Panalibe Mamiliyoni 29 Osakhala ndi Inshuwalansi Yathanzi mu 2016
Mu 2013, malinga ndi US Census data, panali 41.8 miliyoni osakhala okalamba osatetezedwa okhala ku United States. Pofika mu 2016, chiwerengero chimenecho chiyenera kukhala 29 miliyoni. Ndiko kuchepa kwakukulu, koma ndi zomveka kudabwa kuti kuli bwanji anthu ambiri opanda inshuwalansi ya thanzi.
The Affordable Care Act inakhazikitsidwa mu 2010, ndipo zambiri mwazokha zinayambitsidwa pakati pa 2014 ndi 2016.
Pofuna kupewa chilango, olemba ntchito ambiri akufunikira kupereka chithandizo chokwanira pa nthawi yawo yonse (antchito 30+ pa sabata). Anthu amafunika kukhala ndi inshuwalansi yathanzi kapena kutsutsidwa pa msonkho wawo. Zothandizira pazinthu zoyambilira ndi kugawana mtengo zomwe zimapereka ndalama zogwirizana zimapanga chithandizo komanso zosamalika kwambiri kwa anthu opeza pakati. Ndipo kufalikira kwa Medicaid kumapangitsa mfulu-kapena pafupifupi kufalitsa kwaulere kupezeka kwa mabanja otsika kwambiri.
Ndiye bwanji anthu okwana 29 miliyoni akadali ndi inshuwaransi ya umoyo ku United States? Chiwerengero chimenecho chiri molingana ndi kafukufuku wopangidwa ndi ACA Signups mu March 2016. Ndipo ngakhale kuti ndi ochepa kuposa anthu 33 miliyoni omwe sanalimbikitsidwe mu 2014 malinga ndi US Census data, zimagwirizana ndi Congressional Budget Office's (CBO) 2012 kuti padzakhalabe mamiliyoni 30 osakhala achikulire ku United States popanda inshuwalansi pa 2022 ( Deta yokhudzana ndi chiwerengero cha anthu opanda inshuwaransi yaumoyo nthawi zambiri imatchula anthu osakhala achikulire, monga Medicare imagwira anthu ambiri kamodzi akafika zaka 65).
Ngakhale kuti Khoti Lalikulu Lalikulu lisanayambe mu 2012 kuti ACA yowonjezera Medicaid ikanakhala yodalirika kwa mayikowa, CBO inanena kuti padzakhala anthu 27 miliyoni omwe sali okalamba omwe sakhala okalamba ku America mu 2022. Olemba malamulo ndi omwe ankadziwa kuyambira pachiyambi kuti ACA idzapangitse chiwerengero chachikulu cha anthu osatetezedwa ku US (ndipo ali ndi), padzakhalabe anthu mamiliyoni ambiri opanda inshuwalansi yochulukitsa zaka zingapo pambuyo pomaliza lamulo lonse.
Nazi zina mwa zifukwa zomwe ACA sizinayambitsire inshuwaransi ya umoyo ku US:
Osamukira M'mayiko Ena
ACA imapereka chithandizo cha inshuwalansi ya mtundu uliwonse kwa anthu osamukira kudziko lina. Osati kokha kuti sangapeze ndalama zothandizira, iwo amaletsedwa kulembetsa ndondomeko yosinthanitsa konse, ngakhale atha kulipira mtengo wathunthu (Ku California kudutsa ndalama mu 2016 zomwe zingalole kuti anthu othawa kwawo osagula kugula zonse- Kuwunikira kwa ndalama ku California kusintha, koma boma liyenera kupeza chiwongolero kuchokera ku boma la federal kuti lizigwiritse ntchito makonzedwe amenewo). Ochokera kwawo osatumizidwa amaletsedwanso kupeza Medicaid.
Kaiser Family Foundation inati mu 2013 kuti panali anthu okwana 4,8 miliyoni omwe sali ovomerezedwa ndi anthu omwe sali ovomerezeka, omwe amawerengetsa anthu pafupifupi 15 peresenti ya anthu osauka.
Kuwomboledwa kwa Chilango ndi Kulephera Kugwiritsa Ntchito
Ngakhale kuti ACA yagawira udindo wawo (aka, "udindo wa munthu aliyense") amafuna pafupifupi anthu onse a ku US kuti azikhala ndi inshuwalansi ya zaumoyo kapena kuti adzalandire chilango, pali mndandanda wautali wa malipiro, ndipo IRS ilibe njira yothetsera kuti akwaniritse chilango pamene chikugwiritsidwa ntchito.
Kumayambiriro kwa chaka cha 2016, IRS inanena kuti anthu 7,9 miliyoni a msonkho amatha kupatsidwa chilango chifukwa chakuti sanalimbikitsidwe mu 2014, koma anthu ena 12,4 miliyoni a msonkho sanalandire chilango, ngakhale kuti sanalimbikitsidwe mu 2014.
Chilango chiyenera kukhala "ndodo," pomwe thandizo la ACA ndi "karoti." Koma monga taonera pamwambapa, anthu osalimbikitsidwa amakhala oyenerera kukhala oyenerera kusiyana ndi kuti adzalandire chilango. Ndipo ngakhale pamene chilangocho chikugwiritsidwa ntchito (mwachitsanzo, msonkho wa msonkho sali woyenerera kulipira kulikonse), IRS singagwiritse ntchito njira zake zowonetsera kuti adzalandire chilango.
Angathe kupeĊµa kubwezeredwa kwa ngongole yomwe imayenera kulipira misonkho (kapena kubwezeredwa kwa ngongole), koma sangagwiritse ntchito zikwama, ndalama, kapena milandu, monga momwe angathere ndi mitundu ina ya ngongole ya msonkho yopanda msonkho. Chotsatira chake, chilango cha kusawerengeka chikuwoneka ngati ena mwachindunji, poganiza kuti amapanga misonkho kuti asayembekezere kubwezeredwa.
Inde, kukhala wosatsimikiziridwa ndikupeza kuti akusowa chithandizo chamankhwala chachikulu ndi vuto lalikulu, koma chiwerengero chosawerengeka cha Amwenye omwe sali ovomerezeka akusankha kuwoloka mlathowo ngati akafika kumeneko, chifukwa malipiro awo ayenera kulipira inshuwalansi ya umoyo ndizoposa zomwe iwo akuganiza kuti ndi zotsika mtengo.
Gawo la Coverage
ACA idapempha boma lirilonse kuti likulitse malipiro oyenera a Medicaid kwa 138 peresenti ya umphawi (133 peresenti, kuphatikizapo 5 peresenti ponyalanyaza ndalama). Dziko lidzapitirizabe kugawanitsa ndalama za boma zomwe zilipo kale ku Medicaid yomwe idali yoyenera kuwonjezereka isanakwane, koma kuyambira mu 2014, boma lidzalipiritsa ndalama zonse zowonjezera anthu omwe angoyamba kumene. Pofika chaka cha 2020, chiwerengerochi chikuchepa mpaka 90 peresenti, koma boma lidzapitiriza kupereka malipiro 90 peresenti m'zaka za mtsogolo, pomwe dzikoli sililipiranso 10 peresenti ya mtengo wophimba anthu omwe angoyamba kumene.
Khoti Lalikulu linagamula mu 2012 kuti boma la federal silingathe kuti mayiko apitirize Medicaid kuti apitirize kulandira ndalama zawo za Medicaid. Zotsatira zake, zida 19 sizinawathandize Medicaid. Pakati pa 18, zigawozi zimatanthawuza kuti pafupifupi anthu mamiliyoni atatu alibe mwayi wopeza ndalama zothandizana nawo kapena ORICIAID ( Wisconsin sizinawononge Medicaid, koma amagwiritsa ntchito ndalama za boma kupereka Medicaid kwa anthu omwe ali ndi ndalama zoperewera pa umphawi , kotero palibe kusiyana kotsekemera).
Kupanda Kumvetsetsa Pa Zomwe Mungapeze
Ngakhale ena omwe sanatsitsikepo ayang'anitsitsa zosankha zawo ndipo adaganiza kuti ndi okwera mtengo kwambiri komanso / kapena sakufuna kulembetsa, pali anthu ambiri omwe sakudziwa zomwe zilipo kapena momwe zingathandizire iwo.
Pa anthu omwe sanalimbikitsidwe m'chaka cha 2015, pafupifupi theka anali oyenerera Medicaid, Child Insurance Insurance Program (CHIP), kapena ndalama zothandizidwa ndi premium pochita nawo masewerawo (theka lachiwiri linali lopanda malire, othawa kwawo osatumizidwa, kapena osaloledwa kuti athandizidwe mwachindunji chifukwa cha ndalama kapena zopereka za abwana zomwe zingawathandize kupezeka mosavuta). Ena mwa anthuwa akudziwa thandizo la ndalama lomwe ali nalo ndipo atsimikiza kuti ayambe kuwathandiza. Ndipo ena ali mumsampha wa machitidwe okhwima monga a glitch a banja , omwe amachititsa kuti zochitika zisawonongeke. Koma ambiri sakudziwa kuti akhoza kupeza malipiro otsika kapena otsika mtengo kupyolera mu Medicaid kapena CHIP, kapena thandizo la premium kuti apange chinsinsi chopindulitsa kuposa momwe chingakhalire.
Ngati muli pakati pa anthu mamiliyoni 29 a ku United States omwe adakali osatsimikiziridwa, ndibwino kuti muwone zomwe mungapeze. Ngati muli woyenera Medicaid kapena CHIP, mukhoza kulemba nthawi iliyonse. Ngati muli oyenera kulandira ndalama zothandizira, kutsegulidwa kwa 2017 kumangoyang'ana pangodya-imayamba pa November 1, 2016.
> Zotsatira:
> Congressional Budget Office, Zomwe Zimayikidwa pa Inshuwalansi Zopereka Zowonjezereka za Ntchito Yodalirika, Zosinthidwa ku Lamulo Lalikulu Lalikulu Lachiwiri, July 2012 .
> Chikalata cha Universal Lawity, Institute Information Information, National Federation of Independent Business v. Sebelius, Kutchulidwa pa March 26, 27, 28, 2012-Anasankha June 28, 2012.
> Kaiser Family Foundation, Zotsatira Zatsopano za Kuyenerera kwa ACA Coverage pakati pa a Uninsured, January 22, 2016.
> Bungwe la Anthu a ku United States, Lamulo la Inshuwalansi ku United States: 2014.