Only New York ndi Minnesota Akhazikitsidwa BHPs
Gawo 1331 la mtengo wapatali wa Care Act limapereka boma kukhazikitsa Basic Health Program (BHP) kupereka chithandizo chaumoyo kwa anthu omwe amapeza ndalama zochuluka kuti ayenerere Medicaid, koma omwe akusowa thandizo lina kuposa ACA. Dziko lirilonse lingathe kukhazikitsa BHP, koma New York ndi Minnesota okha achita izo.
Mtengo wa BHP umapangidwa ndi ndalama komanso boma, kuphatikizapo malipiro odzichepetsa komanso kugawidwa mtengo kwa mamembala.
ACA imangofuna BHPs kuti awonetsetse kuti mamembala sayenera kulipira malipiro ambiri komanso kugawidwa mtengo komwe angapereke pansi pa dongosolo la thanzi labwino (makamaka, ndondomeko ya siliva yomwe imakhala yotsika mtengo kwambiri potsatsa malipiro, ndi platinamu kapena ndondomeko ya golidi-malingana ndi phindu-potsata ndalama zogulitsa kunja), koma olembetsa mu BHPs ku New York ndi Minnesota ali ndi ndalama zochepa kwambiri kuposa momwe angakhalire ndi dongosolo la thanzi labwino.
Ndani Ali Woyenera Kupeza Mapulogalamu Aakulu Achimake?
Ndondomeko Zaumoyo Zamagulu ndizosankhidwa pazigawo. Koma ngati athandizidwa, kuyenerera kumafotokozedwa m'malemba a ACA:
- Anthu ambiri ali oyenerera kulandira chithandizo cha BHP ngati ali ndi ndalama pakati pa 133 peresenti (pakuchita, ndi 138 peresenti yokhala ndi ndalama zopanda ndalama) komanso 200 peresenti ya umphawi wadziko lonse. Kwa kufotokoza kwa 2018, malire apamwamba a munthu mmodzi ndi $ 24,120. Pamene ACA inalembedwa, anthu omwe ali ndi ndalama zopitirira 133 peresenti ya umphawi amayenera kukhala ndi chithandizo cha Medicaid, kotero chithandizo cha BHP chikanatenga kumene Medicaid anasiya. Komabe, pali mayiko 19 omwe anakana kufalitsa Medicaid, zomwe zimachititsa kuti pakhale kusiyana pakati pa 18 mwa iwo (anthu ambiri omwe ali ndi ndalama zoperewera pa umphawi sagwirizana ndi ndalama zowonjezera ndalama ). Koma zokhazo zomwe zagwiritsira ntchito BHP zowonjezera Medicaid.
- Ovomerezeka mwachilungamo omwe sakhala ku US kwa zaka zosachepera zisanu ayenera kulandira chithandizo cha BHP ngati ali ndi ndalama zosachepera 133 peresenti ya umphaŵi. Izi zili choncho chifukwa anthu omwe asamukira kumene sali oyenerera Medicaid (ngakhale m'deralo lomwe lawonjezera Medicaid) mosasamala kanthu za ndalama , kufikira atakhala mwalamulo ku US kwa zaka zosachepera zisanu.
Maiko Awiri Akhazikitsa Mapulogalamu Aakulu Ambiri
Mayiko awiri-New York ndi Minnesota-ayambitsa Basic Health Programs.
New York
BHP ya New York imatchedwa The Essential Plan, ndipo inayamba kupezeka kumayambiriro kwa chaka cha 2016. Zowonjezereka za Kufunika kwa Zowonongeka ndi ndalama zilipo apa ndi apa . Palibe malipiro a anthu olembetsa omwe ali ndi ndalama zokwana 150 peresenti ya umphawi, pokhapokha ngati akufuna kuwonjezera mavoti a mano ndi masomphenya. Amene ali ndi ndalama pakati pa 150 ndi 200 peresenti ya umphaŵi amawalipira $ 20 / mwezi kuti athandizidwe.
Pansi pa The Essential Plan, amalemba ndalama zokwana 150 peresenti ya umphaŵi ($ 18,090 kwa munthu mmodzi mu 2018) alibe copays kapena kugawana mtengo kwa ntchito zambiri, ngakhale kuti pali ndalama zokwana $ 3 za mankhwala osokoneza bongo. Amene ali ndi ndalama zoposa 150 peresenti ya umphawi ali ndi copays kwa mautumiki ambiri, ngakhale kuti palibe deductible ndipo kugawanika kwa ndalama zonse kuli kochepa kuposa momwe zingakhalire padera pokhapokha ku New York State Health (kusintha kwa boma ku New York).
The Essential Plan amapindula amaperekedwa ndi ogulitsa inshuwalansi kuti mgwirizano ndi boma la New York. Pali inshuwalansi 16 omwe amagwira nawo ntchitoyi, ngakhale zambiri zimapereka Chofunika Kwambiri m'madera ochepa a boma ( tchatichi chikuwonetsa komwe bwana aliyense akupereka Chofunika Kwambiri).
Anthu a ku New York akhoza kulemba ku Essential Plan kudzera ku New York State Health. Kusinthanitsa kumatsimikizira kuyenerera kwa Medicaid, The Essential Plan, ndi ndondomeko zaumoyo zoyenera (popanda kapena ndalama zothandizira), malingana ndi ndalama ndi zina.
Kuyambira mu December 2017, panali anthu pafupifupi 720,000 omwe analembetsa mu Essential Plan ya 2018.
Minnesota
BHP ya Minnesota imatchedwa MinnesotaCare, ndipo yapangidwa kukhala Basic Health Program kuyambira 2015 (MinnesotaCare ndi pulogalamu yomwe yakhala ku Minnesota kuyambira 1992, koma idasandulika kukhala BHP pansi pa malamulo a ACA kuyambira mu January 2015, tsiku loyambirira lololedwa pansi pa federal malamulo).
Chifupikitso cha MinnesotaChiwerengerochi chikupezeka apa. Anthu osachepera 21 samalipiritsa kugawa ndalama, koma pali mapepala a olembetsa zaka 21 ndi zaka, komanso ndalama zokwana madola 2.95 pa mwezi (ndalama zokhazokha zimayenera kuperekedwa ngati mukufunikira thandizo lachipatala m'mwezi).
Zowonjezera za MinnesotaCare zimachokera ku ndalama, ndipo zingakhale zoposa $ 80 / mwezi pa munthu aliyense kwa iwo omwe ali ndi ndalama pamapeto akumapeto a zofunikira (200 peresenti ya umphawi, womwe ndi $ 24,120 kwa munthu mmodzi, ndi $ 49,200 banja la anayi; cholembedwa kuti banja la anayi omwe ali ndi gawoli likhoza kulandira MinnesotaCare kwa makolo, koma anawo angayesere Medicaid ngati ali ndi zaka 18 kapena ang'ono).
Monga momwe ziliri ku New York, Minnesota amavomereza mgwirizano ndi mabungwe oyang'anira okhaokha kuti apereke chithandizo pa Basic Health Program. Kuchokera mu 2017, pali asanu ndi awiri a inshuwalansi ndi boma zomwe zimapatsa MinnesotaCare kufalitsa. Anthu a ku Minnesota akhoza kulemba ku MinnesotaCare kudzera mwachinsinsi, kusintha kwa boma. Kusinthanitsa kumapangitsa kuti zikhale zovomerezeka za Medical Assistance (Medicaid), MinnesotaCare, ndi ndondomeko zoyenera zaumoyo (popanda kapena kupereka ndalama zothandizira), malingana ndi zopeza ndi zina.
Kuyambira mu November 2017, panali anthu pafupifupi 93,000 omwe analembetsa ku MinnesotaCare kwa 2018.
Kodi Makhalidwe Abwino Amathandiza Bwanji?
Pansi pa ACA, boma lidzapereka malipoti ndi ndalama za BHP zofanana ndi 95 peresenti ya ndalama zomwe boma la boma likanati lizigwiritsa ntchito pothandizira ndalama zowonjezereka komanso kuchepetsa ndalama zomwe zimagawidwa m'mayiko amenewo (chifukwa anthu omwe amatha kukhala oyenerera ku BHP m'malo mwake kuposa ndondomeko zasiliva zodzikweza-kachiwiri potsatsa, ndi kupereka ndalama zothandizira komanso kuchepetsa kugawa ndalama).
Zaka zisanafike chaka cha 2015, MinnesotaCare inali pulogalamu yomwe inkaperekedwa ndi boma yomwe inapereka chithandizo kwa anthu omwe sankayenera kupita ku Medicaid, ndipo anali ndi ndalama zokwana 275 peresenti ya umphaŵi. Kupititsa ku BHP kunali ndalama zambiri ku Minnesota, popeza zinapereka ndalama zambiri ku federal m'malo modalira kwambiri ndalama za boma (anthu a ku Minnesota omwe amalandira ndalama pakati pa 200 ndi 275 peresenti ya umphaŵi tsopano ali ndi njira zogwirira ntchito zogwirira ntchito kudzera pa Zopereka, ACA imafuna kuti BHPs ikhale yoyenera pamapepala a umphaŵi).
Zinali zopindulitsa kwambiri ku New York kukhazikitsa BHP. Kuyambira m'chaka cha 2001, New York inapereka chithandizo cha boma ku Medicaid kwa anthu omwe asamukira kumeneko (omwe sankayenera kulandira Medicaid ndalama zolimbirana mogwirizana ndi boma ndi boma, popeza ndalama za Medicaid sizingagwiritsidwe ntchito pobisa anthu omwe asamukira ku America. pansi pa zaka zisanu). Popeza kuti kufalitsa kwa BHP kulipo kwa anthu omwe asamukira kumene, kusintha kwa New York ku BHP chitsanzo kumatanthauza kuti sakadaliranso mokwanira pa ndalama za boma kuti apeze anthu ochepa omwe amapezeka kumene.
Chisankho cha Boma la Trump mu Oktoba 2017 kuthetsa ndalama zothandizira ndalama kuti zithetse kuchepetsa ndalama zowonjezera kuchepetsa ndalama zomwe boma limapereka kuti BHP alandire patsogolo, koma ndalama zonse za federal kwa BHPs ndizo ndalama zomwe boma la federal lizigwiritsa ntchito pothandiza ndalama zapadera - ndalama zomwe zikanakhala zitagwiritsidwa ntchito pa kuchepetsa kugawana mtengo ndi gawo laling'ono. Kuchepetsa ndalama zoperekera ndalama zochepetsera ndalama kumagwiranso ntchito yaikulu ku New York ndi Minnesota, ngakhale kuti mabungwe onsewa akupitirizabe kugwira ntchito za BHP ndi 2018, anthu omwe ali oyenerera amakhala ndi ndondomeko zomwezo zomwe zinagwiritsidwa ntchito zaka zapitazi.
Kodi Maiko Ena Adzakhazikitsa BHP?
Pulogalamu ya BHP ilipo ponseponse, koma sizikuoneka kuti mayiko ena ambiri adzatha kukhazikitsidwa. Kawirikawiri, boma likufunika kuti likhale lowonjezera Medicaid ndikukhazikitsa mgwirizano wake wa inshuwalansi kuti BHP ikhale njira yeniyeni. Ndipo ngakhale malingaliro oyenerera okhudzana ndi thanzi saganizire nkomwe pa ndalama za boma, BHP imayika boma pa nkhwangwa yowonjezera ndalama, ngati ndalama za federal sizikwanira (onse a New York ndi Minnesota afunika kuphimba ena mtengo wa BHPs, komanso kuthetsa ndalama za federal kuti zithetse kugawa ndalama zimapangitsa kuti pakhale kusiyana pakati pa zomwe pulogalamu ikulipirira komanso zomwe boma likulipira).
Koma anthu ndi mabanja omwe ali ndi ndalama zochepa kwambiri ku Medicaid amathandizidwa bwino ndi BHPs. M'mayiko omwe alibe BHP, pali "chinyezi" chofunika kwambiri ponena za malipiro ndi kugawana mtengo pakati pa malingaliro ndi ndondomeko zapadera pa kusinthanitsa, ngakhale ndi ndalama zothandizira phindu komanso kugawa malipiro okhudzidwa pa ndondomeko yapadera (zopindulitsa za kuchepetsa kugawana ndalama akadalipo, ngakhale kuti boma la federal silikulipiranso inshuwalansi kuti lizipindula).
Munthu yemwe ali ndi chithandizo cha Medicaid amalipiritsa pang'ono kapena sapanda malipiro, ndipo kugawana mtengo kumangokhala malipiro ochepa chabe pansi pa malamulo a federal. Ngati munthu ameneyo akupeza ndalama zochepa ndipo ndalama zake zimakula kuchokera pa $ 16,600 kufika $ 16,700 (mu 2017), adzatayika ku Medicaid (akuganiza kuti ali mu boma lomwe lawonjezera Medicaid). Ngati ali mu boma ali ndi BHP ndipo ndalama zake zimakhala zapamwamba kwambiri ku Medicaid, adzalandira malipiro a BHP mmalo mwake, omwe adzalipira malipiro ake (kapena ayi, ku New York), malinga ndi ndalama zake ), ndipo ndalama zake zopezeka m'thumba zidzapitirira kukhala odzichepetsa.
Koma ngati ali mu boma popanda BHP, ayenera kugula ndondomeko yathanzi yowonetsera. Malingana ndi komwe amakhala, angakhale woyenera kupereka ndalama zothandizira ndalama zowonjezera zokwanira kuti apeze ndalama zonse zamakonzedwe a mkuwa, koma mapulaniwa amabwera ndi ndalama zambiri (makamaka ndalama zokwana $ 6,500 mu 2018, monga momwe chiwerengerochi chiloledwa $ 7,350). Ngati amasankha osati kusankha ndalama zowonjezera ndalama (zomwe ziphatikizapo kuchepetsa ndalama zogawana ndalama, motero amakhala ndi ndalama zochepa zothandizira), amalipira pafupifupi 3 peresenti ya ndalama zomwe amapeza. Ndipo ngakhalenso ndi phindu logawanika pothandizirapo, iye amapereka zambiri mu zopatsa ndalama ndi zokopa kuposa zonse za BHP ziwiri zomwe zilipozo zimafuna olembetsa awo kuti azilipira.
M'mawu ena, kugwiritsidwa ntchito kwa BHP kumathandiza kuthetsa kusiyana pakati pa chithandizo cha ndalama / ndalama ndi ndondomeko yodziyimira yekha / ndalama, ndipo zimabweretsa ndalama zowonjezera zowonongeka kwa anthu omwe malipiro awo sali apamwamba kwambiri chifukwa cha kuyenerera kwa Medicaid. Koma kukhazikitsa BHP kungafune kuti boma ligwiritse ntchito ndalama zenizeni, ndipo zikhonza kuphatikizapo kusintha anthu omwe ali ndi inshuwalansi (omwe ali ndi chithandizo pazinthu zoyenera zaumoyo) pulogalamu yatsopano, zomwe zingasokoneze anthu okhalamo ndi odwala, ndipo akhoza kukhumudwitsa ponena za kupitiriza kwa chisamaliro.
> Zotsatira:
> Mabanja USA. Zotsatira za umphawi wadziko.
> HealthCare.gov. Werengani Yopanda Thandizo Labwino. Gawo 4, Kukhazikika Kwaboma kukhazikitsa Mapulogalamu Ena. Gawo 1331 (tsamba 93 la ndime).
> Minnesota Department of Human Services. MinnesotaCare (Pulogalamu ya Pulogalamu, Kuyenerera, Kupindula, Mafunsowo).
> State of Health ku New York. The Essential Plan.