医疗改革如何改变年轻人的选择？

 　　GWEN IFILL: The health law was the subject of a rare public conversation between President Obama and former President Clinton today.They sat down together at the Clinton Global Initiative, where President Obama referred to the showdown in Washington and responded to Republican opposition¹.

　　PRESIDENT BARACK OBAMA: Part of what I think the resistance that we have seen ramp² up, particularly over the last couple of months, is all about is, the opponents of health care reform know they're going to sign up.In fact, one of the major opponents, when asked, well, why is it that you would potentially shut down the government at this point just to block Obamacare, he basically fessed up. He said, well, once consumers get hooked on having health insurance and subsidies³, then they won't want to give it up.

　　PRESIDENT OBAMA: Now, that's -- I mean, you can look at the transcript⁴. This is one of the major opponents of health care reform. It is an odd logic⁵. Essentially⁶, they're saying people will like this thing too much, and then it will be really hard to roll back.

　　GWEN IFILL: Beyond the politics, both presidents spoke⁷ at length today about one key aspect of the law, what it will mean for young adults, whose enrollment⁸ is critical to its potential success.That's our focus tonight as part of our ongoing⁹ series in which we try to answer viewer questions about the law.

　　Mary Agnes Carey of Kaiser Health News joins us. Kaiser Health News is an editorially independent organization focusing on health policy.Welcome.

　　MARY AGNES CAREY, Kaiser Health News: Thank you for having me.

　　GWEN IFILL: We're going to get right to the questions. The first is a video question actually that weget from a student. Let's look.

　　MEGHAN SHERWOOD, Missouri: Hi. I'm Meghan Sherwood, and I'm from Willard, Missouri.I was wondering how it would affect me -- I'm going into college in the next year -- and after college.

　　GWEN IFILL: That's a good question. What happens to college students who see their future maybe shrinking?

　　MARY AGNES CAREY: Well, it's a great question.In college, she could certainly stay on her parents' health insurance plan until age 26. The Affordable¹⁰ Care Act allows that to happen. I would check out her student health plan. What does that offer? Is that of interest to her? And also, after college, she could certainly stay on her parents' health insurance plan if that were a better deal for her. Her newemployer might actually offer her coverage¹¹.There will be a catastrophic option for people up to age 30, pretty high deductible, about $6,400, minimal¹² coverage. And then she could look at the subsidies and the online exchanges that are part of the health care law.

　　GWEN IFILL: There's been a lot of discussion about what happens to people who can stay on their parents' health care plan until they're 26.Let's take a question from someone, Vickie in Concord¹³, North Carolina, who wants to know what happens. She's actually an adult over 26 who has no income and has not filed an income tax return is year and is not a dependent of anyone else. Are they eligible¹⁴, she wants to know, for subsidy¹⁵ and the like through the federal exchange?

　　MARY AGNES CAREY: My first thought when I heard about this situation is, what about the Medicaid expansion, if her state is expanding Medicaid? That -- the federal health law allows individuals up to about $16,000 of income. She says she hasn't -- doesn't have any income and hasn't filed a tax return inyears. Would that be a better option than looking at the exchange?

　　GWEN IFILL: Would it?

　　MARY AGNES CAREY: Well, chances are that Medicaid would offer more affordable coverage for her. She could certainly, depending on her income level, even she says she has no income -- the exchanges are open to people over 100 percent of income, but it could be a better deal for her,Medicaid, cover more than -- and at a better -- more affordable to her than if she went and did the exchanges.

　　GWEN IFILL: It sounds like people don't even recognize that Medicaid would still be there as part of this.

　　MARY AGNES CAREY: Well, it's difficult because some states are participating and some states are not.

　　GWEN IFILL: OK.Well, let's go on now to another young person, who is 26 years old, who says that she's single, a freelance photographer, makes about $6,000 a year. She says: "I still live with my parents. I'm from deep south Texas, where income levels are very low. I currently don't have any form of health insurance and don't understand how it works. What options will I have to access affordable health care?"

　　MARY AGNES CAREY: MThis is a complicated question, because her state is not expanding Medicaid.

　　GWEN IFILL: Exactly what we were just talking about.

　　MARY AGNES CAREY: Exactly what we were talking about. Her income is around $6,000 a year.The exchanges are open to people above 100 percent of the poverty line. That's about $11,500. So, in this case, Iwould recommend that she look at community health centers. They're all over the country. They have received additional money in the Affordable Care Act to do a variety of things, including providing more health care to individuals. And your pay is based on a sliding scale that would be based on her income.

　　GWEN IFILL: I have one more question for you, e-mail question from a viewer for you. And this is an interesting one.It's from a woman in Arizona, who writes: "I have a 25-year-old daughter with cerebral¹⁶ palsy who's presently covered by Arizona's version of Medicaid. Will Obamacare change her medical coverage? I also have a 27-year-old daughter who presently has no health insurance coverage. She is underemployed and makes just about poverty level income."Any advice for her?

　　MARY AGNES CAREY: For the younger child who is on Medicaid, you could not qualify her for a subsidy and go into the exchange, so she will stay in Medicaid. For older child, it sounds like she could qualify for a possible subsidy on the exchange to help with her premium¹⁷, and also to get some help with co-pays and deductibles, because, as you remember -- as we remember, when you look at your health care expenditures¹⁸, it's not just your premium. It's your co-pays and deductibles.But it sounds like the older child could get some help on the exchange possibly with both.

　　GWEN IFILL: Why is that people have these basic questions, do you think, at this point? Is it becauseit's just that complicated or is it that there just haven't been enough explanations offered?

　　MARY AGNES CAREY: It is just that complicated.But, also, I think people are very busy with their lives. They're working. Maybe they're taking care of their parents or their children. And now that the exchanges are going to open up on October the 1st, that really focuses people's attention. Will this be a good deal for he? Do I qualify? Can I get a subsidy? Can I get some assistance?I think it's kind of the natural course of things for people not to pay attention until they absolutely have to.

　　GWEN IFILL: Is it also possible that the political debate that Judy was just talking about has made people think this is not really the law?

　　MARY AGNES CAREY: I certainly think that could be part of the issue.When you hear that the House of Representatives has voted over 40 times to defund all or part of the law, you might not remember that it is, in fact, still the law of the land and is being implemented¹⁹. So this is where the Obama administration really has to step up and explain the exchanges, the Medicaid expansion. They will be posting rates soon on the federally run exchanges. Many states have already made their rates there known.And so people need to really look at it and figure out what's the best deal for them.

　　GWEN IFILL: So, let's talk about what's actually law and what's actually real right now.Just for people who -- who get to stay on their parents' insurance until the age of 26, how many people has that affected²⁰ since this actually became law?

　　MARY AGNES CAREY: As of December, according to the Department of Health and Human Services, about 3.1 million young adults, again, up to the age of 26 have stayed on their health insurance plan.It's oneof the more popular provisions of the law. It's been really a godsend for college graduates that maybe haven't found a job or haven't found a job that offers health care insurance.

　　GWEN IFILL: We know that three million have stayed on, but how many more are eligible to stay on? Do we know?

　　MARY AGNES CAREY: Well, the one thought of this is that the exchanges roll out, the government is really trying to aim enrollment at over three million young adults who are healthy -- they tend to be healthier -- to try to get them to get enrolled²¹ in health insurance, whether it's on their parents' planor on the exchanges, because, as we know, when you're younger and healthier, you balance out the risk of the older, sicker people.

　　GWEN IFILL: So everyone's just waiting to see whether this really stays real?

　　MARY AGNES CAREY: Right. And they have to just simply look at it to see what's the best thing for them.

　　GWEN IFILL: Mary Agnes Carey of Kaiser Health News, thanks for helping²² us out.

　　MARY AGNES CAREY: Sure. My pleasure.

1 opposition   

n.反对，敌对

参考例句：

• The party leader is facing opposition in his own backyard.该党领袖在自己的党內遇到了反对。
• The police tried to break down the prisoner's opposition.警察设法制住了那个囚犯的反抗。

2 ramp   

n.暴怒，斜坡，坡道；vi.作恐吓姿势，暴怒，加速；vt.加速

参考例句：

• That driver drove the car up the ramp.那司机将车开上了斜坡。
• The factory don't have that capacity to ramp up.这家工厂没有能力加速生产。

3 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》

4 transcript   

n.抄本，誊本，副本，肄业证书

参考例句：

• A transcript of the tapes was presented as evidence in court.一份录音带的文字本作为证据被呈交法庭。
• They wouldn't let me have a transcript of the interview.他们拒绝给我一份采访的文字整理稿。

5 logic   

n.逻辑(学)；逻辑性

参考例句：

• What sort of logic is that?这是什么逻辑？
• I don't follow the logic of your argument.我不明白你的论点逻辑性何在。

6 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。

7 spoke   

n.（车轮的）辐条；轮辐；破坏某人的计划；阻挠某人的行动 v.讲，谈（speak的过去式）；说；演说；从某种观点来说

参考例句：

• They sourced the spoke nuts from our company.他们的轮辐螺帽是从我们公司获得的。
• The spokes of a wheel are the bars that connect the outer ring to the centre.辐条是轮子上连接外圈与中心的条棒。

8 enrollment   

n.注册或登记的人数；登记

参考例句：

• You will be given a reading list at enrollment.注册时你会收到一份阅读书目。
• I just got the enrollment notice from Fudan University.我刚刚接到复旦大学的入学通知书。

9 ongoing   

adj.进行中的，前进的

参考例句：

• The problem is ongoing.这个问题尚未解决。
• The issues raised in the report relate directly to Age Concern's ongoing work in this area.报告中提出的问题与“关心老人”组织在这方面正在做的工作有直接的关系。

10 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。

11 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。

12 minimal   

adj.尽可能少的，最小的

参考例句：

• They referred to this kind of art as minimal art.他们把这种艺术叫微型艺术。
• I stayed with friends, so my expenses were minimal.我住在朋友家，所以我的花费很小。

13 concord   

n.和谐；协调

参考例句：

• These states had lived in concord for centuries.这些国家几个世纪以来一直和睦相处。
• His speech did nothing for racial concord.他的讲话对种族和谐没有作用。

14 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。

15 subsidy   

n.补助金，津贴

参考例句：

• The university will receive a subsidy for research in artificial intelligence.那个大学将得到一笔人工智能研究的补助费。
• The living subsidy for senior expert's family is included in the remuneration.报酬已包含高级专家家人的生活补贴。

16 cerebral   

adj.脑的，大脑的；有智力的，理智型的

参考例句：

• Your left cerebral hemisphere controls the right-hand side of your body.你的左半脑控制身体的右半身。
• He is a precise,methodical,cerebral man who carefully chooses his words.他是一个一丝不苟、有条理和理智的人，措辞谨慎。

17 premium   

n.加付款；赠品；adj.高级的；售价高的

参考例句：

• You have to pay a premium for express delivery.寄快递你得付额外费用。
• Fresh water was at a premium after the reservoir was contaminated.在水库被污染之后，清水便因稀而贵了。

18 expenditures   

n.花费( expenditure的名词复数 )；使用；（尤指金钱的）支出额；（精力、时间、材料等的）耗费

参考例句：

• We have overspent.We'll have to let up our expenditures next month. 我们已经超支了，下个月一定得节约开支。 来自《简明英汉词典》
• The pension includes an allowance of fifty pounds for traffic expenditures. 年金中包括50镑交通费补贴。 来自《简明英汉词典》

19 implemented   

v.实现( implement的过去式和过去分词 )；执行；贯彻；使生效

参考例句：

• This agreement, if not implemented, is a mere scrap of paper. 这个协定如不执行只不过是一纸空文。 来自《现代汉英综合大词典》
• The economy is in danger of collapse unless far-reaching reforms are implemented. 如果不实施影响深远的改革，经济就面临崩溃的危险。 来自辞典例句

20 affected   

adj.不自然的，假装的

参考例句：

• She showed an affected interest in our subject.她假装对我们的课题感到兴趣。
• His manners are affected.他的态度不自然。

21 enrolled   

adj.入学登记了的v.[亦作enrol]( enroll的过去式和过去分词 )；登记，招收，使入伍（或入会、入学等），参加，成为成员；记入名册；卷起，包起

参考例句：

• They have been studying hard from the moment they enrolled. 从入学时起，他们就一直努力学习。 来自《简明英汉词典》
• He enrolled with an employment agency for a teaching position. 他在职业介绍所登了记以谋求一个教师的职位。 来自《简明英汉词典》

22 helping   

n.食物的一份&adj.帮助人的，辅助的

参考例句：

• The poor children regularly pony up for a second helping of my hamburger. 那些可怜的孩子们总是要求我把我的汉堡包再给他们一份。
• By doing this, they may at times be helping to restore competition. 这样一来, 他在某些时候,有助于竞争的加强。