Kuedza kweGOP Kunowedzera Mipiro Yezvipo uye Wedzera Kuwana Mari
Haisi chakavanzika chokuti vatongi veRepublican vanoda kuwedzera kuwanika kuhutano hwekuchengetedza mararamiro (HSAs) , kuwedzera kushandiswa kwavo, kuvhara zviyero izvo vanhu vanogona kugovera kuHSA, uye vanobvumira kushanduka kwakanyanya maererano nekushandiswa kwevanhu mari yavanowana mu nhoroondo. Hazvina kujeka panguva ino kana kana vazoita izvi, asi iyo inzvimbo yavave vachitsvaka kwemakore.
Iko GOP yehutano hwehutano hwezvehutano hwehutano yakashandura muCongress muna 2017. Kunyange zvazvo zvikamu zvakawanda zvemitemo kubvisa uye kutora Mutengo Wakatarisira Mutengo wakagadzwa-pakuguma paJuly 28, 2017, muSénate kurambwa kwemari yose yavari kufunga-inenge yose kubva kwavari vakatora nzira yakafanana yekuchinja HSAs.
Nekuparara-kwenguva iyo iri-yekuedza kwekugadzirisa kubvisa uye kusimbisa ACA, GOP zvigadziro zveHSA shanduko dzinogona kuiswa pamusana wemoto kwenguva yakati. Asi zvinogoneka kuti kuchinja kweHSA kunogona kuve chikamu chekupedzisira bipartisan kupindirana kwehutano hwehutano hwezvehutano, uye zvinogonawo kuti kuchinja kweHSA kunogona kugadziriswa semutemo wega-oga pane imwe nguva, pasina hurumende dzinochinja iyo mapato ezvematongerwo enyika angada ita kuAmerican healthcare system.
HSAs Inotora Kuchinja Kukuru NeAACA
Nhoroondo dzekuchengetedza utano dzakasikwa neMurepa wePiritori Drug Drug, Improvement and Modernization Act ya2003, uye yakavapo kune vashandi kubva muna 2004.
IAACA yakaita shanduko shoma kune HSAs:
- HSAs ine chirango kana iwe ukabvisa mari yekusashandisa kurapwa usati wava nemakore 65. Chirango ichocho chakanga chiri chegumi, asi ACA yakawedzera kusvika 20 kubva muzana (izvi zviri kuwedzera kumitero inotarirwa kana mari iri yakashandiswa nokuda kwechikonzero chekusava nechiremba). Chirango chacho chinotarisirwa kuve nechokwadi chokuti mari muHSAs inoshandiswa sezvinodiwa: nokuda kwezvokurapa (mushure mezera remakore makumi matanhatu nemashanu, HSA inogona kushanda seyendarama yega yega yekubvisa mari, uye nemitero-asi hapana chirango chinotarirwa kana mari yacho yakabviswa kuvhara kwete mari yemari).
- Yese mishonga-kunze kwe insulini-inofanirwa kuva nechirongwa chechiremba kuitira kuti itenge neHSA mari (kureva, kushandisa mari isina mutero muHSA yako kuti uvatenge). Munguva yakapfuura, mishonga yepamusoro-in-counter inogona kutengwa neHSA mari, asi ACA yakachinja iyo.
Reforman HSA Reform Yaizowedzera Kuwana uye Zvipo Zvokupa
Zvizhinji zvezvikwereti izvo Congressional Republicans zvakataurira kubvisa uye kuchinja ACA zvinosanganisira zvigadziro zvinogona kuchinja mamwe emitemo inoshandiswa kune HSAs. Uyu ndiye mutariri mukuru weGOP rehutano hwehutano hwezvehutano, zvakanyanya zvokuti kuchinja kweHSA kwakatonyanya kuiswa mune peji 8 "pepa" rakadzingwa musangano (Health Care Freedom Act) iyo Senate Republicans yakatanga pakupera kwaJuly 2017 (iyo chiyero hachina kupfuura , sezvo vatatu veRepublican vaipikisa).
Kunyange zvazvo kugadzirisa zvirongwa zvakasiyana-siyana, kune zvikamu zvina zvepamusoro zveHSA shanduko vatongi veGOP vangada kuita:
- Kudzorera chirango cheAACA kuwedzera, uye kudzokera kune chikamu chechikamu chezana chezvikamu makumi matanhatu nemashanu zvekutora zvisiri zvemari.
- Dzorera iyo ACA's provision inodzivisa mishonga-in-counter kubva pakutengwa neHSA mari.
- Wedzerai mibairo yeHSA mitezo, uye bvumira vakaroorana vane makore makumi mashanu nevekare kuti vaite zvipo zvekushambadzira kune imwecheteyo HSA, panzvimbo yekuti vave neHSA dzakasiyana, sezvazviri iye zvino.
- Bvumira HSA mari kuti ishandiswe kubhadhara mari yemishonga yemishuwarenzi yehutano. Pari zvino, unogona kubhadhara mari yemari neHSA mari kana iri yeCOBRA , inshurensi yemazuva mazhinji , Medicare Part B (uye Chikamu A kana iwe usingachipi pachena), uye zvikwereti zvemishonga yehutano yehutano inowanikwa pauri kugamuchira kubhadhara basa. GOP rekugadzirisa zvirongwa zvinogona kubvumira vanhu vakawanda ruzhinji rwekushandisa mari yeHSA kubhadhara mari yemishonga yehupfumi yehutano.
Zvose izvi zvinongorondedzera, asi ngatitarisei zvakanyanya pamiganhu yemipiro. Mari iyo munhu akaisa muHSA haina mutero (kana inodzingwa musati mitero inotarirwa kana mupiro uri mubhadharo wakabviswa, kana uchibviswa pamutero wemuteresi).
Sezvakangoitika kune dzimwe nhoroondo dzetero-dzakanaka, pane muganhu wekuti iwe unogona sei kuwedzera kune HSA. Muna 2017 , kune $ 3 400 kana iwe uri wega-kuparidzirwa pasi peHSA-yakakosha chirongwa chehutano chakakosha (HDHP), uye $ 6 750 kana iwe uine hutano hwemhuri pasi peHSA-inokodzera HDHP (chinyorwa kuti iwe unogona kupa mari kune HSA kana iwe ikozvino unoparidzirwa pasi peHSA-inodiwa HDHP).
I IRS inogadzirisawo kunze kwe-pocket mari yehutano hwehutano hunoonekwa seHSA-inokodzera HDHPs. Zvizhinji zvezvirongwa zveGOP zvekuchinja hutungamiri hweHSA dzinoshevedzera kuti kuwedzere muganhu weHSA wokukwanisa kuenzana nehuwandu huri kunze kwehomwe pasi peHSA-inofanirwa HDHP (kureva, kuitira kuti mari yaunogona kuisa muhomwe yakabhadharwa nekutengesa kuvhara mishonga mari yaizove yakangofanana nemari yakawanda yaunofanira kubhadhara mumari yekunze-ye-pocket pasi pehutano hwehutano inshuwarano).
Nokuda kwekutsanangura, huwandu hwekunze kwepasi pasi peHSA-inokodzera HDHP muna 2017 ibhadhara $ 6,550 kune mumwe chete uye $ 13,100 yemhuri (nhamba yekuti izvi zvakaderera pane zvisizvo zvekunze kwemahombe zvinoshandiswa pane mamwe marudzi ekuparidzirwa ). Saka kana kudai kuchinjwa kwacho kuchizoshandiswa, vanhu vaizokwanisa kupa zvikamu zvinowedzera kaviri kuHSA dzavo vachienzanisa nemitemo yezvino, iyo inopa mutero wakanaka kune vanhu vanogona kukwanisa kuisa mari yakawanda munyaya. Inobatsirawo kuvimbisa kuti vanhu vari nani vakagadzirira kutarisana nemari inokonzerwa nehosha yakaremara kana kukuvadzwa kana vane mari muHSA. Asi, hongu, izvi zvose zvinotenderera kune munhu ane mari yakakwana yekugovera panzvimbo yekutanga.
Ichi chirevo hachisi pasina vatsoropodzi. Mipiro yepamusoro yeHSAs haibatsiri mhuri dzinotora mari shoma, sezvo ivo kazhinji havakwanisi kugovera kunyange ikozvino yakagamuchirwa mari. Uye kune mhuri dzine mari yakawanda, mibairo yepamusoro yemipiro inonyanya kuita kuti HSAs iwedzere nzvimbo yekuchengetera mutero, zvichibvumira vanhu kuti vaise pachena kunyange mari yakawanda yekare isati yatere inogona kukura isina mutero uye pakupedzisira inoshandiswa seyongowedzera kubhadhara mari.
Kunyangwe zvazvo zvose zveGOP zvigadziriswo zveHSA zvave zvichinyanya kugadzirisa miganhu yeH HDHP kunze kwe-pocket maximums, zvinoshamisa kuti Senator Rand Paul (R, KY) akaisa mutemo kumangwanani kwa2017 iyo ingadai yakabvisa mupi weHSA chikwata zvachose , zvichibvumira vanhu kugovera zvikwereti zvisingagumi kune HSA. Ichi chirevo chakanga chisina kuenda chero kupi, asi chaizonyatsove chave chivako chemutero kune vapfumi.
Will HSA Reform Stall NeAACA Kuedza Kuedza?
HSA kuchinja kwave kuri hurumende yehutano hwehutano hwehutano hwehutano hwemakore kwemakore, uye zvakajeka kuti vatungamiriri veRubublican vanoda kuwona vanhu vakawanda vachishandisa HSA, miganhu yakakwirira yezvipo, uye kuchinjeka zvakanyanya maererano nemari iyo inoshandiswa sei.
Vatongi veGOP vakaita sangano rakaoma rekubviswa kwe ACA muhafu yekutanga ye 2017, asi kuedza kwakasimbiswa kumavira kwaJuly. Hazvinyatsozivikanwe kana kuchave nekuvandudzwa kwebipartisan kusvika kuhutano hwehutano hwezvehutano, kana kukanganisa mukuedza uku apo vateereri vemitemo vachitaura zvimwe nyaya.
Asi kuchinja kweHSA chimwe chinhu chingawana rubatsiro rwebipartisan muCongress, uye zvakare chimwe chinhu chingaita kuti zviite pachako, pasina huwandu hwakazara hwehutano hwehutano hweUnited States.
VaDemokorasi vangangoda kuchengetedza chirango chepamusoro cheAACA pasi pemakore 65 kubva kuHSAs nekuda kwekusashandisa mari, sezvo chinangwa cheHSA ndechekuvimbisa kuti mari inowanika kana uye kana zvipatara zvinowanikwa.
VaDemokorasi (uye vazhinji veRubhairian) zviri pachena kuti havazoenda kune imwe sarudzo zvakanyanyisa sezvo Senator Paul asina ruzivo rwekupa mupiro pfungwa, asi kuwedzera kunononoka mumiganhu yemipiro chimwe chinhu chinogona kuwana bipartisan kutsigirwa. Zvinenge zvakadhura kuhurumende yehurumende, zvisinei, nekuda kwekurasikirwa kwemari yemutero-sekunge kune chero kukonzerwa kwemitero, ndicho chipingamupinyi chingafanira kutariswa.
Kubvumira vanhu kubhadhara mari yemishonga yehushandi yehutano neHSA mari inofanirwawo kugadzira bipartisan kutsigirwa, mukuedza kuita kuti zvive nyore kuti vanhu vabhadhara mari yepuraimari (zvakakodzera kukohwa, zvisinei, kuti kuwandisa kweHSA kuenzanisa hakusi pasi ; vanofanira kupa zvakawanda kune HSA kuitira kuti vaite kuti zviwanike mari yekubhadhara mari yepurayamisi).
Shoko Rinobva
Pasinei nokuti HSAs inoshandurwa sei, haisi mararamiro ematambudziko anotarisana nehutano hwehutano hweUnited States. Havabatsiri vanhu vane mari shoma kuti vawane inshuwarisi kana kuti vanogona kutarisirwa, uye kunyange zvirongwa zvehutano zvakanyanya zvakaderedza zvinoderedza kushandiswa kwehutano hwehutano (nokudaro zvichideredza mari), kushandiswa kuduku ndiko kwezvinhu zvose zvinodiwa uye zvisingakoshi mabasa. Kuderedza kushandiswa kwemashoko anodiwa (semuenzaniso, munhu anoparadzanisa mapiritsi kuti aite kuti apedze kwenguva yakareba kuitira kuchengetedza mari, asi nenzira iyo isingateereri kurapwa kwakatemwa) kazhinji haisi yakanaka kumigumisiro yehutano kwenguva refu.
Saka kunyange zvazvo bipartisan nzira yehutano hwehutano hwezvehutano inogona kunge inosanganisira kuchinja kusina kumira kune mitemo yeHSA, nzira yakakwana yeHSA-centric yekuvandudzwa kwehutano hwehutano haigone kuisa rubatsiro kubva kuDemocrats muCongress, kana kubva kuvatsigiri vezvirwere.
> Sources:
> Bhizimisi Rinobatsira Pakutsvakurudza Institute. Health Account Account Kubhadhara, Mipiro, Kugoverwa, uye Zvimwe Zvikosha Zvinokosha, 2015: Inofanirwa kubva kuEBRI HSA Database . Nov. 29, > 2016 > • Nha. 42.
> Internal Revenue Service, Kuparidzirwa 969: Nhoroondo dzeEalth Savings uye Mimwe Mitero-Inobatsira Health Plans. 2016
> Internal Revenue Service, Nzira dzeMutero 2016-28 .
> Paul, Rand MD, S.222, Obamacare Replacement Act, Chikamu neChikamu Chikamu.
> Senate.gov. Amendment 667 ku HR1628. The Health Care Freedom Act ye 2017 . July 27, 2017.