Zvirongwa zvehutano zvevadzidzi zvichiripo, asi ACA yakazvishandura
Mapurogiramu ezvehutano zvevadzidzi ave achishandiswa kwenguva yakareba senzira yevadzidzi vekoroji yekuwana inshuwarisi yehutano. Vadzidzi vakawanda vanofukidzwa pasi peurongwa hwehutano hwevabereki, asi muchiitiko, vanenge 20 muzana yevadzidzi vekoroji vakanga vasina kuvimbiswa. Iko inotengeswa Care Care Act yakaita kuti kuparidzirwa kuwane nyore kune vadzidzi uye zvakare kugadzirisa mapurogiramu ehupenyu hwehutano huripo huripo huripo nemayunivhesiti.
Hezvino izvo zvaunoda kuziva:
1. Zvirongwa zvehutano hwehutano hwevadzidzi dzinofanirwa kuve zvizere-zvinopindirana neAACA yemumwe mutengo wemarike (asi kune zvimwe zviduku zvishoma, zvinokurukurwa pasi apa). Izvi zvinoreva kuti vanofanirwa kuvhara zvidikanwi zvehutano zvinokosha pasina gore negore kana hupenyu hwese hunobatsira maxums (kubvumidzwa kwemiganhu yekubhadhara yakatanga kushanda kwenguva pfupi yezvirongwa zvehutano hwevadzidzi kupfuura kune vamwe vose pamusika asi yakanga yakazara munzvimbo ya2014), uye gore rose -of-mhepfenyuro mari yakatorwa .
Pre-ACA, pasi pegore uye mararamiro ebasa remazuva ose aiwanzoshandiswa pamazano ehutano hwevadzidzi. Arijit Guha, uyo akapfuura muna 2013, aiva ne chirongwa chehutano hwevadzidzi kuburikidza neArizona State University ne $ 300,000 yehupenyu hwekubatsira nguva refu, iyo yaakasangana nayo munguva pfupi mukurapa kwake. Zviratidzo zvakadai seGuha hazvisati zvaitika, sezvo chirongwa chehutano hwevadzidzi hachikwanisi kuvhara mari yavanozobhadhara pamitemo inokosha yehutano.
Muna 2017 Kubatsirwa uye Kubhadharwa Kwemari , HHS yakatsanangura zvikamu zviviri zveAACA zvisingashandisi kurongwa hwehutano hwevadzidzi:
- Zvirongwa zvehutano zvevadzidzi hazvifananidzi kuiswa mumubatanidzwa wemunhu mumwe oga pangozi muhurumende, uyewo mutakuri anofanira kubatanidza dzimba dzengozi dzezvirongwa zvese zvehutano hwevadzidzi mune imwe nyika. Chirongwa chehutano hwevadzidzi chekuchikoro chinogona kuva nedambudziko remvura, kana kuti rinogona kuparadzaniswa nenzira inenge isingatarisiri nehutano hwehutano (semuenzaniso, vadzidzi vadzidza vanogona kunge vari munharaunda imwe yengozi uye pasi pedzimwe mune imwe).
- Pamakore emitemo anotangira kana kana mushure meJuly 1, 2016, zvirongwa zvehutano hwevadzidzi hazvifananidzi kune zvakaderera zvinoenderana neAACA (kureva, zvirongwa zvebhuroni zvine AV pakati pe 58 ne62 muzana, zvirongwa zvesirivha ne AV pakati pe68 ne72 muzana, nezvimwewo). Pane kudaro, ivo vanofanira kungova neAV yevanenge 60 (vanovhara 60 muzana yevhareji yemari), asi AV yavo inogona kuva nhamba ipi neipi pakati pe 60 ne100, panzvimbo pekuda kukwanisa kupinda muzvikwata zveAV zvinotsanangurwa kuti zvirongwa zvehutano hwesimbi the ACA.
2. Makoroji nemayunivhesiti anogona kupa mapurogiramu ehutano hwehutano hwevadzidzi asi haafaniri kuita izvi (cherechedza kuti vanofanirwa kupa inshuwarisi yehutano yeboka kuvashandi vavo - asi kwete vadzidzi vavo - kana vane 50 kana kupfuura vanoshanda nguva yakazara yakaenzana) . Muna 2007-2008, zvirongwa zvehutano zvevadzidzi zvakapiwa ne 57 muzana yemakoroji , kunyange zvazvo zvakasvetuka kusvika 82 kubva muzana kana taingofunga nezvezvikoro zvemakore mana.
Iye zvino kuti ACA yakasika dzimwe nzira dzakawanda dzevadzidzi kuwana inshuwarhu yehutano - uye yakawedzera mutengo wehutano hwehutano hwevadzidzi nekuda kwemitemo inoshandiswa kuhuwandu - dzimwe dzikoro dzakasarudza kurega kupa mapurogiramu ehutano hwehutano hwevadzidzi. Izvi zvinosanganisira zvikoro zvakasarudza kumira kupa mishonga yehutano yevadzidzi nekuda kweAACA zvinoda kuti zvirongwa zvehutano zvinofanira kuvhara kubata pamuviri.
3. Kuwedzera kune zvirongwa zvehutano zvevadzidzi zvinopiwa nezvikoro, kune dzimwe nzira dzinoverengeka dzevadzidzi dzinogona kuwana inshuwarisi yehutano , iyo yakawanda yakasimbiswa neAACA:
- Vakuru vechidiki vanobvumirwa kuramba vari muurongwa hwehutano hwehutano hwevabereki kusvika vasvika makumi maviri (izvi zvinoshanda pasinei nokuti vari kuchikoro). Kune vadzidzi vazhinji, iyi ndiyo mhinduro yakanaka, asi kune zvimwe zvivako zvekunzwisisa: chirongwa chemubereki hachifanirwi kuvhara kubatsirwa kwevabereki kune vanovimba, uye chirongwa chemubereki chingave chisingasanganisi vatengesi vemunharaunda munzvimbo iyo mudzidzi anoenda kuchikoro. Uyewo, zvichienderana nekuwanda kwemubereki kuripa mari yepayimusi mushure mekupikidzwa kwevashandi, zvinogona kuva mari yakawanda yemhuri kuitira kuti mudzidzi atenge munhu wehutano inshuwarhu kana kunyora muurongwa hwehutano hwevadzidzi. Hapana humwe-huno-hunokodzera-yose mhinduro.
- Medicaid kukodzera kwave kuchiwedzerwa pasi pe ACA , uye makumi matatu nematanhatu pamwe neDDC (uye munguva pfupi, Louisiana) vakagadzirisa mitsva yakakodzera yekufambiswa. Mune dzimwe nyika, kugoverwa kunowanikwa nemari yemhuri kusvika 138 muzana yehurombo, iyo inonzi $ 16,394 muna 2016 kune mumwe chete. Kana vabereki vako vachikuti iwe uri munhu anovimba naye, zvakadaro, mari yavo inotorwa uye inofungidzirwawo kuitira kuti vaone kugona (mumamiriro ezvinhu akadaro, huwandu hwemhuri huchave huchienderana nehuwandu hwevanhu vanozviti pamutero wavo wekubhadhara).
- Zvikwereti zvekutanga zvekugadzirisa mari yehutano yveshuwarhu inowanikwa mune imwe nyika, kuburikidza nekutsinhanisa (chinyorwa chokuti rubatsiro runogona kushandiswa kutenga inshuwalisi yehutano yevadzidzi inopiwa nezvikoro). Kupiwa rubatsiro rwekubhadhara kunobva kune mari yaanoita mari yemunhu. Vadzidzi vanofanirwa kugamuchira rubatsiro (vachifunga kuti vanofanirwa nemari inowanikwa) pasinei nokuti chikoro chawo chinopa hupenyu hwehutano inshuwarisi . Kubatsiridza kunovimbisa kuti mari inoshandiswa purogiramu yesirivha haisi yepamusoro pezvakatemerwa muzana yemari yaanowana mari. Kubatsira kunowanikwa kune vanoita basa vasina kukodzera kuMedicaid uye vanove nemari inowanikwa ne100 muzana yehurombo, asi haisi mazana mana kubva muzana ehurombo huripo (nokuda kwehupfumi hwe 2016, mitemo yehupfumi ye 2015 inoshandiswa). Sezvo neMedicaid kukodzera, mhuri yevadzidzi inowana mari inosanganisira mari yemhuri yose kana mudzidzi achiverengwa semutero unotarisirwa.
- Vashandi vane makumi mashanu kana makumi maviri evashandi vanofananidzwa nguva yakazara vanofanirwa kupa zvikwereti zvinotengesa inshuwarhu yehutano panguva yavo yakazara (maawa makumi matatu nemavhiki) vashandi , kana kubhadhara chirango. Saka, kuvadzidzi vekukoloni avo vanoshandawo nguva yakazara yevashandi vakuru, inshuwarisi yehutano inenge inowanikwa nevanoshandira .
4. Zvimwe zvirongwa zvehutano zvinotengeswa kune vadzidzi hazvisi maererano neAACA . Izvi zvinosanganisira zvirongwa zvenguva pfupi . Kungofanana nepurogiramu yekugadzira mapurisa inotaura kuti yakakosha yevadzidzi haisi kuita chirongwa chehutano hwevadzidzi.
5. Inishuwarenzi yehutano yevadzidzi haina kuonekwa seboka remishonga inshuwarano yehutano, uye izvi zvinoita kuti vadzidzi vanopedza kudzidza vakagadziriswe yehutano yehutano yepureimende premium reimbursement . Pasi pemitemo yakatanga kushanda muna 2014 (asi yakaderedzwa kusvika 2015 ), vashandi havabvumirwi kubhadhara vashandi pamishonga yemishonga yemishuwarenzi yehutano. Vhivhesiti zvakajeka hazvibvumirwi kubhadhara mari yemishonga yemishonga yveshuwarhu yehutano yevashandi vadzo venguva yakazara (sezvo mapurogiramu ezvehutano hwevadzidzi asingatarisirwi sechikwata cheboka), asi pakanga pane kuvhiringidzika kuti izvi zvakashandiswa sei pamusoro pevadzidzi vanoshandawo kuchikoro.
Makunivesiti mazhinji anopa vadzidzi (avo vanowanzopedza kudzidza) nevadzidzi, uye vadzidzi vanoshumira sevadzidzisi vadzidzisi uye vanobatsira pakutsvakurudza. Mukuwedzera kune chikoro chekubhadhara mari uye kuisa mari yekubhadhara mari yekugara, inowanzonziwo kumayunivhesiti kubhadhara zvose kana chikamu chemari yevadzidzi vakapedza kudzidza pachirongwa chehutano hwevadzidzi. Pasi pemitemo inorambidza kubhadhara mubhadharo wemishandirapamu yega, chirango chekusaisa mutemo ndicho chakanaka che $ 100 pazuva, nemushandi (kureva, kusvika ku $ 36,500 gore negore, pamushandi).
Zviri pachena kuti mubvunzo unova kuti kana kuti kwete vadzidzisi vekutsvakurudza vakapedza kudzidza uye vadzidzisi vekudzidzisa vashandi vashandi, uye kuti kana iyo iyo yunivhesiti iri kushandiswa pakurambidza kubhadhara vashandi vasiri vemu-inshurensi yehutano hwehutano nekubhadhara chikamu chemakambani emakambani evadzidzi. MunaFebruary 2016, IRS yakabudiswa Chirevo 2016-17 , iyo inopa rubatsiro rwekutsvaga kumayunivhesiti ari kubhadhara mari yemishonga yemishonga yveshuwarisi yehutano nekuda kwevadzidzi vakapedza kudzidzawo avo vanoshandawo pachikoro. Nokuda kwemakore ekugadzirira anotangira pamberi paJanuary 1, 2017, IRS haingatori chiito kune chikoro chinoshandisa urongwa huri urongwa (saka gore remarongerwo rinotevera gore ra2016-2017 revadzidzi richagara richienderana kana chikoro chiri kubhadhara mamiririmi ehutano yevadzidzi vehutano yehutano).