Pokhudzana ndi zambiri zokhudza Care Affordable Care Act, omwe amadziwikanso kuti Obamacare , nthawi zina zimakhala zovuta kusiyanitsa zoona ndi zabodza. Kaiser Family Foundation posachedwapa inanena kuti pafupi 14 peresenti ya anthu a ku America amaona kuti malo ochezera a pa Intaneti monga Facebook ndi Twitter kukhala malo okhulupilika a ACA.
Koma chidziwitso chokhudza ACA chimachitika nthawi zonse pazinthu zokhudzana ndi chitukuko-ndipo nthawizina chimabweretsa mafunso omwe amachititsa anthu kudabwa. Ngati mutayamba kulemba "Kodi Congress ex ..." mu Google, choyamba chodzidzimutsa chimathetsa funsoli ngati "kuchotsedwa ku Obamacare?" Ichi ndi funso lomwe anthu ambiri ali nalo, mosakayikira mbali imodzi chifukwa cha chiwerengero chochuluka cha nkhaniyi zomwe zafalitsidwa pazolumikizana pazaka zochepa zapitazo.
Obamacare Kwenikweni Amafunikanso Kwambiri Ku Congress
Choyamba, kuti tifotokoze, Congress siyikuchokera ku Obamacare.
Koma tiyeni tiwone momwe nkhaniyi inayambira, ndipo malamulo-omwe ali ovuta kwambiri kuposa momwe Obamacare akugwirira ntchito kwa tonsefe-omwe amagwiritsidwa ntchito ku Congress.
Kubwerera pamene ACA inali kukambirana pa Congress mu 2009, panali mafunso ngati olemba malamulo akutsutsa kusintha kwa ACA zosiyanasiyana-kuphatikizapo kusinthanitsa kwa inshuwalansi ya umoyo-ku boma la America popanda kuthandizira pa inshuwalansi yawo ya umoyo.
Ichi chinali chisamaliro chosamvetsetseka, chifukwa, monga ambiri a ku America, mamembala a Congress anali ndi inshuwalansi yothandizira inshuwalansi, kotero iwo sanali anthu omwe mabungwe a inshuwalansi ya umoyo adalengedwera. Koma ACA inachititsa kuti phokoso landale likhale lopanda pake, ndipo zinthu zina zoterezi zinataya phokoso, ndipo mphekeserayo inapitiriza kunena kuti Congress "inachokera" ku Obamacare.
Mbiri Yobwerera
Obamacare ndilo lamulo. Zimagwira ntchito pafupifupi onse a ku America, ndipo ndizowonjezereka kwambiri kusiyana ndi kusinthanitsa. Zimapereka mankhwala ambiri otetezera, ndipo zimaphatikizapo chithandizo chochulukitsa kuti phindu likhale lopanda ndalama kwa anthu a ku America omwe amapeza ndalama zochepa. Koma malinga ndi zomwe lamulo likufuna kwa munthu aliyense wa ku America, ndizomveka bwino: Anthu ayenera kusunga malipiro ochepa, kapena kulimbana ndi chilango cha msonkho (zina zoyenera zimagwiritsidwa ntchito kwa olemba ntchito ndi inshuwalansi za umoyo, koma zoyenera kuti munthu akhale nazo kufalitsa).
Kupanga zofunikira zochepa kumaphatikizapo ndondomeko zothandizidwa ndi ogwira ntchito, Medicaid , Medicare , Ndondomeko ya Inshuwalansi ya Ana (CHIP) , ndi malonda akuluakulu a zamalonda, kuphatikizapo omwe adagulidwa pogwiritsa ntchito kusinthanitsa kapena kusinthanitsa , komanso agwirizano ndi abambo ambiri . Palinso mitundu ina yowunikira yomwe imagwirizananso ndi zofunikira zowonjezera maambulera-makamaka, kufotokoza "kwenikweni" kudzagwira ntchito, koma zinthu monga inshuwalansi ya kanthawi kochepa, zopatsirana zoopsa, ndi mapulani ochepa omwe sali othandizira sizomwe zili zofunikira kwenikweni.
Popeza ambiri omwe sali achikulire Achimereka amapereka ntchito kudzera mwa abwana awo, sanafunikire kusintha chifukwa cha Affordable Care Act.
Malingana ngati akhala akupitiriza kukhala ndi inshuwaransi yothandizira, akutsatira malamulo.
Izi zikanakhala choncho kwa Congress, chifukwa idali pansi pa Federal Employee Health Benefits Program (FEHBP), yomwe imapereka chithandizo cha umoyo kwa ogwira ntchito ku federal.
Koma mu 2009, Senator Chuck Grassley (R, Iowa) adafuna kusintha kwa malamulo pamene akukangana, poyesa kuti Congress ikhale " yofunika kuti iwonongeke. tepi yofiira monga nzika iliyonse . "
Kumbukirani kuti ambiri a ku America safunika kugula malonda.
Zokambiranazo zinakonzedwa kuti zithandize anthu omwe amagula inshuwalansi ya umoyo wawo chifukwa sangathe kupeza ntchito ya abwana, komanso omwe sanalimbikitsidwe.
Anthu omwe ali ndi chithandizo cholimbikitsidwa ndi abwana (chomwe chinaphatikizapo Congress kumbuyo pamene Chithandizo cha Care Affordable chinali kukonzedwa) sichiyenera kuthana ndi kusinthanitsa nkomwe, ndipo palibe "tepi yofiira" yowonjezera kwa iwo pansi pa ACA, kupatula kuwona bokosi pamabwerero awo a msonkho omwe akunena kuti ali ndi inshuwalansi yathanzi chaka chonse (ngati mutagwira ntchito yaing'ono, bwana wanu angagule malingaliro kudzera muzitsulo zazing'ono (SHOP), mutero, mungathe kutsogoleredwa kuti mutenge Ndondomeko yanu. Koma bwana wanu akugula zowonjezereka ngati choncho, ndikupatseni ndalama zanu zapadera).
Grassley Amendment
Koma kusintha kwa Grassley kunapanga lamulo. Gawo 1312 (d) (3) (D) la Affordable Care Act limati:
(D) MEMBERS OF CONGRESS MUCHINYAMATA .- (i) ZOFUNIKA.-Ngakhale kuti pali lamulo lina lililonse, pambuyo patsiku lomveka bwino la ndondomekoyi, ndondomeko zokha zaumoyo zomwe boma la federal lingapereke kwa a Congress ndi a congressional staff ponena za ntchito yawo monga membala wa Congress kapena congressal staff adzakhala mapulani azaumoyo omwe ali
(I) adalengedwa pansi pa lamulo lino (kapena kusintha kwa lamuloli); kapena
(II) kuperekedwa kudzera mu Kusinthanitsa kokhazikitsidwa pansi pa lamulo lino (kapena kusintha kosinthidwa ndi lamulo lino).
Chotsatira chake, Congress ndi ogwira ntchito mu congressional akhala akugula malonda kudzera ku DC Health Link ya SHOP kusintha kuyambira 2014. DC Health Link ndi inshuwalansi ya umoyo ku District of Columbia.
Kusinthana kwa SHOP kunapangidwira olemba aang'ono kuti agwiritse ntchito, koma kusinthanitsa kwa DC kumatsegulira anthu a Congress ndi antchito awo, kuti azitsatira zomwe ACA amafuna kuti apeze chithandizo kudzera mwachindunji. Anthu a Congress ndi a congressional ogwira ntchito amawerengera zambiri za olembetsa a DC Health Link a SHOP.
Nanga Bwanji Zothandizira?
ACA imapereka ndalama zothandizira (msonkho wokhoma msonkho) kuthetsa mtengo wa malipiro kwa anthu amene amagula malonda awo pamsika. Koma m'masewero a SHOP, olemba ntchito amapereka ndalama zothandizira, pogwiritsa ntchito zopereka za abwana ku msonkhanowu.
Pamene zinthu zinkasokoneza kwambiri kuti mamembala a Congress adapindula kale ndi ndalama zokwana madola 5,000 kwa ogwira ntchito (kutanthauza, boma) zopereka zawo ku FEHBP ngati iwo atalembedwa okha, komanso ngati madola 10,000 ngati atalembedwa m'banja. Onani kuti izi ndizovomerezeka, ndipo zimakhala zogwirizana ndi ndalama za inshuwalansi zowonjezeredwa zomwe abwana amagwira ntchito m'malo mwa antchito.
Kusinthana kwa msika wogulitsa pamsika kudzathetsa mwayi wopeza ndalama zothandizira olemba ntchito, monga ACA imaletsa olemba ntchito kuti azilipira malonda awo kwa ogwira ntchito awo. Koma zikutanthauzanso kuti ambiri mwa anthuwa-kuphatikizapo mamembala onse a Congress ndi ambiri a ogwira ntchito-akanatha kupeza mwayi wothandizana nawo, popeza ndalama zothandizana nazo zimachokera ku ndalama, ndipo ndalama za Congressional zimakhala zapamwamba kwambiri kuti zisayenere chifukwa chothandizira pokhapokha ngati banja liri lalikulu kwambiri.
Sungani Zopereka Zogwira Ntchito, koma Lowani kudzera ku Exchange
Choncho, Office of Personnel Management (OPM), yomwe imayendetsa dziko la FEHBP, idalowamo. Iwo adagonjetsa mu 2013 kuti Congress ndi a Congressional athe kulembetsa ku bungwe la DC Health Link la SHOP ndipo akadatha kusunga ndalama zawo Kuphunzira.
Izi zikuoneka kuti zikutsutsana, ndi anthu ena akunena kuti Congress ndi ogwira ntchito zawo ayeneradi kusiya kupereka ndalama zawo kwa olemba ntchito za FEHBP ndikulembetsa ku mgwirizano wa msika, pokhapokha ngati angapeze ndalama zopezera ndalama. Tiyenera kukumbukira kuti Grassley mwiniwake adati mu 2013 kuti cholinga choyambirira cha chisinthiko chinali kulola Congress ndi ogwira ntchito kuti azipereka zopereka zomwe amapatsidwa ku inshuwalansi zawo za umoyo, ngakhale kuti akuyenera kulembetsa mwazochita . Grassley adatsutsa kuti kusinthako kunalibe kulembedwa pambuyo poti awatumize ku Senate Mtsogoleri Waukulu, Harry Reid (D, Nevada).
Chifukwa cha ulamuliro wa OPM, Congress ndi ogwira ntchito awo adakali ndi ntchito yothandizira awo ku inshuwalansi ya umoyo wawo, koma amapeza kufotokozera kudzera ku bungwe la DC Health Link SHOP. Ichi ndi chiyanjano chimene chikuyesera kukwaniritsa zofunikira za ACA, koma popanda kusokoneza Congress ndi antchito awo ponena za antchito omwe amapindula ndi ntchito zina zomwe zikufanana.
Zomwe zikuchitika panopa zinadza chifukwa cha chinenero cha ACA chomwecho chomwe chimatchulidwa makamaka za ubwino wa thanzi la Congress ndi antchito awo. Popanda chilankhulochi, pakanakhala palibe funso-Congress siyingagulepo kugulitsa, chifukwa inali ndi chithandizo chogwiritsidwa ntchito ndi abwana. Izi sizikutanthauza kuti iwo "sanamasulidwe" kuchokera ku Obamacare. Iwo adayenera kukhalabe ndi inshuwalansi yathandizira kapena kuti adzalandire chilango, monga wina aliyense wa ku America.
Kusinthana kunakhazikitsidwa kwa anthu omwe analibe chithandizo chogwiritsidwa ntchito ndi abwana (ndi mabungwe ang'onoang'ono omwe akufuna kugulira ntchito kwa antchito awo). Koma chifukwa cha Grassley Amendment ku ACA, Congress inkayenera kusintha kuchokera kuntchito zawo zothandizidwa ndi abwana ku FEHBP, ndipo m'malo mwake muzisintha kuti mukhale nawo ku DC Health Link ya SHOP. Ili ndilo lamulo limene silinayidwe pa gulu lina lililonse la antchito pansi pa ACA, kuphatikizapo antchito ena a boma omwe amagwiritsa ntchito FEHBP.
Sikuti Congress siyiyikanso ku ACA, lamulo lidawathandiza kuti likhale ndi gawo limodzi la anthu (mwachitsanzo, iwo omwe adapangana nawo) omwe sakanakhala nawo.
> Zotsatira:
> Healthcare.gov. Werengani Yopanda Thandizo Labwino.
> Kaiser Family Foundation, Employer Health Benefits, 2016 Chidule cha Zomwe Zapeza .
> Kaiser Family Foundation, Inshuwalansi ya Umoyo wa Anthu Onse. 2015.
> Kaiser Family Foundation, Kaiser Health Tracking Poll, Mwezi wa 2016.
> Ofesi Yogwira Ntchito. Mafunso Ofunsidwa Kawirikawiri: Inshuwalansi.