美国国家公共电台 NPR Here Is What's In The House-Approved Health Care Bill

 

ROBERT SIEGEL, HOST:

President Trump¹ and congressional Republicans celebrated² in the White House Rose Garden today after the House narrowly passed health care legislation to replace the Affordable³ Care Act.

(SOUNDBITE OF ARCHIVED RECORDING)

PRESIDENT DONALD TRUMP: This is a great plan. I actually think it will get even better. And this is - make no mistake. This is a repeal⁴ and a replace of Obamacare. Make no mistake about it.

(APPLAUSE)

SIEGEL: That bill now goes to the Senate. And here to explain what is in the bill and how it's likely to change is NPR's health policy correspondent Alison Kodjak. Hiya.

ALISON KODJAK, BYLINE⁵: Hi, Robert.

SIEGEL: House Republicans did today what they failed to do back in March when House Speaker Ryan had to pull the bill for lack of votes. What changed the bill so much to make the difference?

KODJAK: Well, the original bill - the conservative wing of the House Republicans which are known as the Freedom Caucus⁶ really thought it kept way too much of Obamacare in place, and so they didn't like it. And then the more moderate side was worried about preexisting condition protections and other regulations that are in Obamacare being protected. And so they couldn't get the votes together at that point.

So what they did in the meantime is basically create a compromise where state governors can apply for waivers to get out of those Obamacare regulations, those protections for consumers, which pleases the Freedom Caucus because it gives people more freedom to buy different kinds of insurance. But it also technically⁷ in the federal regulation keeps all those protections for people with preexisting conditions.

SIEGEL: Well, the Congressional Budget Office said that the earlier version of the bill would have cost less than Obamacare, but it would cover 24 million fewer Americans. Why don't we have a clear idea of what impact this version of the bill would have?

KODJAK: Well, in part because we haven't heard yet from the Congressional Budget Office. There have been a number of amendments⁸ to the original bill, as I mentioned before. Since then, they have allowed these waivers, and there's no saying how many states really will accept them. Although, you know, you could do a poll and figure out how many governors are interested. And they've created a variety of funds to help people with preexisting conditions if they are left out of some of these insurance plans to help them get coverage⁹. And they have offered other changes in the bill that the CBO hasn't scored yet. So there's no - there's some sense among experts that this is going to cost more because they put...

SIEGEL: Yeah.

KODJAK: ...More money in the bill, but - and may - in those states that go for waivers, have fewer people covered even.

SIEGEL: And the CBO is the official scorer in these matters for...

KODJAK: It's the official scorer.

SIEGEL: ...If it becomes - if this bill were to become law as it is, who would be the big winners and who the big losers by its passage?

KODJAK: Well, the big winners would be younger, healthier people who would probably see their insurance premiums¹⁰ go down because they wouldn't be subsidizing people who are older and sicker. And those are exactly the people who might lose - are the older, sicker people who would see their subsidies¹¹ really go down so that they would have to pay much more for insurance and people on Medicaid. There's Medicaid expansion in the - in Obamacare, and that's being rolled back in this plan.

SIEGEL: The bill now goes to the Senate where Republicans have a much slimmer lead - 52 of the hundred seats. Do they need, in this case, just 51 to win in the Senate, by the way?

KODJAK: They need just 51.

SIEGEL: Not 60.

KODJAK: No.

SIEGEL: What's likely to change in the bill over there?

KODJAK: Well, there are a lot of senators who are already saying they're very worried about that Medicaid rollback, the Medicaid expansion rollback, so that's one thing that's going to be on the list of things that may change. And then there might be some more protection for people with preexisting conditions in these state waivers because there are a lot of members of the Senate who say they are worried about people losing coverage.

SIEGEL: After which, if all that happens, it has to go back and be approved by the House again. So...

KODJAK: Exactly.

SIEGEL: OK. NPR health policy correspondent Allison Kojak, Thanks.

KODJAK: Thanks, Robert.

(SOUNDBITE OF MASSIVE ATTACK'S "EXCHANGE")

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 celebrated   

adj.有名的，声誉卓著的

参考例句：

• He was soon one of the most celebrated young painters in England.不久他就成了英格兰最负盛名的年轻画家之一。
• The celebrated violinist was mobbed by the audience.观众团团围住了这位著名的小提琴演奏家。

3 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。

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 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。

6 caucus   

n.秘密会议；干部会议；v.（参加）干部开会议

参考例句：

• This multi-staged caucus takes several months.这个多级会议常常历时好几个月。
• It kept the Democratic caucus from fragmenting.它也使得民主党的核心小组避免了土崩瓦解的危险。

7 technically   

adv.专门地，技术上地

参考例句：

• Technically it is the most advanced equipment ever.从技术上说，这是最先进的设备。
• The tomato is technically a fruit,although it is eaten as a vegetable.严格地说，西红柿是一种水果，尽管它是当作蔬菜吃的。

8 amendments   

（法律、文件的）改动( amendment的名词复数 )； 修正案； 修改； （美国宪法的）修正案

参考例句：

• The committee does not adequately consult others when drafting amendments. 委员会在起草修正案时没有充分征求他人的意见。
• Please propose amendments and addenda to the first draft of the document. 请对这个文件的初稿提出修改和补充意见。

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 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》

11 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》