美国国家公共电台 NPR Draft Of Health Care Bill Addresses Trump Concerns About 'Bailouts' For Insurers

 

MARY LOUISE KELLY, HOST:

There's a new plan to stabilize¹ the Affordable² Care Act for next year, specifically to shore up its insurance markets. Now, this is a bill from a bipartisan group of senators led by Republican Lamar Alexander and Democrat³ Patty Murray. The centerpiece is a guarantee - a guarantee that the government will keep paying subsidies⁴ to insurance companies who sell Obamacare policies. Insurance companies call the payments crucial to keep health premiums⁵ low. But President Trump⁶ calls them a bailout, and he has sent mixed signals about whether he's going to get behind this bill.

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PRESIDENT DONALD TRUMP: I won't do anything to enrich the insurance companies because right now, the insurance companies are being enriched. They've been enriched by Obamacare like nothing anybody's ever seen before.

KELLY: NPR's health policy correspondent Alison Kodjak is here to walk us through this. Hey there, Alison.

ALISON KODJAK, BYLINE⁸: Hey, Mary Louise.

KELLY: So the president says he does not want to bail⁷ out insurance companies. Start there. Are these payments a bailout?

KODJAK: Well, no, they're really not. These would be best described as reimbursements⁹. Because the Affordable Care Act requires the insurance companies to give discounts on co-payments and deductibles to their low-income customers, the law says the government will pay the companies back for that cost. So these are really known - they're called pass-through payments because the government gives the money to the companies, and then they pass that money along to consumers at discounts.

KELLY: And remind us of the history here because we're all trying to keep up with all of the twists and turns of what is going on with health care and what the future may hold. These payments have been controversial for a while. They were the subject of a lawsuit¹⁰. The House sued the Obama administration, claiming they were legal. What was that argument about?

KODJAK: So the House argued that the payments have never been appropriated. They never passed a bill saying, you can have this money. And a judge agreed. So the Obama administration appealed, and the judge said the government could continue making the payments during that appeal. But that meant their future's always been in question. And President Trump - from the moment he took office, he's been threatening to cut them off. And finally last week, he said he's ending them for good starting immediately.

KELLY: Right, by executive action. What happens if that decision stands? What are the implications if this money goes away?

KODJAK: Well, insurance companies have been planning for it because of these ongoing¹¹ threats. And they still have to give their customers these discounts because that's written into the law. So they basically all announced - or most of them announced that they would raise premiums starting next year. And on average, across the board, those premiums are going up about 20 percent to make up for the revenue that's lost.

KELLY: OK, and now into the fray¹² comes this bill. This is the Patty Murray-Lamar Alexander bill which would restore these payments. How exactly would it do that? How would it work?

KODJAK: So it would bring back the subsidy¹³ payments starting immediately - so next month even. And it appropriates the money for them for this year, 2018 and 2019. But then that creates this whole new problem, which is that the insurance companies, as I just said, have already said they're going to raise their premiums next year because they didn't think these payments would be in place. And that could be what the president's referring to when he talked about enriching insurance companies.

They - the subsidies were going to disappear, and now they're not. The bill spends a lot of time making sure that these payments are somehow paid back and go to consumers rather than enriching insurance companies, as the president is afraid that they will. And ultimately, the Affordable Care Act limits how much profit insurers can make. They have to spend 80 percent of their premiums on health care. So consumers could get a rebate¹⁴ that way, too.

KELLY: That's NPR health policy correspondent Alison Kodjak. Alison, thank you.

KODJAK: Thank you.

1 stabilize   

vt.（使）稳定，使稳固，使稳定平衡；vi.稳定

参考例句：

• They are eager to stabilize currencies.他们急于稳定货币。
• His blood pressure tended to stabilize.他的血压趋向稳定。

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 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。

4 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》

5 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》

6 trump   

n.王牌，法宝；v.打出王牌，吹喇叭

参考例句：

• He was never able to trump up the courage to have a showdown.他始终鼓不起勇气摊牌。
• The coach saved his star player for a trump card.教练保留他的明星选手，作为他的王牌。

7 bail   

v.舀（水），保释；n.保证金，保释，保释人

参考例句：

• One of the prisoner's friends offered to bail him out.犯人的一个朋友答应保释他出来。
• She has been granted conditional bail.她被准予有条件保释。

8 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。

9 reimbursements   

n.偿还( reimbursement的名词复数 )；退款；补偿；赔偿

参考例句：

• We had to put in for the food reimbursements again. 我们不得不再次申请食物赔偿。 来自互联网
• Have you figured up the total of the reimbursements I gave you? 你有没有把我给你的报销账目全部加总了呢？ 来自互联网

10 lawsuit   

n.诉讼，控诉

参考例句：

• They threatened him with a lawsuit.他们以诉讼威逼他。
• He was perpetually involving himself in this long lawsuit.他使自己无休止地卷入这场长时间的诉讼。

11 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。

12 fray   

v.争吵；打斗；磨损，磨破；n.吵架；打斗

参考例句：

• Why should you get involved in their fray?你为什么要介入他们的争吵呢？
• Tempers began to fray in the hot weather.大热天脾气烦燥。

13 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。

14 rebate   

v./n.折扣，回扣，退款；vt.给...回扣，给...打折扣

参考例句：

• You can claim a rebate on your tax.你可以要求退回部分税款。
• Customers are to benefit from a rebate on their electricity bills.顾客将从他们的电费退费中得到实惠。