no recorded vote for him, so I could not confirm it. A third-party opposition-research site, an AI-generated Smarter.vote summary and a Localcandidates.org profile (not opened) make other claims about Smith that I could not trace to a primary source.

• Self-reported and partisan material. Merkley’s figures on coverage loss, hospital closures and the cost of the Republican budget law are his own characterizations in partisan remarks, and the Congressional Budget Office figures were not checked. His 2017 and 2021 items are old. His votes were not checked on congress.gov; the release on the budget law reports an amendment he supported but not the final tally, and the November 2025 release is an announcement that he would vote no.

• Right Now Oregon and OPB. Right Now Oregon’s article cites candidate sites and releases, and its leaning is not stated. The October 14, 2026 OPB article has almost nothing on health care from either candidate.

• Not found: Merkley on IVF, maternal care, insulin, pharmacy benefit managers, parity and 988; Smith on coverage, the ACA, Medicaid, pre-existing conditions, contraception, IVF, maternal care, drug prices, parity, workforce and veterans.

• Next checks: Smith’s campaign site and voters’ pamphlet statement, his Oregon floor votes on health bills, Merkley’s congress.gov roll calls for the 2025 and 2026 votes, and any Oregon Senate debate transcript.

 

 

Sources

• Opened and read in full unless marked otherwise. Pages marked “seen in search only” could not be opened.

• Merkley releases: Choose Medicare Act, June 12, 2025, Medicare for All cosponsorship, 2017, budget law statement, July 1, 2025, funding bill vote, Nov. 9, 2025, Medicaid hearing, Aug. 4, 2026 and school counseling bill, May 27, 2026

• Merkley abortion and contraception: Women’s Health Protection Act, June 25, 2025 and Right to Contraception Act, 2023

• Merkley pages: campaign issues page, Senate health care page, health care releases, recent, health care releases, page 37, 2021 drug price item and 2016 public option release

• Smith: Portland Civic Lab voters’ guide, KDRV on SB 1536, Southern Coos Hospital on his bill, iVoterGuide (conservative voter guide; he did not answer), Tigard Today and KOIN campaign launch report via Yahoo

• Both: OPB, Oct. 14, 2026, Right Now Oregon, Aug. 31, 2026, OnTheIssues: Merkley, OnTheIssues: Smith, Wikipedia: Smith and Legiscan HB 3391 roll call