Nyika dzakawanda Dzinofunga Nezvavo Dziri Mamiririri Evanhu
Kubvira muna 2014 kusvika muna 2018, mutemo weAACA wega wega wakapa chirango kune vanhu vakapinda vasina inshuwalhu yehutano, kunze kwekuti vakwanise kubhadhara chikwereti (uye hongu, chirango ichiri kushanda kana iwe usina kubvumirwa muna 2018 ).
Asi kutanga munaJanuary 2019, chirango chehurumende chekuve usina uninsured chichava $ 0. Kuchinja ikoko kwakagadziriswa sechikamu cheMutero Wemitero uye Jobs Act, iyo yakasayirwa mutemo muna December 2017.
Izvi zvingava nhau dzakagamuchirwa kune vanhu vakarohwa nechirango mumakore apfuura uye vakaronga kuramba vachiita kusavimbiswa, asi kuchinja kunogona kutungamirira kumakambani makuru ehurumende yehushuwarisi uye kune vamwe vasina kuvimbiswa veAmerica.
Hurumende yeBongress yeHurumende inofungidzira kuti mari yepuraimusi mumusika mumwe nomumwe ichave yakapetwa ne10 muzana kupfuura iyo ingadai yakave iyo iyo iyo mvumo yakange yagara munzvimbo, uye kuti vanhu vashoma mamiriyoni matatu vachawana ruzivo rwevanhu (kwete boka) bhizimusi yemari 2019. Kuderedzwa kwehuwandu hwevanhu vane hutengeswe hwemisika kune imwechete inotarisirwa kuwedzera kusvika mamiriyoni mashanu kubva muna 2021-chikamu chakakura chemusika, iyo iye zvino inenge ine vanhu vanosvika mamiriyoni 15-17 chete vakanyoresa.
Vanhu vanogona kubva mumusika ndevaya vane hutano uye vaduku, sezvo vanorwara, vanhu vakwegura vanoona kuwedzera kukosha muhutano hwehutano hwehutano.
Kubuda kwevechidiki, vanyori vanyori vane hutano ndicho chikonzero ma-premium anofanirwa kuwedzera. Kune avo vanofanirwa kubhadharwa mari yepayimusi , rubatsiro runokura huchakura kuti rwuenderere mberi nezvikwereti, kuvhara rufu ruchienda uye kuchengetedza misika iri yakasimba. Asi kune vanhu vasina kuwana rubatsiro rwemari, premiership icharamba ichiwedzera mari.
Mamiriro Ehurumende Funga Mavamiro Evanhu Mumwechete Kuti Aite Kuti Mararamiro Awo Akagadzikana
Mukuedza kuedza kuwedzera kwekutanga kwekuwedzera uye spike mumutengo uninsured, huwandu hurumende dzave dzichitsvaga hurumende dzakagadzirirwa nemunhu. Vamwe-vanotsanangurwa gare gare munyaya ino-vanogona kugumisa kushandisa mvumo muna 2020 kana kupfuura. Asi zvishoma zvehurumende zvingave zvichiri kushandisa humwe hurumende dzinotora hurumende pakarepo sezvo chirongwa chehurumende chemutemo chichibviswa pakupera kwe 2018.
Massachusetts
Massachusetts inenge iine mvumo yega yega, inotangira nguva yeAACA. Hurumende yakagadzirisa chinangwa muna 2006, uye yakaramba ichigara kubvira ipapo. Asi kubva muna 2014 kusvika muna 2018, hurumende yega yega yega chirango ichibviswa kubva muhurumende yehurumende, ichivimbisa kuti Massachusetts vagari havafaniri kubhadhara zvikwereti zviviri zvekusabvumirwa. Uye muMassachusetts, chirango chinongoshanda kune vanhu vakuru, asi pasi pe ACA, mhuri dzinofanirawo kubhadhara chirango chokuva nevana vasina kuvimbiswa. Kutanga negore ra2019 ritero (nokuda kwekudzoka kwakaiswa kumavambo 2020), Massachusetts inongorongedza hurumende yehurumende iripo, asi hapachazovi chirango chekutsvaga chibvumirano chokutora kubva muhurumende yenyika.
District of Columbia
MunaFebruary 2018, bhodhi revatungamiri ve DC inishuwarenzi yehutano ichishandura pasina kubvumirana nekugadzirisa kurumbidza mumwe munhu mvumo muDDC, kunyange zvazvo guta reguta rine chirevo chekupedzisira. Kana hurumende yeguta ichibvumirana nekubvunzurudzwa kwekutsinhanisa, DC ichava nemvumo yega yega uye chirango chinosanganiswa chinogona kunge chakafanana nenzira dzakawanda kumutemo weAACA mumwe nomumwe, asi nezvimwe zvinopesana zvakakosha kuti zvienzane nezvido zve DC .
DC Mayor, Muriel Bowser, akafumura Budget Gore ra2019 rakarongwa gore ra2002, iro rinosanganisira $ 1.1 mamiriyoni ekubhadhara mari yekuita basa rega rega DC.
Mari iyo inogona kuvhara teknolojia yekuchinja, kugadziriswa kumutsetse wemutero weD DC, uye ruzivo rwehuruzhinji rwemashoko pamusoro pemutemo wega wega, pamwe chete nezvimwe zvinodiwa mari. Dare reguta richakurukura bhajeti reMeya Bowser muna April naMay 2018 .
Munguva yakapfuura, Congress yakabvumirwa kubvumirana nemari yeDDC mushure mekunge gwaro reguta rivabvumira, asi mutemo iwoyo wakashandurwa muna 2013, uye dare reguta reDDC rinotsanangura kuti "kana Congress kana matareti haana kutora matanho okukwirira kana kuputsa" zvigadziridzo zvinobvumira DC kuumba bhajeti yake pasina Congressional kubvumirwa.
Hawaii
IHawaii Senate yakapfuura SB2924 munaMarch 2018 nevhoti ye 24-1, uye mushumo iye zvino wava neImba. SH2924 yaizoshandisa mutemo wega wega uye chirango chakabatanidzwa muHawaii, kutanga muna 2019.
Izvo zvinogadziriswa nehurongwa, kusanganisira kusunungurwa, zvinonyanya kuratidzira kodzero yeAACA, asi chikamu chechirango hachijekeswi mumutemo - chikonzero icho Dhipatimendi reHawaii reMitero chave chichicherechedza muhupupuriro pamusoro pemutemo.
Dhipatimendi reMitero yakaratidzawo "kunetseka nekukwanisa kwayo kururamisa zvakakodzera chirango ichi," zvichipiwa kuti "Dhipatimendi haisi nyanzvi yehutano hwehutano inshumo," uye inokurudzira kuti kana hurumende inoshandisa mutemo uye chirango, chechitatu (kureva, kwete muHawaii Department of Taxation) inofanira kuva nemhosva yekugadzirisa kana vateresi vematare vanobhadhara mari.
Vermont
Vadzidzisi vemitemo muVermont's House of Representatives vakapfuura H696 muna March 2018, vachikumbira hurumende yega yega kubva munaJanuary 1, 2019. Pakutanga, mutemo wacho wakataura zvakajeka zvechirango chaizoshandiswa (zvikurukuru zvakafanana nechirango cheAACA chekuve uninsured), asi gwaro racho rakazogadziriswa kuti ribvise izvozvi.
Pane kudaro, shanduro yemutemo waipfuura muImba yaizopa mutemo wega wega muna 2019 asi inobva pamashoko chaiwo echirango cheboka rinoshanda raizove rakarongerwa kurumbidza kunyatsoshanda kwatinofanira kuitwa nehurongwa. Bhuku rekushanda raizotanga kusangana naJuly 2018 uye raizotumira mushumo wekupedzisira kune vateereri vemutemo pasati yaNovember 1, 2018.
Senate, zvisinei, yakaratidza kushushikana pamusoro pemafungiro ekuisa mutemo weumwe munhu kutanga munaJanuary 2019, pasina mifananidzo yakajeka yekuti basa racho raizoshandiswa nekusimbiswa sei. Saka Sénate yakapfuura shanduro yemutemo uye zuva rakabviswa rakabviswa. Chirongwa chavo ndechokubvumira boka rekushandira kupedzisa mushumo wavo, uye kune vateereri vemutemo kuti vaongorore mushumo mukati megore ra2019 sangano rekutonga. Imba yacho haina kubvumirana neshoko reSeneti, zvisinei, saka mutemo wacho wakatamira kumusangano wekomiti wakashanda nekushanda kusiyanisa.
New Jersey
New Jersey vanyori vemitemo vakapfuura mitemo (SB1877 neA3380) mumusangano wegore ra2018 kuti vashandise gwaro rega rega uye chirango chakabatanidzwa muNew Jersey, kutanga muna 2019.
A3380 yakapfuura Gungano nevhoti ye50-23, uye yakapfuura Senate nevhoti 22-13, pakati peApril. Achifunga kuti Gavhuna Phil Murphy anoratidza mutemo uyu mutemo, New Jersey ichava nemvumo yega yega kutanga muna 2019, kusanganisira chirango chinoshandisa mitemo yakafanana iyo yakashandiswa pachirango cheAACA. Zvikwereti zvepamusoro muNew Jersey zvingava zvakaenzana nereji yepamusoro yehurongwa hwebhandi muNew Jersey, zvisinei, panzvimbo yevhareji yenyika yose inodhura hurongwa hwebhandi.
Rutsigiro rwehuruzhinji rweAACA rwakasimba muNew Jersey, asi vanopfuura hafu yevagari vepoteredzwa vaipikisa pfungwa yehurumende yepamusoro-soro kubva muna 2017. Kutsigira kwehurumende kunowedzera, zvisinei, sezvo vanhu vanoziviswa pamusoro pekuti mutemo inobatsira kudzivisa kusarudzwa kusarudzo uye kugadzirisa yemusika yemusika.
Nyika Iyo Inofungidzirwa Mitemo Asi Haisati Yashanda
Dzimwe nyika dzakawanda dzakatarisa kuti zvinogona kuitwa nehupfumi hwehurumende, asi kushandiswa kunogona kunge kwakapfuura gore ra2019, zvichibva pane zvinyorwa zvematongerwo enyika uye shanduko dzakarongwa.
Connecticut
Vakuru vemitemo yeK Connecticut vakafunga mabhiriro maviri aizoita mumwe nomumwe mvumo, asi nenzira dzakasiyana-siyana. Zvisinei, muna April 2018, mutemo wega wega wega wakabviswa kubva kune rimwe bhiri, uye imwe chikwereti chakanga chisati chapfuura zvachose.
HB5039, sezvakaiswa, ingadai yakagadzirisa chinangwa cheumwe munhu nechirango chiduku chiduku pane chirango chaAACA. Izvo zvaizove zvakakura kune 2 muzana yemari yekuwana mari kana $ 500 pamunhu mukuru asina kubhadharwa, pasina chirango chevana (zvakasiyana, chirango cheAACA ndicho chikuru che2,5 muzana yemari inowanikwa mumhuri kana $ 695 pamunhu mukuru asina kubhadhara uye $ 347.50 pamwana asina kubatsirwa ).
Mutemo wacho waivawo nezvimwe zvakasiyana-siyana zvehutano hwekugadzirisa zvirongwa. Asi komiti yeDzimba yakasimudza bhiri muna April 2018 yakabvisa mutemo wega wega wega. Inogona kuwedzerwa zvakare muImba yepasi, asi kwenguva iyo iripo, hapana hurumende yega yeHB5039.
HB5379 yaizoita mutemo wega wega nehomwe yakakura-kusvika ku $ 10 000-asi inobvumira vanhu vasina kukodzera kubhadhara mari yepamusoro (uye iyo inishuwarenzi yehutano inodhura zvinopfuura 9,66 muzana yemari yemari) kuti ipe chirango chinyorwa chekuchengetwa kwehutano pane kungozvipa hurumende (iyo yezvehupfumi uye kugadziriswa kwechirongwa zvakataurwa apa ). Kubva munaEpril 2018, mutemo uyu wakanga usati wapinda muImba uye waiva wekufa kwema 2018. Asi zvakananga zvemutemo zvinonakidza pakuti ndiyo inomirira simba rakasimbiswa kune dzimwe nyika dzakatarisa.
Kujekesa, chirango cheAACA chairo chemunhu chinogona kunge chakakwira se $ 16,320 pamhuri yevanhu vashanu kana kupfuura avo vasina kuvimbiswa muna 2017, uye iyo chikwata chechibharo chichave chakanyanya kusvika muna 2018 nokuti chakasungirirwa pamwero wekutengesa hurongwa hwebhandi, iyo yakakura gore negore. Asi hazvishamisi zvikuru kuti imba ibhadhe chikamu chechiyero ichocho pasi pe ACA. Imba inofanirwa kuva nemari yakawanda inodarika madhora 600 000 kuitira kuti iwane chirango ichocho, uye hazvishamisi kune mhuri ine mari yakadaro kuti ive isina inshuwarhu yehutano.
Asi pasi peConneconi HB5379, $ 10 000 chirango chaizoshanda kune mhuri inowana mari shomanana ye $ 100,000. Zviduku zviduku zvinoshandiswa kune dzimba dzine mari shoma, asi chirango chaizove chakaenzana nemari yebhadharo yakaderera-mari yakawanda. Vanhu vaizova nemukana wekushandisa mari iri muhomwe (uye kusawana chinhu mukudzoka) kana kushandisa mari yakafanana pane imwe yegoridhe muchirongwa-kana kushandisa zvishoma uye kuwana chirongwa chemhangura.
Imwe yezvitsoropodzero zveAACA chirango chemunhu mumwe oga ndechekuti haina simba, uye chirango chinodhura zvakaderera kupfuura mari yehutano hwevamwe vanhu vanyoresa vasingagamuchiri rubatsiro rwakakosha rwemari. HB5379 yaizobvisa chikumbiro chekubhadhara chirango panzvimbo yekutenga hutano hwehutano sezvo chirango chakanga chisingazove chakadhura kupfuura kutenga kugoverwa.
Chimwe chikwereti, HB5114, chakatangwa muConnecticut munaFebruary 2018, chinoda hurumende yega yega uye chirango, asi haisi mhemberero chero ipi zvayo pamusoro pekushandiswa kana kushanda kwesimba. Mutemo iwoyo hauna kufambira mberi.
Maryland
The Protect Maryland Health Care Act ye 2018 (SB1011) yakatangwa muna February 2018 nehurumende Senator Brian Feldman (D, Montgomery). Mutemo unoda hutsika dzakasiyana-siyana dzekugadziriswa kwemisika, kusanganisira mutemo wega wekutanga kubva muna 2019.
SB1011 haina kutora musangano wegore ra2018, asi inogona kuongororwa mune ramangwana gore, uye inomiririra nzira yakasiyana-siyana kune pfungwa yehurumende yega .
Kukura kwechirevo chemurairo pasi peSB1011 kwaizove kwakangofanana nechikwereti cheAACA (chikuru che2,5 muzana yemari, kana $ 695 pamunhu mukuru asina kuvimbiswa-hafu yezviyero izvi nokuda kwomwana-ane flat rate chirango chakashandurwa nokuda kwekuwedzera kwegore gore). Asi kuongorora kwechirango kwaizosiyana. Pasi peAACA, apo chirango chinoongororwa ne IRS, mari yacho inotungamirirwa kune General Treasury fund, uye munhu akabhadhara chirango haawani chero chinhu.
Asi pasi pemitemo inorongwa yeMadganis manditi, nyika inoshandisa chikamu chechirango se "kubhadhara kuripo" kwehutano hwehutano hwehutano hwemunhu. Kana munhu wacho akafanirwa kubhadharwa mari yepamusoro uye rubatsiro pamwe chete nehomwe / kubhadhara chikwereti zvingakwana kuti zvikwanise kuvhara zvikwereti zvepurogiramu ipi zvayo (kureva kuti, urongwa hwaizova nezvikwereti zero zvinowedzera), hurumende ichazonyora pasi munhu wacho chero ipi zvayo yema-premium plan ine yepamusoro yezvinokosha , kunze kwekuti munhu wacho aifanira kusarudza zvakananga (panguva iyo, chirango chaizotumirwa kune general insurance stabilization fund pane).
Kana pasina zero-premium zvirongwa zviripo, mari kubva muhomwe / pasi yekubhadhara inogona kuchengetwa munhoroondo inofarira uye mutengi angashandisa panguva yekunyorwa kunotevera, kushanda kune mari yehupi hupi huri hutano insurance plan. Kana munhu wacho achiri kusarudza kuenda pasina bhuwarisi panguva iyoyo, chirango chaizotumirwa kune general inshurensi stabilization fund mushure mekuguma kwekunyora.
Asi pasi pemhirizhonga yaMalton, hurumende yaizoita zvose zvingaita kuti vanhu vasingabatsiri vagari vashandise mari yavo yekubhadhara kune hutengo hwehutano inshuwarheni, pane kuramba vasina uninsured uye vasina kuwana zvakanakira kubhadhara chikwereti.
Iyi nzira inowedzera kutonga zvinongorori pane kungowedzera chirango chemari yemari inoshandiswa uye kuchitungamira kune chikwereti chakazara, asi zvinowanzoitawo kuti kuwedzere kufungidzira kusina kunaka kwevanhu vanhu vane kodzero yemunhu mumwe nomumwe uye chirango chakabatanidzwa, saka ndiyo nzira iyo imwe inogona kutarisa mumasangano ekutevedza emangwana.
California
Vakuru vemitemo veCalifornia vakaratidza kufarira mukana wekuti mumwe munhu apiwe gwaro, asi haana kuisa mutemo mumusangano we2018 kuti uite imwe. Sangano reCalifornia Association of Health Plans rakabvumirana nomutemo mutemo weumwe munhu , uchikumbira hurumende kuti itore chiito chekuita kuti vanhu vachiri kudiwa kuti vave nehupfumi muna 2019 uye mberi.
Vakuru vemitemo veCalifornia vari kutarisa zvikamu zvakawanda zvemitemo muna 2018 izvo zvingagadzirisa hutano hwehutano inshuwarheni, asi hurumende yega yega haisi pakati pemitemo iripo iye zvino iri kuongororwa, pasinei nokuti nyika yakataurwa kare kare kare muna 2018 sehurumende kutarisa mumashoko hwemunhu mumwechete kutevedzwa.
Kunyange zvazvo nguva yakatarwa yekuisa mutemo mutsva muCalifornia yema2018 svondo yaive munaFebruary, zvikwereti zviripo zvinogona kuchinjwa kuti zvibatanidze hurumende yega, kana kuti inogona kuiswa muhutongwa hwebhajethi. Saka California inogona kuguma iine mvumo yega yega muna 2019.
Washington
SB6084 ingadai yakagadzira boka rebazi muWashington rakatsaurirwa "kuongorora zvisarudzo pakushandisa uye kushandisa zvinodiwa nehurumende kuitira kuchengetedza hutachiwana hunodiwa hutano hwekutarisira." Mutemo uyu wakapfuudza Washington Senate munaFebruary, asi wakakundikana kupfuurira muImba panguva iyo sangano rezvemitemo rapera muna March.
Mutemo uyu wakataura kuti Washington yega yehutano yemushuwarisi yemusika yakagumburwa muma1991, zvichienderana nekuti hurumende inoda inshuwarhu yehutano kuti ive nechokwadi-kureva (kureva, inopiwa pasinei nehutano hwehutano) kutanga muna 1993, asi haina kumboshandisa munhu wacho mvumo yaive yakagadzirirwa kushanda makore akawanda gare gare.
Vatsigiri vezvemitemo vakati vaida kubvisa kudzokorora kwema1990 ekupedzisira kuWashington, apo purogiramu yega yemakethe yakanga isiripo zvachose. Asi zvinofanira kuonekwa kuti kuparara kwemusika kwakazara, kufanana neWashington mune zvema1990, hakuzoitike pasi pemitemo yemazuva ano, sezvo rubatsiro rwe ACA's premium rucharamba ruchienderera mberi ruzivo rwakakosha kune vakawanda vanyoresa, pasinei nokuti vanyori vane hutano vanogara mumusika kana kwete. Kuvhara hazvizoiti kuti zvive nezvikwereti kune vanhu vasingakodzeri kubhadhara mari yepayimusi, asi kune vakakwana vanobhadhara vanozvitengera munharaunda yese yega kuti kuchengetedza mutengesi mumwe nomumwe.
Zvaunotarisira Kuenderera mberi
Pakutanga kwa2018, zvinyorwa zvemashoko zvakanga zvichiparidza kuti zvisi zvipfumbamwe kana gumi zvakanga zvichifunga nezvemirairo yemumwe wegore ra2019. Asi vamwe vaingotaura nezvechirevo kana kufunga nezvekusikwa kweboka revanhu kuti varambe vachinyatsofunga pfungwa yacho, panzvimbo yekuisa mutemo unogona kusimbisa individual mandate. Uye mune zvimwe zviitiko, mutemo waive uri pasi pekufungisisa pakutanga kwegore wapera.
Kubva munaEpril 2018, Massachusetts ine basa rega rega, uye mutemo uchiri kuongororwa muHawaii, Vermont, DC, uye New Jersey.
Rhode Island yakagadzira boka rinoita basa rinenge richifunga nzira dzekutarisana nehurumende kubviswa kwemutemo wega wega, uye dzimwe nyika, kufanana neCalifornia, inogona kugadzirisa nyaya yacho kubva pane zvinyorwa zvekutonga kana zvemitemo muna 2018.
Asi matambudziko ekugadzirisa mafungiro aripo, kusanganisira kusafarirwa kwevamwe mazita. Kune humwe hurumende dzisati dzisina mutero wemari, uye kunyange zvazvo Washington iga yega inofunga nezvemhando ipi neipi yehutongi hweumwe munhu, kuita saizvozvo pasina mitero yemitero kunoda rudzi rwakasiyana rwehutungamiri huripo kune rwakashandiswa nehurumende yehurumende kusvika muna 2018.
Nokuda kwenguva iyo, vagari vemuMassachusetts vachafanira kuchengetedza kuparidzirwa muna 2019 kana kutarisana nechirango. Uye kune mukana wekuti vagari vemuzvikamu zvishomanana vanogonawo kutarisana nemirango nekuda kwekusabvumirwa. Muhuzhinji hwemunyika, zvisinei, mutemo wega wega wekutonga haubviri muna 2019, kunyange zvazvo izvozvo zvingashanduka mumakore anotevera.
> Sources:
> Congressional Budget Office. Kudzokorora Mutemo Mumwechete: Anofungidzirwa Kuvandudzwa . November 2017 .
> Internal Revenue Service. Revenue Procedure 2017-48 .
> Mass.gov. Technical Information Release. > TIR 18-2: Mutemo wega woga Mutongo weMitero Gore 2018. February 13, 2018.
> Scott Morton, Fiona M (Theodore Nierenberg Purofesa weEconomics), Yale School of Management. Chikoro cheConnecular Individual Healthcare Responsibility Fee . February 5, 2018.