Malamulo adatsegula mwayi wopezeka kwa anthu omwe nthawi zambiri amakana kulengeza
The Affordable Care Act (ACA), yotchuka kwambiri yotchedwa Obamacare, idasindikizidwa kukhala lamulo pa March 23, 2010 kuti athetsere inshuwalansi, yokhazikika komanso yotsika mtengo inshuwalansi kwa onse a ku America. ACA imangopereka chithandizo cha inshuwalansi pa umoyo umene anthu ndi mabungwe ang'onoang'ono amatha kuyerekezera ndi kugula inshuwalansi, imapereka ndalama zothandizira anthu a ku America omwe amapeza ndalama zambiri kuti agule pogwiritsa ntchito kusintha kwa boma.
Kuonjezera apo, ACA inakwaniritsa kulandira kwa Medicaid kwa anthu osauka a ku America omwe amapanga zosakwana 133 peresenti ya momwe boma limaperekera umphawi, zomwe zakhala zikupezeka kwa anthu omwe ali olumala chifukwa cha HIV.
Ngakhale anthu ena ayesa kutsutsa kapena kutsutsa lamulo, thandizo la boma la ACA lakhala likupita patsogolo pang'onopang'ono, ndi mavoti a maganizo omwe akusonyeza kuwathandiza kuthandizira malamulo kuchokera kwa voti a Democratic ndi Republican kuyambira pamene kutsegulidwa kwa Trump.
Malingana ndi kafukufuku wochokera ku Kaiser Family Foundation ku Washington, DC, anthu aang'ono, omwe ali ndi ndalama zochepa (pansi pa $ 40,000 pachaka), ndipo omwe adadziwika okha monga Democrat anali ambiri ochirikiza malamulo.
Ngakhale kuti zotsatira za ACA pa dongosolo lachipatala cha US ndizosatsutsika, zikhoza kutsutsidwa kuti anthu mamiliyoni 1.2 a ku America omwe ali ndi kachirombo ka HIV angakhale atamva kwambiri. Zisanachitike lamuloli, anthu 17 pa 100 alionse omwe ali ndi kachilombo ka HIV anali ndi inshuwalansi yathanzi poyerekeza ndi 54 peresenti ya anthu ambiri.
Komanso, kawiri konse anthu analibe mankhwala (29 peresenti) poyerekeza ndi Achimereka popanda HIV (14 peresenti).
Zotsatira za Kuwonjezeka Kwambiri
Kuchokera mu 2010, mwayi wopititsa patsogolo chithandizo chaumoyo walandiridwa bwino ndi anthu omwe ali ndi kachilombo koyambitsa matenda a Edzi.
Mwachitsanzo, ku Virginia, 47 peresenti ya omwe adalandira chithandizo kudzera mu boma la AIDS Drug Assistance Program (ADAP) adalowetsa ndondomeko za inshuwalansi za ACA mu 2014. Ali ndi njira zatsopano zothandizira anthu odwala kachilombo ka HIV, odwala inshuwalansiyo ikanatha kukwaniritsa ndi kusunga zosawerengeka za tizilombo kusiyana ndi odwala omwe ali ndi ADAP.
Kuwonjezera apo, mwezi umodzi uliwonse wolembetsa mu inshuwalansi unagwirizanitsidwa ndi magawo asanu ndi limodzi omwe amatha kukhala ndi kachilombo koyambitsa matenda, ndipo anthu omwe amalembetsa chaka chathunthu amakhala oposa 60 peresenti yowonjezera mavitamini okhudzidwa kwambiri.
Makhalidwe ofananawa akuwonetsedwa kwinakwake, ndi California, boma lomwe liri ndi pulogalamu yaikulu kwambiri ya ADAP, pofotokoza kuti chiwerengero cha 27 peresenti chinasiya kulembetsa chiwerengero kuyambira 2012. Masiku ano, oposa 28,000 a California akupeza ADAP poyerekezera ndi anthu oposa 38,000 omwe anachita zimenezi mu 2012-otsika kwambiri nambala yowonetsedwa kuyambira 2006.
Izi sizikutanthauza kuti sipakhala mavuto aakulu pulojekitiyi. Mu L2015, mabungwe ambiri a ACA omwe amawunikira amatsutsidwa chifukwa chotsutsa anthu omwe ali ndi kachilombo koyambitsa matenda a Edzi pochita zinthu zovuta , zomwe odwala amaletsedwa posankha ndondomeko ya inshuwalansi mwa kuika ndalama zowononga mankhwala osokoneza bongo.
Nthaŵi zina, ndalama zogwiritsira ntchito mankhwala osokoneza bongo kwa anthu omwe ali ndi kachilombo ka HIV zinali $ 3,000 apamwamba pa chaka poyerekeza ndi inshuwalansi omwe sanalowetse mavuto.
Mu March 2015, pambuyo pa kusefukira kwa magulu opatsirana kachilombo ka HIV, Aetna Inshuwalansi inakonzanso ndondomeko zake zamkati, kuchotsa mankhwala ochepetsa kachilombo ka HIV kuchokera kumtunda wapamwamba kwambiri kwa omwe kulipira ngongole kumatha kulikonse kuchoka pa $ 5 mpaka $ 100 mutatha kukwanitsa.
Komanso, kuyesayesa kwina kulimbikitsa kuwonjezereka kwa Medicaid kumakhala ngati Virginia, Louisiana, Texas ndi Florida akusiya anthu osauka kwambiri a dzikolo-omwe nthawi zambiri amakhala ndi chiopsezo chachikulu chotenga kachilombo ka HIV - mwazing'ono, mwachindunji, kupeza chithandizo cha mankhwala.
Pakali pano, mayiko 19 a US adakana kukula kwa Medicaid .
Nthawi ndi Momwe Mungalowere
Kulembetsa koyamba ndi nthawi ya chaka chomwe mungagwiritse ntchito thandizo la ndalama, kusintha ndondomeko, kapena kulembetsa ndondomeko yaikulu ya zachipatala yomwe imawerengedwa ngati chiwerengero chofunikira chofunikira chofunika ndi lamulo.
Pulogalamu yoyamba yolembetsa imayamba pa November 1, 2017 ndi tsiku logwira ntchito yoyambira kuyambira pa January 1, 2018. Chonde dziwani kuti Trump mayendedwe atsimikiza kuchepetsa mawindo olembetsa kuyambira pa January 31 mpaka pa December 15, 2018 . Izi zimapereka anthu masabata asanu ndi limodzi okha kuti athe kulembetsa.
Pakalipano, mayiko asanu ndi atatu omwe akugwira ntchito yodzitetezera okha adasankha kuwonjezera tsiku lolembetsa, kulikonse kuyambira pa 22 mpaka 31, 2018.
Pansi pa ACA, kulembetsa kumaikidwa pakati pa malo a Health Insurance Marketplace. Msika uliwonse umagwiritsidwa ntchito ndi boma kapena federal boma ndipo imakupatsani chisokonezo chazomwe mungapeze zomwe mungapeze, ngakhale mukufuna
- Inshuwalansi yathanzi
- Ndalama zothandizira msonkho kuti ziwononge ndalama za premium
- Kulembetsa kwa Medicaid
- Pulogalamu ya Inshuwalansi ya Ana (CHIP)
- Ndondomeko Yathandizira Yamagulu Amalonda (SHOP)
- Ndondomeko yothandizira inshuwalansi
Dipatimenti ya zaumoyo ku United States yakhazikitsa Health Insurance Market portal ku Healthcare.gov kuti ikuthandizeni kudziwa momwe mungakwaniritsire ndikukutsogolerani ku ofesi kapena ofesi yomwe mukufuna. (Chilankhulo cha chinenero cha Chisipanishi chingapezeke ku Cuidadodesalud.gov).
Mutangotenga zowonjezereka, mungagwiritse ntchito pa intaneti, payekha, kapena mwa makalata. Ndondomeko zimatha kusiyana ndi boma, koma zolemba zosavuta zimakhala zochepa komanso zosavuta kumvetsetsa, zomwe zimafuna nambala ya chitetezo cha anthu okhaokha (kapena chiwerengero cha chiwerengero ngati muli wochokera kulamulo) W-2s, malipoti a msonkho).
Mukatumizidwa, nthawi yotsatila ili pakati pa masabata awiri kapena awiri, pafupifupi.
Numeri Yofunika Kwambiri
Malo a Inshuwalansi Zaumoyo Msika Wamalonda Hotline (yomwe ilipo maola 24 pa tsiku):
- 1-800-318-2596
- TTY: 1-855-889-4325
Hotline Yamagulu Amalonda Ambiri (Lolemba mpaka Lachisanu, 9:00 am mpaka 5:00 pm EST):
- 1-800-706-7893
- TTY: 1-800-706-7915
Kuti mudziwe zambiri zokhudza kukula kwa Medicaid m'boma lanu, lipoti la State of State Action likupezeka kuchokera ku Kaiser Family Foundation.
>> Zotsatira:
> Kaiser Family Foundation (KFF). "Kaiser Health Tracking Poll: Public's View pa ACA." Washington, DC; inapezeka pa November 3, 2015.
> McManus, K .; Rhodes, A .; Yerkes, L .; et al. "2014 Care Affordable Care Act Kulembetsa kwa AIDS Drug Assistance Programs Clients ndi Associated HIV zotsatira." Mlungu Wosabata 2015. October 9, 2015; San Diego, California; > kalankhulidwe; zolemba 728.
> Jacobs, D. ndi Sommers, B. "Kugwiritsa Ntchito Mankhwala Osokoneza Bongo Kusankha - Kusankhidwa Kwambiri ku Market Market." New England Journal of Medicine. January 29, 2015; 372: 379-402.
> Advisory Board Company. "Pamene mayiko amaima pa Kukulitsa kwa Medicaid." Washington, DC; inapezeka pa November 3, 2015.