Asterisks omwe amatsutsana ndi chiletso cha moyo wawo ndi makapu opindula pachaka
Mmodzi mwa ogulitsa malonda mu Affordable Care Act ndiloletsedwa patsiku ndi phindu la moyo wosatha. Maximums maxima a moyo wosatha salinso ololedwa konse, ngakhale pazinthu zazikulu. Chaka ndi chaka - koma osati moyo - malire opindulitsa angagwiritsebe ntchito kwa mapulani a anthu akuluakulu, koma osati magawo a gulu.
Izi zikutanthauza kuti ogula sali pangozi yodzipeza okha akusowa chithandizo cha khansa ndi ndondomeko yaumoyo yomwe ili ndi ndalama zokwana madola 300,000 za moyo wathanzi.
Ndipo anthu omwe ali ndi matenda ovuta komanso ovuta kwambiri sangakhalenso pangozi yoti adzalandire ndondomeko yawo pamene ndalama zawo zonse zamalonda zikufika padera.
Koma pali zolemba zingapo zomwe ndi zofunika kumvetsa.
Zofunikira zathanzi
Pamene ACA inalembedwa, olemba malamulo adatsimikiza kuti panali mitundu khumi ya chisamaliro chomwe chinkaonedwa kuti ndi chofunikira. Iwo amawatcha iwo mapindu othandizira azaumoyo, ndipo gulu lonse lirilonse likukonzekera tsiku lothandizira la Januwale 2014 kapena pambuyo pake liyenera kuphatikizapo kulumikizidwa kwa iwo (mano a ana ndi imodzi mwa mapindu othandizira azaumoyo, koma malamulo ndi osiyana ndi chithandizo cha mano a ana).
Kuletsedwa kwa miyezi yonse yopindulitsa ya moyo ndi ya pachaka kumagwira ntchito pazinthu zofunika zathanzi. N'zoona kuti pafupifupi zonse zofunika kusamalira mankhwala zimakhala pansi pa ambulera yofunikira kwambiri ya thanzi, chifukwa zina mwazigawozi ndizochepa (mwachitsanzo, kuchipatala ndi chimodzi mwa zinthu zofunika kwambiri zaumoyo, ndipo chisamaliro cha kuchipatala ndi china).
Koma monga chitsanzo, mautumiki akuluakulu a mano samaganiziridwa kuti ndizofunikira phindu la thanzi pansi pa ACA. Zili zosavuta kupeza dongosolo laumoyo lomwe limaphatikizapo kulumikizidwa kwa mano akuluakulu, koma alipo. Komabe, ndondomeko zoterezi zingapange chithunzithunzi cha phindu la pachaka komanso la moyo kwa akuluakulu a mano akuluakulu, popeza sizinthu zofunikira zathanzi.
Nkhani za intaneti
Kuletsedwa kwa ACA pa moyo wawo ndi malire a pachaka amapindula kuntchito zonse zopezeka pa intaneti komanso kunja. Koma malingaliro azaumoyo sakufunika kuti asamalire chisamaliro chatsopano. Ngati atero, sangapereke malipiro a dola pachaka kapena phindu lililonse.
HMO zambiri zimangotenga chisamaliro chomwe amalandira kuchokera kwa anthu omwe ali mu-network, kupatula ngati mwadzidzidzi amapezeka kunja kwa malo ogwira ntchito, kapena malo omwe ali pafupi ndi malo osowa mwachangu si mbali ya intaneti ya HMO. Koma chifukwa cha chisamaliro chosayembekezereka chomwe chinaperekedwa kunja kwa makina a HMO, wodwalayo nthawi zambiri amakhala ndi udindo pa bili yonseyo.
PPO ikukonzekera kuti ikhale yotsekemera, koma ndi malire apamwamba kwambiri omwe amadwala komanso ochepa kwambiri. Chikwama cha ACA cha $ 6,850 pa ndalama zowonongeka mu 2016 chimangowonjezera ku chisamaliro cha intaneti; odwala omwe amasankha kutuluka kunja kwa intaneti kapena kugwiritsa ntchito osagwiritsa ntchito makina osagwiritsa ntchito makina akhoza kuthetsa ndalama zowonjezera. Zimakhalanso zowonjezereka kuti PPO ikukonzekera kukhala ndi chidziwitso chopanda malire kuchipatala chomwe chinalandidwa kunja kwa pulaneti. Koma ngati ndondomekoyi ikukhudzana ndi chisamaliro chofunikira cha thanzi, sizingapangitse kuti phindu la moyo kapena pachaka likhale lopitirira.
Dziwani kuti nkofunika kumvetsetsa kusiyana pakati pa makapu opindula ndi makapu osatuluka; Phukusi lopindulitsa ndilo ndalama zochuluka zomwe kampani ya inshuwalansi idzalipira, ndipo ndicho chimene sichiloledwanso. Phukusi lachikwama ndilofunika kwambiri kuti wodwala ayenera kulipira patsiku lapatsidwa, mosasamala kanthu za momwe akunenera milandu yake yonse; Ndizo zomwe zasankhidwa pa $ 6,850 mu 2016 kuti azisamalidwa pafupipafupi zothandiza zaumoyo (chipewacho chidzakhala madola 7,150 mu 2017; dziwani kuti izi ndizopatsidwa mwayi - mapulani akhoza kukhala ndi malire ochepa kwambiri kuposa awa).
Pakhoza kukhala malire, iwo sangakhoze basi kukhala madola
Kuletsedwa kwa ACA pa malire a moyo ndi phindu la pachaka la phindu la thanzi labwino kumagwirizana ndi malire omwe akunenedwa pamadola.
Kotero malingaliro azaumoyo sangathe kukhala ndi ndalama zokwana madola 3,000,000 za moyo, mwachitsanzo, kapena ndalama zokwana $ 500,000 pachaka.
Koma ndondomeko zathanzi zikhozabe_ndipo_izoyika malire ena pa chisamaliro chomwe iwo angachiphimbe. Mwachitsanzo, dongosolo lingathe kunena kuti lidzapereka maulendo 20 pafupipafupi pa chaka, kapena masiku 60 a unamwino wodziwa bwino pachaka. Ngakhale pamene chisamaliro chomwe chili pamunsichi chikugwera pansi pa chimodzi mwazofunikira zothandiza zaumoyo, ogwira ntchito akhoza kuchepetsa kufalitsa. Iwo sangakhoze basi kuchita izo ndi malire omwe akunenedwa mu madola. Kotero iwo sangakhoze kunena kuti iwe ukhoza kukhala ndi mankhwala okwana madola 2,000 pachaka pachaka, ngakhale kuti angakhoze kunena kuti iwe ukhoza kukafika 20 maulendo ophimbidwa kwa wodwala thupi pa chaka.
Zotsatira:
Federal Register, PPACA - HHS Chidziwitso cha Kupindula ndi Malipiro A Zowonjezera za 2017. Zapezeka 5/14/2016.
Yarbrough, Cassandra, MPP; Vujicic, Marko, PhD ;; Nasseh, Kamyar, PhD., Health Policy Institute ndi American Dental Association, Zowonjezereka Zowonjezera Madokotala mu 2015 Za Inshuwalansi Zaumoyo M'misika. Inapezeka pa 1/19/2016.