Obamacare Ndiyo ACA; Kuwedzera kweMedicaid Icho Chikamu cheOmbacacare
Zvechokwadi, Obamacare inongova nickname ye Affordable Care Act. Iro pakutanga raishandiswa mukufungidzira pejorative nevashori vemutemo, asi Mutungamiri Obama akagamuchira izwi iri muna 2012, uye rakashandiswa kubva panguva iyoyo nevashori vose nevatsigiri veAACA.
Sezvo Obamacare yakafanana neAACA, inosanganisira zvose zvekugadzirisa kushandiswa kunoshandiswa kune mumwe munhu wehutano inshuwarheni yemakethe (zvose uye pasina-kushandurana , zvose zvitsva zvirongwa zvezvechirongwa zviri ACA-zvinogamuchirika), pamwe chete nekuchinja kunoshanda kune machechi maduku uye mazana emakethe.
Inowedzerawo kuwedzera kweMedicaid, iyo inombo yekona yeAACA. Uye inosanganisira mutemo wega wega uye vashandisi vashandi-iyo ACA "inonamatira" kukurudzira vanhu kuwana ruzivo-pamwe chete nemari inobhadharwa-premiro-"makaroti" -kuti kugoverwa kunogona kuwanika muhutano hwehutano inshuwarisi.
Kunyange zvazvo vatongi veRipublican uye Hurumende yeTrump vakamanikidza kubviswa kwezvikamu zvizhinji zveAACA muna 2017, chikamu chega chemurairo chakazopedzisira chabviswa chaiva chirango chega roga, uye icho chinodzokorora hachizoiti kusvikira 2019 . Iko GOP mitero yemutero (Tax Cuts uye Jobs Act) yakagadzwa munaDisemba 2017 ichazopedzisira yabvisa chirango chemunhu mumwe nomumwe, asi chirango ichi chichiri kuongororwa (pakutanga kwegore ra2019) pamitero yevanhu vasina kuvimbiswa muna 2018 .
Saka ACA inoramba yakanyatsopindira muna 2018, uye zvikamu zvizhinji zvayo zvinogona kunge zvichiri kushanda muna 2019 uye mberi.
Kushandiswa kwekufananidzira kwe "Obamacare" = Zvirongwa Zvakatengeswa muKushandura
Kunyange zvazvo izwi rokuti Obamacare rinowanzobatanidza zvose zveAACA, vanhu vanowanzoshandisa naro kutarisa kumapurogiramu ehutano hwehutano hwehutano hutengeswa muhutano hwehutano hwehutano . Nokuda kwechinangwa chechinyorwa chino, tichaenda nekushandiswa kwemashoko aya, uye tarisa musiyano pakati pezvirongwa izvi neMedicaid.
"Obamacare" zvirongwa zvirongwa zvega; Medicaid inotungamira hurumende
Chinyanya kukosha pakati peMedicaid uye Obamacare ndechokuti zvirongwa zvehutano zveOmbamacare zvinopiwa nemakambani ehutano ehutano hwehutano apo Medicaid inorongwa hurumende.
Medicaid, chirongwa chehurumende yehutano yehutano yehupfumi hweUnited States vagari, chirongwa chemagariro ehupfumi seSNAP zvidhori zvekudya kana Mushandi Wenguva Dzakakwana kuVanotambura Mhuri.
Izwi rokuti Obamacare rinowanzoshandiswa kurondedzera hutano hwehutano hwehutano hwakatengwa kuburikidza neChamupatiki Care Act yehutano hwekushandiswa kweishuwarisi . Obamacare zvirongwa zvehutano hwehutano zvinopiwa nemakambani ehutano inshuwarheni akadai seBlue Cross, Kaiser Permanente, Molina, Aetna, Cigna, Wellpoint, nevamwe. Obamacare zvirongwa zvehutano hazvisi izvo zvinotungamirirwa nehurumende, asi zvinofanira kutevera mitemo yakasiyana-siyana yehurumende.
Zvakakosha kuziva, zvisinei, kuti zvinodarika zvitatu zveMedicaid zvinonyorwa munyika yose ndezveMedicaid dzakachengetwa zvirongwa zvekuchengeta, izvo zvinoreva kuti inshuwarisi yavo inotarisirwa nevanomwe vatsigiri vehurumende iyo inotengesa inshuwarisi yezvemabhizimisi kuvanhu nemabhizimisi. Izvo zvirongwa zvinoshanda kuburikidza nekontrakiti nehurumende yehurumende kuti ipe Medicaid zvinobatsira.
Izvi zvinogona kuvhiringidza kuvanhu, uye zvinowanikwa nekuti mune dzimwe nyika, chirongwa cheMedicaid hachina "Medicaid" muzita rayo (Apple Health muWashington, somuenzaniso, uye BadgerCare Plus muWisconsin).
Ndiani Anowana Medicaid Vs. Ndiani Anowana Obamacare
Zvakaoma kuwana Medicaid kudarika kuwana chirongwa chehutano hweBobamacare.
Kana iwe uri mutemo unogara kuUnited States, unogona kutenga chirongwa cheU inshuwarhu yehutano yeUmamacare kuburikidza neAAA yehutano yehutano yehutano chero bedzi usingakodzeri Medicare . Kana zvikwereti zvako zvichitengeswa 100% uye 400% yehurumende yehurumende yehurombo , iwe unogona kukodzera rubatsiro runobatsira kubhadhara chikamu chemishonga yako yemainishuwarenzi yehutano hwemwedzi wepamusoro (nhamba yekuti pasi rezasi yekubhadhara mari inokwana 139 muzana yehurombo huri mune zviti vakawedzera Medicaid; mune iyo iyo, Medicaid inowanika kune vanhu vane mari kusvika 138 muzana yehurombo uhu).
Kana mari yako iri pamusoro pe400% yeFPL kana pasi pe100 muzana yeFPL, haungawani rubatsiro kubhadhara inshuwarhu yehutano inotengeswa kuUbamacare kugoverana, asi unogona kutenga chirongwa cheBobamacare chero zvakadaro. Muchiitiko ichi, iwe uchava nemhosva yekubhadhara 100% yemwedzi wepuraimari iwe pachako. [Cherechedza kuti zviri pamutemo-ikozvino vapoteri vane mari iri pasi pehurombo huri kukodzera kubhadhara mari yepamusoro kana vasingakodzeri Medicaid pamusana pemakore mashanu ekumirira kwevachangobva kubuda.]
Nzira yekuwana Medicaid yakasimba uye inopesana kubva kuhurumende kuenda kune imwe nyika. Chinangwa chepakutanga cheAACA ndechokuti vose vanogara mumatare vane mari kusvika 138% yeFPL vaizowana kuvharwa kweMedicaid pasina. Zvisinei, chisarudzo cheDare Repamusorosoro chakakonzera kuwirirana nechikamu ichi cheChinakidza Care Act chisarudzo. Izvi zvakaguma nenzira yakavhiringidza umo vamwe vanoti vane Medicaid yakakwana yekugadziriswa kodzero nokuti vatungamiri vavo vakasarudza kusawedzera kuwedzerwa kweMedicaid, asi dzimwe nyika dzine ruremekedzo rweMedicaid dzinokodzera kukosha vatungamiri vavo vakasarudza kupinda ACA's Medicaid kuwedzera .
Kubva muna 2018, pane 19 dzinotaura dzisina kuwedzera Medicaid. Vanenge mamiriyoni 2,4 mamiriyoni gumi nemakumi mapfumbamwe ematunhu aya ari mune izvo zvinozivikanwa sepakati pekugoverana: mari yavo inowanikwa zvakanyanya kuti vabatsirwe muhutano (pasi pehurombo huripo), asi ivo havakwanisiwo kuMedicaid).
Kana iwe uchigara mune imwe nyika yakawedzera Medicaid kugoverwa, iwe uchave wakakodzera kuMedicaid kana iwe shanduko yakagadziridzwa mari yakawanda haisi ye 138% yeFPL. Izvi zvinowanzosunungurwa kwauri, kunyange zvazvo dzimwe nyika dzichipa chikwereti chiduku, chechipiri yegore roga roga rekugoverwa kwevanhu vane mari kune hurombo.
Kana iwe uchigara mune imwe nyika iyo isina kukura kujekesa kweMedicaid, iwe uchafanirwa kusangana nevakuru, zvakasimba zvekugadziriswa zvirongwa. Iyi nzira yakasimba inokonzera kubva kune imwe nyika kuenda kune imwe nyika. Zvinosanganisira zvikwereti zvisingabatsiri uye zvingada kuti uve nhengo yeboka revanhu vane utano hwakadai sevakwegura, vakaremara, mapofu, vana, vakadzi vane pamuviri, uye vabereki kana vakwegura vakuru vevana vaduku.
Saka, somuenzaniso, kana iwe usina mwana, ane makore makumi matatu ane utano ane makore ane $ 10 000 pagore, iwe kana kuti iwe hauna kukodzera kuMedicaid inobva kune imwe nyika yaunogara. Kana uchigara mune imwe nyika yakawedzerwa Medicaid kuparidzira kune munhu wose anoita 138% yeFPL, iwe uchawana Medicaid nokuti unosangana nemiganho yekuwana mari. Kana iwe uchigara mune imwe nyika iyo isina kukwanisa kuwedzerwa Medicaid, haungakodzeri Medicaid, kunyange zvazvo iwe mari yako yakaderera, sezvo iwe hauna kukwegura, wakwegura, mapofu, kana mubereki wemwana muduku (Wisconsin iyo yakasiyana-siyana; hurumende haina kubvuma mari yezvemari yekuwedzera Medicaid, asi inopa Medicaid kune vagari vane mari kusvika kuhurombo, naizvozvo hapana nzvimbo yekuvhara muWisconsin).
Kunyora Kunyoresa Nguva Pfupi ye Obamacare Vs. Nyora chero nguva ye Medicaid
Vanhu vakakodzera vanogona kunyoresa muMedicaid gore rese. Asi kunyoresa muzvirongwa zveBobamacare zvinongowanikwa panguva yekunyorwa kwegore negore kana kuti iwe unosangana nekodzero yekugadzirisa nguva yakanyanya yokunyora . Kana zvisina kudaro, iwe unofanira kumirira kusvika panguva yakatevera yekunyora yakasununguka kuti ushande kune chirongwa cheBobamacare (chinyorwa kuti izvi ndezvechokwadi pasinei nokuti uri kunyora kuburikidza nekutsinhanisa kana kusagadzirisa-shanduro; zvirongwa zvinotengeswa kunze kwekutsinhanisa ndeye ACA-inogamuchirika zvakare, uye vane mahwindo akaenzana ekunyorwa kwevheji; Nevada ndeyezvisizvo, apo mazano ekutsinhana-shandiswa anotengeswa gore rose, asi ane mazuva 90 ekumirira nguva isati yatanga kupera).
Paunenge uchikumbira urongwa hweBobamacare panguva yekunyora kuzarura (yakarongwa kuti uite umwe neumwe kubva munaNovember 1 kusvika kuDecember 15), kugoverwa hakubatsiri kusvika musi waJanuary 1 wegore rinotevera. Somuenzaniso, kana iwe ukanyoresa chirongwa cheBobamacare panguva yekunyora kuzarura mumavambo a2018, chirongwa chako cheBobamacare chichaitika musi waJanuary 1, 2019 (pane mitemo yakasiyana yezuva inoshandiswa mune dzimwe mamiriro apo vanhu vanoshandisa semugumisiro we chiitiko chakakodzera , chakadai sekuberekwa kwomwana).
Zvisinei, paunoshandisa Medicaid uye unogamuchirwa mudhipatimendi reMedicaid, hapana nguva yekumirira usati wapera.
Retroactive Coverage for Medicaid Vs. Hapana Retroactive Coverage yeOmbamacare
Mune zvimwe zviitiko, kubudiswa kweMedicaid kunogona kudzoka zvakare. Semuenzaniso, kana uri nemwedzi mishanu pamuviri paunenge uchitsvaga uye ukawana Medicaid kugoverwa, Medicaid inogona kubhadhara kubhadhara kwawakabata kwawakawana mukati memwedzi 1-4 kubva pamuviri wako, kunyange usati wanyorera Medicaid. Izvo hazvisi chokwadi nezvehutano hwehutano hwehutano hwehutano hwakatengeswa kuObamacare kugoverana.
Zvinofadza kuti Hurumende yeTrump yatanga kubvumira zvikumbiro zvekuregererwa kubva kune zvese zvinoda kugumisa kuparidzirwa kwekuitazve pasi peMedicaid. Pasina kutaridzika zvakare, Medicaid inowedzera kufanana nehutano hwehutano inshuwarheni maererano nezvinoitika kana kugoverwa kunogona kushanda.
Pasi Pasi-Kugoverana kweMedicaid Vs. Obamacare
Muzviitiko zvizhinji, Medicaid hairevi zvakawanda munzira yekubhadharwa, kubhadhara , kana kubviswa . Sezvo Medicaid iyo inofanirwa kune avo vane mari shoma kwazvo, chero chimwe chinhu kunze kwechiratidzo chekugovana-kugovana mari kunenge kusingagoneki kune vanogamuchira Medicaid uye kupa chinetso chinogona kutarisira.
Kune rumwe rutivi, zvirongwa zvehutano zveBobamacare zvinouya nemabhadharo, zvikwereti, uye coinsurance. Sezvo kubviswa kwemazana emadhora emadhora kunogona kuva kwakaoma kuvanhu vane mari shoma yokubhadhara, kune mari yekugovana-mari inowanika kune avo vanoita pasi pe 250% yeFPL iyo inobatsira kuderedza mari yekugovana-kudhura. Vaya vanoita zvinopfuura 250% zveFPL ndivo vane mhosva yehuwandu hwehupi hwekugovana-mari inotarisirwa nehurongwa hwavo hwehutano hwaObamacare.
Medicaid & Medicare Inogona Kubatanidzwa; Obamacare & Medicare Hazviiti
Zviri pamutemo zvakakwana uye zvinobatsira kuva neMedareid uye Medicaid kuparidzira panguva imwe chete kana iwe uchikodzera vose. Kutaura zvazviri, pane zita ravanhu vane zvose: vaviri vanokwanisa .
Kunyange zvakadaro, kazhinji hazvibatsiri kuva neIndamacare yehutano yehutano hurongwa uye Medicare. Hazvibvumirwe zviri pamutemo kune wekuchengetedza mari yega yega kuti atengese imwe chirongwa chemari mushure mekunge wakakodzera Medicare, kunyange vasingakwanisi kukumanikidza kurega chirongwa cheBobamacare chaunenge uine kana iwe unokodzera Medicare. Asi munyaya iyo, iwe ucharasikirwa nehupi hwemari yekubhadhara iyo iwe unogamuchira kana iwe uchikodzero yeMedare, uye hapachinawo kuwirirana kwebatsiro pakati peMedare uye pamusika mumwe nomumwe. Saka zvinowanzokurudzirwa kuti Obamacare anyoresa kuregera ivo pachavo kugoverwa kana vakagadzirirwa kuMedare.
Cherechedza kuti nzira iyi haisi yega; iwe unotanga kuregererwa kubviswa kweObamacare wako uronga iwe pachako. Kana iwe uchikodzera kuMedare, iwe unoda kurongedza kuregererwa kwehutano hwako hwehutano inshuwarisi nekutangira Medicare yako. Izvi ndezvechokwadi pasinei nokuti iwe unyoresa kutanga kweMedicare Parts A uye B , kana kuti Medicare Part C, Medicare Advantage chirongwa .
Sei Uchitaura Kusiyana Kusiyana neMedicaid & Obamacare Inogona Kuoma
Kunzwisisa kusiyana kweMedicaid uye Obamacare kunogona kuvhiringidza nokuti
- Kazhinji, iwe unodzidza kuti uri kukodzerwa neMedicaid paunozadza sarudzo yehutano inshuwarheni pane ACA yako yehutano kushandiswa. Kana kuchinjana kusarudza kuti iwe unofanirwa kutenga Medicaid munharaunda yako, ichaendesa mberi iyo mashoko ku Medicaid, kutanga chirongwa chekuita Medicaid. Sezvo iwe wakatumira mushandi wako wehutano wehutano hwekutanga kuhutano hwehutano hwehutano, zvinogona kuvhiringidza paunopedza kugamuchira Medicaid panzvimbo yeurongwa hweUbamacare wega.
- Kunyange zvazvo Medicaid iyi chirongwa chehurumende, munyika dzakawanda, Medicaid manheru evanhu vazhinji vanonyora inopiwa nekambani yehutano yehutano yehutano. Ichokwadi, maererano neKaiser Family Foundation, vanodarika vatatu-voga veMedicaid vagamuchiri vari muhutano hwekutarisira zvirongwa zvehutano. Chirongwa cheMedicaid kugamuchira kadhi yake yeMedicaid ID kubva kuUnitedHealthCare, Humana, Kaiser, kana Blue Cross, inogona kunge yakanganisa kuti yakagamuchira inshuwarisi yehutano yeUbamacare yega yega. Muzvokwadi, chirongwa chake cheMedicaid chirongwa chakabvumirana nemumwe munhu wekuchengetedza mari yega yega kuti agadzirire kuchengetedzwa kweMedicaid. Kunyange zvazvo kambani yega yega iri kutarisira Medicaid inobatsira, zvikomborero ivo pachavo ndezveMedicaid uye mari yekubhadhara iyo zvikomborero pakupedzisira inobva pakubatanidza federal nehurumende mari yemubhadhara.
Sezvo vazhinji vevanhu vachitenga inshuwalhu yehutano ku ACA yehutano yehutano kushandiswa kuwana rubatsiro kubhadhara iyo inshuwarisi yehutano nenzira yezvibatsiro kubva kuhurumende yehurumende, zvinogona kuvhiringidza pamusoro pekuti hurumende inobhadharwa yehurumende yehutano (Obamacare) ndeyei chaizvo iyo yakasiyana nehurumende-yakabhadhara mari Medicaid.
> Sources:
> Centers for Medicare neMedicaid Services, Inowanzobvunzwa Mibvunzo NezveMurengeti neMusika . August 1, 2014.
> Kaiser Family Foundation, The Coverage Gap: Uninsured Varombo Vakuru Munyika Dzisina Kuwedzera Medicaid. November 1, 2017.
> Kaiser Family Foundation, Total Medicaid Yakatungamirirwa Nekunyorwa Kunyoresa, 2014.