Pulezidenti Barack Obama adasindikizidwa ndi malamulo mu 2010, Odwala ndi Otetezeka Care Act akuyambitsa kusintha kwakukulu kwa dongosolo lachipatala cha United States kuyambira mu 1965 pa Medicare ndi Medicaid .
Chiyambi
Otsutsana kwambiri otsutsana ndi magulu achipani, a Republican amatsutsana ndi Care Affordable Care Act, mogwiritsira ntchito mawu akuti Obamacare pofotokoza za Act.
Pofika chaka cha 2012, Pulezidenti Obama adalandira dzina lakuti Obamacare, ndipo tsopano likugwiritsidwa ntchito kwambiri ndi omutsatira komanso otsutsa malamulo. Koma kutsutsana za ACA kupitirira pambuyo pake, ndi khoti lalikulu likutsutsana ndi lamulo; lamulo likutsutsanabe pansi pa Ulamuliro wa Trump.
Kodi Zinthu Zasintha Zotani?
Zina mwazikonzedwe zomwe zimagwiritsidwa ntchito ndi Affordable Care Act zimaphatikizapo kukhazikitsa Zokambirana za Inshuwalansi za Zaumoyo , kapena malonda, kumene anthu, mabanja, ndi malonda ang'onoang'ono angagule nkhani yotsimikiziridwa yokonza inshuwalansi yathanzi yoyenera ndi malipiro odula . Ndondomekozi zimakwaniritsa udindo wa ACA womwe ukufuna kuti anthu omwe alibe inshuwalansi azigula inshuwalansi.
ACA imapereka ndalama zogulira ndalama zapakati ndi zapakati pafupipafupi kuti zithe kupeza inshuwalansi yodalirika. (Olembetsa oyenerera sangathe kupeza ndalama zopitirira 400 peresenti ya umphaŵi, kapena $ 98,400 kwa banja la anayi), ndi thandizo lothandizira kuchepetsa ndalama malipiro olembera oyenerera (ndalama sizingapitilire 250 peresenti ya umphaŵi kapena $ 61,500 kwa banja la anai mu 2018).
Panthaŵi imodzimodziyo, lamulo limapereka chilango cha msonkho kwa iwo omwe satsitsimutsidwa; Chilangochi chinayambira mu 2014, ndipo pang'onopang'ono chinafika pofika pa 2016. Zidzasinthidwa kuti mitengo ifike patsogolo, koma mu 2017 ndi 2018, kusintha kwa inflation kunali $ 0, choncho chilango sichinasinthe kuyambira 2016 (malamulo adaperekedwa Senate mu December 2017 yomwe ikhoza kubwezera chilango cha munthu aliyense, koma kusiyana kwa Nyumbayi kuyenera kuyanjanitsidwa, kotero kwa nthawiyi, palibe chosinthika pa chilango chalamula).
ACA imalepheretsa inshuwalansi kukana kubisa anthu omwe ali ndi chikhalidwe chisanayambe , kapena kuwapatsa ndalama zowonjezereka chifukwa chokhalapo kale. Izi ndi zoona pokhapokha ndikusiya kusinthanitsa ndipo zikuyimira kusintha kwakukulu kuchokera momwe msika wina umagwirira ntchito pasanafike chaka cha 2014 pafupi ndi boma lililonse.
ACA inathetsa ndalama zapachaka ndi za moyo nthawi zonse kuti kampani ya inshuwalansi idzaperekere chithandizo chamankhwala a inshuwalansi, ndi kuika malipiro omwe angakhale nawo .
ACA imafuna mapulani a inshuwalansi azaumoyo m'misika yamagulu ndi gulu laling'ono kuti lipeze mapindu khumi othandizira thanzi . Chimodzi mwazinthu zofunika kwambiri za umoyo ndi chithandizo chodziletsa, ndipo ntchito zothandizira zothandizira zowonongeka zimayenera kuwonetsedwa popanda kugawa ndalama .
ACA imafuna olemba ntchito akuluakulu omwe ali ndi antchito oposa 50 kapena ochuluka-omwe amapereka chithandizo chamtengo wapatali, inshuwalansi yapamwamba ya ntchito ya nthawi zonse (30+ maola ndi sabata) ogwira ntchito, kapena chiopsezo chilango mwa abwana amagawana udindo . Olemba ntchito ayenera kuonetsetsa kuti kufotokozera akugwiritsidwa ntchito kuti angakwanitse kwa wogwira ntchito, koma palibe kuyerekezera kwa ndalama zokwanira kuti aziphimba mamembala omwe ali m'banja. Chifukwa cha momwe izi zimagwirira ntchito ndi momwe kupezeka kwapadera kumatsimikiziridwa pa kusinthanana, anthu ena satha kupeza malingaliro otsika mtengo chifukwa cha zomwe amatchulidwa kuti " banja labwino ".
[Zambiri mwazimenezi sizimagwiritsidwa ntchito kwa agogo aakazi komanso omwe anabadwapo.]
Mbali zina zazinthu zothandizira pazinthu zowonjezera zakhala zikuchedwa kapena kuchotsedwa
Mbali zina za ACA sizidzagwiritsidwa ntchito: Supreme Court inakana chigamulo chomwe chingawononge ndalama za Medicaid kuti ziwonongeke kuti sizinaperekedwe kwa Medicaid kwa anthu ambiri. Izi zachititsa kuti pakhale kusiyana pakati , komwe anthu mamiliyoni awiri mwa anthu 18 aliwonse omwe ali ndi zaka 18 sakhala ndi mwayi wopeza chithandizo.
Kuwonjezera pamenepo, Congress inaphwanya thandizo la ACA, lomwe limadziwika kuti CLASS Act , mu January 2013, atatha kuwona kuti Dipatimenti ya Zaumoyo ndi Zaumunthu idasintha.
Mbali zambiri za ACA zinachedwetsedwa, kuphatikizapo abwana anagawira udindo wawo (zomwe zinagwira ntchito mu 2015, osati 2014, ndipo sizinathetsedwe mpaka 2016), msonkho wa Cadillac (womwe wayamba kuchitika mu 2020), ndipo kuthetsedwa kwa mapulani omwe sanali aatali, omwe sanali a ACA omwe adaperekedwa patsogolo pa 2014 (zolingazi ndi zosintha, kapena "agogo aakazi," ndipo amaloledwa kupitiriza kugwira ntchito mpaka kumapeto kwa 2018, podziwa za mayiko ndi inshuwalansi za thanzi).
> Zotsatira:
> Dipatimenti ya zaumoyo ndi zithandizo zaumunthu, Kuphatikiza kwa Chitetezo cha Odwala ndi Ntchito Yodalirika Yothandiza .
> Kaiser Family Foundation, Mtsogoleri Woweruza Khoti Lalikulu ku ACA's Medicaid Expansion , August 2012.
> Kaiser Family Foundation. Paka Gap: Osauka Osauka Osauka M'madera Amene Sapititsa Mavuto. November 1, 2017.
> Lemieux, Jeff; ndi Moutray, Chad, Za msonkho wa Cadillac, Health Affairs, pa April 25, 2016.