Hapana mubvunzo kuti hurumende yaDonald Trump-pamwe chete nehuwandu hweRwandaan huri muCongress-huchava nehuwandu hweHurumende inobatsira (Obamacare) uye nzira iyo inshuwarano yehutano inoshanda muUnited States.
Asi mushure mekunge vaudza vimbiso yekubvisa Obamacare "pazuva rimwe," Trump yakatsigira iyo nzvimbo mumazuva anotevera sarudzo, ichicherechedza kuti kune dzimwe nhengo dzemurairo yaaida kuichengeta, kusanganisira kugoverwa kwekusimbiswa-nyaya pasinei nezvakaitika kare, uye urongwa hunobvumira vechidiki kuti varambe vari purogiramu yehutano hwevabereki kusvikira makore 26.
Zvechokwadi, zvikamu zvemurairo zvinowanikwa mukurumbira uye zvine simba rekutsigira bipartisan, sekuita mitemo inobvumira vatsigiri vehutano kuti varege kuisa gore negore kana hupenyu hwehupenyu hwose pahuwandu hwekugovera .
Asi kune zvimwe zvikamu zveAACA izvo zvisinganyanyozivikanwa, kusanganisira zvinodiwa kuti vose veAmerica-kunze kwekukodzero yekuregererwa-vane hutano hwehutano hwehutano kana kuti vanotarisana nemutero wekuteresa .
Izvi zvishoma-zvakakurumbira zvirongwa ndezvokutsvaga "kubvisa uye kuchinja" maitiro ayo Congressional Republicans akatanga pazuva rimwe re 2017 sangano remutemo. Pamberi peMutungamiri Trump vakashanda, Congress yakanga yatodarika kusarudzwa kwebhajhini inotungamirira mitemo yemitemo kuti ishandure mutemo kubvisa zvikamu zvine chokuita nemari zveAACA kuburikidza nekuyananisa. Uye musi wekutanga waTrump muhofisi, akasaina sarudzo yepamusoro inotungamirira masangano ehurumende kuti ave munyoro pakushanda kwavo kweAACA mitero uye zvikwereti.
Dare rekugadzirisa nekugadzirisa ACA rinogona kukwevera kune zvizhinji zve 2017, asi kana uye kana richipfuura, kubvumirana kwakanyanya ndechokuti kushandiswa kwekuchinja kupi zvako kunonoka kusvika kusvika 2018, uye zvichida 2019.
Repeal
Kana Congress inotora musangano wekuyananisa (unongoda huwandu hushoma uye hune filibuster-uchapupu), vanogona kubvisa kushandiswa kwemari-yakabatana muAACA.
Izvozvo zvinosanganisira zvinhu zvakadai semari inobhadharwa mari yepamusoro , kugovana-kugovana-mari , uye kuwedzera kweMedicaid , pamwe chete nemitengo inosanganiswa nemushandi wevashandi uye chinangwa chega .
Asi bhiri rekuyananisa haringakwanisi kubvisa zvimwe zveAACA izvo zvisingafananisi nekushandisa-zvinhu zvakadai sokugoverwa kwekuti kugoverwa kwose kunogadziriswa-nharo pasinei nenyaya yezvokurapa, uye zvinoda kuti mapoka evanhu ega ega uye maduku avhare hutano hunokosha hunobatsira .
Kugadzirisa izvo zvinoda kuitwa zvinogona kuitwa nemutemo nguva dzose, uye veRepublicans vakapa mazano akawanda pamusoro pemakore mashomanana apfuura, kusanganisira blueprints for maonero avo ezvehutano uyewo mitemo yakawanda yemitemo, kusanganisira zvimwe zvigadziriswa zvinyorwa zvakaiswa mumavhiki ekutanga musangano we 2017 wekutonga.
Uye zvechokwadi, pane nzira dzakawanda dzekuita shanduko yehutano inshuwarano uye utano hwehutano muSouth Hapana mubvunzo kuti ACA pachayo yaive ichida kugadziriswa pamusoro pemakore mashomanana apfuura, asi yaiva yakadaro yehutende inopisa yezvematongerwo enyika iyo vateereri vemitemo haikwanisi kuwana nzira yekuvandudza kusavhiringidza kunogona kutora mavhoti akakwana kuti apfuure.
Kuchinja Kwechokwadi
Apo inouya kune nuts uye mabhoti ekutsiva Obamacare, pane zvimwe zvinetso zvinomuka kana zvakanyanya kuisa pakuramba zvinhu zvakakurumbira zvemurairo paunenge uchibvisa zviduku zvishoma zvakakurumbira.
Pasi pemutungamiri weTrump uye Republican vazhinji muCongress, zvinenge zvakavimbiswa kuti hurongwa hwedu hwehutano hwehutano hwehutano huchagara munzvimbo, panzvimbo yekutendeuka kune mubhadhari mumwe chete. Nokudaro mupfungwa, panofanira kuva nechinangwa chekuita kuti vhutsi vese vave nechirudziro chekuenderera mberi kupa kugoverwa mune imwe yehutano inshuwarisi yemusika.
Ruzhinji rwehutano inshuwarhu yega yega inoshandiswa-inobhadharwa kugoverwa, uye izvo zvicharamba zvichive zviri mamiriro ehupenyu hunotaridzika: Huwandu hwemakambani makuru akapa inshuwarheni kuvashandi vavo nguva refu ACA isati yavada kuti vaite kudaro, uye vazhinji ramba uchidaro kunyange kana dare reAACA rinoshandiswa; utano hwehutano inshuwarheni ndeimwe chikamu chemakwikwi anobatsira avo vanoshandisa kushandisa kukwezva nekuchengetedza vashandi.
Kunyange zvazvo ACA yakashandura zvimwe zvevashandi-vanobhadhara inishuwarenzi, ruzhinji rwekushandura kwayo rwakanga ruchida kune imwe yehutano inshuwarheni yemusika. Kune vanhu vanosvika mamiriyoni makumi maviri nematanhatu muUnited States vane hutano hwehutano hwehutano (zvinoreva kugoverwa kwavanozvitenga ivo pachavo, pane kuwana kubva kumushandi kana kubva kuhurumende). Kubva muna 2016, inenge hafu yeivo vaive nehuwandu hwekugoverana kwakasimbiswa pasi pe ACA. Iyo imwe hafu yakanga yatenga kugoverwa kwavo zvakananga kubva kune hutano inshuwarisi vanotakura kushandiswa-kushandiswa , kana kuti vachiri kugoverwa pasi pezvigadziro zvekurukuru kana zvikuru.
Ndiyo misika-yega yehutano inshuwarisi-iyo yakave yakanyanya kuchinja kunoenderana neAACA. Uye kune zvikamu zvina zvakakosha zvemurairo izvo zvakagadzirirwa kushanda pamwe chete kuti zvive nechokwadi chokuti humwe hutano hwehutano inshuwarheni hunowanikwa kune wese anohuda:
- Kubhadharwa kwepa Premium kubhadhara mari inotengesa vanhu avo vangave vasingakwanisi kubhadhara miriyamisi. Kubhadhara mari yepamusoro pasi peAACA inowanikwa kuti inyorerwe nemari kusvika kune 400 muzana yehurombo, iyo iri $ 97,200 yemhuri yevana muna 2017.
- Chinovimbiswa-nyaya chinyorwa , zvinoreva kushandiswa kwezvechiremba hakusi kushandiswa kuziva kana vanhu vanogona kuwana kugoverwa mumusika mumwe nomumwe, kana kuti kuisa mishonga yavo. Musati gore ra2013, nyika dzose asi mashanu dzakabvumira zvikwereti zvehutano hwehutano kuti zviite hurukuro dzakawanda dzehutano hwekurapa kuti uone kana munhu anokumbira aigona kugoverwa, uye mubayiro wei waizobhadhara. Zvikwereti zvepamusoro-kana kuramba kwekuparidzira zvachose-zvaiwanzoongororwa pane zvose kubvira pakuberekwa kusvika kune zvakaitika zvekenza yekunyanya kuderedza kuve nechirwere chepamu.
- Nguva dzekunyoresa zvishoma . IAACA yakagadzirisa nguva dzekunyora dzakapetwa gore negore (dzinoshandiswa mukutengeserana uye kunze kwekutsinhana), izvo HHS yaive yakagadzirirwa kuronga. Nguva yokutanga yokunyora yakazaruka (yegore ra2014 kugoverwa) yakagara mwedzi mitanhatu. Kubva panguva iyoyo, gore rimwe nerimwe kunyorwa kwekuvhura kwakasvikika kwave kwemwedzi mitatu yakareba, uye iyo yakarongerwa kuti ichange iine nyaya ye 2018.
Asi kutanga muna 2019 kupararira, kuzarura kuzarura kuchave kufupika , kunotangira kubva munaNovember 1 kusvika kuDecember 15 gore roga rega (HHS iri kufunga nezvekugadzirisa kupfupisa nguva yekunyora yakasununguka muna 2018, zvichiita kuti kushandura kuve nguva shomanana yokunyora gore gore rakapfuura kupfuura rakarongwa kare). IAACA inobvumirawo nguva dzekunyora dzakapiwa dzinoita kuti vanhu vakwanise kugadziriswa pamusika mumwe kunze kwekunyora kwakasununguka, kana vane chiitiko chekufananidzira chinokonzera nguva yekunyora inokosha .
Mienzaniso iri kuwanana, kuva nemwana, kana kurasikirwa nehupenyu hwehutano hwehutano hwehutano. Asi pasina chiitiko chakakodzera, inshuwarano yehutano haigoni kutengwa kunze kwekunyora kusununguka, kana pane shanduko kana zvakananga kubva kunehutano inshuwarisi. Pfungwa yewindo rekunyoresa zvishoma ndechekudzivirira vanhu kubva pakudzokorora kunyoresa kusvikira vasisina hanya. - Mutemo wega wega unoda kuti munhu wose ave nehutano inshuwarisi kana kubhadhara mutero. Chireji chirango chakaongororwa kuvanhu vakanga vasina kuvimbiswa muna 2014 chaingova madhora 210 chete, asi yakawedzera kusvika ku $ 470 kune vanhu vasina kuvimbiswa muna 2015, uye ichave yakanyanya kunyanya apo 2016 chirango chinoongororwa pamitero inosvika yakaitwa muna 2017.
Chinhu chakavimbiswa-nyaya chinyorwa chakapararira mukuzivikanwa. Kubatsiridzirwa kwepa Premium kune imwe nzvimbo yekufarirwa, kunyange zvazvo dzakawanda zvekugadzirisa kushandiswa kweAACA dzinovimba nemari yakawanda yemitero isingasungiriri kune mari, asi iyo inogona kunge isingakanganwi kudiwa kwehushuwarhu hwehutano. Maitiro akadaro emitero anogona kunge asina kukwana sezvo nguva inopera kana mari yehutano yakaramba ichingokura nokukurumidza kudarika huwandu hwehupfumi.
Asi hurumende yega yega inonyanya kushamisika, uye hurumende yeRepublican yekugadzirisa zvirongwa zvinowanzodana kuibvisa (pasinei nokuti pfungwa yokuti mumwe munhu ane simba iri yakakurumbira nemagadzirirwo anofungidzirwa matanho uye vateereri vadzo mumakore makumi mapfumbamwe nemakumi matanhatu nemakumi matatu).
Iwe Unogona Kuva Wakavimbiswa-Nyaya Yenyaya Isina Mvumo Here?
Kana iwe ukachengetedza gwaro rakagadziriswa kupa kweAACA asi kubvisa mutemo wega wega, iwe unotarisana nechinetso chakakosha: Vanhu vanogona kuenda vasina uninsured kana vaine hutano, uye vobva vasainira inshuwarheni kana vachida kurapwa. Zvikwereti zvinokonzera kushandiswa kwemishonga yepurijhini zvakaisvonaka zviri nyore kufanotaura mumamiriro ezvinhu akadaro.
New York yakagadziriswa-yakabhadharwa kuparidzirwa makumi maviri makumi maviri asati ACA iunza chirevo munyika yose, asi vakange vasina mvumo yega. Chigumisiro chacho chaive mari yepamusoro yepamusoro-soro kupfuura nyika yose (kunyange muna 2017, purojeimende yehutano yehutano yehutano inopfuura 50 muzana pasi muNew York kupfuura yaive muna 2013).
Zvechokwadi, icho chave chiri chikamu chedambudziko iyo ACA yakave nayo pamusoro pemakore maviri apfuura: mumwe munhu anotengesa pamusika ave akwegura uye ari kurwara kudarika kutarisirwa (nokuti hazvikwanisi vaduku, vanhu vane utano vakanyoresa kuti vawane dambudziko risina ngozi), uye zvikwereti hazvina kukwana kuvhara mari iyo vatsigiri vanga vachiita mumusika mumwe nomumwe. Kune zvikonzero zvakasiyana-siyana zveizvi, kusanganisira chokwadi chokuti chirango cheAAC chairo chairo hachikwanisi kushanda, uye kuti kunyatsokodzera nguva yekunyora kwakakodzera kwave kwakashata; hapana chikonzero chimwe chete chechikamu chepasi-chinotarisirwa chevanyori vanyori vane utano hwakanaka.
Asi kukanganisa kwemari mumusika woga woga nei chiverengero chakawanda chevatsigiri vehurumende vakasarudza kubuda kugoverana kana kumusika wega wega wega muna 2017. Chakanga chisingave chiri chekuti chikamu chemusika chinobatsira chavo, uye chikamu chiduku chemusika chero zvakadaro, saka vatsigiri vanosimuka kunze kwemusika mumwe oga vanogona kutarisa kune zvikamu zvakakura zvemakethe, kusanganisira mubhadhari-anotsigirwa inshuwarheni, Medicare Advantage , uye Medicaid inotarisirwa.
Muchidimbu, vatsigiri vehurumende havasi kuzopa ruzivo mumusika wega woga kunze kwekuti vangava nechokwadi chakanaka kuti misika icharamba yakasimba, uye vanhu vane hutano vakakwana vanozonyora kuti vabhadhara mari yekufukidza avo vanonyora vanoda kurapwa.
Kune nzira dzakasiyana-siyana dzekufamba pamusoro peizvi, asi zvose zvinosanganisira mamwe marudzi ezvigaro zvekuita kuti zvive zvakaoma kana zvisingaiti kuti vanhu vaende vasina kuvhara kana vaine hutano. Inogona kuva mvumo yega munhu, kana inogona kuva mihoro yepamusoro yakakwirira kune vanhu vasinganyori apo pakutanga vakakodzera (izvi ndizvo zvakaita Medicare Part B uye Chikamu D basa). Kana kuti inogona kuva mihoro mikuru yakakosha yakagadzirwa nehutano hwekunyoresa kuvanhu vasingaiti kuchengetedza nguva dzose (ichi chikamu chekugadziriswa kwakaitwa neCommunity Republicans muna 2016).
Asi nenzira imwe chete kana imwe, panofanira kuva nekukurudzira kuita kuti vanhu vanyorwe, chero bedzi tiri kuvimba pane imwe nzira inoshandisa inshuwarhu yehutano yega yega nekunyora kwokuzvidira. Musati gore ra2013, izvo zvinokurudzirwa ndezvekuti kuvhara kwakanga kusina kuvimbiswa mumatunhu akawanda, saka vanhu vaifanira kunyora apo vakange vaine utano hwakanaka-uye vakaramba vachiverengwa-kuti varege kudzivirirwa kana kana vakagadzira mamiriro ezvinhu aimbovapo.
Tinogona kudzokera kumashure ezvo, asi kudzokera kumamiriro ezvinhu akambovapo uye kunyanya pasi rose kwezvokurapa kunyoresa hakuzove mune zvematongerwe enyika. Zvinopfuura zvingangodaro, zvakagadziriswa-nyaya yekuparidzira iri pano kuti ugare, mune imwe nzira. Uye izvi zvinoreva kuti chimwe chechirango chekusainyorera zvakare pano kuti ugare, mune imwe nzira. Zvinogona kuva zvikwereti zvepamusoro zvevanhu vanozonyora gare gare kana mamwe marudzi ezvokurapa pasi pezvinyorwa kune vanhu vasingaiti kuchengetedza nguva dzose. Asi hapana nzira yekuchengetedza gwaro rakagadziriswa rekupihwa kweAAC pasina kuve nechokwadi kuti vanhu vane utano hwakakwana vanopinda muchikwata kuti vaenzanise padziva risina ngozi.
> Sources:
> Centers for Medicare neMedicaid Services, March 31, 2016, Kuverengwa kwakanyatsorodzwa Snapshot.
> Imba yeVamiririri, GOP Healthcare Proposal. Nzira Yakanakisisa, Chiono Chedu chekutendeseka America . June 22, 2016.
> Kaiser Family Foundation, Health Insurance Coverage ye Total Population, 2015.
> Koskinen, John, Internal Revenue Service, Tsamba kuCongress pamusoro pekutanga kwekutsvaga kubva mugore ra2015 rekutsvaga maererano neAgordable Care Act anorongwa muna October 2015 . January 8, 2016.
> Koskinen, John, Internal Revenue Service, Tsamba ku Congress maererano ne 2016 mitero yemitero yakabatanidzwa neAne Affordable Care Act. January 9, 2017.