Zvichinyorerwa mutemo neMutungamiri weBarack Obama muna 2010, Murwere Wezvokuchengetedza uye Affordable Care Act ndiye anokonzera kuchinja kwakanyanya kwehutano hweUnited States kubvira muna 1965 ndima ye Medicare neMedicaid .
Background
Vachikwikwidzana vachipikisana nemapoka emapato, veRepublicans vanopesana neAne Affordable Care Act, vachinyanya kushandisa izwi rokuti Obamacare kurondedzera Mutemo.
Pakazosvika gore ra2012, Mutungamiri Obama akabvuma zita rokuti Obamacare, uye ikozvino rave rinoshandiswa zvikuru nevatsigiri nevashori vemutemo. Asi kupopotedzana pamusoro peAACA kwakapfuurira mushure mekufamba kwaro, uye nedare rakawanda rinopesana nemutemo; iyo mitemo inoramba ichikakavadzana pasi peTrute Administration.
Chii Chichigadzirisa?
Zvimwe zvekugadziriswa kunoitwa neAne Affordable Care Act zvinosanganisira kuisa Health Insurance Exchanges , kana misika, apo vanhu, mhuri, uye mabhizimisi maduku vanogona kutenga nyaya yakagadziriswa inyanzvi yehutano yehutano yehutano ine zvikwereti zvisingakwanisi. Zvirongwa izvi zvinogutsa hurumende yeAACA inoda kuti avo vasina utano hwehutano hutengi vatenge inshuwarisi yehutano.
IAACA inopa vanotengesa pasi uye vari pakati nepakati pekubhadhara kuti vawane inshuwarano yehutano isingakwanisi (avo vanogona kubhadhara havagoni kuwana mari inopfuura 400 muzana yehurombo, kana $ 98,400 pamhuri yevana), uye rubatsiro rwekuderedza kunze kwehomwe mari inokodzera kubhadhara (inowanikwa haigone kudarika 250 muzana yehurombo kana kuti $ 61,500 yemhuri yevana muna 2018).
Panguva imwecheteyo, mutemo unoisa mutero wemitero kune avo vanoramba vasina uninsured; iyo chirango yakatanga muna 2014, uye zvishoma nezvishoma yakasimudzirwa kusvika pakukwirira kwayo kusvika muna 2016. Ichagadziriswa nokuda kwekuwedzera kwezvinhu zvishoma nezvishoma zvichienda mberi, asi muna 2017 ne2018, kugadziriswa kwezvakaderera kuri $ 0, saka chirango chakaramba chisina kuchinjwa kubva muna 2016 (mutemo wakapfuura Senate munaDisemba 2017 iyo inogona kubvisa chirango chemunhu mumwe nomumwe, asi kusiyana kweNyoro yeChirungu inofanira kuyananiswa, saka kwenguva iyo iri, hapana chakachinja pamusoro pechirevo chechirevo).
IAACA inodzivirira vatsigiri vehurumende kuti varambe kuvhara vanhu vane mamiriro ezvinhu akambovapo , kana kuti kubva kuvaraira miriyamisi yakakwirira nekuda kwehutano hwakagara huripo. Izvi ndezvechokwadi pavari uye kunze kwekugoverana uye zvinomiririra shanduko inokosha kubva kune imwe iyo misika yakashanda pamberi pegore ra2014 munenge mamiriro ose enyika.
IAACA yakabvisa mari yegore negore uye yehupenyu hwekwangani kambani yemishuwarenzi ichabhadhara yehutano hwehutano hunovharidzirwa, uye inogumira ma-max-pocket maximums .
IAACA inoda zvirongwa zvehushuwarano hwehutano mumakambani ega uye madiki emakambani ekufukidza hutano hunobatsira hwehutano . Chimwe chezvinhu zvinokosha zvehutano zvinobatsira ndezvokuchengetedza kwekuchengetedza, uye zvakasiyana-siyana zvekuchengetedza kwekuchengetedza zvinotarisirwa kuvharwa pasina kugoverwa mari .
IAACA inoda vashandirwi vakawanda-avo vane makumi mashanu kana makumi maviri evashandi venguva yakazara yakaenzana-kupa zvikwereti, huwandu hunokosha inshuwarhu yehutano kune nguva yose yakazara (30+ maawa nevhiki) vashandi, kana kuti pangozi chirango pasi pevanoshandira chikamu chekuita basa . Vashandi vanofanira kuve nechokwadi chokuti kugoverwa kunoonekwa sekukwanisika kune mushandi, asi hapana kukwanisa kugadziriswa kwemari yekuvhara nhengo dzemhuri pasi peurongwa. Nemhaka yekuti izvi zvinoshanda sei uye kuti kuwanikwa kwekubhadhara kunotsanangurwa sei pakugoverana, vamwe vanhu havakwanisi kuwana kuwanika kwepamusoro nekuda kwezvinonzi " mhuri inobwinya ."
[Zvizhinji zvezviri pamusoro apa hazvishandisi kune vazukuru uye vazukuru vakawanda.]
Zvimwe Zvikamu zveZvinhu Zvisingakwanisi Kutarisira Mutemo Zvave Zvaderedzwa kana Zvabviswa
Zvimwe zvikamu zveAAC hazvizomboshandisirwi: Supreme Court yakaramba urongwa huchazobvisa Medicaid mari yehurumende kuti inotaura kuti haina kupa Medicaid kune vamwe vanhu. Izvi zvakaguma nekuputika kwepakati , umo vanhu vanosvika mamiriyoni 2,4 vari mumakore gumi nematanhatu vachitaura kuti havakwanisi kuwana zvakakwana kugoverwa.
Uyezve, Congress yakaderedza kushandiswa kwenguva refu kweAACA, inozivikanwa seCORASS Act , munaJanuary 2013 mushure mokunge Dhipatimendi reHurumende neHuman Services yakaratidza kuti yakanga isingaiti.
Zvikamu zvakawanda zveAACA zvakanonoka, kusanganisira mubashandi akagovera basa rekuita (rakaitwa muna 2015, pane 2014, uye rakanga risina kukwana zvakakwana muna 2016), Cadillac Tax (ikozvino yakagadzirirwa kushanda muna 2020), uye kubviswa kwezvirongwa zvisingabatsiri, kwete-ACA-yakagadziriswa pamberi pegore ra2014 (zvirongwa izvi ndezvekushandura, kana kuti "vazukuru," uye vanobvumirwa kuramba vachishanda kusvikira pakupera kwa2018, pamusana pezvakaitika uye vatsigiri vehutano).
> Sources:
> Dhipatimendi reZvipatano neHuman Services, Kubatanidzwa kwevarwere kuchengetedzwa uye kutengeswa kwekutarisira mutemo .
> Kaiser Family Foundation, Mutungamiri weDare Repamusorosoro rekutonga paAACA's Medicaid Expansion , August 2012.
> Kaiser Family Foundation. The Coverage Gap: Uninsured Varombo Vakuru muDzimwe Dzisina Kuwedzera Kurapa. November 1, 2017.
> Lemieux, Jeff; uye Moutray, Chad, Neyo Cadillac Imitero, Health Affairs, Kubvumbi 25, 2016.