美国参议院周四批准了影响深远的医疗改革法案，这对白宫倡导的医改计划而言是一个标志性时刻；白宫希望扩大医保范围，以纳入目前没有医保的3,000多万美国人。
The Senate approved sweeping health-overhaul legislation on Thursday, a landmark moment for White House-led efforts to expand insurance coverage to more than 30 million Americans.
美国参议院以60比39的票数通过了这一法案，这将使得民主党得以兑现允诺已久的将医保范围扩大至所有人的承诺，并推动美国联邦社保体系自1965年创建医疗补助计划(Medicare)以来进行最大规模的扩张。医疗补助计划是面向老年人和残疾人的医保项目。
The bill, approved by a 60-39 vote, would deliver on a long-promised Democratic goal of extending coverage to nearly every American, and would represent the biggest expansion of the federal safety net since the 1965 creation of Medicare, the health-insurance program for the elderly and disabled.
参议院周四的投票是总统奥巴马(Barack Obama)的一次胜利，他将医疗改革当作了首要国内问题，虽然在民主党内遭遇持续意见分歧，面临共和党的强烈反对。此次投票验证了参议院多数派领袖雷德 (Harry Reid)决定在他这一派达成共识，而不越过党派界线寻求共和党人的支持；此举可能会使医改的预期被迫降低。
Thursday's vote was a victory for President Barack Obama, who made the issue his top domestic priority despite lingering divisions among Democrats and the fierce opposition of Republicans. And it was a validation of Senate Majority Leader Harry Reid's decision to build consensus on his side of the aisle, rather than reach across party lines, a move that would have forced a lowering of ambitions.
现在各方必须开始谈判，推动众议院和参议院就各自版本法案之间的差异达成一致，分别就折衷法案再次进行表决。奥巴马希望在明年1月底发表国情咨文讲话之前签署这一法案。
Negotiations now must begin to reconcile differences between the House and Senate versions of the bill, with the compromise bill facing another vote in each chamber. President Obama hopes to sign the bill before his State of the Union address in late January.
共和党人说，这一法案会给纳税人和企业带来巨大的监管和财务负担，使得政府更加深陷赤字泥潭。参议院少数派领袖、肯塔基州共和党参议员麦康奈尔(Mitch McConnell)在表决前对参议院说，民主党人回家时应会被愤怒的选民骂到耳朵起茧。
Republicans said the bill would impose massive regulatory and financial burdens on taxpayers and businesses, and would dig the government even deeper in debt. Senate Minority Leader Mitch McConnell (R., Ky.) told the chamber just before the vote that Democrats should expect an 'earful' from angry constituents when they go home
麦康奈尔说，这场纷争远远没有结束。我和同事将努力阻止这一法案成为法律。这是美国人民的明确意愿。
'This fight is long from over,' Mr. McConnell said. 'My colleagues and I will fight to ensure this bill doesn't become law. That's the clear will of the American people.'
所有58名民主党参议员和2名独立参议员都投票支持医改法案，而39名共和党参议员投了反对票。肯塔基州共和党参议员布宁(Jim Bunning)没有投票。
All 58 Democrats and two independents voted for the bill, while 39 Republicans voted against it. Sen. Jim Bunning (R., Ky.) did not vote.
雷德说，他也预计会听到耳朵起茧，但是来自那些将从医保范围扩大以及保险公司新规定中受益的美国民众。他说，我们需要继续前进，这项法案符合自杜鲁门(Harry Truman)以来各任总统一直努力争取的国家需求；虽然一些人可能会延缓进程，但他们阻止不了。
Mr. Reid said he also expected to get an earful, but from Americans who will benefit from the expanded health-care coverage and new rules on insurance companies. 'Our charge is to move forward,' he said, adding that the bill meets a national need that presidents have pushed for since Harry Truman. 'Though some may slow the progress, they cannot stop it,' he said.
美国总统奥巴马对参议院投票结果表示欢迎。他说，我们现在终于可以兑现扩大医疗保险和改革美国医疗体系的诺言了。奥巴马施压要求议员们完成这项工作，在未来数周将达成一致的法案提交给他签署。
At the White House, President Obama welcomed the Senate vote and said, 'We are now finally poised to deliver on the promise' of expanding care and overhauling the nation's health system. Mr. Obama pressed lawmakers to 'finish the job' and deliver a compromise package to his desk in the 'coming weeks.'
这项为期10年、总额8,710亿美元的医改法案将扩大面向贫困人口的医疗补助计划(Medicaid)范围，创建新的税项补贴，帮助中低收入家庭遵守购买保险的要求。政府将向不购买保险的个人处以至多750美元的处罚。
The 10-year $871 billion measure would expand Medicaid, the federal-state health program for the poor, and create new tax subsidies to help lower- and middle-income families comply with a mandate to purchase insurance. That mandate would be enforced by a financial penalty of up to $750 for any individual who fails to get coverage.
非党派的美国国会预算办公室(Congressional Budget Office)预计，这项法案将通过对医疗行业加税和削减支出，在未来十年将美国预算赤字削减1,320亿美元。医改法案主要削减了支付给医疗提供商的医疗补助计划支出。
The nonpartisan Congressional Budget Office estimates the legislation would reduce the budget deficit by $132 billion over the next decade, through a combination of tax increases on the health-care sector and spending cuts, which largely fall on Medicare payments to health-care providers.