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下周表决 美新医改议案前途难料

2017-06-29 18:23:17   经济参考报

原标题:下周表决 美新医改议案前途难料

美国参议院26日公布最新的医改草案,美国国会预算办公室(CBO)当天稍晚时候发布了针对参议院医改议案计划的预估。从目前情况看,参议院共和党人修改后准备取代奥巴马医保的医改法案仍无法得到各方认可,这份新医疗法案将在7月4日国会休会前在参议院投票表决,其命运仍未卜。

在争取到共和党内保守派和温和派的支持后,特朗普取代奥巴马时代医疗法案的新医疗法案于5月4日在国会众议院以217票对213票通过。目前参议院的并行医改法案也面临投票。

参议院在法案中增加了一项措施。根据新增措施,那些让自己在更长时期内不被医保覆盖的个体将受到惩罚;对于那些医保流失时间超过63天的人,修订版医改议案建议实施一个长达六个月的等待期,然后再将相关投保人重新纳入个体市场。

保费方面,根据参议院版本法案,一个单身投保人2018年的保费将比现行制度下贵20%。在2019年,单身人士的保费预计将比现行制度下贵10%。不过,到2020年,单身投保人士的保费预计将比目前制度下低30%。修改前的方案被指将令受保人群的平均健康状况变差,并且会提高医疗开支。

国会预算办公室预计,对比参议院医改议案和现存奥巴马医改法,到2026年,该法案将令美国失保人数增加2200万,并在今明两年提高许多人的保费。国会预算办公室称,在2026年,预计将有4900万人没有被医保覆盖,而根据当前医改法,届时的未投保人数预计为2800万。

不过,国会预算办公室认为,该法案在2017-2026年未来10年将减少赤字3210亿美元。相比之下,5月份通过的众议院的法案将令2300万人失保,并减少赤字1190亿美元。对于公共开支而言,参议院医改议案草案最大的结余将来自医疗补助计划开支的削减。相比现存医改法,在2026年,参议院医改议案将让医疗补助计划开支下降26%。

在福克斯新闻25日早间谈话节目中,特朗普对节目主持人表示,“新医疗法案是一个很好的法案,并请民主党给予支持,以便使该法案能在国会通过。”

不过,参议院民主党领导人舒默对参议院共和党人提出的等待期新条款提出了严厉的批评。他在一份声明中表示,由于失业或临时经济问题,每年有数千万美国人中断医疗保险。舒默说:“这项规定将会在伤口上撒盐,因为这6个月的禁令规定,美国家庭的断保时间将变得更长。”他说,参议院共和党人医改议案让人羞愧难当,有关等待六个月的条款“不近人情”。

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