Rosenbaum Sara, Wilensky Gail
Sara Rosenbaum ( sarar@gwu. edu ) is the Hirsh Professor and founding chair of the Department of Health Policy, Milken Institute School of Public Health, at George Washington University, in Washington, D.C.
Gail Wilensky is a senior fellow at Project HOPE, in Bethesda, Maryland.
Health Aff (Millwood). 2020 Mar;39(3):514-518. doi: 10.1377/hlthaff.2019.01463.
Eight years after the US Supreme Court's landmark decision in , more than two million of the nation's poorest working-age adults continue to feel its effects. These are the people who, because of the decision, remain without a pathway to affordable health insurance coverage because they live in a state that has not expanded Medicaid under the Affordable Care Act (ACA). Closing the coverage gap created by represents the ACA's most pressing piece of unfinished business. Several options, which vary in cost and political complexity, exist for closing the gap in ways that respect the ACA's pluralistic approach to insurance coverage while adhering to constitutional principles. These considerations must be balanced against the urgency of the problem and the fact that, constitutionally speaking, Medicaid alone can no longer guarantee a national remedy to the fundamental issue of health insurance inequality for the poorest Americans.
在美国最高法院做出具有里程碑意义的裁决八年后，该国超过200万最贫困的劳动年龄成年人仍在受其影响。由于这一裁决，这些人仍然没有获得负担得起的医疗保险的途径，因为他们生活在一个根据《平价医疗法案》（ACA）尚未扩大医疗补助计划的州。弥合由[裁决名称]造成的保险覆盖缺口是《平价医疗法案》最紧迫的未完成事务。有几种选择，在成本和政治复杂性方面各不相同，这些选择旨在以尊重《平价医疗法案》多元化保险覆盖方式的同时坚持宪法原则来弥合缺口。这些考量必须与问题的紧迫性以及从宪法角度来看仅靠医疗补助计划已无法再为最贫困美国人的医疗保险不平等这一根本问题提供全国性解决方案这一事实相平衡。
