来源：《华盛顿邮报》
原文刊登日期：2021年6月17日
文章结构
最高法院第三次拒绝推翻奥巴马医改。
事已至此，共和党人不应该对废除奥巴马医改再抱有希望。
共和党人应该执行奥巴马医改，实现全民医保。
接受奥巴马医改后，能继续推进改革，降低保费。
全民医保已经是美国人民共识，共和党人应该真诚合作，实现这一目标。
The Supreme Court rejected on Thursday the latest major legal challenge to the Affordable Care Act, also known as Obamacare. This should have been no shock; the most desperate of the three big Obamacare cases the court has considered, the suit was based on feeble arguments that even many critics of the ACA admitted were fake. The biggest surprise was that two justices, Samuel A. Alito Jr. and Neil M. Gorsuch, dissented from the 7-to-2 decision, telegraphing an eagerness to rip up the law on even the thinnest legal pretext. But it is worth pausing to note and appreciate this: The rest of the justices showed once again that the court is an institution in which thoughtfulness and restraint often rule, even in big cases. The court is not the wholly political, ends-driven monster that some activists and politicians insist it is.
周四，最高法院驳回了对《平价医疗法案》(又称奥巴马医改)的最新重大法律挑战。这应该并不令人震惊；这是最高法院审理过的三大“奥巴马医改”案中共和党人最孤注一掷的一宗，诉讼基于无力的论据，就连许多ACA的批评者也承认这些论据是假的。最令人惊讶的是，在7比2的判决结果中，两名少数派大法官——小塞缪尔·a·阿利托和尼尔·m·戈萨奇——显示出渴望以最微不足道的法律借口撕破《平价医疗法案》。但值得停下来注意和欣赏的是：其他大法官再次表明，最高法院是这样一个机构，即使在重大案件中，深思熟虑和克制往往占主导地位。最高法院并不像一些活动人士和政客所坚持的那样，是一个完全出于政治目的、被目的驱使的怪物。
If anti-Obamacare zealots’ first two failures at the court did not persuade them to give up hope that the justices would suddenly eviscerate the ACA, this one should. So many of the horrors that many Republicans predicted the law would produce have not come to pass. Some 23 million people rely on the law for health coverage. The law has filled an important gap during the covid-19 pandemic: One million people signed up for coverage in a special enrollment period President Biden opened earlier this year. The ACA drastically slashed the uninsured rate in the United States.
如果反奥巴马医改的狂热分子在最高法院的前两次失败都没有说服他们放弃大法官会突然打击ACA的希望，那么这一次应该会。许多共和党人预测ACA将产生的恐怖事件都没有出现。大约有2300万人依靠ACA获得医疗保险。ACA填补了新冠大流行期间的一个重要空白：在拜登总统今年早些时候开放的特别登记期间，有100万人注册了医保。ACA大幅削减了美国的未参保率。
Rather than continuing their crusade to undermine a successful policy, a decade-long effort in which many Republican leaders have denied health-care coverage to as many vulnerable people as they could, it is past time for Republicans to help make it work better. About 2 million low-income people could get coverage immediately if states such as Georgia, Florida and Texas would expand their Medicaid programs as the law envisioned. When put to a popular vote, Medicaid expansion has passed even in the deepest-red of states.
在长达十年的努力中，许多共和党领导人拒绝为尽可能多的弱势群体提供医疗保险，与其继续他们的运动来破坏一项成功的政策，共和党人已经是时候帮助它更好地发挥作用了。如果乔治亚州、佛罗里达州和德克萨斯州等州按照ACA的设想扩大医疗补助计划，大约200万低收入人群可以立即获得保险。当进行全民投票时，医疗补助计划的扩大甚至在最红的州也获得了通过。
A willingness to accept the ACA as settled law would set the stage for Congress to make improvements. Health-care costs need to be restrained before they eat up ever-increasing portions of national income. A reform that Democrats pushed through in their covid-19 relief bill — shoring up Obamacare’s subsidy system so that no one pays more than 8.5 percent of their income on premiums — is scheduled to expire after 2022 but should be permanent.
如果愿意接受《平价医疗法案》作为既定法律，将为国会做出改进奠定基础。在医疗费用吞噬国民收入日益增长的部分之前，必须对其加以限制。民主党人在其新冠救济议案中推动的一项改革计划将在2022年后到期，但应该是永久性的。这项改革旨在支撑奥巴马医改的补贴体系，使任何人支付的保费都不超过其收入的8.5%。
The country has embraced the principle that the government should ensure that all Americans have access to good health-care coverage. Republicans should finally cooperate in good faith to make that a reality.
美国已经接受了这样一个原则，即政府应该确保所有美国人都能获得良好的医疗保障。共和党人最终应该真诚合作，使之成为现实。