医疗成本不断上涨迫使美国人降低保险覆盖率、缩短工时或面临负担不起的保险费,而联邦不作为和ACA补贴延展停滞不前使情况恶化。 Rising health care costs force Americans to drop coverage, cut hours, or face unaffordable premiums, worsened by federal inaction and a stalled ACA subsidy extension.

包括北达科他州在内的全国范围内的美国人正面临着严重的财政压力,因为保健和保险费用迅速上升,迫使家庭放弃保险,企业削减工时或避免雇用,地方政府不顾3%的财产税减免上限,不得不应付不可持续的工资支出。 Americans nationwide, including in North Dakota, are facing severe financial pressure from rapidly rising health care and insurance costs, forcing families to drop coverage, businesses to cut hours or avoid hiring, and local governments to grapple with unsustainable payroll expenses despite a 3% spending cap on property tax relief. 有些州寻求豁免上限,有可能造成预算不稳定,而个人报告每年的保险费超过24 000美元。 Some counties seek exemptions to the cap, risking budget instability, while individuals report premiums exceeding $24,000 annually. 联邦的无所作为,包括未能延长负担得起的照护法补贴,以及政府最近对该问题的停业,加深了危机,使许多尚未提供持久解决办法的领导人感到被抛弃。 Federal inaction, including the failure to extend Affordable Care Act subsidies and a recent government shutdown over the issue, has deepened the crisis, leaving many feeling abandoned by leaders who have yet to deliver lasting solutions.