Amid roiling health care debate, the share of uninsured Americans is growing
2019-11-07 00:00:00


JUDY WOODRUFF: One of the biggest issues inthe 2020 presidential campaign is about expanding(1)
朱迪·伍德鲁夫(JUDY WOODRUFF):2020年总统大选的最大问题之一是扩大规模

health coverage or not.(2)
是否有健康保险。

Millions of Americans are at that time ofyear when they have to decide whether to get(3)
数以百万计的美国人在一年中的那个时候必须决定是否获得

their coverage through the marketplaces createdduring the Obama years.(4)
他们通过奥巴马时代创建的市场进行报道。

Amna Nawaz looks at this moment.(5)
Amna Nawaz此时此刻。

AMNA NAWAZ: Judy, several reports find thepercentage of uninsured Americans is rising(6)
AMNA NAWAZ:Judy,几份报告发现没有保险的美国人比例正在上升

for the first time since the Affordable CareAct took effect.(7)
自《平价医疗法案》生效以来,这是第一次。

That increase is backed up by Census Bureaudata.(8)
人口普查局的数据支持了这一增长。

But experts are asking, why are those numbersrising?(9)
但是专家们在问,为什么这些数字在增加?

We're going to look at that question and thisenrollment season.(10)
我们将研究这个问题和这个注册季节。

But, bear in mind, as this plays out, PresidentTrump says he remains committed to killing(11)
但是请记住,在这种情况发生时,特朗普总统表示他仍然致力于杀死

the Affordable Care Act and has backed a statelawsuit to do so.(12)
负担得起的医疗法案”,并为此支持了州法律诉讼。

At the same time, it's the law of the land.(13)
同时,这是土地的法律。

The president also says he wants to coverpeople with an alternative that would offer(14)
总统还说,他想用其他替代方案覆盖人们

some of the same consumer protections andlower health care premiums.(15)
一些相同的消费者保护措施和较低的医疗保健费用。

But he has not offered any new plan yet.(16)
但是他还没有提出任何新计划。

For more on this, Margot Sanger-Katz joinsme here now.(17)
有关此的更多信息,Margot Sanger-Katz现在就加入我的行列。

She reports on all of this for The New YorkTimes.(18)
她在《纽约时报》上报道了所有这一切。

Welcome back to the "NewsHour."(19)
欢迎回到“新闻时报”。

MARGOT SANGER-KATZ, The New York Times: Thanksfor having me.(20)
《纽约时报》玛格特•桑格-卡茨:感谢您的光临。

AMNA NAWAZ: So, let's just start with wherewe are.(21)
AMNA NAWAZ:所以,让我们从我们的位置开始。

We're a couple of days into the enrollmentseason.(22)
入学季已经两天了。

How are things looking so far?(23)
目前情况如何?

MARGOT SANGER-KATZ: So, despite everythingyou said, the Trump administration is no fan(24)
玛格特·桑格·卡茨(MARGOT SANGER-KATZ):所以,尽管您说了一切,但特朗普政府并不支持

of Obamacare, but this year looks pretty good.(25)
奥巴马医改,但今年看起来不错。

Compared to last year, there are more choicesin a lot of parts of the country, and premiums(26)
与去年相比,该国许多地方有更多选择,保费

actually have come down a little bit.(27)
实际上已经下降了一点。

And it's been this interesting sort of boomerang.(28)
这就是这种有趣的飞旋镖。

When the Trump administration came in, theydid a whole bunch of things that made those(29)
特朗普政府进来时,他们做了很多事情,

markets really bumpy and problematic.(30)
市场真的坎bump而成问题。

Prices went way up.(31)
价格上涨。

A lot of insurers left the market.(32)
许多保险公司退出了市场。

There was a lot of concern and policy uncertainty.(33)
存在很多担忧和政策不确定性。

And then, over time, things have kind of stabilized,and so we're kind of correcting back to a(34)
然后,随着时间的流逝,事情已经趋于稳定,因此我们正在将其改正为

more normal, stable place.(35)
比较正常,稳定的地方。

AMNA NAWAZ: Let me ask about this number that'scatching everyone's attention now, the overall(36)
AMNA NAWAZ:让我问一下这个数字,它现在引起了所有人的关注,总体而言

number of Americans who are uninsured.(37)
未投保的美国人数量。

Take a look at this number and the increase.(38)
看看这个数字和增加。

From 2017, it was 7.9 percent of the Americanpublic who were uninsured.(39)
从2017年开始,未投保的美国民众占7.9%。

That went up in 2018 to 8.5 percent.(40)
在2018年上升到8.5%。

That's about 27.5 million people.(41)
大约有2750万人。

The economy is doing well.(42)
经济状况良好。

You wouldn't expect to see these numbers.(43)
你不会希望看到这些数字。

What's happening there?(44)
那里发生了什么事?

MARGOT SANGER-KATZ: Yes, I mean, I think thisis a pretty troubling development.(45)
MARGOT SANGER-KATZ:是的,我的意思是,我认为这是一个令人不安的发展。

It's been about a decade since we have reallyseen the uninsured rate go up.(46)
自从我们真正看到无保险率上升以来已经过去了大约十年。

So it's not just Obamacare, but even beforethen.(47)
因此,不仅是奥巴马医改,甚至在此之前。

And, generally, as you say, when the economyis doing better, more people have jobs that(48)
而且,正如您所说,一般而言,当经济状况好转时,会有更多的人从事

give them coverage.(49)
给他们报道。

And I think there are a couple of differentthings that are going on here.(50)
我认为这里发生了一些不同的事情。

One has to do with things that states aredoing in their Medicaid programs, where they're(51)
一个与州在其医疗补助计划中正在做的事情有关

making a little bit harder for people to getenrolled and stay enrolled.(52)
使人们难以入学和继续入学。

And that's something that is not an explicitfederal policy, but the Trump administration(53)
那不是一项明确的联邦政策,而是特朗普政府

has made it a little bit easier for statesto do those sorts of things.(54)
使各州做这些事情变得容易一些。

I think another major possible source of thesecoverage losses are concerns about immigration(55)
我认为这些保险损失的另一个主要可能来源是对移民的担忧

policy, where a lot of families where theremight be children who are U.S. citizens and(56)
政策中,有很多家庭可能会有孩子是美国公民,

parents who are either undocumented immigrantsor even legal immigrants who are in the process(57)
父母,要么是无证移民,要么是合法移民

of getting their green card or their citizenship,they may be more reluctant to sign up for(58)
获得绿卡或公民身份,他们可能更不愿意签约

public coverage because they're worried thatit may affect their immigration status.(59)
公开报道,因为他们担心这可能会影响他们的移民身份。

And then I think there's this third categorythat's linked to the Obamacare markets that(60)
然后我认为这是与奥巴马医改市场相关的第三类

we talked about earlier.(61)
我们之前讨论过。

The premiums for Obamacare plans are reallyhigh.(62)
奥巴马医改计划的保费确实很高。

They have risen a lot over the course of theprogram.(63)
在该计划的过程中,它们已经上升了很多。

And there are people who do not qualify forany financial assistance buying those plans.(64)
而且有些人没有资格获得任何经济援助来购买这些计划。

And we can see that more than a million peoplehave basically left that market because they(65)
我们可以看到,基本上有超过100万人离开了该市场,因为他们

have decided that it's too expensive.(66)
认为它太贵了。

AMNA NAWAZ: There's another subgroup you havelooked at in your reporting that caught my(67)
AMNA NAWAZ:您在报告中看到的另一个子类别吸引了我

attention because of another alarming number.(68)
由于另一个惊人的数字引起注意。

You looked at the number of children who nolonger have health insurance.(69)
您查看了不再拥有医疗保险的孩子人数。

And this is, as you reported, the number ofchildren without Medicaid or health insurance.(70)
正如您所报告的,这是没有医疗补助或健康保险的儿童人数。

That number increased by more than a millionbetween 2016 and 2018.(71)
在2016年至2018年期间,这一数字增加了超过一百万。

What is happening there?(72)
那里发生了什么事?

Why children?(73)
为什么是孩子?

MARGOT SANGER-KATZ: So, again, I think thisis a little bit of a complicated portrait,(74)
MARGOT SANGER-KATZ:因此,我再次认为这是一张复杂的肖像,

but it is a really, really worrisome sign,more so even then insurance coverage for adults.(75)
但这是一个非常令人担忧的信号,甚至成人保险也是如此。

We know that there are huge public healthand economic benefits for children having(76)
我们知道,患有以下疾病的儿童将获得巨大的公共健康和经济利益

health insurance.(77)
健康保险。

So kids that have Medicaid are more likelyto be healthy when they're older.(78)
因此,拥有医疗补助的孩子长大后更可能健康。

They're more likely to finish high schooland college.(79)
他们更有可能读完高中和大学。

They're less likely to have children themselvesas teenagers.(80)
他们不太可能自己有孩子。

And there's even some evidence that they earnmore income as adults.(81)
甚至有证据表明,他们成年后的收入更高。

So I think it's a combination of various factors.(82)
因此,我认为这是多种因素的综合。

As I said, I think some states are takingactions that is making it harder for families(83)
正如我所说,我认为某些州正在采取行动,使家庭生活更加困难

to enroll their children in Medicaid or tokeep them enrolled.(84)
让他们的孩子参加医疗补助或保持他们的入学资格。

And I do think that there's a lot of concernamong immigrant families.(85)
而且我确实认为,移民家庭中有很多担忧。

My colleague Abby Goodnough went to Houston,Texas, and talked to some immigrant families(86)
我的同事艾比·古德诺(Abby Goodnough)去了得克萨斯州的休斯顿,并与一些移民家庭进行了交谈。

where they had kept their kids in Medicaidfor many years, and then were starting to(87)
他们将孩子留在Medicaid多年,然后开始

disenroll them because they were worried itcould affect their legal status.(88)
之所以取消他们的注册,是因为他们担心这会影响其法律地位。

AMNA NAWAZ: So the question everyone has afterall of this -- this is the question everyone's(89)
AMNA NAWAZ:因此,所有人都有这个问题-这是每个人的问题

asking right now in this political climate-- is, what plan and what kind of health care(90)
在这种政治氛围下问的是-什么计划和什么样的医疗保健

system should we have?(91)
系统应该有?

You and your colleagues at The New York Timespartnered with the Commonwealth Fund and with(92)
您和您在《纽约时报》上的同事与英联邦基金会以及

Harvard, and you asked that question of anumber of Americans.(93)
哈佛,你问了几个美国人这个问题。

You surveyed a number of people and said,what is the kind of plan that you think you(94)
您调查了很多人,然后说,您认为自己的计划是什么

would like?(95)
想?

What you found was basically a three-way splitbetween a Medicare-for-all-type plan and Obamacare-plus,(96)
您发现的基本上是针对所有人的医疗保险计划和奥巴马医保计划之间的三分法,

right, Affordable Care Act-enhanced, and thena Republican plan, which would be less federal(97)
权利,首先是增强《可负担医疗法案》,然后是共和党计划,该计划将减少联邦制

government involvement, more money and moreresources to states.(98)
政府的参与,更多的资金和更多的州资源。

And that -- I should say, those numbers allfall within the margin of error.(99)
而且-我应该说,这些数字都落在误差范围之内。

So it's basically a three-way split.(100)
因此,这基本上是三分法。

What does that tell you?(101)
这告诉你什么?

MARGOT SANGER-KATZ: I think, first of all,it tells us there about two-thirds of Americans(102)
MARGOT SANGER-KATZ:我认为,首先,它告诉我们大约三分之二的美国人

or at least 60 percent of Americans that favorsort of Democratic solutions.(103)
或至少60%的美国人赞成某种民主解决方案。

And that's consistent with other polling,where we see that people tend to trust the(104)
这与其他民意调查一致,我们看到人们倾向于信任

Democratic Party a little bit more on healthcare.(105)
民主党在医疗保健方面多了一些。

There's only a third that are really enthusiasticabout the plan that President Trump is talking(106)
只有三分之一的人真的对特朗普总统正在谈论的计划充满热情

about.(107)
关于。

But among people favoring those more Democraticoptions, there is a real divide.(108)
但是,在偏爱那些更民主的选择的人们中,确实存在分歧。

And I think we see that in the Democraticprimary contest, where some candidates really(109)
我认为我们在民主党初选比赛中看到了

want to do Medicare for all, a sort of single-payersystem where everyone gets their insurance(110)
想要为所有人提供医疗保险,一种单一支付系统,每个人都可以得到自己的保险

from the government.(111)
来自政府。

And then there are some candidates that wantto try to figure out, how do we work within(112)
然后有一些候选人想尝试弄清楚我们如何在

the existing system to fill in holes and tocover some of these people that are falling(113)
现有系统来填补漏洞并覆盖其中一些正在下降的人

through the cracks?(114)
通过裂缝?

And I think we're going to continue to seethat debate going on through this primary(115)
我认为我们将继续在这一主要阶段继续进行辩论

and probably into the general election aswell.(116)
并且可能也会参加大选。

AMNA NAWAZ: It remains a top issue for Americanvoters out there.(117)
AMNA NAWAZ:对于美国选民来说,这仍然是头等大事。

Margot Sanger-Katz of The New York Times,thanks so much for being here.(118)
纽约时报的Margot Sanger-Katz非常感谢您的光临。

MARGOT SANGER-KATZ: Thank you so much forhaving me.(119)
MARGOT SANGER-KATZ:非常感谢您的邀请。


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