Kusamalidwa kwaulere kwapadera - limodzi mwa mapindu othandizira azaumoyo a ACA - ndi limodzi mwazinthu zowonjezera za Care Act. Insureds pazinthu zonse za ACA-zovomerezeka siziyenera kulipira chirichonse pa mndandanda wautali wa ntchito zothandizira zomwe zimagwira akazi, ana, ndi akulu onse.
Kusamalidwa kwaulere kumaphatikizapo ndondomeko zambiri zaumoyo ku US tsopano, ndipo zinakhazikitsidwa chisanayambe kuchuluka kwa zochitika za ACA mu 2014.
Mapulaniwa amagwiritsidwa ntchito pazinthu zapadera komanso magulu akuluakulu ndi ang'onoang'ono. Ndondomeko za umoyo wathanzi sizingatheke kufunika koyang'anira chisamaliro chopanda malipiro (malingaliro omwe anabadwa nawo ndi omwe anali atagwira ntchito kuyambira pa March 23, 2010 a ACA atasindikizidwa kukhala lamulo). Mu 2014, pafupifupi gawo limodzi mwa magawo anayi a antchito omwe analandira mapulani omwe amathandizidwa ndi abwana awo adakhala akudziwitsidwa. Koma kuchuluka kwa mapulani a abambo akuchepa kwambiri kuyambira 2010.
Zokambirana zapakati - zomwe zilipo zaulere?
HHS inakhazikitsa mndandanda wa chisamaliro chodziletsa cha amayi chomwe chinayamba kugwira ntchito pazinthu zonse zatsopano komanso zatsopano zomwe sizinali zazikulu kuyambira August 2012. Zimaphatikizapo kulandira chithandizo popanda kulandira ndalama. Koma izi sizikutanthauza kuti njira iliyonse yopezera kubereka idzaperekedwa ndi wothandizira inshuwalansi wanu popanda ndalama.
HHS inafotokoza kuti ndondomeko zathanzi ziyenera kuwonetsa njira imodzi yokha ya ma ARV yovomerezeka yobereka, kupatulapo mankhwala osokoneza bongo (mapulani a zaumoyo safunikanso kubisa njira za kulera kwa amuna, kuphatikizana ndi matendawa).
Pamene mitundu yeniyeni ya kulera imapezeka, dongosolo la thanzi lingapereke zowonjezereka popanda kugawana mtengo koma zimapereka copay ngati bwanayo akusankha dzina la chizindikiro (pali chofunika kuti copay ikhetsedwe ngati dokotala wa inshuwalansi amatsimikiza kuti njira ina yoperekedwa popanda malipiro ndi dongosolo la thanzi lingakhale yosayenera kwa wodwalayo).
Pakalipano pali mitundu 18 yosiyana siyana ya kulera kwa amayi yovomerezedwa ndi FDA:
• Kuchita opaleshoni
• Kupanga kupatsirana kwa opaleshoni
• Ndodo yokhazikika
• Chida cha intrauterine (IUD)
• IUD ndi progestin
• Shot / jekeseni (Depo-Provera)
• Mankhwala opatsirana pakamwa (pilisi), ndi estrogen ndi progestin
• Kupatsirana mwachisawawa ndi progestin kokha ("piritsi mini")
• Kupatsirana mwachisawawa ndi ntchito yowonjezereka yomwe ikuchedwa kuchepetsa msinkhu (kumatchedwanso kuti piritsi yakugonjetsa)
• Chigamba
• Ngongole yobereka
• Mfupa
• Sponge
• Chipewa cha khola
• Kondomu yazimayi
• Spermicide
• Kuperekera mwachangu (Mapulani a B / mapiritsi a m'mawa)
• Kupatsirana mwamsanga (Ella / Ulipristal acetate)
Wothandizira inshuwalansi wanu akuyenera kukupatsani mwayi umodzi mwa magawo khumi ndi atatuwo, osakhala ndi ndalama zambiri. Kwa mitundu ina ya kulera, pali njira zambiri zomwe mungapeze, ndipo bwenzi lanu la inshuwalansi lanu likhoza kuitanitsa ndalama zambiri kwa iwo, malinga ndi zomwe simungapereke kwaulere.
LARC - yotsika mtengo pansi pa ACA
Chofunika kuti njira iliyonse ya kulera ikhalepo popanda kugawana ndalama ndizofunika kwambiri kwa njira zothandizira kupanga njira zowonongeka kwa nthawi yaitali.
Zosankhazi nthawi zambiri zimakhala zotsika mtengo potsata ndalama zogwiritsira ntchito chithandizo chamagulu asanalandire chithandizo (ACA) ngakhale kuti pa nthawi ya moyo wawo, nthawi zambiri zimakhala zocheperapo kusiyana ndi kulera kovomerezeka. Koma iwo ndi ogwira mtima kwambiri ndipo maphunziro apeza kuti amayi amawakonda iwo njira zina za kulera pamene mtengo suli chotchinga. Ntchito yogwiritsira ntchito njira zowonongeka kwa nthawi yayitali inali ikuwonjezeka kale mu 2012, ndipo akatswiri akukonzekera kuti kugwiritsa ntchito kwawo kudzawonjezeka chifukwa cha ACA.
zovuta zothandizira kulera
ACA inachotsa mipingo ndi zipembedzo zopanda phindu kuchokera ku ntchito ya kulera, koma mabungwe ena adanyoza lamuloli ndipo ena apambana m'khoti.
Mu 2014, Lobby Labby inagwirizana ndi ufulu wochotsa mitundu inayi ya njira zothandizira kulera (onse awiri, limodzi ndi Plan B ndi Ella) kuchokera ku ndondomeko ya thanzi lawo. Khoti Lalikulu Lachitatu linagwirizana ndi Mafilimu Othandiza Anthu Kuchita Zabwino, akulamula kuti boma liyenera kupeza njira zowonetsetsa kuti mabungwe ogwirira ntchito (monga Hobby Lobby) akutsutsa njira zina kapena njira zonse zothandizira kubereka angapewe kulipira monga gawo za dongosolo lawo la thanzi.
Mu July 2015, poyankha ku Burwell v Hobby Lobby ruling, HHS anamaliza chigamulo chomwe chimaloleza nyumba za "bungwe lopindulitsa ndalama zomwe zimatsutsana ndichipembedzo kuti zipereke chithandizo cha zina kapena zonse zothandizira kulera," akadali Kuonetsetsa kuti amayi ali ndi mwayi wopeza njira zothandizira ana a EDA. Pansi pa nyumbayo, wothandizira inshuwalansi (kapena wothandizira chipani chachitatu payekha payekha) amatenga mtengo wophimba zina kapena zonse zothandizira, popanda ndalama kwa mkazi kapena abwana. Malo ogwirira ntchito omwe amagwiritsidwa ntchito mosamala ndi ofanana ndi malo omwe HHS anali atapereka kale kuti asakhale achipembedzo.