VOA常速英语2013--关键州退出奥巴马医改条款（在线收听）

Hospitals at Risk in States that Opt Out of Key Obamacare Provision 关键州退出奥巴马医改条款

ANDERSON, SOUTH CAROLINA — Nearly half of all U.S. states are rejecting a key component of the new U.S. health care reform law popularly known as "Obamacare." These states - almost all with strong Republican majorities - are citing unsustainable costs as the reason for opting out.  But, by not participating, states like South Carolina could lose billions of dollars in federal funds.

At the Anderson Free Clinic in South Carolina, people line up early in the morning to see a doctor.

在南卡罗来纳的安德森免费诊所,大清早来到这里的患者们排起了等待就医的队伍长龙。

The clinic treats more than 2,000 people a year.

这家诊所每年接待近2000人。

Most of the patients-like Ronnie Green, who is 60-years-old and living on a small pension-are either unable to work or have limited incomes.

而大多数患者都像靠着微薄养老金过活60岁高龄的罗尼·格林一样—都已经无法工作或者收入有限。

“My nerves are real bad. I cry all the time. I shake.

“为此我的精神变得很糟糕。我时常以泪洗面。而且感到动摇。

Can't hold nothing. My nerves just gone," said Green.

什么都没有。一直心烦意乱。”格林说道。

Under the Affordable Care Act, also known as "Obamacare," almost all of these patients would have their costs covered by Medicaid-the government-funded health care program for the poor.

而凭借负担得起的医疗法,也被称为“奥巴马医改”,几乎所有这些患者都会得到医疗补助,政府资助卫生保健计划帮助穷人。

But because South Carolina has chosen not to expand Medicaid, free clinics remain are the only option for many people.

但是因为南卡罗来纳选择了不扩大医疗补助,免费诊所对许多人来说仍然是唯一的选择。

Barb Baptista, the clinic's director, says there are not enough exam rooms to handle the growing number of patients.

诊所负责人巴博·巴普蒂斯塔表示没有足够的诊疗室来接待越来越多的病人。

“The exam rooms are only a piece of it.

“诊疗室就那么大点地方。

Having the providers who are willing to volunteer at the free clinic and having the financial means to support our budget are a huge concern," said Baptista.

寻求从事志愿工作的帮助人士和支持我们预算的财政是个老大难问题,”巴普蒂斯塔说道。

The clinic sends seriously ill patients to the AnMed hospital emergency room-often by taxi rather than ambulance to save money.

而这家诊所会将重病患者送往安曼德医院急诊室—通常为了省钱搭乘出租车而不是救护车。

Hospitals that accept federal funds are required by law to provide emergency care regardless of an individual's ability to pay.

这是因为法律规定接受联邦资助的医院无论个人的支付能力如何，都必须提供紧急护理。

But Obamacare will phase out the federal program that reimburses hospitals for some of these bills-replacing it by covering more people under Medicaid.

但奥巴马医改将逐步淘汰报销医院这些账单的联邦项目—取而代之的将是医疗补助覆盖更多的人。

Bill Manson, who heads AnMed Health, says South Carolina's decision not to expand Medicaid imposes on hospitals all of the law's cuts but none of the benefits.

安曼德负责人比尔·曼森表示南卡罗来纳不扩大医疗补助的的决定是强加于所有法律削减,而且没有任何益处的医院。

“By not participating in the expansion, we kind of have almost a perfect storm of all the reductions that were built into the law without the resulting increase in coverage of the uninsured," said Manson.

“不参与扩张,我们几乎会有一场完美风暴,所有削减中内置的法律不会出现未保险的覆盖增加的结果。”曼森说道。

Under Obamacare, federal funds will pay 100 percent of added Medicaid costs-gradually reducing that to 90 percent by 2020.

根据奥巴马医改,联邦基金将支付100%增加的医疗补助费用, 而预计到2020年逐渐减少至90%。

But Conservatives like Ashley Landess with the South Carolina Policy Council say the costs are adding to a budget deficit that is unsustainable.

但像是南卡罗来纳州政策委员会的保守派阿什利·兰德斯表示增加的预算赤字成本是不可持续的。

“The fix is not to continue the cycle of dependency on dollars that are really coming from debt for the most part but rather to cut that dependency and put control of health care back into the hands of providers and the patients," said Landess.

“这样的修复不能维持来自债务大多数情况下真正依赖美元的循环,而且会减少这种依赖,把卫生保健控制权交到提供者和病人手上。”兰德斯说道。

Unless some compromise is reached in states like South Carolina, the number of poor without health care will continue to grow and hospitals will face increasing financial risk.

除非在南卡罗来纳等州出现妥协,否则没有医疗保障的穷人数量将继续增长而且医院将面临不断上升的金融风险。