Obamacare Ndi ACA; Kuwonjezeka kwa Medicaid Ndi gawo la Obamacare
Mwachidziwitso, Obamacare ndi chabe dzina lakutchulidwa kwa Care Affordable Care Act. Poyamba ankagwiritsidwa ntchito mwachinyengo ndi otsutsa lamulo, koma Pulezidenti Obama adalandira mawuwa mu 2012, ndipo wakhala akugwiritsidwa ntchito kuyambira nthawi zonse ndi otsutsa ndi omuthandiza a ACA.
Popeza kuti Obamacare ndi ofanana ndi ACA, zimaphatikizapo kusintha komwe kumachitika pamsika wa inshuwalansi payekha (payekha ndi kusinthanitsa , mapulani onse atsopano azachipatala ndi ACA-ovomerezeka), komanso kusintha komwe kumagwira ntchito misika yaing'ono ndi magulu akuluakulu.
Ikuphatikizaponso kukula kwa Medicaid, yomwe ili mwala wapangodya wa ACA. Ndipo zimaphatikizapo udindo wa munthu aliyense komanso udindo wake - ACA "imamatira" kuti alimbikitse anthu kupeza chithandizo-kuphatikizapo ndalama zothandizira ndalamazo - "kaloti" zomwe zimapanga ndalama zambiri zogulira inshuwalansi.
Ngakhale kuti malamulo a Republican ndi Trump Administration anakakamiza kubwezeretsa zigawo zambiri za ACA mu 2017, gawo lokha la lamulo limene linathetsedwa ndilo chilango cha munthu aliyense, ndipo kubwezeretsa sikudzatha kufikira 2019 . Ndalama ya msonkho wa GOP (Tax Cuts and Jobs Act) yomwe inakhazikitsidwa mu December 2017 idzathetsa chilango cha munthu aliyense, koma chilangocho chidzayankhidwa (kumayambiriro kwa chaka cha 2019) pamabwerero a msonkho a anthu omwe sali olimbikitsidwa mu 2018 .
Kotero ACA imakhalabe yolimba mu 2018, ndipo mbali zambiri za izo zikhoza kukhazikika mu 2019 ndi kupitirira.
Ntchito Yabwino ya "Obamacare" = Mapulani Ogulitsidwa mu Kusintha
Ngakhale kuti mawu akuti Obamacare akuphatikizapo ma ACA onse, anthu amagwiritsira ntchito ntchitoyi kuti agwiritse ntchito malonda a inshuwalansi za malonda omwe amagulitsidwa pa kusinthanitsa kwa inshuwalansi . Kotero kuti cholinga cha nkhani ino, tipite ndi kugwiritsa ntchito mawuwo, ndikuyang'ana kusiyana pakati pa mapulaniwa ndi Medicaid.
"Obamacare" mapulani ndi mapulani aumwini; Medicaid ndikutanganidwa ndi boma
Kusiyana kwakukulu pakati pa Medicaid ndi Obamacare ndikuti mapulani azaumoyo a Obamacare amaperekedwa ndi makampani a inshuwalansi apadera pomwe Medicaid ndi pulogalamu ya boma.
Medicaid, ndondomeko ya inshuwalansi ya umoyo kwa anthu omwe ali ndi ndalama zochepa m'mayiko a United States, ndi ndondomeko ya chitukuko monga Sampula chakudya kapena Msautso Wosakhalitsa kwa Amayi Osowa.
Mawu akuti Obamacare nthawi zambiri amagwiritsidwa ntchito pofotokoza inshuwalansi ya umoyo waumwini yomwe imagulidwa ndi kusinthanitsa kwa inshuwalansi ya Care Act. Mapulani a inshuwalansi a Obamacare amaperekedwa ndi makampani a inshuwalansi monga Blue Cross, Kaiser Permanente, Molina, Aetna, Cigna, Wellpoint, ndi ena. Ntchito za umoyo wa Obamacare siziyendetsedwa ndi boma, koma ziyenera kutsatira malamulo osiyanasiyana a boma.
Ndikoyenera kudziwa kuti kuposa magawo atatu a Medicaid omwe amalembetsa dziko lonse lapansi, ali pa ndondomeko za chisamaliro za Medicaid, zomwe zikutanthauza kuti inshuwalansi yawo imayendetsedwa ndi a inshuwalansi apadera omwe amagulitsanso inshuwalansi ya malonda kwa anthu ndi malonda. Zolingazi zimagwira ntchito pogwiritsa ntchito mgwirizano ndi boma la boma kuti lipereke madalitso a Medicaid.
Izi zikhoza kusokoneza anthu, ndipo zikuphatikizidwa ndi kuti m'mayiko ambiri, pulogalamu ya Medicaid ilibe "Medicaid" mu dzina lake (Apple Health ku Washington, mwachitsanzo, ndi BadgerCare Plus ku Wisconsin).
Ndani Amalingalira? Amene Amapeza Obamacare
Zimandivuta kupeza Medicaid kusiyana ndi kupeza dongosolo la umoyo wa Obamacare.
Ngati muli mdziko la United States, mungagule ndondomeko ya inshuwalansi ya umoyo wa Obamacare kudzera mu inshuwalansi ya ACA ngati mulibe oyenera Medicare . Ngati ndalama zanu zikukhala 100% ndi 400% za umphawi wadziko lonse , mukhoza kukhala ndi chithandizo chomwe chimakuthandizani kulipira malipiro anu a inshuwalansi ya mwezi uliwonse (chitsimikizo kuti chiwerengero chapansi cha ndalama zothandizira ndalama ndi 139 peresenti ya umphawi wamba kuti awonjezera Medicaid; m'mayiko amenewo, Medicaid imapezeka kwa anthu omwe ali ndi ndalama zoposa 138 peresenti ya umphaŵi).
Ngati ndalama zanu zoposa 400% za FPL kapena pansi pa 100 peresenti ya FPL, simungapeze thandizo kulipira inshuwalansi ya umoyo yogulitsidwa pazitsulo za Obamacare, koma mukhoza kugula dongosolo la Obamacare. Pankhani iyi, mudzakhala ndi udindo wolipira 100% ya mwezi uliwonse. [Dziwani kuti alendo ovomerezeka mwalamulo omwe ali ndi ndalama zoperewera pa umphawi ayenera kulandira thandizo la premium ngati sakuyenera Medicaid chifukwa cha zaka zisanu akudikirira alendo omwe asamukira kumene.]
Njira yothetsera Medicaid ndi yovuta ndipo imasiyanasiyana ndi boma. Cholinga choyambirira cha ACA chinali chakuti anthu onse okhala ndi ndalama mpaka 138% a FPL angapeze chithandizo cha Medicaid kwaulere. Komabe, chigamulo cha Khoti Lalikulu chinagwirizana ndi gawo ili la mtengo wapatali wa Care Act. Izi zinayambitsa dongosolo losokoneza maganizo limene ena amatsutsa kwambiri Medicaid chifukwa atsogoleri awo anasankha kusawonjezera chithandizo cha Medicaid, koma mayiko ena ali ndi ufulu wovomerezeka wa Medicaid chifukwa atsogoleri awo adalowa mu ACA's Medicaid .
Pofika mu 2018, pali ma 19 omwe sanatulutse Medicaid. Pafupifupi anthu mamiliyoni 2,4 mwa khumi ndi asanu ndi atatu (18) mwa maiko amenewa ali m'gulu lomwe limatchedwa kusiyana: ndalama zawo zimakhala zochepa kwambiri chifukwa cha ndalama zothandizana nazo (pansi pa umphawi), koma sichiyeneretsanso Medicaid).
Ngati mumakhala m'dera lomwe lawonjezera chithandizo cha Medicaid, muyenera kulandira Medicaid ngati ndalama zanu zosinthidwa zisintha kuposa 138% ya FPL. Kufotokozera kwa Medicaid nthawi zambiri kumakhala kwaulere kwa inu, ngakhale kuti ena amalemba ndalama zochepa patsiku, zomwe zimaperekedwa kwa anthu omwe ali ndi ndalama kuposa umphaŵi.
Ngati mumakhala m'dera lomwe silinayambe kulengeza chithandizo cha Medicaid, mudzakwaniritsa zofunikira zowonjezera, zoyenera. Njira zowonongekazi zimasiyana kuchokera ku boma kupita ku dziko. Zimaphatikizapo zofunikira zowonjezera ndalama zomwe zingafunike kuti mukhale membala wa gulu la anthu omwe ali ndi thanzi lachilombo monga okalamba, olumala, akhungu, ana, amayi apakati, ndi makolo kapena akuluakulu osamalira ana.
Mwachitsanzo, ngati mulibe ana, wathanzi wamwamuna wazaka 30 wokhala ndi ndalama zokwana madola 10,000 pachaka, kaya muli woyenerera kupita ku Medicaid zimadalira mtundu umene mumakhalamo. Ngati mukukhala mudziko lomwe lakula Kupereka chithandizo cha mankhwala kwa aliyense amene amapanga 138% ya FPL, mumalandira Medicaid chifukwa mumakwaniritsa zofunikira zanu. Ngati mumakhala m'dera lomwe silinalikulitsa chithandizo cha Medicaid, simungayenerere Medicaid, ngakhale kuti ndalama zanu zili zochepa, popeza simuli olumala, okalamba, akhungu, kapena kholo la mwana wamng'ono (Wisconsin) ndizosiyana; boma silinagwirizane ndi ndalama za federal kuti lipititse patsogolo Medicaid, koma amapereka Medicaid kwa anthu omwe ali ndi ndalama zowonjezera umphaŵi, kotero kuti palibe kusiyana kotere ku Wisconsin).
Nthawi Yowonjezera Yochepa ya Obamacare Vs. Lowani Nthawi Yonse ya Medicaid
Anthu ovomerezeka angathe kulemba ku Medicaid chaka chonse. Koma kulembedwa kwa mapulani a Obamacare kumapezeka pokhapokha pokhapokha mutakhala olembetsa pamsonkhano wapachaka kapena mukakwaniritsa zolembera zochepa zolembera . Kupanda kutero, muyenera kuyembekezera nthawi yotsatira yolembera kuti mugwiritse ntchito dongosolo la Obamacare (chitsimikizo kuti izi ndizoona mosasamala kanthu kuti mukulembetsa kupyolera mwa kusinthanitsa kapena kusinthanitsa nawo; ndondomeko zogulitsidwa kunja kwa kusinthanitsa ndizogwirizana ndi ACA Komanso, ndikukhala ndi mawindo ochepa olembetsa; Nevada ndizosiyana, komwe kumagulitsidwa kusinthanitsa chaka chonse, koma ndi nthawi ya kuyembekezera kwa masiku 90 chisanadze chithandizo).
Mukapempha dongosolo la Obamacare panthawi yolembera (yomwe ikukonzedwa kuti iwononge kugwa kwa November 1 mpaka December 15), kufalitsa sikugwira ntchito mpaka January 1 chaka chotsatira. Mwachitsanzo, ngati mulembetsa ndondomeko ya Obamacare panthawi yolembera kumapeto kwa chaka cha 2018, zolemba zanu za Obamacare zidzakwaniritsidwa pa January 1, 2019 (pali malamulo osiyana ogwiritsira ntchito nthawi zina pamene anthu amagwiritsa ntchito chifukwa cha choyenerera , monga kubadwa kwa mwana).
Komabe, mukamagwiritsa ntchito Medicaid ndipo mukuvomerezedwa pulogalamu ya Medicaid, palibe nthawi yolindira chisanachitike.
Zomwe Mungachite Kuti Mutha Kugonjetsedwa Vs. Palibe Zojambula Zowonongeka za Obamacare
Nthawi zina, chithandizo cha Medicaid chikhoza kubwereranso. Mwachitsanzo, ngati muli ndi pakati pa miyezi isanu pamene mukupempha ndi kulandira chithandizo cha Medicaid, Medicaid ikhoza kubweza chithandizo chomwe muli nacho pakapita miyezi 1-4 ya mimba yanu, musanayambe kuitanitsa Medicaid. Izi siziri choncho pazinthu za inshuwalansi zaumoyo zomwe zimagulitsidwa pa kusinthana kwa Obamacare.
Ndizokondweretsa kuti Ulamuliro wa Trump wayamba kuvomereza zopempha zoyenera kuchoka kuchokera ku mayiko omwe akufuna kuthetsa kufotokozera kachilombo ka HIV pansi pa Medicaid. Popanda kuchitapo kanthu, Medicaid imakhala yofanana kwambiri ndi inshuwalansi ya umoyo payekha pokhapokha ngati kufalitsa kungayambe kugwira ntchito.
Kulipira Ndalama Zowonongeka Kwa Kugonjetsedwa Vs. Obamacare
Nthaŵi zambiri, Medicaid sichimafuna njira yopezera ngongole, ndalama zothandizira , kapena zotsalira . Popeza kuti Medicaid imapangidwira anthu omwe ali ndi ndalama zochepa kwambiri, chilichonse choposa kuwonetsera ndalama zochepa zomwe zingakhale zopanda malire kwa ovomerezeka a Medicaid ndikupereka chingwe chothetsera chisamaliro.
Komano, ndondomeko za umoyo wa Obamacare zimabwera ndi zopatsa malipiro, mapepala, ndi ndalama zothandizira ndalama. Popeza ndalama zokwana madola zikwi zingapo zingakhale zovuta kwa anthu omwe ali ndi ndalama zochepa kuti azilipira, pali ndalama zothandizira ndalama zomwe zimaperekedwa kwa omwe amapanga ndalama zopitirira 250% za FPL zomwe zimathandiza kuchepetsa ndalama zogawa ndalamazi. Omwe amapanga 250% mwa FPL ali ndi udindo wochuluka wa kugawana mtengo kulikonse kofunikira ndi dongosolo lawo la umoyo wa Obamacare.
Medicaid & Medicare Imatha Kuphatikizidwa; Obamacare & Medicare Sangathe
Ndizomveka mwamalamulo komanso kopindulitsa kukhala ndi chithandizo cha Medicare ndi Medicaid panthawi imodzimodzi ngati muli woyenerera onse awiri. Ndipotu, palinso dzina la anthu omwe ali nawo awiri: awiri amalephera .
Komabe, kawirikawiri palibe phindu kukhala ndi ndondomeko ya inshuwalansi ya Obamacare ndi Medicare. Ndiloletsedwa kwa inshuwalansi yapadera kuti ndikugulitseni malonda omwe mumagulitsa mwapadera mutalandira Medicare, ngakhale kuti sangakukakamizeni kusiya Chipangizo cha Obamacare chomwe muli nacho pamene mukuyenera ku Medicare. Koma mukatero, mudzataya ndalama zomwe mumalandira pokhapokha mutakhala oyenera ku Medicare, ndipo palinso kusagwirizana komwe kulipo pakati pa Medicare ndi msika. Choncho, akudziwitsidwa kuti Obamacare amalembetsa ntchito zawo pokhapokha atalandira thandizo la Medicare.
Tawonani kuti njira iyi sizongowonongeka; Mukuyenera kuti muyambe kukonza dongosolo lanu la Obamacare nokha. Mukakhala oyenerera ku Medicare, muyenera kuonetsetsa kuti chithandizo cha inshuwalansi cha umoyo wanu cha Obamacare chikuyambira panthawi yoyamba ya Medicare. Izi ndi zoona ngakhale mutasayina mankhwala oyambirira a Medicare Parts A ndi B , kapena Medicare Part C, ndondomeko ya Medicare Advantage .
Chifukwa Chiyani Kufotokozera Kusiyanitsa Pakati pa Medicaid & Obamacare Kungakhale Kovuta?
Kumvetsetsa kusiyana pakati pa Medicaid ndi Obamacare kungasokoneze chifukwa
- Kawirikawiri, mumaphunzira kuti ndinu woyenera Medicaid mukamaliza kugwiritsa ntchito inshuwalansi ya umoyo pa ACA inshuwalansi ya umoyo wanu. Ngati kusinthanitsa kumatsimikizira kuti mumayenera kukhala ndi Medicaid m'boma lanu, zidzatumiza uthenga ku Medicaid, kuyambitsa ndondomeko ya ntchito ya Medicaid. Popeza mudapereka inshuwalansi yanu yoyamba ku inshuwalansi ya Obamacare, zingakhale zosokoneza mukamaliza kulandira Medicaid m'malo mwa dongosolo la Obamacare.
- Ngakhale Medicaid ndi pulogalamu ya boma, m'mayiko ambiri, misonkhano ya Medicaid kwa olembetsa ambiri amaperekedwa kudzera mu kampani ya inshuwalansi yathanzi. Ndipotu, malinga ndi Kaiser Family Foundation, oposa atatu pa atatu a Medicaid omwe alandila amatha kusamalira ndondomeko zaumoyo. Pulogalamu ya Medicaid kulandira khadi lake la Medicaid ID ku UnitedHealthCare, Humana, Kaiser, kapena Blue Cross, akhoza kuganiza molakwika kuti walandira inshuwalansi ya umoyo wa Obamacare. Ndipotu pulogalamu yake ya Medicaid inagwirizana ndi munthu wothandizira ndalama kuti asamalire madokotala a Medicaid. Ngakhale kuti kampani yapadera ikuyendetsa madalitso a Medicaid, ubwino womwe ulipobe ndi Medicaid ndi ndalama zomwe zimalipilira zomwe zimapindulitsa pamapeto pake zimachokera ku kuphatikiza ndalama za boma ndi boma.
Popeza anthu ambiri akugula inshuwalansi pa inshuwalansi ya ACA yothandizira kupeza chithandizo cholipirira inshuwalansi ya umoyo monga thandizo la boma, zingakhale zotsutsana ndi inshuwalansi yaumwini yaumwini (Obamacare) zosiyana ndi boma-zidalipira Medicaid.
> Zotsatira:
> Magulu a Medicare ndi Medicaid Services, Mafunso Ofunsidwa Kawirikawiri Ponena za Medicare ndi Marketplace . August 1, 2014.
> Kaiser Family Foundation, Gawo Lophatikizapo: Osauka Osauka Osauka M'mayiko Osawawonjezera Mavuto. November 1, 2017.
> Kaiser Family Foundation, Total Medicaid Inayang'anira Kulembetsa Kusamalira, 2014.