奥巴马签署医疗改革法案

President Barack Obama has signed the landmark healthcare bill into law that will help shape his legacy and his chances of holding onto power in the US Congress.

奥巴马总统签署生效了这部具有里程碑意义的医疗改革法案，此举也改写了历史，也为奥巴马在国会中掌权增加了砝码。

He sealed the hard-fought victory in a ceremony at the White House where he praised the American public telling them that the "extraordinary achievement has happened because of all of you and because of all the advocates all across the country."

在白宫举行的签字仪式上，奥巴马为这个艰苦卓绝的医改之战划上了句号。他赞扬美国公众说，“这个非凡成就的取得离不开你们所有人，离不开举国上下的支持者们。”

Mr Obama reinforced the main idea behind his controversial healthcare reforms and said that the core principle of the bill is "that everybody should have some basic security when it comes to their healthcare".

奥巴马重申了这次很有争议的医改的主要观点，他说，这部法案的核心准则就是“让每个人都享有一定的，最基本的医疗保障。”

The overhaul will extend health coverage to 32 million Americans who were previously uninsured. It will also impose new taxes on the wealthy and ban insurance practices like refusing cover to people with pre-existing medical conditions.

这次对医疗法案的整改将会把3千2百万之前不享有医疗保险的美国人纳入到医保行列之中。法案还包括对高收入家庭采取新的征税方案，保险公司不得拒绝对有过往病史的人投保等。

Since signing the historic bill, Mr Obama is now expected to launch into a publicity blitz that Democrats hope will overcome widespread public doubts and confusion about the plan.

签署了这部具有历史意义的法案之后，预计奥巴马又要开展一场宣传战。民主党希望，奥巴马能够通过宣传来为那些对医改怀有质疑和不甚了解的人们释疑解惑。

American voters have been split by the healthcare debate and the opposition party has vowed to try to repeal the bill.

在关于医改的讨论当中，参与投票的大臣们分成了两派。并且，反对医改的共和党声称要对这项法案提出诉讼。

The Republicans say they are angry over the bill's passage and it could make them less likely to work with Democrats on other issues such as climate change legislation and immigration reform.

对于这项法案的通过，共和党表示感到愤慨，并表示，这让他们更加无法与民主党在其他议题上合作了，其中包括气候变化立法以及移民改革等。

However, the President's aides described the atmosphere at the White House as"euphoric" after the healthcare legislation was narrowly approved on Sunday.

不过，据总统的助手们描述，在上周日，当医改法案以微弱多数通过时，白宫内的气氛很“愉快”。

美国医保改革相关词汇

health care reform 医疗保险改革

health insurance 医疗保险

health coverage 医保覆盖面

premium 保费

deductible 自付扣除金

uninsured 没有医疗保险的人

under-insured 医保不足的人

indemnity plan/fee-for-service 定额理赔制度（美国最初实行的医疗制度）

managed care 管理式医疗

government-funded plans 由政府支持的医保项目

Employer-Provided Insurance 由雇主为雇员提供的保险

fomulary （保险）处方药物表

Medicare 医疗保险制（针对65岁以上老人的老年医保）

Medicaid 医疗援助制（以穷人和伤残者为对象的医疗补助制度）

Medigap 差额医疗保险（填补联邦医疗保险之不足）

pre-existing conditions （投保前已存在的疾病）

comprehensive coverage全险

hospital-surgical coverage 住院及手术费补偿

catastrophic coverage/major medical insurance 重大疾病险

specified disease policies 定向疾病险

long-term policies 长期护理险，如用于养老院的开支

policy 医保保单

coinsurance 分担保险（指的是投保人对于超过自付额以上那部分医疗费要分担一定金额或比例的费用，通常为20%）

copayment 分担金额（即投保人为每次就诊支付少量费用，虽然通常不超过10美元，但主要还是为了防止投保人滥用医疗资源）

capitation 保险公司每年赔付投保人的总额上限

out-of-pocket maximum 投保人每年自付额的上限