美国国家公共电台 NPR With Obamacare Here to Stay, Some States Revive Medicaid Expansion

 

LOURDES GARCIA-NAVARRO, HOST:

The Republicans' failure to repeal¹ the Affordable² Care Act opened up an opportunity for advocates wanting to expand Medicaid. They see one last chance to get billions of federal dollars for their states and cover hundreds of thousands of low-income people. But as NPR's Alison Kodjak reports, that effort faces some of the same political and ideological³ fights that played out in Washington.

ALISON KODJAK, BYLINE⁴: Kansas is overwhelmingly Republican and undeniably conservative. So it was a bit of a surprise last week when both houses of the state's legislature voted by wide margins⁵ to expand its Medicaid program.

BARBARA BOLLIER: This been a long time and a hard road.

KODJAK: That's Kansas senator Barbara Bollier. She's a Republican and a doctor. And she's been fighting for years to get her colleagues to agree to open up Medicaid to more low-income Kansans. The expansion is allowed under the Affordable Care Act, also known as Obamacare. Thirty-one states plus Washington, D.C., have expanded their Medicaid programs. But after November's election, that momentum⁶ slowed because Republicans in Congress promised to repeal key parts of Obamacare, including Medicaid expansion. Now that the repeal effort appears to be dead in Washington, Bollier says it's time for Kansas to move on.

BOLLIER: We are not taking away the Affordable Care Act. It is the law of the land. We need to live in it and move forward.

KODJAK: She says expanding Medicaid could cover 150,000 people who aren't now eligible⁷. But many Republican lawmakers remain opposed to anything related to Obamacare, like Kansas Senator Ty Masterson, who compared the bill to a broken amusement park ride during last week's debate.

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TY MASTERSON: It's broken. And we're saying we want to go ahead and get on the ride. There's a reason there's nobody in line behind us. Sign's up - out of order. I don't want to be first in that line. I want to get out of that line.

KODJAK: On Thursday, Kansas Governor Sam Brownback vetoed the bill, saying it's too expensive and it allows money to go to what he calls the abortion⁸ industry. So expansion supporters are working furiously this weekend to switch a handful of votes in hopes of overriding⁹ the veto, perhaps as soon as tomorrow. About 1,200 miles due east from the fight in Wichita is Richmond, Va., where Governor Terry McAuliffe is a Democrat¹⁰ pushing his Republican legislature to expand Medicaid. But so far, they're not buying.

TERRY MCAULIFFE: I have had more excuses out of my Republican general assembly, none of them correct. The most recent argument was - is that this was going to be repealed¹¹. Well, now it's not.

KODJAK: McAuliffe says about 400,000 Virginians could be eligible for the expanded Medicaid, and the federal government would send about $2.4 billion a year to the state to cover the cost. But he says lawmakers fear the political fallout of embracing anything related to Obamacare.

MCAULIFFE: But the problem is my legislature is terrified of the Tea Party. That's the only reason they're not voting for it - because they're afraid they'll get taken out in the primary, plain and simple.

KODJAK: But Virginia lawmakers say they just don't trust the federal government will keep paying the Medicaid tab for the long term. So in Virginia, expanding Medicaid is still a long Shot. But up north in Augusta, Maine, expansion may be on a path to approval. That state's Republican Senate and Democratic House have passed Medicaid expansion bills five times. And five times, Governor Paul LePage has vetoed them. Republican Senator Tom Saviello favors Medicaid expansion because it'll help his constituents¹²' health and the local hospital.

TOM SAVIELLO: You know, I'm a Republican. And somebody else is paying taxes to support Medicaid expansion. I want to take those taxes and apply it towards my citizens rather than not expand and send that money out of state.

KODJAK: But with LePage still in charge in Maine, the legislature is handing control to voters. A citizens group has gathered enough signatures to put the question to a referendum.

SAVIELLO: Because we have the citizens petition, we're putting it in the citizens' hands. And I have polling data that I did for the last couple years - 60 percent of the people in Maine want Medicaid expansion. So it's going to happen. It's coming.

KODJAK: With Obamacare repeal delayed if not dead in Washington, these may be just the first states to look at Medicaid expansion and determine it could be a good deal. Alison Kodjak, NPR News, Washington.

1 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。

2 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。

3 ideological   

a.意识形态的

参考例句：

• He always tries to link his study with his ideological problems. 他总是把学习和自己的思想问题联系起来。
• He helped me enormously with advice on how to do ideological work. 他告诉我怎样做思想工作，对我有很大帮助。

4 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。

5 margins   

边( margin的名词复数 )； 利润； 页边空白； 差数

参考例句：

• They have always had to make do with relatively small profit margins. 他们不得不经常设法应付较少的利润额。
• To create more space between the navigation items, add left and right margins to the links. 在每个项目间留更多的空隙，加左或者右的margins来定义链接。

6 momentum   

n.动力，冲力，势头；动量

参考例句：

• We exploit the energy and momentum conservation laws in this way.我们就是这样利用能量和动量守恒定律的。
• The law of momentum conservation could supplant Newton's third law.动量守恒定律可以取代牛顿第三定律。

7 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。

8 abortion   

n.流产，堕胎

参考例句：

• She had an abortion at the women's health clinic.她在妇女保健医院做了流产手术。
• A number of considerations have led her to have a wilful abortion.多种考虑使她执意堕胎。

9 overriding   

a.最主要的

参考例句：

• Development is of overriding importance. 发展是硬道理
• My overriding concern is to raise the standards of state education. 我最关心的是提高国民教育水平。

10 democrat   

n.民主主义者，民主人士；民主党党员

参考例句：

• The Democrat and the Public criticized each other.民主党人和共和党人互相攻击。
• About two years later,he was defeated by Democrat Jimmy Carter.大约两年后，他被民主党人杰米卡特击败。

11 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。

12 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》