Imizamo ye-GOP iya kwandisa iMida yeeNkxaso kunye nokwandisa ukufikelela kwiifowuni
Ayikho imfihlelo yokuba abameli beRiphabhuliki bafuna ukwandisa ukufikelela kwi- akhawunti yokulondoloza impilo (HSAs) , ukwandisa ukusebenzisa kwabo, ukukhupha imali ekubakho abantu abanokufaka isandla kwii-HSA, kwaye bavumele ukuguquguquka okukhulu ngendlela abantu abangasebenzisa ngayo imali abayifumanayo akhawunti. Akucacile kweli nqanaba ukuba okanye xa baya kufeza oku, kodwa yimeko abaye bayichukumisa ngayo iminyaka.
Ingxoxo ye-GOP yokujongana nokunakekelwa kwezempilo yenzeke kwiCongress ngo-2017. Nangona iinqununu ezininzi zomthetho ukuchithwa nokutshintsha uMthetho woNonophelo ongenakunqwenelekayo uye waqalwa-ekugqibeleni ngoJulayi 28, 2017, kwi-Senate yokwenyulwa kwazo zonke iindleko ababezicingayo-phantse zonke kubo baye bathatha indlela efanayo yokutshintsha ii-HSAs.
Ukupheliswa kwexesha-kuba yimigudu yomthetho yokuphinda nokutshintsha i-ACA, iziphakamiso ze-GOP zokulungiswa kwe-HSA zingafakwa kwi-burner yangemva kwithuba elithile. Kodwa kunokwenzeka ukuba ulungiso lwe-HSA lube yinxalenye yecala lokutshatyalaliswa kwezempilo, kwaye kuya kwenzeka ukuba ulungiso lwe-HSA lungenziwa njengemithetho yokuzimelela ngethuba elithile, ezizimeleyo kwienguqu ezinkulu ezopolitiko zifuna ukwenza kwinkqubo yokunakekelwa kwempilo yaseMelika.
Ii-HSAs zenze iinguqu ezincinane kunye ne-ACA
Iimali zokulondolozwa kwempilo zenziwe yi-Medicare Prescription Drug, Act Improvement and Modernization Act ka-2003, kwaye yafumaneka kubaxhasi ngo-2004.
I-ACA yenza iinguqu ezincinane kwii-HSA:
- Ii-HSA zinesihlomelo xa uhoxisa imali ye-non-use usetyenziso lwezokwelapha ngaphambi kokuba uneminyaka engama-65. Esi sigwebo sisetyenziselwa ukuba sibe ngama-10 ekhulwini, kodwa i-ACA yenyusa ukuya kuma-20 ekhulwini (oku ngaphezu kweerhafu ezihlolwe ukuba imali zisetyenziselwa iinjongo ezingezizo unyango). Izahlwayo zenzelwe ukuqinisekisa ukuba imali kwi-HSA isetyenziswe njengoko ijoliswe kuyo: kwiinjongo zonyango (emva kweminyaka yobudala engama-65, i-HSA ingasebenza njenge-akhawunti yomhlala-phantsi yomntu ngamnye, kunye neerhafu-kodwa akukho nanye ihlawulwe ihlawulwe ukuba imali ihoxiswe indleko zonyango).
- Zonke iilisi-ngaphandle kwe-insulin-kufuneka zibe negunya logqirha ukuze zithengwe nge-HSA iimali (oko kukuthi, ukusebenzisa imali engenahla yerhafu kwi-HSA yakho ukuyithenga). Kwixesha elidlulileyo, amayeza angaphinda athengwe nge-HSA iimali, kodwa i-ACA yatshintsha loo nto.
I-Reform Reforms HSA I-Reform iza kwandisa i-Access Access kunye neMingcele yemingcele
Ininzi yeebhili i-Congressional Republicans ezenzile ukuchithwa nokutshintsha ii-ACA ziquka imibandela eya kutshintsha enye yemithetho esebenza kwi-HSAs. Lo ngumqeshi ophambili wohlaziyo lwezempilo lwe-GOP, kangangokuthi ukulungiswa kwe-HSA kwadibaniswa kwiphepha le- 8 "iphepha elikhutshweyo" leNkundla yeNtengiso (i-Health Care Freedom Act) ukuba iiSenethi zeRiphabhlikhi zazisa ngasekupheleni kukaJulayi 2017 (loo mqathango ayizange idlule , njengamaRephabliki amathathu awachasayo).
Nangona iziphakamiso zohlengahlengiso ziye zahluka ngokuthe ngandlela-thile, kukho iindawo ezine eziphambili ze-HSA ukulungiswa ukuba abagwebi be-GOP bangathanda ukuphumeza:
- Ukuguqula isaphulelo se-ACA sokunyuswa, kwaye ubuyele kwisigwebo se-10 seepesenti ezingaphezulu kwe-65 zokurhoxiswa kweendleko ezingezizo zonyango.
- Ukuguqula ukubonelelwa kwe-ACA okuvimbela amayeza angaphezulu kokuthengwa nge-HSA iimali.
- Ukwandisa imilinganiselo yegalelo le-HSA, kwaye uvumele abatshati abaneminyaka engama-55 nangaphezulu ukuba benze imali yokubambisa kwi-HSA efanayo, kunokuba babe ne-HSA ezahlukileyo, njengokuba kunjalo ngoku.
- Vumela iimali ze-HSA zisetyenziselwe ukuhlawula iiprimiyam zomshuwalense. Okwangoku, unakho ukuhlawula iiprayimari kunye ne-HSA iimali ukuba ngaba yi- COBRA , i-inshorensi yenkathalo yesikhathi eside, ii-premium ze- Medicare Part B (kunye neCandelo A ukuba awufumani mahhala), kunye neeprojama ze-inshorensi zempilo ezenzeka ngexesha ufumana umvuzo wokungasebenzi. Iziphakamiso zokulungiswa kwe-GOP ziza kwenza abantu baninzi ithuba lokusebenzisa imali ye-HSA ukuhlawula iiprimiyamu ze-inshorensi yezempilo.
Ininzi yaloo nto iyicacisa, kodwa masiqwalasele ngokuthe ngqo umda wegalelo. Imali umntu ayifake kwi-HSA ayinanto yerhafu (mhlawumbi inqunywe phambi kokuba irhafu ibalwe ukuba igalelo lihlawulwe i-payroll, okanye incitshisiwe kwi-tax return tax).
Njengoko kunjalo nakwamanye ama-akhawunti athathwe ngerhafu, kukho umda malunga nokuba unako ukufaka isandla kwi-HSA. Ngo-2017 , i-$ 3,400 ukuba unayo i-auto-cover kuphela phantsi kwe-HSA-i-HDHP ye-health plan ephezulu (qualifier) ye-HDHP kunye ne-$ 6,750. Ukuba unobuncwane bentsapho phantsi kwe-HH-qualified HDHP (inqaku lokuba unokwenza imali kuphela kwi-HSA ukuba okwangoku unika ingxelo phantsi kwe-HH-qualified HDHP).
I-IRS iphinda ibeke iindleko ze-out-of-pocket kwizicwangciso ze-inshorensi yezempilo ezibhekwa njenge-HSA-ezifanelekileyo ze-HDHP. Uninzi lweziphakamiso ze-GOP zokuguqula ii-HSAs zibiza ukunyusa umlinganiselo wenkxaso ye-HSA ukulingana ne-Out-of-pocket phantsi kwe-HH-qualified HDHP (okt, ukwenzela ukuba imali ongayifaka kwi-akhawunti ehlawulwe irhafu ukuze ikhuphe Iindleko ziya kuba zifana nexabiso eliza kufuneka lihlawule kwiindleko zangaphandle kwe-inshorensi yakho yempilo).
Ukubhekiselele, i-out-of-pocket esiphezulu phantsi kwe-HH-qualified HDHP ngo-2017 yi-$ 6,550 yeyodwa kunye ne-13,100 yezigidi kwintsapho (phawula ukuba oku kuncinci kunama -maximi angaphandle kweefowuni ezisebenza kwezinye iindidi zokuxhaswa ). Ngoko ukuba ukuguqulwa okucetywayo kwakuza kuphunyezwa, abantu babeza kuba negalelo eliphindwe kabini kwii-HSAs xa kuthelekiswa nemithetho ekhoyo, enika ikhefu elihle lentela kubantu abangakwazi ukubeka imali eninzi kwi-akhawunti. Kwakhona kunceda ukuqinisekisa ukuba abantu balungele ukulungelelaniswa neengxaki zemali zesifo esibi okanye ukulimala xa benemali kwi-HSA. Kodwa ke, konke kuxhomekeke kumntu onemali eyaneleyo yokufaka isandla kwindawo yokuqala.
Esi siphakamiso asikho ngaphandle kwabagxekayo. Imilinganiselo ephezulu ye-HSA ayincedisi imindeni engenamvuzo ophantsi, kuba ngokubanzi abanako ukufaka isandla nakwiimali ezivumelekileyo zamanje. Kwaye kumakhaya aphezulu afumana imali, imingcele ephakamileyo yamandla yenza i-HSA enye indawo yokukhusela irhafu, evumela abantu ukuba babeke imali engaphambili yentela engakhulisa irhafu kwaye ekugqibeleni isetyenziswe njenge-akhawunti yomhlala-phantsi.
Nangona zonke iziphakamiso zokulungiswa kwe-GOP ze-HSA ziye zaphazamisa umda wegalelo kwi-HDHP ngaphandle kwe-pocket maximums, kuyaphawuleka ukuba iSenator Rand Paul (R, KY) yazisa umthetho ngasekuqaleni kuka-2017 oya kususa nje i-HSA yenkxaso yegalelo ngokupheleleyo , evumela abantu ukuba banike ixabiso elingenamkhawulo kwi-HSA. Esi siphakamiso asizange sihambe naphi na, kodwa kuya kubonakala ukuba yindawo yokukhusela yengxowa yabatyebi.
Ngaba i-HSA Reform Stall iya ku-ACA?
Ulungiso lwe-HSA lube lubonelelo olubalulekileyo lwezamelelo zokulungiswa kwempilo yaseRiphabliki iminyaka, kwaye kucacile ukuba iinkokheli zaseRiphabliki zifuna ukubona abantu abaninzi basebenzisa ii-HSA, imida ephakamileyo yemigangatho, kunye nokuguquguquka ngokumalunga nendlela imali isetyenziswa ngayo.
Abalawuli be-GOP benza i-push push ukuze i-ACA ichithwe kwisiqingatha sokuqala sika-2017, kodwa loo mzamo waqedwa ngasekupheleni kukaJulayi. Akucaci ukuba ngaba kuya kubakho indlela yokuvuselelwa kwezempilo, okanye ukukhwela kwimizamo ngelixa abagwebi bejongana neminye imiba.
Kodwa ukulungiswa kwe-HSA yinto enokufumana inkxaso ye-bipartisan kwiCongress, kwaye yinto enokuthi yenziwe ngokwayo, ngaphandle kokugqithiswa ngokupheleleyo kwemimiselo yezempilo yase-US.
Abademokhrasi banokufuna ukugcina isohlwayo esiphezulu se-ACA phantsi kwe-65 kwii-HSA zeendleko ezingezizo zonyango, kuba injongo ye-HSA kukuqinisekisa ukuba imali iyafumaneka xa kwaye kunye neendleko zonyango zivela.
Iidemokhrasi (kunye neRiphabhliki ezininzi) ngokucacileyo aziyi kuhamba nesiphakamiso njengento engathandekiyo njengeSenator Paul engenakulinganisela ingcamango, kodwa ukunyuka okuthobekileyo kwimingcele yenkxaso yinto enokufumana inkxaso ye-bipartisan. Kuya kuba yindleko ku rhu lumente, nangona kunjalo, ngenxa yengeniso yerhafu elahlekileyo-njengokuba kukho nawuphi na umonakalo werhafu, oyisithintelo esiya kulungiswa.
Ukuvumela abantu ukuba bahlawule iipresimenti zempilo ye-inshurensi ngemali ye-HSA nayo ingcamango ekwazi ukugcina inkxaso ye-bipartisan, ngenzame yokwenza kube lula abantu ukuba bahlawule i-premium (kubalulekile ukuba kuqaphele, nangona kunjalo, ukuba i- HSA balance balance is lowly ; kufuneka negalelo elongezelelweyo kwii-HSA ukwenzela ukuba benze umthombo wenkxaso-mali osebenzayo kwiiprayimari).
ILizwi
Kungakhathaliseki ukuba i-HSA ishintshwe njani, ayilona i-panacea kwiingxaki ezijongene neenkqubo zezempilo ze-US. Ababancedi abantu abanomvuzo ophantsi ukuba bafumane i-inshurensi okanye banakekele unyango, kwaye nangona izicwangciso zezempilo ezichithwe kakhulu zinciphisa ukusetyenziswa kweenkonzo zonyango (ngaloo ndlela zihlawule iindleko), ukusetyenziswa okuncitshisiweyo kubonelelo oluyimfuneko kunye neenkonzo ezingadingekile. Ukusetyenziswa okuncitshiswa kweenkonzo eziyimfuneko (umzekelo, umntu ohlula iipilisi ukuba azigcine ixesha elide ukuze alondoloze imali, kodwa ngokungahambisani nokunyanga okumiselweyo) ngokuqhelekileyo akulungile kwiziphumo zempilo zexesha elide.
Nangona i-bipartisan indlela yokuguqulwa kwezempilo ingabandakanya ukuguqulwa okuthobekileyo kwimithetho ye-HSA, indlela epheleleyo ye-HSA yokulungisa utshintsho lwempilo ayinakufumana inkxaso yenkxaso evela kumaDemokhrasi kwiNgqungquthela, okanye kwiintetho zabameli.
> Imithombo:
> I-Institution Research Benefit Institute. I-Akhawunti ye-Savings Health, Imirhumo, iMida, kunye nezinye izinto ezibalulekileyo, u-2015: Uqikelelo lwe-EBRI HSA Database . NgoNovemba 29, >> 2016 > • No. 42.
> INkonzo yeNgeniso yangaphakathi, Ukupapashwa 969: IiAkhawunti ze-Savings Health kunye nezinye iziCwangciso zezeMpilo eziNcedo. 2016
> INkonzo yeNgeniso yangaphakathi, iNkqubo yeNgeniso 2016-28 .
> UPawulos, uRandi MD, iS.222, uMthetho we-Obamacare Replacement Act, iCandelo leSahluko seSishwankathelo.
> Senate.gov. Isihlomelo 667 ku-HR1628. UMthetho woKhuseleko lwezeMpilo ka-2017 . Julayi 27, 2017.