Yiyiphi iSicwangciso seCongo sokuPhinda i-Obamacare Ngaba ubukeka
NgoMatshi-ngoMeyi 2017: Inzame yokuqala yayiyi- American Health Care Act . INdlu yadlulisela ngoMeyi 4, 2017. Yayiquka ezininzi izinto ezingenayo inxalenye yee-bills zeSteti. Yanikezela ngetyala lentlawulo yecala elibhekiselele kwiminyaka engengeniso . Le mali ayixhomekeke kwiindleko zezicwangciso, ngoko kuya kuphakamisa iindleko ezininzi.
Esi sicwangciso sasiquka iNgxowa-mali yoMonde kunye neSizwe eya kuzinceda ukuhlawula iiprayimas eziphantsi kweepesenti ezingama-20 emva ko-2026. Kuya kuba yindleko kwi-federal government $ 100 yezigidigidi ngaphezu kweminyaka eyi-10. Amazwe ayenokhetho lokusebenzisa le ngxowa-mali ukudala amachibi aphezulu . Oku kuya kuthetha iindleko eziphakamileyo kubantu abaneemeko zangaphambili.
Umthetho-mali weNdlu wawuye wavumela amazwe ukuba acime imithetho emininzi ye-ACA phantsi kweemeko ezithile. Kwimihlaba ekhethiweyo yokukhetha imithetho, izifo ezingapheliyo zizifo ziza kuhlawula amanqanaba aphezulu.
I-Medicare exhaswa ngemali nge- grant block . Esi sicwangciso uSomlomo uPaul Ryan ukhuthaze iminyaka. Ukunquma imali ye- Planned Parenthood kunye neentlawulo ze-Obamacare. Ukulahlekelwa kwemali ye- Obamacare kuya kufaka i-$ 460 yezigidigidi kwi-matyala engaphezu kwe-10 iminyaka.
Abaxhasi bangecebo abazange bachaze indlela icebo labo lingayi kudibanisa ngayo ityala. Esi sizathu esinye sezizathu ezininzi ezichasene nazo. Yadlulisela iNdlu kodwa ayisayi kuphumela kwi-bill ye-Senate eyimpumelelo.
NgoJuni-Julayi 2017: Ngokusekelwe kuMthetho weMpilo weMpilo yaseMelika, iNtloko enkulu yeNdlu uMitch McConnell inqumle i-Senate yokuqala ye-Trumpcare. UMthetho woNxibelelwano loNxibelelwano olungcono uvumele izigqibo ukuba zigcine zonke iintlawulo zezempilo ezibalulekileyo ezi-10 . Oku bekuya kwenza ukuba iinkampani zihlawulise ngakumbi kulabo abaneemeko zangaphambili .
Isicwangciso sazohlwaya abo baye bahlawula i-inshurensi yabo kwaye basebenziselwa ukuhanjiswa kwiintsuku ezingama-63. Isindisa iinkampani zomshuwalense ngemali ngokudambisa abantu ukuba bafumane i-inshorensi kuphela xa begula. Kodwa akuyi kubavusa abantu abanempilo ukuba bayeke ukuvalela kwabo, ukunyusa iindleko kubo bonke abantu kwaye ngokukodwa abagulayo.
Esi sicwangciso sinokuthi sinciphise iindleko zeMedicaid ukususela ngo-2020. Kuye kunciphisa iikhredithi ze- Obamacare kunye neenkxaso-mali. I-CBO iqikelele ukuba ukuchithwa kwezibonelelo kunye neMedicaid kuya kuthintela abantu abayizigidi ezingama-22 ukuba bafumane i-inshurensi. Oku kuya kunciphisa ityala nge $ 321 billion ngaphaya kweminyaka eyi-10.
Isicwangciso seSenate siza kuvumela iinkampani ukuba zihlawulise abadala abadala amahlanu ngamawaka angama- America amancinci, ngokuphindwe kathathu. Isicwangciso sasiza kubetha iMedicaid kunye neSihloko X sokubuyiselwa kweenkonzo zoNonophelo lwezeNzululwazi ngezeMpilo ngonyaka. Nangona le mali engasetyenziswanga ukukhipha isisu, iRiphabliki ikhathazeke ukuba umbutho usebenzisa imali yokuphanda abachasayo. Eli nyathelo liya kwandisa iindleko zeMedicaid . Inokunyusa inani labasetyhini abafuna ukukhipha isisu ngenxa yokuba abazange bafumane ukunakekelwa kwangaphambi kokubeletha okunikezelwa nguCwangciselwe Parenthood.
Isicwangciso siya kuphelisa irhafu kulabo abangathengi i-inshorensi .
I-CBO iqikelele ukuba ii-premiums ziza kuba ngama-15 ukuya kuma-20 ekhulwini ngaphezulu ngo-2018 no-2019. Kuya kususa irhafu kwiinkampani ezinganikezeli ngomshuwalense wezempilo. Abasebenzi abaninzi baya kulahlekelwa ingqalelo xa abaqashi bengenyanzelekile ukuba banikele.
Umthetho-mthetho we-Senate ukwandise igalelo elivumelekileyo kwiAkhawunti yokuThengiswa kweMpilo . Ii-HSA zifumaneka kuphela kulabo abanezicwangciso ze-inshorensi eziphezulu. Oku akuncedi abantu abangenako ukukwazi ukubeka bucala kwi-HSA. Kuya kuvumela wonke umntu ukuba athenge i-inshorensi yempilo yengozi . I-ACA ivumela kuphela abantu ukuba bathenge ezi zicwangciso ukuya kwi-30 ubudala. Abafihla iinkonzo zokuthintela kodwa zingabizi.
UTump wayecele iCongress ukuba ithathe indawo ye-ACA ngaphambi kweSeptemba 30, 2017. Leyo yosuku lokugqibela i-Senate Republican inokuyidlulisela ibhilida ngokukhulula ininzi yevoti engu-51.
Bazama ukugqithisa iindleko ezine, kodwa abazange bafumane iivoti.
I-Senate yayidinga uninzi lwamavoti angama-60 lokuphelisa ngokupheleleyo i-ACA. Amademokhrasi awayi kuphinda aphelise isenzo abayidalile. Endaweni yoko, iiSenethi zeRiphablikhi zafuneka zisebenzise ibhajethi yokuxolelana nohlahlo lwabiwo-mali ukuze ziqhekeze iindleko kunye neengeniso ze-ACA. Baya kuwusebenzisa kuphela kwi-bill ye-bill ayizange ifakwe kwi-matyala kwiminyaka eyi-10 ezayo.
NgoJulayi 18, 2017, uMcConnell waqonda ukuba akanakufumana iivoti ezaneleyo zeRiphabhlikhi zokudlula uMthetho oNgcono loNgcando. Kodwa uMongameli uTrump ubeka uxinzelelo kwi-Republican holdings. Bavume ukuba ubuncinane bavumele ukuba ibhajethi iqhubeke phambili kwingxoxo.
NgoJulayi 2017: "Ukutshitshiswa kwe- Senate " kweSenethi kuya kuphelisa igunya lika-ACA lokuba umntu athenge i-inshorensi. Kuye kuyeka ukufuna iinkampani ukuba zinike iinkonzo zomshuwalense. Kuye kuphelisa irhafu kwizakhiwo zonyango. Kuya kuhlawula imali ye-Planned Parenthood, i-Prevention kunye neMpilo yezeMpilo kwiNgxowa-mali, kunye neNgxowa-mali yeZiko lezeMpilo.
I-CBO ifumene ukuba iza kushiya abantu abayizigidi ezili-16 bengena-inshorensi. Kwakhona waxwayisa ukuba ibhilikhwe yayiya kwandisa iipriyamu ngama-20 ekhulwini ngonyaka. Kungenxa yokuba iinkampani ze-inshorensi zempilo ziya kulahleka imali.
NgoJulayi 28, ngo-2017, uSenat John McCain , R-Ariz., Waphonsa ivoti yokhetho malunga ne "bill bill". Akazange avume le nkqubo kwaye wabongoza ukuba kubuyiselwe kumthetho wokwenza umgaqo-bipartisan.
NgoSeptemba 2017: Ii-Senators Lindsey Graham, RS.C., kunye noBill Cassidy, uR-La., Bancedisa i-bill yangoku. Isibhengezo se-Graham-Cassidy siya kuguqula inkxaso-mali ye-Medicaid yase-Obamacare kunye nenkxaso-mali ye-inshorensi yokunika inkxaso-mali yebhloko. Yashiya ukuya kumazwe ukuyila iiprogram zonyango lwempilo kunye neemali.
Izibonelelo zebloki ezizinzileyo aziyi kuhlawula amaMerika amaninzi njengengxelo ye-ACA yokunika inkxaso. Kuya kunceda abanye bathi ngelixa abanye bengabonakali.
Umthetho-mali uvumelekile ukuba amazwe afune ukuba abafumana iMedicaid banomsebenzi ngaphandle kokuba bebekhulile, abantwana, abakhubazekile okanye abakhulelweyo. Yayixhaswa ngemali ngo-2027.
Umthetho osayilwayo unomdla wokuvakalisa amalungelo amalungelo. Kuye kunciphisa iindleko zonyango lwempilo, njengoko iinkampani zomshuwalense ziza kufuneka zihambisane nemimiselo kaRhulumente. I-Trump ikholelwa ukuba izibonelelo zebhanki ziya kwenza imali yombuso iphumelele. Kwakhona kuthetha ukuba iMedicaid yayiza kukhuphisana nezinye izinto eziphambili. Yilokho eyabangela ukungaphumeleli kwamaziko ezempilo yengqondo phantsi kokususwa komthetho .
Kodwa abaninzi bathi 'abalawuli beMedicaid bayalumkisa ukuba abaxhotywanga ukwenza inkqubo kwinkqubo yebhilidi yexesha eliyiminyaka emibili kunye neengxowa-mali zebloki' ezingenayo imali.
U-Graham-Cassidy wasusa irhafu kulabo abangathengi i-inshorensi ephindaphindiweyo ukuya ku-2016. I-CBO iqikelela ukuba abantu abayizigidi ezili-14 baya kuhlawula i-inshorensi yabo.
NgoSeptemba 22, 2017, uSenator McCain wayevalile umyalelo-mthetho weGraham-Cassidy. Uthe akukho nto yolwazi olwaneleyo malunga nendlela i-bill iya kubachaphazela ngayo abantu kuba iqhutywe ngokukhawuleza ukuhlangabezana nomhla wokugqibela.
Indlela Ukupheliswa Kwempahla Yomzimba Okuya Kukuchaphazela Ngayo
AmaRiphabhuliki angaqalisa ukuzama ukuphelisa nokubeka iiplani ze-Obamacare ngo-2018. Ukuba kunjalo, kufuneka bahambise iziphakamiso zabo kwilizwe ngoMeyi ukuba kukho nayiphi na inguqu eyokwenzeka ngoJanuwari 2019. Ezi zizwe zivunyelwe ngokugqibela kuba zijongene nokuphunyezwa.
Ukuba ukutshitshiswa kwenzeka, iindleko zezicwangciso ngamnye ziya kukwanda kubantu abaninzi. I-Fund ye-Commonwealth Fund kunye ne-Rand Corporation yophando ifumene ukuba umgaqo-nkqubo oqhelekileyo uza kuvela kwi-$ 3,200 ukuya kwii-4,700 zamaRandi.
Ezi zicwangciso zeConference ziza kunciphisa iindleko zakho ukuba:
- Unobucandelo elincinci. Awuyi kuphinda uhlawule isohlwayo xa unganikezeli ngomshuwalense.
- Unayo inkampani yecandelo lezonyango okanye i-salon yokucoca. Awuyi kuphinda uhlawule irhafu ye-Obamacare.
- Ukutshitshiswa kuza kukuchaphazela ngakumbi ukuba ungowesinye sezizwe ekunciphiseni iintlawulo ezi-10 ezibalulekileyo. Kuya kunciphisa iindleko zakho ukuba uphilile okanye usemncinci.
Baya kukwandisa iindleko ukuba:
- Unesifo esingapheliyo.
- Ukhulile. Izicwangciso zeCongress zivumela iinkampani ze-inshorensi ukuba zihlawulise abadala abantu amahlanu ukuba zihlawula abantu abatsha. I-Obamacare ilinganiselwe ngokuphindwe kathathu. Iindleko zakho ziza kuvela xa usesikhundleni esiphakamileyo esilahlekelwa ngumyinge we-Medicaid phantsi kwesicwangciso. Abaninzi abakhulileyo badinga i-Medicaid ukukhupha iindleko ze-Medicare zangaphandle.
- U khulelwe. Amaninzi amaninzi aya kunciphisa oku kwiindleko ezibalulekileyo.
- Ufuna ukukhipha isisu. Izicwangciso zithintela iinkampani ze-inshorensi ezithengiswayo kwiintengo zokungenisa izisu.
- Inkampani yakho inikezela ngokukhawuleza ngenxa yokuba i-ACA iwamisele.
- Wena ungomnye wabantu abayizigidi ezingama-22 abafumana inkxaso okanye ukunyuswa kwamaMedicaid.
- Usebenzisa iinkonzo zempilo yengqondo kunye nokuziphatha, kubandakanywa nokusetyenziswa kweziyobisi. Isicwangciso seNdlu siquka i-$ 2 yezigidigidi ukuhlawula amaziko kunyango lweziyobisi. Akunelisekanga ukucima izicucu kwiiMedicaid kunye neenkampani zomshuwalense eziyekelela ukukhutshwa kwezi nkonzo.
- Uya kugqiba ukuphinda ufake isicelo se-inshurensi yempilo emva kokuphela kweentsuku ezingama-63. Uya kufuneka uhlawule ikhementi ye-premium ye-30%.
- Ungumonde wesicwangciso soMzali. Isicwangciso seSenate isaphulelo semibutho yonyaka omnye nje.
Imvelaphi
Amaqela amakhulu esibhedlele aphikisana nezicwangciso zamaRiphabhulikhi. Bayazi ukuba iindleko zabo zamagumbi eziphulo-zindleko ziya kukwanda xa unyango lokukhusela phantsi kwe-Medicaid lukhutshwa. I-inshurensi yempilo yomshuwalense, iMicrosoft Insurance Plan, ichasene nayiphi na iyancitshiswa kwiMedicaid. Ukwandiswa kwe-ACA kwabakho baninzi abathengi abatsha.
Icandelo le-inshorensi yezempilo liya kufaka iisetyenziswano malunga naluphi na isicwangciso abaxhasayo. Icandelo lidlala indima ebalulekileyo ekwakheni i-Obamacare. Ngokomzekelo, bekuxanduva lomntu ngamnye . Iinkampani ze-inshorensi aziyi kuqinisekisa abo abagulayo ngaphandle kokuba urhulumente anikwe igunya lokuba nempilo ifakwe.
Ukuqonda kakuhle i-ACA, khangela incwadi yam, "I-Ultimate Obamacare Handbook."