美国国家公共电台 NPR CBO Predicts Rise In Deficit If Trump Cuts Payments To Insurance Companies

 

AUDIE CORNISH, HOST:

The Congressional Budget Office has weighed in on a health care proposal floated by President Trump¹. He's been threatening to cut off payments the government makes to insurance companies to lower the cost of co-payments and deductibles. Now, if he goes ahead, the nonpartisan CBO says it will cost taxpayers² nearly $200 billion over the next 10 years. The new CBO report also says premiums³ would rise by about 20 percent, but that increase would be offset⁴ by higher government subsidies⁵. To help us sort this out is NPR health policy correspondent Alison Kodjak. Welcome to the studio.

ALISON KODJAK, BYLINE⁶: Hi, Audie.

CORNISH: So what exactly are these payments for?

KODJAK: Well, so the Affordable⁷ Care Act actually requires insurance companies to offer discounts to low-income customers. They offset their deductible and their co-payments. And the law says the government will reimburse⁸ the company for those costs. But Republicans have been opposed to these payments. They're known as cost-sharing payments. And the president has been threatening to cut them off on Twitter quite a lot this summer.

CORNISH: Now, if this increases the premiums and increases the federal deficit⁹ by - the precise number was 194 billion, what's the argument that the White House is making for cutting off the payment?

KODJAK: Well, one analyst¹⁰ I talked to said this plan doesn't actually meet any policy goals, assuming those are to increase access to health care or to cut costs. But one thing the president has said over and over is that he wants to let Obamacare implode¹¹. That would help him to be able to force a replacement¹² of the program that he just doesn't like. So these threats to cut off the - these payments came in that context. But what we learned today from the CBO is that even getting rid of these reimbursements¹³ probably would not kill the Affordable Care Act, and it may actually help because it may lead more people to sign up for insurance.

CORNISH: What do you mean by that? I mean, why would it cost so much?

KODJAK: Well, so it would increase subsidies. Twenty percent of the entire - this is 20 percent of the entire cost of the Affordable Care Act, that $194 billion. And the Affordable Care Act design says people pay a specific share of their income toward health care premiums. So if the premiums go up, which they would under - if he cut these payments off, then the subsidies go up. And the government has to pay subsidies for a lot more people than it pays for these cost-sharing payments.

CORNISH: And before I let you go, you said this also might increase the number of people with health insurance. How would that work?

KODJAK: Well, that's because of those subsidies going up. So people, even those who didn't get the cost-sharing payment reductions, they would have a bigger subsidy¹⁴ to go shop for insurance. So they might find that the insurance is cheaper, and they could then maybe be lured¹⁵ into the markets and decide to buy insurance even if maybe in the past they thought it was a little too expensive.

CORNISH: To step back for a moment, were these payments supposed to be for the long term? Like, when the Affordable Care Act was set up, did they think, we're always going to be helping¹⁶ out the insurance companies?

KODJAK: Yeah. Yeah. Well, it was - it was not really helping out the insurance companies. It's really a pass-through to help those low-income people meet their medical costs. So if you buy a policy that has a $5,000 deductible, that doesn't make insurance very affordable. So these payments were to get the insurance companies to offer the same plan but with a lower deductible.

CORNISH: Oh, so they wouldn't just say, oh, these people are too sick or too poor. We want out of the system.

KODJAK: Right. It was just to help lower-income people to be able to afford their health care. So the president's called it a bailout, but really, it's a subsidy for lower-income people and not a subsidy for insurance companies.

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

KODJAK: Thank you, Audie.

(SOUNDBITE OF VETIVER'S "STRICTLY RULE")

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 taxpayers   

纳税人，纳税的机构( taxpayer的名词复数 )

参考例句：

• Finance for education comes from taxpayers. 教育经费来自纳税人。
• She was declaiming against the waste of the taxpayers' money. 她慷慨陈词猛烈抨击对纳税人金钱的浪费。

3 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》

4 offset   

n.分支，补偿；v.抵消，补偿

参考例句：

• Their wage increases would be offset by higher prices.他们增加的工资会被物价上涨所抵消。
• He put up his prices to offset the increased cost of materials.他提高了售价以补偿材料成本的增加。

5 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》

6 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。

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 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。

9 deficit   

n.亏空，亏损；赤字，逆差

参考例句：

• The directors have reported a deficit of 2.5 million dollars.董事们报告赤字为250万美元。
• We have a great deficit this year.我们今年有很大亏损。

10 analyst   

n.分析家，化验员；心理分析学家

参考例句：

• What can you contribute to the position of a market analyst?你有什么技能可有助于市场分析员的职务？
• The analyst is required to interpolate values between standards.分析人员需要在这些标准中插入一些值。

11 implode   

v.内爆，剧减

参考例句：

• The engine imploded.发动机内爆了。
• He has nightmares about the tanks imploding.他老是做油箱爆炸的噩梦。

12 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。

13 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

14 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。

15 lured   

吸引，引诱（lure的过去式与过去分词形式）

参考例句：

• The child was lured into a car but managed to escape. 那小孩被诱骗上了车，但又设法逃掉了。
• Lured by the lust of gold,the pioneers pushed onward. 开拓者在黄金的诱惑下，继续奋力向前。

16 helping   

n.食物的一份&adj.帮助人的，辅助的

参考例句：

• The poor children regularly pony up for a second helping of my hamburger. 那些可怜的孩子们总是要求我把我的汉堡包再给他们一份。
• By doing this, they may at times be helping to restore competition. 这样一来, 他在某些时候,有助于竞争的加强。