Into oya kuyenza kwaye ayiyi kuLahla Ukuba i-Obamacare iyasuswa
Injongo ephambili ye-ACA kukunciphisa iindleko zonyango kwixesha elide. ICongress iyaqonda ukuba iindleko ze-Medicare, Medicaid, kunye neenzuzo zezempilo zomsebenzi zidla uhlahlo lwabiwo-mali.
Kungenxa yoko bavuma ukuba ukuguqulwa kwezempilo kubaluleke kakhulu. Isicwangciso sikaMongameli uDonald Trump sokutshintsha i-Obamacare inezicwangciso ezahlukeneyo zokunciphisa iindleko.
I-ACA inciphisa iindleko ngeendlela ezintathu.
- Yenza i-inshurensi yezempilo efikelelekayo ngokubonelela ngemali. Intloko iguqula oku.
- Ugxininisa ukunakekelwa kokukhusela. I-Trumpcare ishintsha ezinye zezi.
- Iphucula indlela ukunakekelwa kwempilo ngokwayo. I-Trumpcare ayitshintshi le nto.
Izicwangciso ezintathu zakwa-Obamacare zithetha ukuba abantu abaninzi banokufumana unyango ngaphambi kokuba badinga ukunakekelwa kwegumbi lexakeka.
Kutheni le nto ibaluleke kangaka? Umhla esibhedlele ubiza phakathi kwe-$ 2,000 ukuya kwii-20,000 zamawaka. Uninzi lwabantu lucinga ukuba i-inshurensi yabo ihlawulela uninzi lwale. Abanye bengazilungele ukuhlawula imali ephezulu. Kodwa ngaphambi kokuba i-ACA, ibuye ihlaselwe enye ibhilikhwe. Abaninzi bafumanisa ukuba izicwangciso zabo ziphezulu. Babenomthwalo kwiindleko ezingaphezulu kwelo. Esi sizathu esenza ukuba unyango lwezempilo lube yiNombolo 1 yokubangela ukuchithwa .
Emva kokuba isigulane sichaza i-bankruptcy, isibhedlele kwakufuneka sichaze ilahleko nakweyiphi na inyango engahlawulwanga. Ukwenza inzuzo, badlulisela le ntlawulo kumntu wonke.
U-Obamacare unciphise inani lokuchithwa kwe-bankruptcy. Ngo-2010, abantu abayizigidi eziyi-1.5 bafaka. Oku kwawa ku-770,846 ngo-2016. Ii-ACA zinyanzele iinkampani zomshuwalense ukuba zigubungele zonke iindleko ngokuphelisa umda wonyaka kunye nobomi.
Oko
Isicwangciso se-Obamacare sisebenzela ukunciphisa ukwanda kweendleko zonyango. Phakathi kuka-1990 no-2008, imali yokusetyenziswa kwempilo yaphakama ngama-7.2 ekhulwini ngonyaka. Emva kokutshintshisana kwavulwa ngo-2014, ukuchitha imali kwiinkathalo zempilo kwandipha ngokukhawuleza. Kwakhula ama-5.3 ekhulwini ngo-2014 kunye nama-5.8 ekhulwini ngo-2015.
Esi sizathu esinye sokuba i-ACA ikwazi ukunciphisa ukulahleka kwee-143 ezigidigidi zeebhiliyoni ngaphezu kweminyaka eyi-10 yokuqala. Ukongeza kokunciphisa iindleko zonyango. Kwakhona kwatshintsha iindleko zenkcitho kubaboneleli bezempilo kunye neenkampani zoshishino. Ekugqibeleni kuncinci, kwaphakamisa iintlawulo kulabo abafumana ubuncinane i-$ 200,000 ngonyaka. Ezi ntlawulo ziya kuchithwa phantsi kweTrondcare. Yingakho ukuchithwa kwe-Obamacare kuya kwandisa ityala.
Yenza i-Ininshurensi enganakunciphisa
I-ACA inikeza iikhredithi zemali yerhafu kwinqanaba eliphakathi (ngaphantsi kwama-400 ekhulwini kwinqanaba lehlwempu). Iyanciphisa iindleko ze-pocket e-$ 7,150 kwisicwangciso ngasinye kunye ne-14,300 yezigidi kwisicwangciso seentsapho ngo-2017. Senza i-Medicaid ibe ngama-138 ekhulwini kwinqanaba lehlwempu kwaye libonelela ngolu hlobo kubantu abadala abangenabantwana okokuqala. I-Trumpcare iphelisa ukwandiswa ngo-2020.
Ngo-2014, amazwe ayadingeka ukuba amise ukutshintshiselwa kwe-inshorensi okanye asebenzise utshintshiselwano loorhulumente karhulumente ukwenzela ukuba kube lula ukuthenga izicwangciso ze-inshorensi.
Ungayisebenzisa ukuthelekisa amaxabiso kunye nokuthenga i-inshorensi ye-intanethi. Ungakuqhathanisa oogqirha, izibhedlele kunye nabanye ababoneleli kwingingqi yakho. Banikeza nokubonelela ubuso nobuso okanye nomnxeba uncedo ekufakeni isicelo se-inshorensi. Qiniseka ukuba uyazi indlela yokufumana i-Obamacare . Unyaka ngamnye, ixesha lokubhalisa liqala ngoNovemba 1 .
Ngo-2010, abazali bavunyelwe ukongeza abantwana babo ukuya kuma-26 kwizicwangciso zabo. Oku kunciphisa iindleko kubo bonke abantu ngokufaka ii-premiums ezivela kubantu abaphila kakuhle kwimali yenkampani ye-inshorensi. I-Trumpcare yagcina le nto ibonakalisiweyo.
I-ACA iyakususa i-Medicare Part D " umgodi wenkxaso " ngo-2020. Le nzuzo yaqulunqwa ngokuhamba kwexesha . Yanikezela abantu abadala ithuba lokunciphisa izidakamizwa zamachiza (iipesenti ezingama-42 kwi-generic) ngo-2016. Le mali inyuka ide ihlawule kuphela i-25 ekhulwini ngo-2010.
Amashishini anabasebenzi abangaphezu kwama-50 kufuneka anike i-inshurensi yempilo. Amashishini amancinci athabatha inkokhelo yentela engamaphesenti angama-35 egalelo labo kwi-inshorensi yempilo yabasebenzi. Iingeniso zifumana i-25 yeepesenti zemali. Abasebenzi bafumana isishwankathelo esifanayo, kunye nesaziso sokuqala kwangama-60 ukuba kukho nayiphi na inguqu kwi-coverage yabo.
Izicwangciso zeemarike ezincinci kufuneka zifumane iingeniso zempilo ezibalulekileyo kunye neentengo ezincinci (ekuqaleni kwe-$ 2,000 ngamnye, i-4 000 yeentsapho ze-$ 000). Kodwa kumntu ngamnye, i- Obamacare iya kuba neendleko ezahlukeneyo .
Gxi ninisa u Thintelo
I-ACA iyanciphisa iindleko ngokufuna zonke izicwangciso ze-inshorensi zijongene nezibonelelo zezempilo ezibalulekileyo ezi-10 . Ininzi yalo yinkathalo yokukhusela ekufuneka inikwe ngaphandle kweendleko. Ezi zibandakanya ukutyelela ngokufanelekileyo kwamabhinqa, ukuhlolwa kobundlobongela basekhaya kunye nokuphathwa kwezifo ezingapheliyo. Ikwabandakanya iimvavanyo zebhanki ukuxilonga izifo, kubandakanywa iimmogram kunye nee-colonoscopies. Ukongezelela, ukunakekelwa kwabazali kunye nosana olusandul 'umntwana, kunye nokunakekelwa kwamazinyo kunye nombono wabantwana kukhululekile. Oomama bafumana ixesha elivela emsebenzini kunye negumbi labucala ukuba banake abantwana babo / ubisi olucacileyo. Ukunyamekela ukukhusela kunciphisa iindleko ngokuchonga nokuphathwa kwezifo ngaphambi kokuba zibe ziziganeko.
Oku kubandakanya unyango lwempilo yengqondo, umlutha kunye nezifo ezingapheliyo. Ezi zi gulane zinokuba zibiza kakhulu ukunyanga, ke kutheni iinkampani ze-inshorensi zizama ukuphepha ukukhawuleza. Ukuba ayishiywanga engaphendulwanga, abaninzi banokuphela bengenamakhaya okanye entolongweni, ebiza uorhulumente ngaphezulu. Ngenxa yokuba ibiza kakhulu, le nyango iya kunqunyulwa phantsi kweTrondcare.
I-ACA iquka iinkonzo kunye nezixhobo zokunceda abantu abanokulimala, ukukhubazeka okanye izimo ezingapheliyo. Iquka izibonelelo ezininzi zeziyobisi. Ngokuqinisekileyo, ukugcinwa kwe-inshorensi yendabuko, njengegumbi lexakeka, ukunyamekela izibhedlele kunye nokunyamekela, kuqukwa kwakhona.
I-Trumpcare ivumela amazwe ukuba akhethe iinjongo eziza kubhalwa. Izicwangciso ze-inshorensi zempilo zonyango zivunyelwe ukuba zikhethe naziphi na izicwangciso zelizwe. Uninzi lwezicwangciso zenkampani ziza kufezeka kwilizwe kunye neyona ncinane. Oko kuthetha ukuba iTumpcare iya kunciphisa ukukhutshwa komntu wonke, kungekhona nje ezo zicwangciso ze-Obamacare.
Enye indlela iAACA inikeza umnatha wokhuseleko ngokukuphelisa ixesha lokuphila kunye nemigangatho yonyaka. Oku kunceda abo abaneengxaki ezingapheliyo bafumane i-inshurensi eyaneleyo yokukhusela unyango. Le ntlawulo yokukhusela ibaluleke kakhulu kwiimvelo kunye nezingane ezineengxaki zentliziyo okanye umhlaza. Oku kuya kususwa.
I-Obamacare ivimbela iinkampani zomshuwalense ukuba zikhanyele umgaqo-nkqubo ngenxa yokuba unayo, okanye ufumana, imeko yempilo. Oku kwaziwa njengemeko esele ikhona, kwaye igcinwe izigidi ukuba zifumaneke. Iinkampani azikwazi ukuyeka ukufikelela kwakho ngenxa yokuba wenze iphosakelo kwisicelo sakho, okanye ngenxa yokuba ungene kwisilingo seklinikhi ngomhlaza okanye esinye isifo esisongela ubomi. Izicwangciso azikwazi ukwenza ulinde ngaphezu kweentsuku ezingamashumi asibhozo ngaphambi kokuqala koqaphelo. Unokwenza isibheno sokutshatyalaliswa kwesibango okanye ezinye izigqibo ze-inshurensi yezempilo ngokusebenzisa umlawuli welizwe. I-Trumpcare igcine le ngxenye ye-ACA.
I-ACA idinga ukuba iinkampani ze-inshorensi zichithe iipesenti ezingama-85 zazo zonke i-dolum ye-premium kumalungiselelo amakhulu omqeshi kwiinkonzo zonyango kunye nokuphuculwa komgangatho. Oku kwehla kuma-80 ekhulwini kwizicwangciso ezithengiswa ngabanye kunye nabaqeshi abancinci. Ukuba abaqinisekisi abahlangabezane neenjongo, kuba iindleko zabo zokuphatha okanye inzuzo ziphezulu kakhulu, kufuneka bathumele izibuyiso kumthengi. Usenokuba ufumene kakade, kwaye awukwazi ukuba yinto ngenxa ye-Obamacare. Le nxalenye yomthetho mhlawumbi ayiyi kuchithwa.
I-ACA ihlawulisa iBhunga likaZwelonke lokuLungisa ukulungelelanisa zonke iinzame zempilo zentsebenziswano ukuze kukhuthazwe indlela yokuphila engenakho iziyobisi. Yongeza iibhiliyoni ezili-15 kwi-Prevention and Public Health Fund ukutyalomali kwiinkqubo zempilo zikarhulumente ezibonakalisiweyo, ukuyeka ukutshaya ukulwa nokunyanya. Le nxalenye yomthetho ayiyi kutshintshwa, kodwa imali iya kunqunyulwa.
Ukuphucula indlela yokuNakekelwa kweMpilo ngokwayo
I-ACA igunyazisile i-Medicare ukutshintsha indlela ihlawula ngayo oogqirha nezibhedlele. Yayisetyenziswa ukuhlawula zonke iimvavanyo kunye nenkqubo oyifumanayo. Kuya kutshintshela kwinkqubo esekelwe iintlawulo malunga nendlela oyifumana ngayo. Okubangela izibhedlele, oogqirha kunye nabasemasimini ukuba basebenze kunye ngendlela epheleleyo. Kuze kube ngoku, ezi zibizwa ngokuba yiNkcazo yokuNakekela iAxanduva zibonise iziphumo ezibalulekileyo. I-ACA ikhuthaza ezinye zazo. Ekubeni oku ngaphantsi kwe-Medicare, ayiyi kuchithwa yiTrondcare.
Mhlawumbi ucinga ukuba ugqirha wakho wokunyamekela usuqalile ukulungelelanisa unonophelo oluthabathela ekutyeleleni esibhedlele, iingcali kunye neemvavanyo. Kodwa inkqubo yangaphambili ayizange ihlawulwe ngaphezulu ukwenza oko. Oogqirha namhlanje kufuneka bagxile kwimisebenzi eyenza ingeniso. Oko kuthetha ukuba nezenzo ezingcono azikwazi ukulungelelanisa ukunakekelwa.
I-ACA isebenzisana nomthetho ongaphambili ukuqinisekisa ukuba zonke iirekhodi zonyango zifakwa kwiikhomputha ukwenzela ukuba zihanjiswe ngekhompyutha. Mhlawumbi wacinga ukuba kwenzeka kwakhona, kodwa iirekhodi zezokwelapha zigcinwe ngokuqhelekileyo kwiirekhodi zamaphepha. Oku kuthetha ukuba iziphumo zokuvavanya kufuneka zithunyelwe ngeposi okanye zifeksi. I-ACA isebenza kwinkqubo egcina irekhodi yekhompyutha. Oku kuya kubavumela bonke oogqirha bakho ukuba babelane ngolwazi lwabo kunye nokunyango kunye nolwazi lwakho lokubhala kunye nentlawulo. Emva kokuphunyezwa, iirekhodi zekhompyutha ziza kunciphisa iindleko zonyango lwempilo.
Le yinguqu enkulu. Nalu uluhlu lwezinye izibonelelo.
- I-ACA idinga amazwe ukuba aqiniseke ukuba iintlawulo zeMedicaid zifumana oogqirha azingekho ngaphantsi kwamaxabiso okuhlawula amayeza. Ixhasa imali yokubhalwa kwemali kunye nokubolekwa kwemali mboleko ukuba kuphindwe kabini inani labanikezeli benkonzo yempilo kwiminyaka emihlanu. Yongeza inkxaso-mali ekutsaleni oogqirha kuma-68 ekhulwini emiphandleni engalondoloziwe kwimimandla yasemaphandleni.
- I-Obamacare iseka iZiko elitsha leMida neMedicaid Innovation ukudala isicwangciso sikazwelonke sokuphucula unyango lwempilo kunye neendleko eziphantsi. Yakha iBhodi eNgcebiso yokuTyala ngokuzimeleyo ukucebisa iCongress ngendlela yokwandisa ubomi be-Medicare Trust Fund. IBhodi iya kujolisa inkunkuma kwinkqubo. Kuya kuphakamisa iindlela zokunciphisa iindleko, ukuphucula iziphumo zempilo nokwandisa ukufikelela ekunakekeleni eliphezulu.
- I-ACA ijolise ulwalamano lobugqirha / umthengisi. Inika i-$ 250 yezigidi ukuba ihlasele phantsi kwinqanaba le-inshurensi eyingozi. Kwakudinga ukuhlolwa kweemvelaphi zabo bonke abasebenzi basekhaya labahlengikazi, ukukhusela ukusetyenziswa kakubi kwabantu abadala. I-Obamacare yenza i-Option Community Choice Option. Ikhuthaza amazwe ukuba anikeze iinkonzo zasekhaya nakwiindawo ezisemgangathweni kumntu onzima ngokwenyama ngokusebenzisa iMedicaid. Oko kuthoba iindleko ngokuzigcina eziphuma emakhaya asebekhulile.
Kukho iingxaki ezili-10 ze-Obamacare .
Olungakumbi kwi-Obamacare
Iinkonzo kunye neNgcaciso | Ingaba isebenza kanjani? | I-Obamacare Isishwankathelo | Yintoni kwiBill Bill
Ukuqinisekisa ukuba ufumana zonke iinzuzo zakho ze-Obamacare, funda incwadi yam Ultimate Obamacare Handbook (2015-2016) .