A Tarisa Mazano Ekuchinja Medicaid uye Medicare
Mutungamiri Donald Trump akaita zvivimbiso kuvaAmerica pamushandirapamwe. Kudzokorora Obamacare nekuchengetedza Medicare kwaiva pamusoro peyo runyorwa. Mutungamiri wedu ari kurarama kusvika kumakwikwi aya anopikira here?
A Tarisa Mushandirapamwe weTrump Anovimbisa
Sechiyeuchidzo, Mutungamiri Trump akakurudzira pane chirongwa chinomwe chehutano hwehutano. Nekuchinja kwekutevera, akapikira kuita kuti utano hwakanaka huve zvakare.
- Dzorerai Chisingakwanisi Kutarisira Mutemo, aka Obamacare
- Rega kutengesa zvirongwa zvehutano kumativi ehurumende chero bedzi zvirongwa zvehutano zvinotevera mitemo yenyika
- Bvumira vanhu kuti vauye mari yemishonga yemishuwarenzi yehutano pamitero yavo yepamusoro
- Rega vanhu kuti vashandise Health Savings Accounts (HSA)
- Inoda kuti mutengo uonekwe mukati mehutano hwehutano
- Rambai mvumo yehurumende kuti itaure nezveMedicaid
- Kubvumira kuwedzera kuva mumisika dzisina ruzivo, kusanganisira kutenga zvidhura zvinodhaka kune dzimwe nyika, kuderedza mari yekurapa mishonga
Mutungamiri Trump arikuendesa pamushandirapamwe wake anopikira here?
Trump inotora paMedicaid
Hazvina mhosva kuti uri kutarisa sei, Medicaid mari ndeyekuchera. Izvi zvinogona kukanganisa kuti vanhu vangani vanogona kuwana hutano hwehutano kuburikidza nepurogiramu.
Repealing Obamacare
Apo Mutengo Wokunetseka Wechipatimendi wakatangwa muna 2010, kwaiva nehuwandu hwemamiriyoni makumi maviri nemashanu evanhu vasina kuvimbiswa veAmerica, anenge 15,7 muzana yevanhu.
Maererano neCenters for Medicare neMedicaid Services, ruzivo rwemutemo rwakaderedza nhamba iyoyo kusvika 9.2 kubva muna 2015.
Obamacare yaibvumira vechidiki kuti varambe vachiita zvirongwa zvevabereki vavo kwenguva yakareba, vakadzivirira makambani einishuwarenzi kubva kuwedzerwa mari yepurayamisi inotarirwa nemamiriro ezvinhu aimbovapo , akabvumirwa kuwedzera kune mapurogiramu aivepo eMedicaid uye akavandudza Health Insurance Marketplace sechinhu chinogadziriswa kune avo vasina kusangana zviyero zveMedicaid.
Zvichinyatsojeka, mari inoshandiswa purogiramu yechuwarisi yega yega panguva iyoyo yakanga yakanyanya kukwirira kuti vanhu vazhinji vatarise.
Vakawanda vanopokana kuti Obamacare akaenderera mberi nekusiya zvirongwa zvehutano zvichibva mune zvemari. Zvinokonzerwa nezvirongwa zvakawanda zvakave zvakakwirira zvekuti vanhu vazhinji havagone kuzviwanira. Izvo zviri nani pane kuva asina utano here?
Nokupfuura neAmerica Health Care Act (AHCA), Mutungamiri Trump anoronga kuchinja mitemo yakawanda yakaitwa naOmamacare. Mukuita kudaro, Congressional Budget Office inofungidzira kuti vanhu vanosvika mamiriyoni 14 vacharasikirwa nehutano hwehutano inshuwarano gore rinotevera uye vanhu vane mamiriyoni 23 mumakore gumi. Kuti tive yakanyatsojeka, kana tikatevera nzira yemazuva ano pasi peOmbamacare, vanhu vane mamiriyoni makumi maviri nemasere pasi pemakore makumi matanhatu nemashanu vanove vasina uninsured muna 2026 asi neAHCA, nhamba iyoyo yaizosvika kumamiriyoni 51.
Kudzvora Sangano reMari kuMedicaid
Obamacare akakukurudzira kutaura kuti wakasarudza kupfuurira neMedicaid kuwedzera . Izvo nyika dzakagamuchira madhora ehurumende kuti dzivabatsire, kusvika kuzana muzana yekuwedzera kwemari kwemakore matatu uye makumi mapfumbamwe kubva muzana yemari inotora kusvika muna 2020. Kuwedzera kweMedicaid kwaizomira pasi peAHCA, kunyange zvazvo Trump hurumende yaizoenderera mberi nemari yakapikirwa kuburikidza ne2020 .
Kunze kwekudarika Obamacare, iAHCA inotarisira kuderedza mamwe mapepa ekubhadhara mari kuMedicaid programs zvakare. Yakaronga kurerutsa mari yekuvhara zvipo . Kubvira muna 1965, nyika dzakagamuchira mari yehurumende yeMedicaid inotarwa nenhamba yevanhu vaikodzera chirongwa. Block mvumo inogona kuchinja zvose, kupa chigarire chemari yeMedicaid pasinei nehurumende inoda. Kushandiswa kwekubhadhara kunogona kuchinja nyika dzose, kwete chete avo vakapinda mukuwedzera kweMedicaid.
Kuderedza kubatsirana kwehurumende kweMedicaid kunotakura mutoro unorema pamatunhu kuti awane zvigaro. Nyika dzakawanda dziri kurwisana nemabhadharo emari sezvazviri.
Muna 2016, inopfuura hafu yezvematongerwo enyika yakawana mari shoma kudarika mari yavo yakarongwa uye 19 yavo yaifanira kuita bhajheti inopera pakati pemakore kuti irambe iripo.
Sangano reBongress reBabri rinofungidzira kuti AHCA ichapedza Medicaid mari ye $ 800 mabhiriyoni mumakore gumi anotevera. Nokuisa dambudziko rakawanda pane zvinyorwa kuti zvipe mari, ndiani uye chinonzi Medicaid chinogona kuchinja chii. Dzimwe nyika dzinogona kusarudza kuisa zvinyorwa zvekunyoresa kana kugadzira mazita ekumira kweMedicaid zvikwereti kune vanhu vanosangana nekodzero yekudiwa. Dzimwe nyika dzinogona kukamanikidzwa kuderedza zvikwereti kuchengetedza mari mukutarisa. Vamwe vanogona kuita zvose.
Trump Inotora Pamutara
Pamusangano uyu, Mutungamiri Trump akavimbisa kuti haazochera Medicare rubatsiro, asi AHCA yaizove yakakosha kune vanopiwa Medicare. Akaitawo zvivimbiso zvakasiyana-siyana zvevakuru veAmerica kuti aifanira kutora matanho.
Kutaurirana Nezvinodhaka Zvinodhaka
Mishonga imwechete inoshandiswa muUnited States inowanzobhadhara zvishoma kune dzimwe nyika. Somuenzaniso, Advair, mishonga inowanzoshandiswa kurapa chirwere , inodhura madhora 309.60 pamwedzi muUnited States asi inongodhura $ 74.12 muCanada uye $ 46.99 muUnited Kingdom. Penguva ino, Medicare haibvumiri vanyori kuti vatenge mishonga yavo kunze kwenyika kuti vashandise mari inodhura madhiragi. Mutungamiri Trump anoda kuchinja izvozvo. Mishonga yemishonga, zvisinei, yakagadzirirwa.
Mutungamiri Trump anodawo kutaurirana nemakambani ekuAmerica emishonga kuti ave nani. Medicare Chikamu D chirongwa chezvinodhaka zvemishonga iye zvino chinotungamirirwa nemakambani einishuwarenzi ega, uye mitemo iri munzvimbo iyo inodzivisa hurumende yehurumende kupinda mukati mekutengesa. Zvakare, kune zvakakosha kupindira nekambani dzemishonga kuti urambe iri mutemo.
Neine gumi chete muzana yehutano hwemari yakataurwa pamusoro pemishonga, Congressional Budget Office (CBO) inotaura kuti havangatarisiri mari inodhura yekuderedza nehurumende inopindira. Mimwe mitemo yemisangano inoratidza kuti Medicare inogona kuchengetedza mari yakawanda se $ 16 mabhiriyoni gore roga roga kuburikidza nekukurukurirana uye kuderedza mari yezita remishonga yemishonga kuhutano hurumende yehurumende yakatotaurirana pamusoro peMedicaid neVeterans Administration .
Kusvika parizvino, hapana chiito chekuita mutemo chakatorwa kuzogadzirisa mutengo wemishonga.
Tax Savings
Mutungamiri Trump angapa maAmerica mikana yekuchengetedza pamitero yavo. Parizvino, vatsigiri veMedare havabvumirwi kushandisa mari yekuchengetedza zvikwereti. Nekushandurwa kwemitemo, varimi veMedricare vanogona kuisa kunze kwemari yemutero-pasina nekuda kwekubhadhara mari yezvoutano.
Nekuitawo mari yekubhadhara mari yemari inowanikwa (yakabhadharwa kubva pa $ 1,608 kusvika ku $ 5,143 kuMedareti Part B muna 2017) , vakwegura vanogona kuchengetedza zvakawanda zvekubhadhara mari yavo.
Zvakare, hapana kuedza kwakatorwa kuisa izvi mumutemo wepamutemo.
Kudzokorora Obamacare Kunobatsira Medicare
Kunyangwe kutarisirwa kwave kwakanyanyisa kuMedicaid uye kusina uninsured, kubhadhara zvakakwana kweChinakidzika Care Act kunogona kuva nemigumisiro yakakosha yevanhu veMedare pamwe chete. Obamacare akabatsira kuvaka zvirongwa zvokuvandudza kutarisirwa kwechipatara, kuderedza Medicare unyengeri, uye kugadzira matsva ekubhadhara matsva anogona kuchengetedza mari yepurogiramu. Yakapararirawo pamutambo weMedare, zvichiita mabasa ekudzivirira semakolonoscopies uye mammograms vakasununguka paunogamuchira kutarirwa kubva kune anopa mupiro . Chinonyanya kukosha, chakabatsira kuderedza mari yezvinodhaka zvinodhaka kuvanhu pane zveChikamu D.
Pakutanga, zvakanga zvisinganzwisisi kuti sei AHCA ichagadzirisa nyaya idzi, asi zvinoratidzika kwete kuti zvose zvakagadzirwa neOmbamacare zviri kuvhara. IAHCA haizogadziri kugoverwa kwezvinobatsiro, uye ichabvumira kuti gomba rive rakapedzisira ravharwa ne2020 sezvarongwa.
Zvinoshandiswa ndezvikwereti. IAHCA inogona kubvisa chirwere cheMedare chekubhadhara mari kune vanowana mari yakawanda, zvichireva kuti mari shoma ichave iripo kune Medicare Trust Fund munguva. Zvechokwadi, inofungidzirwa kuti Medicare Trust Fund icharasikirwa ne solvency ne2025, makore matatu zvisati zvaitika zvakagara zvataurwa muna 2016, kana AHCA ichiitika.
Tichaitei kana Medicare inopera mari ?
Ichokwadi chekutonga kweTrump
Mutungamiri Trump akaenda kushanda ndokusayira mutungamiri wehurumende musi waJanuary 20, 2017, zuva rekugadzwa kwake. Mutemo wakarayirwa nehurumende dzehurumende kuti dzidzoke zvakare kuObamacare "kusvika pamwero wakabvumidzwa nemutemo". Murairo uyu hauna, asi, kubvisa iyo Affordable Care Act uye haina kurondedzera kuti masangano aizoenderera sei panyaya yacho.
Kunyange zvazvo akataura kuti aisazobata purogiramu yeMedare, Mutungamiri Trump anonzi Mumiririri Tom Price semunyori weHutano neHuman Services iyo yakasimbiswa musi waFebruary 10 mushure mekutaura kweSeneti kukakavara. Mutengo wave uchingopfuura kungodanidzira pamusoro pokutsvaga kuwedzerwa kweMedare. Akabvumira kusavhengana kweMedare nehurongwa ne "Nzira Yakanakisisa" yakarongwa neGOP muna 2016. Mukuwedzera pane izvozvi, akatsigira kutyora kukuru kune chirongwa cheMedicaid.
Mutungamiri akabatanidza Seema Verma kuti ashandise Centers for Medicare neMedicaid Services (CMS). Muongorori wezvoutano uye muvambi weSVC. Inc., basa rake muIndiana rinotungamirira kune zvinodiwa kuti vanhu veMedicaid vabhadhara mari yemwedzi kana kuti zvimwe vanorasikirwa nehuwandu hwemwedzi mitanhatu. Mune dzimwe nyika, akashanda pane zvido zvinoda vanhu kuMedicaid kuti vabhadhara chikamu chekutarisira kwavo kana kuti vanovada kuti vashande kana kushingairira basa. Kusvika iye zvino, akatsigira pamamiriro ezvinhu enyika, asi mubasa rezvematongerwo enyika, aigona kuchinja mitemo munyika yose.
Zvipikirwa zvizhinji zvakaitwa uye hupenyu huzhinji husina mubvunzo huchabatwa. Mutungamiri Trump akatumira zviratidzo zvakavhenganiswa kuvanhu veAmerica. Izvo zvaakavimbisa pamusangano wekushandira pasina nguva dzose zvave zvichienderana nekuita kwake seMutungamiri. Anobamacare kubviswa zvinogona kuitika, zvichida zvishoma, kana AHCA ichiitika. Medicaid kucheka ndeyechokwadi kutevera. Chii chichaitika kune Medicare, zvisinei, iyo inofungidzira mutsara.
Shoko kubva
IAHCA yakarongwa yakapfuura neUnited States House of Representatives, asi kusvikira inogamuchirwa neSeneti, ine Affordable Care Act inoramba iri mutemo wenyika. Mutungamiri Trump akavimbisa kubvisa Obamacare, asi AHCA sezvakanyorwa zvichakanganisa zvikamu zvemurairo chete. Akavimbisa kuchengetedza Medicare kusati yabvunzwa, asi AHCA ichachera mari kune Medicare. Icho chichiri mberi kwekutonga kwehutungamiri wehurumende, uye nguva bedzi ichataura kana Mutungamiri achararama maererano nezvivimbiso zvaakaitira kuvanhu vakamuvhorera pamushandirapamwe.
> Sources:
> America Health Care Care: Kukoshesa Mari. Congressional Budget Office. https://www.cbo.gov/publication/52486. Yakabudiswa March 24, 2017.
> Nzira Yakanakisisa: Nemaonero Adu Ekuti Tive nechokwadi cheAmerica - Utano Hwakanaka. Zviri nani.GOP. http://abetterway.speaker.gov/_assets/pdf/ABetterWay-HealthCare-PolicyPaper.pdf. Yakabudiswa naJune 22, 2016.
> Farmer L. Budget Shortfalls Anotarisirwa muNyika Dzose Kubvira Kudzoka. Website governing Govern.com. http://www.governing.com/topics/finance/gov-nasbo-state-spending-survey-2017.html. Yakabudiswa naDecember 13, 2016.
> Kukurukurirana kweMadhora Emishonga Emadhora muMedare Chikamu D. Komiti Yenyika Yokuchengetedza Social Security neMashire website. http://www.ncpssm.org/EntitledtoKnow/entryid/2061/negotiating-for-lower-drug-costs-in-medicare-part-d.
> Obamacare Enrollment Numbers. Obamacare Facts website. http://obamacarefacts.com/sign-ups/obamacare-enrollment-numbers/. Yakasvika musi waApril 18, 2016.