密歇根新闻广播 在特朗普医保政策下 有些人就医会更困难

On Thursday, the U.S. House approved a new health care policy designed by Republicans representatives to replace Obamacare. Each one of Michigan's Republican representatives voted in favor of the replacement¹ bill, while no Democrats² (in Michigan or any other state) gave the bill their support.

Michigan Republicans were likewise united in the condemnation³ of Obamacare – also known as the Affordable⁴ Care Act (ACA). Representative Tim Walberg, for instance, said, "Obamacare is on the brink⁵ of collapse⁶ and has failed to live up to its many promises."

Representative John Moolenar called the ACA, "the collapsing⁷ health care law."

Not everyone agrees with those assessments⁸.

John Ayanian is the Director of the Institute for Healthcare Policy and Innovation at the University of Michigan. He said that while the Affordable Care Act is not without its flaws, it "has done a lot of good over the past several years."

He highlighted the Healthy Michigan Plan, which was created through the ACA's Medicaid expansion, as an example of one piece of the health care law that has worked.

"It's expanded coverage⁹ to about 650,000 adults in Michigan between ages 18 and 64," he told Stateside. "So it's really had an important impact on access to care and reducing the financial stress that goes with being uninsured for Michigan adults."

Ayanian noted¹⁰ that so-called "charity care" – urgent care of uninsured patients for which hospitals receive no compensation – has gone down by 50% since implementation¹¹ of the ACA. That has strengthened the financial prospects¹² of many hospitals in Michigan, allowing them to focus on providing better care.

As for the replacement bill, the American Health Care Act (ACHA), the path to passage remains¹³ daunting¹⁴. Before becoming law, the bill must work its way through the U.S. Senate, where it is sure to undergo significant changes. Senate rules will make portions of the ACHA impossible to pass without the support of at least a few Democrats.

If the bill does reach the President's desk in its current form, the ACHA is likely to produce some winners and losers.

Ayanian said that an analysis of a prior version of the bill by the Congressional Budget Office found that, "older, sicker, and less wealthy adults – particularly those over age 50, with chronic¹⁵ conditions and lower incomes – they could see their costs of health insurance and out-of-pocket spending for medical care go up substantially."

Listen to our full interview with John Ayanian, Director of the Institute for Healthcare Policy and Innovation at the University of Michigan, above.

1 replacement   

n.取代，替换，交换；替代品，代用品

参考例句：

• We are hard put to find a replacement for our assistant.我们很难找到一个人来代替我们的助手。
• They put all the students through the replacement examination.他们让所有的学生参加分班考试。

2 democrats   

n.民主主义者，民主人士( democrat的名词复数 )

参考例句：

• The Democrats held a pep rally on Capitol Hill yesterday. 民主党昨天在国会山召开了竞选誓师大会。
• The democrats organize a filibuster in the senate. 民主党党员组织了阻挠议事。 来自《简明英汉词典》

3 condemnation   

n.谴责; 定罪

参考例句：

• There was widespread condemnation of the invasion. 那次侵略遭到了人们普遍的谴责。
• The jury's condemnation was a shock to the suspect. 陪审团宣告有罪使嫌疑犯大为震惊。

4 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。

5 brink   

n.(悬崖、河流等的)边缘，边沿

参考例句：

• The tree grew on the brink of the cliff.那棵树生长在峭壁的边缘。
• The two countries were poised on the brink of war.这两个国家处于交战的边缘。

6 collapse   

vi.累倒；昏倒；倒塌；塌陷

参考例句：

• The country's economy is on the verge of collapse.国家的经济已到了崩溃的边缘。
• The engineer made a complete diagnosis of the bridge's collapse.工程师对桥的倒塌做了一次彻底的调查分析。

7 collapsing   

压扁[平]，毁坏，断裂

参考例句：

• Rescuers used props to stop the roof of the tunnel collapsing. 救援人员用支柱防止隧道顶塌陷。
• The rocks were folded by collapsing into the center of the trough. 岩石由于坍陷进入凹槽的中心而发生褶皱。

8 assessments   

n.评估( assessment的名词复数 )；评价；（应偿付金额的）估定；（为征税对财产所作的）估价

参考例句：

• He was shrewd in his personal assessments. 他总能对人作出精明的评价。 来自《简明英汉词典》
• Surveys show about two-thirds use such assessments, while half employ personality tests. 调查表明，约有三分之二的公司采用了这种测评；而一半的公司则采用工作人员个人品质测试。 来自百科语句

9 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。

10 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。

11 implementation   

n.实施，贯彻

参考例句：

• Implementation of the program is now well underway.这一项目的实施现在行情看好。

12 prospects   

n.希望，前途(恒为复数)

参考例句：

• There is a mood of pessimism in the company about future job prospects. 公司中有一种对工作前景悲观的情绪。
• They are less sanguine about the company's long-term prospects. 他们对公司的远景不那么乐观。

13 remains   

n.剩余物，残留物；遗体，遗迹

参考例句：

• He ate the remains of food hungrily.他狼吞虎咽地吃剩余的食物。
• The remains of the meal were fed to the dog.残羹剩饭喂狗了。

14 daunting   

adj.使人畏缩的

参考例句：

• They were faced with the daunting task of restoring the house.他们面临着修复房子的艰巨任务。
• Starting a new job can be a daunting prospect.开始一项新工作有时会让人望而却步。

15 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。