Kodi ndondomeko ya Trump ya October 2017 idzakhudza bwanji inshuwalansi ya umoyo?
Pa October 12, 2017, Purezidenti Trump anasaina lamulo lotsogolera "kulimbikitsa chisankho ndi chisamaliro chonse ku United States." Lamulo lolamulira linabwera maola ochepa kuti Boma la Trump lisawononge kuti ndalama zothandizira kugawa malire a ACA (CSR) zidzathera pomwepo , kotero n'zosadabwitsa kuti zotsatira za kapangidwe ka kayendetsedwe ka ndalama ndi CSR kudulidwa nthawi zina.
Koma ngakhale ndalama za CSR zitadulidwa zinali zoonekeratu zomwe zinagwira ntchito mwamsanga, lamulo lotsogolera silinasinthidwe ndi lokha, ndipo zotsatira zake zidzatenga nthawi yokwanira. Lamulo lolamulira limangoyang'anira mabungwe osiyanasiyana a federal kuti "aganizire zopangira malamulo" kuti asinthe malamulo osiyanasiyana okhudza inshuwalansi ya thanzi labwino, mgwirizano wathandizira, komanso njira zothandizira odwala. Malamulo amenewa amayenera kupyolera muchitidwe wopanga malamulo, zomwe zimaphatikizapo nthawi yowunikira anthu.
Tiyeni tiwone momwe kusintha kumeneku kudzakhalire, ndi momwe zingakhudzire inshuwalansi ya umoyo wanu.
Inshuwalansi Yathanzi ya Nthawi yayitali
Ndondomeko ya inshuwalansi yochepa, yochepa (STLDI) imangokhala ngati: inshuwalansi ya umoyo kuti mungathe kupitiriza nthawi yayitali. Koma kutalika kwa nthawi yomwe wina angakhale nako kufotokoza kwafupikitsa kwakhala kutsutsana zaka zaposachedwapa.
Inshuwalansi yochepa yaumoyo siiliyendetsedwa ndi Wopindulitsa Care Act. Choncho oyenerera oyenerera kufotokozera akadakalipo pa mbiri yawo yachipatala, zinthu zomwe zakhalapo kale sizinaphimbidwe, zamoyo zonse komanso zopindulitsa zapachaka zimagwiritsidwa ntchito, ndipo ndondomeko siziyenera kubwereza zofunikira za thanzi la ACA .
Malamulo omwe amalephera kulandira thandizo la mankhwala (MLR) sakugwiritsanso ntchito pafupipafupi, choncho palibe chofunika kuti ndalama zambiri zithetsedwe pazinthu zamankhwala.
Mwachidule, mapulani awa ali ofanana ndi njira zambiri zazinthu zamagulu akuluakulu azachipatala zomwe zinagulitsidwa m'madera ambiri chisanafike chaka cha 2014. ACA inaletsa kugulitsidwa kwa mapulani monga choncho mu msika waukulu wa zachuma monga wa 2014, koma Malamulo atsopano sakugwiritsidwa ntchito pazinthu zam'nthawi yaifupi.
Popeza kuti ndondomeko zazing'ono zapitazo zatha kupitiriza kupereka chithandizo kwa anthu omwe ali ndi thanzi labwino lokhazikika pamapindula, ndipo chifukwa chakuti mapulaniwa ali ndi nthawi yochepa, ndalamazo zimakhala zochepa kwambiri kusiyana ndi mtengo wamtengo wapatali m'msika wa ACA wokondweretsa (pokhapokha pokhapokha ndikusinthanitsa, pokhapokha ngati ndondomeko yaikulu ya zachipatala ikuyenera kutsata malamulo omwewo kunja kwa kusinthanitsa omwe amatsatira mkati mwa kusinthanitsa).
Zisanafike chaka cha 2017, tanthawuzo la federal la ndondomeko ya nthawi yaying'ono linali kufotokozera komwe kunalipo kwa masiku 364. Ena mwa malamulowa anali ndi malamulo ovuta kwambiri (ochepa samalola nthawi yayitali, ndipo ena amalephera kwa miyezi isanu ndi umodzi), ndipo mabungwe ambiri a inshuwalansi amalephera kukwaniritsa zolinga zawo zapakati pa miyezi isanu ndi umodzi, mosasamala kanthu kuti kusintha kumeneku kumaperekedwa ndi boma kapena federal boma.
Koma m'madera ambiri, panali zochepa zochepa zomwe zimakhalapo ndi nthawi ya pafupifupi chaka chimodzi.
Kulembetsa m'makonzedwe ameneŵa kunapitirira pambuyo poti malamulo a ACA athandizidwa, pamene anthu ankafuna njira zina zotsika mtengo ku chidziwitso chovomerezeka cha ACA. ACA imapanga malonda okhaokha omwe angakwanitse kupeza ndalama zothandizira ndalama , koma omwe ali ndi ndalama zoposa 400 peresenti ya umphaŵi (mwachitsanzo, osayenera kulandira thandizo la premium) nthawi zina amapeza kuti zolinga zawo zili zopitirira bajeti idzalola.
Kwa anthu awa, malinga ngati ali ndi thanzi labwino, ndondomeko ya nthawi yaying'ono ingapereke njira yodalirika yopanda chilimbikitso.
Koma mapulani a nthawi yayitali ali ndi zovuta zazikulu (zomwe anthu samazidziŵa nthawi zonse mpaka atapeza chithandizo chamankhwala chachikulu), ndipo pamene anthu odwala amachoka pakhomo la chiopsezo cha ACA pofuna kuthandizira njira zina, zimasiya Dothi loopsya la mapulani ovomerezeka a ACA amalimbana kwambiri ndi anthu odwala, zomwe zimabweretsa msika wosakhazikika.
Ngakhale anthu omwe amadalira inshuwalansi yaifupi yayamba kugonjetsedwa ndi chilango cha ACA kuyambira chaka cha 2014 (chifukwa inshuwalansi yayifupi sichiwerengedwa kuti ndi yofunika kwambiri), Obama Administration adafuna kukweza malamulowa ndikuonetsetsa kuti inshuwalansi yayitali Zingagwiritsidwe ntchito monga momwe zinalili poyamba: kudzaza kusiyana kochepa pakati pa inshuwalansi za umoyo wathanzi, osati monga cholowa chokhala ndi inshuwalansi yathanzi.
Choncho adakhazikitsa malamulo kumapeto kwa chaka cha 2016 (chomwe chinayamba kugwira ntchito mu Januwale 2017 ndipo analimbikitsidwa kuyambira mu April 2017) omwe amaletsa mapulani a nthawi yayitali kwa miyezi itatu.
Ndondomeko yoyendetsa Trump ikuwoneka kuti idzabweretsa malamulo atsopano omwe adzabwezeretse lamulo la 2016 ndi kubwezeretsanso malamulo oyambirira omwe analola mapulani a nthawi yayitali kuti akhale ndi nthawi ya masiku 364. Koma anthu omwe amadalira mapulani afupikitsa akadakalibe chilango chaufulu wa ACA, monga inshuwalansi yayifupi idzaonedwa kuti ndi yopanda phindu, motero sizowonjezera zofunikira zochepa.
Pali zodetsa nkhawa kuti kubwezeretsanso malamulo pazowonjezereka kungachepetse mgwirizano wa ACA. Koma ena amanena kuti angakhale ndi malamulo oletsedwa omwe anali nawo chaka cha 2016, ndipo ena angagwiritse ntchito malamulo omwewo kuti ateteze ACA-yovomerezeka kwambiri pamsika wamalonda.
Mapulani a Zaumoyo Achiyanjano
Ndondomeko ya Trump imayitanitsa "kuwonjezera mwayi" ku bungwe la zaumoyo (AHPs), kuti alole malonda ang'onoang'ono kuti adziphatikize palimodzi ndikupeza chithandizo chachikulu cha gulu (kugula kwa inshuwalansi kapena self-insured), osati kuti bizinesi iliyonse igule yake ndondomeko ya kagulu kakang'ono.
ACA yakhazikitsa malamulo ambiri pa msika wa gulu limodzi ndi ochepa. Ngakhale ogwira ntchito zazikulu (ogwira ntchito 50+ okhawo omwe akufunikira ndi lamulo kuti apereke chithandizo kwa antchito, momwe angagulitsire magulu ang'onoang'ono omwe akugula ndiwowonjezereka kuposa momwe angapezere magulu akuluakulu.
Pofuna kufalitsa mwezi wa January 2014 kapena mtsogolo, ACA imafuna kuti mapepala ang'onoang'ono a magulu azigwiritsidwa ntchito pokhapokha pa zaka za ogwira ntchito, fodya, ndi malo omwe akukhala nawo. Ndipo ndondomeko zing'onozing'ono za gulu zimayenera kubisa zofunikira za thanzi la ACA . Zonsezi sizinagwiritsidwe ntchito pazinthu zazikulu za gulu (magulu ochuluka kwambiri a magulu ndi omwe amadzipangira okha, koma zofunikira za ACA sizikugwira ntchito mwa njira iliyonse).
Choncho lingaliro ndi AHPs ndilolola magulu ang'onoang'ono kuti agwirizane palimodzi kuti apange magulu akuluakulu, ndipo pewani malamulo ena a ACA panthawiyi. Koma ngakhale bwana wamkulu ali ndi chidwi choonetsetsa kuti ogwira ntchito ake akhalabe athanzi ndipo thanzi lawo labwino ndi lolimba kwambiri kuti likhale luso lokonzekera ndi kusungirako zinthu, zomwe sizingakhale zoona ku mgwirizano wa thanzi.
Ndipo ngakhale kuti wogwira ntchito yaikulu ayenera kuganizira mozama za phindu lake lonse, palibe chomwe chingalepheretse bizinesi yaying'ono kuchoka ku AHP pamene ogwira ntchito ake ali ndi thanzi labwino, ndikubwereranso ku msika wa magulu aang'ono ovomerezeka a ACA patsiku lomaliza ngati Njira imeneyi ikanakhala yosangalatsa kwambiri chifukwa cha kusintha kwake. Choncho palinso nkhaŵa kuti kuwonjezera kukula kwa AHPs kukhoza kuthetsa msika wa magulu ochepa wa ACA mwa kukopa magulu ang'onoang'ono ochepa kuchoka ku mgwirizano wa ACA-ndi AHPs.
Mikangano Yowonjezera Umoyo
Lamulo lapamwamba likufunanso malamulo atsopano kuti "kuwonjezera kusintha ndi kugwiritsa ntchito" njira zothandizira kubwezera ndalama (HRAs). Lingaliro, makamaka, ndilololeza olemba ntchito kugwiritsa ntchito HRA kuti abwezeretse antchito pa malipiro awo pamsika.
Olemba ntchito ankatha kuchita izi. Koma izi zinaletsedwa m'malamulo oyambirira omwe analembedwera kuti agwiritse ntchito ACA (kuletsedwa kunkayenda ndi zabwino kwambiri: $ 100 patsiku kwa wogwira ntchito ngati abwana akupitiriza kubwezera antchito pa mtengo uliwonse wa malonda). Choletsedwacho chinachepetsedwa pang'ono ndi 21st Century Cure Act, yomwe inayamba kugwira ntchito mu 2017 ndipo ikulola antchito ang'onoang'ono (ogwira ntchito osachepera 50) kuti abwezeretse ndalama za inshuwalansi za malonda omwe amagwiritsidwa ntchito pa msika , pogwiritsa ntchito HRAs.
Koma abwana ang'onoang'ono sakufunika kupereka chithandizo pa zonse pansi pa ACA, pamene abwana akulu ali. Ndipo pakalipano palibe njira yomwe imalola olemba ambiri kubwezera ogwira ntchito pa mtengo uliwonse wa malonda. Ogwira ntchito ali ndi ufulu kupeza mtundu uliwonse wa inshuwalansi omwe amawakonda-kuvomereza chithandizo cha abwana awo inshuwalansi ya umoyo, kapena kugula ntchito pa msika wawo - koma wogwira ntchito wamkulu sangathe kulipira malonda payekha (makamaka, wogwira ntchito sangathe kupeza ndalama zothandizira payekha malonda payekha ngati abwana akupereka inshuwalansi, inshuwalansi ya thanzi labwino).
Malangizo a Trump akuyenera kuti apangitse malamulo omwe angapangitse kuti olemba ntchito agwiritse ntchito HRA kuti azibwezeretsa antchito awo payekhapiritsa malonda, ngakhale abwana ali ndi antchito 50 kapena ambiri.
Chimene sitidziwa ndi kuchuluka kwa malamulo omwe akufuna. Kodi kutenga ACA-yovomerezeka kokha kungayesedwe kukhala woyenera kubwezera, kapena kupatulapo zopindulitsa (monga momwe ndondomeko zan'chidule zanenedwa) ziyeneretsedwe? Kodi abambo akuluakulu angaganizidwe mothandizidwa ndi udindo wa abwana (mwachitsanzo, chofunikira kuti apereke chithandizo kapena mwina ayenera kulipiritsa chilango) ngati agwiritsira ntchito ma HRA kuti azibwezeretsanso malipiro awo pamsika m'malo mogawira gulu?
Kodi Tidzawona Liti Zatsopano?
Zambiri zimakhala zikuwoneka mogwirizana ndi zomwe zikufotokozedwa m'malamulo omwe akubwera. Malamulo a AHPs ndi inshuwalansi ya kanthawi kochepa amayenera kukonzedwa mkati mwa masiku 60 kuchokera tsiku lotsogolera, choncho tiyenera kuwawona chisanafike mapeto a chaka. Ndipo malamulo okhudzana ndi HRA akuyenera kuperekedwa mkati mwa masiku 120, choncho ayenera kupezeka kumayambiriro kwa 2018.
Pambuyo pa malamulo omwe akutsatiridwawo atulutsidwa, padzakhala nthawi yowunikira anthu pasanayambe kugwira ntchito, kotero ngati mutapereka ndemanga kwa bungwe la federal lomwe likugwira ntchito pazinthu izi, lidzakhala mwayi wanu kugawana nawo.
> Zotsatira:
> Dipatimenti ya Treasury; Dipatimenti ya Ntchito; Dipatimenti ya zaumoyo ndi zithandizo zaumunthu. Zopindulitsa Zina, Moyo Wosatha ndi Zopeka Zachaka, ndi Nthawi Yang'ono Ya Nthawi yayitali Inshuwalansi . October 2016.
> White House, Ofesi ya Mlembi wa Press. Pulezidenti Wotsogolera Pulezidenti Kulimbikitsa Chosankha ndi Mpikisano wa Zaumoyo Ku United States. October 12, 2017.