关键还是医疗成本，笨蛋。周二蓝色浪潮让民主党拿下众议院和参议院多数席位后，华盛顿仍在收拾局面——但民主党人已经在筹备一项医疗保健议程，意在刺激总统唐纳德·特朗普否决选民支持的政策。
It’s healthcare costs, stupid. Washington is still collecting itself after a blue tsunami delivered House and Senate majorities on Tuesday — but Democrats are already gearing up a healthcare agenda to goad President Donald Trump into vetoing policies voters support.
容易下手的最初目标包括逆转医疗补助计划削减，以及恢复共和党任其失效的《平价医疗法案》强化税收抵免；随着医疗保险费飙升，这两项政策正冲击家庭预算。但议员们将需要弄清楚如何为这些努力买单，而加州选民本周表明，即便在蓝色浪潮中，对富裕美国人增税也颇具挑战。其他立法推动还可能预示民主党人2028年的竞选主张。
Easy initial targets include rolling back Medicaid cuts and restoring Affordable Care Act enhanced tax credits that the GOP allowed to lapse, two policies hitting household budgets as healthcare premiums spike. But lawmakers will need to figure out how to pay for those efforts, and California voters demonstrated this week that even in a blue wave, raising taxes on wealthy Americans is challenging. Other legislative pushes could preview what Democrats run on in 2028.
进步派将不可避免地要求在众议院就全民医保法案进行投票，即便预计将出任众议院议长的众议员哈基姆·杰弗里斯更希望先进行一场“家庭内部对话”。特朗普倾向于支持最惠国药品定价立法，这可能意味着民主党人可以尝试将按其他富裕国家药价支付的做法写入法律。
Progressives will inevitably demand a House vote on a Medicare for All bill, even if Rep. Hakeem Jeffries, the expected House speaker, would prefer to first have a “family conversation.”Trump’s propensity to support most-favored-nation drug pricing legislation could mean Democrats could attempt to codify paying what other wealthy nations offer for drugs.
“民主党人和特朗普总统在解决药品价格问题上的说法相似，因此可能会出现一种奇特盟友式的交易机会，”将于明年1月出任凯泽家庭基金会首席执行官的拉里·莱维特说。
“Democrats and President Trump talk similarly about addressing drug prices, so there may be opportunities for a strange-bedfellows kind of deal,” said Larry Levitt, who will become the CEO of KFF in January.
来自佛蒙特州的独立参议员伯尼·桑德斯将试图利用他很可能担任的参议院卫生委员会主席职位，为联邦医疗保险增加牙科、视力和听力保险。此外，预计还会就是否重新授权为美国食品药品监督管理局提供约一半资金的用户收费展开争斗——制药业认为这项立法必须通过，而桑德斯几十年来一直反对。
Sen. Bernie Sanders, I-Vt., will try to use his likely perch atop the Senate Health Committee to add dental, vision, and hearing coverage to Medicare. And expect a fight over whether to reauthorize user fees that fund roughly half the FDA — legislation that pharma considers must-pass and that Sanders has opposed for decades.
当然，也会有一批民主党议员打算利用这一时机，把医疗保险公司和制药商高管拉到国会作证，并拖延特朗普提名的食品药品监督管理局和卫生与公众服务部空缺职位人选。
Of course there’ll be a contingent of Democratic lawmakers intent on using this moment to drag health insurer and drugmaker executives before Congress and slow-roll Trump nominees in open roles atop the FDA and HHS.
但民主党人真正的机会在于，明确说明如果他们拿下总统职位将会做什么。
But the real opportunity for Democrats is to lay out what they will do if they take control of the presidency.