Kuchengeta Vana veAmerica Utano
Vose Medicaid uye Vana Health Health Program (CHIP) inopa hutano hwehutano hwevana vanotora mari shoma. Mapurogiramu maviri aya anobatanidzwa pamwe chete nehurumende uye hurumende dzehurumende. Zvose izvi zvinoshandiswa nehurumende.
Pano pane mamwe maitiro akasiyana pakati pemapurogiramu maviri aunoda kunzwisisa kana iwe une mwana unoshaiwa utano hwakanaka. Zvichinyatsojeka, zvinoenderana nokuti unogara kupi.
Medicaid Kufanirwa Kwevana
Vana vakwegura mumhuri vanowana 133 kubva muzana kana kuti vashoma vehurumende yehurumende yehurombo (FPL) gore vanokodzera Medicaid. IFPL inoratidzwa neDhipatimendi reMweya weUnited States uye Human Services gore roga roga uye inobva pauwandu hwevanhu vari mumhuri vachifungisisa zvakare kunopiwa kune nzvimbo. Mushure mezvose, mamwe magwaro anonyanya kukosha kuti ararame kune vamwe, somuenzaniso, Alaska neHawaii.
Pamberi peNotengeswa Care Care Act (ACA) yakapfuura muna 2010, vana vakakwanisa kupiwa Medicaid zvichienderana nezera ravo nemhuri. Kakawanda, mwana akwegura akawana, zvishoma kuti aifanira kuwana Medicaid kugoverwa kwemhuri imwe chete. Zvisinganzwisisiki, izvi zvaireva kuti vamwe vana chete mumhuri imwe chete vangagona kuvharwa mugore rose rakapiwa. Mutemo mutsva wakaita kuti mari yekuwana mari yakakodzera yakafanana kune vana kubva kune makore kusvika kune makumi mana.
Zvimwe zvezvematongerwo enyika zvinenge zvichiri zvakasiyana-siyana zvekugadziriswa kwemazana emapoka emakore akasiyana, asi kukosha kwemazuva ano kwave kwakagadzirirwa zvikamu 133 kubva muzana zveFPL kune vose vana. Pamberi peAACA, chikwata chekugadzirisa chakanga chakagadzirirwa ne100 chete muzana yevana pakati pemakore matanhatu ne19.
Kukodzera kweCIP
Medicaid inotarisirwa kugovera vana varombo zvikuru.
Purogiramu yeCIP yakasimbiswa muna 1997 senzira yekuwedzera kugoverwa kune vana vane mari shoma yemhuri asi vanowira kunze kweMedicaid yekugadzirisa window.
Izvo nyika inoguma ichisarudza kukodzera kwechikonzero cheCIP, asi huwandu hwehurumende (46 dzinotaura uye Dunhu reColumbia) inogadzirisa chikumbaridzo pa200% yeFPL kana kupfuura.
Sangano reMari reMedicaid
Apo zvinouya kuMedicaid, hurumende yehurumende inobatana nehurumende kushandisa mari ye "dollar," kunyanya mufungwa. Inoshandisa izvo zvinonzi Federal Medical Assistance Percentages (FMAP) kusarudza kuti ichabhadhara zvakadini. FMAPs inofunga nezvemazana ehurumende yemari yakaenzana neyemutengo wenyika yose.
Hurumende imwe neimwe inopiwa FMAP yevanenge makumi mashanu kubva muzana, kureva kuti hurumende yehurumende inopa 50 muzana yeMedicaid mari. Mamwe ose ehurumende anogamuchira chikamu chepamusoro cheMedicaid mari zvichienderana neFMAAP yakaverengwa. Pamwe nepamusoro-soro kune imwe yenhare yemari, Mississippi ine 2017 FMAP ye 74.63 muzana kuitira kuti hurumende yehurumende inobhadhara $ 2.94 ye $ 1 iyo nyika inoshandisa.
Kuti uwane iyi Medicaid mari, nyika dzinobvumirana kune mamwe mazwi. Hurumende haibvumirwi kuisa vanhu pane zvinyorwa zvekurindira, haikwanise kuva nechikwata chokunyora, uye haikwanise kutenga mari yepayimisi kana zvikwereti kune ani zvake anotambira pasi pe 150 muzana yeFPL.
Mari yeGurumende yeCIP
Federal federation for CHIP, kune rumwe rutivi, inotanga kugadzirisa miganhu. Hurumende imwe neimwe inopiwa mugove gore negore sekubvumira rubatsiro. Dhora iripo yakagadziriswa pasinei nenhamba yevanhu vakafukidzwa nepurogiramu.
Vaya 50 vanoti uye District of Columbia vane chisarudzo chekushandisa zvipo zvavo zvekuvimba mune imwe yenzira zvitatu:
- Sekubatanidza Medicaid-CHIP chirongwa (29 mapurogiramu enyika)
- Sechikamu chehurumende yeMedicaid kuwedzera (9 mapurogiramu enyika)
- Sekuparadzanisa CHIP chirongwa (13 mapurogiramu enyika)
Kukurudzira hurumende kuti iite chikamu muCIP, hurumende yehurumende inopa huwandu huri nani kupfuura hunoita kuMedicaid.
Ivhareji yenyika yose yeMedicaid inofanana ne 57 muzana asi iyo 70 muzana yeCIP. Zvakare, inotaura nehupfumi hwezvido zvekubhadhara dzinodzoswa pamutengo wakakwirira.
Izvo zvinoreva kushandisa mapurogiramu ekubatanidza kana kuwedzerwa kweMedicaid vane chirongwa chimwechete chekuda sechimiro cheMedicaid. Nyika dzine mapurogiramu akasiyana eCIP, zvisinei, ane wiggle room. Kana zvichidiwa, vanogona kuisa vana pakurindira mazita kana kuisa zvinyorwa zvekunyoresa kuti vadzorezve muCIPIP mari. Vazhinji vehurumende idzodzo vachapawo mari yepayimisi uye zvikwereti kune avo vanobhadhara.
Kusiyanisa muBhuku reMedicaid neCIP
Mitemo yehurumende inorayira Medicaid inopa mazano chaiwo kune vana vakavharwa. Izvi zvinosanganisira Kutanga uye Kuongorora Periodic, Kuziva uye Kurapa (EPSDT), maitiro akazara anotarisa kuchengetedza nekuchengetedza. Inosanganisira zvinotevera:
- Kunyatsorongororwa kwenhau yekare
- Dental care
- Kunzwa kuongororwa, kusanganisira cochlear transplants uye kunzwa kunzwa
- Immunizations uye vaccination
- Tungamira kuongorora
- Kuongorora kwehutano hwepfungwa nekupa mazano
- Kuongorora kwepanyama
- Chiono chekuongorora, kusanganisira magirazi emaziso
Zvirongwa zvakare zvakafukidzwa neMedicaid dzinosanganisira kutarisirwa kunowanikwa kuFederally Inokodzera Health Centers (FQHCs) uyewo mabasa ekuvandudza.
Zvirongwa zveCIP, zvisinei, hazvifaniri kusangana nemitemo yakagadzirirwa neEPSDT, kunyange zvazvo inofanirwa kupa urongwa hwekucherechedza hunosanganisira kutarisirwa kuchipatara, laboratory zvidzidzo, x-rays, uye zviongorori zvevana, kusanganisira majekiseni. Utano hwemazino hungave huri hwakazara sehupi hwakapiwa pasi peEPSDT asi hunofanirwa kuva chikamu chekubatanidzwa kubhadharo. Kumugumo uyu, humwe hurumende inogona kusarudza mazino avo emazino zvichienderana nehurumende inonyanyozivikanwa yehutano hwemazino, iyo inonyanya kuzivikanwa yevashandi varongwa vemazino evanhu vanovimba, kana kugoverwa kubva kune inonyanyozivikanwa yehurumende yunivhesiti hurongwa muhurumende.
The Future of Medicaid uye CHIP
Zvematongerwo enyika, Medicaid inyaya yakakonzerwa. Ikozvino hurumende iri kuedza kubvisa iyo Affordable Care Act, iyo inogonawo kuisa kuguma kuMedicaid kuwedzera. Chinangwa ndechokuderedzawo mari yehurumende mari yeMedicaid.
Chirongwa cheHIV chekuita zvehutano chichangobva kuitwa chinoda kutora sangano rinofananidza neMedicaid ne flat flat rate rate kune imwe nyika. Kunyange zvazvo kubhadhara mari yekubatsira kwakabatsira purogiramu yeCIP, purogiramu yeCIP inokosha zvikuru kudarika Medicaid. Uyewo, kubhengira zvikwereti zvishoma kudarika kuti vangani vana vanogona kuvhara pasi peCIP. Nyika dzine zvikwereti zvekuvimba zvinowedzerawo vana pakurindira mazita.
Vangani vana vacharasikirwa nehutano hwehutano kana GOP kuchinja kwehutano kuchiitika?
Shoko Rinobva
Vana vakakwidziridzwa mumhuri dzakaderera-famba vanofanirwa nehutano hwakanaka hwehutano hwakanaka sevamwe vavo vanowana mari yakakwirira. Medicaid inopa mhuri dzinotambura zvikuru apo CHIP inowedzera kuparidzira kune nhamba yakawanda yevana. Kuchengeta kuburikidza nepurogiramu yeMedicaid inogona kunge yakanyanyisa, asi chirongwa cheCIP chinopawo kupararira kwakadzika kwekuparidzirwa. Kunzwisisa musiyano pakati pemapurogiramu aya maviri uye shandisa zvakanyanya utano hwemwana wako.
> Sources:
> Vana Health Health Program (CHIP). Medicaid.gov website. https://www.medicaid.gov/chip/chip-program-information.html.
> Tsvaga Zvirongwa muHurumende Yenyu. InsureKidsNow.gov website. https://www.insurekidsnow.gov/state/index.html.
> Medicaid uye CHIP Inyoresa Data. Medicaid.gov website. https://www.medicaid.gov/medicaid/program-information/medicaid-and-chip-enrollment-data/index.html
> Patrick SW, Choi H, Davis MM. Kuwedzerwa muhurumende yemitambo inobatanidza nekubudirira kunowanikwa mukugoverwa kwevana kuburikidza neMedicaid uye CHIP. Health Aff . 2012 Aug; 31 (8): 1796-802. doi: 10.1377 / hlthaff.2011.0988.
> Racine AD, Long TF, Helm M ME, et al. Vana Health Health Program (CHIP): zvigadzirwa, zvinetso, uye mitemo inorayirwa. Pediatrics. 2014 Mar; 133 (3): e784-93. doi: 10.1542 / peds.2013-4059.