美国国家公共电台 NPR Obamacare Repeal Could Threaten Provisions That Help Older Adults
时间:2018-12-02 作者:英语课 分类:2017年NPR美国国家公共电台1月
SCOTT SIMON, HOST:
Congressional Republicans are trying to figure out when to repeal 1 and how to replace the Affordable 2 Care Act. Whatever happens, there's a lot at stake for older Americans. NPR's Ina Jaffe covers aging. She joins us for our regular conversation we call 1 in 5, which refers to the 1 in 5 Americans who, by the year 2030, will be 65 years of age or older. Ina, thanks so much for being back with us.
INA JAFFE, BYLINE 3: It's good to be back with you, Scott.
SIMON: Now, don't Americans over 65 have Medicare?
JAFFE: Well, they do. But what people don't always realize about the Affordable Care Act is it's not just a discrete 4 program in and of itself. It changed other government programs, too, and that includes Medicare.
SIMON: What was the biggest change for Medicare?
JAFFE: Well, the one that's gotten the most attention is the change to prescription 5 drug coverage 6. You may have heard about something called the doughnut hole. That's where Medicare would get you a discount on prescriptions 7 but only up to a point. After that, you had to pay full price for drugs until you shelled out around 1,300 bucks 8. Then Medicaid would help you out again.
Now, some people never really reached that point because when they had to pay full price, they just started skipping some of their prescription meds. So the Affordable Care Act has been phasing out this gap. It saved people on Medicare more than $23 billion. But this program could go away with the repeal of the law.
SIMON: That could go away, and we should say, once again, that we don't know yet what any replacement 9 will look like. What have you heard among the ideas being proposed that might affect older Americans?
JAFFE: Well, a few members of Congress, Republicans, have circulated their own proposals for replacing the Affordable Care Act. And one thing that comes up in some of them, including in House Speaker Paul Ryan's plan, is a major change to Medicaid. Now, that's known as the program that provides health care for the poor. But it's also the program that pays for long-term care for a lot of older people. In fact, Medicaid pays the bills for most nursing home residents.
SIMON: That could be jeopardized 10?
JAFFE: Well, certainly the people putting forth 11 these plans don't think it would be. What they want to do is change Medicaid from a guaranteed benefit to a block grant to states. So a state would get a fixed 12 amount of money from the federal government and decide for itself how to spend it. The idea is that states know their needs better than the feds, and this would give them flexibility 13.
What critics of this idea worry about is, what happens in an economic downturn when demand on Medicaid goes up? They say states could be left with a sort of Sophie's choice. Do you cut back on services for poor children or for the frail 14 elderly?
SIMON: I know we've talked about Medicare and Medicaid. Are there proposed changes that would affect older Americans who might buy their own health care coverage?
JAFFE: Yeah. In fact, there's a little-known feature of the law that helps people in their 50s and early 60s, people who aren't yet eligible 15 for Medicare. Insurance companies used to be able to charge them many times more than they charge a younger person for the same policy. The Affordable Care Act put a limit on that.
Now insurance companies can only charge them three times as much. But the various replacement proposals that are out there either set the limits higher at five or six times more or they don't have any limit. And researchers say that could result in around 400,000 older adults being unable to afford to buy health insurance anymore.
SIMON: NPR's Ina Jaffe, thanks so much.
JAFFE: You're welcome.
(SOUNDBITE OF JULIAN LAGE AND CHRIS ELDRIDGE'S "BUTTER AND EGGS")
SIMON: This is NPR News.
- 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。
- 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。
- 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。
- The picture consists of a lot of discrete spots of colour.这幅画由许多不相连的色点组成。
- Most staple fibers are discrete,individual entities.大多数短纤维是不联系的单独实体。
- The physician made a prescription against sea- sickness for him.医生给他开了个治晕船的药方。
- The drug is available on prescription only.这种药只能凭处方购买。
- 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。
- The hospital of traditional Chinese medicine installed a computer to fill prescriptions. 中医医院装上了电子计算机来抓药。
- Her main job was filling the doctor's prescriptions. 她的主要工作就是给大夫开的药方配药。
- They cost ten bucks. 这些值十元钱。
- They are hunting for bucks. 他们正在猎雄兔。 来自《简明英汉词典》
- 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。
- The soldier jeopardized his life to save his comrade. 这个士兵冒生命的危险救他的同志。
- The occasional failed project or neglected opportunity does not jeopardized overall progress. 偶然失败的项目或失误的机会并没有影响总的进展。
- The wind moved the trees gently back and forth.风吹得树轻轻地来回摇晃。
- He gave forth a series of works in rapid succession.他很快连续发表了一系列的作品。
- Have you two fixed on a date for the wedding yet?你们俩选定婚期了吗?
- Once the aim is fixed,we should not change it arbitrarily.目标一旦确定,我们就不应该随意改变。
- Her great strength lies in her flexibility.她的优势在于她灵活变通。
- The flexibility of a man's muscles will lessen as he becomes old.人老了肌肉的柔韧性将降低。