如果民主党人在11月赢得大选，他们希望撤销特朗普的大型综合法案，扩大医疗服务的普及范围，并争取“让美国再次健康”运动的支持。
If they win in November, Democrats want to roll back Trump’s megabill, expand access to care, and win over the Make America Healthy Again movement.
如果该党明年获得多数席位，众议院民主党人的医疗政策愿景清单包括争取卫生与公众服务部长小罗伯特·F·肯尼迪的支持者，同时推翻共和党人为削减政府医疗保健资金所做的一切。
House Democrats’ health policy wishlist, should the party have a majority next year, includes winning over Health Secretary Robert F. Kennedy Jr.’s followers, alongside rolling back what Republicans have done to reduce government health care funding.
这还包括扩大医疗保险覆盖范围和保护堕胎权等传统的民主党优先事项。但据POLITICO获取的这份84页的议程承认，对于“全民医保”尚未达成共识。该议程是少数党领袖哈基姆·杰弗里斯于6月成立的一个工作组的研究成果，如果民主党人在11月获胜，杰弗里斯有望成为众议院议长。杰弗里斯曾表示，医疗保健将是民主党人的首要议题。
It also includes the traditional Democratic priorities like expanding health insurance coverage and protecting abortion access. But the 84-page agenda obtained by POLITICO acknowledges there’s no consensus on “Medicare for All.” The agenda is the product of a working group established in June by Minority Leader Hakeem Jeffries, who aspires to be speaker if Democrats win in November. Jeffries has said health care would be Democrats’ top issue.
工作组9月份的备忘录指出：“废除《H.R. 1法案》只是底线，而非上限。”该备忘录指的是总统唐纳德·特朗普的《一个美丽的大法案》（One Big Beautiful Bill Act），该法案将医疗白卡（Medicaid）资金削减了近1万亿美元。备忘录接着说，议员们在“遏制企业垄断、投资可持续的医疗系统以及朝着全民覆盖迈出雄心勃勃的步伐”方面达成了“广泛共识”。备忘录还预示了民主党党团内部派系之争的不可避免性——如果该党掌权的话。它提议大幅扩大“红蓝白卡”（Medicare和Medicaid）的覆盖范围、保护堕胎权、扭转肯尼迪的疫苗政策并恢复科学研究资金。但它并未背书进步派青睐的“全民医保”，而是将其作为扩大保险覆盖范围的几种可选方案之一。
“Undoing H.R. 1 is the floor, but not the ceiling,” the working group’s September memo says, referring to President Donald Trump’s One Big Beautiful Bill Act, which slashed Medicaid funding by nearly $1 trillion. The memo goes on to say members have “broad consensus” to “rein in corporate monopolies, invest in a durable healthcare system, and pursue an ambitious path towards universal coverage.” The memo also previews the factional disputes within the Democratic caucus that are sure to come if the party takes power. It proposes sweeping expansions of Medicare and Medicaid, abortion access protections, a reversal of Kennedy’s vaccine policies and a restoration of science research funding. But it does not endorse Medicare for All, which the party’s progressive wing favors, instead proposing it as one option among several to expand insurance coverage.
来自纽约州的“全民医保”进步派支持者亚历山大·奥卡西奥-科尔特斯与来自阿拉巴马州立场较为温和的泰瑞·塞维尔共同领导了该工作组，后者并未支持这一构想。
A progressive supporter of Medicare for All, Alexandria Ocasio-Cortez of New York, led the working group alongside the more-moderate Terri Sewell of Alabama, who hasn’t endorsed the idea.
“随着共和党和特朗普政府继续大幅削减数百万美国人赖以生存的医疗保健项目，民主党必须提出一个大胆的方案，以降低医疗成本、扩大医疗服务的可及性，并为后代提供更优质的医疗服务，”奥卡西奥-科尔特斯（Ocasio-Cortez）和休厄尔（Sewell）在6月份被任命领导这项工作时表示。
“As Republicans and the Trump Administration pursue devastating cuts to healthcare programs that millions rely on, Democrats must put forward a bold vision that lowers costs, expands access, and strengthens care for future generations,” Ocasio-Cortez and Sewell said in a June statement when they were selected to lead the effort.
这两位议员以及杰弗里斯（Jeffries）并未立即回应外界的评论请求。
The representatives and Jeffries did not immediately respond to requests for comment.
这个医疗保健工作组是杰弗里斯召集的五个工作组之一，其余四个工作组的议题分别是：养老护理服务、食品杂货价格、能源费用以及住房问题。
The health care working group is one of five Jeffries convened to focus on affordability and lowering the cost of living. The other four topic areas are caregiving, groceries and goods, gas and utilities and housing.
根据相关备忘录，该工作组共与139名民主党议员进行了交流，这占目前众议院民主党议员总数的60%以上。工作组还向145个利益相关方（包括患者权益组织、行业协会、医院及医生团体）征求了意见。
The health care working group met with 139 caucus members, the memo said, which is more than 60% of current House Democrats. The group also solicited feedback from 145 stakeholder groups, including patient advocacy organizations, trade associations, hospitals and physician groups.
一位熟悉该备忘录的人士匿名评价道：“这份备忘录实际上是一个‘集思广益’的产物——每个人的意见都得到了充分的体现；似乎没有人被拒绝。”除了推翻特朗普政府的医疗改革措施外，该备忘录还提出了其他建议，如监管大型医疗企业、扩大预防性医疗服务的范围、投资医疗人力资源、加强妇女和生殖健康保障，以及延长《奥巴马医改》中规定的保费税收优惠政策（该政策去年已被国会废除）。
“It’s clear it was a kitchen-sink-type document where everyone got their idea put in,” said a person familiar with the memo granted anonymity to give a candid assessment of it. “Nobody was told no, it seems.” Beyond reversing Trump’s health care moves, the memo suggests regulating large health care companies, expanding preventive care, investing in the health workforce and strengthening women’s and reproductive health. It also recommends extending enhanced premium tax credits in Obamacare, which Congress let expire last year.
这份政策提案并非完全出于党派立场；工作组还提出了一系列跨党派的措施，例如要求医院向患者收取与医生相同的价格、扭转医疗保险对医生支付的下降趋势、增加医学住院医师的培训名额、取消特朗普政府对护士和医学生贷款的限制、建立社会保障体系的长期护理保险机制等。
The policy program isn’t all partisan proposals. The group recommends a slate of bipartisan policies to force hospitals to charge the same prices as physicians, to reverse declining Medicare pay for doctors, to add medical residency slots, to remove the Trump administration’s caps on nursing and medical student loans, to create Social Security long-term care insurance benefits, to expand access to clinical trials and more.
该平台还建议对肾上腺素自动注射笔（EpiPens）设定价格上限、消除医疗债务、将社区卫生中心的资金增加一倍、将整体医疗费用限制在美国人收入的8%以内，并扩大特朗普用于投资农村卫生项目的基金。
The platform also suggests price caps on EpiPens, eliminating medical debt, doubling funding for community health centers, limiting total health care costs to 8% of Americans’ incomes and expanding Trump’s fund to invest in rural health programs.
民主党人还提议“夺回MAHA”，即小肯尼迪发起的“让美国再次健康”（Make America Healthy Again）运动。该运动已成为共和党联盟内部的一个派系，其成员对小肯尼迪在改善食品和药物质量方面取得的进展以及制药、食品和农业行业在华盛顿的持续影响力感到不满。
The Democrats also propose “reclaiming MAHA,” Kennedy’s Make America Healthy Again movement. It’s become a fractious group within the GOP coalition dissatisfied with Kennedy’s progress in improving the quality of food and medicine and the continuing influence of the pharmaceutical, food and agriculture industries in Washington.
奥卡西奥-科尔特斯在幕后领导了长达数月的努力，以争取MAHA的支持者倒向民主党。她认为该党的反大企业信息可以吸引那些对特朗普和小肯尼迪的领导感到不满的选民。截至目前，民主党人仍不愿在支持疫苗的问题上妥协，而许多MAHA运动的成员认为疫苗尚未经过充分的安全测试。
Ocasio-Cortez has led a monthslong effort behind the scenes to court MAHA advocates to the Democrats’ side. She thinks the party’s anti-corporate message can appeal to those voters disaffected with Trump and Kennedy’s leadership. As yet, Democrats have not been willing to bend on their support for vaccines that many in the MAHA movement believe have not been adequately safety tested.
该备忘录建议取消特朗普政府对草甘膦的保护措施。MAHA支持者认为，这种杀虫剂会导致癌症。今年2月，特朗普发布了一项旨在加强国内草甘膦供应的行政命令，这激怒了该运动。这种化学物质是某些农达（Roundup）产品的一部分，后者是美国最常用的除草剂。
The memo recommends removing the Trump administration’s protections for glyphosate, the pesticide that MAHA advocates say can cause cancer. It riled the movement in February when Trump issued an executive order to bolster the domestic glyphosate supply. The chemical is part of some Roundup products, the most commonly used weedkillers in America.
赢得众议院将为民主党人提供一个向选民展示其发展方向的机会。除非他们同时夺回参议院和白宫，否则他们将无法实现这一目标。
Winning the House will give Democrats an opportunity to show voters where they want to go. They won’t be able to go there unless they get back the Senate and White House too.