Iimashishini ze-inshurensi zishintshe njani inkqubo ye-Obama yokuHlaziya kwezeMpilo
Ngaphandle kokuguqulwa, iindleko zempilo ezinyanzelekileyo zonyango kwi-Medicare ayinakusindiswa. Iirhafu zokuhlawula i-Medicare kunye nama-premium zihlanganisa kuphela i-57 ekhulwini zeenzuzo zangoku.
Iipesenti ezingama-43 eziseleyo zixhaswa ngemali evela kwingeniso jikelele. Ngenxa yokunyuka kweendleko zonyango, iindleko eziqhelekileyo ziza kufuneka zihlawule i-62 ekhulwini zeendleko ze-Medicare ngo-2030. I-Congress yavuma ukuba yayiyona sizathu esibalulekileyo sokuba kutheni ukunakekelwa kwempilo kuyadingeka kuguqulwe.
I-ACA iya kunciphisa iindleko ezimbini zokunakekelwa kwezempilo: izindlu eziphuthumayo kunye nezifo ezingapheliyo. Okokuqala, yenze i-coverage efikelelekayo kubantu abaninzi. Oko kwabenza bakwazi ukunyamekela ukukhusela nokukhusela iindleko eziphezulu zonyango loncedo. Incedise amayeza kubantu abadala ukuba baphathe izifo zabo ezingapheliyo.
Ezi ntlawulo zihlawulwa ngerhafu ye-Obamacare kwimindeni ephezulu engenayo kunye nabanikezeli bezempilo. Kwakudinga ukuba wonke umntu athole i-inshurensi. Ukunyanzelisa abantu abaselula nabanobuchopho ukuba bakhokhe iiprimiyamu ze-inshorensi. Loo myalelo wawunzima kumthetho. Ngomnyaka we-2012, iNkundla ePhakamileyo yenze isigqibo sokuba urhulumente wephondo unelungelo lokurhafisa abo bangathengi i-inshurensi.
U-2008: U-Obama wamemezela iSicwangciso sokuNyango lweMpilo
U-Obama wabhengeza ekuqaleni ulungiselelo lokulungisa utshintsho lwempilo njengenxalenye yesikhulumi sakhe soMongameli we-2008 . Isicwangciso sakhe esicetywayo esidlangalaleni, esifana nelokuthandwa yiCongress, esibizwa ngokuba yi-Federal Employees Health Benefits Programme.
U-Obama wathembisa "ukukhutshwa", oko kwakuthetha ukuba abantu abayi kuphinda bahlangane nesicwangciso somqeshi wabo, kodwa bangakhetha icebo labo kwaye bahlale nalo.
Bangakhetha ukhetho lukahulumeni "ukhetho lwabantu" okanye bathenge i-inshurensi yabo ngokutshintshiselana. Akukho mntu unokuphika i-inshorensi yempilo ngenxa yeso simo esele sikhona.
Urhulumente waseburhulumenteni uza kwandisa inkxaso ye-Medicaid. Kuza kubonelela ngemali kwabo bawenza kakhulu ukuba bakwazi ukufumana iMedicaid. Naphezu kwazo zonke ezi zinzuzo, abantu abaninzi babesaba ukufakwa kwesi sikhundla sikaRhulumente waseburhulumenteni ebomini babo, besithi kwakukhokelela endleleni eya kumayeza asekuhlaleni.
U-2009: Ukunyamekela iMpilo kwiMelika
Emva kokuba ukhethwe ngo-2009, u-Obama wancenga iMpilo yokuCwangcisa iMelika. Yanikwa inshurensi yonyango efana ne-Medicare kubo bonke abayifunayo. Abo bavuyiswa yi- inshorensi yempilo yabo esele ikwazi ukuyigcina. Ubungakanani boorhulumente bombuso buchaza ukuba bube nokuthengisana kwamanani aphantsi kunye nokunciphisa ukungaphumeleli. Ngokubambisa bonke abangaxhaswanga kunye, kunciphise ingozi yomshuwalense.
Ishedyuli yokuhlawula yile:
- $ 70 ngamnye.
- US $ 140 isibini.
- $ 130 kwintsapho engumzali oyedwa.
- $ 200 kuzo zonke ezinye iintsapho.
Kwabanika abaqeshi ukhetho, ngokunjalo. Ukuba banikezela i-inshurensi yezempilo eyayiyilungileyo njengecebo lika-Obama, bahlala begcina oko babenayo. Ukuba akunjalo, abaqeshi bahlawula irhafu yeerhafu yeerhafu, efana nokuhlawulwa kwemisebenzi, ukunceda ukuhlawula isicwangciso sika-Obama.
Abo babezisebenzisayo bahlawula irhafu efanayo.
Ikhusele impilo yengqondo, impilo yomama kunye nomntwana. Ukukhawulelana neendleko eziphuma ngaphandle kweendleko ezihlawulwa ngabhalisi kwaye zinikezelwa ngokukhawuleza kweziyobisi. Utshintsho olulawulwe ngumbutho luya kulawulwa ngolwazi lwempilo yononophelo. Kwakhona wathembisa ukuphucula ulwazi lokugula ngononophelo kwimeko ye-elektroniki.
Isicwangciso esithembisa ukunyusa iindleko zonyango ngama-1.5 ekhulwini ngonyaka, ekubeni urhulumente wezemfundo angabelana ngamaxabiso amancinci kwaye anciphise ukungaphumeleli, ngokweBhunga labacebisi ngezoQoqosho . Iindleko zezempilo ezingaphantsi ziguqulelwe kwii-2,600 zamaRandi ngaphezulu kwintsapho ngo-2020 kunye ne-R10 000 ngo-2030. Yanciphisa ukulahleka kohlahlo lwabiwo-mali ngamaphesenti angama-6 yomkhiqizo wekhaya owenziweyo ngowama-2040. Oku kuya kunciphisa ukungabikho kwemisebenzi ngama-0.25 ekhulwini ngonyaka, ukudala imisebenzi engama-500 000.
Isicwangciso sonyango lwempilo ka-Obama sika-2009 sanciphisa ukutyelela kwigumbi lokuxakeka ngongxamisekileyo. Oku bekuya kugcina i-$ 100 yezigidigidi, okanye iipesenti ezi-0.6 ze-GDP, ngonyaka. Intshurensi yempilo exhaswe nguRhulumente isuse loo mthwalo kumashishini amancinci , okubenza bakwazi ukukhuphisana nokukhupha abasebenzi abanezakhono.
Inkcaso yayicinga ukuba icebo lika-Obama lithetha ukuba urhulumente wesigqeba uza kutyhola uhlobo oluthile lokunakekelwa kwezempilo. Abo bavuyiswa yi-inshurensi yempilo yabo ekhoyo babesaba ukuba kufuneka bawunike, nangona oku kwakungeyona nyaniso. Abanye babenenkxalabo malunga neplanethi yecandelo likarhulumente eliza kuthi liza kuthathwa oko kuza kufunyanwa ngeenkqubo zinshorensi entsha (kubandakanywa noxhaswa ngu rhu lumente) kwaye oko kwakungeke kwenzeke.
I-Conservatives yayikhathazeke ngokukodwa ukuba urhulumente anganquma ukuhlawula ukukhupha izisu ezingafuneki nawaphi na amaxwebhu okanye iimvume zamantombazana angaphantsi. Ekugqibeleni kodwa ubuncinci babeyizichaso kwiindleko kunye noko kuza kwenza ntoni kwixabiso lebhajethi .
Injongo kaMongameli uBaba kwakuwukuqalisa ingxoxo, okwenziwe ngokuqinisekileyo. Isicwangciso sakhe saphefumlelwe iCongress ukuphuhlisa izicwangciso zayo.
Isiphakamiso seSenate
I-Senate ekuqaleni icebise inkqubo yebambiseneli engenzi-nzuzo esikhundleni se-Obama-run-run plan-insurance plan. Ngo-Oktobha 26, 2009, iNtloko yeSizwe i-Leadership Leader uHarry Reid yamemezela ukhetho lukaRhulumente kwi-bill ye-Senate. Kwakuquka ukunyusa i-Medicare inzuzo kulabo abaneminyaka yobudala engama-55 ukuya kuma-65 Amazwe angakhetha ukuphuma, ukuba ayenqwenela. Olu khetho luye lwasuka kwi-bill yeyokugqibela ngenxa yenkcaso evela kwivoti yokhetho, uSenator Joe Lieberman.
INkqubo yoLungiselelo lwezeMpilo kwiNdlu
Okokuqala ebhokheni yayiyilwayo yeNdlu. Indlu yabaBameli base-United States yadlulisela ingqungquthela yokuqala ye-Billing Reform Bill ngoNovemba 8, 2009, emva kokumemezela ngo-Oktobha 29, 2009. Ixabisa i-$ 894 yezigidigidi ngaphezu kweminyaka eyi-10. Yiyo eyi-40 billion yeebhiliyoni ngaphezu kwe-Bill ye-bill yexesha elizayo kwaye ingaphantsi kweNkcazo ye-Barack Obama yokuqala ye-$ 900 yezigidigidi. Yanciphisa ubuncipheko ngeeRandi ezili-104 ezigidigidi kwaye igcinwe i-$ 460 yezigidigidi ngaphezu kweminyaka eyi-10 ngokuhlawula i-surtax kubantu abafumana umvuzo ophezulu.
Umthetho-mali wezindlu uhlinzekwe inkqubo ye-inshurensi yempilo efana ne-Medicare. Yanikela inkxaso-mali ngqo kubantu abangaqinisekanga ukuba bancede bathenge i-inshorensi ngokutshintshiselana . Kwakudinga ukuba abantu bathenge i-inshorensi nabo bonke kodwa abaqeshi bancinci ukubonelela ngeenkonzo zempilo.
Umthetho-mali weNdlu uqinisekisile "ukuphela kobomi" iseshoni yokucebisa abantu abadala abafuna ukuxoxa ngale ngogqirha. Oku kuchazwa ukuba ithetha ukuba urhulumente uya kubagunyaza ukuba abantu abadala bakule ngxoxo malunga nendlela yokuphelisa ubomi babo ngokukhawuleza, ehla "indlela ekhohlisayo eya kwi-euthanasia ekhuthazwa nguRhulumente."
Yilwayo kwakhona:
- Ukuqinisekisa ukuba abagcini besikhokelo sabanempilo babucala abo babeneemeko zangaphambili.
- Faka i-inshorensi yonyango yempilo phantsi kwemithetho ye-antitrust yomthetho. Oku kugqiba imimiselo ekhokelwa ngumgaqo-nkqubo.
- Ukhuphe i-5.4 pesenti ye-overtax kubantu abenza imali engaphezu kwama-500,000 kunye nezibini ezifumana imali engaphezu kwe-1 million.
- Ukwandiswa kweMedicaid kulabo abanemivuzo ukuya kuma-150 ekhulwini kwintlupheko , kunye nokwandisa inkxaso kumazwe.
- Ukwandiswa kwenkcazo ye-Medicare inkqubo yeziyobisi, kunye nokunyuswa kwe-Federal inkxaso kwinkqubo ye-Medicaid.
ISicwangciso seNkqubo yezoNyango lwezeMpilo
I-Senate ivume ingqungquthela yayo ye-Bill Care Reform Bill ngevoti yokugqibela kwiKrisimesi ngo-2009. Yayifana kakhulu ne-ACA yokugqibela. Umthetho-mali weNdlu uqulethe ulwimi olunzima nolusisiseko. Umthetho-mali we-Senate unentlawulo kwiiprogram ze-inshurensi ephezulu. Ingena endaweni yomshuwalense wempilo yomshuwalense we-state esikhundleni senkqubo yokunakekelwa kwempilo yoluntu.
I-bill ye-Senate yayiye yavumela abantu abayizigidi ezingama-31 ukuba bafumane i-inshorensi yezempilo. Nangona kunjalo, izigidi ezingama-23 zazingasayi kuqinisekiswa. Umthetho-mali uza kubiza i-$ 871 yezigidigidi ngaphezu kweminyaka eyi-10. Ukunceda ukuhlawula iindleko zeeprogram, bekuya kukwandisa irhafu kwiinkonzo zonyango, iinkampani zonyango, abathengi bee-salon, kunye neenkqubo zinshurensi eziphezulu.
IBhunga labacebisi bezoQoqosho livumile ukuba imali iya kuphakama ngokukhawuleza ukuba ikhusele ukunyuka. Kodwa, kwiminyaka eyi-10 ezayo, bekuya kunciphisa iindleko ze-federal ngamaphesenti angama-0.7, ngaloo ndlela ukunciphisa ulwabiwo-mali lwama-billion 132.
UMthetho-osaYilwayo weNgcaciso wezeMpilo weSizwe uza kuba:
- Kufuneka wonke umntu abe ne-inshorensi yonyango, kodwa anike inkxaso yabo abanako ukuhlawula iipresimenti. Kwakhona kwakuya kwandisa iMedicaid.
- Abaqeshi abangazange banikele i-inshorensi baza kuhlawulwa. Kodwa amashishini amancinci athe afumane irhafu xa bengenako ukuthenga iinshurensi.
- Iinkampani ze-inshorensi ezingavunyelwe ukuhlawulela abantu abaninzi abanezifo ezinzulu okanye abadala.
- Yenza kubekho mthethweni kubaqhorensi ukuba banqabe ukukhutshwa kweemeko zangaphambili. Eli lungiselelo likhankanywe kubantwana ngo-2010, kwaye abadala ngo-2014.
- Abantu abavunyelwe kunye namashishini amancinci ukuthenga izicwangciso ze-inshorensi ngokusebenzisa utshintsho olulawulwa nguRhulumente.
- Iindleko zonyango zempilo zonyaka.
- Yongeza irhafu yerhafu kwiiprogram zomshuwalense ophezulu.
Ngo-2010: I-ACA idlulile
Ukudideka kunye nobunzima phakathi kwazo zonke iziphakamiso zenze i-rumor-mongering, eyakhokelela kwiingcamango malunga noko kwakucetywayo. Umthetho weBhili kunye neNdlu yeBhili yeeNtebe kwakufuneka ihambelane ngaphambi kokuba ithunyelwe kwideskiti lika-Obama ukuba isayinwe.
NgoJanuwari 26, 2010, zombini iindleko zagqitywa xa amaDemokhrasi alahlekelwa ngu -60-voting-proof of majority-votes in the Senate. Yilapho iRiphablikhi yaseScott Scott Scott ithola isihlalo sikaTed Kennedy eMassachusetts. Abaninzi bacinga ukuba oku kuphelelwa lithemba lokudlula nayiphi na inqununu yokunakekelwa kwezempilo. Kodwa uMongameli Obama waqalisa isilungiso esitsha sokunakekelwa kwempilo ngoFebruwari 22, 2010.
NgoMvulo, ngoMatshi 22, iNdlu yadlulisela uMthetho oyiYilwayo woLungelelaniso (HR 4872). Iimpawu ezidibeneyo zeBhili ye-Senate kunye nesicwangciso esilandelayo sika-Obama. Isabelo esivela kwi-Bill ye-Senate saba ngumthetho xa u-Obama wasayina. Inxalenye yeNdlu yavunywa yi-Senate. Yonke into, xa isayinwa nguMongameli Obama, yaba nguMkhuseli weMonde kunye noMthetho woNonophelo oThathaka .
Ngomhla wama-30 kuMatshi 2010, uMongameli uBrazil wasayina umThetho woNxibelelwano woNyaka ka-2010 (HR 4872). I- bimacare yokugqibela ye- Obamacare idibene kunye nama-bills ye-Senate neNdlu. Yigcine ukutshintshwa kwe-inshorensi elawulwa yi-state, kunye nemimiselo kwi-federal funding yokukhipha isisu, kodwa unciphise irhafu kwiiplani zempilo eziphelileyo. Yandisa irhafu yerhafu ye-Medicare kwabanikezeli abafumana imali engenayo kunye neerhafu zeMedare kwiingeniso-mali. Abo babenemeko esele ikhona ngaphambili bebephikisiwe ukufumana ingxelo baza kufumana ufikelelo lwe-inshurensi yempilo yesikhashana de kubekho utshintshi lubekwe.
I-Obamacare yatshintsha kakhulu unyango lwempilo ngokwenza inshuwalense ifumaneke kwizigidi ezingama-32 zaseMelika, okanye iipesenti ezingama-95 zomthetho. Ngaphezulu kweminyaka eyi-10 yokuqala, lo Mthetho uza kuhlawula i-$ 940 yezigidigidi. Nangona kunjalo, ezi ndleko ziya kunqunyulwa ngokunciphisa iindleko kwiprogram yemboleko yemfundo ephakamileyo kunye nokwandiswa kwemali evela kwiirhafu kumakhaya aphezulu angeniso. Kwiminyaka engaphezu kwe-10, iindleko zokunyaniseka kwe-Obamacare kulolu hlanga ziya kuba yi-$ 138 billion yokunciphisa imali.
Ekujuleni: Kusebenza njani? | Iinkonzo kunye neNgcaciso | I-Obamacare - Yilula ngokulula ukuchaza kubantwana bakho | Ulungiso lwezeMpilo Uhlalutya | Ingxelo ye-CBO