Mamwe Mimwe Mitemo Yakasiyana Shingairira Medicaid uye yeNyuniti Kubatsira
Kana iwe uri mutorwa achiuya kuUnited States, chimwe chezvinhu zvokutanga pane zvaunofanira kuita-kuwana inshuwarhu yehutano. Kusiyana nedzimwe nyika dzakawanda, iU.S. haina hutano hwehutano hwehutano, uye kunyange zvazvo Medicare neMedicaid zvirongwa zvehurumende zvinotsigirwa nehurumende, hazviwanikwi kune vatsva vanobva kune dzimwe nyika.
Saka ngatitarise mimwe mibvunzo inowanzobvunzwa pamusoro pezvinowanika kune vanobva kune dzimwe nyika, kusanganisira vatsva vasvika nevaya vave vari muUnited States kwenguva yakareba.
Ko ACA Premium Subsidies Limited kune vemuUnited States?
Nha. Kubhadhara mari yepamusoro (premium tax credits) mukutengeserana kunowanikwa kune avo vanogara zviri pamutemo-vagari vemo, iyo inosanganisira runyora rurefu rwemasimende ekupinda kune dzimwe nyika (chinyorwa chinoti Deferred Action for Childhood Arrivals-DACA-haina kufungidzirwa kuti inokodzero yekupinda kune imwe nyika yekutenga kugoverwa mu the exchange).
Ichokwadi, rubatsiro rwekutanga huripo kune vanobva vabva kune imwe nyika vane mari iri pasi pehurombo huripo, izvo hazvisizvo kune vasiri vabva kune dzimwe nyika kana vatorwa vanogara zviri mumutemo vekuAmerica kwemakore anopfuura mashanu.
IAACA inoda kuti vanhu vane mari iri pasi peurombo hwekuwana Medicaid panzvimbo yezvirongwa zvavo pachavo mukutsinhanisa, ndicho chikonzero mari yekubhadhara mari yepamusoro inowanikwa haisi kuwanikwa kune vanoita mari ine mari iri pasi pehurombo. Asi vasati vabva kune dzimwe nyika havagoni kuwana mari yeFedica-funded Medicaid kusvikira vasvika kuUnited States kwemakore mashanu (inoshandisa sarudzo yavo yekuwedzera Medicaid kuparidzira kune vanobva kune dzimwe nyika, izvo vamwe vanoita, zvikurukuru munyaya yevakadzi vane pamuviri).
Apo ACA yakanyorwa, vateereri vemutemo vakaona kuti ACA yakasununguka mari yepamusoro yekubhadhara mari yepamusoro (kureva, urombo hwehutano) yaizobva kune vabva kune dzimwe nyika vaine mari shoma shoma pasina zvingasarudzwa. Saka vakanyatsotanga kupa rubatsiro rwekubhadhara mari iyo yaizovhara vatsva vanobva kune imwe nyika vane mari pasi pehurombo.
Mune mamiriro ezvinhu aya, mari yeunoshandira inotarisirwa sekuti iri muurombo (kana 133 muzana yehurombo huri mune hurumende dzakawedzera Medicaid, iyo ndiyo inowanikwa mari yakaderera iyo inoita kuti munhu akwanise kubhadhara mari inoshandiswa panzvimbo yeMedicaid) . Muna 2017, izvi zvinoreva kuti munhu anenge achibhadhara aifanira kubhadhara mazana maviri nezana kubva muzana yemari yaanowana mari yechipiri-yakaderera-yakawanda yegoridhe muchirongwa (pano ndiyo tsanangudzo yekuti mathemusi anoshanda sei).
Zvinotoshamisa ndezvokuti gwaro rekuparidzira rakange riri kuedza kudzivirira kune vati vabva kune dzimwe nyika rakapedzisira richizoshanda kune mamiriyoni maviri nemakumi maviri nevasiri vatorwa munyika gumi nemasere vakasarudza kusagamuchira mari yehurumende yekuwedzera Medicaid (imwe sarudzo inonzi yakaguma neDare Repamusorosoro ra2012 kutonga kwakabvisa kodzero yehurumende yehurumende yekutarisa Medicaid mari yakawanda pamusoro pekuda kwehurumende kuwedzera kuparidzirwa).
Nemhaka yokuti nyika idzodzo dzisina kukura Medicaid, vanhu vakuru vasina vana vanovimba navo kazhinji havatenderwi neMedicaid pasinei nokuti kudhura kwavanoita kwakaderera sei. Uye sezvo mari inotangira rubatsiro isiripo kune vanhu vane mari iri pasi pehurombo (sezvo vachifanirwa kuva neMedicaid pasi peAACA), ivo vanhu havangova nehupi hwechokwadi hwekusvika kune inshuwarano yehutano, sekubhadhara mutengo wakakwana wekugoverwa 't kazhinji inoshanda kune vanhu vane mari iri pasi pehurombo.
Asi mumamiriro ese ezvinhu, vati vabva kune dzimwe nyika vaine mvumo yepamutemo yepamutemo vanokwanisa kubhadharwa mari yepamusoro kunyange kana mari yavo iri pasi peurombo.
Kuchinja Kunoziva Sei Vachikumbira Vanopa Mutemo?
Pakati penzira yekunyora, kugoverana kunofanirwa kusimbisa kuti anyoresa anowanikwa zviri pamutemo muUnited States Kune chikamu chekushanda apo vanhu vasiri vagari vanogona kupinda muhupenyu hwavo hwekuenda kune dzimwe nyika uye vanoshandisa mashoko akadai semunhu wokune imwe nyika kana nhamba yeI-94 (pano rondedzero yakakwana yemapepa anogona kushandiswa kuratidza chimiro chekuenda kune dzimwe nyika, uye kuti ungapinda sei kana iwe uri kunyora kuburikidza neChristianCare.gov; kushandiswa kwehurumende kune zvimwe zvakafanana).
Kana iwe usingakwanisi kupinda nhamba yedhipatimendi kana iwe ukawana kukanganisa, iwe uchange uine sarudzo yekuisa kopi yemabhuku ako ekufambisa, kana kutumira tsamba kune imwe shanduko. Kana iwe usingakwanisi kugovera zvinyorwa zvekufambisa zvachose, kugoverwa kwako kunogona kupedzisira kugadziriswa zvekare.
Muna 2014, pakange pane vanenge 109 000 vanhu vane HealthCare.gov vakanyoreswa vakaregererwa pavakange vasingakwanisi kupa uchapupu hwomutemo hwekugara kweUnited States. Uye pakati pegore ra2015, kugoverwa kwakagumiswa kwevamwe vanhu 306 000 vakanyoresa HealthCare.gov zvirongwa zvegore ra 2015 asi vakanga vasati vapa zvinyorwa zvakakwana zvekufambisa.
Saka kana iwe uchinyoresa uye uri kutambudzika nehurongwa hunofunga nezvehutungamiri hwehutungamiri, usangoita kuti huderere, sezvo kugovera kwako kunogona kubviswa kana iwe uchiita. Dzokera kune imwe shanduro kune rubatsiro, kana pafoni kana mu-munhu pane nzvimbo yekunyora, uye iva nechokwadi chokuti zvinyorwa zvako zvinogamuchirwa.
Chii Chinodiwa Chinowanikwa kune Vapoteri Vane 65 kana Vakwegura?
Pasati gore ra2014, pakanga pane zvishoma zvingasarudzwa zvevakabuda munguva ichangopfuura vane makore 65 kana kupfuura. Pamwe pehutano inshuwarhu yehutano mitemo kazhinji yakanga isiripo kune ani zvake ari pamusoro pemakore makumi matanhatu, uye seMedicaid, kune makore mashanu akamirira vasati vabva kune dzimwe nyika vanogona kunyoresa kuMurengeti. Saka vanhu vakwegura vakagara vachinge vaifanira kuvimba nehuwandu hwemainishuwarenzi yekufamba, kunze kwekunge vaine ruzivo rweurongwa hunobhadharwa nevanoshandira muUnited States.
Kunyangwe mushure memakore mashanu, Medicare kazhinji yaisakanganiswa kune vanoenda kune dzimwe nyika. Sezvo Medicare inobhadharwa nemari nemitero yemitero iyo vashandi veUnited States vanobhadhara pamabasa avo, Medicare Part A (inshuwarhu yehupatara) haisi yepamusoro-yega kune vanhu vakabhadhara Medicare mitero kwemakore anenge gumi (kugara-kumba-vakaroorana vanogona kukodzera Medicare inobva pamabasa emumwe wemumwe mukadzi).
Mushure memazuva mashanu, vatorwa vese vane makore 65 kana kupfuura vanokwanisa kutenga Medicare kunyange kana vasina kubhadhara mumutambo we Medicare nemitero yemitero. Muna 2017, Medicare Part A inodarika $ 413 / mwedzi yevanhu vasina nhoroondo yebasa, uye Medicare Part B i $ 134 / mwedzi (munhu wose anopa mubayiro weMedareti B , pasinei nebasa remabasa). Medigap kugoverwa uye Medicare Chikamu D zvakakosha zvinowedzera zvinogona kuwedzerwa kuMedare, asi zvinouya nezvikwereti zvemari.
Asi mutemo-varipo vanoenda kune dzimwe nyika vanogona kunyoresa muzvirongwa zvavo pachavo mumusika mumwe nomumwe pakarepo pavanosvika kuU.S., uye nekuda kweAACA, havasisina kudzivirirwa kuita kudaro kana vaine makore anopfuura makumi matanhatu (mutengo mumwe nomumwe Kubudiswa kunowanikwa pasinei nemakore, chero bedzi munhu wacho asina kunyorwawo kuMureare). Mukuwedzera, rubatsiro rwekutanga huripo pasinei nezera, uye sezvarondedzerwa pamusoro apa, rubatsiro runowanikwa kune vekubva kune dzimwe nyika vane mari iri pasi peurombo hwehutano.
Kubva ikozvino, pasi pe ACA, mapeimisi evanhu mapoka uye maduku evanhu vakwegura vakanyorerwa pasina kana katatu mubayiro wekodzero yevane makore 21. Saka ane makore ane makore makumi mashanu nemashanu (85-year-old) achapiwa chikwereti chakafanana nemakore makumi matanhatu nematatu (mumatambudziko acho ose, katatu chikamu chakakonzerwa nemakore makumi maviri nemaviri, kunze kwekuti nyika inoda chikamu chechidiki; yakakwirira kudarika matatu kusvika kune imwe).
IAmerican Health Care Act (AHCA), iyo yakapfuurira Dzimba muna May 2017 uye iri pasi pekufungidzirwa muSeneti , yaizowedzera chiyero, zvisinei, kuitira kuti vanhu vakwegura vakanyoreswa katatu kana kupfuura vaduku vanyori (kana kupfuura, kana hurumende yaifanira kutsvaga kusunungura uye kushandisa chikwata chepamusoro).
Kune huri huri hupenyu hwehutano huri zvirongwa uye "inbound immigrant" zvirongwa zvehutano zviripo, asi dzinowanzove dzisingakwanisi muhupamhi kupfuura zvirongwa zviripo mukutsinhanisa, nemabhadharo anobatsira uye kusati kwavepo maitiro akawanikwa. Zvirongwa izvi hazvioneki sechinhu chinonyanya kukosha kugoverwa, zvinoreva kuti chirango cheAACA chekusachengetedzwa kunoongororwa pamutemo-varipo vanobva kune dzimwe nyika vanovimba nemarongwa aya, kunze kwekuti vane kodzero yekuregererwa.
IAHCA yaizobvisa chirango cheAACA nekudzoka kutanga kwe 2016, asi kusvikira mutemo wekubvisa chirango ichigadziriswa, kuchine chirango chekusava nezvishoma zvakakosha kugoverwa muna 2017 , kunze kwekuti iwe unokodzera kubhadhara chikwereti .
Ko Mumiririri Anokwanisa Kunyora Mukuvhara Kunze kweKunyoresa Vakasununguka?
Ehe. Kuve mugari weUnited States kana kuwana mvumo yepamutemo-ikozvino muU.S. chiitiko chinofanirwa, chinopa munhu wacho mazuva makumi matanhatu kuti adyore muurongwa kuburikidza nehutano hwehutano inshuwarheni (chinyorwa ichi ichi chimwe chezviitiko zvishoma zvinokodzera zvisingaiti nguva yakanyora yokunyorwa kwepurogiramu dzekuchinjana -shanduka ; nguva yekunyora inokosha inongowanika muchitsinhanisi).
Vamwe vachangobva kupinda kune dzimwe nyika vanogona kuwana zvirongwa zvinoshandiswa nevashandirwi, uye zvirongwa izvi zvinewo nguva dzekunyora dzakakosha kune vanhu vakashandira kunze kwekunyora kwakasununguka kana kuwana ruzivo rwechiitiko . Nokudaro kunyange kunyorwa kwakasununguka-kune vose uye vashandirwo-vanoronga zvirongwa-chete vanouya kamwe kamwe pagore, vatsva vanobva kune imwe nyika vane mukana wekunyora muhuwandu pasinei kana pavanopinda.
Vanhu Vasingatauri Vakabva Kumusha Vanogona Kuwana Mukana Here?
Pasi pemitemo yeAACA, avo vanobva kune mvumo yepamutemo vanoenda kune dzimwe nyika vanogona kunyoresa muzvirongwa zvinopiwa kuburikidza nekutsinhanisa, uye vanogona kugamuchira rubatsiro rwemari yepamusoro kana mari yavo ichiita kuti vakwanise. Asi ACA haina mvumo iyo inobvumira vasina kutumirwa kune dzimwe nyika kuti vawane chinyorwa.
Mutemo unonyatsodzivirira vanhu vasina kutumirwa kubva kune dzimwe nyika vachibva kune dzimwe nyika vachitenga kugoverwa mukutsinhana-kunyange kana vachibhadhara mutengo wakakwana; ona chikamu 1312 (f) (3) yeAACA . Vasingazivikanwi vanobva kune dzimwe nyika vanewo mvumo yeMedicaid. Sezvo vasingakwanise kunyora mukutengesa kana Medicaid, vasina kunyorwa vanobva kune dzimwe nyika vanobviswa pamutemo weAACA mumwe mutongo .
California yakatanga kushandisa hurumende yekuita kuti Medicaid (Medi-Cal) inowanikwa kune vasina kunyorwa nevana vanoenda kune dzimwe nyika kubva muna 2016, uye vana 170 000 vakawana kugoverwa semugumisiro.
Vakuru veCalifornia vaida kutora danho iri mberi uye vanobvumira vasina kutumirwa vakuru vakuru kuti vatenge kuvhara (pasina rubatsiro) muCalifornia's exchange, Covered California. Hurumende yakagadza mitemo (SB10) munaJune 2016 kuti ibhola rifambire pamusoro peizvi, uye yakapa sarudzo ye 1332 yaiver kuhurumende yehurumende munaSeptember 2016 , sezvo kugamuchirwa kwehurumende kunokosha kuitira kuti tishandure mitemo iyo ikozvino inodzinga vasati vabva kune dzimwe nyika kubva kunotenga kunyange zvizere zvekutengesa zvirongwa.
Asi munaJanuary 2017, mazuva maviri pamberi peDonald Trump isati yavhurwa, California yakabudisa sarudzo yavo ye1332 pakunetseka pakati pezvinetso izvo Trump Administration inokwanisa kushandiswa neCovered California deta kuti iwane nekudzinga vanhu vasina kutumirwa kune dzimwe nyika.
Vakasununguka vanoenda kune dzimwe nyika vanogona kuwana ruzivo pasi pezvirongwa zvinoshandiswa nevashandirwi kana zvirongwa zvehutano zvevadzidzi kana ivo vasina kukodzera, uye vanogonawo kutenga purogiramu yemusika chero bedzi ivo vachizvitenga -kushandiswa . Asi kwenguva iyo iri, havakwanisi kunyoresa kugoverwa kuburikidza nehutano hwehutano inshuwarheni mune chero nyika.
> Sources:
> Healthcare.gov. Nzvimbo yekupinda kune imwe nyika uye Marketplace.
> Internal Revenue Service, Nzira dzeMutero 2016-24 .
> Kaiser Family Foundation: The Coverage Gap: Uninsured Varombo Vakuru muDzimwe Dzisina Kuderedza Medicaid. Gumiguru 19, 2016.
> Medicare.gov. Medicare 2017 Zvinodhura Pakukudzwa.
> National Immigration Law Center. "Taura Nenzira" Vanhu Vose Vanokodzera pasi peChechi Chakanaka Chinodiwa.