The 2010 Patient Protection and Affordable Care Act (or “Obamacare”) was intended to ameliorate these threats – and there are strong indications that it is on its way to significantly reducing the number of uninsured Americans. But, partly owing to a Supreme Court decision and the obduracy of Republican governors and legislators, who in two dozen US states have refused to expand Medicaid (insurance for the poor) – even though the federal government pays almost the entire tab – 41 million Americans remain uninsured.
2010年患者保护和平价医疗法（Patient Protection and Affordable Care Act，即“奥巴马医改”）本是为了消除这些威胁——而强有力的信号表明该法案正在显著降低无保险美国人的数量。但是，部分拜最高法院一项的裁决以及共和党执政者和立法者的顽固所赐——二十四个州拒绝扩大面向穷人的医疗补助（Medicaid）计划，机关联邦政府几乎全额负担了其中的成本——仍有4,100万美国人没有医保。当经济不平等性演变为政治不平等性时——美国大部分地区就是如此——政府却没有关注底层人民的需要。