Kusunga Ana Achimereka Amtendere
Pulogalamu ya Medicaid komanso ya Health Insurance (CHIP) imapereka chithandizo chaumoyo kwa ana opeza ndalama zochepa. Mapulogalamu onse awiriwa amathandizidwa ndi magulu a boma ndi boma. Onse awiri akuthamangitsidwa ndi mayiko.
Pali kusiyana kosiyana pakati pa mapulogalamu awiri omwe muyenera kumvetsa ngati muli ndi mwana wosowa chithandizo chamankhwala. Mwachidule, zimadalira m'mene mumakhalira.
Kulingalira kwa Medicaid kwa Ana
Ana oleredwa m'mabanja omwe amapeza ndalama zokwana 133 peresenti kapena zochepa za federal poverty level (FPL) pachaka ali oyenerera Medicaid. FPL imawerengedwa ndi Dipatimenti ya Zaumoyo ya Zaumoyo ku United States chaka chilichonse ndipo imakhala yowerengedwa ndi anthu omwe ali pamabanja omwe amaganiziranso malo. Ndipotu, maiko ena ndi okwera mtengo kwambiri kuposa ena, mwachitsanzo, Alaska ndi Hawaii.
Asanafike pa 2010, ana adalandira Medicaid malinga ndi msinkhu wawo komanso banja lawo. Kawirikawiri, mwana wamkulu akapeza, mosakayikira ankayenera kupeza chithandizo cha Medicaid kuti apeze phindu limodzi la banja. Chodabwitsa, izi zikutanthauza kuti ana ena okha omwe ali m'banja lomwelo akhoza kubwerezedwa chaka chilichonse. Lamulo latsopanoli linapangitsa kuti ana omwe ali ndi zaka 0 mpaka 19 azikhala oyenerera.
Mabungwe ena adakali ndi zofunikira zosiyana ndi magulu osiyanasiyana, koma mtengo wamtengo wapatali tsopano wapangidwa ndi 133 peresenti ya FPL kwa ana onse. Pomwe ACA isanayambe, malo oyenererawo adayikidwa pa 100% peresenti kwa ana a pakati pa 6 ndi 19.
Kuyenerera kwa CHIP
Medicaid cholinga chake ndi kusamalira ana osauka kwambiri.
Pulogalamu ya CHIP inakhazikitsidwa mu 1997 monga njira yowonjezera chithandizo kwa ana omwe ali ndi ndalama zochepa za banja koma omwe amachoka kunja kwawindo loyenera la Medicaid.
Pomwe pamapeto pake amapeza chisankho cha CHIP, koma mabungwe ambiri (46 akuti ndi District of Columbia) anaika chigawochi pa 200% mwa FPL kapena zambiri.
Zothandizira Zachigawo za Medicaid
Pankhani ya Medicaid, boma la federal likugwirizana ndi boma likugwiritsa ntchito "dola ya dola," mwa lingaliro. Amagwiritsa ntchito zomwe zimatchedwa Federal Medical Assistance Percentages (FMAP) kuti adziwe kuchuluka kwa ndalamazo. FMAPs amalingalira ndalama zomwe boma limapeza pokhudzana ndi chiwerengero cha dziko.
Dziko lirilonse lapatsidwa FMAP la magawo 50 peresenti, mwachitsanzo, boma la boma limalipira 50 peresenti ya ndalama za Medicaid. Maiko ena onse amalandira ndalama zapamwamba za Medicaid ndalama pogwiritsa ntchito FMAP yawo yowerengedwa. Pogwiritsa ntchito ndalama zowonjezera pamwezi, Mississippi ili ndi 2017 FMAP ya 74.63 peresenti kotero kuti boma likupereka $ 2.94 kwa $ 1 ndalama zomwe boma likugwiritsa ntchito.
Pofuna kupeza ndalama za Medicaid, mabungwewa amavomereza mawu ena. Chikhalidwe sichiloledwa kuika anthu pa ndandanda yodikira, sichikhoza kukhala ndi chikwama cholembetsa, ndipo sichikhoza kulipilira malipiro kapena mapepala a ndalama kwa aliyense wopeza zosakwana 150 peresenti ya FPL.
Ndalama Zachigawo za CHIP
Ndalama zothandizira zachitukuko za CHIP, zakhala zikuyimira malire. Dziko lililonse limapatsidwa chigawo chaka chilichonse ngati ndalama. Ndalama za dola zimakhazikitsidwa mosasamala chiwerengero cha anthu omwe ali ndi pulogalamuyi.
A states 50 ndi District of Columbia ali ndi mwayi wogwiritsa ntchito ndalama zawo mwa njira imodzi:
- Monga mgwirizano wa Medicaid-CHIP (mapulogalamu 29 a boma)
- Monga mbali ya kukula kwa Medicaid (mapulogalamu 9 a boma)
- Monga pulogalamu yapadera ya CHIP (mapulogalamu 13 a boma)
Polimbikitsa dziko kuti lichite nawo ku CHIP, boma la federal limapereka chiwerengero chokwanira kuposa Medicaid.
Chiwerengero cha mtundu wa Medicaid chofanana ndi 57 peresenti koma ndi 70 peresenti ya CHIP. Kachiwiri, akunena kuti zosowa zachuma zapamwamba zibwezeredwa pamtunda wapamwamba.
Amenewa akugwiritsa ntchito mapulogalamu osakaniza kapena kuwonjezereka kwa Medicaid ali ndi zofanana pulojekiti monga Medicaid yachikhalidwe. Mayiko omwe ali ndi mapulogalamu a CHIP osiyana, komabe ali ndi chipinda chokwanira. Ngati kuli kofunikira, akhoza kuika ana pazindi zodikira kapena kukhazikitsa zikhomo zolembera kuti azibwezeretsanso ndalama za CHIP. Ambiri mwa maikowa adzapatsanso ndalama zapayimenti ndi mapepala kwa omwe amapindula nawo.
Kusiyanasiyana kwa Coverage for Medicaid ndi CHIP
Federal malamulo mandate Medicaid amapereka chithandizo kwa ana awo ophimbidwa. Izi zikuphatikizapo Kuyang'ana ndi Kuyang'ana Nthawi Zonse, Kuzindikira ndi Kuchiza (EPSDT), ntchito zowonjezereka zomwe zimayang'ana chisamaliro ndi chitsimikizo. Izi zikuphatikizapo zotsatirazi:
- Kufufuza mwachidule mbiri
- Kusamalira mano
- Kumvetsetsa, kuphatikizapo mapuloteni a cochlear ndi zothandizira kumva
- Katemera ndi katemera
- Yambani kuyang'ana
- Kufufuza zaumoyo ndi uphungu
- Kuyezetsa thupi
- Kuunika kwa masomphenya, kuphatikizapo magalasi
Mapulogalamu omwe amaphatikizidwanso ndi Medicaid akuphatikizapo chisamaliro chomwe chimaperekedwa ku Maofesi a Health Federally Qualified (FQHCs) komanso ntchito zothandizira anthu.
Mapulogalamu a CHIP, komabe, sakuyenera kutsata ndondomeko ya EPSDT, ngakhale kuti ayenera kupereka chithandizo chachithandizo chomwe chimaphatikizapo chisamaliro cha chipatala, maphunziro a laboratory, x-ray, ndi mayeso a ana abwino, kuphatikizapo katemera. Kusamalira mazinyo sikungakhale kwakukulu monga zomwe zinaperekedwa pansi pa EPSDT koma ziyenera kukhala mbali ya phukusi lopindulitsa. Kuti izi zitheke, boma lirilonse lingasankhe malingaliro awo a mano pogwiritsa ntchito ndondomeko yotchuka kwambiri ya antchito a boma, omwe amagwiritsidwa ntchito kwambiri ku federal ogwiritsira ntchito mano a anthu ogwira ntchito, kapena kufotokozedwa kuchokera ku ndondomeko yotchuka ya inshuwalansi ya malonda mu boma.
Tsogolo la Medicaid ndi CHIP
Politically, Medicaid ndi nkhani yotsutsidwa. Utsogoleri wamakono ukuyesera kubwezeretsa Chithandizo Chamtengo Wapatali cha Care Care, chomwe chidzathetsa kuwonjezereka kwa Medicaid. Cholinga chake ndi kuchepetsanso ndalama za federal kuti zitheke ku Medicaid.
Ndondomeko ya posachedwapa ya zaumoyo ya GOP ikufuna kusintha malo omwe amagwirizana ndi Medicaid ndi thandizo loperekera malire ku boma lililonse. Ngakhale kulandira thandizoli kunali kopindulitsa pa pulogalamu ya CHIP, pulogalamu ya CHIP ndi yochepa kwambiri kuposa Medicaid. Ndiponso, malipiro oletsa malire amalephera kuchuluka kwa ana omwe angapezeke pansi pa CHIP. Mayiko omwe amapereka ndalama zothandizira anawo amaika ana pamndandanda wodikira.
Ndi angati ana omwe angatayire chithandizo chaumoyo ngati GOP kukonzanso kuchipatala kukuchitika?
Mawu Ochokera
Ana oleredwa m'mabanja opeza ndalama akuyenera kulandira chithandizo chamankhwala chofanana ndi anzawo omwe amapeza ndalama zambiri. Medicaid imapereka chisamaliro kwa mabanja osauka kwambiri pamene CHIP imapereka chithandizo ku chiwerengero cha ana ambiri. Kusamalira pulogalamu ya Medicaid kungakhale kwakukulu, koma pulogalamu ya CHIP imaperekanso kufotokozera kwakukulu. Kumvetsetsa kusiyana pakati pa mapulogalamu awiriwa ndi kupindula kwambiri ndi thanzi la mwana wanu.
> Zotsatira:
> Child's Health Insurance Program (CHIP). Webusaiti ya Medicaid.gov. https://www.medicaid.gov/chip/chip-program-information.html.
> Pezani Mapulogalamu mu Boma Lanu. InsureKidsNow.gov webusaitiyi. https://www.insurekidsnow.gov/state/index.html.
> Dongosolo la Kulembetsa kwa Medicaid ndi CHIP. Webusaiti ya Medicaid.gov. https://www.medicaid.gov/medicaid/program-information/medicaid-and-chip-enrollment-data/index.html
> Patrick SW, Choi H, Davis MM. Kuwonjezeka mu federal machesi kugwirizana ndi zofunikira zopindulitsa mu kufotokozera ana kudzera Medicaid ndi CHIP. Health Aff . 2012 Aug; 31 (8): 1796-802. lembani: 10.1377 / hlthaff.2011.0988.
> Racine AD, Long TF, Helm ME, ndi al. Pulogalamu ya Inshuwalansi ya Ana (CHIP): zopindulitsa, zovuta, ndi ndondomeko za ndondomeko. Matenda. 2014 Mar; 133 (3): e784-93. lembani: 10.1542 / peds.2013-4059.