Rutsva Rutsva Inopa Kubhadhara Zvikuru Kubva Mukurara Kwemishonga
Iko Inogadziriswa Care Act uye iyo inotevera mitemo yakagadziriswa pakuwedzera kuwanika kwekuvhara kwekubata pamuviri. Asi vakadzi iye zvino vari kushamisika kana inishuwarenzi yekuvhara kwechirwere ichi ichapera, uye kana vachifanira kuwana IUD mune ramangwana rekare, kana vakadzoka vachibhadhara mazana emadhora madhora.
Uye zvichibva pakuregererwa kwetsika uye mitemo yekusununguka kwechitendero yakabudiswa muSweden Register yeOctober 6, pane chokwadi chinokonzera kuve nehanya.
Asi kuchinja kwakangoerekana kwasangana nematambudziko emutemo uye nhamba yevashandi vanotarisirwa kuti vashandise zvikwereti hazvina kunaka.
Ngatitarisei mvumo yekubata pamuviri weAACA, iyo yakakonzerwa nayo, uye zvatinokwanisa kutarisira kuenda mberi.
Zviratidzo zvepabonde Pasi pe ACA
Chimwe chezvinhu zvinopesana zvakanyanya zveChinamatira Care Act (Obamacare) ndezvekuvhara kwekuvhara. Pasi peAACA, zvirongwa zvese zvehutano zvisingabatsiri zvinofanira kuvhara-pasina kugovana-mari imwechete yemhando 18 yemhando dzakasiyana-siyana dzekudzivirira kwevakadzikadzi dzeDAA (zvinoratidzika kuti zvirongwa zvekudzivirira zvirongwa zvinowanzoita chikamu chikuru chemashandiro -ponsored plans; maererano nemitemo yakanyatsorongwa, vanhu vanosvika mamiriyoni 36,5 vane ruzivo rwakabhadharwa nevashandi vari pane zvirongwa zvakawanda, izvo zvisingatenderwi kupa mishonga pasina kubhadhara mari).
Kunyange zvazvo akawanda emakambani eCACA asina kutora kusvika muna 2014, zvinoda kuti zvirongwa zvivhakidze kubata pamuviri zvave zviripo kubvira muna August 2012, zvezvikamu zvose zvitsva uye zvitsva.
Nokuda kwezvirongwa zvisiri izvo zvakarongedzwa zvakasimbiswa pashure pacho, pfungwa yekuvhara pamuviri yakawedzerwa pakutanga kugadziriswa. Saka munaAugust 2013, zvirongwa zvese zvisina kuzadzwa zvaisanganisira kubata pamuviri. Chimwe chikamu chakapiwa kune masangano echitendero, zvisinei, uye akawedzerwa muna 2014 (semugumisiro wekutonga kweDare Repamusorosoro muBurwell v. Hobby Lobby) kusanganisira "zvakanyatsobatwa" masangano ayo vadzidzisi vane zvinopesana nechitendero kumutemo wekudzivirira pamuviri.
Bhuku ra2015 rekuongorora nezvehutano rakaziva kuti chirongwa cheAACA chekudzivirira kubata pamuviri chakanga chiri kuchengetedza mushandi wepurogiramu wepabonde wepabonde $ 255 pagore, uye muvhareji weUUD user $ 248 pagore (pasina kodzero yekudzivirira pamuviri weAACA, IUDs inowanzobhadhara $ 500 kusvika ku $ 1 000. Pre-ACA, kuti ibhadzwe kumusoro-mberi, asi kuchengetwa kunoverengerwa gore negore, rakapararira pamusoro pemakore iyo mukadzi ane chigadzirwa).
Pasi peAACA, vakadzi vanochengetedzwa nevashambadziri vasina kubhadharwa havafaniri kubhadhara chero nguva panguva yavanowana kuberekwa kwavo, vachifunga kuti vanosarudza zvirongwa zvekuti vana vavo vezvehutano vanovhara zvakakwana (ACA inoda kuti zvirongwa zvehutano zvifukidze zvishoma chimwe chemarudzi ose; hazvidi kuti ivo vavhare mapeji ose emhando imwe neimwe).
Kunyange zvazvo izvi zvinowanzozonzi "kusununguka" kuzvarwa kwevana, vanotsoropodza vanocherechedza kuti hakuna chakanaka. Muzvokwadi, mari yekubata pamuviri yakaputirwa muzvikwereti zvekuti vakadzi nevanoshandira vavo vanobhadhara kugoverwa. Nokuda kwekujekesa, kukurukurirana pamusoro pekudzivirira kusununguka kwekusununguka munyaya ino kunoreva kuberekwa kwekuberekwa kwakapiwa pasina kugovana mari paunenge uchiwana.
Kuwedzererwa Kwokuwana Kuberekwa Kunopedza Kubvisa Mimba & Teen Birthrate
MunaNovember 2016, CDC yakabudisa mashoko ekuratidza kuti gore ra2013, kubvisa pamuviri mahara kwaive panguva yakazara muSouth America
Kubvisa pamuviri vashori vanocherechedza kuti izvi zvingavewo zvichibva pamutemo wemitemo wakaparidzwa munyika dzakasiyana-siyana kukonzera kubvumirwa kubvisa pamuviri mumakore achangopfuura. Asi humwe uchapupu hunobva kuColorado-iyo haisi pakati pematongerwo enyika akaisa mitemo inogadzirisa kubvumirwa kubvisa pamuviri-inoratidza kuti kuwana rubatsiro rwekudzivirira kubata pamuviri zvechokwadi kuri kutamba basa rinokosha: Colorado Colorado Planning Initiative yakatanga kupa zvipembenene zvekuita zvekare kwenguva refu (IUDs uye implants) ku vaduku uye vakadzi vane mari shoma muna 2009, vasati vasvika pamutemo weAACA. Pakazosvika gore ra2014, mwana wechidiki akaberekwa uye kubvisa pamuviri mahara akanga adarika ne48 muzana.
IUDs uye Zvisikwa Kuwana Kubudiswa Pasi Payo ACA Mitemo
ICDC inotaura zvakare kuti kushandiswa kwemishonga yakareba kwenguva refu yekuita zvekuita (LARC) kunosvika nguva yakareba pakati pevakadzi veAmerica.
Izvi zvinokonzerwa nekubatanidzwa kwedzidzo yepamusoro pamusoro peRAR uye kuti ACA yakabvisa zvigadziriro zvisingakwanisi izvo dzimwe nguva zvakadzivirira vakadzi kuti vawane LARC vasati vashandise zvinodiwa neAACA.
Miitiro yeMutemo yekudzorera ACA Yakundikana
Mutungamiri weTurump uye GOP-yakarongedzwa Congress yakatanga 2017 ine tarisiro yakakwirira yekubvisa ACA, asi izvozvo hazvina kuitika muna 2017. VaRwanda Republican vakapfuura neAmerica Health Care Act (AHCA) muna May 2017, asi Senate haina kupfuura chero shanduro dzaro dzemutemo, uye gore raSeptember 30 kuguma kwegore rekutora raiva nguva yekupedzisira yekushandisa kuyananiswa kuitira kukwanisa kubvisa ACA nemavhoti makumi mashanu chete (pamwe nevhoti-breaker vote kubva kumutevedzeri wemutungamiriri wenyika).
Imba iyo yeAHCA uye zvikwereti zvakasiyana-siyana zvakaiswa muSénate zvingadai zvisina kubvisa kodzero yekudzivirira yeAACA, asi vazhinji vavo vangadai vakabvumira nyika kuti dzitsvake hurumende kuitira kuti dzidzorezve mararamiro anokosha ehutano. Kuchengetedza kwekuchengetedza, kunosanganisira kubata pamuviri, ndeimwe yekubatsira kwehutano hweAACA . Kana mitemo yaifanira kugadziriswa iyo yakabvumira nyika kuti iwane mari yekudzikinura iyo inoshandurazve hutano hunokosha huripo, kubata pamuviri kunogona kunge kusingadi kudiwa.
Zvikwereti zvakasiyana-siyana zveAACA zvakadzingwa nevatongi veRepublican mu 2017 zvingadai zvakapedza federal mari yePlanned Parenthood kwegore rimwe, kuderedza kusvika pakudzivirira kubata pamuviri pakati pevakadzi vanovimba nePlned Parenthood kuti vatarisire.
Asi hapana chimwe chezvikwereti izvi chakapfuura, uye Gumiguru zvakaratidza kuguma kwemukana wakakurumidza wokuita mutemo wekubvisa ACA. VaRepublican lawmakers vakapika kuti vacharamba vachiedza kurambidza mutemo, asi Mutungamiri weTrump aive achishanda kuchinja kuburikidza nevakuru vakuru nemitemo mitsva.
Chii chiri mumitemo mitsva?
Musi waMay 4, 2017-zuva rimwechete House House Republicans vakapfuura mutungamiri weAHCA-Mutungamiri Trump Akabudiswa mutungamiri wehurumende unotungamirira Vanyori veMari, Labor, uye HHS, " kufunga nezvekupa mitemo yakagadziriswa, yakaenderana nemutemo unoshanda, kugadzirisa hana- zvakagadziriswa zvinopesana nehutano hwekuchengetedza. " Izvi zvakagadzirisa danho remitemo mitsva, iyo, maererano neThe New York Times, Mutungamiri weTrump yaifungisisa munaMay.
Musi waMay 31, Vox yakawana gwaro rakakonzerwa neHHS nemitemo yeRS, izvo zvingaderedza zvakanyanya simba razvino rekudzivirira kubata pamuviri. Hapana chakaitika kwemwedzi mishomanana inotevera, uye kukoshesa mukati mezhizha kazhinji kwaive pamutemo yekuedza kubvisa ACA.
Asi musi waOctober 6, mitemo miviri mitsva yakabudiswa muBritain Register iyo inobvumira vashandi kubatana zvakakwana kusunungurwa kubva kumutemo wekudzivirira pamuviri: kuregererwa kwemitemo uye kusununguka kwechitendero .
Mitemo yacho inotanga kushanda pakarepo, pasina chiitiko chinowanzoitwa uye nguva yekupindura. Mhinduro dziri kugamuchirwa kwemazuva makumi matanhatu (kuburikidza neDecember 5), asi mitemo yakatanga musi waOctober 6. HHS inowanzogamuchirwa mazwi ehurumende pamitemo inorongwa, inofungisisa, uye inotsanangura kuti vanhu vanotaura sei vakaumba mutemo wokupedzisira.
Asi munyaya iyi, vari kutaura kuti vane " chikonzero chakanaka " kuti vateerere mitemo pakarepo uye kuti "ichange isingakanganisi uye inopesana nehuwandu hwevanhu kunonoka kuisa izvi zvigadziriswa munzvimbo kusvikira vanhu vese vakaona-uye-maitiro rakapedziswa. "Mukuzvidzivirira kudarika chiziviso uye nguva nguva, HHS yakataurawo kuti haifaniri kupfuurira kuburikidza nehutano hwezvekuita zvakare, sezvo vakatowana mazano pamusoro pemubvumirano wemvumo yekuberekwa apo mitemo yakabudiswa mumakore akapfuura. Zvakakosha kuziva, zvisinei, kuti mitemo iyi mitsva yakareba zvikuru kupfuura iyo yekurairirwa kwemvumo yeHIV yakasimbiswa kare, uye izvi zvingave zvakasiyana zvakasiyana zvakare.
Pasi pemitemo mitsva, chero vashandi, yunivhesiti, kana vehutano wehutano vanogona kukumbira kusunungurwa kubva pamutemo wekubata pamuviri, pamwe nechitendero chero chipi zvacho kana kuti chetsika chikonzero sechikonzero chekuregererwa. Kuregererwa hakufaniri kubvumirwa nehurumende-vashandi vasingatsvaki kubata pamuviri muboka ravo rezvirongwa zvehutano vanongoda kuzivisa vashandi vavo nezvekushanduka kwezvibereko.
Mitemo mitsva inotsanangura kuti " Kuwedzera kusunungurwa kunobvisa zvipingamupinyi zvechitendero / tsika izvo masangano uye vamwe vanhu vangasangana nevanoda kuda kutora chikamu mumutengo wehutano hwehutano. " Asi vanotsigira kuti nyika yose iripo inozivikanwa nezvekuvhara kwepabonde kuti zvinokonzerwa nomutemo zvichave kuti vashomanana vakadzi vane maitiro chaiwo ekuwana zvirongwa zvekudzivirira vana, kunyanya kushandiswa kwekuita zvekudzivirira kwemishonga (IUDs uye implants) iyo inowanzova yakakwirira-yakatarwa mari kana isina kuvharwa nehutano inshuwarisi.
Apo maitiro emitemo akaiswa muna May, ACLU yakavimbisa " kuona Trump inotonga mudare kana vachiedza kutevera kuburikidza nezvirongwa izvi. " Zvechokwadi, ACLU yakaisa suti pakarepo paOctober 6, sezvakaita Massachusetts Attorney General Maura Healey.
Kuti ive yakajeka, Obama Administration yatotora matanho ekusimbisa kuti vashandi vezvitendero vaisakwanisa kubhadhara zvakananga nekuda kwekudzivirira kubata pamuviri, asi basa rinogadziridza richiri kuvimbisa kuti vakadzi vakafukidzwa nezvirongwa zvehutano hwevashandi vanoenderera mberi kuva nekuwana mari isingabhadharwi (iyo haisi nguva dzose yakasungirirwa, asi, uye vamwe vakadzi vane vashandi vezvitendero havangakwanisi kuwana mari yekudzivirira mari kuburikidza neurongwa hwehutano hwavo hunobhadharwa). Asi iyi ndiyo mhinduro iyo vamwe vashandi vezvitendero vanotenda vachiri kukanganisa rusununguko rwechitendero.
Chii Chinoitika Pashure?
Iyi mitemo mitsva inotarisana nematambudziko emutemo, uye inokurumidza kutaura kana ivo vachamira mudare. Muchitaudzo pamusoro pemitemo, HHS inotaura kuti mitemo mitsva "haichazokanganisa pamusoro pe99.9 muzana yevakadzi vane mamiriyoni 165 muUnited States" nokuti vanotarisira chete masangano makumi maviri-aya akatotanga kutonga mhosva pamusoro pemvumo yekubata zvechitendero kana zvido zvemitemo-ichakumbira kusunungurwa pasi pemitemo mitsva.
Asi vatsigiri vevatengi vanoshushikana kuti mitemo inogona kuguma iri kuva yakareba zvikuru, uye kuti mitemo mitsva inove yakakosha mumutemo wekudzivirira.
Dzimwe nyika dzakashandisa mitemo yavo yekubata pamuviri, asi iyo inongoshanda kune zvirongwa zvehurumende. Zvirongwa zvekuzvipira (izvo ndizvo zvinoshandiswa nevashandirwi vakawanda kwazvo) zvinotungamirirwa pasi pehurumende, panzvimbo yekutaura, mutemo. Dare reAACA rekudzivirira kubata pamuviri rinoshandiswa pasi rose, asi mitemo yehurumende haishandisi kune zvirongwa zvehupfumi.
Wekare Rep.T. Tom Price (uyo akabva ari Representative Representative kubva kuGeorgia, uyo akazova Munyori weHHS kwenguva pfupi pasi peHurumende yeTrump asati asara munaSeptember 2017) akati muna 2012 kuti "hapana mumwe chete" mukadzi akanga asingakwanisi kuwana mishonga yekurapa Simba reAACA. Asi kuongororwa kwe2010 kwakaitwa na Plan Plan Parenthood kwakawanika kuti 34 muzana yevakadzi vakanga "vachinetseka nemari yekurapa kuberekwa kwepamusoro pane imwe nguva muupenyu hwavo."
Muna 2012, mudzidzi wesangano reGeorgetown University, Sandra Fluke, akapupura pamberi pebato rezvematongerwo enyika pamusoro pekuvhara pamuviri pasi peAACA. Akapupura kuti 40 muzana yevakadzi vechikoro cheGeorgetown yepamutemo yevadzidzi vakapupurira kuti chirongwa chehutano hweyunivhesiti kusava nekugoverana kwekudzivirira kubata pamuviri kwakange kwaita kuti vashande mari.
Kudzoka kumabhadharo kugoverana kana kushayikwa kwehutano inshuwalhu yekuvhara kwekudzivirira kubata pamuviri hakugone kuisa dambudziko rakawanda kuvadzimai vane mari inowanikwa mukati mechikamu chepakati. Asi zvinogona kuunza dambudziko guru kune vakadzi vanotora mari shoma. Uye kuwanika kweIUDs zvakanyanya uye zvinobudirira zvinogona kuve zvakakanganiswa kana zvikwereti zvadzo zvepamusoro zvinorega kugadzirirwa zvizere nehutano inshuwarhu.
> Sources:
> Dzimba rekudzivirira zvirwere uye kudzivirira, Kubvisa pamuviri-United States, 2013. Nhasi 25, 2016.
> Chirongwa Chetachiona Kudzora nekudzivirira, National Centre for Health Statistics. Mitambo yeKubata Kwekuita Kubata Kushandiswa Kwemazuva Akareba Shandisa pakati peAmerica Vakadzi Vakwegura 15-44. February 2015 .
> Colorado Department of Public Health & Environmental, Chirwere cheMatorike cheColorado Chinoramba Chichienderera mberi. Gumiguru 21, 2016.
> Dhipatimendi Rezvoutano uye Human Services, Health Resources uye Services Administration, Kuvandudza Women's Preventive Services 'Mirayiridzo, 2011.
> Federal Register. Dhipatimendi reMariki; Dhipatimendi reHutano neHuman Services. Maitiro Ezvetsika uye Nzvimbo dzeNzvimbo dzeKubatanidzwa kweZvamwe Zvokuchengetedza Mabasa Pasi Pezvakagadzirirwa Kutarisira Mutemo . > October 6, 2017.
> Federal Register. Dhipatimendi reMariki; Dhipatimendi reHutano neHuman Services. Kusunungurwa Kwechitendero uye Nzvimbo dzeNzvimbo dzeKubatanidzwa Kwezvimwe Zvidziviriro Zvevhisi Pasi Pezvakagadzirirwa Kutarisira Mutemo . > October 6, 2017.
> HealthAffairs. Vakadzi vakaona Kuderedza Kukuru Mukure-kwe-Pocket Kutenga Kwemishonga Yokudzivirira Pashure peAACA Mandate Kucheneswa Kugovana Kugovana. Vol 34, Kwete 7, July 2015.