美国国家公共电台 NPR It's Not Clear How Many People Could Actually Work To Get Medicaid

 

AUDIE CORNISH, HOST:

Republican House leaders are making last-minute changes to their health care proposal in a bid to woo more conservatives ahead of a vote scheduled for Thursday. One of those changes would let states impose work requirements on some Medicaid recipients¹. A handful of states asked for that authority from the Obama administration but were denied. Here's Arkansas Republican Governor Asa Hutchinson.

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ASA HUTCHINSON: You're talking about healthy individuals that are capable of working that might need training, that might need opportunities. And we want to be able to have that to be a part of the Medicaid expansion program.

CORNISH: For more on this idea of requiring Medicaid recipients to work, we're joined by Leighton Ku. He's a professor of health policy at George Washington University. Welcome to the program.

LEIGHTON KU: Thank you very much.

CORNISH: We heard the Arkansas governor there talking about this concept. What do you think is the overall goal? What are people expecting to happen if they add a provision like this?

KU: I think that they believe that millions of people will no longer be enrolled² on Medicaid and that those are people who they feel are not meeting their social obligation to try to work. I think people think that it might help more people work. That remains³ to be seen.

And I guess that's a tradeoff. If some people - some additional people work because of this requirement, how do we decide to trade that off against the millions who might lose their health insurance because they are unable to find meaningful work?

CORNISH: So you've studied the population of people who enrolled in Medicaid under the expansion under the Affordable⁴ Care Act. So what does the data tell you? How many people out there are able-bodied and, like, not looking for work or not in school or not pregnant?

KU: So when we looked at the people who were in the expansion population, about half of them were disabled or had serious health problems. Of the other half of the group, the great majority were already working or looking for work or in school. So there is a portion, about 13 percent or so, of these adults who might be considered able-bodied but not working right now. And of those, the great majority said the reason they weren't working was because they were taking care of family members.

So there are some - and probably if you look across the nation it could be millions of individuals - who are receiving Medicaid benefits at the moment but who would be potentially required to work under the new rules that Congress is considering.

CORNISH: Now, proponents⁵ of this idea said it would be like the work requirement for some recipients of food stamps that was part of the welfare overhaul⁶ in the '90s. What do you make of that comparison?

KU: Well, there - there are some work requirements that already exist in the food stamp program now called SNAP. But that makes a little more sense in the context in which you think if people work, they will earn income and that can help make themselves economically self-sufficient.

In the context of Medicaid, that makes less sense because only about a quarter of the jobs that are available to people who were in the Medicaid sort of range offer health insurance to their workers. It's not as though work requirements get them to the point where they're going to be able to be self-sufficient with respect to health insurance coverage⁷.

The other thing where I would disagree somewhat with Governor Hutchinson is he says this is creating opportunity for people. People already have the opportunity to seek work, to get job training. This will actually disallow⁸ some of them who are trying to pursue other opportunities. So, for example, if someone is going to college and trying to get training so they can have a meaningful job over time, guess what? That doesn't count as meeting the work requirements under these policies.

CORNISH: Leighton Ku is director of the Center for Health Policy Research at George Washington University. Thank you for speaking with us.

KU: It was nice to be here.

1 recipients   

adj.接受的；受领的；容纳的；愿意接受的n.收件人；接受者；受领者；接受器

参考例句：

• The recipients of the prizes had their names printed in the paper. 获奖者的姓名登在报上。 来自《简明英汉词典》
• The recipients of prizes had their names printed in the paper. 获奖者名单登在报上。 来自《现代英汉综合大词典》

2 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》

3 remains   

n.剩余物，残留物；遗体，遗迹

参考例句：

• He ate the remains of food hungrily.他狼吞虎咽地吃剩余的食物。
• The remains of the meal were fed to the dog.残羹剩饭喂狗了。

4 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。

5 proponents   

n.（某事业、理论等的）支持者，拥护者( proponent的名词复数 )

参考例句：

• Reviewing courts were among the most active proponents of hybrid rulemaking procedures. 复审法院是最积极的混合型规则制定程序的建议者。 来自英汉非文学 - 行政法
• Proponents of such opinions were arrested as 'traitors. ' 提倡这种主张的人马上作为“卖国贼”逮捕起来。 来自辞典例句

6 overhaul   

v./n.大修，仔细检查

参考例句：

• Master Worker Wang is responsible for the overhaul of this grinder.王师傅主修这台磨床。
• It is generally appreciated that the rail network needs a complete overhaul.众所周知，铁路系统需要大检修。

7 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。

8 disallow   

v.不允许；拒绝

参考例句：

• I believe oneself,I am obstinate disallow me to stay back!我相信我自己，倔强不允许我退后！
• The policy adopted in this book is to disallow Leibnizian notation within the text.本书采用的办法是在正文中不用莱布尼兹记号。