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🆕 特朗普新政府可能带来的医疗保健变化
How health care could change under the new Trump administration
美国前总统唐纳德·特朗普的再度当选，可能会带来一些公共医疗保险项目的缩减和生育健康服务的限制。
这些政策变化不仅会影响到华盛顿特区，还可能波及全美范围的医保体系和公共健康政策。具体如下⬇️
Changes to Obamacare
✅特朗普表示他不会试图再次废除《平价医疗法案(ACA)》，但他的新政府将面临是否继续支持补贴扩展的问题。若补贴停止，保费可能大幅上涨，导致保险覆盖率下降。
While Trump has said he will not try again to repeal the Affordable Care Act, his administration will face an immediate decision next year on whether to back an extension of enhanced premium subsidies for Obamacare insurance plans.
Without the enhanced subsidies, steep premium increases causing lower enrollment are projected. The current uninsured rate, about 8%, could rise.
Drug price negotiation
✅特朗普支持者称其可能会支持保留《通胀削减法案》赋予Medicare的药品价格谈判权，这是他一贯支持的降低药价的措施之一。特朗普在2020年曾尝试将部分药品价格与国际价格挂钩，但因制药公司起诉未能推行。
Other Trump supporters say the president-elect may support preserving Medicare’s authority to negotiate drug prices, another provision of the IRA. Trump has championed reducing drug prices, and in 2020 advanced a test model that would have tied the prices of some drugs in Medicare to lower costs overseas, said Merkel, who worked in Trump’s first White House. The drug industry successfully sued to block the program.
Leadership of health agencies
✅一些可能担任卫生与公众服务部领导人的人选包括：前路易斯安那州州长Bobby Jindal，以及特朗普时期的Medicare和Medicaid管理中心负责人Seema Verma。肯尼迪已公开支持特朗普，并称特朗普承诺他将有重要职位，但参议院确认可能会遇到阻碍。
Within Trump’s circles, some names have already been floated as possible leaders for the Department of Health and Human Services. They include former Louisiana Gov. Bobby Jindal and Seema Verma, who ran the Centers for Medicare & Medicaid Services during the Trump administration.
Kennedy, who suspended his independent presidential run and endorsed Trump, has told his supporters that Trump promised him control of HHS. Trump said publicly before Election Day that he would give Kennedy a big role in his administration, but he may have difficulty winning Senate confirmation for a Cabinet position.
Cuts or restrictions on Medicaid
✅特朗普表示支持Medicare，但对Medicaid的具体措施未明确表态。分析人士认为，Medicaid项目可能会被削减，尤其是在共和党希望通过设定联邦拨款上限来控制支出的情况下。
While Trump has vowed to protect Medicare and said he supports funding home care benefits, he’s been less specific about his intentions for Medicaid, which provides coverage to lower-income and disabled people. Some health analysts expect the program will be especially vulnerable to spending cuts, which could help finance the extension of tax breaks that expire at the end of next year.
Possible changes include the imposition of work requirements on beneficiaries in some states. The administration and Republicans in Congress could also try to revamp the way Medicaid is funded. Now, the federal government pays states a variable percentage of program costs. Conservatives have long sought to cap the federal allotments to states, which critics say would lead to draconian cuts.
📒note：Medicare，由联邦医保医补中心CMS管理和运营，主要为年满65岁以上的老人，以及65以下有特殊身体状况（特定疾病或残疾）的美国居民提供的一项国家医疗保险计划。
Reproductive health
✅特朗普表示堕胎问题应由各州决定，并且曾经表示，不会签署全国堕胎禁令。目前美国有13个州几乎全面禁止堕胎，其他28个州则对堕胎期限有所限制。
Less clear is the potential future of reproductive health rights.
Trump has said decisions about abortion restrictions should be left to the states. Thirteen states ban abortion with few exceptions, while 28 others restrict the procedure based on gestational duration, according to the Guttmacher Institute, a research and policy organization focused on advancing reproductive rights. Trump said before the election that he would not sign a national abortion ban.
✅但可能会采取措施限制堕胎药物的获取，这类药物用于超过一半的堕胎案例。可能会撤销FDA对这些药物的批准，或者执行19世纪的《Comstock Act 》，反堕胎人士认为该法案禁止邮寄堕胎药物。不过，特朗普表示通常不会使用该法律来禁止药物的邮寄配送。
Trump could move to restrict access to abortion medications, used in more than half of abortions, either by withdrawing the FDA’s authorization for the drugs or by enforcing a 19th-century law, the Comstock Act, that abortion opponents say bans their shipment. Trump has said he generally would not use the law to ban mail delivery of the drugs.
原文地址：https://www.npr.org/sections/shots-health-news/2024/11/06/nx-s1-5181861/2024-election-trump-kennedy-health-care
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