Yayisayinwe nini kuMthetho?
Lo Mthetho, owaziwa ngokuba yi- Obamacare , usayinwe kumthetho ngoMatshi 3, 2010. Wadlulelwa kwiminyaka emine. Wonke ummi wayefuneka ukuba abe ne-inshorensi yempilo ngo-Matshi 31, 2014, okanye ajongane nomrhumo werhafu yengeniso.
Wonke umntu unokukhetha indlela yokufumana ingxelo. Ukuba sele sele isicwangciso, ngaba ngabaqeshi babo, iMedicaid, Medicare, okanye ngasese, bayayigcina. Abo bangenakufumana i-inshorensi yempilo baneenketho ezongezelelweyo. Baya kuthenga ityhuwalense yezempilo kwaye mhlawumbi bafumane inkxaso . Basenokufaneleka phantsi kwezikhokelo zeMedare. Abantu abaninzi bafumene abafanelekayo ukukhululwa . Fumana i- Obamacare Ingakanani Iindleko?
Injongo
Injongo ye-ACA ephezulu kukunciphisa iindleko zikaRhulumente kwiinkonzo zempilo. Ngo-2009, i-Medicare neMedicaid ixabisa i-$ 676 yezigidigidi, okanye i-10.4 pesenti yohlahlo lwabiwo-mali. Ezi ndleko ziza kuphinda ziphindwe kabini ngo-2020, ukuya kuma-20 ekhulwini lwabiwo-mali. Zombini iinkqubo ziyinxalenye yemali efunekayo engenakunqunyulwa ngaphandle koMthetho woqobo weNgqungquthela.
Indlela yodwa yokunciphisa imali yokunakekelwa kwempilo yonyango kukunciphisa iindleko zempilo yononophelo lwesizwe. Indlela efanelekileyo yokwenza oko yanciphisa inani lokutyelela esibhedlele.
Ngo-2011, omnye kwabafundi abahlanu basebenzisa igumbi lexakeka. Leyo yonyango ephezulu kakhulu. Ingxenye yesithathu yazo zonke iindleko zonyango eMelika. Ukuba oko kuya kuncitshiswa, iindleko zonyango kunye nemali yokunakekelwa kwempilo yonyango, iya kugxotha. Ukufumana okungakumbi, jonga iindleko zokuNakekelwa kweMpilo yiNombolo 1 yeNkcazo yokuBhankanya .
(Umthombo: "Iphepha leNkcazo," iZiko leSizwe leeNkcukacha zezeMpilo, ngoJulayi 2014; "Iphepha leNkcazo," iZiko leSizwe leeNkcukacha zezeMpilo, ngoFebruwari 2014.)
I-ACA ifuna ukunciphisa iindwendwe eziphuthumayo kwikhenketho. Yingakho kufuna ukuba wonke umntu abe ne-inshurensi. Baya kufuna unyango kwizifo zabo ngaphambi kokuba kube yingxaki. Inkathalo yokukhusela yindlela efanelekileyo yokunciphisa iindleko zeMedicaid zesizwe. Le nkqubo ibuyisela izibhedlele kuzo zonke iinkonzo zonyango ezingxamisekileyo. Kuyinto engabizi ukuhlawula ukunyamekela kokukhusela kunokuba uhambo oluya esibhedlele. Ngaphezulu, jonga ukuba Kutheni ukunakekelwa koKhuseleko kuya kunceda iindleko zonyango kwiMelika .
Iindleko
Ngaphezulu kweminyaka eyi-10 yokuqala, i-ACA idibanisa i-$ 940 yezigidigidi kwi- budget yemali. Uhlolwe yi-Ofisi ye-Budget ye-Congressional yathi uMthetho ojongene noNonophelo olungabonakaliyo uya kunciphisa ubuninzi bebhajethi nge-143 biliyoni kule minyaka eli-10 efanayo. Njani? UMthetho unqanda iindleko zawo ngokuthi:
- Ukuhlawula iintlawulo kwizibhedlele.
- Ukwenyuka kweerhafu kwiirhafu kwiimali eziphezulu ezingenayo.
- Ukuvavanya izigwebo kubaqeshi abangabanikeli, kunye nabantu abangathathi, inshorensi yezempilo.
- Ukuvavanya irhafu kwimisebenzi eyahlukeneyo yempilo.
- Ukunciphisa ngaphezulu ngokuhlanganisa inkqubo yokubolekisa imfundo ephakamileyo kunye nenkqubo ye- Pell Grant .
Indlela i-ACA yatshintshe ngayo ukunakekelwa kwezempilo
2010. Amashishini amancinci athola iikritshi zerhafu ukufihla kuma-35 eepesenti yazo zonke iintlawulo zeempesimenti zabasebenzi. Oku kwanda ukuya kuma-50 ekhulwini ngo-2014
Iinkonzo zokunyusela ngaphakathi zihlolwe i-10 yepesenti zerhafu.
Inkqubo ye-inshurensi yokuhlaziya iindleko zezempilo ezineminyaka engama-55 ukuya ku-64 ubudala abaphoqelelwe ukuba bangene emhlalaphantsi .
Abaxhamli be-Medicare abawela kwi-Medicare Part D Isigulana seMichiza "don hole hole" bafumana isaphulelo samaRandi ezingama-250. Bafumana isaphulelo sama-50 ekhulwini kwiimpawu zegama lonyango ngo-2011, kwaye umgodi we-donut upheliswa ngo-2020.
Abantwana bavunyelwe ukuba bahlale kwi-inshorensi yempilo yabo yabazali kude kube ngu-26.
Izicwangciso ezizimeleyo ezidalwe emva ko-2010 zafuneka ukuba zikhusele iinkonzo zokukhusela ngaphandle kweentlawulo zentsebenziswano, kwaye ziyakhululwa kwii-deductibles.
Abathengi abafake izicelo kwizicwangciso ezintsha banokufikelela kwinkqubo yokubhenela kwangaphandle ukuba ukukhutshwa kwesikhokelo.
Iinkampani ze-inshurensi zazingavunyelwe ukuyeka ukukhawuleza ukuba umntu ugule ngokwenene. Akwazanga ukudala imida yokufihla ubomi. Babenakukwazi ukukhanyela ukuhanjiswa kubantwana abaneemeko zangaphambili . Okufanayo kufakelwe kubantu abadala ngo-2014. Kuze kube ngoko, abantu abadala abaneemeko zangaphambili eziye zachithwa ukuba bafumane ukufikelela kwiinkonzo zomshuwalense wezexeshana zempilo kuze kube yilapho kuthengiswa ukutshintshana.
2011. Iinkonzo zokukhusela i-Medicare-ezikhutshwe nge-Medicare zaxolelwa kwii-deductibles kwaye i-pay-co-pay wasuswa.
Iinkampani zomshuwalense kufuneka ziqinisekise ukuba zichithe ubuncinane i-80 ekhulwini zeentlawulo zeprayimenti kwiinkonzo zonyango, kunokuba zizinto ezifana nokuthengiswa kunye nemivuzo yolawulo. Abo babengazange bafune ukubonelela ngezaphulelo kumnini-nkqubo.
Amazwe ayexhaswa ngemali ukuba afune iinkampani ze-inshorensi zempilo ukuba zingenise ukulungelelaniswa kuzo zonke izantya.
Iimali zandisiwe ukwenzela ukwandisa inani loogqirha kunye nabongikazi, kunye namanye amaziko empilo asekuhlaleni. Kwanele ukuphindwa kabini inani lezigulana abanokuziphatha kwiminyaka emihlanu ezayo.
2013. Iindleko zonyango kufuneka zibe yi-10 ekhulwini yengeniso ngaphambi kokuba zichithwe ngabantu abangaphantsi kweminyaka engama-65. Abavelisi kunye nabangenisa izixhobo zonyango bahlawula i-2.3 yepesenti yentlawulo. Imali ye-Federal yonyuswa ukuba ivumele iMedicaid ukuba inikele ngeenkonzo zokukhusela ezikhululekile, kunye nokwandisa i-CHIP kwiminyaka emibini eyongezelelweyo. Urhulumente wePhondo uxhaswa ngemali ukuhlawula amayeza angama-100 ekhulwini lemali ye-Medicare. I-Medicare iqalile inkqubo yovavanyo ukukhuthaza izibhedlele ukuba zinike iinkonzo ngaphambi kokuba zithumele ukuhlawula. (Umthombo: Ezempilo.gov.gov)
Iirhafu ezongezelelweyo zavanywa kwi-1 yezigidi zabantu abenza ngaphezulu kwama-200,000, kunye nezigidi ezi-4 ezizibini ezithandana ngokubambisana ezenza ngaphezulu kwama-250,000. Ngokukodwa, bahlawule ipesenti ezingama-2,35 (ukusuka kwi-1,45 pesenti) Iirhafu zonyango kwimali engenayo ngaphezu komyinge, kwaye i-3.8 pesenti Iirhafu zonyango kwi-less (a) izabelo, inzuzo eyinkunzi , irente kunye neerhafu (b) ingeniso engaphezulu kwembombo . Ngaphezulu, khangela i- Obamacare Taxes .
Imindeni kwiindawo ezininzi zingaqala ukuthenga kwiintengiso ze- inshurensi yempilo ukususela ngo-Oktobha 1, 2013. Amashishini anabasebenzi abangaphantsi kwama-50 aqale ngoNovemba.
2014. I- inshorensi yempilo yathengiweyo ngokuthengwa kwemali. Ukulungelelaniswa kweMedicaid kwandiswe ukuba kubandakanye abo abaneemali ukuya kuma-133 ekhulwini kwinqanaba lika-Ulwaphulelo lobuNtshatsheli (loo nto i-$ 31,720.50 yeentsapho ezine). Uncediso olutsha lwafumaneka kulabo abaneemali ukuya kuma-400 ekhulwini lobuhlwempu (i-$ 95,400 kwiintsapho ezine). Fumanisa Okuninzi .
Abo bangathenge i-inshorensi bavavanywa irhafu. Ubuncinane babengu-$ 95 kumntu omdala kunye no-47.50 ngemali ngamnye ngomntwana, abanjwe kwi $ 285 nganye. Ubuninzi beepesenti e-1 yemali engenayo ehlaziywayo (AGI), ekhutshwe ngeendleko zokuthenga isicwangciso se- inshurensi yezempilo "yethusi".
2016. Irhafu kulabo abangathengi i-inshorensi yenyuka yaba ngu-695 $ ngamnye kumntu omdala. I $ 347.50 ngomntwana kwaye ifakwe kwi-$ 2,085 kwintsapho. Ngaphezulu, khangela i- Obamacare Taxes .
Amashishini anama-100+ abasebenzi kufuneka ahlawule i-$ 2,000 ngabasebenzi (ngaphandle kweyokuqala 30) ukuba awaniki i-inshurensi yezempilo. Oku kusebenza kumashishini anabasebenzi abangama-50-99 ngo-2016. Irhafu iyasebenza ukuba ngaba omnye umqeshwa omnye unokufumana inzuzo efanayo kunye ne-premium yeendleko ezantsi. (Umthombo: UNondyebo we-US, iMimiselo yokugqibela esebenzayo uMxanduva loXanduva lwabaqeshi kunye neSplace Market Market)
Ngaba i-ACA kufuneka iphindwe kwakhona?
Kukho ukuchasana kakhulu kwi-ACA ngaphambili, ngexesha nangemva kokuba kube ngumthetho. Ama-Lawsuits athi isigunyaziso sokuba bonke abemi baseUnited States bathenge i-inshorensi yokunakekelwa kwezempilo kwi-private carrier, okanye ukuhlawula isohlwayo, kwakungekho mthethweni. Inkundla Ephakamileyo yathetha ukuba yayingumgaqo-siseko, phantsi kwelungelo leCongress lokumisela irhafu.
INdlu yabameli ivotelwe ukuchithwa komthetho amaxesha amaninzi. Ngo-2013, bavala u rhu lumente kwaye besongela ukuba bangagqibekanga kwityala ukuba bekungahlawulwanga . Kukho inkcaso enkulu, ngokwenene, ukuba iipesenti ezingama-22 zamaMerika zicinga ukuba umthetho usuphelile.