埃伦·艾伦手里拿着特朗普总统亲笔写的信，信中说明了她收到的500美元款项的相关情况。这笔钱大约相当于她在2026年每月需支付的医疗保险费的四分之一——当时《平价医疗法案》规定的保险费大幅上涨。为保护个人隐私，NPR对信中她的住址信息进行了处理。
Ellen Allen holds the letter from President Trump that explains the $500 payment she got. It's about a quarter of what she had to pay monthly in 2026 after her ACA insurance premiums skyrocketed. NPR has redacted her address in the letter to protect her privacy.
苏·朱利安：欢迎收听NPR政治播客，获取关于中期选举重大新闻的每日深度分析。
Sue Julian Check out the NPR Politics Podcast for daily analysis of the biggest news on the midterms.
周一，西弗吉尼亚州查尔斯顿附近的埃伦·艾伦家中收到了美国财政部寄来的支票以及特朗普总统的亲笔信。对此她心情复杂。
Ellen Allen has mixed feelings about the check from the U.S. Treasury and letter from President Trump that arrived at her house near Charleston, W.Va., on Monday.
“我简直不敢相信，这太不可思议了，”艾伦说道。她是一家名为“西弗吉尼亚州民众呼吁降低医疗成本”的小型非营利组织的执行主任。在她看来，发放这些支票不过是一种“政治噱头”。NPR最早于2025年夏天采访过埃伦·艾伦。当时她63岁，尽管联邦政府提供的医疗保险补贴即将终止，但她深知自己必须通过Healthcare.gov购买保险。
"I just can't believe it; I mean, that's crazy," says Allen, who's the executive director of a small nonprofit called West Virginians for Affordable Health Care She says, in her opinion, sending out these checks is a "political stunt." NPR first spoke to Ellen Allen in the summer of 2025 She was 63 years old at the time, and knew she needed coverage from Healthcare.gov even as generous federal subsidies for her premiums were ending.
她患有严重的眼疾，需要使用价格昂贵的眼药水来保护视力。她曾呼吁由共和党控制的国会延长相关补贴政策，但未能如愿。最终，从2026年1月至8月，她不得不动用退休储蓄来支付每月1,967美元的保险费。
She has a serious eye condition and needs expensive drops to preserve her vision. She advocated for the Republican-controlled Congress to extend the subsidies. It didn't. She ended up using retirement savings to pay $1,967 every month for her premiums from January through August, 2026.
随后她迎来了65岁生日，符合了参加联邦医疗保险的资格。“午夜刚过我就去申请了——从可以申请的第一天起我就立刻行动了，”她笑着说。还会有第二笔补贴款吗？
Then her birthday came; she turned 65 and was eligible for Medicare. "I was ready at midnight — the first day I could apply, I did," she laughs. A second check on the way?
艾伦选择了传统的联邦医疗保险计划，这意味着她很快可能还会收到美国财政部寄来的另一笔款项。上周，特朗普总统宣布，将向2000万名参加联邦医疗保险的民众发放每人90美元的补贴。
Allen chose traditional Medicare, which means she could soon be getting another check from the U.S. Treasury. Last week, President Trump announced that $90 checks will be sent to 20 million people enrolled in Medicare.
“90美元——说实在的，这点钱根本不算什么，”艾伦说道。她的工作内容就是与西弗吉尼亚州各地的民众探讨医疗费用相关问题。“人们不会被这种做法蒙骗，”她预测道，“大家现在都日子艰难，一整年都在为高昂的医疗费用发愁。”“如果真想做点实事，就应该致力于降低医疗费用，而不是偶尔发发支票罢了，”艾伦说。
"The $90 is — I mean, that's just nothing," Allen says. In her work, she talks to people about healthcare costs all over West Virginia. "People aren't going to be fooled by this," she predicts. "People are hurting. People are feeling the cost of healthcare all year long." "If they wanted to do something meaningful, they would work on affordable health care instead of just sending out checks every now and then," Allen says.
这两类支票的发放对象都经过严格筛选。上周特朗普政府寄出的500美元支票，仅发放给那些居住在30个使用Healthcare.gov作为医保平台的州的居民；此外，领取者个人年收入还需超过6.4万美元，这一收入水平已超出了申请补贴的门槛。这类人群和艾伦一样，在国会未能延续拜登总统时期推出的额外经济援助政策后，很可能遭受重创。
Both checks are directed to select groups. The $500 checks mailed by the Trump administration last week were only sent to people who live in one of the 30 states that use Healthcare.gov for their insurance marketplace. They also make more than $64,000 annually for an individual, which is too much money to qualify for subsidies. These are people, like Allen, who were likely to be hard hit when Congress failed to extend the extra financial help put in place under President Biden.
即将发放给医保受益人的90美元支票，也仅面向部分参加联邦医疗保险B计划的参保者；而那些参加由保险公司运营的“医保优势计划”的参保者则无法获得这笔款项。特朗普能这么做吗？
The $90 checks that will be sent to Medicare beneficiaries are only going to certain people enrolled in Medicare Part B People in Medicare Advantage plans, which are managed by insurance companies, will not get checks. Can Trump do that?
这些支票恰好在中期选举前几周寄达民众信箱。随支票一同寄出的信件内容大肆吹嘘特朗普政府在医疗政策方面的“政绩”，同时对拜登政府加以批评。
The checks are hitting people's mailboxes just a few weeks before the midterm elections. The text of a letter sent along with the money touts the Trump administration's efforts on health policy and criticizes the Biden administration.
“这明显带有竞选宣传的意味，”密苏里州圣路易斯市华盛顿大学法学院的法律与政府伦理学教授凯瑟琳·克拉克指出，“其目的显然是为了影响选民投票意向，而这是法律所禁止的。”她解释称，这一行为尤其违反了《哈奇法》——即“禁止动用联邦权力与资金干预党派政治选举的相关法规”。此外，这种做法还可能属于未经国会授权的资金使用方式。
"This reads like electioneering," says Kathleen Clark professor of legal and governmental ethics at Washington University law school in St. Louis, Missouri. "This reads as though it's intended to influence votes. That is prohibited by law." Specifically, it would violate the Hatch Act, "the statute that prohibits using federal power and money to influence partisan political elections," she explains. It may also be a use of funds that's unauthorized by Congress.
这些用于资助Healthcare.gov参保者的资金，来源于保险公司为参与该医疗市场而支付的费用；用于资助Medicare受益人的资金则来自一项专项改善基金。此前，这两类资金都未曾被用于直接向参保者发放款项。
The money for Healthcare.gov enrollees is from fees insurance companies paid to participate in the marketplace, and the money for Medicare beneficiaries is from a general improvement fund. Neither of these funds have been used for direct payments to enrollees before.
“这看起来像是一种孤注一掷的举动——本质上就是试图用金钱收买收到这封信的人，好让他们在即将到来的中期选举中出于感激之情把票投给特朗普，”她补充道。
"It looks like a pretty desperate effort to, in essence, bribe the recipients of this letter to vote in gratitude to Trump in the upcoming midterm elections," she adds.
这些支票与信件无论是否合法，都在源源不断地寄到民众的邮箱中。克拉克指出，过去最高法院曾多次纵容特朗普的违法行为。“因此，他自然觉得自己有底气这么做，”她说道。
An empowered executive branch The checks and letters are arriving in people's mailboxes, whether they're legal or not. Clark notes the Supreme Court has enabled Trump's illegal actions many times in the past. "So, of course, he feels empowered to go ahead and do this," she says.
对于NPR提出的关于选举干预、此举是否违反《哈奇法》以及艾伦所称的这是否属于“政治噱头”等问题，白宫并未直接作出回应。
The White House did not respond directly to NPR's questions about electioneering, whether the action is a violation of the Hatch Act or if it is a "political stunt," as Allen put it.
“这种批评完全脱离实际，”特朗普政府发言人艾莉森·舒斯特在邮件中写道。“奥巴马医改平台的运营成本让美国民众承担了过高的费用，特朗普总统把他们辛苦挣来的钱还给了他们。这位总统始终致力于推行能让民众把钱留在自己口袋里的政策，帮助他们掌控自身的健康事务。”“只够买半箱油的额度”近年来，一些共和党人主张直接向民众发放资金，而非拨付给健康保险公司，不过该党尚未确定具体的实施方案。
"This is an out-of-touch criticism," Trump Administration spokeswoman Allison Schuster wrote in an email. "Americans were overcharged for the operation of the Obamacare exchange, and President Trump returned their hard-earned money. This President will never stop enabling Americans to take control of their health by implementing policies that put money back in their pockets." 'Half a tank of gas' Some Republicans in recent years have advocated for giving more money directly to people rather than to health insurance companies, although the party has yet to settle on a particular approach.
不过，保守派智库美国企业研究所的荣誉高级研究员约瑟夫·安托斯表示，发放这些支票与此项举措并无关联。民众完全有权自行决定如何使用这笔钱，并无任何规定要求他们必须将其用于医疗开支。
In any case, sending these checks is unrelated to that effort, says Joseph Antos senior fellow emeritus at the conservative think tank American Enterprise Institute. There's nothing that requires people to use this money for their health.
“从普通老年人的角度来看，收到90美元的支票就意味着实实在在的钱，”他补充道，指的是即将发放给医疗保险受益人的这笔款项。“拿着90美元，他们可以去麦当劳买两个汉堡加一杯奶昔，或许还能加半箱油。”
"From the perspective of the average senior citizen, when they get a $90 check, it's money," he adds, referencing the forthcoming checks for Medicare beneficiaries. "You can go out to McDonald's and buy probably two hamburgers and a shake for $90 [and] maybe buy a half a tank of gas."
一项民意调查显示民众对政府的信任度差距正在扩大。在这次年中选举即将到来之际，非营利性健康研究机构KFF周二发布的民调显示，选民们普遍为医疗费用发愁，并希望候选人能切实解决这一问题。
A widening trust gap, poll says A few weeks from the midterm elections, voters say they are struggling with health costs and want candidates to address them, according to a poll released Tuesday by the nonprofit health research organization KFF.
“11月投票时，医疗费用问题必定是选民们最关心的议题，”KFF调查方法部门主任阿什利·基尔津格说道。“目前来看，在所有选民中，民主党更受信赖，被认为更有能力处理医疗问题；在独立选民群体中，民主党同样占据优势——而这部分选民对中期选举的结果至关重要。”她指出，在医疗费用处理能力方面，民主党与共和党之间的信任差距正在不断扩大。
"The cost of healthcare is what's going to be front of mind as they're casting their votes in November," says Ashley Kirzinger director of survey methodology for KFF. "And what we are seeing is that the Democratic Party has the advantage overall among all voters on which party voters trust to handle healthcare, but they also have the advantage among independent voters, and that's a really important voting block for midterm elections." She says there is "a widening gap" between the Democratic Party and Republicans when it comes to which party voters trust to handle health costs.
“今年4月时这一差距仅为10个百分点，如今已扩大至20个百分点，”她说。民调结果显示，仅有22%的选民信任共和党能妥善处理医疗问题，而信任民主党的比例则高达42%。共和党候选人该获得多少赞誉？
"It was just a ten-point margin back in April, and now we're seeing it to be a 20-point margin," she says. The poll found 22% of voters trust Republicans on the issue, compared to 42% who trust Democrats. Where's the credit for GOP candidates?
美国企业研究所的安托斯称，特朗普政府决定发放这笔款项的行为“令人费解”。他认为此举在政治上显得十分怪异：一个一贯批评奥巴马医改政策的共和党政府，如今却要投入更多资金支持该计划；从财政角度来看也“不合常理”，毕竟国家债务规模正持续攀升。
Antos, of AEI, calls the Trump administration's decision to send out these checks "inexplicable." He describes the move as politically strange, since a Republican administration that disparages Obamacare is investing more money into it, and "unreasonable from a fiscal standpoint," because of the growing national debt.
他还指出，大多数美国人都拿不到这些补助金。“那些有雇主提供的医疗保险的普通低收入劳动者呢？”他问道，“他们什么也得不到。这是为什么？这样公平吗？”
He also notes that most Americans won't be getting these checks. "How about the average, lower-income worker who has employer coverage?" he asks. "They're not getting anything. Why is that? Is that fair?"
他怀疑这一举措能否为共和党候选人带来政治上的好处。“首先，特朗普并没有说是当地的国会议员为大家争取到了这些福利，而是声称是他亲自促成的，”安托斯说道，“我实在无法理解，也看不出这对任何人有什么好处，包括唐纳德·特朗普本人。”
He is doubtful the move will have a political benefit for Republican candidates. "For one thing, Trump is not saying that your local congressman did this for you, Trump is saying he did it for you," Antos says. "I don't get it and I don't see any advantage to anybody, including Donald Trump."
尽管心情复杂，西弗吉尼亚州“为全民享有可负担医保”组织的艾伦·艾伦仍打算把刚收到的500美元补助金存入账户。“我不会把钱退回去，”她说，“我会把它存入我的医疗储蓄账户，继续为实现全民医保而努力。”
Despite her mixed feelings, Ellen Allen of West Virginians for Affordable Health Care is planning to deposit the $500 check she just received. "I'm not going to send it back," she says. "I'm going to put it in my health savings account and keep working towards health care for all."