Kuchinja kwehutano kwehutano kwakange kuri munhau dzinenge dzisingasviki muna 2017, saka kana iwe uchivhiringidzika pamusoro pezvakaitika uye zvichazoitika muna 2018, iwe hausi wega. Ngatitarisei kuti chii chinoshanduka, chii chiri kuramba chiri chimwe chete, uye chii chaunogona kutarisira maererano nehutano hwehutano uhu muna 2018.
Zvichiitwa Shanduko Zvisina Kuitwa
Pasinei nezvinyorwa zvepamusoro zvehutano nezvekushandura kwehutano muna 2017, dzakawanda zvekushandurwa kwakarongwa zvakasvava pamuzambiringa.
Sangano reAmerican Health Care Act (AHCA) rakapiwa neHarare Republic Republic munaMayai mukuedza kubvisa Mutengo Wakaitirwa Mutemo, asi Sangano reSenate, Better Care Reconciliation Act (BCRA), rakakundika munaJuly. Ichokwadi, Senate Republican akaedza kudarika shanduro nhatu dzakasiyana dzebhiri-"kubvisa" kubviswa, Obamacare Repeal Reconciliation Act, uye BCRA-uye hapana akawana kutsigirwa zvakakwana kudarika.
Muna Svondo, Graham-Cassidy-Heller-Johnson kugadziriswa kwakaiswa sangano reSenate rakarondedzerwa yeAACA kudarika mutemo, asi kubudirira kwacho kwakaratidzika kusina chokwadi shure kweSenatori John McCain (R, Arizona) akazivisa kupikisa kwake.
Senetaire Rand Paul (R, Kentucky) akanga atozivisa kushorwa, uye Senators Lisa Murkowski (R, Alaska) naSusan Collins (R, Maine) vakanga vatarisira kutsoropodza. Svondo 30 ndiyo nguva yakatarwa yeSeneti kushandisa sarudzo yekuyananisa mari iyo inogona kuvabvumira kubvisa ACA nemavhoti makumi mashanu (pamwe chete nevheti-breaker vote yakakonzerwa naVhini vemaMutungamiriri wehurumende) uye kudzivisa mafirimu.
Uye kana vatatu kana kupfuura Republican Senators vanopikisa chiyero, hachizopfuuri.
Nokudaro kunyange zvazvo paine nhengo dzakawanda dzemutemo dzakatangwa muna 2017-uye Imba yakapfuura neAmerican Health Care Act-hapana kana imwe yadzo yakagadzwa.
Izvozvo zvinoreva kuti ACA ichiri kunyatsogadzirisa, kusanganisira kubhadhara mari yepamusoro, kugovana-kudhura kugoverwa (aka, kugoverana mari dzinodhura), kuwedzera Medicaid , hurumende yega , basa revanoshandira , kuchengetedzwa kwevanhu vane mamiriro akambovapo , zvinokosha utano hunobatsira , mitemo yekurasikirwa mitemo, nezvimwewo.
Kugovana-kubhadhara mari dzinobatsira kuenderera mberi kuwanika muna 2018, pasinei nokuti hurumende yehurumende inopa mari yevatsigiri vekuchengetedza kuti vagovafukidza (iyo mari yakabhadhara yakange ichikonzera kusava nechokwadi kukuru muna 2017). Vatsigiri vehurumende dzakawanda vari kusanganisira mari yekupa mari yekugoverana mari muzvikwereti zvavanenge vachiripira muna 2018, uye iyo mihoro mikuru ichakanganiswa kune vakawanda vanyoresa nezvikwereti zvakakura. Kuparadzanisa kubhadhara mari yekubhadhara mari yakawanda (kana kuti rubatsiro rwepamberi) kunogona kuitwa kuburikidza nemitemo.
Kuchinja Pamusana Pematengesi Kugadzirisa Kutonga
MunaMuvhuro 2017, HHS yakagumisa kutengesa kwemisika pamakambani avo vainge vataura munaFebruary. Kunyange zvazvo mutemo wakanga uine chinangwa chokugadzirisa hutano hwehutano hutengesheni, hauna kutarisa zvinhu zviviri izvo zvave zvichive zvakanyanya kukanganisa kumusika mumwechete: kusakwanisa kushanda kwakasimba kwesimba rega rega (chaicho kana chakanzwisisika, sezvo vachiri vashomanana vanhu vane hutano vanozvinyora muchikwata uye dziva risina ngozi iro rinowedzera hutano hutano huzhinji), uye huripo huripo huripo hwekugadzirisa kudhura mari.
Kwete nyaya idzi dzisingatauri mumitemo yekusimudzira marusi, dzakaramba dzichikonzera kukosha kwekutengeserana mumwedzi inotevera, uye yakaita basa rinokosha mune vamwe vashandi vezvekutsigira vachibva mumusika pakupera kwe 2017 kana kuti vakapa zvikwereti zvakakwirira zvikuru kwe 2018 kupfuura zvavangadai vakapa mhosva.
Asi hutongi hutsika hutongi hwakataurira dzimwe nyaya dzakawanda, zvisinei zvishoma kudzvinyirira kunze kwehutongi hwemunhu uye kugovana-kudhura kuderedza. Kuchinja kwacho kunowanzoshanda kune vanhu vanozvitenga pamusana pekugoverwa kwemusika, kana kuvhara-kutengesa :
- Munyika dzakawanda, kunyorwa kwakasununguka kwakapfupiswa kusvika kwevhiki dzinopfuura matanhatu uye zvichabva kubva munaNovember 1 kusvika kuDecember 15, uye zvirongwa zvose zvinobudirira munaJanuary 1, 2018. Asi pane mapfumbamwe ekutsvaga kutengeswa kwenyika akawedzera nguva yekupedzisira yekunyora , saka Iva nechokwadi chokuti unoziva kuti rinoshanda sei munharaunda yako.
- Kana hurongwa hwako hwakabhadhara nokuda kwekusabhadhara mari yepurayamendi muna 2017 uye iwe zvakare kunyoresa nemubhizimisi umwechete (kana imwe inshuwarisi inobatana nekambani yemubereki) panguva yekunyora kuzarura, mubhadhadziro achakwanisa kukumbira iwe kuti ubhadhe yako yekare- miriyamu yakakodzera musati maita zvinyorwa zvitsva. Nenzira yakawanda, inofanira kuva mwedzi mumwechete wepfuura-zvichibva pamitambo inokweretwa, sezvo mapurumisi asina kukwidzwa mushure mekunge chirongwa chapera.
- Izvo zvinotenderwa actuarial kukosha zvinotaridzika kune imwe neimwe yehutachire yehupfumi mumusika wega wega uye wechidiki wakaderedzwa. Zvigadziri zvemhangura zvichave ne -4 / + 5 zvakasara, asi sirivha, ndarama, uye platinum zvirongwa zvichave -4 / + 2. Zvigadziri zvemhangura zvine purogiramu yezvinodial inenge inenge 60 muzana, sirivha inenge 70 muzana, ndarama inenge 80 muzana, uye platinum inenge 90 muzana. Asi zvinogona kusiyana maererano neyakagamuchirwa ne minimus ranges, iyo yakawedzerwa kusvika muna 2018. Izvi zvinongoreva kuti pane zvingave zvakasiyana-siyana kubva kune rimwe chirongwa kusvika kune imwe mukati mehuni yakagadzirwa nedare, saka vanhu nemabhizimisi maduku vachada kuenzanisa zvakajeka zvisarudzo zvakasiyana-siyana zvinowanikwa muna 2018.
Kubatsirwa uye kugoverwa kuchinja mumusika mumwe nomumwe neboka duku kuchaitika sezvakaitwa mumakore akapfuura, nekugadziriswa kwezvikwereti zvekudzvora uye zvekunze, pamwe chete nevanopa mishonga uye mapepa emishonga akavharwa. Usafungidzira kuti chirongwa chawakasarudza gore rakapera chichave chiri chakanakisisa kwauri muna 2018-nguva dzose kuchenjera kuenzanidza maitiro aunowanikwa kwauri panguva yekunyora kuzarura, uye kuchinja kana zvichidiwa.
Pashoma Kutengesa nekunyora Rubatsiro
Kana iwe uchigara mune imwe nyika isina hutano hwehutano kushandiswa uye inotenderera pane HealthCare.gov, unogona kuona kuti kutengesa, kufambisa, nekunyora rubatsiro kunopera panguva yekunyorwa kwekuzarura kwegore ra2018 kupfuura ivo yakambove yakapfuura.
HHS yakaparidzira kumagumo eAgasti kuti vaizove vachichera bhajeti rekutsvaga yeHerldCare.gov kusvika kusvika $ 10 mamiriyoni gore rino, kubva ku $ 100 mamiriyoni gore rapera. Vakataurawo kuti vaizove vachichera bhajeti yehurongwa hweVanigator, iyo inopa rubatsiro rwekunyorwa kwe-munhu kune vanhu vari muhurumende dzisingataurirane ivo pachavo. Kugoverana kwehurumende kunobhadhara zvirongwa zvavo zve Navigator, uye majejeti avo haasvibwi nehurumende yemari inotemwa.
Zvirongwa zvehutano mumusika mumwechete zvakare zvave zviri kuderedza hurumende dzemakambani ekugadziriswa kwemakethe pamakore mashomanana apfuura, kubvisa zvachose pane dzimwe nguva. Izvi zvinokonzerwa nehurukuro huru kune iyo isiri iyo inobatsira yemumwe mutengesi kune vatsigiri vakawanda, ikozvino kuti ACA yakashandura mitemo; vamwe vatsigiri vehurumende vakasarudza kuti havadi kubhadhara vatengesi kuti vauye nebhizinesi iyo pakupedzisira inokonzera mari ye inshuwarisi. Komisheni ndiyo inongova nzira chete yevatengesi kuti vabhadharwe, saka vamwe vatengesi vakasarudza kusashanda nemumwe mutengesi wemisika nokuti havagone kushanda kusununguka.
Zvose izvi zvinoreva kuti pamusika mumwe nomumwe anonyora kune dzimwe nzvimbo dzenyika angawana kuti hakuna huwandu huripo hwekunyora rubatsiro hunowanikwa sezvakambove. Izvo zvicharamba zvichiine rubatsiro rwakakosha, asi vanoverengeka vachada kuronga mberi uye kwete kumirira kusvika kuminiti yekupedzisira-vachengeta mupfungwa kuti mhedziso yekupedzisira ichasvika nokukurumidza mune dzakawanda nyika gore rino kupfuura zvakaitwa mumakore apfuura.
Iyo inowanikwa zvakare kuti HealthCare.gov, nzvimbo yekutsinhanisa yekutengesa inoshandiswa nevanhu muhurumende makumi mana nemakumi matatu, ichange iri pasi kwekugadziriswa kwekugadzirirwa kwechimwe chikuru chunk yeSvondo dzakawanda panguva yekunyora kuzarurirwa uku kuwira, uye kunyange usiku husiku hwekutanga kunyoresa, kuNovember 1. Ichi chinhu chinokonzera kukakavara, uye chinogona kuguma kuchinjwa kusati kwanyora. Asi nokuda kweizvi, vanhu vane mararamiro emusika mumwe nomumwe vangave vakachenjera kuronga kunyoresa kana chirongwa chekuchinja kunotora nguva yakareba kudarika nguva ino gore rino.
Kunyoresa Platforms uye Kuronga Kuwanikwa
Kana iwe uine chinyorwa mumusika woga woga, kana uchida kushandura-shanduko, iwe unogona kutsvaga chirongwa chakasiyana che 2018 nekuda kweu insurer yako inobva pamusika, kana iwe unogona kuwana kuti iwe unogona kuwana zvirongwa zvitsva nemhaka ye inshurenti inopinda mushamba munzvimbo yako (heino urongwa hwekubuda kukuru uye masuo).
Kunyange zvazvo pane hurumende yakaramba ichitaura nezve "vasina" masangano muna 2017, nharaunda yose iri munyika ine bhisi imwe yveshuwa iyo yakagadzirirwa kupa 2018 kugoverana mukushandura pakati peSeptember. Izvo zvinogona kugadzirisa, asi zvinofadza kuti mumamiriro ose enyika maiva nenzvimbo dzokutanga pasina vatsigiri vakagadzirirwa kupa kugoverwa kwe 2018, vatsigiri vezvekambani vakabva vauya kuzozadza nzvimbo dzakasara (izvi zvakaitika muOhio, Wisconsin, Nevada, Virginia, Indiana , Kansas, Missouri, neWashington).
Iko kushandiswa kweinishuwarenzi ivo pachavo hakushanduki muna 2018. Zvose zvehurumende dzinotungamirana kugoverana kwavo muna 2017 dzicharamba dzichiita saizvozvo muna 2018, uye nyika dzose dzinoshandisa HealthCare.gov muna 2017 dzicharamba dzichidaro. Zvinyorwa gumi nembiri bedzi zvine zvinyorwa zvavo zvekunyora; zvese-kusanganisira zvese kuburikidza nekudyidzana kwebambani, kushandiswa kwemasangano, uye kushandiswa kwehurumende kunoshandisa shanduro yehurumende-yese kushandisa HealthCare.gov.
Zvisinei, vatengi muhurumende dzakawanda vangaona kuti zviri nyore kunyora "pakutsinhanisa" kuburikidza newechitatu-web web broker's site, sezvo hurumende yehurumende iri kubvumira " proxy nzira yekunyora yakananga " kutanga uku kuitika kuchagumisa kudiwa kwevakakumbira dzokera kumashure kubva kune web site web broker ku HealthCare.gov. Vatengi vacharamba vachida kugadzira kero pa HealthCare.gov, asi vachakwanisa kupedzisa zvakasara zvebasa pawebhu webhuta webhu.
Uye kana uri kutengesa kugoverana kweboka muchikwata, unogona kuona zvimwe zvakasiyana, sezvo HealthCare.gov yakashandura kushandisa imwe nzira yekunyora yakananga kumabhizimisi maduku. Bhizinesi rehutano hwehutano hwehutano husati rambove rwakakurumbira, zvisinei; mabhizinesi akawanda akanyoresa-kushandura-zvakananga kuburikidza nevanishuwarenzi-kubva pakutanga.
Kuchinja Nokuda kweDare Rokutonga kwaTrump paAACA
Pazuva rake rokutanga muhofisi, Presiden Trump yakasayira urongwa hukuru hwakakonzerwa "nekuderedza mutoro wezvematongerwo enyika weMutevedzeri Wekuchengetedzwa uye Mutengo Wekugadzirisa Mutemo unenge uchiri kupera." Panguva iyoyo, kutarisira pakati pekutonga kweTrump kwaiva kuti kubhadhara kweAACA kwaizopedzwa nokukurumidza, izvo zvisina kuitika.
Asi mutungamiri wehurumende anotungamirira masangano ehurumende kuti ave akareruka sezvinobvira- kunze kwekutevedza mutemo-paunenge uchisimudzira mazano eAACA.
Mutemo wega wega, unoda vakawanda vekuAmerica kuti varambe vachichengetedza hutano hwehutano inshuwarheni kana kutarisana nemhosva yemitero, yave iri nyaya yekufungidzira nguva dzose kubvira pakagadziriswa sarudzo. Kuti ive pachena, hurumende yega yega inenge iripo muna 2017 , uye inoita seyo ichava zvakare muna 2018. Zvizhinji zveAACA kubvisa zvikwereti izvo maRepublicans muCongress akaunza muna 2017 (kusanganisira Graham-Cassidy-Heller-Johnson Bill) ingadai yakaderedza chirango chemunhu mumwe nomumwe kusvika $ 0, ichidzoka kusvika pakutanga kwe 2016. Asi hapana chimwe chezvikwereti chakaitwa.
Panyaya yehutano, Tim Jost yakashuma munaAugust kuti mutemo mumwe nomumwe wakanga uchingosimbiswa ne IRS, pasinei nekunyomba kunopesana, uye iyo website ye IRS inotaura kuti pasinei nehutungamiri hwehurumende, " zvigadziro zvemitemo zveAACA zvichiri kushanda kusvikira kuchinjwa neCongress, uye vateresi vanoramba vakasungirwa kutevera mutemo uye kubhadhara zvavanokweretesa. Vateresi vanofanira kuramba vachipa mitero yavo yemitero sezvavanowanzoita . "
Zvisinei, IRS yakabvumira vanhu kuisa 2016 mutero wemitero munguva yegore ra 2017 iyo isina kupindura mubvunzo pamusoro pekuti firimu yakanga ine utano hwehutano mu 2016 . Vakanga vabvumira izvozvo gore ra2014 ne2015, asi vaida kurambidza kudzoka kwakadaro kwegore ra2016, uye vanoda kuti firiji dzose dzipindure mubvunzo. Vakadzoka nzira pachinje ichi chichitevera hutungamiri hwehutungamiri hwaTrump, uye vakaramba vachigamuchira kudzoka "kwakanyarara" kusina kutaura kana kana kwete mutero wechirwere aine utano hwehutano inshumo.
Hazvinyatsozivikanwe kana IRS ichashandura mamiriro avo panyaya iyi inopinda mumutero wekufambisa mutero kutanga kwegore ra2018, asi hazvigone kuti ivo, vachapiwa urongwa hukuru hweTrump.
Boka rakakura, Medicare, uye Medicaid: Kazhinji Gore negore kuchinja Shandisa
Zvizhinji zvehutano hwekushandura kwehutano hwehutano muna 2017 zvakanyatsotarisana nemusika mumwe nomumwe, mushamba muduku weboka, uye Medicaid. Asi sezvakataurwa pamusoro apa, mazhinji emakakatanwa aya haana kukonzera kuchinja chero kupi zvako kunooneka. Kune vanhu vanowana inshuwarisi yavo kubva kuvashandirwi vakuru, Medicare, kana Medicaid (vakatorwa pamwe chete, ndivo vazhinji vevanhu), kuchinja kwe 2018 kuchawanzo kuva imwechete yechinjuko chinoitika gore negore.
Vhura kushandiswa kweMedare Advantage uye Medicare Part D inotanga kubva munaOctober 15 kusvikira kuDecember 7, pamwe nekuchinja kwose kwakasununguka musi waJanuary 1, 2018. Zvirongwa zvezvino zvichachinja zvimwe zve 2018-sezvavanoita gore rega rega-saka zvakakosha kuti vanyora kuti vatore nguva pavanenge vazaruka kunyoresa kuti uenzanise zvakasiyana-siyana zvaunogona kusarudza uye sarudza iyo ichazoita zvakanakisisa zvido zvavo mugore rinotevera.
Izvozvowo ndezvechokwadi kune avo vanoshandira-zvigadziriswa zvirongwa. Vazhinji vashandi vane ruzivo rwakasununguka pakudonha, uye kubatsirwa kunobatsira munaJanuary 1. Kana hurongwa hwako huri kuchinjwa kwegore rinotevera, kana kana pane zvitsva zvinogona kuwanika kwauri, kunyora kuzarura kuchava mukana wako wekuchinja mararamiro ako kana ukasarudza kuita kudaro.
Hapana humwe humwe hwehutano hwekushandura kwehutano hunoenderana neMedicaid hwakagadzwa muna 2017, izvo zvinoreva kuti kukodzera kuchaenderera muna 2018 zvakanyanya kusina kubva muna 2017, kusanganisira ACA's Medicaid kuwedzera. Hapana hurumende itsva dzakagadzirisa Medicaid kukodzera muna 2017, saka mari yehutachiwana yekuwedzererwa kweMedicaid inoramba yakangofanana neyeiyo pakutanga kwegore. Kana iwe ukawana chikumbiro kubva kunharaunda yako Medicaid sangano kuti udzokezve Medicaid yako yakakodzera, iwe unoda kugovera zvinyorwa zvinodiwa nokukurumidza sezvinobvira kuti urege kupera muhuwandu.
> Sources:
> Cassidy.Senate.gov. Rugwaro rwechigadziro 543 kuna HR1628 ( Graham-Cassidy-Heller-Johnson kuchinjwa kweAmerican Health Care Act ). Yakabudiswa musi waSeptember 13, 2017.
> Centers for Medicare neMedicaid Services. Nguva Yemberi ye SHOP. CMS Inotarisira Kubvumira Mabhizimisi Matshoma muSOPO Kushandisa HealthCare.gov Kuwedzera Kunzwisisa paKunyoresa kuHealthcare Coverage . May 15, 2017.
> Dhipatimendi Rezvoutano uye Human Services. Murwere Anodzivirirwa uye Anononoka Kuchengetedza Mutemo: Misika Yakadzika . April 2017.
> Internal Revenue Service, Mumwe Nomumwe Mutoro Wekugoverwa.
> WhiteHouse.gov, Office of the Press Secretary. Executive Order Kuderedza Mhosva Yezvemari yeMurwere Kuchengetedzwa uye Kutengeswa Kwebasa Rinotarisirwa Riri Kutarisira Kudzoka. January 20, 2017.