Ukupheliswa koMthetho woNonophelo ojongene noNyaka (Obamacare)
Yintoni eyenzekayo: Iinkokeli zeCongress zithetha ngokumisela umthetho ngo-Februwari oya kuphelisa i-ACA, kodwa yiyiphi ifomu echithwayo ingathatha ingacacanga.
U-Karen Pollitz, umntu omdala ongekho inxaxheba kwi-Kaiser Family Foundation, uthi mhlawumbi "imfuneko yokuba umntu athenge i-inshorensi yempilo kunye nemfuneko yabaqeshi abayinkulu ukuba ayinike" iya kubanjiswa ngokukhawuleza, ngelixa ezinye iziqendu zomthetho ziya kuhlala zide isicwangciso sokutshintshwa siyavunyelwana. Ngakolunye uhlangothi, uDonon Herrick, uqoqosho lwezeMpilo kwiZiko likaZwelonke loPhando lwePolisi, i-tank thinking tank, ikholelwa ukuba abantu baseRephablikhi baya kuqhubeka beqaphele. "AbaRiphabhliki abakwazi ukucima u-Obamacare ngaphandle kokuncedwa ngaba-8 abaDemokhrasi," utsho.
Oko kuthetha ntoni kuwe: Ukuba kunye naxa i- ACA ichithwe, abantu abasempilweni okwangoku bathenge i-inshorensi yezempilo abavakalelwa kukuba umthwalo weendleko unokuyeka ukukhutshwa kwabo ngaphandle kwehlwayo. Kuxhomekeke kubangaphi, ukunyusa ngokweqile abantu abangabinempilo kwintsholongwane yempilo yomshuwalense kuya kubakhokelela kubanini-bhaki ukuba banyuswe amaxabiso abo.
Ngo-2018, iingcali ziqikelela ukuba iinkampani ezininzi ze-inshorensi ziya kushiya indawo.
Ngaba unokwenza nantoni na ukuyilungisa? "Kufana nokulungiselela ikhephu - mhlawumbi iya kuwa okanye ayikho," kusho uPollitz. "Abantu abangcono kakhulu abanokukwenza ngoku bafumana ukufumana ingxelo efumanekayo kubo kunye nolwazi lwemali [ngendlela yemali-mali] abanelungelo lokuba phantsi komthetho wangoku."
Ukutshintshwa kwe-ACA
Yintoni eyenzekayo: Izicwangciso ezintathu ezahlukeneyo zokufaka endaweni ye-ACA zithengiswa yienkokheli zePublic Republic kunye neCongress. Isicwangciso esinye sivela kwiSenators uRichard Burr (R-NC) kunye no-Orrin Hatch (R-UT), kunye noMongameli uFred Upton (R-MI); omnye uvela kwiNdlu Somlomo uPaul Ryan (R-WI); kwaye okwesithathu ivela kwiCongressman kunye neHHS oyiNtloko yeTom Price (R-GA). Asiyazi kakuhle ukuba isicwangciso esithatha indawo siya kubonakala ngathi, kodwa kukho ezinye izinto eziqhelekileyo.
Oko kuthetha ntoni kuwe: I-ACA ifake umxholo "weemfuno zonyango ezibalulekileyo" - umgangatho osemgangathweni wenzuzo ekufuneka unikezwe nayiphi na isicwangciso se-inshurensi-kubandakanya iinkonzo zonyango, impilo yengqondo, unyango lokubeleka, iziyobisi kunye nokulawulwa kokuzalwa. Iziphakamiso ezintathu zeRiphabhliki azibandakanyi lolu hlobo lwenzuzo yezempilo, ngoko unokulahlekelwa yimiba eyahlukileyo yoxanduva lwakho, kwaye unxunguphako luya kubangela iindleko eziphezulu ezingaphandle kwee-pocket ngenxa yee-deductibles eziphezulu.
Ngakolunye uhlangothi, unokwenza uhlawule i-premium yenyanga ephantsi ukususela kwithuba elifunekayo, kwaye awuyi kunyanzelwa ukuba uhlawule umvuzo ongacingayo ukuba uyawufuna okanye uhlawule isigwebo xa uphuma. I-ACA iphinda ifake imigangatho yendlela abaxhamli abanokufuneka ngayo ukuba bahlawule ngokuxhomekeka kwabo, kwaye ezi zicwangciso ezintathu ziya kuphelisa loo migangatho yokwabelana ngexabiso.
Izicwangciso zokutshintshwa zixubusha ukugcina isigatshana se-pre-existing conditions, kodwa kuphela abantu abahlala bekhutshwe ngokuqhubekayo-kuthetha ukuba ukuphelelwa amandla kunokuthetha ukuguquka okanye ukuhlawula amaxabiso aphezulu. Ekugqibeleni, ininzi yezigidi ezingama-Amerika ezingama-65 zingaphantsi kweminyaka engama-65 kunye ne-inshurensi yezempilo yifumana ngomsebenzi, "kusho uPollitz. Kodwa enye into efana nale mivuzo iya kuba kukukhawulela okanye ukuphelisa inkxaso-mali yerhafu ukuba urhulumente wesigqeba unikezele ngeenzuzo zempilo zabasebenzi. Oku kuya kubakho abaqeshi ukuba banqande okanye banciphise iingenelo okanye batshintshe ngaphezulu umthwalo wendleko kuwe.
Isibheno seNkundla yokuLawulwa
Yintoni eyenzekayo: NgoMeyi wokugqibela, ijaji elilawulayo lilawula-ekuthandeleni iiRephabliki zaseNdlwini-ukuba ulawulo luka-Obama lwalichithe imali engekho mthethweni ukuba iCongress yayingakaze ihlawulwe ukuhlawula inxalenye ye-ACA. Iintlawulo ezikhutshweyo zenziwa ngeenkxaso-mali zokwabelana ngeendleko zokunciphisa ii-copays kunye neengxowankulu kwiirejistreshini ezifumana imali encinci; malunga neepesenti ezingama-60 zabantu abasemarike ngoku bafumana.
Nantsi indlela le nto idlalwe ngayo: Yithi uthenge isicwangciso "sesiliva" (nge-deductible ye $ 2,000 okanye i-$ 3,000 ngomntu ngamnye). Inkampani yomshuwalense ithengisa kuwe ngeli xabiso, kodwa ikhupha izicwangciso zeenzuzo (ukuya kwiindawo ezininzi zegolide okanye iplatinum), kwaye urhulumente kamva uhlawula inkampani yomshuwalense emva kwayo. Baye bakhetha ukwenza lo msebenzi, uPollitz uyachaza, kuba kuya kuba yintloko yokuba urhulumente abhale inkcazo enye xa uhamba ugqirha okanye wenze inkqubo. Iinkampani ze-inshorensi zithengisa ngeCadillac ngentengo yeVolkswagen kwaye emva koko ihlawulwa nguRhulumente, "kusho uPollitz.
Kodwa ijaji yavuma ukuba ulawulo luka-Obama alinalo igunya lokubuyisela loo nkampani yomshuwalense kwaye yalela ukuba ulawulo luyeke. Ijaji yahlala i-oda-ithetha ukuba ayiyi kusebenza-isalathiso sikhalazo, kwaye umhla wokugqibela wokufakela eso sibheno ngoFebhuwari 21. Ukuba isigwebo sinobheno singasifumana iNkundla ePhakamileyo malunga nexesha eliyiminyaka emibili.
Oko kuthetha ntoni kuwe: Ukuba isigwebo siphezulu, iinkampani ze-inshorensi kwindawo yeemarike zinokuthi zenzeke-ziza kuba zilahlekelwe yimali ngokukhawuleza ngenxa yokuba ziza kuba nezicwangciso ezingcono kwiindleko eziphantsi kwaye aziyi kubuyiselwa. Ngenxa yoko, banokwandisa iirhafu zabo okanye bashiye i-marketplace ngenxa yoko. ICongress inokugqiba nokugqiba ukulungelelanisa imali leyo, kodwa loo nto inenkxalabo. Kwaye, utsho uHerrick, esi sigwebo singasetyenziselwa ukuba sisetyenziswe xa kuziwa ekufumaneni isicwangciso sokutshintsha.
WeMedare Reform
Yintoni eyenzekayo: " UDonald Trump sele esithi akafuni umntu ochaphazelekayo kwi-Medicare," kusho uJoseph Antos, onguchwepheshe wezobugcisa kwi-American Enterprise Institute. "Andiboni nayiphi na inguqu enkulu kwiprogram ye-Medicare , kodwa ndabona ezinye iinguqulelo ezinxulumene ne- Medicare Benevantage ." Iingcali ezingaphezulu kwe-30 ze-Medicare abaxhamli njengamanje zicwangciso ze-Medicare Benevantage ezizimeleyo. U-Antos ukholelwa ukuba utshintsho olwenziwe ngulawulo olutsha luyakwandisa ukhuphiswano ngokufumana i-planard ye- Medicare plan (apho abaninzi abantu babhalisa ngokuzenzekelayo xa befikelela kuma-65) ngokuthe ngqo ngokubhekiselele kwizicwangciso ze-Medicare Benevantage.
Oko kuthetha ntoni kuwe: Ukhuphiswano oluninzi luzisa izinto ezintle. Yaye ukuba uthetha isigqibo sokuhamba nesicwangciso se-Medicare Benevantage, ngokuqinisekileyo uya kulawulwa ngokunyamekela unonophelo oluthathayo, u-Herrick uthi. Kodwa kunokubakho iindleko ezingalindelekanga-kwaye icebo lingaba lula ukuliqonda.
Uxilongo
Yintoni eyenzekayo: I- Medicaid okwangoku isebenza ngamazwe kwaye iyahlawulwa ngabo bobabini kunye norhulumente wephondo. Amazwe athumela zabo iindleko ku rhu lumente, kwaye urhulumente unganikezeli ngokubanzi kuxhomekeke kwimeko. Ngokomzekelo, kwiindawo ezinobuncwane ezifana neCalifornia neNew York, urhulumente wephondo uhlawula malunga nama-50 entente kwidoli. Emazweni ampofu, iAlabama okanye i-Mississippi, urhulumente wesigqeba uhlala esondele kuma-75 eentente, utsho uAntos.
Ulawulo olutsha lujolise ekunikeni isibonelelo semali nganye kwisibonelelo semali - isibonelelo sebhloko-esekelwe kubemi. Oku kwenza ukuba inkululeko enkulu ikwazi ukuqhuba izicwangciso zabo, kodwa ngokufanayo ibeka uxinzelelo kubo ukuze baqinise iindleko. Enye inkalo yolu ngonyusa lweMedicaid. Amashumi amathathu anesibini (ukuba ubala DC) wandisa inkqubo phantsi kwe-ACA, ufumana i-100 yeepesenti yokubuyisela iminyaka embalwa, kunye neepesenti ezingama-90 ngoku. AmaRiphabhulikhi aya kuba aphantsi kakhulu kwipesenteji, oku kuthetha ukuba ezinye iindawo ziza kuphinda ziphinda ziphinda ziphinda ziphinda ziphinda ziphinda ziphucule inkqubo yabo yokwandisa - kwaye abanye abantu baya kulahleka ukufaneleka.
Oko kuthetha ntoni kuwe: Imali engaphantsi kwenkqubo kwimeko nganye ichaza ukuba akusayi kuba yinto elula ukuya kuyo, ithi, igumbi lokuphuthuma phakathi kobusuku, utsho uAntos. Abaxhamli banokunyanzeliswa ukuba benze izigqibo ezincinci zendleko, njengokwenza utyunjwa ukuba babone oogqirha kwiikliniki, kunokuba i-ER. Abanye abaxhamli banokuphulukana nokufaneleka ngokuxhomekeka kwisigqibo ngasinye selizwe malunga nenkqubo yokwandisa. Kwaye ekubeni imigaqo iya kuba yi-state-by-state, utshilo uHorrick, oorhulumente boorhulumente banokuphinda bahoxise ukufaneleka kokuphula imithetho ethile yelizwe, njengokungahlawulanga i-co-pay time.
Kunye neHayden Field