Xa kufikelele kwingcaciso malunga noMthetho onoxanduva loKhathalelo, mhlawumbi owaziwa ngokuba yi- Obamacare , ngamanye amaxesha unokuba nzima ukuba uhlukanise inyaniso kwimbali eqingqiweyo. I-Kaiser Family Foundation isandul 'ingxelo nje ukuba ama-14 eepesenti kuphela aseMerika ajonga ii-media media sites ezifana ne-Facebook kunye ne-Twitter ukuba imithombo ethembekileyo yokwaziswa malunga ne-ACA.
Kodwa ulwazi malunga ne-ACA luhlala luvela kumajelo asekuhlaleni-kwaye ngamanye amaxesha luphakamisa imibuzo eyenza abantu bazibuze. Ukuba uqala ukuthayipha "Ngaba iCongress ex ..." kwiGoogle, i-autofill yokuqala iphetha loo mbuzo ngokuthi "ukuxolelwa kwi-Obamacare?" Ngokucacileyo umbuzo abantu abaninzi abanakho, ngokungathandabuzeki inxalenye ngenxa yenani elikhulu leemviwo kwesi sihloko esasazwe kwiindaba zentlalo kwiminyaka embalwa edlulileyo.
I-Obamacare iyasebenza kakhulu kwiCongress
Okokuqala, ukucacisa, iCongress ayifumanekanga kwi-Obamacare.
Kodwa makhe sijonge indlela le ngxelo eqale ngayo, kunye nemithetho-eyona nto igqithiseleyo kunokuba i-Obamacare isebenza njani kuthi sonke-leyo iyasebenza kwiCongress.
Emuva xa i-ACA ixoxwa kwiNgqungquthela ngo-2009, bekukho imibuzo malunga nokuba ngaba umthetho baxhomekeke kwiimpembelelo ezahlukeneyo ze-ACA-kubandakanywa ne-inshurensi yezempilo-kwi-American yoluntu ngaphandle kwefuthe kwi-inshurensi yezempilo.
Le nto yayiyixhalaba, kuba, njengabaninzi baseMerika, amalungu eNgqungquthela ayengumshuwalense wezempilo oxhaswe ngumqeshi, ngoko ke babengengabantu abantu abathengiswayo nge-inshurensi yezempilo. Kodwa i-ACA ivelisa umlilo onjalo wezopolitiko ukuba iinkcukacha ezinjengelo hlobo lilahlekile ngomsindo, kwaye i-rumor yaqhubeka yathi iCongress inokuthi "ixolelwe" kwi-Obamacare.
Ibali leMva
I-Obamacare ngumthetho. Isebenza kuwo wonke amaMerika, kwaye ininzi kakhulu kunokuba nje ukutshintshana. Inika uninzi lwezikhuselo zabathengi, kwaye luquka uncedo oluninzi lokwenza uhlawulelo olunokuhlawulekayo kubantu baseMelika abanomvuzo ophantsi kunye nabangaphakathi. Kodwa ngokubhekiselele kulo myalelo ofunwa ngabanye baseMelika, kuboniswe ngqo: Abantu kufuneka bahlale begalelo elifunekayo, okanye bajongane nesohlwayo serhafu (ezinye iimfuno zisebenza kubaqeshi kunye nabathwali bomshuwalense wezempilo, kodwa imfuno kubantu ngabanye ifuna ukugcina ukufihla).
Inkcazelo engundoqo ebalulekileyo iquka izicwangciso ezixhaswe ngumqeshi, iMedicaid , i- Medicare , iNkqubo ye-Intshuwalense yeMpilo yabantwana (CHIP) , kunye nezicwangciso zonyango ezinkulu zonyango, kuquka nezo kuthengwa ngokutshintshiselana okanye ukutshintshiselana , kunye nezicwangciso ezinkulu kunye nezicwangciso ezingenanto. Kukho ezinye iindidi zokukhawulela ezifanayo phantsi kweyona nto ibalulekileyo ye-sambuli-cover, ngokuqinisekileyo, nayiphi na ingxelo "yangempela" iya kusebenza, kodwa izinto ezinjenge-inshorensi yempilo yexesha elifutshane, izongezelelo zeengozi kunye nezicwangciso ezixhamlileyo zincinci ayiyona ingcaciso ebalulekileyo.
Ekubeni abaninzi abantu baseMelika abangaphantsi kweemali baqeshwe ngabaqeshi babo, akufuneki ukuba benze nayiphi na inguqu ngenxa ye-Care Affordable Act.
Ngethuba nje baqhubeka be-inshorensi yempilo exhaswe ngumqeshi, bahlala behambelana nomthetho.
Kwakuya kwenzeka kwintlanganiso yeCongress, ekubeni ihlanganiswe phantsi kweProgram ye-Federal Employee Benefits Programme (FEHBP), enika inkxaso yezempilo kubasebenzi baseburhulumenteni.
Kodwa ngo-2009, uSeninkulu u-Chuck Grassley (R, Iowa) wabiza ukulungiswa komthetho njengoko kuxoxwa ngawo, ngenzame ukuqinisekisa ukuba iNkomfa yayiza kufuneka " inxaxheba ekutshintshisweni ukuze sihambe ngokufanayo ibomvu ebomvu njengawo wonke ummi . "
Khumbula, uninzi lwabantu baseMerika abayithengi kwiintengiso.
Ukutshintshisana kwakujoliswe ngokukodwa ukukhonza abantu abathengayo iinshurensi yabo yezempilo ngenxa yokuba abanakho ukufikelela kwisicwangciso somqeshi, kunye nabo bangenakuqinisekiswa ngokupheleleyo.
Abantu abaneenkcukacha zokuxhaswa ngumqashi (ezibandakanya iCongress back when the Act Careable Affordable Act) yayingenakuhlangabezana nokutshintshana kuwo onke, kwaye akukho "obomvu" obongeziweyo kubo phantsi kwe-ACA, ngaphandle kokujonga ibhokisi kwiimbuyekezo zabo zentlawulo ezichaza ukuba banesifo se-inshorensi yempilo kunyaka wonke (ukuba usebenzela ibhizinisi elincinci, umqeshi wakho angathengisa ukuhanjiswa kweshishini elincinci (SHOP), kwimeko apho, unokubhekiswa kwintengiso ukuze ukhethe isicwangciso sakho. Kodwa umqeshi uthengela i-coverage kwimeko apho, kwaye uncedise imali kwinxalenye ye-premium yakho).
IsiGuqulelo seGrassley
Kodwa utshintsho lukaGrassley lwalwenza lube ngumthetho. Icandelo 1312 (d) (3) (D) loMthetho woNonophelo ongenakunqununu uthi:
(D) AMALUNGU ENKQUBO NGEZIKHAKATHI .- (i) IMFUNO.-Nangona nayiphi na enye imimiselo yomthetho, emva komhla wokuqalisa walo mxholo, izicwangciso zempilo kuphela zikarhulumente ukuba uRhulumente wePhondo awanikelele kuMalungu eNkomfa kunye nabasebenzi bebandla ngokubhekiselele kwinkonzo yabo njengeLungu leNgqungquthela okanye abasebenzi bebandla baya kuba izicwangciso zempilo ezikhoyo
(I) owadalwa phantsi kwalo Mthetho (okanye ukulungiswa okwenziwe ngulo Mthetho); okanye
(II) unikezelwa ngeSashishini esungulwe phantsi kwalo Mthetho (okanye ukulungiswa okwenziwe ngulo Mthetho).
Ngenxa yoko, iCongress kunye nabasebenzi be-congressional baye bathengisa ukuhanjiswa kwi-DC Health Link ye-SHOP exchange ukususela ngo-2014. I-DC Health Link yintengiso yomshuwalense wezempilo kwiSithili sase-Columbia.
I-SHOP zintengiso zenzelwe ukuba abaqeshi abancinci basebenzise, kodwa utshintshiswano lukaDDC luvulelekile kumalungu eCongress kunye nabasebenzi babo, ukwenzela ukuba bahambisane neemfuno ze-ACA ukuba bafumane ukuthengwa ngokutshintshiselana. Amalungu eNkomfa kunye nabasebenzi bebandla kunye nenani labasebenzi be-SHOP kwi-SHOP yobhaliso.
Kuthiwani Ngokuxhasa?
I-ACA inikeza inkxaso-mali (iikhredithi zerhafu) ukukhupha iindleko zeepriyamu kubantu abathengayo ukuthengwa kwemarike nganye kwiintengiso. Kodwa kwii-SHOP zokutshintshana, abaqeshi banikezela ngemali-mali, ngohlobo lomrhumo womqeshi kwi-premium.
Apho izinto zazingcolisa ukuba amalungu eCongress ayexhamla kwi-$ 5,000 kumqeshi (oko kukuthi, urhulumente) umrhumo kwi-FEHBP yabo enoba babhalise ngokwabo, kwaye malunga ne-$ 10,000 ukuba babhalise kwi-family coverage. Qaphela ukuba oku kusemthethweni, kwaye kuninzi malunga negalelo lemali ye-premium ye-inshorensi eyenziwa ngumqeshi oqhelekileyo egameni labasebenzi.
Ukutshintshelana nokuthengiswa kwemarike nganye kuya kuphelisa ukufikelela kwiminikelo yomqeshi, njengoko i-ACA imenqabela abaqeshi ukuba bahlawule umrhumo ngamnye wemarike yabasebenzi babo. Kodwa kuya kuthetha ukuba abaninzi balabo bantu-kuquka onke amalungu eCongress kunye nabaninzi babo abasebenzi-babeya kulahlekelwa ukufikelela kwiinkxaso ngokupheleleyo, kuba inkxaso-mali ekutshintshiseni isekelwe kwingeniso, kunye neengeniso zeCongress ziphezulu kakhulu ukuba zifaneleke ngenxa yenkxaso ngaphandle kokuba intsapho inkulu kakhulu.
Gcina Iminikelo Yabasebenzi, kodwa Bhalisa nge-Exchange
Ngoko i-Office of Personnel Management (OPM), eqhuba i-FEHBP, yangena kuyo. Babusa ngo-2013 ukuba abasebenzi beCongress kunye neCongress bazokwazi ukubhalisa kwi-DC Health Link ye-SHOP exchange kwaye baya kukwazi ukugcina iminikelo yabo yomqeshi ukufihla.
Le nto yayibonakala ingquzulwano, nabanye abantu besithi iCongress kunye nabasebenzi bayo kufanele ukuba bayeke ukunikela iminikelo yabo yomqeshi we-FEHBP kwaye babhalise kwi-exchange exchange, kunye neenkxaso ezifumaneka kuphela ukuba zifanelekile ngokusekelwe kwimali engenayo. Kufuneka kuphawulwe ke, ukuba uGrssley ngokwakhe wathi ngo-2013 ukuba injongo yangaphambili yesihlomelo yayikuvumela iCongress kunye nabasebenzi ukuba baqhubeke negalelo lomqeshi esenziwa kwiimali-mali ze-inshorensi zezempilo, nangona bekufuneka ukuba babhalise . UGrssley uxelele ukuba ukulungiswa akubhalwanga kakuhle emva kokuba iinkcukacha zithunyelwe kwiSenate Majority Leader, uHarry Reid (D, Nevada).
Ngenxa yesigqibo se-OPM, iCongress kunye nabasebenzi bayo banegalelo lomqeshi kwiimali-mali zabo ze-inshorensi zempilo, kodwa bafumana ingxelo yabo kwi-DC Health Link SHOP. Oku kukungqinelaniyo okuzama ukuzalisekisa iimfuno ze-ACA, kodwa ngaphandle kweNgqungquthela kunye nabasebenzi babo ngokwemivuzo yabasebenzi ngokumalunga neminye imisebenzi efana nayo.
Imeko yangoku ivele ngenxa yelwimi kwi-ACA ngokwalo ekhankanya ngokukodwa kwiinzuzo zezempilo zeCongress kunye nabasebenzi babo. Ngaphandle kolwimi, bekungekho mbuzo-iCongress yayingayi kuze ithengise ekutshintshisweni, kuba yayineenkcukacha zokuxhaswa ngumqeshi. Oku kwakungeke kuthetha ukuba "baxolelwa" kwi-Obamacare. Baya kufuneka bebe nokugcina i-inshorensi yempilo okanye bajongane nesohlwayo, njengawo onke amaMerika.
Ukutshintshiselwa kwasungulwa kubantu abangenayo inqaku lokuxhaswa ngumqeshi (kunye namashishini amancinci anqwenela ukuthenga ukuthengwa kwabasebenzi bawo). Kodwa ngenxa yohlengahlengiso lweGrassley kwi-ACA, iCongress yayinokuguquka kwimivuzo yezempilo exhaswe ngumqeshi kwi-FEHBP, kwaye utshintshele esikhundleni se-DC Health Link ye-SHOP exchange exchange. Lo ngumqathango ongazange ubekwe kuyo nayiphi na icandelo labasebenzi phantsi kwe-ACA, kuquka nabasebenzi baseburhulumenteni abasebenzisa i-FEHBP.
Akukhona nje kuphela ukuba iCongress ingasayi kuxolelwa kwi-ACA, umthetho ngokwenene waphuma kwindlela eya kubandakanyeka kwicandelo labantu (oko kukuthi, abo abo batshintshiselwa khona) apho bengenakufaka khona.
> Imithombo:
> Healthcare.gov. Funda uMthetho woNonophelo ongenakunceda.
> IKaiser Family Foundation, iiNzuzo zezeMpilo zabaSebenzi, 2016 isishwankathelo seziFundo .
> I-Kaiser Family Foundation, iNgcaciso yoMshuwalense wezeMpilo yoBonke abantu. 2015.
> Kaiser Family Foundation, iKaiser Health Tracking Poll, Oktobha 2016.
> Ofisi yoLawulo lwaBasebenzi. Imibuzo ebuzwa rhoqo: i-inshorensi.