美国国家公共电台 NPR Q&A: What Does The Senate Health Bill Mean For Me?

 

ROBERT SIEGEL, HOST:

We've received a lot of questions from listeners about what the Republican proposals could mean for them and their families. And NPR health policy correspondent Alison Kodjak has been sorting through them with our producers, and she's here to answer a few of them. Hi, Alison.

ALISON KODJAK, BYLINE¹: Hi, Robert.

ARI SHAPIRO, HOST:

The first listener we're going to hear from has a very common situation. Here she is.

DENISE ESTRADA: My name is Denise Estrada, and I live in Los Angeles, Calif. My husband, Rick (ph), and I are both self-employed, and we're both in our early 50s with one daughter in college. And we get our health care through the California exchange. We use Kaiser. Our family premium² now costs us about $1,100 a month, so we're looking at about $16,000 a year just for our premiums³ not including our deductible, and we do not receive a subsidy⁴.

So here's my concern. Based on what I've read and what I've watched on television, it appears that our age group - we're not retired⁵ yet, but we're over the age of 50. We stand to see the biggest increase in our premium cost. So there's a lot of stress about that because it's a big unknown. Will our premiums rise astronomically⁶ due to our ages?

KODJAK: You know, that's a valid⁷ concern. This bill does allow insurers to charge older people more than they do now, and the Affordable⁸ Care Act has limits on that. It allows insurers to charge older people three times more than it charges the youngest. This bill allows that to go up to five times more. So the hope is that it will lower premiums for younger people. But at the same time, the Congressional Budget Office says it's going to raise premiums for older people. And I actually looked up Mrs. Estrada's specific situation. The Kaiser Family Foundation has this little widget, and a 60-year-old in Los Angeles County who doesn't qualify for subsidies⁹ is likely to see her premium increase $2,600 a year.

SIEGEL: Now, we also heard from listeners who are anxious about the potential introduction or perhaps reintroduction of lifetime maximums for insurance coverage¹⁰.

AMY LOWE: My name is Amy Lowe, and I'm from Dayton, Ohio. We get our insurance through my husband's employer. My daughter is 16 years old, and she has Crohn's disease, which is an autoimmune condition that affects her small and large intestine¹¹. She requires infusions¹³ of a drug called Remicade every six weeks, and each infusion¹² costs $20,000. So I would like to know if lifetime maximums are in fact being considered. And if so, what happens to people like my daughter?

KODJAK: And that's a really good question. It's a complicated answer. The Affordable Care Act does ban lifetime limits on benefits. And those protections are at risk because states under this bill are allowed to ask for waivers from those consumer protections, those regulations that are in Obamacare that define what insurance companies have to cover. And because of some loopholes in the law, even if just one state gets a waiver from those, all large employers can opt¹⁴ into those rules.

So if a state gets a waiver from lifetime limits, there could be a lot of insurance policies, even those you get through employer, that might have a $1 million, $2 million, $5 million limit. And it's not really a theoretical question because before the Affordable Care Act, almost 60 percent of employer plans had a lifetime limit on it.

SHAPIRO: And of course a lot of people who use Medicaid are wondering what the future might hold for them. Let's listen to this.

EMILY KANE: My name is Emily Kane, and I live in Pittsburgh, Pa. My son's 2-and-a-half years old, and he qualified¹⁵ for Medicaid through a clause that allows children who are chronically¹⁶ ill to receive Medicaid support. He has an endocrine disorder¹⁷ called adrenal insufficiency. In order to get him back to health and stability, he's needed the assistance of a feeding tube, which is now surgically¹⁸ placed. So I'd like to know how the GOP's health care bill will affect our family's financial future and the future of my son's medical care.

KODJAK: That's a tough one. Obviously it's impossible to know exactly how this bill will play out over that much time. The Medicaid program that helped her son specifically is a state program. A lot of Medicaid programs can be implemented²⁰ by the states. And so this is a Pennsylvania-specific program. The law - the proposed bill in the Senate would actually give states more power to regulate and implement¹⁹ their Medicaid program. So there's no reason to think this specific program's at risk, but Medicaid's also facing enormous cuts. The CBO says that in 10 years, there's going to be 26 percent less money for Medicaid. So that's where the concern is - whether the benefits will be there.

SHAPIRO: NPR's Alison Kodjak answering your questions about the health care proposal. Thanks very much.

KODJAK: Thanks, Ari.

SIEGEL: And if you have questions about the Republican health care proposals, email them to us at [email protected], and put health care in the subject line. And tomorrow morning, we'll hear what the Senate bill would mean for veterans. Most of them receive health care through Medicaid or the exchanges, not through the VA. Listen for that and more as you begin your day with MORNING EDITION.

1 byline   

n.署名；v.署名

参考例句：

• His byline was absent as well.他的署名也不见了。
• We wish to thank the author of this article which carries no byline.我们要感谢这篇文章的那位没有署名的作者。

2 premium   

n.加付款；赠品；adj.高级的；售价高的

参考例句：

• You have to pay a premium for express delivery.寄快递你得付额外费用。
• Fresh water was at a premium after the reservoir was contaminated.在水库被污染之后，清水便因稀而贵了。

3 premiums   

n.费用( premium的名词复数 )；保险费；额外费用；（商品定价、贷款利息等以外的）加价

参考例句：

• He paid premiums on his life insurance last year. 他去年付了人寿保险费。 来自《现代英汉综合大词典》
• Moves are afoot to increase car insurance premiums. 现正在酝酿提高汽车的保险费。 来自《简明英汉词典》

4 subsidy   

n.补助金，津贴

参考例句：

• The university will receive a subsidy for research in artificial intelligence.那个大学将得到一笔人工智能研究的补助费。
• The living subsidy for senior expert's family is included in the remuneration.报酬已包含高级专家家人的生活补贴。

5 retired   

adj.隐退的，退休的，退役的

参考例句：

• The old man retired to the country for rest.这位老人下乡休息去了。
• Many retired people take up gardening as a hobby.许多退休的人都以从事园艺为嗜好。

6 astronomically   

天文学上

参考例句：

• The bill was astronomically high. 账单上的金额高得没谱儿。
• They have only been read as the multitude read the stars, at most astrologically, not astronomically. 它们之被群众阅读，有如群众之阅览繁星，至多是从星象学而不是从天文学的角度阅览的。

7 valid   

adj.有确实根据的；有效的；正当的，合法的

参考例句：

• His claim to own the house is valid.他主张对此屋的所有权有效。
• Do you have valid reasons for your absence?你的缺席有正当理由吗？

8 affordable   

adj.支付得起的，不太昂贵的

参考例句：

• The rent for the four-roomed house is affordable.四居室房屋的房租付得起。
• There are few affordable apartments in big cities.在大城市中没有几所公寓是便宜的。

9 subsidies   

n.补贴，津贴，补助金( subsidy的名词复数 )

参考例句：

• European agriculture ministers failed to break the deadlock over farm subsidies. 欧洲各国农业部长在农业补贴问题上未能打破僵局。
• Agricultural subsidies absorb about half the EU's income. 农业补贴占去了欧盟收入的大约一半。 来自《简明英汉词典》

10 coverage   

n.报导，保险范围，保险额，范围，覆盖

参考例句：

• There's little coverage of foreign news in the newspaper.报纸上几乎没有国外新闻报道。
• This is an insurance policy with extensive coverage.这是一项承保范围广泛的保险。

11 intestine   

adj.内部的；国内的；n.肠

参考例句：

• This vitamin is absorbed through the walls of the small intestine.这种维生素通过小肠壁被吸收。
• The service productivity is the function,including external efficiency,intestine efficiency and capacity efficiency.服务业的生产率是一个包含有外部效率、内部效率和能力效率的函数。

12 infusion   

n.灌输

参考例句：

• Old families need an infusion of new blood from time to time.古老的家族需要不时地注入新鲜血液。
• Careful observation of the infusion site is necessary.必须仔细观察输液部位。

13 infusions   

n.沏或泡成的浸液（如茶等）( infusion的名词复数 )；注入，注入物

参考例句：

• Intravenous infusions are also used to administer medications. 静脉输液也可作为一种给药方法。 来自辞典例句
• INTERPRETATION: GKI infusions significantly reduced plasma glucose concentrations and blood pressure. 结论：静脉滴注GKI显著降低血压和血糖浓度。 来自互联网

14 opt   

vi.选择，决定做某事

参考例句：

• They opt for more holiday instead of more pay.他们选择了延长假期而不是增加工资。
• Will individual schools be given the right to opt out of the local school authority?各个学校可能有权选择退出地方教育局吗？

15 qualified   

adj.合格的，有资格的，胜任的，有限制的

参考例句：

• He is qualified as a complete man of letters.他有资格当真正的文学家。
• We must note that we still lack qualified specialists.我们必须看到我们还缺乏有资质的专家。

16 chronically   

ad.长期地

参考例句：

• Similarly, any pigment nevus that is chronically irritated should be excised. 同样，凡是经常受慢性刺激的各种色素痣切勿予以切除。
• People chronically exposed to chlorine develop some degree of tolerance. 人长期接触氯气可以产生某种程度的耐受性。

17 disorder   

n.紊乱，混乱；骚动，骚乱；疾病，失调

参考例句：

• When returning back,he discovered the room to be in disorder.回家后，他发现屋子里乱七八糟。
• It contained a vast number of letters in great disorder.里面七零八落地装着许多信件。

18 surgically   

adv. 外科手术上, 外科手术一般地

参考例句：

• Unsightly moles can be removed surgically. 不雅观的痣可以手术去除。
• To bypass this impediment an almost mature egg cell is removed surgically. 为了克服这一障碍，通过手术，取出一个差不多成熟的卵细胞。

19 implement   

n.(pl.)工具，器具；vt.实行，实施，执行

参考例句：

• Don't undertake a project unless you can implement it.不要承担一项计划，除非你能完成这项计划。
• The best implement for digging a garden is a spade.在花园里挖土的最好工具是铁锹。

20 implemented   

v.实现( implement的过去式和过去分词 )；执行；贯彻；使生效

参考例句：

• This agreement, if not implemented, is a mere scrap of paper. 这个协定如不执行只不过是一纸空文。 来自《现代汉英综合大词典》
• The economy is in danger of collapse unless far-reaching reforms are implemented. 如果不实施影响深远的改革，经济就面临崩溃的危险。 来自辞典例句