纽约时报 民主党人警告称 医改法案将引发"5级火警"(5)（在线收听）

Encouraging enrollment has never been a priority for Trump administration officials,

特朗普政府的官员从来就没有拿鼓励登记当他们的当务之急，

and confusion caused by the court decision in Texas could further depress enrollment, which was already lagging behind last year’s numbers.

而且，今年的登记人数较去年已经落后了，而德克萨斯法院这次的裁决带来的困惑可能还会进一步压低登记人数。

From Nov. 1 to Dec. 8, about 4.1 million people had signed up for Affordable Care Act coverage through the federal marketplace,

从11月1日到12月8日，通过联邦市场签署平价医疗法案的人数才410万左右，

with new enrollment in the 39 states that use the federal website Healthcare.gov down by 20 percent compared with the same period last year.

使用联邦网站Healthcare.gov的39个州新登记人数与去年同期相比下降了20%。

In all, 11.8 million people in all 50 states signed up for health insurance through the law’s marketplaces for 2018.

总体来看，2018年全美50个州共有1180万人通过该法案的市场注册申请医疗保险。

This year’s enrollment period is now ending except for in Rhode Island, where it will end Dec. 23,

今年的注册时间即将结束，除了罗德岛，该地区的注册时间要到12月23日才结束，

and in California, Colorado, Massachusetts, Minnesota, New York and the District of Columbia, where it will end in January.

以及加州、科罗拉多、马萨诸塞、明尼苏达、纽约和哥伦比亚特区，这些地方的注册将持续到明年1月。

“During a year when most people don’t know when the deadline is,

“在今年这个大多数人都不知道截止日期的年头，

if the only news you hear is that the A.C.A. was struck down, that is only going to hurt enrollment,”

如果大家听到的唯一的消息还是《平价医疗法案》被废除了，那结果只会影响登记人数，”

Josh Peck, a co-founder of the group Get America Covered and the former chief marketing officer for Healthcare.gov during the Obama administration, said in an email.

“覆盖全美”医保组织联名创始人，奥巴马政府Healthcare.gov网站前首席市场官乔什·佩克在一封邮件里说到。

The administration has slashed marketing efforts and enrollment assistance

特朗普政府大幅削减了营销力度和登记援助，

and encouraged people to buy skimpier, less expensive plans that do not meet the standards of the law.

还鼓励人们购买不满足法律标准的更不全面、更便宜的保险。

These actions, and the elimination of the law’s tax penalty for not having coverage starting next year, are most likely among the reasons fewer people are signing up.

这些举措，以及从明年开始取消因没有医保而罚税的规定，很有可能就是登记人数减少的原因之一。

Even as enrollment in private plans under the Affordable Care Act will most likely be smaller next year,

即使明年根据《平价医疗法案》加入私人保险计划的人数很可能会减少，

hundreds of thousands more low-income adults are expected to enroll in expanded Medicaid in five states that recently gave them the option through citizens’ initiatives or legislative action.

在最近通过公民倡议或立法行动为低收入人群提供了加入私人保险计划这一选择的五个州，预计还是会有数十万低收入成年人在医疗补助计划扩大后加入补助计划。

Those states are Idaho, Maine, Nebraska, Utah and Virginia.

这五个州分别是爱达荷、缅因、内布拉斯加、犹他和弗吉尼亚州。

Last month’s Kaiser tracking poll found that 59 percent of respondents living in the 14 states that have not yet expanded Medicaid want them to do so.

凯撒上个月的追踪调查发现，居住在尚未扩大医疗补助的14个州的受访者有59%的人都希望政府能扩大医疗补助。

Other broadly popular provisions of the law are one that allows young people to stay on their parents’ health insurance plan until they turn 26,

该法案中其他广受欢迎的条款还包括允许年轻人在26岁之前继续享受父母的医疗保险计划，

and another that allows people to get certain types of preventive care, like vaccinations, mammograms and other types of screenings for diseases, at no charge.

以及允许人们免费获得某些类型的预防保健，比如疫苗接种、乳房x光检查和其他类型的疾病筛查。