Malamulo onsewa ali ndi chithandizo choyambirira, koma amasiyana kwambiri
Kubwerera mu Januwale 2017, Nyumba yamalamulo Paul Ryan adapempha kuti awonetsere kuti pempho lachipatala la Republican liyenera kukhala ndi "ngongole yobwezeretsa msonkho" -njira yomwe adati idzakhala "yabwino kuposa ndalama [ACA]. "
Akatswiri a ndondomeko ya zaumoyo adafulumira kunena kuti ACA idagwiritsira ntchito kalembedwe za msonkho, zomwe ndizofanana ndi momwe anthu a Republican House amathandizira ku American Health Care Act (AHCA).
AHCA inadutsa Nyumbayi pa May 4, ngakhale kuti Senatayo idzapeza ndalama zosiyana, zomwe ziyenera kuyanjanitsidwa ndi nyumba ya House .
Ndalama za msonkho ndi chimodzi mwa zinthu za AHCA zomwe Senate ingasinthe. Koma tiyeni tikambirane za AHCA zomwe Nyumbayo inadutsa, ndikuwona momwe msonkho wa msonkho udzafanane ndi ndalama zomwe anthu amapeza kale pansi pa ACA.
Kodi "Ngongole Yopereka Ngongole Yopindulitsa" imatanthauza chiyani?
Ngongole yobwezeretsa msonkho ndi imodzi yomwe mungalandire mokwanira ngakhale ngati ndalama zomwe mumalipira misonkho (poyerekeza, ndalama zokhoma msonkho zomwe simungabwerere zingagwiritsidwe ntchito kuthetsa msonkho wanu wa msonkho, koma simungalandire ndalama zina za msonkho wa msonkho pamwambapa ndi zomwe simungapereke kwa msonkho). Ngongole yobwezeretsa msonkho ikhoza kuthetsa zomwe mumalipira misonkho, ndipo ngati ndalama zatsala, IRS idzakutumizirani msonkho wokhoma msonkho.
Kapena ngati muli ndi ngongole yobwezera, IRS idzawonjezera ngongole ya msonkho kwa kubwezera kwanu.
Kotero mwachitsanzo, tiyeni tinene kuti msonkho wa msonkho wa Jane ndi $ 1,500. Tiyeneranso kunena kuti adagula malipiro ake pogwiritsa ntchito malonda, koma analipira mtengo wake wonse inshuwalansi chaka chonse, posankha kuti apereke msonkho wapadera pa msonkho wake .
Ngati zikutanthauza kuti ngongole yake ya msonkho ndi $ 2,000, IRS idzagwiritsira ntchito $ 1,500 ya msonkho wa msonkho kwa msonkho wake, ndipo mutumizeni ndalama zina $ 500 ngati chekeni chobwezera.
Ndi momwe ndalama zopezera msonkho za ACA zimagwirira ntchito, komanso momwe misonkho ya AHCA ikugwirira ntchito.
Ngongole yamtengo wapatali ndi yomwe mungalandire pasadakhale, musanayambe kubweza msonkho wanu. Ngati mwalembetsa ndondomeko ya inshuwalansi ya zaumoyo pogwiritsa ntchito ndalama zogulira msonkho ndikulipiritsa msonkho kwa inu mwezi uliwonse, mukupindula ndi kuti ndalama za ACA zapamwamba zowonjezera zilipo (pafupifupi 83 peresenti ya anthu Kukonzekera mu 2017 ndiko kulandira ndalama zowonjezera msonkho, kapena APTC).
Iyi ndi njira yokha yomwe ngongole zokhomera msonkho zingagwiritsidwe ntchito moyenera kuti zowonjezera zitheke mosavuta, chifukwa anthu angakhale ovuta kulipira mtengo wathunthu wowonjezera chaka chonse ndikudikirira kuti adzalandire msonkho wawo misonkho mmawa wotsatira, pa msonkho wawo.
Tawonani kuti ngongole za msonkho zimasiyanasiyana ndi zochepa za msonkho. Kuchotsa kumakupatsani mwayi wochotsa ndalama kuchokera ku msonkho wokhoma msonkho, motero kuchepetsa kuchuluka kwa msonkho umene mukulipira. Koma ngongole ya msonkho imachotsedwe mwachindunji ku msonkho wathunthu umene ulipira.
Malingaliro a inshuwalansi a zaumoyo angathe kuchotsedwa panthawi zina , koma poganiza kuti kupanga inshuwalansi ndi yotsika mtengo, $ 2,000 za ngongole ndizofunika kwambiri kuposa ndalama zokwana madola 2,000.
Kodi Zothandizira Zisonkho za AHCA zingasiyane bwanji ndi CAA Credits?
Tiyeni tiyang'ane momwe ndalama zopezera msonkho za ACA zimagwirira ntchito:
Malipiro a msonkho wa ACA amatha kupezeka kwa anthu omwe ali ndi pakhomo pakati pa 100 peresenti ndi 400 peresenti ya umphawi (m'munsi mwawo ndi 139 peresenti ya umphawi mu 31 states ndi DC- kumene Medicaid yakula ).
Cholinga cha ndalama za msonkho wa ACA msonkho ndikulingalira malipiro a anthu omwe amapeza ndalama zofanana, kaya ali ndi zaka zingati kapena inshuwalansi yochuluka bwanji m'dera lawo.
Ndipo pansi pa ACA, mbiri yakale ya zachipatala silingaganizidwe pokhapokha atapereka malipiro olembera, kotero kuti sichidziwikiranso (kale, kale, mpaka 2014).
Choncho, pansi pa ACA, ndalama zambiri za msonkho zimakhala zazikulu kwa anthu achikulire (omwe amapereka ndalama zothandizira anthu okalamba apamwamba), komanso anthu omwe amakhala m'madera omwe inshuwalansi ndi okwera mtengo kwambiri.
Mwachitsanzo, malipiro amtengo wapatali (mwachitsanzo, musanayambe kulipira msonkho) ku Alaska ndi oposa katatu kuposa momwe aliri ku Utah. Kotero ndalama zambiri zokhoma msonkho ku Alaska ndi $ 848 / mwezi, pamene mtengo wapadera wa msonkho ku Utah ndi $ 200 / mwezi. Ndichifukwa chakuti ndalama zonse za ACA zothandizana nazo ndizofananitsa ndalama zothandizana ndi ndalama zothandizira panthawi yonse ya dziko, kuonetsetsa kuti anthu omwe amapeza ndalama zofanana akulipira malipiro omwewo (Alaska ali ndi umphawi wochuluka, womwe umapatsa anthu kumeneko chithandizo chapang'ono pang'ono ndi premium zawo).
Koma malipiro a msonkho wa ACA amachotsedwa ponseponse pa 400 peresenti ya umphaŵi. Mphepete mwachindunji yowonjezera yachititsa kuti phindu la inshuwalansi lingawonongeke kwa mabanja apakatikati m'madera ena a dzikoli. Mayiko angathe kuthana ndi izi paokha (Minnesota adachita, chaka chino, Colorado ankawona kuti ndizofanana koma sizinadutse), koma ACA mwiniyo siyikwaniritsa momwe angagwiritsire ntchito malonda omwe ali ndi ndalama zopitirira 400 peresenti ya umphaŵi (chifukwa cha lingaliro, kuti cutoff ndi $ 97,200 kwa banja la anayi mu 2017).
Tsopano tiyeni tiwone m'mene AHCA angalandirire msonkho:
Ngati Nyumba ya AHCA iyenera kukhazikitsidwa, bungwe la ACA liyenera kukhalabe mu 2018 ndi 2019, ndi kusintha kwake. Koma ndalama zothandizira msonkho zikhoza kupezeka kuti zigwiritsidwe ntchito ndi mapulani osagwirizana, osaphatikizapo zidzukulu, zidzukulu , ndi mapulani afupikitsa (chifukwa cha malingaliro osagwirizana, msonkho wa msonkho ukhoza kubwezeredwa, koma osakonzekera; anthu ayenera kulipira mtengo wathunthu kutsogolo kwa zochitika zawo-monga momwe akuchitira panopa zotsatsa malonda-ndipo akhoza kudandaula msonkho wa msonkho pamabwerero awo a msonkho).
Pambuyo pa 2019, AHCA ikusintha kuchoka pa malipiro amtengo wapatali kwa anthu omwe ali ndi ndalama zofanana, ndipo m'malo mwake amapanga kupereka malipiro ofanana a msonkho kwa omwe ali ndi zaka zofanana. Izi ndizofunikira kusintha. Mmalo mwa dongosolo lomwe anthu amapereka ndalama zomwe zimaonedwa kuti ndi zotsika mtengo pogwiritsa ntchito zomwe amapeza, anthu amalandira msonkho womwewo ngati wina aliyense mu msinkhu womwewo, mosasamala kanthu za ndalama, mpaka pakhomo la ndalama kwa ngongole ya msonkho wa AHCA. Mwa kuyankhula kwina, "chilungamo" cha chithandizocho chidzatsimikiziridwa ndi kuchuluka kwa ndalamazo, m'malo mofuna ndalama za munthu payekha komanso mtengo wa kufalitsa gawo lililonse.
Zokongola za AHCA za msonkho ndizopambana kuposa kapu ya ACA. Ndalama za AHCA zikhoza kupezeka kwa anthu osakwatira omwe ali ndi ndalama zokwana madola 75,000, ndipo okwatirana ali ndi ndalama zokwana madola 150,000 (ziwongoladzanja ziyamba kuyambira pamwamba pa magulu awo). Kwa munthu mmodzi yekha, $ 75,000 ndi 621 peresenti ya umphawi wa 2017, choncho msonkho wa msonkho pansi pa AHCA ukatambasula kwambiri pakati pa gulu lapamwamba ndi apamwamba-makamaka kuganizira kuti ngongole sizingatheke mwana wa zaka 60 mpaka ndalama zinakwana $ 115,000 kwa munthu mmodzi (kumapeto kwake kwa gawoli kungakhale $ 95,000 kwa mwana wazaka 29).
Koma malipiro a msonkho wa AHCA okha, angakhale ochepa, kusiyana ndi ndalama za ACA. Kaiser Family Foundation yapeza kuti ndalama zochepa zokhomera msonkho zingakhale zazing'ono 36 peresenti pansi pa AHCA.
Zopereka za msonkho wapanyumba zingawoneke ngati izi mu 2020, ndipo zikanakhala zowerengedwa kuti zidzatengera zaka zapitazi:
- $ 2,000 payekha kufika pa zaka 29
- $ 2,500 payekha wa zaka 30-39
- $ 3,000 pa zaka za 40-49
- $ 3,500 pa zaka zapakati pa 50-59
- $ 4,000 pamsinkhu wa zaka 60+
- Mabanja adzakhala oyenerera kuitanitsa ndalama zokhala ndi ndalama zambiri kwa anthu asanu achikulire, omwe ali ndi chikwama cha $ 14,000 pachaka.
Zopereka za msonkhozi zikanatha kukhalapo kunja kwa kusinthanitsa mu 2020 ndi kupitirira, chifukwa cha ndondomeko zomwe sizinali zazikulu, zidzukulu, kapena nthawi yayifupi (pokhapokha pali njira yowonjezeredwa, mapulani a mapologalamu apamwamba adzakhala atatha kumapeto kwa 2018).
Ndani Amagonjetsa, Ndipo Ndani Akuchotsa?
Mwachiwonekere, AHCA ndi yopindulitsa kwa anthu omwe ali ndi ndalama zopitirira 400 peresenti ya umphaŵi, koma pansi pa chikhomo cha msonkho wa AHCA. Anthu omwewo sapeza ndalama iliyonse pansi pa ACA, ndipo amayamba kutenga 2020 ngati nyumba ya AHCA iyenera kukhazikitsidwa.
Koma pali zodetsa nkhaŵa zazikulu zokhudzana ndi momwe angapangidwire pa AHCA kwa anthu osauka kwambiri, anthu okalamba (omwe ndalama zawo zonse zidzakhala zazikulu pansi pa chiwerengero cha AHCA), ndi anthu omwe amakhala kumadera kumene inshuwaransi yaumoyo ili kwambiri mtengo wapatali.
Kwa anthuwa, msonkho wa ACA umayendetsa bwino. Iwo ndi akuluakulu kwa anthu amene angapereke malipiro apamwamba, omwe amaphatikizapo anthu omwe ali ndi malo okwera mtengo komanso anthu okalamba. Ndipo amakhalanso akuluakulu kwa anthu omwe ali ndi ndalama zochepa, zomwe zimawathandiza kupeza ndalama zambiri.
Zitetezozo zimatha kusanduka pansi pa AHCA. Lipoti la CBO la AHCA (lofalitsidwa pa May 24, pafupifupi milungu itatu pambuyo pa Nyumbayi idavomerezedwa) limasonyeza kuti mwana wa zaka 64 amene amalandira $ 26,500 / chaka, ndalama zamtengo wapatali za pachaka zidzawonjezeka kuchokera $ 1,700 pansi pa ACA, mpaka $ 16,100 pansi pa AHCA. Izo ziri muzinena kuti samafuna kusiya ACA zotetezera ogula; muzimene zikutanthauza, msonkho wamtengo wapatali udzakhala wotsika pang'ono- $ 13,600-koma phindu lidzachepetsedwenso ndipo mwayi wolowa inshuwalansi udzakhala wochepa kwa anthu omwe alipo kale komanso malo ochepa.
Kawirikawiri, opambana pansi pa AHCA adzakhala achinyamata omwe ali ndi malipiro apamwamba, makamaka ngati amakhala m'madera omwe inshuwalansi ya umoyo imakhala yotsika mtengo.
Otaika angakhale anthu achikulire, anthu opeza ndalama zochepa, ndi anthu m'madera omwe inshuwaransi yaumoyo ndi yokwera mtengo kwambiri.
> Zotsatira:
> Pulogalamu ya Medicare ndi Services Medicaid, Kusinthidwa Kwambiri ku Ntchito Yodalirika Yothandiza Care-Malangizo Ovomerezeka , February 2017.
> CMS.gov, 2017 Malo Olembera Pa Nthawi Yoyamba Kulembetsa Anthu Ogwiritsa Ntchito Maofesi
> Jost T. Kufufuza Nyumbayo Republican ACA Kukhazikitsa ndi Kukhazikitsa Malamulo. March 7, 2017.
> Kaiser Family Foundation, Pulezidenti ndi Mikopo ya Misonkho Pansi pa Ndalama Zopindulitsa Zowonjezera vs. American Health Care Act: Mapulogalamu Othandizira. April 27, 2017.
> Kaiser Family Foundation, Chidule cha American Health Care Act, May 2017.