美国国家公共电台 NPR GOP Leaders Urge Return To 'High-Risk Insurance Pools' That Critics Call Costly

 

SCOTT SIMON, HOST:

And House Republicans, as we noted¹, have met to discuss potential replacements² for the Affordable³ Care Act. One suggestion to lower some people's premiums⁴ is to create what are called high-risk health insurance pools. But as Minnesota Public Radio's Mark Zdechlik reports, Minnesota tried this system once, and it was expensive.

MARK ZDECHLIK, BYLINE⁵: The argument goes like this. Separate out the healthy people who don't cost very much to insure from people with pre-existing conditions. They could get health insurance through subsidized, high-risk coverage⁶. Minnesota's newest congressman⁷, Republican Jason Lewis, endorsed⁸ high-risk pools on CNN.

(SOUNDBITE OF TV SHOW, "STATE OF THE UNION")

JASON LEWIS: Minnesota had one of the best insurance pools - high-risk pools in the country.

NEERA TANDEN: Which failed in most states.

LEWIS: It was - and it was undone⁹ by the ACA.

ZDECHLIK: It's true that Obamacare banned state high-risk pools, including the Minnesota Comprehensive Health Association, or MCHA. That's because the ACA requires that insurers sell to everybody, regardless of their health. The high-risk pools were government-sponsored programs to help insure people other health plans refused to cover. That kept high-cost people out of the general insurance market and helped hold down costs for everybody else. Supporters tout¹⁰ a return to that approach as a smart way to bring down premiums. But, says Craig Britton of Plymouth, Minn...

CRAIG BRITTON: I think that's a lot of baloney.

ZDECHLIK: Britton was forced to buy MCHA coverage because of a pancreatitis diagnosis¹¹. He paid more than $18,000 a year in premiums.

BRITTON: That is catastrophic cost.

ZDECHLIK: That's the problem with high-risk pools, says Minnesota health department economist¹² Stefan Gildemeister.

STEFAN GILDEMEISTER: It's not cheap coverage to the individual, and it's not cheap coverage to the system.

ZDECHLIK: MCHA premiums cost policyholders 25 percent more than conventional coverage.

GILDEMEISTER: So there were people out there without - who had a chronic¹³ disease or had a pre-existing condition who couldn't get a policy.

ZDECHLIK: And he says, for the insurer, even the higher premiums fell far short of covering the full cost to care for the roughly 25,000 people on MCHA. The program needed more than $173 million in subsidies¹⁴ in its final year of normal operation. The money came from fees on commercial insurance plans, essentially¹⁵ shifting the cost to people who get insurance through work.

University of Minnesota health policy Professor Lynn Blewett says there is a better alternative than a return to high-risk pools. It's called reinsurance, and it provides health plans with extra money if they get nailed with higher-than-expected costs. The big question, Blewett says, is whether lawmakers will balk¹⁶ at the cost of keeping premiums down for consumers, whatever the approach.

LYNN BLEWETT: That's the kind of rub, is where that funding is going to come from. And is the federal government or the state government willing to put up the funding needed to make some of these fixes?

ZDECHLIK: A national plan offered by Republican Speaker of the House Paul Ryan would fund high-risk pools with $25 billion over 10 years. The nonpartisan Commonwealth¹⁷ Fund estimates it would cost much more than that, almost $180 billion a year. Researchers at the consulting firm McKinsey & Company say reinsurance would likely cost about a third what the high-risk pool option would.

For NPR News, I'm Mark Zdechlik in St. Paul.

SIMON: And that story is part of a reporting partnership¹⁸ with NPR, Minnesota Public Radio and Kaiser Health News.

1 noted   

adj.著名的，知名的

参考例句：

• The local hotel is noted for its good table.当地的那家酒店以餐食精美而著称。
• Jim is noted for arriving late for work.吉姆上班迟到出了名。

2 replacements   

n.代替( replacement的名词复数 )；替换的人[物]；替代品；归还

参考例句：

• They infiltrated behind the lines so as to annoy the emery replacements. 他们渗透敌后以便骚扰敌军的调度。 来自辞典例句
• For oil replacements, cheap suddenly looks less of a problem. 对于石油的替代品来说，价格变得无足轻重了。 来自互联网

3 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。

4 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》

5 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。

6 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。

7 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。

8 endorsed   

vt.& vi.endorse的过去式或过去分词形式v.赞同( endorse的过去式和过去分词 )；在（尤指支票的）背面签字；在（文件的）背面写评论；在广告上说本人使用并赞同某产品

参考例句：

• The committee endorsed an initiative by the chairman to enter discussion about a possible merger. 委员会通过了主席提出的新方案，开始就可能进行的并购进行讨论。 来自《简明英汉词典》
• The government has broadly endorsed a research paper proposing new educational targets for 14-year-olds. 政府基本上支持建议对14 岁少年实行新教育目标的研究报告。 来自《简明英汉词典》

9 undone   

a.未做完的，未完成的

参考例句：

• He left nothing undone that needed attention.所有需要注意的事他都注意到了。

10 tout   

v.推销，招徕；兜售；吹捧，劝诱

参考例句：

• They say it will let them tout progress in the war.他们称这将有助于鼓吹他们在战争中的成果。
• If your case studies just tout results,don't bother requiring registration to view them.如果你的案例研究只是吹捧结果，就别烦扰别人来注册访问了。

11 diagnosis   

n.诊断，诊断结果，调查分析，判断

参考例句：

• His symptoms gave no obvious pointer to a possible diagnosis.他的症状无法作出明确的诊断。
• The engineer made a complete diagnosis of the bridge's collapse.工程师对桥的倒塌做一次彻底的调查分析。

12 economist   

n.经济学家，经济专家，节俭的人

参考例句：

• He cast a professional economist's eyes on the problem.他以经济学行家的眼光审视这个问题。
• He's an economist who thinks he knows all the answers.他是个经济学家，自以为什么都懂。

13 chronic   

adj.(疾病)长期未愈的，慢性的；极坏的

参考例句：

• Famine differs from chronic malnutrition.饥荒不同于慢性营养不良。
• Chronic poisoning may lead to death from inanition.慢性中毒也可能由虚弱导致死亡。

14 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》

15 essentially   

adv.本质上，实质上，基本上

参考例句：

• Really great men are essentially modest.真正的伟人大都很谦虚。
• She is an essentially selfish person.她本质上是个自私自利的人。

16 balk   

n.大方木料；v.妨碍；不愿前进或从事某事

参考例句：

• We get strong indications that his agent would balk at that request.我们得到的强烈暗示是他的经纪人会回避那个要求。
• He shored up the wall with a thick balk of wood.他用一根粗大的木头把墙撑住。

17 commonwealth   

n.共和国，联邦，共同体

参考例句：

• He is the chairman of the commonwealth of artists.他是艺术家协会的主席。
• Most of the members of the Commonwealth are nonwhite.英联邦的许多成员国不是白人国家。

18 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。