Ichavhara zvipo uye per capita zvigaro zvinokuvadza Medicaid here?
Kuchinja kwehutano kwehutano kwave kwave kuve kwekutarisana kwemaitirwo enyika. Ko GOP inogona kubvisa yekutengesa Care Act, yakaitwa Obamacare, kana kuti maRepublicans achawana dzimwe nzira dzekudzorera pamitemo yayo here? Mushure meAmerica Health Care Act (ACHA), aka Trumpcare, vakakundikana kugamuchira vheti muImba muna March 2017, zvakaoma kuziva zvingatarise pasi pehutungamiri huripo.
Hondo iri kure kure. Mutauriri weimba Paul Ryan achiri kutarisa kuti atore matanho ekuchengetedza utano, kunyange zvazvo asina kuzvipira kune nguva yekupedzisira. Tariro, imwe chirongwa chezvehutano hwehutano huchaiswa panzvimbo yevanhu veAmerica. Chirongwa chakadai chingave chinosanganisira Medicaid, chirongwa chehutano hwakabata varombo uye vakaremara?
Maitiro eHurumende yeHurumende inosvika kuMedicaid
Medicaid chirongwa chinotungamirirwa nehurumende nehurumende dzehurumende. Hurumende yehurumende inoisa mitemo yekuti ndiani uye chii chinofanirwa kuvharwa, uye humwe humwe sarudzo hunosarudza kana kuti kwete kuwedzera mamwe mazano kune chirongwa chacho. Havagoni kupa zvishoma. Nezvekubhadhara mari, hurumende uye hurumende dzehurumende pamwe chete dzinobatsira pazvirongwa zvavo zveMedicaid.
Kuti tinzwisise kuchinja kunogona kuuya kunzira yedu, tinoda kunzwisisa kuti hurumende yehurumende yakabhadhara sei Medicaid pakutanga kwekutonga kweTrump.
Zvose zvinogamuchira mari yehurumende kuburikidza nemitatu mitatu.
- Zvikamu zvisingaenzaniswi Zvokugoverwa Chipatara (DSH) zvikwereti: Nekubhadharwa kweMedicaid anozivikanwa zvikuru, zvipatara zvinotarisira nhamba yepamusoro yevanhu veMedare kana kuti yevasina kunetseka inogona kurwisana nemari. DH mubhadharo inobhadharwa kumahurumende ekuparidzirwa kune zvipatara zvinoshaiwa.
- Chirongwa cheBrath Medical Assistance Percentages (FMAP): Hurumende yehurumende inobatanidza mari yehurumende paMedicaid yemari yeDhora uye inopa huwandu hwehuwandu hwehurumende huri nehuwandu huri pasi pemari.
- Kuwedzerwa kuenzanirana nemitengo: Hurumende yehurumende inobhadhara kumusoro uye kunze kweFMAP yehutano hwehumwe hutano hunosanganisira asi husingatariswi kumakumbo uye muchirwere chemukondombera , urongwa hwemhuri, hutano hwehutano hwemusha, uye kudzivirira kuvhara kwevanhu vakuru .
Mubvunzo ndewokuti nzira idzi dzehurumende dzinotsigira dzichaenderera mberi pasi peMutungamiri Trump kana kana ichatsiviwa nedzimwe nzira yekubhadhara mari.
Nhepfenyuro yeGedhi yeMedicaid Kuwedzera
Medicare kuwedzera kwakatanga muna 2014 uye yakanga iri chikamu chikuru cheChinakidzwa Care Act. Yakashandura miganhu yekuwana iyo inogona kukodzera vanhu kuMedicaid uye yakabvumira vanhu vasina kuroora vasina vana kuti vave vakakodzera kana vakasangana nemiganhu iyoyo yekuwana.
Iyo federal poverty level (FPL), inotsanangurwa gore rose, inobva pakuti iwe uri wega kana mumhuri, uyewo nehukuru hwemhuri yako. Nyika dzakagadzirisa Medicaid kukodzera zvichienderana nezvikamu zvePFPL. Obamacare inowedzera mvumo yekuwana mari yekufanirwa kweMedicaid kusvika ku13 muzana yeFPL nokuda kwenyika iyo yakasarudza kutora chikamu, apo inotaura kuti kuderedzwa kweMedicaid kuwedzera kunogona kuchengetedza zvigadziriswa pamutengo wekare, 44 muzana yeFPL.
Zvisizvo-zvisingatori nhepfenyuro zvinogona kupfuurira kusarura vanhu vakuru vasina vana kubva pakugoverwa.
Zvinonzwisisika, izvi zvakakanganisa mari yehurumende yepurogiramu. Nyika nekuwedzera kweMedicaid yakagamuchira mamwe madhora ehurumende kuti avabatsire, kusvika kusvika kuzana muzana yekudhura kwemari kusvika muna 2016 uye 90 muzana yeiyo inodhura kusvika muna 2022.
Chinangwa Chekubhadharwa Kwemari Kuchinja kweMedicaid
IAmerican Health Care Act yaisanganisira zvikamu zvakawanda zvinodhura mari yeMedicaid. Kunyange zvazvo chirongwa chacho chakanyanyisa kuderedza Medicaid kuwedzera, yakataura kuti yaizopa mari yakawedzerwa yokutaura iyo yakanga yavimbiswa kuburikidza ne2022.
Maererano neNational Health Expenditure Data, kushandiswa kweMedicaid kwakapfuura madhora 545 mabhiriyoni muna 2015, kuverenga zvikamu makumi mapfumbamwe nezana zvezana zvehutano hwehutano.
Neyoyo nhamba pakusimuka, veRepublicans vari kutsvaga nzira yekuderedza pane iyo kushandiswa. Zvinyorwa zviviri zvakakosha zveMedicaid kuchinja ndeyekuchinja kumiganhu yega rega kana zvikwereti.
Per capita mitsara ndiyo mari yakatarwa yemari yaizobhadhara kune nyika gore negore. Kukosha kunobva pane vanhu vangani vari muProject Medicaid. Izvi zvinotendera kuti federal federal iwedzere mumakore anotevera kana vanhu vakawanda vakakodzera uye vakanyoresa purogiramu. Pakati pemiganhu yeMedicaid yakarongedzwa nekutanga kutungamirirwa kweAmerican Health Care Act.
VaRepublican vakawanda, kunyanya Freedom Caucus, vaidavira pamiganhu yemitemo havana kuenda zvakakwana kuderedza mari yekushandisa mari kuMedicaid. IAmerican Health Care Act yakashandura kubva pakupa mimwe mitemo kumiganhu yekushandisa zvipo zvekuvimba neMedicaid. Kusiyana nemaganhu evanhu, zvipo zvekubvisa hazvina kutora nhamba yevanhu paMedicaid. Mitero yehurumende inopararira mune imwe yakagadzirirwa inogona kuwedzera mumiganhu gore negore kuti iite nenyaya yekuwedzera kwezvinhu. Dambudziko nderekuti kutengesa kwenyika kunogona kusimuka kunonoka kudarika mari yekurapa.
Kuongororwa kwakaitwa naAvalere, wehutano hwehutano hwehutano, inofungidzira kuti makore anopfuura mashanu hurumende yehurumende yaizochengetedza zvakakwana madhora 110 mabhiriyoni kana ikashandisa mamiriyoni emitengo kana $ 150 mamiriyoni kana ikashandiswa zvipo zvekuvimba neMedicaid.
Ko Medicaid Programs Adapt?
Mubvunzo unoramba uripo kana imwe yezvisarudzo izvi ichanyorwa sechikamu chekusarudzwa kwehutano hwehutano hwekusangana kwehutano. Kana mumwe nemudzimai asingakwanisi kuvhara kana kubvisa zvipo zvigadziriswa, inotaura kuti icharasikirwa nehuwandu hwekubhadhara mari. Kuti vadzivirire kurasikirwa ikoko, vangave vachida kuita shanduko dzinoita kuti zvirongwa zvavo zveMedicaid zvive zvakanyanya.
Nyika dzinogona kuisa huwandu hweMedicaid yavo yose, kupedza hupi hupi hupi hunofukidzwa neMedicaid, kana kuisa miganhu yevanhu vangani vanogona kunyora, kunyange kana vanhu ivavo vachikwanisa kugadziriswa. Block mvumo inenge ichinyanya kukanganisa kutaura nokuti inogona kuderedza zvose kushandiswa nekunyora kuwedzera.
> Sources:
> HR1628 - American Health Care Act we 2017. Congress.gov website. https://www.congress.gov/bill/115th-congress/house-bill/1628. Yakapedzwa musi waMarch 24, 2017.
> National Health Expenditure Data Fact Sheet. Zvikamu zveMedhareid uye Medicaid Services website. https://www.cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/nationalhealthexpenddata/nhe-fact-sheet.html. Yakapedzwa musi waDecember 2, 2016.
> Pearson CF. Mari Yakapetwa muMedicaid Inogona Kujekesa Kuderedza Federal Spending. Avalere.com. http://avalere.com/expertise/managed-care/insights/capped-funding-in-medicaid-could-significantly-reduce-federal-spending. Yakabudiswa naFebruary 6, 2017.
> Rosenbaum S, Schmucker S, Rothenberg S, Gunsalus R. Chii Chingavhara Mipiro kana Mipiro Pamusoro pePapita Inoshandiswa Mukureva Medicaid? Nyaya Yfupi (Commonw Fund). 2016 Nov; 39: 1-10. https://www.ncbi.nlm.nih.gov/pubmed/27959479.
> US Federal Poverty Guidelines Inoshandiswa Kugadzirisa Kwemari Kubvumirwa Kwezvikamu Zvimwe Zvehurumende. Office of the Assistant Secretary for Planning and Evaluation, Department of Health and Human Services website. https://aspe.hhs.gov/poverty-guidelines. Yakarongwa musi waJanuary 31, 2017.