Zvichida Kuchinja Kunotyisa Kuenderana Nekupi Kwaunowana Inishuwarenzi Yako
Donald Trump akazivisa chivimbiso chokuti aizokurumidza kubvisa Affordable Care Act (Obamacare), uye aizotsiva "nehuwandu hwekugadziridza kwakagadzirirwa kushandiswa kunoenderana nemitemo yemashamba uye izvo zvichadzosera rusununguko rwehupfumi uye chokwadi kuvanhu vose vari munyika ino. "
Congressional Republicans haina kupedza nguva yekuita bhora richiputika pamutemo weAACA, kupfuudza gadziriro yebhajeti pamberi pekugadzirisa kweTrump, kutungamirira congressal komiti kutanga kutora mitemo kuti iparadze kushandiswa kwemari-yakabatana kweAACA.
Uye musi wekutanga waTrump muhofisi, akabudisa mutungamiri wehurumende achitungamirira masangano ehurumende kuti ave munyoro pakushanda kwavo kweAACA mitero uye zvikwereti.
Asi ACA yakaratidza kuti yakadzika midzi muhutano hwedu hwehutano, uye zvakaoma kudzokorora kupfuura hutungamiri hweGOP hwakarongerwa. Pasinei nechocho chokwadi chekuti veRepublicans vanotonga imba, Senate, uye White House, kubviswa kweAACA kwakakundikana muna 2017. VaRwanda Republican vakapfuudza maitiro avo okudzingwa ( American Health Care Act ) munaMay 2017, asi Senate Republicans yakakundikana kudarika nhatu shanduro yemutemo muna July 2017, uye basa rekupedzisira muSeptember 2017 harina kusvika pakusarudzwa kweSenate pasi, nekuda kwekushayikwa kwekutsigirwa.
Asi Hurumende neKutonga kweTrump vave vachikurumidza kubvisa mutemo wehutano hwekugadzirisa hutsika nenzira duku, dzimwe dzingakanganisa hutano hwehutano hwevanhu:
Mutongo wega wega wega wega wekutongwa wakapera muna 2019
Muna December 2017, Mutero Wemitero uye Jobs Act yakabvisa mutemo weAACA mumwe nomumwe, kubva muna 2019.
Icho chiripo chirango chekusavimbiswa muna 2018 , asi hapachazove nechirango chekusavimbiswa muna 2019 nekupfuura, kunze kwekuti iwe uri muMassachusetts kana imwe nyika inoshandisa chirango chayo chairo.
Mamwe emitero yeAACA, kusanganisira mutero weC Cadillac , akave akazononoka, pasi pemitemo yeHJ Res.125, muyero wekushandiswa kwemashgap wakaitwa pakutanga kwegore ra2018.
Kugadziriswa kweCRR Inobatsira
Hurumende yeTurump yakabvisa mari yekubhadhara mari (CSR) muna Gumiguru 2017. Asi kubatsirwa kudhura-kugovana- mari kunowanikwa kune vanotora chikwereti, uye huwandu hwekutsinhanisa huripo huri nani, kana kuti huri nani, ikozvino mari yakabviswa. Izvi zvinoreva kuti vatsigiri vezvematongerwo enyika vakawanda vanongowedzera mari yeCRR kumapurani esirivha epurogiramu ye 2018 , iyo yakaguma nehomwe yepamusoro yekubhadhara rubatsiro rwevamwe vanokodzera kubhadhara mari yepamusoro.
Chero bedzi hurumende yehurumende ichiramba ichibvumira vatsigiri vekuwedzera mari yeCRR kumabhadharo emari esirivha mumakore anotevera, vazhinji vanozonyora vachadzivirirwa kubva pamagumisiro ekubviswa kweSRR mari, uye vazhinji vacharamba vari nani, nekuda kwe mari yepamusoro yepamusoro.
Proposed Regulations
Uye Mutungamiri weTrump akasarudzawo mitemo inobvumira zvirongwa zvenguva pfupi zvekare zvakare kuva nemakore makumi matatu nemazana makumi matatu nemasere (murairo wekuti Obama Administration yakanga yakasimbiswa, mukuedza kudzivirira mutengesi mumwe nomumwe), uye kubvumira zvimwe vanhu vanozvidzivirira uye mabhizimisi maduku kuti vanyora musangano rehutano hwehutano .
Mamwe Leniency for Medicaid Waivers
Mutungamiri weTrump akacherechedza zvakare kuti ivo vachave vakanyatsoteerera kupfuura Obama Administration yaiva maererano nekubvumira 1115 waivers nekuda kwehurumende dzinoda kuchinja kune mapurogiramu avo eMedicaid.
Pamusoro peimwe zvinyorwa 'chishuwo chemashoko ndechekudiwa kwebasa reMedicaid (iro raigara rakarambwa neBrazil Administration), uye nyika nhatu dzatove dzagamuchira chibvumirano chekudiwa kwebasa muna 2018: Arkansas, Kentucky, neIndiana, nedzimwe dzakawanda inotaura 'kusarudzwa kunotsanangurwa kunoitwa nehurumende yehurumende.
Saka kunyange zvazvo ACA pachayo inoramba yakanyatsogadzikana, inogona kunge ichiri kuchinja mafoot. Ngatitarisei kuti izvo zvingashandurwa zvingave zvakakonzera sei inshuwarano yehutano, zvichienderana neiko iwe iye zvino uri kuwana kugoverwa kwako. Tichatarisa pane zvikamu zvina zvakanyanya zvekugoverwa zvinosanganisira vazhinji vanobva kuAmerica chitubu chemishonga inshuwarisi:
- Zvirongwa zvebashandi-zvikwereti (49 muzana yeAmerica)
- Kupararira kwemusika mumwe nomumwe (7 muzana yeAmerica)
- Medicare (14 muzana yevaAmerica)
- Medicaid (19 muzana yevaAmerica)
Mushandi-Apihwa Health Health Insurance
Muchidimbu:
- Kana wako waunoshandira achipa kugoverwa ikozvino, vangangoramba vachidaro. Mubhizimisi vashandi, izvo zvinoda kuti vashandirwi vakawanda vape kupa mari, inoramba isingachinji.
- Zvikwereti zvako zvinogona kuramba zvichiri kutora mutero.
- Unogona kuona kuchinja kune zvirongwa zvehutano zvakanyanya-deductible (HDHPs) uye nhoroondo dzekuchengetedza hutano (HSAs).
- Kana iwe ukashanda kwebhizimisi shoma, wako waunoshandira angaguma achinjira kune rimwe sangano rehutano hwehutano.
Mashoko acho:
Vanenge hafu yevaAmerica vanowana inshuwarhu yehutano kumunhu anoshandira. Uye apo ACA yakanyatsoita shanduko pamusoro pekushandira-kubhadhara mari, zvirongwa zvebashandi-zvakagadzirirwa zvakanga zvatove zvanyanya kutongerwa, pasi peHIPAA, kupfuura zvirongwa zvemakethe.
IAACA inoda vashandi vakura (makumi mashanu kana kupfuura vashandi) kuti vape zvikwereti zvisingakwanisi, kubhadhara zvakakwana nguva yakazara (30 + maawa pavhiki) vashandi. Uye kunyange zvazvo chirango cheAACA chairo chemunhu chichanyangarika kubva muna 2019 (kureva, hapachazovi chirango chakakonzerwa kune vanhu vasina ruzivo), mutemo wevarangi vashandi anoramba aripo, uye vashandi vakuru vanofanira kuramba vachipa kugoverwa .
Kunyange kana mushandi wevashandi aifanira kubviswa nemutemo wemberi, vashandirwi vakawanda vangave vachienderera mberi kupa hupfumi. Vanenge vese vashandi vakuru vatove vagova nehutano huripo pamberi pe ACA. Kaiser Family Foundation data inoratidza kuti 96 muzana yevashandi vakakurumbira (50+ vashandi) vaipa zvipo zvehutano muna 2015. Izvo zvaingova zvishoma zvishoma pane 95.7 muzana yevashandirwi vakuru vaive vachipa zvipo zvehutano muna 2013, apo gwaro revanoshandira rakanga risina asi panzvimbo.
Vashandi vanoshandisa inshuwarhu yehutano-pamwe chete nezvose zvakabatsirana purogiramu-kukwezva nekuchengetedza vashandi vakanakisisa. Uye ivo vanoshandisa kushandisa mari yemutero wekutengesa mari yekubhadhara zvikwereti zvavanopa ( sezvinoita vashandi ). Kuvharidza kuchinja kukuru kwekodhi yemutero, zvichida kuti vashandi vacharamba vachipa kugoverwa kuenda mberi, zvichida munguva iri pedyo.
Zvinogoneka kuti mutemo weramangwana unogona kuguma nekuchinja kwekodhi yemitero iyo inoshandiswa kumagadziro anotsigirwa nevashandi. Imba Republicans yakabudisa chirongwa chehutano hwekugadzirisa hutano muna June 2016 iyo inoda kuti pave nehomwe yekuregererwa kwehutano huripo kubva pamitero yakabhadhara. Tsanangudzo inotsanangura nzira idzi dzingazosiyana neAACA's Cadillac Tax asi kubva kune vashandi vanoona, chigumisiro chaizove chakafanana zvakafanana: Vashandi vanozotanga kunyangarika zvirongwa zvakakosha, sezvo chikamu chemishandirapamu chinogona kuguma kuva chekubhadhara. Asi hapana chakafanana icho chakagadziriswa muna 2017, uye kuchinja kukuru kumagariro ezvehutano hazvibviri kutaridzirwa mugore rekusarudzwa, naizvozvo izvi zvinogona kunge zviri patafura yenguva yacho.
Kana iwe ukashandira mushandi muduku uye iwe waunoshandira akawana chirongwa cheboka duku kubvira muna 2014, chirongwa chako chinosanganisira kugoverwa kwemazano ehutano anokosha eAACA . Kana maAAA anokosha emararamiro ehutano aifanira kuchinjwa achienderera mberi, zvakananga zvekuvhara kwako zvinogona kuchinja. Asi mutemo unogona kuchinja mararamiro ehutano hunokosha hauna kupera muna 2017, naizvozvo hapana chakashanduka kwenguva. Uye kunyange dai yakashandura mune ramangwana, pakanga pane kuchinja kwakasiyana siyana-kwakadai seHIPAA uye Bumbiro Rokuzvidzivirira Kwemimba-izvo zvaive zvichishanda kumushandi-aine hutano hwehutano yemusika mushure meAACA, uye haazogadziriswi chero kuchinja kunoitwa kuAACA.
Kana Hurumende yeTrump inopedzisa mitemo yakasarudzirwa yehurongwa hwehutano hwemasangano , inogona kuzarura zvirongwa izvi kune mamwe mabhizimisi maduku. Izvozvo zvingaguma nezvikwereti zvishoma zvemishonga yveshuwarensi yehutano, pamwe nekuderedzwa kwehutano huripo, kumabhizimisi maduku anobatana nemagariro ehutano. Izvozvo zvingave zvichiita kuti zvikwereti zvemishonga yehutano yepamusoro yepamusoro zvigadzirise zvikwereti zviduku zvebhizimisi zvinoramba zvichatenga kutenga ACA-zvinotenderwa, nokuti zvingava hutano, mapoka mashoma anotamira kune masangano ezvehutano, achisiya munhu anorwara, dambudziko guru remvura yeAACA zvirongwa zvinogamuchirika.
Individual Market Market Insurance
Muchidimbu:
- Mutemo wega wega unenge uripo, uye iwe uchiri kungoda kuchengetedza kugoverwa kwe 2018. Kana iwe usina kunyora panguva yekunyorwa kwakasununguka, iwe unogona kunyora pasi mune zvimwe zviitiko kana ukawana chiitiko chinodiwa (gadzirira kupa uchapupu hwekufanirwa chiitiko).
- Kubatsiridzirwa kwepa Premium uye kudhura-kugovana kwezvikwereti zvichiri kuwanika kune avo vanogona kunyora.
- Coverage ichiripo yakagadziriswa nyaya.
- Health Savings Accounts (HSAs) uye zvirongwa zvehutano zvakanyanya-deductible (HDHPs) zvinowanzosimbiswa mumakore anotevera.
- Zvirongwa zvenguva pfupi zvinogona kuwanika nekugara kwenguva refu mumatunhu mazhinji.
- Nhengo dzezvirongwa zvehutano dzinogona kuwanika kuvanhu vanozvishandira.
Mashoko acho:
Kana iwe uchitenga yako yehutano inshuwarisi, kana muchitsinhanisi kana kusina -kushandiswa , iwe unotoziva kare kuti ACA yakaita shanduko huru kune mumwe munhu wehutano inshuwarheni yemusika.
Zvose zvekugadziridza izvo zvichiri panzvimbo, uye zvichida kuramba zviri panzvimbo yehupenyu huchakurumidza. Mutemo wega wega wekupiwa chirango wakabviswa muna 2019, asi uchiri munzvimbo ye 2018, uye uchaunganidzwa muna 2018 mutero wemitero, wakaiswa pakutanga kwegore ra2019.
Kubatsira kwe ACA's premium uye kugovana-kudhura kunoramba kuchiwanikwa kune vakakodzera kushandiswa kunyoresa, uye hapana pamusoro peizvi chinogona kuchinja munguva ichangopfuura. Congressional Democrats vakagadza mutemo unogona kupedzisa mari, zvichiita kuti zvive zvakasimba uye zvinowanikwa kuvanhu vakawanda, asi kuchinja kwakadaro kungangoitika chete kana Democrats ine hukuru muCongress mushure mekusarudza kwegore ra2018.
Mune mirayiridzo inorongwa ye 2019, HHS inotaura kuti inoronga "kukurudzira vanotora kuti vape HDHPs [zvirongwa zvehutano zvakakosha] zvinogona kuwirirana neHSA [nhepfenyuro yekuchengetedza kwehutano] sechisarudzo chisingabhadhari chekubhadhara." Sangano racho rakatiwo "vari kutsvaga nzira yekushandisa zvirongwa zvekuratidza zvirongwa paChristianCare.gov kukurudzira kuwanikwa kweHDHP kune avo vanoita basa." Saka vatengi vanogona kuona zvimwe zvirongwa zvehutano hweHSA-zvakakodzera zviripo mumusika mumwechete muna 2019 uye mberi. Asi zvirongwa zvisiri izvo-HSA-zvinozoenderera mberi zvicharamba dzichiita huwandu hwezvinhu zvinowanikwa pamakethe.
Kana mitemo yakasarudzirwa yezvirongwa zvenguva pfupi inogadziriswa, vanhu vari munyika dzakawanda vanogona kutanga kuona zvirongwa zvenguva pfupi zvekugadzirira nemazuva ekusvika mazuva makumi mana nemazana matanhatu. Kune vanyori vane hutano hwakanaka, zvirongwa izvi zvingangodaro zvive zvitsva zvinokwezva kune ACA-zvirongwa zvinogamuchirika, sezvo zvichange zvisina mari shoma. Uye kubva muna 2019, hapachazovi nemvumo yega yega chirango chinoongororwa kune vanhu vanotenga nguva shoma. Asi zvirongwa zvenguva pfupi zvinongopedzerwa muhuwandu hwehuwandu hwazvo (zvizhinji hazvifukidzi kubereka, hutano hwepfungwa, kana mishonga yemishonga), uye vanowanzova nehombodo dzisingabvumirwi mumamiriro ezvinhu akambovapo. Mukuwedzera, zvirongwa zvenguva pfupi zvinowanikwa gore negore uye zvoupenyu hunobatsira maximums zvinogona kunge zvakaderera, zvichienderana neurongwa.
Zvirongwa zvenguva pfupi zvicharatidza kuti zvinokanganisa vanhu vane hutano, semamiriro ezvinhu akambovapo asati avharwa. Zvichienderana nehuwandu hwevanhu hunotenga zvirongwa zvenguva pfupi, denga rekuchengetedzeka kwezvirongwa zveAACA-zvinogadzirisa zvinogona kuva nani hutano hwakanaka kune vanorwara, vashandi vakwegura, zvichiita kuti vawedzere mari mihoro. Kune vanhu vanowana rubatsiro rwekutanga, mari inowedzera ichakanganiswa nehomwe yepamusoro yekubatsira mari. Asi kune vanhu vasina kukodzera kubhadharwa mari yepayimusi, mari yemaimari inowedzera ichangoita kuti kupararira kuwedzere kusagadzikana.
Chinhu chimwe chete ichocho chichaitika zvichienderana nehurongwa hwehutano hwevanhu vanozvishanda. Kana mitemo ikagadziriswa inobvumira vanozvishanda kutenga sangano rehutano hwehutano panzvimbo yeAACA-inoenderana nehutano hukuru hwehutano, vanhu vanorarama vakagadzikana zvikuru vanogona kutendeukira kumapurani ehurumende yepasi, vachirega vanhu vakwegura, vanorwara paAACA -kugadzirira mapurogiramu, ane zvikwereti zvakakura zvakafanana.
Zvikwata zvekutanga mumakambani eCAA-zvinoenderana zvakare zvinogona kunge zvakakwirira semugumisiro wekuregwa kwechirango chemunhu mumwechete muna 2019. Congressional Budget Office (CBO) yakaratidza kuti vanhu vashoma mamiriyoni matatu vachave nekutengeserana kwemisika muna 2019 semugumisiro yekurairwa kwechirango, kukura mamiriyoni mashanu kusvika muna 2021. CBO inofanotaura kuti mari yepurayamisi ichave inenge 10 muzana yakakwirira gore roga roga kupfuura iyo ingadai yakave iyo iyo chirango chemhosva chakanga chiripo panzvimbo, sezvo vanhu vangangodonha kugoverwa pasina mutemo vanhu vane utano (vanhu vanorwara vacharamba vachivhara, pasinei nokuti pane chirango).
Zvakare, sekuwedzera kwekuwedzera kwaizoitwa nekugadziriswa zvirongwa zvenguva pfupi uye hurongwa hwehutano hwehutano, vanhu vanowana rubatsiro rwemari yepamusoro vacharamba vachichengetwa kubva kumitambo yepamusoro-soro (kuburikidza nehukuru hwekubhadhara mari), neavo vasina kukodzera kubatsirwe ichava pasi pekuwedzera kusingagoni kushandiswa pakusarudza.
Medicare
Muchidimbu:
- Hapana chiri kuchinja iye zvino. GOP kuchinja sarudzo haisi pasi pekufungisisa ikozvino, uye kana vakazogadziriswa, vanoshevedza kuchinja kwenguva refu, panzvimbo pekuchinja kwechimbichimbi.
- Imba Mutauriri Paul Ryan ave achikurudzira kuchinja kweMedare kuvanhu vari pasi pemakore makumi maviri nemashanu, uye mikana yekuita kuti zviitike zvakakwirira zvikuru pasi pekutonga kweTrump kupfuura zvaive pasi peMutungamiri Obama. Asi rongwa rwaRyan runotarisana neRepublicans kuchengetedza vazhinji vavo muCongress mushure mekusarudzwa kwe 2018.
- IAACA iri kuramba ichivhara chirango cheMedareti D, uye hapana chakachinja pamusoro pekufambira mberi ikoko.
Mashoko acho:
IAACA haina kuita zvakawanda kuMedare. Yakaida kuti Medicare inotanga kuvhara kushanya kwegore negore, uye yakaramba ichingopedza Medicare Part D donut hole , iyo ichazadzikiswa zvachose ne2020. Uye kunyange yakaderedzwa kubhadharwa kwezvirongwa zveMedare Advantage, kunyoresa mu Medicare Advantage kwakura gore negore sezvo ACA yakagadzwa.
Medicare kugadzirisa uye kushandiswa kwevashandi kwenguva yakareba kwave kwenguva refu iri hurukuro yekutaurira muzvirongwa zveGOP zvekugadzirisa hutano. Imba yeRepublicans yakabudisa rondedzero yekubhadhara Medicare muna 2016, asi haina kufambira mberi kusvika muna 2018, uye mutemo mukuru haugoneki ikozvino, uchienda muzhizha regore rekusarudzwa.
Asi iyo House Republicans '2016, iyo inogona kuve iri patafura mumakore anotevera kana Republicans dzichichengetedza hukuru hweChishanu apo Hurumende yeTrump iri panzvimbo, inoshandiswa kuchinja kweMedare kune dzimwe, kusanganisira kusimbisa Medicare Advantage , iye zvino iye oga purogiramu yeMedare enrollees.
Kutanga muna 2020, sangano rePublic Republican ' raizodanirwa kuti Medigap zvirongwa zvive zvakanyanyiswa. Parizvino, kune dzimwe zvirongwa zveMedigap zvinotakura zvose kana kuti zvinenge zvese zvinyorwa zvekubhadhara zvakaderera pasi peChinese Medicare. Imba inoratidzira iyo inogona kugadzirisa kuti yakawanda sei kunze kwehomwe yakaita kuti Medigap zvirongwa zvigone kuvhara, mukuedza kudzivirira overutilization (pfungwa yokuti kana vanhu vanyoresa vasina mari yekunze yega, vanowanzoita kuwandisa mabasa, zvichiguma nepamusoro zvakakwana mari). HR2, Medicare Access uye CHIP Reauthorization Act, kana MACRA, yakasayirwa kuva mutemo muna 2015, inodaidza kutengesa kweMedigap Plans F uye C kuti ipedze pakupera kwegore ra2019, sezvo zvirongwa izvi zvichitarisa Medicare Part B inodzingwa zvakakwana.
Chirongwa cha2016 chaizongobatanidza Medicare Part A uye Chikamu B , pamwe chete kubatanidza kubhadhara uye kubhadhara mari. Izvo zvichange zvishoma nezvishoma kuwedzera Medicare mukana wekugonesa kuti urambe uchifambidzana nekuwedzera kwe Social Social retirement retirement.
Imba yePublic Republican 'inoratidzirawo chirongwa cheMedare "premium support" chirongwa chinozoshandiswa zvishoma makore gumi pasi pomugwagwa, uye zvinenge zvichinyanya kuenderana nehurongwa huri kunyanya kunyanya kune Medicare Advantage-style yokuparidzira. Sezvo paizova nekunonoka kwemakore gumi, vanhu vane makore 55 kana kupfuura vangadai vaine Medicare sezvazviri nhasi. Asi vaduku veAmerica vangave nechisarudzo-kana vachisvika ku Medicare kukodzera-kuti vanyoranidze pane chirongwa chega, panzvimbo yeHedarere premium kutsigiro yekubhadhara yakaitwa nokuda kwavo kune inshuwarisi.
Mutero iwoyo waizofukidza zvose kana chikamu chepamusoro, chaizogadziriswa kumusoro kune vanhu vanorwara vanotarisana nezvikwereti zvepamusoro, uye vangave vaduku kune vakwegura vakwegura vanogona kubhadhara chikamu chikuru chepurayamisi yavo. Ikoko kwaizovawo rubatsiro rwezvemari kune vakwegura vane mari shoma avo vanoda rubatsiro rwekuvhara mari yavo kunze kwehomwe.
Medicaid
Muchidimbu:
- Kana hupfumi hwako hwawedzera Medicaid pasi pe ACA, iyo mitemo yakakodzera inenge ichiri kushanda, uye vazhinji vehurumende vanozvipira kuchengetedza ivo zvachose, kunyange zvichida nezvimwe zvinodiwa zvinodiwa.
- Kentucky, Arkansas, neIndiana dziri kuita basa rinodiwa kune vasiri vanhu vakaremara, uye dzimwe dzakawanda dziri kutarisira mvumo yehurumende yekuita zvinhu zvakafanana.
- Nyika dzisina kuwedzera Medicaid dzinogona kuita zvakadaro, pamwe chete nehurumende yemari inoshandiswa mune dzimwe nyika dzakatotambanudza Medicaid pasi pe ACA.
Mashoko acho:
Purogiramu imwe neimwe Medicaid program inobatanidzwa pamwe chete nehurumende uye mari yehurumende. Nyika nepamusoro pemari yemari inowana mari shomanana yehurumende inofanana neyemari, asi avo vane mamiriyoni emadhora emadhora vanotambira mari yakawanda yekufananidza mari. Mune hurumende yakawedzera Medicaid (31 states uye District of Columbia), hurumende yehurumende iri kubhadhara 94 kubva muzana yemari yekufukidza vanhu vachangobva kukodzera muna 2018. Izvozvo zvichaderera kusvika 90 muzana kusvika 2020, uye zvicharamba zviripo kuenda mberi.
Mamwe magwaro 19 anokwanisa kusarudza kuwedzera Medicaid. Mutemo waifungidzirwa muna 2017 kubvisa ACA ungadai wakavhara dzimwe nyika kubva pakuwedzera Medicaid, asi mutemo iwoyo hauna kumbogadzwa. Maine vheti vakabvumidza Medicaid kuwedzera munaNovember 2017, saka Maine yakarongedzwa kuwedzera Medicaid nezhizha ra2018.
Mutungamiri weTrump akajekesa kuti ivo vachave vakanyanyisa kupfuura Obama Administration yakanga iri maererano nekubvumira 1115 waivers kune zvese zvekuti vanoda kushandura kumapurogiramu avo eMedicaid. Muna 2018, Kentucky, Indiana, uye Arkansas zvatove zvagamuchira kugamuchirwa kwehurumende yekuita basa rinodiwa neMedicaid. Dzimwe humwe humwe humwe hurumende dziri kumirira chikumbiro chekuregererwa, uye vamwe vakawanda vari kufunga nezvekuregererwa kwezvirongwa. Saka munhu asiri akwegura anonzi Medicaid anonyora mune dzimwe nyika angangoerekana awana ivo vachifanira kupa uchapupu hwemabasa avo (kana kuzvipira, chikoro, kurovedza mabasa, etc.) maawa kuitira kuchengetedza Medicaid yavo.
Mamwe mashomanana anotaura, kusanganisira Arizona, Kansas, Maine, Utah, uye Wisconsin, vakatsanangurawo kukanganisa mararamiro eupenyu hweMedicaid kwemakore mashanu nekuda kwevasina kubhadhara vanyori, kunyange zvazvo nyika dzisina kugamuchira mvumo yeiyo kutanga kwegore ra2018.
Saka nepo huwandu huripo hweMedicaid huchigadziriswa husingashanduki, vanyori vanogona kunge vari kuwedzera kune huno hunodiwa mitemo yakakodzera, yakadai sekudiwa kwebasa kana mishandirapamwe shoma, uye mamwe maitiro anowanzotenderwa.
Shoko Rinobva
Kunyange zvazvo ACA yakange iri munzvimbo yemakore masere, yakagara iine mutemo wezvematongerwe enyika. Congressional Republicans vakakoniwa kuidzokorora muna 2017, asi mitemo yepamutemo uye yekutonga yekuendesa kunze kweAACA iri kuenderera mberi.
Kune chikamu chikuru, kuchengetedzwa kwevatengi nemitemo yehushuwarisi inoramba isingashandurwi muna 2018, uye mutemo mukuru haugoneki sezvatinopinda mukatikati megore rekusarudzwa. Asi kugadziriswa kwehutano hucharamba kuchiita hurukuro huru kumamiriro maviri enyika nehurumende mumakore mashomanana anotevera, uye 2020 mapurisa ehurumende angangodaro anowedzera huwandu hwehutano hwekugadzirisa zvirongwa.
> Sources:
> Dhipatimendi reMariki, Dhipatimendi reVashandi, Dhipatimendi reHutano neHuman Services. Nguva Yenguva Pfupi, Yakawandiswa Nguva Inoshuwarenzi (mitemo yakarongwa). February 2018.
> Federal Register. Murwere Anodzivirirwa uye Anogadziriswa Kuchengeta Mutemo, Proposed Notice of Benefit uye Payment Parameters ye 2019. November 2, 2017.
> Imba yeVamiririri, GOP Healthcare Proposal. Nzira Yakanakisisa, Chiratidzo Chedu chekutenda America . June 22, 2016.
> Kaiser Family Foundation. Utano Inishuwarenzi Inoshandiswa yeVanhu Vose. 2016.
> Kaiser Family Foundation. Nhoroondo yeMedicaid Per Capita Cap Proposals, June 22, 2016.
> Kasier Family Foundation. Percent of Private Sector Establishments That Offer Injection Health kune Vashandi, neFirm Size. 2012-2015.