For Robert F. Kennedy Jr., “Make America healthy again” is far more than a nice slogan. His cosmic purpose in life, he has said, is to fix the country’s health woes. “The first thing I’ve done every morning for the past 20 years is to get on my knees and pray to God that he would put me in a position to end the chronic-disease epidemic,” Kennedy told senators during his confirmation hearing in January. As health secretary, he has continued to emphasize his commitment to that goal. But yesterday, Kennedy cheered a move that is all but guaranteed to make America less healthy.
对于小罗伯特·肯尼迪（Robert F. Kennedy Jr.）而言，“再次使美国再次健康”远不止是一个好口号。他说，他的宇宙目的是解决该国的健康困境。肯尼迪在一月份的确认听证会上对参议员说：“过去20年中，我每天早上做的第一件事是跪下来，向上帝祈祷，他将使我能够结束慢性疾病的流行。”作为卫生部长，他继续强调自己对这一目标的承诺。但是昨天，肯尼迪欢呼了一项举动，这几乎可以使美国的健康状况不佳。
Trump’s “Big Beautiful Bill,” which the Senate passed yesterday, includes provisions that would dramatically change Medicaid, the government program that provides health insurance primarily to low-income people. The bill requires a significant portion of Medicaid enrollees to work in order to access benefits, and creates other barriers for people enrolling in the program. All told, it would kick nearly 12 million people off health insurance by 2034, according to an estimate from the nonpartisan Congressional Budget Office. If the bill passes the House, it will then head to President Donald Trump, who will sign it into law.
参议院昨天通过的特朗普的“大美丽法案”包括将大幅度改变医疗补助的规定，这是政府计划，该计划主要为低收入人士提供健康保险。该法案要求大部分的医疗补助招待会来工作以获取福利，并为参加该计划的人们造成其他障碍。总而言之，根据非党派国会预算办公室的一项估计，到2034年将使将近1200万人撤离健康保险。如果法案通过房屋，它将前往唐纳德·特朗普总统，后者将签署为法律。
Medicaid is an expensive program, and the White House has said that more stringently policing who can access it will root out fraud and save funds for the neediest Americans. (Fraud is indeed a problem with the program.) Kennedy, who oversees Medicaid as the head of Health and Human Services, has echoed that message. Yesterday, he posted on X that the bill will allow the Trump administration “to deliver better care to America’s most vulnerable citizens.” But nearly the entire medical establishment warns that slashing Medicaid and limiting access to medical care would have grave consequences for Americans’ health. The American Hospital Association has said the bill “will result in irreparable harm to our health care system.” The American College of Emergency Physicians has said that it “will have dangerous ripple effects that impact anyone in need of lifesaving emergency care.”
医疗补助是一项昂贵的计划，白宫说，更严格的警务人员可以访问它，将把欺诈行为扎根，并为最需要的美国人节省资金。（欺诈确实是该计划的问题。）监督医疗补助为卫生和公共服务部负责人的肯尼迪回应了这一信息。昨天，他在X上发布了该法案，该法案将允许特朗普政府“为美国最脆弱的公民提供更好的护理。”但是，几乎整个医疗机构都警告说，削减医疗补助并限制获得医疗服务的机会将对美国人的健康造成严重后果。美国医院协会表示，该法案“将对我们的医疗保健系统造成无法弥补的伤害”。美国急诊医师学院表示，“它将具有危险的连锁反应，影响需要救生急诊护理的任何人。”
Kennedy has argued several times that the number of people on Medicaid needs to shrink. In a recent congressional hearing, Kennedy argued that Medicaid should be for only “poor children,” “mothers,” and “the disabled,” rather than “able-bodied people who are not looking for jobs.” During his Senate confirmation hearing, Kennedy made clear that his problem with Medicaid is unsatisfactory outcomes. “We are spending $900 billion, and our people are getting sicker every single year,” he said. (An HHS spokesperson didn’t respond to a request for comment.)
肯尼迪多次辩称，医疗补助人数需要缩水。在最近的国会听证会上，肯尼迪辩称，医疗补助应该只适合“贫穷的孩子”，“母亲”和“残疾人”，而不是“不寻求工作的人”。在参议院确认听证会上，肯尼迪明确表示，他在医疗补助的问题不令人满意。他说：“我们花费9000亿美元，我们的员工每年都会厌倦。”（HHS发言人没有回应置评请求。）
But cutting Medicaid would directly undermine Kennedy’s MAHA agenda. Many of the sickest Americans are on Medicaid, and they might not otherwise be able to afford health insurance. The program allows them to access care for the kinds of diseases that RFK Jr. is set on remedying. Nine in 10 adults who are on Medicaid and have chronic conditions report seeing a doctor in the past year, versus just 63 percent of uninsured adults, according to KFF, a nonpartisan organization.
但是切割医疗补助将直接破坏肯尼迪的Maha议程。许多最病的美国人正在医疗补助中，否则他们可能无法负担健康保险。该程序允许他们获得RFK Jr.的各种疾病的护理。无党派组织KFF的说法，在过去的一年中，有10名正在医疗补助和慢性病的成年人报告了医生，而无保险成年人的63％是党派。
There’s a lot for Kennedy to like in the services Medicaid provides. The health secretary is perhaps the most outspoken advocate for the concept that food is medicine, but Medicaid has long embraced the idea. Every state runs its own Medicaid program, and Massachusetts, for example, provides healthy meals to people with certain diet-related conditions. This pilot program has reduced hospitalizations by nearly a quarter, according to one study. Kennedy has also cited his longtime advocacy for people with disabilities. Several states, including California, pay for aides who can help disabled enrollees with personal-care tasks. Some will even pay for renovations to make homes more accessible, ensuring that people with disabilities can live more independently.
肯尼迪在医疗补助提供的服务中有很多值得喜欢的东西。卫生部长也许是食品是医学的概念最直言不讳的倡导者，但医疗补助长期以来一直接受了这个想法。每个州都开展自己的医疗补助计划，例如，马萨诸塞州为具有与饮食有关的患者提供健康的餐食。一项研究显示，该试点计划使住院时间减少了近四分之一。肯尼迪还引用了他对残疾人的长期倡导。包括加利福尼亚在内的几个州为助手付费，这些助手可以帮助残疾人进行个人护理任务。有些人甚至会为装修费用，以使房屋更容易获得，以确保残疾人可以独立生活。
With his framing on Medicaid, Kennedy has reversed the causes and effects of America’s health woes. He is right to point out that Medicaid serves an incredibly sick population. Adults below the poverty line are roughly twice as likely to report only fair or poor health compared with the entire U.S. population, according to the CDC. But Medicaid is part of the solution, not the problem itself.
肯尼迪凭借对医疗补助的框架，扭转了美国健康困境的原因和影响。他正确地指出，医疗补助服务人群令人难以置信。疾病预防控制中心（CDC）称，贫困线以下的成年人与整个美国人口相比仅报告公平或不良健康的可能性大约是健康的两倍。但是医疗补助是解决方案的一部分，而不是问题本身。
