美国国家公共电台 NPR Obamacare Repeal Threatens A Health Benefit Popular In Coal Country

 

STEVE INSKEEP, HOST: 

The Affordable¹ Care Act includes special provisions that make it easier for coal miners to get black lung benefits. If the ACA goes away, obtaining those benefits could become harder. Kara Lofton of West Virginia Public Broadcasting has more.

KARA LOFTON, BYLINE²: At the Pulmonary Rehabilitation³ Clinic in Scarbro, W.Va., oxygen tubes dangle⁴ from the noses of three miners slowly pedaling on stationary⁵ bikes. All of these men have black lung, a disease caused by breathing in coal dust. Over time, the dust coats the lungs and causes them to harden. Hard lungs are difficult to expand and contract which makes it hard to breathe.

JAMES BOUNDS: You try to get air in them, and they don't want to cooperate with you like they did before.

LOFTON: That's James Bounds, one of the retired⁶ miners at the clinic. Not every coal miner gets black lung in the same way that not every smoker⁷ gets cancer, but for those who do, the disease is devastating⁸.

BOUNDS: As your disease grows more in you, there's no cure for it at all. It keeps getting harder and harder until, I guess, one day when you take your last breath, and they just won't expand for you no more.

LOFTON: Bounds is currently one of about 38,000 miners and dependents receiving black lung benefits, compensation for the physical damage he sustained while doing his job. It took him four and a half years to get approved, despite the fact that his lungs are so bad, he has to stop moving to talk.

Debbie Wills is black lung program coordinator⁹ for Valley Health primary care system. She says that prior to the Affordable Care Act, it was almost impossible to qualify for the compensation benefits. Coal companies pay the benefits and also pay into a federal trust fund that pays when coal companies can't.

DEBBIE WILLS: Coal company lawyers would doctor shop around the country and find two, three, four, five, seven doctors to say, yes, this miner is disabled, but it's not because of black lung.

LOFTON: Now it's a little bit easier, and the process often goes more quickly. That's because the Affordable Care Act includes something called the Byrd Amendments¹⁰. One part shifted the burden of proof. Wills explains that instead of miners having to prove that mining caused their black lung, the coal companies have to prove that mining didn't.

WILLS: Once we had the Byrd Amendments, you still have to prove that 100 percent disability which is hard to prove, but if you can prove that and you've worked 15 years or longer in the mines, then you're entitled to a presumption¹¹ that your disease arose from your coal mine employment.

LOFTON: Another part provides lifetime benefits to certain eligible¹² dependents who survive the death of a miner if the miner had been receiving the benefits before their death. If the ACA is repealed¹⁴ without a replacement¹⁵, cases that were approved after the ACA went into effect could be reopened, leaving the miner or surviver vulnerable to losing the benefits. And burden of proof may shift again making it difficult for applicants¹⁶ to qualify.

Earlier this month, both the House and the Senate introduced resolutions to preserve the Byrd Amendments from a broader ACA repeal¹³. Republican West Virginia Representative Evan Jenkins, an ACA opponent, introduced the measure in the House.

EVAN JENKINS: I am a firm believer that Obamacare is already in a death spiral and desperately¹⁷ needs to be fixed¹⁸. So while we are going to work to improve our health care system, I feel strongly about my resolution to make sure that the presumption relating to black lung is contained in whatever is the end product of this year.

LOFTON: But that end product is still a pretty big question at this point. For NPR News, I'm Kara Lofton in Charleston, W.Va.

INSKEEP: This story is part of a reporting partnership¹⁹ with NPR, West Virginia Public Broadcasting and Kaiser Health News.

1 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。

2 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。

3 rehabilitation   

n.康复，悔过自新，修复，复兴，复职，复位

参考例句：

• He's booked himself into a rehabilitation clinic.他自己联系了一家康复诊所。
• No one can really make me rehabilitation of injuries.已经没有人可以真正令我的伤康复了。

4 dangle   

v.(使)悬荡，(使)悬垂

参考例句：

• At Christmas,we dangle colored lights around the room.圣诞节时，我们在房间里挂上彩灯。
• He sits on the edge of the table and dangles his legs.他坐在桌子边上，摆动著双腿。

5 stationary   

adj.固定的，静止不动的

参考例句：

• A stationary object is easy to be aimed at.一个静止不动的物体是容易瞄准的。
• Wait until the bus is stationary before you get off.你要等公共汽车停稳了再下车。

6 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。

7 smoker   

n.吸烟者，吸烟车厢，吸烟室

参考例句：

• His wife dislikes him to be a smoker.他妻子不喜欢他当烟民。
• He is a moderate smoker.他是一个有节制的烟民。

8 devastating   

adj.毁灭性的，令人震惊的，强有力的

参考例句：

• It is the most devastating storm in 20 years.这是20年来破坏性最大的风暴。
• Affairs do have a devastating effect on marriages.婚外情确实会对婚姻造成毁灭性的影响。

9 coordinator   

n.协调人

参考例句：

• The UN Office for the Coordination of Humanitarian Affairs, headed by the Emergency Relief Coordinator, coordinates all UN emergency relief. 联合国人道主义事务协调厅在紧急救济协调员领导下，负责协调联合国的所有紧急救济工作。
• How am I supposed to find the client-relations coordinator? 我怎么才能找到客户关系协调员的办公室？

10 amendments   

（法律、文件的）改动( amendment的名词复数 )； 修正案； 修改； （美国宪法的）修正案

参考例句：

• The committee does not adequately consult others when drafting amendments. 委员会在起草修正案时没有充分征求他人的意见。
• Please propose amendments and addenda to the first draft of the document. 请对这个文件的初稿提出修改和补充意见。

11 presumption   

n.推测，可能性，冒昧，放肆，[法律]推定

参考例句：

• Please pardon my presumption in writing to you.请原谅我很冒昧地写信给你。
• I don't think that's a false presumption.我认为那并不是错误的推测。

12 eligible   

adj.有条件被选中的；(尤指婚姻等)合适(意)的

参考例句：

• He is an eligible young man.他是一个合格的年轻人。
• Helen married an eligible bachelor.海伦嫁给了一个中意的单身汉。

13 repeal   

n.废止，撤消；v.废止，撤消

参考例句：

• He plans to repeal a number of current policies.他计划废除一些当前的政策。
• He has made out a strong case for the repeal of the law.他提出强有力的理由，赞成废除该法令。

14 repealed   

撤销，废除( repeal的过去式和过去分词 )

参考例句：

• The Labour Party repealed the Act. 工党废除了那项法令。
• The legislature repealed the unpopular Rent Act. 立法机关废除了不得人心的租借法案。

15 replacement   

n.取代，替换，交换；替代品，代用品

参考例句：

• We are hard put to find a replacement for our assistant.我们很难找到一个人来代替我们的助手。
• They put all the students through the replacement examination.他们让所有的学生参加分班考试。

16 applicants   

申请人，求职人( applicant的名词复数 )

参考例句：

• There were over 500 applicants for the job. 有500多人申请这份工作。
• He was impressed by the high calibre of applicants for the job. 求职人员出色的能力给他留下了深刻印象。

17 desperately   

adv.极度渴望地，绝望地，孤注一掷地

参考例句：

• He was desperately seeking a way to see her again.他正拼命想办法再见她一面。
• He longed desperately to be back at home.他非常渴望回家。

18 fixed   

adj.固定的，不变的，准备好的；(计算机)固定的

参考例句：

• Have you two fixed on a date for the wedding yet?你们俩选定婚期了吗？
• Once the aim is fixed,we should not change it arbitrarily.目标一旦确定，我们就不应该随意改变。

19 partnership   

n.合作关系，伙伴关系

参考例句：

• The company has gone into partnership with Swiss Bank Corporation.这家公司已经和瑞士银行公司建立合作关系。
• Martin has taken him into general partnership in his company.马丁已让他成为公司的普通合伙人。