美国国家公共电台 NPR Health Insurers Say They Don't Want To Go Back To Being The Bad Guys

 

AUDIE CORNISH, HOST:

President Trump¹ and other Republican leaders are working furiously to repeal² and replace the Affordable³ Care Act. Millions of Americans who have health insurance through the Obamacare marketplaces are wondering what will happen to them. Also scratching their collective heads - insurance companies. The Urban Institute and the Robert Wood Johnson Foundation recently interviewed executives at 13 insurers to get their perspectives at this moment of uncertainty⁴.

Sabrina Corlette of Georgetown University was one of the researchers, and she joins us in studio. Hi there, Sabrina.

SABRINA CORLETTE: Hi, Audie.

CORNISH: You know, one thing you noted⁵ in your report was that in some ways the insurers were caught off guard by the election and election results, which surprised me because the problems (laughter) in the Affordable Care Act have been in the making for a while.

CORLETTE: I think many insurers were preparing for Hillary Clinton to win the election and expecting that if there were changes to the Affordable Care Act, they would be fairly modest. And so we were surprised as well in that the number of executives we spoke⁶ to that were sort of scrambling⁷ to figure out what their options were in this new policy environment.

CORNISH: All right. So in your research, you are making these phone calls to insurance executives, and you're asking them, OK, how worried are you about this repeal idea this year? What kinds of things do they say to you?

CORLETTE: Well, the first thing to know about insurers is they're not monolithic⁸. They're coming from very different places. We talked to large national carriers. We talked to for-profits and nonprofits. We talked to local community-based provider-led plans. They really are coming at this from different perspectives. Some are very, very committed to staying in the market and serving this population. Others - not so sure about it.

But across the board, all of them said we cannot tolerate uncertainty. And so there comes a certain point when you just can't price your product high enough to account for the uncertain environment that they're in.

CORNISH: And they start making those decisions this year for next year.

CORLETTE: Exactly. They have to make these decisions right now because they're putting together their products and everything else for the review process, which starts in May. And my guess is when those plans and rates come out in May, we're going to see some pretty big price hikes because the uncertainty that they're feeling in the policy world from Congress and the White House is going to play out into the premiums⁹ that people will ultimately pay.

CORNISH: There's lots of ideas floating around about how a repeal or how a replacement¹⁰ should work. Did you hear insurance executives talking about specific provisions that they think need to go or stay that they were worried about?

CORLETTE: Well, one thing we heard over and over again was the need to maintain some form of incentive¹¹ for healthy people to sign up for coverage¹². Of course, the Obamacare approach has been a penalty for people who don't enroll¹³, which has been very controversial. Insurance companies will tell you they don't think it was a strong enough incentive. But they feel like that needs to stay, or it needs to be replaced with something at least as strong in terms of incentive to get healthy people to sign up.

CORNISH: Do you get the sense from insurers that they want things to be the way they were before the Affordable Care Act?

CORLETTE: No, not at all. I mean, if you remember before the Affordable Care Act, insurance companies were in many ways sort of, you know, the bad guy, right? People didn't like them because they were denying coverage to sick people, and they were charging them more and denying care.

Now I think their public image has improved because everybody gets covered even if you have a preexisting condition. So I don't think they want to go back to the days when they were sort of the - considered the bad guys.

CORNISH: Right. Now Obamacare itself is the bad guy - right? - ironically.

CORLETTE: (Laughter) Right. So I don't think they want to go back to that. On the other hand, I don't think they feel that Obamacare was a perfect law by any means. They've found plenty to criticize in it. So I - my sense is that they would rather see improvements to the basic structure of the law rather than starting back from scratch.

CORNISH: Sabrina Corlette is a professor at the center on health insurance reforms at Georgetown University. Thank you so much for speaking with us.

CORLETTE: Thank you, Audie.

1 trump   

n.王牌，法宝；v.打出王牌，吹喇叭

参考例句：

• He was never able to trump up the courage to have a showdown.他始终鼓不起勇气摊牌。
• The coach saved his star player for a trump card.教练保留他的明星选手，作为他的王牌。

2 repeal   

n.废止，撤消；v.废止，撤消

参考例句：

• 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。

3 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。

4 uncertainty   

n.易变，靠不住，不确知，不确定的事物

参考例句：

• Her comments will add to the uncertainty of the situation.她的批评将会使局势更加不稳定。
• After six weeks of uncertainty,the strain was beginning to take its toll.6个星期的忐忑不安后，压力开始产生影响了。

5 noted   

adj.著名的，知名的

参考例句：

• The local hotel is noted for its good table.当地的那家酒店以餐食精美而著称。
• Jim is noted for arriving late for work.吉姆上班迟到出了名。

6 spoke   

n.（车轮的）辐条；轮辐；破坏某人的计划；阻挠某人的行动 v.讲，谈（speak的过去式）；说；演说；从某种观点来说

参考例句：

• They sourced the spoke nuts from our company.他们的轮辐螺帽是从我们公司获得的。
• The spokes of a wheel are the bars that connect the outer ring to the centre.辐条是轮子上连接外圈与中心的条棒。

7 scrambling   

v.快速爬行( scramble的现在分词 )；攀登；争夺；（军事飞机）紧急起飞

参考例句：

• Scrambling up her hair, she darted out of the house. 她匆忙扎起头发，冲出房去。 来自《现代英汉综合大词典》
• She is scrambling eggs. 她正在炒蛋。 来自《简明英汉词典》

8 monolithic   

adj.似独块巨石的；整体的

参考例句：

• Don't think this gang is monolithic.不要以为这帮人是铁板一块。
• Mathematics is not a single monolithic structure of absolute truth.数学并不是绝对真理的单一整体结构。

9 premiums   

n.费用( premium的名词复数 )；保险费；额外费用；（商品定价、贷款利息等以外的）加价

参考例句：

• He paid premiums on his life insurance last year. 他去年付了人寿保险费。 来自《现代英汉综合大词典》
• Moves are afoot to increase car insurance premiums. 现正在酝酿提高汽车的保险费。 来自《简明英汉词典》

10 replacement   

n.取代，替换，交换；替代品，代用品

参考例句：

• 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。

11 incentive   

n.刺激；动力；鼓励；诱因；动机

参考例句：

• Money is still a major incentive in most occupations.在许多职业中，钱仍是主要的鼓励因素。
• He hasn't much incentive to work hard.他没有努力工作的动机。

12 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。

13 enroll   

v.招收；登记；入学；参军；成为会员（英)enrol

参考例句：

• I should like to enroll all my children in the swimming class.我愿意让我的孩子们都参加游泳班。
• They enroll him as a member of the club.他们吸收他为俱乐部会员。