Mitemo Inotarisirwa Kugadzirisa Inishuwarenzi Makambani
Kunetseka pamusoro pokusimbiswa kwehutano hwehutano inshuwarisi yemisika (zvose uye kunze-kushandurana) yave ichimhanya kwenguva yakati. Vatsigiri vakawanda vanobva kune imwe nyika kana kuti misika yose pamagumo e 2016, uye mapeamisi ekutanga-rubatsiro akawedzera nereji ye25 muzana ye 2017 ( rubatsiro mukutengeserana rukawedzera kukura kwezvinhu zvakawanda zvekuwedzera kwekubhadhara vanhu vanobhadhara avo vanotenga kugoverana muchishandiso, kuitira kuti zvive zvakajeka, zvikwereti hazvina kuwedzera nevhareji ye 25 muzana yevanhu vakawanda vanotenga zvirongwa zvavo mukutsinhana).
Kugadzirisa kukanganisa kwemakemikari, Dhipatimendi reHutano neHuman Services yakaronga huwandu hwekuchinja huri pakati peFebruary, mazuva mashomanana mushure meHHS Munyori Tom Price yakasimbiswa neSeneti.
Chiratidzo chekugadziriswa kwehutungamiri kune zvose pamusoro pemakethe kugadziriswa pamakambani emunhu mumwechete uye maduku. Muzhinji, misika miduku yeboka yakave isina kunyatsogadzikana. Asi iyo misika yemamwe mune dzimwe nyika yakanga iri pamucheto wekudengenyeka pakupera kwe 2016, uye Humana akazivisa musi waFebruary 14 kuti vaizobuda zvachose muhutano hwehutano inshumo munyika yose pakupera kwe 2017 (ivo iye zvino vanopa mapurogiramu ega muhurumende 11 ).
Musi waApril 13, HHS yakapedzisa mitemo yavo yekusimudzira mitemo, kunyanya se-yakarongwa. Vamwe vatengesi vematanda vakarumbidza mitemo sechinhu chakanaka chekuita kuti mishonga yveshuwarenzi igadzikane, asi vamwe vakataura kuti mamwe emitemo mitsva inozoita kuti misika ikanganise.
Zvakakosha kuziva kuti sezvo vatsigiri vese vachigadzira zviyero zvavo uye zvirongwa zvegore ra2018, vanowanzocherechedza kuti zviviri zvezvinhu zvinokosha zvakakonzera kumusika kukanganisa zvinoshandiswa kushandiswa kwebato reAACA , uye kusava nechokwadi chekuenderera mberi mari nekuda kwemari-kugovera rubatsiro .
Hapana imwe yenhau idzi inotarirwa nemitemo yekusimudzira mitengo, uye zvirongwa zveTrump Administration zvakaita kuti zvikwereti zvive nyore kuparara munzvimbo idzi dzose.
Ko Mutengo Wematengesi Akadzikisa Unobatsira Sei Utano Wenyu Hwehutano?
Vanhu vanowana hutano hwavo hwehutano kubva kune avo vashandi vakawanda (mumatunhu akawanda, izvo zvinoreva kuti 50+ vashandi ), Medicaid , kana Medicare hazvizogadziriswi nechinjuko icho HHS chapedzisa. Kuchinja kunowanzoshanda pamusika mumwe nomumwe, iyo inenge inenge 7 muzana yevanhu vemuUnited States, kunyange zvazvo vanhu vanoshandira vaduku vashandi vanogona kuona zvakakwirira zvekunze kwepahomwe, uye zvichida mari shoma shoma.
1. Kune vanhu vanotenga inshuwarhu yavo yehutano inshuwarani, kubhadharwa kwekuvhura kwe 2018 kuchave kufupika kupfuura yakange iri mumakore apfuura.
Pamberi pemutemo wekugadziriswa kwemusika, nguva yekubhabhatidzwa yakabuda muna 2018 yakagadzirirwa kutevera purogiramu imwechete yakashandiswa 206 ne 2017 (November 1 kusvika January 31). Asi nekuda kwegore ra2019, chirongwa chacho chaiva kutanga kutanga kushandisa nguva shomanana yekunyora, kubva munaNovember 1 uye kupedzisa musi waDecember 15. HHS yakasarudza kushandura kune nguva shomanana yokunyora yakatanga gore rimwe chete, uye kutanga kushandisa iyo pakupera kwe 2017 (nokuda kwehupfumi hunobudirira muna 2018), panzvimbo yekumirira kusvika pakupera kwe 2018.
Saka vanhu vanotenga inshuwarisi yavo yehutano (kureva kuti, havasi kuwana kubva kumushandi kana kubva purogiramu yehurumende seMedareria kana Medicaid) vachave nehwindo shoma kuti vasarudze hurongwa hwe 2018. Huchazotanga musi waNovember 1, 2017, uye kupera kwaDecember 15, 2017.
Izvi zvinoreva kuti hapana chirongwa chinoshandiswa mushure mekutanga kwegore, saka hapachazove mukana wekushandura zvirongwa munaJanuary kana kupiwa kwekutanga kwako kuchibata iwe uchidzivirira. Zvichave zvakakosha kubhadhara zvakanyanya purogiramu ipi neipi uye shanduko kuchinja zviziviso zvaunogamuchira munaOctober / November kubva kune yako inshuwarisi yekambani kana kushandurana, uye ita chirongwa chinoshanduka tisati musi we15 December.
Mushure mezvo, ronga kugadzirisa uye kunyora zvitsva kuchagoneka kana iwe uine chiitiko chakakodzera .
Izvi hazvizoshanduri chero chinhu pamusoro pewindo rekunyoresa rakasununguka kwevashandi-vanochengetedzwa hutano hwehutano kana Medicare.
2. Vanhu vanyoresa muzvirongwa zvekuchinjana kunze kwekunyorwa kwakasununguka vachafanirwa kupa uchapupu hwechiitiko chakakodzera, uye kukodzera kwemazuva ekunyora kwakapedzisira kunongororwa mune dzimwe nguva.
IAACA nemitemo inotevera inobvumira vanhu vane zviitiko zvakasiyana-siyana zvinokodzera kuti vanyorwe mukugoverana kuburikidza nekushandura (uye mune dzimwe nguva, kunze kwemakakatanwawowo ), pasinei nenguva yegore.
Izvi zvinonzwisisika, uye ndiyo nzira iyo mushandirwi-inotsigirwa inshuwarisi inoshandawo. Kana munhu akasiya basa rake uye akarasikirwa nehuwandu hwevashandirwi-anorayirwa hutano hwehutano inshumo munaJune, haagoni kutarisirwa kumirira kusvikira munaJanuary kuti ave nehuwandu hutsva. Uye kana mwana akaberekwa munaEpril, zvingasava zvine musoro kumanikidzira mhuri kuti imirire kusvikira vanyora kuzarura kuti vawane rubatsiro rwemwana.
Saka chiitiko chinofananidzira chinokonzera nguva yakanyoresa nguva (SEP), panguva iyo uyo anenge akakumbira ane mazuva makumi matanhatu okunyora chirongwa chitsva. Asi pakave nekukakavara kukuru kwakapoteredza SEPs. Pane zvinonetsa kuti vanhu vangave "kutamba" sangano kuburikidza vachizvifananidza kuva nechiitiko chinodiwa kana vachizviwana vachida kurapwa, uye vatsigiri vakaona kuti zviyero zvinodhura zvinodhura zvakanyanya kune vanhu vanyoresa panguva dzeZEP kusiyana nevanhu nyora panguva yekunyora kusununguka.
Asi kune rumwe rutivi rwemari, vatsigiri vevatengi vakataura kuti vashoma chaizvo SEP-vakakodzera vanhu vanozvinyora mubhuku, uye zvinoda uchapupu hwechiitiko chinokwanisa kukanganisa vanyori vane hutano kubva pakuzadzisa dambudziko. Izvi zvakaratidzwa kune imwe nguva muhupenyu hwehutachiona hweEPP hunogadziriswa kuti HealthCare.gov yakagadziriswa muna 2016.
Pakati pevakakumbira vane makore 55-64, 73 muzana vakapa uchapupu hwechiitiko chakakodzera. Asi pakati pevakakumbira vane makore 18-24, 55% chete ndivo vakapa uchapupu hwechiitiko chinodiwa. Izvi zvinoguma mune dziva re insureds rine yepamusoro yevhareji yemakore, iyo inobatanidza nekuwedzera kwehutano hwekutarisira mari.
I Obama Administration HHS yakanga yakaronga purogiramu yekufambisa ndege, kutanga muzhizha ra20177, umo 50 muzana ye HealthCare.gov vashanduri (vari kusarudzwa kusarudzwa) vaifanira kupa uchapupu hwechiitiko chakakodzera kusati kwava kugadziriswa.
Asi mutemo mutsva weHHS unoshandura iyo ku 100 muzana. Kubva munaJune 2017, vose HealthCare.gov vanyoresa avo vanyoresa kunze kwekunyora kwakasununguka vachafanirwa kupa uchapupu hwechiitiko chinodiwa vasati vashandisirwe.
Mukuwedzera, mitemo mitsva inoderedza kusvikirwa kweZEP mune mamwe mamiriro ezvinhu:
- Muchato uchaongororwa sechiitiko chekufanirwa kana mumwe mudiwa anenge atova nehuwandu hunokosha hwekugovera (kana kugara kunze kweU.S. kana mundima yeUnited States vasati varoorana).
- Kana munhu atove akanyoresa chirongwa ane mwana kana kuti akabata mwana, mubereki anorega kuwedzera mwana kumurongwa uripo, kana kunyora mwana ari oga pane imwe hurongwa huripo (kana, nokuda kwechimwe chikonzero, mwana haakwanisi kuva akawedzerwa kurongwa, mubereki anogona kunyoresa mune imwe chirongwa panguva imwechete yesimbi , pamwe chete nomwana). Munhu asina kuvimbiswa uye ane mwana kana kuti anogamuchira mwana achiri kukodzera kunyoresa, pamwechete nemwana, pane chero chirongwa chiripo. Asi munhu anenge atova nehupfumi haabvumirwi kushandisa kuwedzerwa kune anovimba semukana wekushandura zviripo zvake zviripo kune chirongwa chitsva.
- Vanhu vanorasikirwa nekutaridzirwa kwekusabhadhara mari yepamusoro pane imwe nguva panguva yegore vachafanirwa kubhadhara mari yavo yepayimari yekare-kare vasati vadzokorora zvakare-panguva ye SEP kana kuwanyoreswa nguva dzose dzekunyora-muurongwa kubva kune imwe inshuwarisi (kana kuti imwe inshuwarisi pasi pekambani imwechete yemubereki). Vachange vaine mubayiro wekare-wekubhadharwa pamusana pemwedzi mitatu yekugoverwa, sezvo vasati vari pachikwereti chepuraimisi kana chirongwa chigumiswa nokuda kwekusabhadhara kwepayamu. Kana vanhu vari mumamiriro ezvinhu aya vakanyoresa, iyo inshuwarheni inobvumirwa kushandisa mari yavo yepamusoro yebhadharo kune yekare-yekuenzanisa.
3. Kutanga muna 2018, kuchava nehuwandu hwakawanda maererano nehuwandu hwemari iyo zvirongwa zvehutano zvinofanira kuvhara. Izvi zvingaguma nemapurayamisi mashoma, asi yakakwirira deductibles uye copays. Izvo zvinogonawo kureva rubatsiro rwemari shoma shoma mukutengeserana.
Pasi peAACA, hurongwa hupi hwehutano hwemunhu mumwechete uye hudiki hutano hunofanirwa kunge hunofananidzwa mune imwe yezviyero zvina zvematare: ndarira, sirivha, ndarama, kana platinum (zvirongwa zvinotyisa zvinowanikwa kune vamwe vanyoresa). Chirongwa chesimbi chakagadziriswa nehuwandu hwezvinodial (AV), iyo inenge yehuwandu hwehuwandu hwehutano hwehutano huri kurongwa kwehutano huchabhadhara, huchienzaniswa nehuwandu hwehuwandu hwevanhu. Zvigadziri zvemhangura zvine AV ye60 muzana, zvirongwa zvesirivha zvine AV ye70 muzana, zvirongwa zvegoridhe zvine AV ye80 muzana, uye zvirongwa zveplatinum zvine AV ye 90 muzana.
Asi zvaizova zvakaoma kumakambani emishuwarenzi ehutano kuti agadzire zvirongwa zvakakunda iyo nhamba chaiyo (pre-ACA, pakanga pasina kumira kweAV yaidiwa, saka vatsigiri havafaniri kushungurudzika nekurova imwe AV yavari kuda). Saka zvirongwa zvehutano zvakabvumirwa kushandiswa neAV mararamiro panzvimbo pane chaiyo yehuwandu. Pari zvino, rutivi rwuri +/- 2. Saka chirongwa chesirivha chinogona kuva neAV iyo yakaenzana kubva 68 kusvika 72 muzana (zvirongwa zvendarira zvine yavo minimus range, ikozvino yakagadzirirwa pa2 / + 5).
Pasi pemitemo itsva yeHHS, kutanga muna 2018, iyo yakabvumidzwa huri -4 / + 2, zvinoreva kuti chirongwa chesirivha chinogona kuva neAV chero ipi zvayo mumatanda 66 kusvika ku72 muzana (zvirongwa zvendarira, yakabvumidzwa huri -4 / +5).
Saka nokuda kwezvirongwa zvavari kukura kuitira 2018 kufambisa, makambani einishuwarenzi anobvumirwa kukura kunze kwe-podhedha mari ( dzinodhakwa , copays , coinsurance ), nokuti hazvizofaniri kuvhara zvakakwana chikamu chemazana evhareji mari. Izvozvo zvinoreva kuti premiums inogona kuderera zvishomanana, asi mari iyo vanhu vanofanira kuripa kana vachida kutarisirwa kwehutano ichandowedzera (chinyorwa chokuti premium decline inopindirana nezvingadai dzisiripo shanduko iyi; miriyamu yakawanda ichiri kuwedzera muna 2018, zvichida chaizvo zvakanyanyisa nekuda kweimwe misika yemasikirwo iyo iriko, kusanganisira kusasha kwekujekesa maererano nezvokuti mari yekugoverana mari inoramba ichingobhadharwa).
Izvi zvinorevawo kuti rubatsiro rwemari yepamusoro runogona kuva duku zvishoma kudarika kwaizove kusina shanduko iyi, sezvo ichitarirwa pamutengo weiyo yechipiri-yakaderera-yegoridhe chirongwa (chirongwa chekufananidzira) munzvimbo imwe neimwe. Kana chirongwa chechipiri-chechikwereti-chendarama chine imwe yeAV ye 66 muzana, ichave yakaderera zvakaderera pane mamwe mapiritsi esirivha neAV ye68 muzana kana kupfuura. Uye chirongwa chepabhenekeri chepasi-pasi chinoshandura kune rubatsiro ruduku.
4. Inishuwarenzi inobvumirwa kushandisa mihoro miviri yekare kune yakawanda-yakaenzana nemari.
Pasi pemitemo yapfuura, kana chirongwa chakanga chisisipo nokuda kwekusabhadhara mari yepurayamisi, munhu wacho aigona kunyorazve muurongwa iwoyo panguva yekunyora kusununguka, kana panguva yekunyora yakadzama, pasina chakaipa. Kubhadhara kwepa Premium kwaizotanga kupfuura kwezuva idzva rinobudirira, uye kambani ye inshuwarisi haina kubvumirwa kuti munhu wacho abhadhara mapeimamu avo ainge apfuura kubva kune chirongwa chekare.
Iyi mitemo mitsva inopa makambani einishuwarenzi mamwe mazano ekuunganidza mari-yepamutemo yepayimusi kana munhu akasarudza zvakare kunyoresa muurongwa kubva kune inshuwarisi imwechete iyo inogumisa kutanga kwekubhadhara kwekusabhadhara mari yepurayamisi (kana inshuwarheni iyo chikamu cheboka rimwe chete rinodzorwa, kana kambani yemubereki). Zvikwereti zvakabhadharwa zveurongwa hutsva zvinogona kushandiswa pamakambani ezvipfuura-zvichibva pamwedzi 12 yapfuura, uye vatsigiri vanobvumirwa kuramba kushanda mutemo mutsva kusvikira apfuura-kubva pamabhazimisi kubva mugore rakapera vakabhadharwa.
Zvikwereti zvemunhu zvakapfuura-kare zvinongowanzova kwemwedzi mumwe chete kana mitatu yekugoverwa, kubvira kare-kubva pamabhadhayamu haafaniri kuramba achiwedzera mushure mekunge chirongwa chave chaguma nokuda kwekusabhadhara kwepurayamisi.
Vanhu vanogona kutenderera shanduko iyi nekunyora muurongwa kubva kune imwe inshuwarisi, asi mune dzimwe nyika, kune mumwe chete weupuri wenhepfenyuro anopa zvirongwa mukutsinhana. Mune dzimwe nyika, ani naani ane chinyorwa chinobviswa pamusana pekusabhadhara mari yepurayamisi anogona kunge achizvipira kubhadhara-premium asati abvumirwa kunyoresa muurongwa hutsva.
> Sources:
> ACAsignups.net. Avhareji Asingasimbiswi Individual Market Rate Hikes, 2017. Yakagadzirirwa Gumiguru 27, 2016.
> Dhipatimendi Rezvoutano uye Human Services, Mutevedzeri Kudzivirirwa uye Anogadziriswa Care Care Act; Market Stabilization . February 15, 2017.
> Dhipatimendi Rezvoutano uye Human Services, Mutevedzeri Kudzivirirwa uye Anogadziriswa Care Care Act; Misika yakasimbiswa, yekupedzisira. April 13, 2017.
> Humana. Humana > Inoenderera Kuvaka Pamusoro Pechirongwa Chekutevera Kugumisa Kwekubatana neAetna; Inopa 2017 Financial Guidance; Inoparidza Kuburitsa Kwekutsvaga Mazano. February 14, 2017.
> Kaiser Family Foundation. Utano Inishuwarenzi Inoshandiswa yeVanhu Vose, 2015.