美国国家公共电台 NPR GOP Health Bill Leaves Many 'Pre-Existing Condition' Protections Up To States

 

ROBERT SIEGEL, HOST:

Right now under the Affordable¹ Care Act, people with pre-existing conditions have a lot of protections. But the House bill passed last week leaves a lot of those provisions up to state politics. Bram Sable-Smith of member station KBIA in Missouri reports.

BRAM SABLE-SMITH, BYLINE²: Ryan Lennon Fines seems like a typical 2-year-old.

RYAN LENNON FINES: What's that?

SCOTT FINES: What is that?

RYAN: Fire truck.

FINES: That's right.

SABLE-SMITH: He and his parents, Scott Fines and Brianna Lennon, flip³ through a picture book of emergency vehicles. They land on a photo of an airplane.

FINES: Hey, there's an air ambulance. You rode in that. You rode in one of those.

SABLE-SMITH: When Ryan was born in 2014, his mouth was not connected to his stomach. After three months in a hospital in St. Louis, the family flew to Boston where Ryan had surgery.

FINES: And we were there from the 17th until just before Memorial Day that year.

BRIANNA LENNON: We're coming up on his discharge anniversary.

FINES: That's right (unintelligible).

LENNON: It's May 12.

SABLE-SMITH: The surgery worked. Ryan's active. He can eat normally, and he eats a ton. But all that time in the hospital and the surgery were expensive.

FINES: Our insurance was billed about $750,000. And it was 2014, so the ACA was in place, and we didn't end up having to pay $750,000, which was very nice.

SABLE-SMITH: Now the family is worried about Ryan's future. He'll still need about $20,000 to $30,000 of medical care every year. And even though they have insurance through Scott's work, the bill that passed the House last week could really affect them.

All six Republicans from Missouri voted for the bill, including Representative Vicky Hartzler from the district where Scott, Brianna and Ryan live. In a video posted to Twitter, she said passing the bill was an important first step to replacing Obamacare.

(SOUNDBITE OF ARCHIVED RECORDING)

VICKY HARTZLER: It covers pre-existing conditions, still retains the ability for young people to stay on their parents' policies, and it makes sure that there are no lifetime caps.

SABLE-SMITH: But the bill gives states license⁴ to make a lot of changes. It does keep the provision that people like Ryan with pre-existing conditions cannot be denied coverage⁵, but a last-minute amendment⁶ allows states to ask permission for insurers to charge more based on a patient's health history if their coverage ever lapses⁷. This tremendously weakens the current protections, says Larry Levitt with the Kaiser Family Foundation.

LARRY LEVITT: This would guarantee access to insurance for people with pre-existing conditions in theory but not really in practice because they could be charged astronomically⁸ high premiums⁹.

SABLE-SMITH: What's more, right now under Obamacare, there are limits to the amount someone would have to pay out of pocket any year, and there are no lifetime limits on benefits. Language in the bill may end up weakening those protections also.

Missouri's governor, Eric Greitens, supported the GOP health plan in March. His office didn't respond to questions about whether he'd want Missouri to opt¹⁰ out, but Larry Levitt says it's likely conservative states that might want to.

LEVITT: States that have not expanded Medicaid made a decision to not go along with the Affordable Care Act where they can, and you'd probably see those states facing a similar kind of decision here.

SABLE-SMITH: Scott, Brianna and Ryan face tough decisions if this bill becomes law.

Would you all consider moving?

FINES: I think we'd pretty much have to. We would have to either move to a state that didn't waive¹¹ community protections or out of the country entirely¹². I'm not going to risk my son's health on the political whims¹³ of Jefferson City.

SABLE-SMITH: But before any decisions are made in Missouri's state capitol, the bill moves on to the U.S. Senate where it could change. For NPR News, I'm Bram Sable-Smith in Missouri.

SIEGEL: And that story is part of a reporting partnership¹⁴ of NPR, Side Effects Public Media 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 flip   

vt.快速翻动；轻抛；轻拍；n.轻抛；adj.轻浮的

参考例句：

• I had a quick flip through the book and it looked very interesting.我很快翻阅了一下那本书，看来似乎很有趣。
• Let's flip a coin to see who pays the bill.咱们来抛硬币决定谁付钱。

4 license   

n.执照，许可证，特许；v.许可，特许

参考例句：

• The foreign guest has a license on the person.这个外国客人随身携带执照。
• The driver was arrested for having false license plates on his car.司机由于使用假车牌而被捕。

5 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。

6 amendment   

n.改正，修正，改善，修正案

参考例句：

• The amendment was rejected by 207 voters to 143.这项修正案以207票对143票被否决。
• The Opposition has tabled an amendment to the bill.反对党已经就该议案提交了一项修正条款。

7 lapses   

n.失误，过失( lapse的名词复数 )；小毛病；行为失检；偏离正道v.退步( lapse的第三人称单数 )；陷入；倒退；丧失

参考例句：

• He sometimes lapses from good behavior. 他有时行为失检。 来自辞典例句
• He could forgive attacks of nerves, panic, bad unexplainable actions, all sorts of lapses. 他可以宽恕突然发作的歇斯底里，惊慌失措，恶劣的莫名其妙的动作，各种各样的失误。 来自辞典例句

8 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。

9 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》

10 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？

11 waive   

vt.放弃，不坚持(规定、要求、权力等)

参考例句：

• I'll record to our habitat office waive our claim immediately.我立即写信给咱们的总公司提出放弃索赔。
• In view of the unusual circumstances,they agree to waive their requirement.鉴于特殊情况，他们同意放弃他们的要求。

12 entirely   

ad.全部地，完整地；完全地，彻底地

参考例句：

• The fire was entirely caused by their neglect of duty. 那场火灾完全是由于他们失职而引起的。
• His life was entirely given up to the educational work. 他的一生统统献给了教育工作。

13 WHIMS   

虚妄，禅病

参考例句：

• The mate observed regretfully that he could not account for that young fellow's whims. 那位伙伴很遗憾地说他不能说出那年轻人产生怪念头的原因。
• The rest she had for food and her own whims. 剩下的钱她用来吃饭和买一些自己喜欢的东西。 来自英汉文学 - 嘉莉妹妹

14 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。