Ukugcina abantwana baseMerika beMpilo
I- Medicaid kunye neNkqubo ye-Intshuwalense yezeMpilo (Children's Health Programme) (CHIP) inikezela ngeenkonzo zempilo yabantwana abancinci. Zombini iinkqubo zixhaswa ngemali kunye noorhulumente bamazwe kunye noorhulumente. Zombini ziqhutywa yilizwe.
Kukho ukungafani okwenziwe phakathi kweenkqubo ezimbini ozoziqonda ukuba unayo umntwana ofuna unyango lwempilo. Ukubeka nje, kuxhomekeke kwimeko ohlala kuyo.
Ulungelelwaniso lweMilisionid for Children
Abantwana abakhuliswa kwiintsapho ezifumana iipesenti ezingama-133 okanye ngaphantsi kwezinga lokuhlupheka kwentsha (FPL) ngonyaka bafanelekile kwiMedicaid. I-FPL ibalwa yiSebe laseMelika lezeMpilo kunye neNkonzo zoLuntu ngonyaka kwaye kusekelwe kwinani labantu kwintsapho ngokuqwalaselwa kwakhona kwendawo. Emva koko, ezinye iindawo zibiza kakhulu ukuhlala kunezinye, umzekelo, iAlaska neHawaii.
Ngaphambi koMthetho wokuNakekelwa ongenakunceda (ACA) wadluliselwa ngowama-2010, abantwana banelungelo lokufumana iMedicaid ngokusekelwe kwiminyaka yabo yobudala kunye nemali yengeniso. Ngokuqhelekileyo, umntwana omdala ufumene, kungenakunokwenzeka ukuba wayefumana ukufumana ingxube yeMedicaid yengeniso efanayo yentsapho. Ngokungaqhelekanga, oku kuthetha ukuba kuphela abantwana abathile kwintsapho efanayo kuya kubanjelwa kunyaka nawuphi na unyaka. Umthetho omtsha wenza inqanaba lokufaneleka lokufumana umvuzo elifanayo kubantwana abaneminyaka eyi-0 ukuya kwe-19 ubudala.
Ezinye iinjongo zineemfuneko ezahlukileyo zokufaneleka kwiqela elihlukeneyo, kodwa ixabiso eliqhelekileyo ngoku lihlelwe ubuncinane kuma-133 ekhulwini kwi-FPL kubo bonke abantwana. Ngaphambi kokuba i-ACA, umgca wokufaneleka ubekwe kwipesenti eziyi-100 kuphela kwabantwana abaphakathi kweminyaka eyi-6 no-19 ubudala.
Ulungelelwano lwe-CHIP
I-Medicaid ijoliswe ekunakekeleni abantwana abahluphekayo.
Inkqubo ye-CHIP yasungulwa ngo-1997 njengendlela yokwandisa ukunika ingqalelo kubantwana abanemali engaphantsi kwintsapho kodwa abawela ngaphandle kweWedicaid iwindi yokufaneleka.
Amazwe ekugqibeleni anquma izilungelo zokufaneleka ze-CHIP, kodwa ininzi yezizwe (46 zichaza kunye neSithili sase-Columbia) zibeka loo mbundu kwi-200% yeFPL okanye ngaphezulu.
Uxhasomali lwe-Federal for Medicaid
Xa kuziwa kwiMedicaid, urhulumente wephondo udibanisa imali yaseburhulumenteni "idola ye dollar," ubuncinci kwingcamango. Isebenzisa oko kwaziwa ngokuba yi- Federal Medical Assistance Percentages (FMAP) ukuqikelela ukuba uza kuhlawula phi. I-FMAP ziqwalasela umyinge wesiqingatha somvuzo welizwe kumyinge wesizwe.
Urhulumente ngamnye unikezwa i-FMAP ubuncinane ngama-50 ekhulwini, oko kukuthi urhulumente wephondo uhlawula iipesenti ezingama-50 zeendleko zeMedicaid. Wonke amanye amazwe athola ipesenti ephakamileyo yeemali zeMedicaid esekelwe kwi-FMAP yabo ebalwe. Ngenqanaba elingaphantsi komvuzo ngamnye, i-Mississippi ine-2017 FMAP yama-74,63 ekhulwini ukwenzela ukuba urhulumente wezepoliti uncedise i-$ 2.94 i-$ 1,9 ukuze i-$ 1 i-state isebenzise.
Ukuze ufumane inkxaso-mali yeMedicaid, amazwe avumelana nemigangatho ethile. Urhulumente akavumelekanga ukuba abeke abantu kwizintlu zokulinda, azinako ukufumana isimboli sokubhalisa, kwaye ayikwazi ukuhlawula iiprimiyam okanye iimali zokubhalwa kwemali kumntu ofumana ngaphantsi kwama-150 ekhulwini kwi-FPL.
Uxhasomali lwe-Federal for CHIP
Ngenkxaso-mali ye-Federal ye-CHIP, ngakolunye uhlangothi, imisele imingcele. Urhulumente ngamnye unikezelwa isabelo sonyaka kunyaka wesibonelelo. Isamba se doladi sigxininiseki nantoni yenani elijongene neprogram.
Ama-50 athi kunye neSithili sase-Columbia banokukhetha ukusebenzisa izibonelelo zabo zebhloko ngeendlela ezintathu:
- Njengentlangano ye-Medicaid-CHIP (iinkqubo ezingama-29 zombuso)
- Njengenxalenye yokwandiswa kweMedicaid (iiprogram ezili-9 zaseburhulumenteni)
- Njengenkqubo ye-CHIP eyahlukeneyo (iinkqubo ezili-13 zaseburhulumenteni)
Ukukhuthaza uhulumeni ukuba athathe inxaxheba kwi-CHIP, urhulumente wesigqeba unikezela ngezinga eliphezulu elilinganayo kunokuba lenzelwe iMedicaid.
Umyinge wesizwe weMedicaid ulingana nama-57 ekhulwini ngelixa i-70 ekhulwini ye-CHIP. Kwakhona, ichaza ngeemfuno eziphezulu zezoqoqosho zibuyiselwa kwizinga eliphezulu.
Abo bathetha ukusebenzisa iinkqubo zokudibanisa okanye ukwandiswa kweMedicaid baneemfuneko ezifanayo zohlelo njengeMedicaid yendabuko. Amazwe ahlukeneyo neenkqubo ze-CHIP, nangona kunjalo, zinegumbi elingaphezulu. Ukuba kuyimfuneko, banokubeka abantwana kuloluhlu lokulinda okanye bamise iifom zokubhalisa ukuze zibuyele kwiindleko ze-CHIP. Uninzi lwawo mazwe luya kuhlawula iiprayimari kunye neepayimenti kubaxhamli babo.
Ukwahlukana kwi-Coverage for Medicaid ne-CHIP
Imigaqo ye-Federal regulations I-Medicaid inikezela ngeenkonzo ezithile kubantwana bayo. Oku kubandakanya ukuHlola okuPhambi kwexesha eliPhezulu kunye nokuPhepha, i-EPSDT, iinkonzo ezipheleleyo ezijolise ekunyamekelweni nasekukhuseleni. Kuquka oku kulandelayo:
- Ukuhlolwa kwengxelo epheleleyo
- Ukunakekelwa kwamazinyo
- Ukuvavanya ukuvavanya, kubandakanywa ukuchithwa kwe-cochlear kunye nezixhobo zokuva
- Ukugonywa kunye nokugonywa
- Inkqubo yokuhlola
- Ukuhlolwa kwempilo yengqondo kunye nokucebisa
- Ukuhlolwa kweemvelo
- Umbono wokuhlola, kuquka iiglasi
IiNkonzo ezigqitywe nguMdakala zibandakanya ukunakekelwa okunikezelwa kwiiNkonzo zezeMpilo eziQinisekayo zeFerally (FQHCs) kunye neenkonzo zokubuyisela.
Iiprogram ze-CHIP, nangona kunjalo, akufuneki ukuba zihlangabezane nomgangatho obekwe ngu-EPSDT, nangona kufuneka banikele ngononophelo lwendlela yokubandakanya okubandakanya ukunakekelwa kwebhedlele, izifundo zelabhoratri, ii-ray, kunye neemviwo zomntwana, kuquka nokugonywa. Unonophelo lwamazinyo alukwazi ukuba lukhulu njengoko luqhutywa phantsi kwe-EPSDT kodwa kufuneka lube yinxenye yenkxaso yenzuzo. Kule nto, i-state nganye inokukhetha inzuzo yabo yamazinyo ngokusekelwe kwisicwangciso sezinyathelo zomntu wamaqumrhu asesidlangalaleni, isicwangciso esithile esidumileyo somsebenzi wezentengiselwano sabasebenzi abaxhomekeke kuyo, okanye isigxina kwisicwangciso se-inshorensi esithandwa kakhulu kwi-state.
Ikusasa leMedicaid ne-CHIP
Ezopolitiko, iMedicaid ngumcimbi ohlawulisiweyo. Ulawulo lwangoku luzama ukuphelisa uMthetho ojongene noNonophelo ongenakunqwenelekayo, oza kuphelisa ekunyuseni iMedicaid. Injongo kukunciphisa i-fineral federalid ye-Medicaid yendabuko.
Isicwangciso sezempilo esisandul 'ukugqibela se-GOP sifuna ukutshintshela i-federal matching for Medicaid ne-flat-level block rate kwisibonelelo ngasinye. Nangona iiprogram zebloki zincinci kwinkqubo ye-CHIP, inkqubo ye-CHIP yincinci kakhulu kwinani leeMedicaid. Kwakhona, ukuxhaswa kweemali zancinci ukuba zingaphi abantwana abangabhekisela phantsi kwe-CHIP. Amazwe kunye neendleko zebhloko zibeka abantwana kwizintlu zokulinda.
Bangaphi abantwana abaya kulahlekelwa kwenkxaso yokunakekelwa kwempilo xa ukuguqulwa kwezempilo kweGOP kudlula?
ILizwi
Abantwana abakhuliswayo kwiintsapho ezifumana imali engaphantsi bafanelwe ukhathalelo lwempilo olufanayo njengabafana babo abaphezulu. I-Medicaid inikela ngononophelo kwiintsapho ezihlwempuzekileyo ngelixa i-CHIP idlulisela ukufikelela kwinqanaba labantwana. Ukunyamekela ngeprogram yeMedicaid inokuba yinto ebanzi, kodwa inkqubo ye-CHIP inikezela ngokubanzi ngokubanzi. Qonda ukuhluka phakathi kwezi zimbini iinkqubo kwaye wenze uncedo loluntu lwempilo yakho.
> Imithombo:
Inkqubo ye-Intshumo yezempilo yabantwana (CHIP). Website Medicaid.gov. https://www.medicaid.gov/chip/chip-program-information.html.
> Fumana iiNkqubo kuRhulumente wakho. InsureKidsNow.gov iwebhusayithi. https://www.insurekidsnow.gov/state/index.html.
> Idatha yokuBhalisa kunye neCIP. Website Medicaid.gov. https://www.medicaid.gov/medicaid/program-information/medicaid-and-chip-enrollment-data/index.html
> Patrick SW, Choi H, Davis MM. Ukwandisa kumdlalo wesiganeko ohambelana nokuzuza okubalulekileyo ekujoliseni abantwana ngokusebenzisa iMedicaid ne-CHIP. Aff Aff . Ngo-Agasti ka-2012; 31 (8): 1796-802. i-doi: 10.1377 / hlthaff.2011.0988.
> I-AD, i-TF ende, i-Helm ME, et al. Inkqubo ye-Intshumo yezempilo yeNtwana (i-CHIP): iimpumelelo, imingeni, kunye neencomo zomgaqo-nkqubo. Pediatrics. 2014 Mar; 133 (3): e784-93. i-doi: 10.1542 / iipeds.2013-4059.