Kana iwe uchitenga inshuwarano yehutano mumusika mumwe nomumwe, iwe wakangodaro wakaona zvinyorwa zvemusoro pamusoro pehuwandu hwekuwedzera huchauya muna 2018. Mushamba muduku wemapoka, unotungamirirwa pasi peMitemo inotengeswa yeChechi inotengeswa (ACA) semumwe mutengo , ichaonawo mutengo unowedzera, kunyange huwandu hwekuwedzera husingave hunokosha.
Asi zvinyorwa zvinowanzotarisa pamwero wekuwedzera huwandu, zvichiyambuka nyika yose, kana kune imwe inshuwarisi yose yevanhu ve insureds.
Kune vanhu vane ruzivo mune rimwe boka duku kana kuti mumwe munhu mashizha yemishuwarenzi, iyo chaiyo kuwedzera kwechirongwa chimwe nechimwe uye nhengo yacho inogona kusiyanisa zvikuru kubva kune yevheji yehurumende kana inshuwarisi.
Ndiyo nguva dzose, asi pane shanduko itsva muna 2018 maererano nemari iyo inotarirwa vana-zvikurukuru vachiri kuyaruka-uye inogona kuita kuti zvikwanise kuwedzera kuwedzera kwemamwe mhuri. Saka ngatitarise zviri kuitika nevana vana, uye chii chaunogona kutarisira kune gore idzva.
Vana Vachave Vary Varying Rates
IAACA yakagadza mitemo mitsva pamishandirapamu emakambani emishuwarisi ehutano hwehutano hwemunhu mumwe nemumwe (zvirongwa zvevanhu pachavo ndezvomunhu izvo vanhu vanozvitengera ivo pachavo; zvirongwa zviduku zvishoma zvinowanzopiwa nevanoshandira vane vanosvika makumi mashanu, asi kune zvishomanana kune mapoka evanhu vanosvika zana vanoonekwa seboka duku ).
Pasi pemutemo, mari yepamusoro yevakuru vakwegura haikwanisi kuva kanopfuura katatu mutengo wevane makore 21.
Vana vanogoverwa muzinga wakaderera, izvo zvave ikozvino zvakagadzirirwa pa 63.5 muzana yehuwandu hwemakore gumi nemashanu. Izvi zvakashanda kune vose vana, kubva pachecheche kusvika kune makore makumi maviri, kubva muna 2014.
Kusati gore ra2014 (kureva,, mitemo yeAACA isati yashandiswa), zvikomborero zvaiwanzogadzirirwa kumapoka evanhu vakasiyana-siyana zvichienderana nezvirevo zvinotarisirwa zveboka rimwe nerimwe.
Vana vanowanzova nepamusoro pezvavanenge vachiri vaduku nevana vaduku, zviduku zvakaderera pavanenge vari mumakore ekutanga uye ari pakati pekuchikoro, uye zvino vanoti vanowanzokwira sevana vachipinda mumakore avo ekuyaruka. Kusati gore ra2014, vatsigiri vanogona kuisa izvi mumutengo wavo-kutarisa-vamwe vaiva nezvikwereti zvakakwirira zvakanyanya zvevana vanozvarwa, somuenzaniso.
Asi pasi peAACA inotonga kubva muna 2014 kusvika muna 2017, vana vese kusvika pazera remakore makumi maviri nemakumi maviri vakapomerwa 63.5 muzana yepamuyo iyo yakashandiswa kune ane makore 21. Icho chiri kuchinja muna 2018, nekuda kwemitemo mitsva yakagadziriswa neHHS munaDisemba 2016 (chaiyo yevhesi yemitemo inotsanangurwa mu Appendikisi 1 yeHHS memo ):
- Muyero wevane makore makumi maviri nemaviri uchange uchienderera mberi kuva chiyero chepamusoro apo mamwe maitirwo akaiswa.
- Vana kubva pamakore makumi maviri kusvika ku14 vachatorwa 76.5 muzana yehuwandu hwezinga.
- Vana vane makore gumi nemashanu vachakwaniswa kutengesa 83,3 muzana yehuwandu hwezinga.
- Vana vane makore gumi nematanhatu vachapomerwa 85,9 muzana yehuwandu hwezinga.
- Vana vane makore gumi nemashanu vachatongerwa 88.5 muzana yehuwandu hwezinga.
- Vana vane makore gumi nemasere vachapiwa mhosva 91,3 muzana yevhesi yepamusoro.
- Vana vane makore 19 vachapomerwa 94.1 muzana yehutachire hwezinga.
- Vana vane makore makumi maviri nemashanu vachabhadharwa makumi mapfumbamwe nezana nezana (97%
- Vakuru vacharamba vachiripira mitero yakatarwa nezera ravo, ine chikwata chapamusoro (kune vanhu vane makore 64 nekure) katatu chikwata chekutanga.
HHS yakataura kuti kunyange zvazvo kudaidza mari inowanzove yakakwirira kune vana vasati vava nemakore 4 uye pasi kune vana vane makore 4 kusvika ku14, imwe chete yebhande yevana kubva pakuberekwa kusvikira kune makore gumi nemashanu yakagadzirirwa kuparadzira mari yevanhu vakawanda, uye kuwedzera kwekuwedzera kwekuwedzera kunogona kushandiswa kumhuri ine mwana achangoberekwa kana mitero yakagadzirirwa zvakakwana pamatongerwo anotarisirwa eboka rimwe nerimwe.
Kuchinja uku mune nzira inoshandiswa kuverenga mitengo haisanganisi huwandu hwehuwandu hunowedzera gore rimwe nerimwe nekuda kwemari inowedzera yezvechiremba uye zvimwe zvinokonzera kuwedzera kwehuwandu hunowedzera.
Izvozvo zvichange zvichiwedzera chiyero chepasi, saka chiyero chitsva chemitemo chevana chichave chichishandisa zvikamu zvakakura zvehuwandu hwehuwandu hwehuwandu hwepamusoro, zvichiwedzera kuwedzera kukurumidza kwechikwereti icho chichashanda kuvhura kwevana.
Nharaunda yeColumbia uye zvinomwe zvinomwe-Alabama, Massachusetts, Minnesota, Mississippi, New Jersey, Oregon, neUtah- vanoshandisa purogiramu yavo-yekugadzirisa nzira, saka nhamba itsva yezvikomborero zvevana hazvishandisi mune dzimwe nyika. Mukuwedzera, New York neVermont havabvumiri nguva yepamusoro-soro, saka hapana kuchinjwa kwepayamu inobva muzera mune izvozvi zvese.
Makuru Makuru Akashandisa Kusiyana Kwakaitwa Maitiro
Cherechedza kuti mapurogiramu makuru emapoka evanhu anowanzoenderana nemitengo yezvikamu, uye zvingasiyana zvakasiyana zvichienderana nokuti mushandi ari kunyoresa sewe-oga, mushandi pamwe chete nemudzimai, mushandi pamwe nevana, kana mushandi pamwe chete nomudzimai nevana. Nguva yevana-uye kunyange nhamba yevana-haisi kuchinja mahora ekubhadhara. Mitemo mitsva inorondedzerwa pamusoro apa yekuisa mitero yevana yakananga kumusika wega uye weboka mashoma.
Kuongorora Kuchinja Hakuchazove Wakakosha Kana Vanhu Vachitsvaga 21
Matanho evana achave akakwirira muna 2018 kupfuura zvave akamboita, nekuwedzera kuwedzerwa kunoshandiswa kune vechidiki vakwegura. Asi apo vana ivavo vanozopedzisira vava nemakore makumi maviri nemaviri, havazovi nehuwandu hwehuwandu hwekuwedzera hunoshandiswa kushandisa. Kusati gore ra2018, munhu anenge achidzoka 21 aizobva pakubhadhara 63.5 muzana yehutanda hwebhadharo yekubhadhara chiyero chepasi, zvose mujodzi rimwe; iyo inosvika ikozvino inoshandiswa kunze kwemakore 15 kusvika ku21.
Mitengo Ichava Yechechi Chechidiki kune Vakuru kune Vaizove Vakaita
Zvakakoshawo kuchengetedza mupfungwa kuti mazera ekuenzanisa kwemazera anoshandiswa senzira yekuparadzira mari yose inodhura kunze kwehuwandu hwevanhu ve insureds. Pamusoro pezvikamu zvepuraimari zvinodiwa kuvhara mari yekuchengetedza nhengo yehutano yehuro, huwandu hwehuwandu hwacho huchashanda zvishoma kune vana, izvo zvinoreva kuti ichashanda zvishomanana kuvaduku. Mari yose inofanirwa kuunganidzwa haisati yasvibiswa nehuwandu hwehuwandu hwemagetsi.
Zvechokwadi, izvi zvinoshanda kune imwe nhengo yeurongwa; zvinoitika kumhuri imwe neimwe zvichasiyana, uye imba yakazara nevechiri kuyaruka ichasangana nezvikwereti zvepamusoro zvekubhadhara mari muna 2018 kupfuura zvaizotarisana pasina vana vemazera emakore, kunyange mushure mokunge vaongororwa pamakambani emhuri yevabereki. Asi zvakakosha, zvitsva zvemazera emakore zvevana hazvishandisi mari yakawanda iyo vatsigiri vanozounganidza kubva kumapoka avo ose akabatanidzwa (vachichengeta mupfungwa kuti mari yose inoda kuunganidzwa ichakwirira muna 2018 kupfuura yakange iri 2017, pamusana pezvinhu zvinowanzoita kuti motokari iwedzere kuchinja).
Premium Subsidies Ichagadzirisa Kuenderera mberi Nezvikwereti Zvitsva
Kune vanhu vanozvitenga pamusana pekugoverana kwemakethe mune shanduko ( uye chete muchitsinhanisi ) mumamiriro ose ehurumende, rubatsiro rwemari yepamusoro (premium tax credits) dzakagadzirirwa kuchengetedza mutengo wekugovera kune imwe yepamusoro. Nhamba yebhasiro inoratidzirwa nekunyorera mari yechipiri-yakaderera-inodhura chirongwa chesirivha pane imwechete yezana yemari yeimba, nezvikamu zvishoma zvakanyanyisa kune vanyori vanobhadhara mari, uye yakakwirira kune vanyori vanobhadhara mari.
Sezvo kurasikirwa kwekugoverwa kwemhuri inopiwa kunowedzera, ndizvo zvakaitawo mari yekubatsira kwavo. Zvinosuruvarisa, rubatsiro hahuwanikidzi kune dzimba dzinowana zvakapetwa kanomwe paurombo hwehutano, saka mhuri yevashanu ingave isina kukodzera kubhadharwa mari yepa premium kana mari yavo inodarika $ 115,120 muna 2018. Asi kune dzimba dzine mari inopedzisira isingapfuuri nhatu paurombo hwehupfumi, mari inobhadhara inokura ichienderana nezvose zvakakosha zvekugoverwa, uye rubatsiro runonyanya kudiwa mari yega yega yega yekugoverwa (chinyorwa chokuti rubatsiro hahuwaniki kana uri muMedicaid pangovha yekuvhara kana kana mhuri inobwinya inoshanda kumamiriro ako ezvinhu) .
Zvakakoshawo kunzwisisa kuti maAACA makambani anotarisira vana vari pasi pemakore makumi maviri nemaviri pahuwandu hwevatatu pamhuri, mumashamba maviri neboka rimwechete. Saka mhuri ine vana vatanhatu pasi pemakumi maviri nemashanu inongofanira kubhadhara mari yepamusoro yevatatu vavo (cherechedza kuti kunyange zvazvo vabereki vachigona kuchengeta vana vavo pane chirongwa chavo kusvikira vana vashandura 26, miriyamisi inokwidzwa kune vose vana vane makore 21 nekure, zvisinei vamwe vakawanda vanovimba navo vari kurongwa).
Izvo zvinotora pano ndezvokuti kana zvikwereti zvichanyanya kuwedzera kupfuura zvamazuva ose kumhuri dzine vechidiki, rubatsiro rwemari yekutanga huchakura zvakare kune avo mhuri kana vakakodzera kubhadhara mari. Kune dzimba dzakabhadharwa-dzinokodzera, rubatsiro runoita huchachengeta hutengo hwekutsva hwechipiri-yakaderera-mari yegoridhe hurongwa pane zvingave zvakakwana. Kana mari yemhuri ichiramba isingashanduki kubva muna 2017, mari yekodzero yechipiri-yakaderera-iyo mari yeurongwa hurongwa ichave yakaderera muna 2018 kupfuura yakange iri muna 2017, pasinei nehuwandu hwehuwandu hwekuwedzera kwe 2018 uye nezera rezera rezera revana.
> Sources:
> Centers for Medicare neMedicaid Services. Nzvimbo yeVatengi Ruzivo uye Inishuwarenzi Kutarisa. Market Market Mavandudziro, akavandudzwa June 2, 2017.
> Dhipatimendi Rezvoutano uye Human Services. Inishuwarenzi Mitemo Bulletin Series-Information . December 16, 2016.
> Dhipatimendi Rezvoutano uye Human Services. Murwere Anodzivirirwa uye Anogadziriswa Care Care Act; HHS Chinyorwa cheBatsiro neZokubhadhara Zvikamu zve 2018; Kugadziriswa Kunyoresa Kwemazuva Akazotevera uye Mutengi Akashandiswa uye Akarongeka Zvirongwa Purogiramu . December 16, 2016.
> Jost T. Health Affairs Blog. CMS Inogadzirisa Nhamba yeMushamba Pasi Paya Mutemo Rule, Achibudirira January 17, 2017. December 17, 2016.