Ndiyo New York neNigeria chete Iyo Yakasimbiswa BHPs
Chikamu 1331 cheChinakidza Care Act inobvumira hurumende kutanga Hurongwa Hwehutano Hwehutano (BHP) kupa hutano hwehutano kune vanhu vanowana mari yakawanda kuti vawane Medicaid, asi avo vachiri kuda rubatsiro rwakawanda kupfuura iyo ACA inogona kupa. Chero nyika ipi inogona kugadzira BHP, asi New York neNigeria chete vakaita saizvozvo.
Mari yeBHP yakafukidzwa nehurumende uye hurumende yekubhadhara mari, pamwe chete nezvikwereti zvishoma nezvishoma uye kugovana-mari kunhengo.
IAACA inongoda BHPs kuti ive nechokwadi chokuti nhengo haifaniri kubhadhara mari yepurayamisi uye kugovana-kudhura kwavanozobhadhara pasi pehutano hwehutano hwakanaka (kunyanya, chirongwa chechipiri-chakanyanya kudhura chesirivha maererano nemarangiro, uye platinum kana chirongwa chegoridhe-zvichienderana nemari-muzvikamu zvekunze-kwe-muhomwe mari mukutengeserana, asi kunyoresa muBHPs muNew York uye Minnesota kune zvakaderera zvakakwana mari kupfuura zvavaigona kuva nehutano hwehutano hwakakodzera.
Ndiani Anokodzera Kubatsira Purogiramu Yehutano?
Purogiramu yehutano yehutano inosarudzwa kune zvese. Asi kana ikashandiswa, kukodzera kunotsanangurwa mumashoko eAACA:
- Vanhu vazhinji vanogona kubhadharwa neBHP kana vane mari yepakati pe13 muzana (mukuita, iri 138 muzana neyakavakirwa mune mari isingabhadharwi) uye 200 muzana yehurumende urombo hwehutano. Nokuda kwegore ra2018, mari yepamusoro yekuwana mumwe munhu ndeye $ 24,120. Sezvo ACA yakanyorwa, vanhu vane mari yezasi ye 133 muzana yehurombo huri kutarisirwa kuti vawane Medicaid, saka BHP yaizotora apo Medicaid yakasiya. Zvisinei, kune 19 nyika dzakaramba kuwedzera Medicaid, zvichiita kuti pave nekuputika mune 18 kubva kwavari (vanhu vakawanda vane mari pasi pehurombo huri husina kukodzera kubhadhara mari inowanikwa muchitsinhanisi). Asi izvo chete izvo zvakagadzirisa BHP zvakawedzerawo Medicaid.
- Mutemo wekupa vatorwa vasiri vemuUnited States kwemakore anenge mashanu vakakodzera kubhadharwa neBHP kana vane mari pasi pe13 muzana yehurombo. Izvi ndezvokuti munguva pfupi yapfuura vanhu vanobva kune dzimwe nyika havafanirwi neMedicaid (kunyange mune imwe nyika yakawedzera Medicaid) pasinei nemari , kusvikira vasvika pamutemo muUnited States kwemakore mashanu.
Nyika mbiri dzakasimbiswa hutano zvirongwa
Zvinyorwa zviviri-New York uye Minnesota-zvakagadzira Basic Health Programs.
New York
BHP yeNew York inonzi The Essential Plan, uye yakatanga kuwanika pakutanga kwe 2016. Zvikamu zveEssential Plan yekuvhara uye mari zvinowanikwa pano uye pano . Hapana purogiramu yevanyoresa nemari yekuwana kusvika 150 muzana yehurombo huripo, kunze kwekuti vachida kuwedzera mazino uye maonero ekuonekwa. Avo vane mari yepakati pe 150 ne200% yehurombo huripo huripa $ 20 / mwedzi kuti vawane.
Pasi peThe Essential Plan, inyoresa nemari kusvika kune 150 muzana yehurombo huwandu ($ 18,090 kune munhu mumwe chete muna 2018) haina mapepa kana mamwe ekugoverana mari kune mamwe mabasa, kunyange zvazvo kune madhora mazana matatu emadhora emishonga yemishonga. Vaya vane mari inopfuura 150 muzana yehurombo huwandu hwemari inobhadharwa nehuwandu hwemashumiro, kunyange zvazvo pasina ductible uye mari yekugoverana mari yakawanda kudarika zvingadai iri purogiramu yega yega kuburikidza neNew York State Health muNew York).
The Essential Plan benefits inopiwa navatsigiri vega vega vimbiso neyeNew York. Kune vatori vemapurisa makumi matanhatu nevatatu vanobatanidzwa muurongwa, kunyange zvazvo vakawanda vachikupai Purogiramu Inokosha mune dzimwe nzvimbo dzehurumende ( iyi chati inoratidza apo mumwe mubhadhari anopa Purogiramu Inokosha).
Vagari vomuNew York vanogona kunyoresa kuThe Essential Plan neNew York State Health. Iko kushandurwa kunogadza kukodzera kweMedicaid, The Essential Plan, uye zvirongwa zvehutano zvakakosha (kana pasina kana kubhadhara mari inobhadharwa), zvichienderana nemari inowanikwa uye zvimwe zvikonzero zvakakosha.
Kubva munaDisemba 2017, paiva nevanenge 720 000 vanhu vakanyoresa muThe Essential Plan ye 2018.
Minnesota
BHP yeMinnesota inonzi MinnesotaCare, uye yaive iri chirongwa cheStart Health kubvira muna 2015 (MinnesotaCare chirongwa chave chiripo muMinnesota kubva muna 1992, asi chakashandurwa kuBHP pasi pemitemo yeAAC kusvika munaJanuary 2015, zuva rekutanga rakabvumirwa pasi pehurumende inotonga).
Chidimbu cheMinnesotaCare chinyorwa chinowanikwa apa. Vanhu vari pasi pemakumi maviri nemakumi maviri nevashanu havabhadhari kugovana-mari, asi kune mapepa evanyorese makore makumi maviri nemashanu, pamwe chete ne deductible ye $ 2.95 pamwedzi (iyo inobviswa chete inofanira kubhadharwa kana uchida rubatsiro rwemishonga mumwedzi).
Zvikwereti zveMinnesotaCare zvakabva pamari inowanikwa, uye inogona kuva yakadarika $ 80 / mwedzi pamunhu mumwe kune avo vane mari yepamusoro pamagumo ekupedzisira ezvakakodzera mararamiro (200 muzana yehurombo huwandu, iyo $ 24,120 kune mumwe chete, uye $ 49,200 mhuri yevana: cherechedza kuti mhuri yevana ina iyi inowanikwa mari inokodzera ku Minnesota Minnesota nokuda kwevabereki, asi vana vanozofanirwa neMedicaid kana vari 18 kana vaduku).
Sezvakangoitika muNew York, Minnesota inopinda nevashambadzi vega vega kupa zvikomborero pasi pe Basic Basic Program. Kubva muna 2017, kune vanomwe vapeji vehurumende vane zvibvumirano zvehurumende kuti vawane MinnesotaCare chinyorwa. Vagari vemuMinnesota vanogona kusayina kuMinnesotaCare kuburikidza neNyika, shanduko yehurumende. Shanduro inoita kuti zvikwanise kugadziriswa kweAradic Assistance (Medicaid), MinnesotaCare, uye zvirongwa zvehutano zvakagadziriswa (kana pasina kana kubhadhara mari inobhadharwa), zvichienderana nemari uye zvimwe zvikonzero zvakakosha.
Kubva munaNovember 2017, pakanga pane vanhu vanenge 93 000 vakanyoresa MinnesotaNhare muna 2018.
Ndeapi Maitiro Ehutano Ehutano Akabhadharwa?
Pasi peAACA, hurumende ichapa hurumende neBHP mari yakaenzana nezvikamu 95 kubva muzana yemari iyo hurumende inogona kunge yakashandisa pamabhadharo ekubhadharisa mari uye kugovana-kugoverana kwezvikwereti munharaunda iyoyo (kune vanhu vanozopedzisira vava kukodzerwa neBHP pane kupfuura chechipiri-yakadhura-mari yakagadzirisa zvirongwa zvesirivha muchitsinhanho, nemari yekubhadharwa mari yepamusoro uye kugovana-kudhura kunodhura).
Gore ra2015, MinnesotaCare yakanga iri purogiramu yakabhadharwa nehurumende yaiita kuti vanhu vasati vatarise Medicaid, uye vaive nemari yepamusoro ye 275 muzana yehurombo. Kushandura kune BHP kwaive kunobatsira mari kuMinnesota, sezvo yakabvumira kuti mari yezvemari inobatsire pane kuremekedza zvizere mari yehurumende (vanhu veMinnesota vanowana pakati pe2002 ne275 muzana yehurombo huripo iye zvino pane zvirongwa zvehutano zvakakodzera kuburikidza neNyika, sezvo ACA inoda BHPs kuikodzero yepamusoro pa 200 muzana yehurombo uhu).
Yaiva mari inobatsira kuNew York kuisa BHP zvakare. Kubva muna 2001, New York yakapa mari inotambirwa neMedicaid inotambirwa nehurumende kune vachangobva kubuda (avo vakanga vasingakwanisi kupiwa Medicaid mari inobhadharwa pamwe chete nehurumende nehurumende, sezvo sangano reMedicaid mari risingagoni kushandiswa kuvhara vati vabva kune dzimwe nyika vanga vari muU.S. pasi pemakore mashanu). Sezvo kubudiswa kweBHP kunowanikwa kune vekubva kune dzimwe nyika, kuchinja kweNew York kuenda kumutambo weBHP kwaireva kuti havachafaniri kuvimba zvizere nemari yehurumende kuti vawane mari yakaderera yevatorwa vatsva.
Chisarudzo chekutonga kweTrump muna Gumiguru 2017 kubvisa mari yehurumende yekudhura kugovana mari kunoderedza huwandu hwehurumende yebhadharo iyo BHPs inowanikwa mberi, asi huwandu hwehurumende yezvemari yeBHPs inonyanya mari iyo hurumende inogona kunge yakashandisa pamari yekubhadhara-iyo mari yaizodai yakashandiswa pamiganhu yekugoverana mari ndiyo chikamu chiduku chezvikamu. Kubviswa kwemari yekugovera kuderedzwa mari inenge ichiri kushungurudzika kweNew York neNigeria, kunyange zvazvo zvese nyika dziri kuramba dzichishanda BHPs uye 2018 chinyorwa chinowanikwa kune vagari vakakodzera vane zvirongwa zvakafanana zvezvirongwa zvakashandiswa mumakore apfuura.
Zvimwe Nyika Zvichagadzirisa BHP?
Purogiramu yeBHP inowanikwa munyika yose, asi hazvigoneki kuti dzimwe dzakawanda dzichaguma dzichigadza imwe. Muzhinji, hurumende inoda kuwedzera Medicaid uye yakagadzira hutano hwehutano inshuwarano kuitira kuti BHP ive yechokwadi chaiyo. Uye kunyange zvazvo zvirongwa zvehutano zvakakosha mukutsinhana hazvivimbi zvachose pamusoro pemari yehurumende, BHP inokonzera nyika pachikwereti chekugona kubhadhara mari, kana hurumende isingakwanisi (zvose zveNew York neMinnesota zvakafanirwa kuvhara zvimwe mari yeBHPs yavo, uye kubviswa kwemasangano ekubhadhara mari kunowedzera kuwedzera kwepakati pakati pezvinotengeswa nehurongwa uye izvo hurumende inobhadhara).
Asi vanhu uye mhuri dzine mari inowanikwa nechepamusoro zvikuru kuMedicaid inoshumirwa zvakanaka neBHPs. Mune dzimwe nyika pasina BHP, pane "nzvimbo" yakakosha maererano nemitengo yepayimusi uye kugoverana kwezvikwereti pakati peMedicaid uye zvirongwa zvepaguru mukutsinhanisa, kunyange nemari inobhadhara mari uye kugovana-kudhura kugoverana pane purogiramu yega yega zvichiri kuwanika, pasinei nekuti hurumende yehurumende haisisiri kuripa bhizimisi kuti ipe zvipo izvozvo).
Munhu ane Medicaid chinyorwa achabhadhara zvishomanana kana kuti hapana muhurukuro, uye kugovana-mari kune zvishoma kudhura zvishoma pasi pehurumende mitemo. Kana munhu iyeye akawana kukwidza kuduku uye mari yake inowedzera kubva pa $ 16,600 kusvika ku $ 16,700 (muna 2017), iye acharasikirwa kukodzera kuMedicaid (achifunga kuti ari mune imwe nyika yakawedzera Medicaid). Kana ari muhurumende ane BHP uye mari yake inowedzera zvakanyanya kuMedicaid, iye achakwanisa kubhadhara BHP pane nzvimbo, iyo yaachabhadhara mari yepamusoro (kana kuti kwete zvachose, muNew York, zvichienderana nemari yake ), uye mari yake kunze kwehomwe icharamba ichizvininipisa.
Asi kana ari mune imwe nyika isina BHP, inofanira kutenga chirongwa chehutano chakakodzera mune shanduko. Zvichienderana nekunogara kwaanoita, angave akakodzera kubhadharwa mari yepamusoro yepamusoro yekukwanisa kubhadhara mari yakazara yehurongwa hurongwa hwemhangura, asi zvirongwa izvi zvinouya nemari yakawanda-kunze kwehomwe (inowanzosvika madhora 6 500 muna 2018, uye inowanzove yakakwirira sezvakawanda-zvakabvumirwa $ 7 350). Kana iye akasarudza pane kusarudza chirongwa chesirivha (icho chichasanganisira kugovana-kugovana-kugovana, uye naizvozvo kuva nechepasi-kunze kwehomwe mari), achabhadhara anenge 3 muzana yemari yaanowana muzvikwereti. Uye kunyange nekutengesa kugovana-kudhura, anobhadhara mari yakawanda muzvikwereti uye copays kupfuura imwe yeBHP mbiri iripo inoda kuti vanyori vadzo vabhadhara.
Mune mamwe mazwi, kushandiswa kwehurumende kweBHP kunobatsira kusimbisa musiyano pakati peMedicaid kubhadhara / mari uye purogiramu yega purogiramu / mari, uye zvinoita kuti pave nemari yakawanda inotarisirwa yekutarisira utano kune vanhu vane mari yavanowana isinganyanyi kukosha kuMedicaid kukodzera. Asi kusimbisa BHP kunogona kudikanwa kuti nyika ishandise mari yayo, uye inosanganisira kushanduka kwevanhu vemu inshuwarisi (avo vane hutano pasi pehutano hwehutano hwakanaka) kune purogiramu itsva, iyo inogona kuvhiringidza vagari vemo vagari vezvechiremba, uye zvinogona kuvhiringidza maererano nekutenderera kwekutarisira.
> Sources:
> Mhuri USA. Federal Poverty Guidelines.
> HealthCare.gov. Verengai Mutengo Wakanaka Wenyu. Chikamu 4, State Flexibility yekugadzira Zvimwe Zvirongwa. Chikamu 1331 (peji 93 yemashoko).
> Minnesota Department of Human Services. MinnesotaCare (Program Information, Kubvumirwa, Kubatsira, Kushandisa Info).
> New York State of Health. The Essential Plan.