Ngati mumagula inshuwaransi yanu pamsika, mwinamwake mwawona mitu yokhudza kuwonjezereka komwe kudzabwera mu 2018. Msika wa magulu ang'onoang'ono, womwe umayendetsedwa pansi pa malamulo ofanana ndi Care Act (ACA) ngati msika wina aliyense , adzawonanso kuchuluka kwachulukidwe, ngakhale kuti kuwonjezeka sikudzakhala kofunika.
Koma nkhanizi zimangowonjezera kuchuluka kwa msinkhu, kaya kudutsa dziko lonse, kapena kudutsa mtundu wonse wa insurerds.
Kwa anthu omwe ali ndi magulu ang'onoang'ono omwe ali ndi magulu a inshuwalansi, chiwerengero chokwanira cha ndondomeko iliyonse ndi membala angakhale wosiyana kwambiri ndi a boma kapena a inshuwalansi.
Izi ndizochitika nthawi zonse, koma pali kusintha kwatsopano kwa 2018 malinga ndi momwe ana amawerengera ana makamaka achinyamata - ndipo izi zingachititse kuti mabanja ena aziwonjezeka. Choncho tiyeni tiwone zomwe zikuchitika ndi mitengo ya ana, ndi zomwe mungayembekezere chaka chatsopano.
Ana Adzakhala ndi Malipiro Otsatira
ACA inakhazikitsa malamulo atsopano pa malipiro a ndalama zothandizira inshuwalansi zaumoyo m'magulu a anthu amodzi kapena ang'onoang'ono (malingaliro awo ndi omwe anthu amadzigulira okha; mapulani ang'onoang'ono amaperekedwa ndi abwana omwe ali ndi antchito 50, koma pali zochepa zomwe magulu a antchito 100 amaganiziridwa kuti ndi magulu ang'onoang'ono ).
Pansi pa lamulo, kuyambira kwa akulu akulu sangakhale oposa katatu phindu la mwana wazaka 21.
Ana amapatsidwa mlingo wotsika, umene ukukhazikika pa 63.5 peresenti ya mlingo wazaka 21. Izi zinagwiritsidwa ntchito kwa ana onse, kuyambira khanda mpaka zaka 20, kuyambira 2014.
Zisanafike chaka cha 2014 (ie, malamulo a chiwerengero cha ACA asanayambe kukhazikitsidwa), ndalama zowonjezereka zimayikidwa pa magulu osiyanasiyana a zaka zosiyana siyana malinga ndi zomwe akuyembekezerapo pa gulu lililonse.
Ana amakonda kukhala ndi zifukwa zowonjezereka pamene ali aang'ono ndi ana aang'ono, zifukwa zochepa pamene ali m'sukulu zoyambirira komanso zapakatikati, ndiyeno amadzinenera kuti akukwera ngati ana aloŵa m'zaka zawo zachinyamata. Pakafika chaka cha 2014, mabungwe a inshuwalansi angaphatikizepo zimenezi muyeso wawo-ena anali ndi malipiro apamwamba kwa ana obadwa kumene, mwachitsanzo.
Koma pansi pa ACA ikulamulira kuyambira 2014 mpaka 2017, ana onse a zaka zapakati pa 20 anaimbidwa 63.5 peresenti ya msonkhanowu umene unagwiritsidwa ntchito kwa mwana wazaka 21. Izi zikusintha mu 2018, chifukwa cha malamulo atsopano omwe anamaliza ndi HHS mu December 2016 (njira yeniyeni yowonjezeramo ikufotokozedwa mu Zowonjezera 1 za HHS memo ):
- Mtengo wa msinkhu wa zaka 21 udzapitirira kuchuluka kwa ndalama zomwe ziwerengero zina zimayikidwa.
- Ana a zaka zapakati pa 0 mpaka 14 adzapatsidwa ndalama zokwana 76.5 peresenti ya mlingo woyambira.
- Ana a zaka 15 adzapatsidwa 83.3 peresenti ya mlingo woyambira.
- Ana a zaka 16 adzapatsidwa 85.9 peresenti ya mlingo woyambira.
- Ana a zaka 17 adzapatsidwa chiwerengero cha 88.5 peresenti ya mlingo woyambira.
- Ana a zaka 18 adzapatsidwa 91.3 peresenti ya mlingo woyambira.
- Ana a zaka 19 adzapatsidwa chiwerengero cha 94.1 peresenti ya chiwerengero chawo.
- Ana a zaka 20 adzapatsidwa chiwerengero cha 97 peresenti ya mlingo woyambira.
- Akuluakulu adzalandira malipiro okhudzana ndi msinkhu wawo, ndi chiwerengero chapamwamba (kwa anthu a zaka zapakati pa 64 ndi zapakati) katatu kawiri kawiri.
HHS inanena kuti ngakhale kuti ndalama zogulitsa zimakhala zapamwamba kwa ana a zaka zapakati pa 4 ndi kuchepa kwa ana a zaka zapakati pa 4 ndi 14, chiŵerengero chimodzi chokha cha ana kuyambira kubadwa mpaka zaka 14 chikulingalira kufalitsa ndalama ku chiwerengero chachikulu, ndi kuchepetsa kuwonjezereka kwadzidzidzi komwe kungagwiritsidwe ntchito kwa banja lomwe lili ndi khanda ngati ziwerengero zimakhazikitsidwa mokhazikika pazinthu zomwe akuyembekezeredwa pa gulu lirilonse.
Kusintha kumeneku mwa njira zomwe zimagwiritsidwa ntchito kuwerengera mitengo sizimaphatikizapo kuchuluka kwachiwerengero komwe kumachitika chaka chilichonse chifukwa cha kuchuluka kwa ndalama za chithandizo chamankhwala ndi zina zomwe zimayendetsa kuchuluka kwa kuchuluka kwa mankhwala.
Kusintha kumeneku kudzawonjezera kuchuluka kwa mlingo, kotero chiwerengero chatsopano cha ana chidzagwiritsira ntchito magawo akuluakulu a chiwerengero chachikulu chokhazikika, kuwonjezera kuwonjezereka kwa maulendo omwe angagwiritsidwe ntchito kwa ana.
Chigawo cha Columbia ndi asanu ndi awiri-Alabama, Massachusetts, Minnesota, Mississippi, New Jersey, Oregon, ndi Utah- amagwiritsa ntchito njira zawo-kukhazikitsira njira, kotero nambala zatsopano za ndalama zowonjezera ana sizigwira ntchito m'mayiko amenewo. Kuonjezera apo, New York ndi Vermont salola kuwerengera kwa zaka zonse, kotero palibe kusiyana kwa malipiro ozikidwa pa zaka zomwezo.
Magulu Aakulu Amagwiritsa Ntchito Zosiyana Njira
Zindikirani kuti ndalama zazikuluzikulu za gulu zimakhala zozikidwa pamagulu osiyanasiyana, ndipo zimangokhala zosiyana ngati wogwira ntchitoyo akulembera yekha, wogwira ntchito limodzi ndi mwamuna, wogwira ntchito limodzi ndi ana, kapena wogwira ntchito limodzi ndi mkazi ndi ana. Mibadwo ya ana-ngakhalenso chiwerengero cha ana-samaimirira kwenikweni mapepala omwe aperekedwa. Malamulo atsopano omwe atchulidwa pamwambapa pakuika malipiro kwa ana ndi ofunika ku msika wa gulu limodzi.
Lingaliro la Kusintha Sichidzakhala Lowonjezereka Pamene Anthu Adzasintha 21
Mitengo ya ana idzakhala yapamwamba mu 2018 kuposa momwe idakhalira kale, ndi kuwonjezeka kwakukulu komwe kumaperekedwa kwa achinyamata achikulire. Koma pamene anawo amatha zaka 21, sangawonjezere kuchuluka kwa mlingo umene ukugwiritsidwa ntchito. Zaka zisanafike 2018, munthu wosachepera 21 angayambe kulipira 63.5 peresenti ya mlingo wokhazikika kuti azilipira mlingo woyambira, zonse zowumpha; Dumpha lidzasinthidwa kudutsa zaka 15 mpaka 21.
Mitengo Yidzakhala Yochepa kwa Okalamba Kuposa Zomwe Zikanakhalapo
Ndikofunika kukumbukira kuti mapangidwe a zaka za m'badwo amayendetsedwa ngati njira yofalitsira ndalama zonse zomwe zilipo padziko lonse la insureds. Pa chiwerengero cha malipiro oyambirira omwe amafunika kuti awonetse mtengo wa chisamaliro cha umembala wa gulu lonse, chiwerengero cha chiwerengero chimenecho tsopano chidzagwiritsidwa ntchito pang'ono kwa ana, zomwe zikutanthauza kuti zidzagwiritsidwa ntchito pang'ono pokha kwa akuluakulu. Ndalama zonse zomwe ziyenera kusonkhanitsidwa sizikukhudzidwa ndi njira yatsopano yowerengera.
Inde, izo zikugwiritsidwa ntchito mu umembala wonse wa dongosolo; zomwe zimakhudza banja lirilonse lidzakhala losiyana, ndipo nyumba yodzala ndi achinyamata idzapatsidwa malipiro apamwamba kwambiri mu 2018 kuposa momwe akanati ayang'anire popanda magulu a zaka zatsopano, ngakhale pambuyo powerengera ndalama za makolo awo. Koma mwachilendo, magulu atsopano a ana sangasinthe ndalama zomwe mabungwe amsonkhanowo amasonkhanitsa kuchokera kwa mamembala awo pamodzi (kukumbukira kuti ndalama zonse zomwe ziyenera kusonkhanitsidwa zidzakhala zazikulu mu 2018 kuposa momwe zinalili 2017, chifukwa cha zinthu zomwe zimachititsa kuti galimoto zisinthe).
Thandizo Loyamba Lidzasinthidwa Kuti Liziyenda ndi Zatsopano Zotsatsa
Kwa anthu omwe amagula malonda paokha malonda ( ndikusinthanitsa ) m'mayiko onse, ndalama zowonjezera (msonkho wa msonkho wapamwamba) zimapangidwira kuti ndalama zowonjezereka zikhale zotsika mtengo. Kuchuluka kwa ndalamazo kumatsimikiziridwa polemba mtengo wa ndalama yachiwiri-mtengo wotsika mtengo wa ndalama padera peresenti ya ndalama za pakhomo, ndi magawo omwe ali ochepa kwa olembetsa a ndalama zochepa, ndi apamwamba kwa olembetsa ndalama zapamwamba.
Monga mtengo wa kufalitsa kwa banja lapatsidwa ukuwonjezeka, chomwechonso kuchuluka kwa ndalama zawo. Mwamwayi, ndalama zothandizira sizinapezeke kwa mabanja omwe amapeza ndalama zoposa zinayi za umphawi, choncho banja la asanu liyenera kukhala losavomerezeka pa chithandizo cha premium ngati ndalama zawo zoposa $ 115,120 mu 2018. Koma kwa mabanja omwe ali ndi ndalama zomwe sizingapitilire maulendo anayi a umphaŵi, ndalama zomwe zimapereka ndalama zimakula mofulumira ndi ndalama zowonjezereka, ndipo ndalama zowonjezera zimakhala zogulira ndalama zenizeni za banja lililonse. muli mu kusiyana kwa chithandizo cha Medicaid kapena ngati banja likugwiritsanso ntchito pazochitika zanu) .
N'kofunikanso kumvetsetsa kuti ndalama za ACA zimapereka ndalama kwa ana osapitirira zaka 21 pamtunda wa atatu pa banja, pa msika wa gulu limodzi ndi wazing'ono. Choncho banja lomwe liri ndi ana asanu ndi mmodzi osachepera 21 liyenera kulipira malipiro atatu okha (onani kuti ngakhale makolo angathe kusunga ana awo pazinthu zawo mpaka ana a zaka 26, malipiro amalembedwa kwa ana onse a zaka 21 kapena kuposa, mosasamala kanthu ena ambiri omwe akudalira ali pa dongosolo).
Chotsatira apa ndi chakuti pamene mitengo idzawonjezeka kuposa mabanja omwe ali ndi achinyamata, thandizo la premium lidzakula kwa mabanja amenewo ngati ali oyenerera thandizo. Kwa mabanja omwe ali oyenerera, thandizoli lidzasunga ndalama zowonjezera ndalama zowonjezera-mtengo kwambiri. Ngati chuma cha banja sichinasinthidwe kuyambira 2017, mtengo wamtengo wapatali wotsika mtengo wachiwiri udzakhala wochepa mu 2018 kuposa momwe zinaliri mu 2017, ngakhale kuti chiwerengero chawonjezeka cha 2018 ndi magulu atsopano a ana.
> Zotsatira:
> Magulu a Medicare ndi Medicaid Services. Pulogalamu ya Odziwitsa Anthu ndi Kuyang'anira Inshuwalansi. Kusintha kwa Msika, Kusinthidwa kwa June 2, 2017.
> Dipatimenti ya zaumoyo ndi zithandizo zaumunthu. Makhalidwe a Inshuwalansi Mndandanda-Zowonjezera . December 16, 2016.
> Dipatimenti ya zaumoyo ndi zithandizo zaumunthu. Chitetezo cha Odwala ndi Zopanda Thandizo Labwino; Chidziwitso cha HHS cha Kupindula ndi Kulipira Malipiro a 2018; Kusinthidwa kwa Nthawi Zowonjezera Zapadera ndi Ogulitsa Ogwira Ntchito ndi Okhazikitsa Mapulani Pulogalamu . December 16, 2016.
> Jost T. Health Affairs Blog. CMS Yamalizitsa Pulogalamu Yatsopano Yopereka Msika, Mwachangu pa January 17, 2017. December 17, 2016.