美国国家公共电台 NPR Republican Health Care Proposal Would Cover Fewer Low-Income Families

 

STEVE INSKEEP, HOST:

More than a month ago, the president said he nearly had a plan to replace Obamacare. He told The Washington Post it was down to the, quote, "final strokes on insurance for everybody." One month later, in yesterday's press conference, the president promised there would soon be a plan.

(SOUNDBITE OF PRESS CONFERENCE)

PRESIDENT DONALD TRUMP¹: We're doing Obamacare. We're in final stages. We should be submitting the initial plan in March - early March.

INSKEEP: That plan will come from Congress. House Republicans already have a skeleton proposal. And they've promised that any replacement² will be better. NPR's Alison Kodjak reports it may actually be less generous.

ALISON KODJAK, BYLINE³: Republicans discussed an 18-page proposal to replace Obamacare at a closed-door meeting yesterday at the Capitol. Michigan Congressman⁴ Bill Huizenga says the document gives members something to present to their constituents⁵ over the midwinter break, a sort of rough roadmap.

BILL HUIZENGA: We're going to be taking a six-lane highway or a four-lane highway. I don't think that's been determined⁶ yet. But we know the direction that we want to go and sort of the destiny.

KODJAK: Early analysis of the roadmap suggests it may leave more people without insurance. Caroline Pearson is a senior vice⁷ president at the health-care consulting firm Avalere.

CAROLINE PEARSON: Insurance coverage⁸ and affordability⁹ would both go down under the plan.

KODJAK: For example, the plan includes replacing the Obamacare subsidies¹⁰ that help people buy insurance with fixed¹¹ tax credit to buy coverage on the open market. Those credits are the same no matter how much money you make. So a rich business owner will get the same benefit as a poor, single mom. But there's no indication how big those tax credits will be. Pearson thinks they'll be less generous than Obamacare. And that could leave some low-income people uncovered.

PEARSON: People receiving generous subsidies or Medicaid today are not likely to be able to afford private insurance.

KODJAK: The Republicans' roadmap repeatedly says people will be able to buy so-called catastrophic coverage. That's a policy with limited benefits that pays major bills from a serious illness or accident. But it doesn't pay for everyday care. So some people would have to pay for checkups with health savings¹² accounts. These tax-free accounts are a favorite among conservatives because they encourage people to plan for their health spending and to shop around for low prices.

The Republican plan calls for doubling the amount people can save. But Democrats¹³ say they only help people who have extra money to put away, and they give the biggest tax cuts to people with the highest incomes. Finally, on Medicaid, the Republican plan would limit the amount of money that goes to states, either been giving a certain amount for each beneficiary or putting it in a block grant.

Paul Howard, the director of health policy at the conservative Manhattan Institute, says that might be a good thing. He says Medicaid today is ripe for waste and abuse.

PAUL HOWARD: The current, open-ended match system for Medicaid encourages an awful lot of state shenanigans.

KODJAK: Bottom line - this is the first proposal. And it's not clear how much will end up becoming law. President Trump has promised his plan will be better than Obamacare and cost less. Alison Kodjak, NPR News, Washington.

(SOUNDBITE OF FAUX TALES'S "ASCENT")

1 trump   

n.王牌，法宝；v.打出王牌，吹喇叭

参考例句：

• He was never able to trump up the courage to have a showdown.他始终鼓不起勇气摊牌。
• The coach saved his star player for a trump card.教练保留他的明星选手，作为他的王牌。

2 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。

3 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。

4 Congressman   

n.（美）国会议员

参考例句：

• He related several anecdotes about his first years as a congressman.他讲述自己初任议员那几年的几则轶事。
• The congressman is meditating a reply to his critics.这位国会议员正在考虑给他的批评者一个答复。

5 constituents   

n.选民( constituent的名词复数 )；成分；构成部分；要素

参考例句：

• She has the full support of her constituents. 她得到本区选民的全力支持。
• Hydrogen and oxygen are the constituents of water. 氢和氧是水的主要成分。 来自《简明英汉词典》

6 determined   

adj.坚定的；有决心的

参考例句：

• I have determined on going to Tibet after graduation.我已决定毕业后去西藏。
• He determined to view the rooms behind the office.他决定查看一下办公室后面的房间。

7 vice   

n.坏事；恶习；[pl.]台钳，老虎钳；adj.副的

参考例句：

• He guarded himself against vice.他避免染上坏习惯。
• They are sunk in the depth of vice.他们堕入了罪恶的深渊。

8 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。

9 affordability   

可购性

参考例句：

• Performance-Based Logistics Affordability: Can We Afford Categorical Conversion to Performance-Based Acquisition? 基于性能的后期的可承受性：能否担负得起向基于性能的采办的无条件的转变？
• There would be no crisis of affordability, as't for food or clothing. 就想食物与服装一样，因为供给没有危机。

10 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》

11 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。

12 savings   

n.存款，储蓄

参考例句：

• I can't afford the vacation,for it would eat up my savings.我度不起假，那样会把我的积蓄用光的。
• By this time he had used up all his savings.到这时，他的存款已全部用完。

13 democrats   

n.民主主义者，民主人士( democrat的名词复数 )

参考例句：

• The Democrats held a pep rally on Capitol Hill yesterday. 民主党昨天在国会山召开了竞选誓师大会。
• The democrats organize a filibuster in the senate. 民主党党员组织了阻挠议事。 来自《简明英汉词典》