医疗费用上涨是美国老年人的一大担忧，正在影响他们的财务状况和政治优先事项。
Rising healthcare costs are a major concern for older Americans, and it's affecting their finances and political priorities.
法蒂玛·侯赛因 华盛顿报道 —— 芭芭拉·韦甘德本可以为退休做得更充分准备了。她保持健康，多年勤俭储蓄。
FATIMA HUSSEIN WASHINGTON — Barbara Weigand could not have prepared more for retirement. She stayed healthy and saved diligently for years.
然而今年，一次肩部手术和膀胱癌确诊让她的财务状况经受严峻考验。她最近从退休账户中取出 4000 美元，用于支付癌症治疗相关的医疗费用。
This year, though, a shoulder surgery and a bladder cancer diagnosis have really tested her finances. She recently withdrew $4,000 from her retirement account to cover medical expenses associated with her cancer treatment.
“凭我每月的收入，无法负担新增的医疗开支，”现年 83 岁、居住在俄亥俄州北坎顿的韦甘德说。她目前参加的是 Medicare Advantage 计划（医保优势计划），随着 Medicare（联邦医疗保险）的开放注册期于 10 月开始，她正在寻找新的保障方案。
“On my monthly income, I would not be able to afford my new medical expenses,” says Weigand, 83, who lives in North Canton, Ohio. She is currently on a Medicare Advantage plan and was searching for new coverage as Medicare’s open enrollment period began in October.
对美国老年人而言，医疗费用上涨打击的是最痛处——他们的钱包。随着 Medicare 费用、处方药价格和长期护理开支压垮家庭预算，他们的担忧在周二大选前夕可能具有重要政治分量。
For older adults in the United States, the rising cost of healthcare is hitting where it hurts most — their pocketbooks. With Medicare costs, prescription drug prices and long-term care expenses weighing on household budgets, their concerns could carry significant political weight heading into Tuesday’s elections.
韦甘德属于一个可靠的投票群体；根据 AARP（美国退休人员协会）10 月初进行的一项民调，83% 的 50 岁以上选民表示极其有动力参加中期选票投票。他们对应对医疗费用的担忧，让可负担性问题成为焦点。
Weigand is part of a reliable voting bloc; 83% of voters over age 50 say they’re extremely motivated to vote in the midterms, according to an AARP poll conducted in early October. Their concerns over managing healthcare costs put the issue of affordability squarely in the spotlight.
以下是他们最大的几项医疗担忧——以及韦甘德如何看待这些问题。
Here are some of their biggest healthcare concerns — and how Weigand sees them.
担忧一：Medicare 计划变动 现状：Medicare 计划的开放注册期于 10 月中旬开始，参保人面临一系列将于 2027 年生效的变动。
Worry No. 1: Changes to Medicare plans THE SITUATION: Open enrollment for Medicare plans began in mid-October, and enrollees are facing a slew of changes that will go into effect in 2027.
在注册期间，人们正在考虑更高的 D 部分自付费用上限、临时联邦 D 部分保费补贴的终止以及新的药价谈判。此外，在一些州，保险公司限制 Advantage 计划（优势计划）的参保人数上限、退出市场或取消人们赖以依赖的计划。
During the enrollment period, people are considering higher Part D out-of-pocket caps, the end of temporary federal Part D premium subsidies and new drug price negotiations. Additionally, in some states, insurers put caps on the number of people who can enroll in Advantage plans, pulling out of markets or eliminating plans that people have come to rely on.
KFF医疗保险政策项目主任朱丽叶·库班斯基告诉美联社，开放注册期为参保人提供了“一个评估现有保障并查看是否有更好的选择以获取所需医疗服务、且可能以更低成本的机会”。
Juliette Cubanski, director of KFF’s program on Medicare policy, told The Associated Press that the open enrollment period offers enrollees “an opportunity to evaluate the coverage they have and see if there might be better options for them in terms of accessing the care that they need, at possibly a lower cost.”
虽然韦甘德庆幸自己保持着清醒的头脑可以做功课，也有依靠的精神社区，但她担心其他正在为来年做打算而苦苦挣扎的老年人。“变化太多了，很多我这个年纪的人不知道从何入手，”她说。“他们该怎么办？”担忧之二：处方药负担得起吗形势：特朗普政府已将降低药价作为优先事项，旨在向美国人展示其正在应对飙升的成本。
While Weigand is grateful to have the mental acuity to do the research and the spiritual community that she relies on, she worries about other older people who are struggling to plan for the year ahead. “There are so many changes, and a lot of people my age who don’t know where to start,” she says. “What do they do?”Worry No. 2: The affordability of prescription drugs THE SITUATION: The Trump administration has made lowering drug prices a priority in its effort to show Americans that it is tackling soaring costs.
共和党总统唐纳德·特朗普已与制药公司达成多项最惠国药价协议，并推出了折扣药品网站TrumpRx等，采取了其他多项措施。
Republican President Donald Trump has struck multiple most-favored-nation drug deals with pharmaceutical companies and has launched the discount drug website TrumpRx among other steps.
9月，其政府表示，所有50个州将加入一项计划，该计划将在医疗补助计划中为部分药品提供最惠国定价，将选定药品的净价降至某些其他国家支付的价格水平。
In September, his administration said all 50 states would join in on a program set to provide most-favored-nation pricing to some drugs within the Medicaid program, bringing the net price of selected drugs down to prices paid in certain other countries.
尽管如此，处方药费用仍阻碍部分人购药。KFF3月的一项调查发现，约40%的美国成年人表示，过去一年因费用原因未按医嘱服药。
Still, the cost of prescription drugs prevents some people from filling prescriptions. A KFF survey from March found that about 4 in 10 U.S. adults say they have not taken their medication as prescribed in the past year due to costs.
韦甘德正考虑减量服药以省钱。“我在想——如果我能隔天服一次而不是天天服，让药吃得久一点，”她说。“这不悲哀吗？”KFF报告称，约五分之一的受访者表示，因费用原因，在过去一年里曾将药片掰半或漏服药物。
Weigand is considering rationing her drugs to save money. “I’ve been thinking — if I could just do this every other day rather than every day to make the medicine last longer,” she says. “Isn’t that sad?“The KFF report says about 1 in 5 people surveyed had cut pills in half or skipped doses of medicine in the prior year because of the cost. Worry No. 3: The costs of long-term support The costs of receiving long-term care — whether from spouses, home-care aides or friends — have risen steeply for retirees.
担忧三：长期照护成本 退休人员接受长期照护的费用——无论来自配偶、居家护理助手还是朋友——已大幅上涨。
An AARP report released Wednesday that examines out-of-pocket caregiving expenses finds that family caregivers are spending nearly 60% more supporting a family member or friend than five years ago.
美国退休人员协会（AARP）周三发布的一份报告考察了自付照护开支，发现家庭照护者支持家庭成员或朋友的支出比五年前增加了近60%。根据该报告，他们每年平均花费11508美元支持家庭成员或朋友，而2021年这一数字为7242美元。
They spend an average of $11,508 a year supporting a family member or friend, compared with $7,242 in 2021, according to the report. Nancy LeaMond, AARP’s executive vice president and chief advocacy officer, said “we’re already hearing from our members about healthcare affordability — its prescription drug costs, caregiver costs, co-pays, premiums,” she said.
美国退休人员协会执行副总裁兼首席倡导官南希·利蒙德（Nancy LeaMond）表示：“我们已经听到会员们反映医疗负担能力问题——处方药费用、照护费用、共付额、保费，”她说。“我们不仅在努力帮助家庭照护者解决财务问题，还要让他们获得帮助亲人所需的各类信息。”这些担忧萦绕在老年人心头。根据密歇根大学2025年9月进行的一项全国健康老龄化民意调查，约三分之一的50岁以上美国人定期照护有健康问题或残疾的成年亲属或朋友。
“Not only are we trying to help family caregivers with their finances, but also to get them the kind of information they need to help their loved ones.”These worries are top of mind for older people. About one-third of Americans over 50 provide regular care to an adult relative or friend with a health issue or disability, according to a national poll on healthy aging conducted in September 2025 by the University of Michigan.
担忧四：社会保障偿付能力 社会保障局本月宣布，从2027年开始，老年人和残疾人的年度生活成本调整将上涨3.6%。这意味着领取月度社会保障福利的近7200万人以及约730万领取补充保障收入的受益人，每月将额外获得75美元。如果国会不解决资金缺口，该机构将面临逼近的破产日期。
Worry No. 4: The solvency of Social Security The Social Security Administration announced this month that the annual cost-of-living adjustment for older adults and people with disabilities will rise by 3.6% beginning in 2027. That translates to $75 extra per month for the nearly 72 million people who receive monthly Social Security benefits and about 7.3 million beneficiaries who get Supplemental Security Income. The agency faces an approaching bankruptcy date if a funding shortfall is not addressed by Congress.
社会保障和医疗保障受托人6月的报告指出，涵盖老年及残疾受益人的社会保障合并信托基金将从2034年起无法支付全额福利。此后，收入仅能覆盖约83%的计划福利。
Social Security and Medicare trustees’ report from June states that Social Security’s combined trust funds, which cover old age and disability recipients, will be unable to pay full benefits beginning in 2034. After that, incoming revenue would cover about 83% of scheduled benefits.
2034年已近在眼前，即将召开的国会将不得不确定如何加强该计划。
With 2034 not far away, the upcoming Congress will be on the hook to determine how to shore up the program.
民调公司Impact Research的合伙人马特·霍根对中期选举冲刺阶段的候选人建议道：“不论党派，要想在这些选民中取得进展，社会保障和医疗保险肯定应该成为他们的竞选信息的一部分。”
Matt Hogan, a partner at the Impact Research polling firm, has this advice to candidates in the closing days of the midterm campaign: “Regardless of party, to make inroads with these voters, Social Security and Medicare should definitely be part of their messaging.”