美国国家公共电台 NPR Obamacare Helped The Homeless, Who Now Worry About Coverage Repeal

 

DAVID GREENE, HOST:

We do not know yet if Obamacare will be replaced. As NPR's Pam Fessler reports, one community facing uncertainty¹ are the homeless.

PAM FESSLER, BYLINE²: Joseph Funn was homeless for almost 20 years, and his body took quite a beating living outside. He now sees nurse practitioner³ Amber⁴ Richert fairly regularly at the Health Care for the Homeless Clinic in Baltimore.

AMBER RICHERT: And any chest pains now?

JOSEPH FUNN: I've been like probably closer two weeks, two and a half weeks without any, and that's really good. They were really scary, yo.

RICHERT: And when exactly did you quit smoking?

FESSLER: He says in December when he finally got an apartment. That's a big change for the 56 year old. Last winter, he had to trudge⁵ through deep snow for days until his foot began to swell⁶ so much, he could hardly walk.

FUNN: It was frostbite. So I thought when you had frostbite is like when it turn purple and blue. But when I came to see Dr. Amber, she said, no, that's when they have to cut something off. So I was like whoa, you know? Whoa.

FESSLER: He immediately went to the clinic's convalescent center to be treated, and they got him signed up for Medicaid. Under the Affordable⁷ Care Act, Maryland is one of 31 states that expanded the health insurance program for the poor to cover non-disabled childless adults like Funn. Health Care for the Homeless President Kevin Lindamood says before Obamacare, only 30 percent of their patients had health insurance.

KEVIN LINDAMOOD: Now 90 percent of our clients from 30 percent insured to 90 percent insured either through Medicaid or Medicare. That's a transformation⁸.

FESSLER: One, he says, that's allowed them to open new clinics including one for dental care and to double the number of clients they see. They've also hired more staff to go out and encourage people to come in for help. Homeless advocates have argued that better health coverage⁹ could eventually reduce costly¹⁰ emergency room visits, and that it will help people get off and stay off the street. Lindamood says his clients are now worried.

LINDAMOOD: We're working with very vulnerable people who are now coming to us, hearing the news in general and saying wait a minute. I just got access to care. Does this mean I'm going to lose it?

FESSLER: And no one really knows. Republicans have promised to replace Obamacare, but haven't said how. President Trump¹¹ has said no one will lose coverage, but White House counselor¹² Kellyanne Conway has also said they hope to turn Medicaid into a block grant, meaning states get a set amount of money along with more control over how to spend it. Michael Cannon¹³ of the Libertarian Cato Institute thinks that will ultimately benefit the homeless.

MICHAEL CANNON: I think that's a good case to be made that states will have more money to devote to the truly needy¹⁴ folks because states will be more aggressive in reining¹⁵ in wasteful¹⁶ expenditures¹⁷, reining in unnecessary expenditures, reining in fraud.

FESSLER: But others are skeptical¹⁸. Barbara DiPietro is with the national Health Care for the Homeless Council, a network that serves almost 900,000 homeless patients. She says block grants will likely mean less federal funding forcing cash-strapped states to make tough choices about whom to cover.

BARBARA DIPIETRO: So when we talk about no one will lose coverage, that's heartening. But the details are always very important. What does that coverage look like? The population we serve typically falls through the cracks.

FUNN: I think these are the first pictures I took of it.

FESSLER: Back at the Baltimore clinic, Joseph Funn proudly shows pictures of his new apartment.

FUNN: This is the bedroom there. That's the heater unit. This is the - all the windows go from the floor almost to the ceiling.

FESSLER: He loves that it's so peaceful. One of his biggest problems is stress. Funn says losing Medicaid would be a hardship, but he also thinks there are a lot of people on the streets of Baltimore worse off than he is.

FUNN: I can see them cutting me and giving the money to the people that need the most help.

FESSLER: And his plan right now is to get healthy, so he doesn't need as much help. Pam Fessler, NPR News.

1 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。

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 practitioner   

n.实践者，从事者；(医生或律师等)开业者

参考例句：

• He is an unqualified practitioner of law.他是个无资格的律师。
• She was a medical practitioner before she entered politics.从政前她是个开业医生。

4 amber   

n.琥珀；琥珀色；adj.琥珀制的

参考例句：

• Would you like an amber necklace for your birthday?你过生日想要一条琥珀项链吗？
• This is a piece of little amber stones.这是一块小小的琥珀化石。

5 trudge   

v.步履艰难地走；n.跋涉，费力艰难的步行

参考例句：

• It was a hard trudge up the hill.这趟上山是一次艰难的跋涉。
• The trudge through the forest will be tiresome.长途跋涉穿越森林会令人疲惫不堪。

6 swell   

vi.膨胀，肿胀；增长，增强

参考例句：

• The waves had taken on a deep swell.海浪汹涌。
• His injured wrist began to swell.他那受伤的手腕开始肿了。

7 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。

8 transformation   

n.变化；改造；转变

参考例句：

• Going to college brought about a dramatic transformation in her outlook.上大学使她的观念发生了巨大的变化。
• He was struggling to make the transformation from single man to responsible husband.他正在努力使自己由单身汉变为可靠的丈夫。

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 costly   

adj.昂贵的，价值高的，豪华的

参考例句：

• It must be very costly to keep up a house like this.维修这么一幢房子一定很昂贵。
• This dictionary is very useful,only it is a bit costly.这本词典很有用，左不过贵了些。

11 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。

12 counselor   

n.顾问，法律顾问

参考例句：

• The counselor gave us some disinterested advice.顾问给了我们一些无私的忠告。
• Chinese commercial counselor's office in foreign countries.中国驻国外商务参赞处。

13 cannon   

n.大炮，火炮；飞机上的机关炮

参考例句：

• The soldiers fired the cannon.士兵们开炮。
• The cannon thundered in the hills.大炮在山间轰鸣。

14 needy   

adj.贫穷的，贫困的，生活艰苦的

参考例句：

• Although he was poor,he was quite generous to his needy friends.他虽穷，但对贫苦的朋友很慷慨。
• They awarded scholarships to needy students.他们给贫苦学生颁发奖学金。

15 reining   

勒缰绳使（马）停步( rein的现在分词 )； 驾驭； 严格控制； 加强管理

参考例句：

• "That's a fine bevy, Ma'm,'said Gerald gallantly, reining his horse alongside the carriage. "太太！好一窝漂亮的云雀呀！" 杰拉尔德殷勤地说，一面让自己的马告近塔尔顿的马车。
• I was a temperamental genius in need of reining in by stabler personalities. 我是个需要由更稳重的人降服住的神经质的天才。

16 wasteful   

adj.（造成）浪费的，挥霍的

参考例句：

• It is a shame to be so wasteful.这样浪费太可惜了。
• Duties have been reassigned to avoid wasteful duplication of work.为避免重复劳动浪费资源，任务已经重新分派。

17 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》

18 skeptical   

adj.怀疑的，多疑的

参考例句：

• Others here are more skeptical about the chances for justice being done.这里的其他人更为怀疑正义能否得到伸张。
• Her look was skeptical and resigned.她的表情是将信将疑而又无可奈何。