Zosintha Zingasokonezeke Malinga ndi Kumene Mukupeza Inshuwalansi Yanu
Donald Trump adalonjeza kuti adzalanda mwamsanga ntchito yothandizira ntchito (Obamacare), ndikutsatiranso ndi "kusintha koyambirira koyenera kutsata zomwe zikutsatira mfundo za msika waufulu komanso zomwe zidzabwezeretse ufulu waumwini ndi chitsimikizo kwa aliyense m'dziko lino. "
Mabungwe a Congressional Republic sanawonongeke nthawi yowonjezera mpira kugubuduza pa ACA, kupatula chisankho cha bajeti isanayambe kukhazikitsidwa kwa Trump, ndikuwongolera makomiti a congressional kuti ayambe kulemba malamulo kuti athetse ndalama za ACA.
Ndipo pa tsiku loyamba la Trump mu ofesi, adalamula akuluakulu a boma kuti azikhala osayamika poyendetsa msonkho wa ACA ndi zilango.
Koma ACA yatsimikiziridwa kuti yakhazikika kwambiri m'ntchito yathu ya chisamaliro, ndipo n'kovuta kubwereza kuposa utsogoleri wa GOP womwe uyembekezera. Ngakhale kuti a Republican amayang'anira Nyumba, Senate, ndi White House, kubwezeretsedwa kwa ACA kunalephereka mu 2017. Anthu a Republican aboma anagonjetsa ( American Health Care Act ) mu May 2017, koma a Senate Republican alephera kudula malemba atatu mu July 2017, ndipo khama lomaliza lachinyumba mu September 2017 silinayambe kuvota pa nyumba ya Senate, chifukwa cha kusowa thandizo.
Koma Bungwe la Congress ndi Trump lakhala likuchotsa lamulo la chisamalidwe cha zaumoyo m'zinthu zing'onozing'ono, zina zomwe zingakhudze chithandizo cha umoyo chomwe anthu ali nacho:
Chilango cha munthu aliyense chomwe chinaperekedwa mu 2019
Mu December 2017, Tax Cuts and Jobs Act anachotsa chilango cha ACA payekha, kuyambira mu 2019.
Pano pali chilango chosavomerezedwa mu 2018 , koma sipadzakhalanso chilango chosavomerezedwa mu 2019 ndi kupitirira, pokhapokha ngati muli ku Massachusetts kapena boma lina limene limagwiritsa ntchito chilango chake.
Zina mwa misonkho ya ACA, kuphatikizapo msonkho wa Cadillac , awonetsedweratu, pansi pa mawu a HJ Res.125, ndalama zogwiritsira ntchito stopgap zomwe zinakhazikitsidwa kumayambiriro kwa 2018.
Kuchetsedwa kwa ndalama za CSR
Boma la Trump linachotsa ndalama zothandizira ndalama kuti zikhale zocheperapo ndalama (CSR) mu Oktoba 2017. Koma zopindulitsa za kuchepetsa kugawanitsa ndalama zidakalipo kwa olembetsa oyenerera, ndipo ambiri osinthanitsa nawo saloledwapo, kapena bwino kwambiri, tsopano ndalama zinachotsedwa. Ndichifukwa chakuti mabungwe ambiri amaphatikizapo ndalama za CSR ku ndalama zowonetsera ndalama za 2018 , zomwe zinapangitsa kuti pakhale ndalama zambiri zothandizira anthu omwe ali oyenerera kulandira thandizo la premium.
Pokhapokha ngati boma likupitiriza kulola a inshuwalansi kuwonjezera mtengo wa CSR ku malipiro a ndalama zowonongeka m'zaka za mtsogolo, ambiri olembetsa adzatetezedwa ku zotsatira za kuthetsedwa kwa ndalama za CSR, ndipo ambiri adzapitirirabe bwino, chifukwa cha ndalama zazikulu zothandizira.
Malamulo Operekedwa
Ndipo Ulamuliro wa Trump umapanganso malamulo omwe angalolere ndondomeko yaifupi kuti ikhale ndi nthawi yaitali mpaka masiku 364 (lamulo lomwe Obama Administration adawakhazikitsa, pofuna kuteteza msika wokhazikika), ndi kulola zambiri anthu odzigwira ntchito komanso mabungwe ang'onoang'ono kuti azilembera ku mgwirizano wathanzi .
Zambiri za Leniency kwa Medicaid Waivers
Boma la Trump lawonanso kuti iwo adzakhala ocheperapo kuposa Obama Administration anali kuvomerezera 1115 maivers kwa maiko omwe akufuna kusintha ku mapulogalamu awo a Medicaid.
Pamwamba pa mndandanda wa mayina ena akuti "zokhumba zokhumba ndi ntchito yofunikira ya Medicaid (yomwe nthawi zonse inkawakanidwa ndi Obama Administration), ndipo mayiko atatu adalandira kale ntchito yovomerezeka mu 2018: Arkansas, Kentucky, ndi Indiana, ndi ena ambiri akuti 'zopitilira zofuna zokhudzana ndi boma la federal.
Choncho ngakhale kuti ACA yokha imakhala yosasunthika, pangakhale kusintha kwina. Tiyeni tiwone momwe kusintha kumeneku kungakhudzire inshuwalansi ya umoyo wanu, malingana ndi komwe mukupezeka panopa. Tidzayang'ana mbali zazikulu zinayi zomwe zikuphatikizapo inshuwalansi ya inshuwalansi:
- Ndondomeko zoperekedwa ndi ogwira ntchito (49 peresenti ya Achimereka)
- Kugulitsidwa kwa malonda payekha (7 peresenti ya a ku America)
- Medicare (14 peresenti ya Amereka)
- Medicaid (19 peresenti ya Achimereka)
Wogwira Ntchito-Inshuwalansi Za Umoyo
Mwachidule:
- Ngati abwana anu amapereka chithandizo panopo, iwo adzapitiriza kuchita zimenezo. Ntchito ya abwana, yomwe imafuna kuti abwana ambiri apereke chithandizo, sakhala yosasinthika.
- Payimenti yanu ikhoza kukhalabe msonkho.
- Mukhoza kuona kusintha kwa machitidwe a zaumoyo akuluakulu (HDHPs) ndi akaunti za ndalama zachuma (HSAs).
- Ngati mumagwira ntchito yaing'ono, bwana wanu akhoza kutembenukira kumsonkhano wathanzi.
Zambiri:
Pafupi theka la Achimereka amatenga inshuwalansi ya umoyo kwa abwana. Ndipo ngakhale kuti ACA yapanga kusintha kwakukulu potsatsa chithandizo chogwiritsidwa ntchito ndi abwana, ndondomeko zogwiritsidwa ntchito ndi anchito zakhala zikulamulidwa kale, pansi pa HIPAA, kusiyana ndi malonda a msika.
ACA imafuna antchito aakulu (antchito 50 kapena ambiri) kuti apereke ndalama zowonjezereka, zowonjezera zowonjezera kufikira nthawi zonse (antchito 30+ pa sabata) ogwira ntchito. Ndipo ngakhale kuti chilango cha ACA cha munthu aliyense chidzathetsedwa monga cha 2019 (mwachitsanzo, sipadzakhalanso chilango kwa anthu omwe alibe chithunzi), chilango cha abwana chimakhalabe, ndipo olemba akulu ayenera kupitiriza kupereka chithandizo .
Ngakhale ntchito ya abwana iyenera kuchotsedwa kudzera m'malamulo amtsogolo, olemba ntchito ambiri angapitirizebe kupereka chithunzi. Pafupifupi antchito onse akuluakulu kale amapereka thandizo la thanzi pamaso pa ACA. Kaiser Family Foundation imasonyeza kuti 96 peresenti ya antchito akuluakulu (50+ ogwira ntchito) amapereka chithandizo chamankhwala mu 2015. Icho chinali chapamwamba kwambiri kuposa 95.7 peresenti ya olemba ntchito ambiri amene amapereka chithandizo chamankhwala mu 2013, pamene ntchito ya abwana sanali komabe m'malo.
Olemba ntchito amagwiritsira ntchito inshuwalansi yaumoyo pamodzi ndi phindu lawo lonse - kuti akope ndi kusunga antchito abwino kwambiri. Ndipo amatha kugwiritsa ntchito ndalama zisanapereke msonkho kuti azilipira zomwe amapereka ( monga antchito ). Pogwiritsa ntchito kusintha kwakukulu mukhodi ya msonkho, mwinamwake olemba ntchito adzapitiriza kupereka chithandizo chopita patsogolo, osachepera nthawi yayitali.
Zingatheke kuti malamulo amtsogolo angabweretse kusintha kwa misonkho ya msonkho yomwe ikugwiritsidwa ntchito ndi mapulani omwe amagwiritsidwa ntchito ndi abwana. Nyumba Yapanisiya inafalitsa pempho lokonza chisamaliro cha zaumoyo mu June 2016 lomwe likufuna chikhomo potsata phindu la thanzi kuchokera ku msonkho wokhomera msonkho. Cholingacho chimalongosola njira zomwe zidzasinthidwe ndi msonkho wa ACA wa Cadillac koma kuchokera kwa ogwira ntchito, zotsatira zake zidzakhala zofananako: Olemba ntchito angayambe kukana mapulani okwera mtengo, chifukwa gawo lina la msonkho likhoza kutha. Koma palibe chomwecho chomwe chinakhazikitsidwa mu 2017, ndipo kusintha kwakukulu ku ndondomeko ya zaumoyo sikungatheke kuganiziridwa mu chaka cha chisankho, kotero izi zikhoza kukhala patebulo la nthawiyo.
Ngati mumagwira ntchito kwa abwana ang'onoang'ono ndipo abwana anu adalandira mapulani a kagulu kaching'ono kuyambira 2014, ndondomeko yanu ikuphatikizapo kufotokozera zofunikira za thanzi la ACA . Ngati zofunikira zaumoyo zoyenera za ACA ziyenera kusinthidwa kupita patsogolo, zenizeni za kufalitsa kwanu zingasinthe. Koma malamulo omwe akanasintha madalitso ofunikira ofunikira sanadutse mu 2017, kotero palibe chomwe chatsintha pa nthawiyo. Ndipo ngakhale zitasintha mtsogolomu, panali kusintha kosiyanasiyana-monga HIPAA ndi Pregnancy Discrimination Act-zomwe zinali zogwiritsidwa ntchito kwa msika wa inshuwalansi wathanzi pamaso pa ACA, ndipo sichidzakhudzidwa ndi aliyense kusintha komwe kumapangidwira ku ACA.
Ngati Boma la Trump lidzatsiriza malamulo omwe angapangidwe kuti agwirizanitse mgwirizano wa thanzi , izo zikhoza kutsegulira mapulani awo ku malonda ang'onoang'ono. Izi zingachititse kuti inshuwalansi yaing'ono yothandizira, komanso kuchepetsa ubwino wa thanzi, kwa mabizinesi ang'onoang'ono omwe amalumikizana ndi mapulani a zaumoyo. Izi zikhoza kuchititsa kuti ndalama zothandizira inshuwalansi zapamwamba zogulitsa zamakampani ang'onoang'ono omwe akupitiriza kugula chithandizo chovomerezeka cha ACA, chifukwa chingawathandize kukhala ndi thanzi labwino, magulu ang'onoang'ono omwe amasamukira ku mgwirizano wathanzi, kusiya dziwe lachilombo loopsa la ACA malingaliro ovomerezeka.
Inshuwalansi Zaumoyo Zamagulu Pamodzi
Mwachidule:
- Udindo womwewo ulipobe, ndipo ufunikiranso kufalitsa chaka cha 2018. Ngati simunalembe polembetsa, mungathe kulembetsa pokhapokha mutakhala ndi chiyeneretso (khalani okonzeka kupereka umboni woti mukuyenerera chochitika).
- Zothandizira zapadera ndi kuchepetsa kugawana mtengo zilipobe kwa olembetsa oyenerera.
- Chigwiritsiro chikutsimikiziridwabe.
- Malingaliro Omwe Amapulumutsa Odwala (HSAs) ndi mapulani othandizira kwambiri a zaumoyo (HDHPs) angakhale akugogomezedwa m'zaka zam'mbuyo.
- Mapulani a nthawi yayitali angakhalepo ndi nthawi yayitali m'mayiko ambiri.
- Zolinga zaumoyo zothandizira zikhoza kupezeka kwa anthu ogwira ntchito.
Zambiri:
Ngati mumagula inshuwalansi ya umoyo wanu, kaya mukusinthanitsa kapena kusinthanitsa , mumadziŵa kuti ACA inasintha kwambiri pa msika wa inshuwalansi ya thanzi.
Zonsezi zikukonzekerabe, ndipo zikutheka kuti zikhalebe m'malo mwamsanga. Chigamulo chaulemu chokhacho chinachotsedwa mu 2019, koma chikhalirebe chaka cha 2018, ndipo chidzasonkhanitsidwa pamabwerero a msonkho wa 2018, atayikidwa kumayambiriro kwa 2019.
Kuchokera kwa ACA's premium kuthandiza ndi kuchepetsa kugulitsa zochepa kumapitilira kupezeka kwa olembetsa oyenerera, ndipo palibe chilichonse chokhudza zimenezo chomwe chingasinthe posachedwa. A Congressional Democrats adalimbikitsa lamulo lomwe lingapangitse ndalama zowonjezereka, kuti zikhale zowonjezereka komanso zowonjezera kwa anthu ambiri, koma kusintha koteroko kungachitike ngati a Democrats ali ndi zikuluzikulu mu Congress pambuyo pa chisankho cha 2018 pakatikati.
Mndandanda wa malamulo okonzedwa mu 2019, HHS akufotokoza kuti akukonzekera "kulimbikitsa anthu opereka ndalama kuti apereke HDHPs [mapulani akuluakulu okhudzana ndi thanzi labwino] omwe angagwirizane ndi HSA [akaunti yowononga zaumoyo] ngati njira yosagwiritsira ntchito ndalama." Bungweli linanenanso kuti "akufufuza momwe angagwiritsire ntchito mapulani pa HealthCare.gov kulimbikitsa kupezeka kwa HDHPs kwa opempha." Ogulitsa amatha kuona zambiri zokhudzana ndi thanzi la HSA lomwe likupezeka pa msika umodzi mu 2019 ndi kupitirira. Koma mapulani omwe sali a HSA adzapitiriza kupanga zambiri zomwe zilipo pamsika.
Ngati malamulo omwe akufuna kukwaniritsa mapulani afupikitsa amatha kukwaniritsidwa, anthu ambiri m'mayiko angayambe kuwona zosankha za nthawi yayitali ndi nthawi ya masiku 364. Kuti zilembedwe bwino, mapulaniwa angakhale njira zabwino zokhazokha zothandizira ACA, chifukwa zidzakhala zosakwera mtengo kwambiri. Ndipo pofika mu 2019, sipadzakhalanso chilango cha munthu payekha chomwe chidzayankhidwe pa anthu omwe agula nthawi yayitali. Koma mapulani a nthawi yayitali ali ochepa pa momwe angathere (ambiri samaphimba amayi, amishonale, kapena mankhwala osokoneza bongo), ndipo amatha kukhala ndi zifukwa zosagwiritsidwa ntchito. Kuonjezerapo, ndondomeko za nthawi yayifupi zimakhala ndi phindu la pachaka komanso la moyo wosatha lomwe lingakhale lochepa, malingana ndi dongosolo.
Mapulani a nthawi yaying'ono adzakondweretsa anthu wathanzi, monga momwe zinthu zisanayambe ziliri. Malingana ndi kuchuluka kwa anthu omwe amagula mapulani a nthawi yayitali, dziwe loopsya la mapulani ovomerezeka a ACA likhoza kukhala labwino kwambiri kwa odwala, okalamba, omwe amachititsa kuwonjezereka. Kwa anthu amene amalandira ndalama zothandizira, ndalama zowonjezereka zidzathetsedwa ndi ndalama zowonjezera. Koma kwa anthu omwe sali oyenera kulandira thandizo la premium, kuonjezera ndalama zambiri kumangopanga kufalitsa mosavuta.
Chinthu chomwecho chidzachitika ndi mgwirizano wa thanzi la anthu ogwira ntchito. Ngati malamulo amatha kukhalitsa anthu ogwira ntchito kuti agulitse chithandizo chamagulu m'malo mwa chithandizo chachikulu cha ACA chovomerezeka, anthu omwe amagwira ntchito yathanzi kwambiri amatha kusinthana ndi mapulani ochepetsera ndalama, kusiya anthu okalamba, odwala ku ACA Zolinga zowonjezera, zomwe zili ndi malipiro akuluakulu ofanana.
Zowonjezereka ku mgwirizano wa ACA-zowonjezereka zikhoza kukhala zapamwamba chifukwa cha kuchotsedwa kwa chilango cha munthu aliyense mu 2019. Congressional Budget Office (CBO) inanena kuti anthu 3 miliyoni ochepa adzakhala ndi chidziwitso cha malonda mu 2019 monga zotsatira za kuwonongedwa kwa chilango, kukula kwa 5 miliyoni pofika mu 2021. CBO inaneneratu kuti ndalama zothandizira ndalamazo zidzakhala pafupifupi 10 peresenti chaka chilichonse kuposa momwe zikanakhalira ngati chilango chalamula chikanakhalabe m'malo, chifukwa anthu omwe angayambe kulandira chithandizo popanda ntchito anthu wathanzi (anthu odwala adzapitiriza kufalitsa, mosasamala kanthu kuti pali chilango).
Kachiwiri, mofanana ndi kuwonjezeka kwapadera komwe kungayambitsidwe ndi mapulani afupipafupi a mgwirizanowu, anthu omwe amapereka ndalama zothandizira ndalama zawo adzapatsidwa ndalama zowonjezereka (kupyolera mu ndalama zowonjezereka), pomwe iwo omwe sali woyenera thandizo Zidzakhala zovuta zowonjezera zomwe mungasankhe.
Medicare
Mwachidule:
- Palibe chomwe chikusintha tsopano. Malingaliro a kusintha kwa GOP sali pansi pa kulingalira kwamakono, ndipo ngati atsiriza kukhazikitsidwa, amaitana kusintha kwa nthawi yaitali, osati kusintha kosakhalitsa.
- Nyumba Yolankhula Paul Ryan wakhala akupempha kusintha kwa Medicare kwa anthu omwe ali ndi zaka zapakati pa 55, ndipo mwayi wake wochita zimenezi ndi wapamwamba kwambiri pansi pa Utsogoleri wa Trump kuposa momwe akanakhalira ndi Purezidenti Obama. Koma ndondomeko ya Ryan idzadalira a Republican kusunga ambiri ku Congress pambuyo pa chisankho cha 2018.
- ACA ikupitiriza kutseka chitseko cha Medicare Part D, ndipo palibe chomwe chatsintha pazomwekupita patsogolo.
Zambiri:
ACA sanapange kusintha kwa Medicare. Izi zinafuna kuti Medicare iyambe kuphimba maulendo a pachaka, ndipo yakhala ikutseketsa chitsimikizo cha Medicare Part D donut hole , yomwe idzatsekedwa mwakachetechete ndi 2020. Ndipo ngakhale itachepetsera malipiro a Medicare Advantage plans, kulembetsa kwa Medicare Advantage kwakula chaka chilichonse popeza ACA inakhazikitsidwa.
Medicare kusintha ndi ubongo wakhala nthawi yayitali pa zokambirana za GOP zosamalira zaumoyo. Nyumba ya Republican yatulutsa chikalata chobwezera Medicare mu 2016, koma sichikupita mpaka chaka cha 2018, ndipo sichikutheka kuti malamulo akuluakulu tsopano, akufika kumapeto kwa chaka cha chisankho.
Koma bungwe la Republic Republican 'la 2016, lomwe lingakhalebe patebulo m'zaka za mtsogolo ngati Republicans sungasunge mabungwe awo a Congressional pomwe Trump Administration ikuyendetsedwe, yotchedwa kusintha kwa Medicare, kuphatikizapo kulimbikitsa Medicare Advantage , yomwe ilipo panopa kwa Medicare kulemba.
Kuyambira mu 2020, pempho la a Republic Republic lidaitana kuti Medigap zikhale zoletsedwa. Pakalipano, pali mapulani ena a Medigap omwe amaphimba zonse kapena pafupifupi zonse zomwe amalembetsa olemba pansi pa Original Medicare. Ndondomeko ya Nyumbayi ikanachepetsa malipiro ambiri a Medigap omwe angayang'ane, pofuna kuteteza overutilization (lingaliro loti ngati olembetsa alibe ndalama zopezeka pakhomopo konse, iwo akhoza Kuwonjezera ntchito, zomwe zimapangitsa kuti ndalama zonse zisamalire). HR2, Medicare Access ndi CHIP Reauthorization Act, kapena MACRA, yomwe inasainidwa kukhala lamulo mu 2015, idayitanitsa kale kuti malonda a Plamu F and C atsopano atsitsire kumapeto kwa 2019, popeza kuti malingalirowa akugwira ntchito ya Medicare Part B mokwanira.
Cholinga cha 2016 chidzaphatikiza Medicare Part A ndi Part B , ndi umodzi umodzi wogwirizana ndi ndalama. Zidzathandizanso pang'onopang'ono zaka za Medicare zoyenerera kuti ziziyenda bwino ndi zaka zapuma pantchito yopuma pantchito.
Ndondomeko ya House Republican idapempha kuti Medicare "pulogalamu yothandizira pulogalamu yamakono" ikwaniritsidwe zaka pafupifupi khumi pansi pa msewu, ndipo iyenera kukhala yowonjezereka ku njira ya Medicare Advantage. Popeza padzakhala kuchedwa kwa zaka khumi, anthu omwe ali ndi zaka 55 kapena kupitilira adzalinso ndi Medicare momwe aliri lerolino. Koma achinyamata a ku America angakhale ndi mwayi-akatha kulandira thandizo la Medicare-kulembetsa ndondomeko yaumwini mmalo mwake, ndi malipiro a Medicare premium kupereka kwa iwo kwa inshuwalansi.
Malipiro awo adzakhudza zonse kapena phindu la ndalama, zidzasinthidwa kumtunda kwa anthu odwala omwe ali ndi malipiro apamwamba, ndipo adzakhala ochepa kwa okalamba omwe ali olemera omwe angathe kulipira gawo lalikulu la malipiro awo. Padzakhalanso thandizo lachuma kwa okalamba omwe ali ndi ndalama zochepa zomwe amafunikira kuthandizira kuthandizira ndalama zawo.
Medicaid
Mwachidule:
- Ngati dziko lanu likulitsa Medicaid pansi pa ACA, malangizo oyenererawa adakalipobe, ndipo mayiko ambiri akufuna kuwateteza, ngakhale mwina ndi zofunikira zowonjezera.
- Kentucky, Arkansas, ndi Indiana akukwaniritsa zofunikira za ntchito kwa akulu omwe sali olumala, ndipo maiko ena ambiri akuyembekezera chilolezo cha federal kuti agwiritse ntchito zofanana.
- Mayiko omwe sanatulutse Medicaid angathebe kuchita zimenezi, ndi ndalama zomwezi zomwe zimagwiritsidwa ntchito m'mayiko ena omwe atha kulandira Medicaid pansi pa ACA.
Zambiri:
Ndondomeko iliyonse ya Medicaid imayendetsedwa ndi ndalama ndi boma komanso ndalama. Mayiko omwe ali ndi ndalama zambiri amapeza ndalama zochepa zogwirizana ndi ndalama, pomwe iwo omwe ali ndi ndalama zochepa zimalandira ndalama zambiri zogwirizana ndi ndalama. M'mayiko omwe adalimbikitsa Medicaid (mayiko 31 ndi District of Columbia), boma la boma likulipira 94 peresenti ya ndalama zogwirizira anthu omwe angoyamba kumene kulowa mu 2018. Izi zidzatha kufika pa 90 peresenti pofika 2020, kupita patsogolo.
Maiko ena 19 amathabe kupititsa patsogolo Medicaid. Lamulo lomwe linalingaliridwa mu 2017 kuti lichotse ACA likanatseka mayiko ena kuwonjezera Medicaid, koma lamulo limenelo silinayambe lakhazikitsidwa. Maine omwe amavomereza amavomereza kuwonjezeka kwa Medicaid mu November 2017, kotero Maine akuyenera kukweza Medicaid mu chilimwe cha 2018.
Boma la Trump lawonetsa momveka bwino kuti iwo adzakhala ocheperapo kuposa Obama Administration anali kuvomerezedwa 1115 maivers kwa maiko omwe akufuna kusintha ku mapulogalamu awo a Medicaid. Mu 2018, Kentucky, Indiana, ndi Arkansas zakhala zikuvomerezedwa kale ndi boma kuti zigwiritse ntchito zofuna za Medicaid. Mayiko ena asanu ndi awiri akuyembekezera pempho loperekera, ndipo ena ambiri akuganiza zopepuka. Choncho munthu wamkulu wachikulire Medicaid amene amalembetsa nawo ntchito m'mayiko ena angachedwe kupeza nthawi yowonjezera ntchito (kapena odzipereka, sukulu, maphunziro a ntchito, ndi zina zotero) kuti asunge ma Medicaid.
Mayiko angapo, kuphatikizapo Arizona, Kansas, Maine, Utah, ndi Wisconsin, adafunanso kuti pakhale zaka zisanu zapadera zothandiza anthu odwala Medicaid, ngakhale kuti palibe mayiko omwe adalandira chivomerezo chakumayambiriro kwa 2018.
Tsono ngakhale kuti malangizo onse a Medicaid akuyenera kukhala osasinthika, olembetsa angakhale ndi malamulo oyenerera oyenerera, monga ntchito yofunikira kapena ndalama zazing'ono, ndi maumboni oyenerera nthawi zambiri.
Mawu Ochokera
Ngakhale kuti ACA yakhalapo kwa zaka zisanu ndi zitatu, nthawi zonse yakhala malamulo olekanitsa ndale. Congressional Republican sankatha kuiwononga mu 2017, koma zoyesayesa za malamulo ndi zoyendetsera ntchito ku ACA zikupitirirabe.
Kawirikawiri, malamulo othandizira ogulitsa ndi inshuwalansi akhalabe osasintha mu 2018, ndipo malamulo akuluakulu sitingathe kukhala nawo nthawi yapakatikati ya chisankho. Koma kusintha kwa chithandizo cha zaumoyo kudzapitirirabe kukhala nkhani yaikulu ku boma ndi boma pazaka zingapo zikubwerazi, ndipo mipando 2020 ya pulezidenti ikutheka kuti ikhale ndi ndondomeko yayikulu yothetsera mavuto a zaumoyo.
> Zotsatira:
> Dipatimenti ya Chuma, Dipatimenti Yacchito, Dipatimenti ya Zaumoyo ndi Zaumoyo. Nthawi Yang'ono, Nthawi yayitali Inshuwalansi (malamulo operekedwa). February 2018.
> Federal Register. Chitetezo cha Odwala ndi Ntchito Yodalirika Yopereka Chithandizo, Zoperekedwa Zopindulitsa za Phindu ndi Malipiro Owonetsera a 2019. November 2, 2017.
> Nyumba ya Oimira, Pulogalamu ya GOP Healthcare. Njira Yabwino, Lingaliro Lathu la Chikhulupiriro cha America . June 22, 2016.
> Kaiser Family Foundation. Inshuwalansi ya Umoyo wa Anthu Onse. 2016.
> Kaiser Family Foundation. Chidule cha Medicaid Per Capita Cap Proposals, June 22, 2016.
> Kasier Family Foundation. Peresenti ya Zigawo Zachuma Zomwe Zimapereka Inshuwalansi ya Zaumoyo kwa Ogwira Ntchito, ndi Mphamvu Zolimba. 2012-2015.