经济学人:废除奥巴马医改 成本分摊令人关注(02)

But unless prices fall dramatically, many low-earners would probably have to downgrade to insurance covering only catastrophes.

但是如果价格不大幅度下降,许多低收入者的保险等级可能会降到只覆盖灾难险。

After deregulation, such plans might include chilling limitations, such as caps on how much insurance will pay if a person becomes chronically ill.

放松管制后,诸如此类的计划可能会包含糟糕的限制,比如,保险能报销给慢性病的金额上限。

That would be sickening, especially as most affluent Americans benefit from subsidised health care.

这很令人恶心,尤其是因为大多数富裕的美国人受益于医疗补贴。

Fully 155m workers get health insurance from their employer without paying tax on this income-in-kind.

1.55亿工人全部从雇主那里得到医疗保险,而不对这种收入实行纳税。

The tax exemption cost $268bn (1.4% of GDP) in 2016, enough to pay for Obamacare's subsidies six times over.

免除税额在2016年花费了2680亿美元(占GDP的1.4%),足以支付奥巴马医疗补助六次。

Hated by economists, it encourages firms to give their workers more generous health benefits rather than more pay.

它鼓励公司给员工更多的健康福利,而不是更多的工资,因此被经济学家所痛恨。

One-third of the benefit flows to the top fifth of earners.

有三分之一的收益流向了前五分之一的收入者。

Unfortunately, Mr Obama could not shrink the tax-break, having vilified John McCain, his opponent in the 2008 election, for proposing to scrap it.

不幸的是,奥巴马不能缩减税收优惠,他诋毁2008年选举中的对手约翰·麦凯恩(John McCain),因为对方提议废除这项政策。

Instead, he created the so-called “Cadillac tax” on expensive plans, which is due to come into effect in 2020.

相反,他对高成本计划制订了所谓的“凯迪拉克税”,本该于2020年生效。

Messrs Price and Ryan would do away with that and instead cap the exemption—a simpler approach.

普莱斯和瑞恩先生会将其撤销,而不是采用一种更简单的方法——限制免税额。

It would be best to get rid of it completely.

最好是能完全摆脱它。

Doing so could fund a universal tax credit of $1,500 without touching Obamacare's means-tested payments, The Economist reckons.

经济学人认为,这样做可以为1500美元的普通水平税收抵免提供资金,而不用接受奥巴马医保基于收入的保险支付制度。

Unfortunately, killing the perk would be very unpopular.

不幸的是,砍掉额外津贴的行为非常不受欢迎。

Just ask Mr McCain.

不信去问麦凯恩先生。

Making premiums affordable is only the first step.

使人们负担得起保险费只是第一步。

People must also be able to pay their medical bills up to the point where their insurance coverage kicks in.

人们还必须能够支付他们的医疗费用,达到保险覆盖率的点。

The ACA limits such payments for low-earners, and reimburses insurers accordingly.

ACA限制了给低收入者的此类付款,并相应地偿还给保险公司。

Those reimbursements, though, are currently held up in court after the House sued to stop them in 2014.

但是,自2014年众议院提起诉讼要求其停止后,这笔补偿款现在还在法院手里。

On February 21st it filed to delay legal proceedings.

2月21日,众议院提出推迟诉讼程序。

Deciding what to do about the case—in which Mr Price is now the defendant—is yet another headache for the Republicans.

该如何妥善处理这个案子——普莱斯先生现在还是被告,是另一个共和党人头痛的问题。

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