PBS高端访谈:儿童健康保险项目出现资金问题

Hari Sreenivasan: Children's Health Insurance Program or CHIP was put into place in 1997 to provide health insurance to children families that make too much money to qualify for Medicaid but not enough to afford it on their own. Last year alone, nearly 9 million children were enrolled¹. Politically speaking, the program has always received bipartisan support. But this September, federal funding for the program ran out and there's no agreement yet on Capitol Hill to find the approximately 14 billion dollars a year it costs to run it. That leaves states who administer the program running out of funds and children with uncertain health insurance coverage² as the end of the year approaches. Joining me now from Washington D.C. to discuss this is Diane Rowland executive vice³ president of the Kaiser Family Foundation. Rowland also advised Congress as the inaugural⁴ chair of the congressionally authorized⁵ Medicaid and CHIP payment and access commission. So put this in perspective for us. Has this ever been in as much trouble or uncertainty⁶ before?

Diane Rowland: This is the most uncertain time in Chip's long history. It's always been reauthorized sometimes there's been a debate about how long it should be reauthorized for but it was considered to be a slam dunk.

Hari Sreenivasan: Well what's at the crux⁷ of the disagreement?

Diane Rowland: The crux of the disagreement has mostly been about timing⁸ to begin with. It was always that they were going to first do the ACA repeal⁹ and replace law and they would get to CHIP. Now it's mostly a problem that the House and Senate have differed on how to pay for the bill. The House has made some provisions that reduce some Medicare spending and other things to help offset¹⁰ the cost of CHIP. The Senate has not yet passed any of the pay. So now they're arguing but mostly it's also that very little attention has been put on a priority of getting this bill done.

Hari Sreenivasan: What happens in the meantime? I mean states – some of them are kind of already over their budgets as the end of the year approaches?

Diane Rowland: Well, right now the Health and Human Services Department is trying to put out some of the unexpended funds from prior years to patch together a few of the states programs. But we know that 16 states will run out of funding by the end of January. And many of them are in the difficult position of trying to figure out whether to send a bad letter at the holiday time to families to say you ought to be prepared for us to have to terminate the program and to find other sources of coverage. Some are trying to figure out if they can get their legislatures to deal with additional appropriations¹¹ to cover it with state funds. But I think everyone's hoping that the Congress will finally move to get this program with universal support enacted¹² and on its way back to covering millions of children.

Hari Sreenivasan: So some states have already sent out those letters I think Texas is one. So what happens to these families in the interim¹³ when they're trying to figure out what's going to happen next quarter or whatever especially if they have children who have long term treatments?

Diane Rowland: Well the real problem here is that the reason CHIP exists is that health insurance coverage for many working families of moderate means is unaffordable. And even if they are offered coverage through their workplace, they may not be able to afford that coverage when it comes to full family coverage. So a lot of families are going to be very confused about what to do to get their children coverage, about where they can find affordable¹⁴ coverage. Some of them may try to get coverage through the marketplace but that may not be available to them if they're working for an employer that offers coverage. And for others, they're going to have to really try and look at having their children uninsured.

1 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》

2 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。

3 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。

4 inaugural   

adj.就职的；n.就职典礼

参考例句：

• We listened to the President's inaugural speech on the radio yesterday.昨天我们通过无线电听了总统的就职演说。
• Professor Pearson gave the inaugural lecture in the new lecture theatre.皮尔逊教授在新的阶梯讲堂发表了启用演说。

5 authorized   

a.委任的，许可的

参考例句：

• An administrative order is valid if authorized by a statute.如果一个行政命令得到一个法规的认可那么这个命令就是有效的。

6 uncertainty   

n.易变，靠不住，不确知，不确定的事物

参考例句：

• Her comments will add to the uncertainty of the situation.她的批评将会使局势更加不稳定。
• After six weeks of uncertainty,the strain was beginning to take its toll.6个星期的忐忑不安后，压力开始产生影响了。

7 crux   

adj.十字形；难事，关键，最重要点

参考例句：

• The crux of the matter is how to comprehensively treat this trend.问题的关键是如何全面地看待这种趋势。
• The crux of the matter is that attitudes have changed.问题的要害是人们的态度转变了。

8 timing   

n.时间安排，时间选择

参考例句：

• The timing of the meeting is not convenient.会议的时间安排不合适。
• The timing of our statement is very opportune.我们发表声明选择的时机很恰当。

9 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。

10 offset   

n.分支，补偿；v.抵消，补偿

参考例句：

• Their wage increases would be offset by higher prices.他们增加的工资会被物价上涨所抵消。
• He put up his prices to offset the increased cost of materials.他提高了售价以补偿材料成本的增加。

11 appropriations   

n.挪用（appropriation的复数形式）

参考例句：

• More commonly, funding controls are imposed in the annual appropriations process. 更普遍的作法是，拨款控制被规定在年度拨款手续中。 来自英汉非文学 - 行政法
• Should the president veto the appropriations bill, it goes back to Congress. 假如总统否决了这项拨款提案，就把它退还给国会。 来自英汉非文学 - 政府文件

12 enacted   

制定（法律），通过（法案）( enact的过去式和过去分词 )

参考例句：

• legislation enacted by parliament 由议会通过的法律
• Outside in the little lobby another scene was begin enacted. 外面的小休息室里又是另一番景象。 来自英汉文学 - 嘉莉妹妹

13 interim   

adj.暂时的，临时的；n.间歇，过渡期间

参考例句：

• The government is taking interim measures to help those in immediate need.政府正在采取临时措施帮助那些有立即需要的人。
• It may turn out to be an interim technology.这可能只是个过渡技术。

14 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。