医改下个体户有什么要求和需要达到什么样的效果

 　　JUDY WOODRUFF: Next understanding the health care reform law.

　　Tonight, we are looking at the changes that start taking effect when new online insurance marketplaces known as public exchanges open next month.

　　One big question how employers may respond.

　　Just today, Walgreens announced that it will move 160,000 of its employees into a private exchange where they can choose an insurance plan, but with company subsidies¹.

　　Executives cited generally rising health care costs as one reason, but said expenses associated with the new law were a factor as well.

　　Time Warner, Sears and Trader Joe's have announced similar moves.

　　That brings us to our series in which we try to answer some of your more frequently asked questions.

　　And to Ray Suarez.

　　RAY SUAREZ: The law was designed to provide coverage² for many who don't have health insurance now.

　　But there are still many concerns and questions about what it may mean for employer-sponsored coverage andwhether some businesses may change what they offer as the law takes full effect.

　　The workplace is our focus tonight.

　　And, once again, we're joined by NewsHour regular, analyst³ Susan Dentzer.

　　And, as you know, Susan, we have been going out into the world and basically saying to people, what questions do you still have as the final phase-in of the law begins? And we spoke⁴ to one business owner who was visiting Washington, D.C.

　　JIM TRIMBLE, small business wwner: My name is Jim Trimble. And this is my wife, Janet. We're from Kentucky. And we own a small business there.

　　And we furnish our own health insurance, somewhere around $800 a month.

　　And we're just unsure how this Obamacare may affect our insurance.

　　RAY SUAREZ: Now, Jim buys his own insurance for he and his wife.

　　He doesn't provide it for his six employees.

　　So this new law is now coming into full effect.

　　What does it mean for Jim Trimble?

　　SUSAN DENTZER: If he's only buying it for himself and his wife, it won't mean a whole lot.

　　For employers to be covered -- required to provide coverage under the so-called employer mandate⁵, which, by the way, will not take effect now until 2015, you have to be a business with 50 -- at least 50 employees.

　　And so, clearly, that will not change -- that will not be applicable in his case.

　　It is the case where that if you are a very small business and have 25 or fewer employees at an average wage of $50,000, you can apply for and receive tax credits to help buy insurance.

　　But, again, given what he describes, that's probably not applicable in his case.

　　In essence, the big change for him will be that there will be a new small business health insurance exchange in Kentucky, as in the other states, where small businesses can also go to buy coverage.

　　And this will mean in many states that there are more options available for small businesses than ever before.

　　In some instances, those plans will probably be more reasonably priced, because in effect what is happening now is that we're putting all the small business workers and many states into larger groups, in effect, of people who are going to be buying coverage on the marketplace.

　　RAY SUAREZ: Is Kentucky one of the states that is cooperating with the federal government in rolling out the Affordable⁶ Care Act?

　　SUSAN DENTZER: Kentucky is in fact running its own state-based insurance exchange, so both for the individual exchange and the so-called shop exchange, the small business exchange, those are being run by the state.

　　RAY SUAREZ: We have also been getting through e-mail and other forms of communication, social media, other people's questions.

　　Irma Flieger from Lumberton, New Jersey⁷, writes: "My employer found a loophole where they can drop employees from their benefits coverage.

　　So, come January, I will be out of coverage.

　　For me to get it on the exchange, I need to come up with at least $250 a month, which I don't have.

　　How am I going to get mandated⁸ health care if I don't have extra money to get it?

　　I don't qualify for the subsidized price because my wife and I supposedly make too much."SUSAN DENTZER: Well, not knowing entirely⁹ his circumstances, it sounds as if he may be working less than a full-time¹⁰ job, in which this case his employer felt that it wasn't necessary to provide coverage.

　　Possibly, it could be the case that his employer intends to move to something called a defined contribution plan, where eventually the employer will simply give an employee money to go to an individual insurance exchange to buy coverage.

　　I'm not sure about the subsidies in his case. It is the case that the subsidies are available to families -- say, a family of four with income up around $94,000 a year, four times the federal poverty level.

　　So the subsidies are rather generous in most instances.

　　And they average for an individual about -- the average subsidy¹¹ will be about $5,000.

　　RAY SUAREZ: Stories have been hitting the news from time to time of employers changing what they provide in the wake of the law.

　　Are there any either incentives¹² or disincentives for employers to change what they do when it comes to providing health care options for their workers?

　　SUSAN DENTZER: Well, it certainly is the case that the United States has been an outlier in the sense that we have tied so much health insurance coverage to employment or your employment status or the status ofyour parents or others.

　　So we are an outlier in that respect, and we are moving gradually to a system where people can be assured of coverage even if they're not working.

　　So we're attenuating¹³ this tie to employment over time. And I think in general we expect over time more andmore workers will want to be buying coverage on an exchange by themselves, will want the access to more insurance options than typically many people have through an employer.

　　And I think over time we will see more of the coverage move to people buying it on their own through exchanges, probably with assistance financially from their employers, as well as, of course, from the government for those with low enough incomes.

　　RAY SUAREZ: In a case like that Fliegers, they might have been told to buy COBRA before. Is that still going to exist in the same way for people who are losing their health care from their employer?

　　SUSAN DENTZER: Yes, COBRA will exist, so that if you lose a job,you will have the ability to retain youremployment-based coverage for the COBRA premium¹⁴.

　　However -- this is another aspect of the law that I think for many people will represent a positive.

　　You will have more choices if you're unemployed¹⁵ in the future, because you will be able most likely to buycoverage through the marketplace and to avail yourself of subsidies if your income is low enough.

　　RAY SUAREZ: Susan Dentzer, thanks for making it seem so simple.

　　SUSAN DENTZER: Great to be with you, Ray.

1 subsidies   

n.补贴，津贴，补助金( subsidy的名词复数 )

参考例句：

• European agriculture ministers failed to break the deadlock over farm subsidies. 欧洲各国农业部长在农业补贴问题上未能打破僵局。
• Agricultural subsidies absorb about half the EU's income. 农业补贴占去了欧盟收入的大约一半。 来自《简明英汉词典》

2 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。

3 analyst   

n.分析家，化验员；心理分析学家

参考例句：

• What can you contribute to the position of a market analyst?你有什么技能可有助于市场分析员的职务？
• The analyst is required to interpolate values between standards.分析人员需要在这些标准中插入一些值。

4 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。

5 mandate   

n.托管地；命令，指示

参考例句：

• The President had a clear mandate to end the war.总统得到明确的授权结束那场战争。
• The General Election gave him no such mandate.大选并未授予他这种权力。

6 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。

7 jersey   

n.运动衫

参考例句：

• He wears a cotton jersey when he plays football.他穿运动衫踢足球。
• They were dressed alike in blue jersey and knickers.他们穿着一致，都是蓝色的运动衫和灯笼短裤。

8 mandated   

adj. 委托统治的

参考例句：

• Mandated desegregation of public schools. 命令解除公立学校中的种族隔离
• Britain was mandated to govern the former colony of German East Africa. 英国受权代管德国在东非的前殖民地。

9 entirely   

ad.全部地，完整地；完全地，彻底地

参考例句：

• The fire was entirely caused by their neglect of duty. 那场火灾完全是由于他们失职而引起的。
• His life was entirely given up to the educational work. 他的一生统统献给了教育工作。

10 full-time   

adj.满工作日的或工作周的，全时间的

参考例句：

• A full-time job may be too much for her.全天工作她恐怕吃不消。
• I don't know how she copes with looking after her family and doing a full-time job.既要照顾家庭又要全天工作，我不知道她是如何对付的。

11 subsidy   

n.补助金，津贴

参考例句：

• The university will receive a subsidy for research in artificial intelligence.那个大学将得到一笔人工智能研究的补助费。
• The living subsidy for senior expert's family is included in the remuneration.报酬已包含高级专家家人的生活补贴。

12 incentives   

激励某人做某事的事物( incentive的名词复数 )； 刺激； 诱因； 动机

参考例句：

• tax incentives to encourage savings 鼓励储蓄的税收措施
• Furthermore, subsidies provide incentives only for investments in equipment. 更有甚者，提供津贴仅是为鼓励增添设备的投资。 来自英汉非文学 - 环境法 - 环境法

13 attenuating   

v.（使）变细( attenuate的现在分词 )；（使）变薄；（使）变小；减弱

参考例句：

• Specialty Optical Fiber, Doped Fiber, Erbium Doped Attenuating, Edfa, Fbg, Optical. 采购产品特种光纤，掺铒光纤，掺铒光纤放大器，光纤光栅，光学产品。 来自互联网
• Conclusion MT may be attenuating lipid peroxidation of burned tissue. 结论烫伤组织损伤与脂质过氧化反应有一定的关系，而金属硫蛋白有一定保护作用。 来自互联网

14 premium   

n.加付款；赠品；adj.高级的；售价高的

参考例句：

• You have to pay a premium for express delivery.寄快递你得付额外费用。
• Fresh water was at a premium after the reservoir was contaminated.在水库被污染之后，清水便因稀而贵了。

15 unemployed   

adj.失业的，没有工作的；未动用的，闲置的

参考例句：

• There are now over four million unemployed workers in this country.这个国家现有四百万失业人员。
• The unemployed hunger for jobs.失业者渴望得到工作。