美国国家公共电台 NPR Texas Braces For Medicaid Cuts Under GOP Health Plan

 

STEVE INSKEEP, HOST:

Let's follow up on a statement made a lot about a Republican health care plan. In its current form, the bill is likely to cost many people who voted for President Trump¹. Older people with lower incomes, for example, would pay more for health insurance. People are closely watching the legislation. In Texas, a state that voted for President Trump, one big change would come in funding insurance for low-income people, seniors, people with disabilities, who get help from Medicaid. Texans across the political spectrum² say their state would not do well under this legislation. Here's Ashley Lopez of our member station KUT in Austin.

ASHLEY LOPEZ, BYLINE³: As the GOP repeal⁴ bill works its way through Congress, Anne Dunkelberg with the left-leaning Center for Public Policy Priorities says she's a little stumped⁵.

ANNE DUNKELBERG: I've worked on Medicaid and uninsured and health care access issues in Texas for well over 20 years.

LOPEZ: She says there's a pot of money she's particularly concerned about. Texas has struck deals with the feds to help reimburse⁶ hospitals for the cost of caring for people who don't have insurance, mostly because Texas didn't expand Medicaid. Texas has more uninsured residents than any other state. And Dunkelberg says the GOP plan isn't clear about what happens to this pot of money.

DUNKELBERG: About half of what Texas hospitals get from Texas Medicaid today comes through payments that are outside of the regular Medicaid program.

LOPEZ: That adds up to $4 billion in federal funds every year. But even if, let's say, Texas keeps all that money in the future, there's another whammy. The GOP plan caps how much money states get for Medicaid from the feds for every person they cover. It's called a per capita cap. And the formula for this money, starting in 2020, would be based on how much the state spends this year. Adriana Kohler with Texans Care for Children, an advocacy group based in Austin, says Texas already leaves too many people without care.

ADRIANA KOHLER: Last legislative⁷ session, there were cuts to pediatric therapies for kids with disabilities enrolled⁸ in Medicaid. And we've seen that that has restricted access to services. That's why these cuts coming down from the ACA repeal bill are very concerning to us.

LOPEZ: She says in Texas, children, pregnant women, seniors and people with disabilities will bear the brunt of any belt-tightening. And some on the right agree Texas is getting a raw deal. Dr. Deane Waldman with the right-leaning Texas Public Policy Foundation says there are things he likes in the bill. But in general...

DEANE WALDMAN: Yeah, it's a bad deal for Texas. It's a bad deal for the American people.

LOPEZ: He says the per capita cap punishes Texas for not expanding Medicaid, which he thinks was the right move. Under the GOP replacement⁹ bill, expansion states will be getting more money. And because the Republican bill leaves the door open for states to expand Medicaid before 2020, he thinks more states will do that.

WALDMAN: It's going to be a huge rush, an inducement to drag in as many people as they can drag in 'cause the more they can drag in, the more federal dollars they will get.

LOPEZ: Waldman says he thinks that will make Medicaid spending skyrocket. But if Texas still refuses to expand, it will have to share a pot of $10 billion over five years with other non-expansion states. And that would be a drop in the bucket for a state as big as Texas. For NPR News, I'm Ashley Lopez in Austin.

INSKEEP: That story's part of a reporting partnership¹⁰ with NPR News, KUT and Kaiser Health News.

1 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。

2 spectrum   

n.谱，光谱，频谱；范围，幅度，系列

参考例句：

• This is a kind of atomic spectrum.这是一种原子光谱。
• We have known much of the constitution of the solar spectrum.关于太阳光谱的构成，我们已了解不少。

3 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。

4 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。

5 stumped   

僵直地行走，跺步行走( stump的过去式和过去分词 )； 把（某人）难住； 使为难； （选举前）在某一地区作政治性巡回演说

参考例句：

• Jack huffed himself up and stumped out of the room. 杰克气喘吁吁地干完活，然后很艰难地走出房间。
• He was stumped by the questions and remained tongue-tied for a good while. 他被问得张口结舌，半天说不出话来。

6 reimburse   

v.补偿，付还

参考例句：

• We'll reimburse you for your travelling expenses.我们将付还你旅费。
• The funds are supposed to reimburse policyholders in the event of insurer failure.这项基金将在保险公司不能偿付的情况下对投保人进行赔付。

7 legislative   

n.立法机构，立法权；adj.立法的，有立法权的

参考例句：

• Congress is the legislative branch of the U.S. government.国会是美国政府的立法部门。
• Today's hearing was just the first step in the legislative process.今天的听证会只是展开立法程序的第一步。

8 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》

9 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。

10 partnership   

n.合作关系，伙伴关系

参考例句：

• The company has gone into partnership with Swiss Bank Corporation.这家公司已经和瑞士银行公司建立合作关系。
• Martin has taken him into general partnership in his company.马丁已让他成为公司的普通合伙人。