Ngaba i-AHCA okanye i-BCRA yotshintsho Inkxaso-mali eyenziwa ngabaqeshi?
Nangona ingxoxo malunga nokuguqulwa kwezempilo kunokuthi igxininiswe kwimarike yomshuwalense (oko kukuthi, kubantu abangafumani ngombala kumqeshi) kunye neMedicaid, umthetho ophantsi kokubangela uza kubangela utshintsho olubalulekileyo kwi-inshorensi abaqeshi banikela ngayo babo sebenzi.
Umthetho wokuNakekelwa ongenakuncedo (ACA) usele ndawo ukususela ngo-2010, kwaye abagwebi beRiphabhlikhi bebenokusebenza ukusichitha ukususela oko kwasungulwa.
Umongameli we-Obama we-veto ipeni wagcina umthetho uhleli kuze kube ngo-2017, kodwa xa uMongameli uTrump ethatha isikhundla, kwakukho indlela yamaRiphabhlikhi yokuqhubela phambili kunye nemigudu yabo yokunciphisa.
NgoMeyi 4, abameli beNdlu baphakamise ibhilikhi yokulungiswa kwempilo, i-American Health Care Act (AHCA), 217 ukuya ku-213, kwaye yithumela kwi-Senate. Umthetho wawudinga ukuba amavoti angama-216 adlule, ngoko ukuphumelela kwakuyimida emncinane kakhulu.
I-Ofisi yeBhajethi ye-Congressional yayingazange ilandele ibhaso lokugqibela phambi kweNdlu yokuvota; Izilungiso ezintathu zongeziweyo ukususela nge-CBO ngaphambili ifumene umyalelo-mali ngo-Matshi, ngoko ke impembelelo epheleleyo ye-AHCA yayingacacile, nangona emva kokuba umyalelo-mali usuphume kwiNdlu. Amanqaku e- CBO ekugqityweni kokugqibela kwebhili-mali yapapashwa ngoMeyi 24-malunga neeveki ezintathu emva kokuba iNdlu idlulise umthetho.
I-AHCA: Thatha enye
Indlela eya kupheliswa yinto eqhelekileyo, ekwahlula ngokukhawuleza phakathi kweePhabhulikhi zeNdlu ngokwemimandla ye-ACA kufuneka ishintshwe okanye isuswe.
I-AHCA yaziswa ngo-Matshi 2017, kodwa yadotshwa imizuzu phambi kwevoti ehleliweyo kwiNdlu ngo-Matshi 24, emva kweeyure eziliqela zengxoxo, ngenxa yokungabi ncedi.
Indlebe uSomlomo uParry Ryan (R, Wisconsin) ekuqaleni wathi amaRiphabhliki aya kuhamba kunye nezinye izinto kwi-ajenda yabo, kodwa ngeveki elandelayo, i-AHCA ibuyele etafileni.
I-mpikiswano ukususela ngoku ijikeleze ukuzama ukufumana umgangatho ophakathi ukuhlanganisa iiRiphabhulikhi ezachasene ne-AHCA. Le nto yayinzima, njengoko abo bameli bomthetho bezokwimilinganiselo yee-GOP kunye ne-ultra-conservative.
Kwakukho ubuncinane abameli abangamaRiphabliki abachasene ne-AHCA ngo-Matshi, nangona iRiphabhliki ininzi eNtendeni, inokuthi idlule umthetho xa kungabikho iiRiphabliki ezingavumelekanga ukuvota (bonke abaDemokhrasi babumbene ngokumelene neCAA ukususela ekuqaleni) .
I-AHCA ne-MacArthur Uhlengahlengiso kunye no-Upton Ulungiso: ngoMeyi 4 IVote = Uhambo
Ingxoxo ngo-Ephreli nakwiminyaka yokuqala kaMeyi yayiquka izilungiso ezintathu ezongezelelweyo: ukulungiswa kokungabonakali kwenkqubo yokwabelana ngengozi , i-MacArthur Amendment kunye ne-Upton.
Ulungiso olungabonakaliyo lokwabelana ngolwabiwo lwenkqubo luye lwafakwa ekuqaleni kuka-Epreli, kwaye lubiza i-$ 15 billion kwiimali zenkxaso-mali ngaphezu kweminyaka engama-9 ukukunceda ukuzinzisa iimarike zempilo zonyango.
I-MacArthur Amendment, eyaziswa ngo-Ephreli ngo-Ephreli ngu-Tom MacArthur (R, eNew Jersey), ivumela amazwe ukuba akhuphe ezinye zokukhusela zabathengi be-ACA, kubandakanywa iimfuno zezempilo eziyimfuneko , imilinganiselo yeminyaka yobudala kunye nokulinganisa uluntu.
Ngethuba nje ukuba amazwe athatha amanyathelo athile asemgangathweni ukuze axhaswe kwiimarike zabo ze-inshorensi, ziya kuvunyelwa ukunciphisa ubukhulu bezinto ezifunekayo ezifunekayo ezifunyenwe zizicwangciso zeqela kunye namancinci.
Baya kuba nako ukuvumela iinkampani ze-inshorensi ukuba zihlawulise iiprayimari eziphezulu kubantu abaneemeko esele ikhona ngaphambili. Umntu onesithuba sokubhengezwa ubuncinane ubuncinane kwiintsuku ezingama-63 kwiinyanga ezili-12 ezidlulileyo uya kuhlawuliswa iiprojama ezisekelwe kwimbali yonyango (oko kukuthi, iiprayimari eziphezulu ukuba ziimeko zempilo) kwiinyanga ezili-12 zokuqala emva kokubhalisa kwisicwangciso somntu ngamnye. , imithetho ye-AHCA rhoqo iya kusebenza kwiindawo ezingafuni ukuxoshwa; abafaki-sicelo abanesithuba kwi-coverage baya kuhlawulwa ama-premium angama-30 ephakamileyo kunyaka omnye, kungakhathaliseki ukuba imbali yonyango).
I-MacArthur Amendment ifumane inkxaso evela kwi-House Freedom Caucus, kodwa yenza amaRiphabhlikhi aqhelekileyo ahambe kude ne-AHCA, phakathi kweengxakini ukuba abantu abaneziganeko zangaphambili belahlekelwa ukukhuselwa abaye bafumana phantsi kwe-ACA.
U-Upton Uhlengahlengiso, owaziswa ngoMeyi ngo-Meyi. UFred Upton (R, eMichigan), unikeza i-$ 8 yezigidigidi ngaphezu kweminyaka emihlanu ngenxa yokuba ulungele ukukhuselwa kwimeko esele ikhona, ukwenzela ukuba uncede amazwe acwecwe ezinye iiprayimamu ezongezelelweyo Iimeko ezikhoyo ziya kuhlawula. Nangona kukho iinkxalabo zokuba i-$ 8 yezigidigidi ngaphezu kweminyaka emihlanu ayiyi kuba yaneleyo, kwaye ukuba izilungiso ziyasebenza ngenjongo yokuphambana ne-ACHA eqhubekayo yokufundwa kwempahla, u-Upton Uhlengahlengiso lugxininisa ezinye iimodareyitha ukuxhasa i-AHCA, kwaye i-bill inyuke kwiNdlu. ngemini kaMeyi 4.
Yilwayo Yesizwe
NgoJuni, iiRephablikhi zaseRephabliki zazisa ingqungquthela yabo yowiso-mthetho, obizwa ngokuba yi-Better Care Reconciliation Act (BCRA). Ziye zazisa iinguqu ezimbalwa ze-BCRA; Nantsi inkcazo yeentlukwano phakathi kwe-AHCA kunye ne-BCRA .
I-Senate iye yazisa "ukuchithwa nokulibaziseka" umlinganiselo, ngokuyinxalenye yenguqu ebhaliweyo ye-bill bill eyenziwa yiCongress ngo-2015 (HR3762), kodwa uMongameli uBhabha u-Veto. Intsha entsha yeRiphabliki yenguqu ye-HR3762 ibizwa ngokuba yi-Obamacare Repeal Reconciliation Act ka-2017 (ORRA). Unokufunda isishwankathelo se-bill , kwakunye nokuhlalutya kwe-CBO kwilwayo. Akunakwenzeka ukuba i-ORRA izakuphumelela ngokwaneleyo ngenkxaso phakathi kwamaSephablikhi aseSenethi, njengoko abaninzi bevakalise ukukhuselwa kwimbono yokucima i-ACA ngaphandle kokulungele ukuhamba.
Impembelelo kuMxhasi-Umxhasi oxhasiweyo
I-AHCA isele idlulile kwiNdlu, kodwa ingqungquthela ye-Senate (i-BCRA) ihluke kwiindlela ezimbalwa. Ukuba idilesi yeSeneti idlula, iNdlu iya kufuneka ivumelane nezinguqu ngaphambi kokuba ithunyelwe kuMongameli.
Kodwa ukuba umthetho wokuguqulwa komthetho wawuza kwenziwa, ngaba uza kubachaphazela njani abantu abafumana i-inshurensi yezempilo kumqeshi? Ininzi yokugxila kwi-AHCA kunye ne-BCRA ibe yindlela ekuya kutshintshwa ngayo abantu abathenga i-inshuwalense nganye yemarike okanye bafumane iMedicaid. Kodwa kuthekani malunga nezicwangciso ezixhaswe ngumqeshi?
I- ACA ifake iinguqu ezininzi kwiinshorensi zempilo exhaswe ngumqeshi . Masiqwalasele impembelelo i-AHCA kunye ne-BCRA iya kuba ne-inshurensi yezempilo abantu abayifumana kubaqeshi babo.
Amaqela amakhulu: Ukupheliswa kweMvume yoMqeshi
Abaqeshi nabasebenzi abangama-50 okanye ngaphezulu abayi kuphinda bafuneka ukuba banikeze i-inshorensi yezempilo. Ngaphantsi kwe-ACA, abaqeshi nabasebenzi abangama-50 + kufuneka banikeze i-inshorensi yabo yexesha elizeleyo ye-inshurensi yempilo efikelelekayo enikezela ubuncinci ubuncinane (oko kukuthi, iquka ubuncinane ama-60 ekhulwini weendleko zonyango). Ukuba behluleka ukwenza njalo, baxhomekeke kwisigwebo sentela. I-AHCA iya kuphelisa eso sigwebo, siphendule kwakhona ekuqaleni ko-2016. Ngoko umgaqo we-ACA ofuna ukuba abaqeshi abakhulu babe ngabafundi kwiincwadi, kodwa akukho miphumo yabaqeshi abangazange bayilandele.
Ukucaca, uninzi lwabaqeshi abakhulu bebevele benika iingeniso zempilo phambi kokuba i-ACA yenze imfuneko. Kodwa bonke abazange banikezele ngokufihlakeleyo (okuchazwe yi-ACA ngo-2017 njengomsebenzi-kuphela wokufumana umsebenzi ongekho ngaphaya kwama-9.69 ekhulwini kwengeniso yomzi) kunye nokubanzi. Abanye abaqeshi bafuna abasebenzi ukuba bahlawule iipriyamu ezingayifumananga nenkcazo ye-ACA yexabiso elingathengiyo, kunye nabanye abaqeshi-ngokukodwa kumashishini enkonzo kunye nemisebenzi ene-high-income-provided "mini-meds" ebenomlinganiselo omncinci wokhathalelo lwezonyango ophantsi kakhulu umlinganiselo wokuxhamla (umzekelo, isicwangciso esasigxina ukutyelela ngokugqithisa ugqirha kodwa ukukhawulelana neenzuzo ezipheleleyo kwi $ 5,000 okanye i-$ 10,000 ngonyaka wonke, ongahambi kude ukuba umqeshwa uhlala esibhedlele).
Uhlalutyo lweMicimbi yezeMpilo ngokusekelwe kwi-ACA yangaphambili (2009), yafumanisa ukuba ama-38 ekhulwini yabaqeshi abakhulu babejongene nezigwebo phantsi kwe-ACA ukuba iinzuzo zabo zazingatshintshi xa igunya lomqeshi lisebenza.
Ukuba umqeshi isigunyaziso sesigwebo siyaqedwa, omnye umqeshi omkhulu unokubuyela kwisithuba sokunikezela amathambo, kwaye abanye bangase baqale bafune ukuba abasebenzi bahlawule isabelo esikhulu seprayimari. Oku kwakungeke kuthandwe ngabasebenzi, ngoko kuya kwenzeka ukuba akuyi kubakho ukutshintshwa okupheleleyo kwi-ACA yangaphambili. Kodwa yinto yokubukela, ingakumbi ukuba umqeshi wakho wandise inzuzo yakho kwiminyaka embalwa edlulileyo ngenxa ye-ACA.
Abaqeshi abancinci-abachazwe njengabasebenzi abangaphantsi kwama-50-abazange bafuneke ukuba banikeze ukukhawuleza, ngoko ukuchithwa kwegunya lika-ACA lomqeshi aliyi kubachaphazela. Nangona kunjalo, i-AHCA kunye ne-BCRA iya kuphelisa, ngowe-2020, iikhredithi zerhafu ezinomvuzo ophantsi, abaqeshi abancinci ngoku bangasebenzisa ukukhupha iindleko ze-premium ukuya kwiminyaka emibini yokunika ingxelo. Nangona oku akukona ukusetyenziswa ngokubanzi kwe-ACA, ukucinywa kwayo kungenza kube nzima kwamanye amashishini amancinci ukuba ahlawule.
I- Ofisi yeBhajethi ye-Congressional iqikelele ukuba ngo-2018, inani labantu abagqitywe ngumshuwalense oxhaswe ngumqeshi liza kulahla izigidi ezi-2 ngaphantsi kwe-AHCA, kwaye ngowe-2026, inani elingu-3 yezigidi zabantu liza kubhengezwa phantsi kwezicwangciso ezixhaswe ngumqeshi. Ngaphantsi kwe-BCRA, i- CBO iqikelela ukuba izigidi ezi-4 zabantu abancinci babeza kuba ne-inshurensi yempilo exhaswe ngumqeshi ngo-2018, kodwa ngo-2026, abantu abayi-2 kuphela abantu abancinci babeya kuba ne-inshorensi yempilo exhaswa ngumqeshi (xa kuthelekiswa nendlela eya kuba ngowama-2026 ukuba I-ACA kwakufuneka ihlale ihambelana).
Abanye babo bantu ngabantu abaza kuphuma ngaphandle kwezicwangciso zabo zabaqashi emva kokuba isigwebo somntu ngamnye sigqitywe phantsi kwe-AHCA okanye i-BCRA. Kodwa abanye ngabantu abo abaqeshi abayeka ukunikela ngokukhawuleza ukuba umyalelo wegunya lomqeshi upheliswa ngu-AHCA.
Kuphawuleka ukuba uhlalutyo lwangaphambili lwe-CBO ( olupapashwe ngasekupheleni kweKwindla ) lwe-AHCA luye lwacacisa ukuba inani labantu abaxhaswe ngabaqeshi baxhomekeke kwizigidi ezi-7 ngo-2026. Kuhlalutyo olulandelayo, i-CBO ibone ukuba isizathu sincinci ukuhla kweenani labantu abagqityiweyo kwizicwangciso ezixhaswe ngumqeshi (izigidi ezi-3 esikhundleni sezigidi ezi-7) kukuba ukukhethwa komntu ngamnye kumakethi kuya kuba ngumgangatho omncinci kwaye ufikeleleke kwiindawo ezifuna ukukhutshwa phantsi kwe-MacArthur Amendment.
I-CBO icacisa ukuba abaqeshi abambalwa baya kuqwalasela enye imarike enye indlela efanelekileyo kwiinkcazo zenkampani yabasebenzi babo, kwaye ke baya kuqhubeka nokunika igalelo leqela, nangona bengazange benze njalo ukuba i-MacArthur Amendment yayingenakongezwa AHCA. Nangona i-CBO ingazange izuze i-BCRA kunye ne-Cruz Amendment, abaqeshi banokuthi bafumane ukukhutshwa okufanayo malunga nokuthumela abasebenzi babo kwiimarike ezizithengiweyo ukuba bathenge i-coverage yabo ukuba isilungiso kufuneka siphumezwe njengenxalenye ye-BCRA (i-Cruz Amendment iya vumela abatshutshisi ukuba banike izicwangciso zezempilo ezingamkelekanga, nje kuphela xa zinikeza izicwangciso ezincinci ze-ACA ezifanelekileyo).
Imilinganiselo ye-FSA Yokunikezelwa: ichithwe emva ko-2017
I-ACA ibeka umrhumo kwii- akhawunti ze-Flexible Spending Accounts (ii-FSA) kwi-$ 2,600 ngo-2017, ihlawulwe kwixabiso lentengo. I-AHCA kunye ne-BCRA iya kushenxisa le mingcele emva kokuphela kuka-2017, ukubuyela kwinkqubo phantsi komqeshi ekusetyenziseni inani eliphezulu elinokubanjelwa kwi-FSA yabasebenzi.
Imilinganiselo ye-HSA Yokunikezela: Iyenyuka ngo-2018
Kuba abantu abanezicwangciso zezempilo ezichithwe kakhulu kwi-HSA, umyinge wamanje we- akhawunti yokulondoloza impilo (i-HSAs) yi-$ 6,750 kwintsapho, kwaye i-$ 3,400 enye. Iminikelo ingekahlawulwa, kwaye ingenziwa ngumqeshi okanye umqeshwa, okanye udibaniso lwababini.
Ngaphantsi kwe-AHCA kunye ne-BCRA, umda woxanduva luya kunyuswa ukulingana neendleko ezingaphezulu kweefowuni ezivunyelwe kwizicwangciso zempilo. Ngo-2017, i-$ 7,150 ibe yedwa, kunye ne-13,400 zamawaka kwintsapho. Ngo-2018, kucwangciselwe ukunyuka ukuya kuma-7,350 ukuya kumntu, kunye ne-14,700 zamawaka kwintsapho.
Ukuba abasebenzi banokufaka igalelo lemali eyongezelelweyo kwii-HSA zabo, baya kuphelisa ngemali engenayo ehlawulwayo, kwaye bahlawule irhafu encinane.
Amaqela amancinci: iiNkulumbuso eziPhakamileyo kwabasebenzi abadala
I-ACA ayifuni abaqeshi abancinci ukuba banikezele ukuxhaswa, kodwa ukuba bayakwenza, ukufihla ngokwaso kulawulwa yi-ACA. Izicwangciso zeqela elincinci ezingabonakaliyo (kunye nezicwangciso zentengiso ngamnye abantu abazithengayo ngokwabo) zinomda ngokwemali ephakamileyo yeeprayimari ezinokubhaliswa kwabangaphantsi kubhaliso abancinane.
Ngaphantsi kwe-ACA, umlinganiselo ngowama-3: 1 . Oko kuthetha ukuba umfundi oneminyaka engama-64 ubudala akanako ukuhlawulwa ngokuphindwe kathathu kangangoko uneminyaka engama-21 ubudala.
Ngaphantsi kwe-AHCA kunye ne-BCRA, ke, oko kuya kuguqulwa ukuya ku-5: 1 (okanye ngaphezulu, ukuba urhulumente usebenzisa i-waiver), ngaphandle kokuba urhulumente ekhethileyo ukugcina ubungakanani beminyaka yobudala be-ACA kwindawo (ekuhlalutheni kwabo kwi-BCRA, Iiprojekti ze-CBO ezininzi ziza kukhetha ukuvumela umlinganiselo we-5: 1). Ngomlinganiselo we-5: 1, ukubhaliswa kwabangaphantsi kwabo banokuhlawulwa kathathu kangangoko kubhalisa abancinci (leyo yindleko yenkampani yenkampani yomshuwalense, ehlawulwa ngabasebenzi kunye nxalenye ngabaqeshi; imali abaqeshi abafuna ukuba bahlawule ngayo ingahluka ubudala, kodwa kukho imithetho yokunyanzeliswa kweminyaka esetyenziswayo).
Ulungiso lwe-MacArthur kwi-AHCA lunikela amazwe ukuba asebenzise umlinganiselo ophezulu kunama-5: 1, oko kuthetha ukuba abasebenzi abancinci abangaphantsi kweminyaka engama-50 banakho ukuhlawulwa abangaphezu kwamahlanu abaqeshwa abaneminyaka engama-21 ubudala.
Amaqela amancinci: Unokupheliswa kweemfuno zeNqanaba leMigangatho
I-ACA idinga ukuba izicwangciso zeqela elincinci ezingabonakaliyo zihambelane neendlela ze-ACA zetsimbi: ithusi, isilivere, igolide, okanye i-platinum. Lo ngumlinganiselo wexabiso lexabiso elikhoyo (ipesenti yeendleko zezempilo ezicwangciselwe ukuba zicwangcise ukucwangcisa inani elipheleleyo labasebenzi ababhalisiweyo; Izicwangciso zebhonze zikhupha malunga neepesenti ezingama-60 zeendleko, iiplani zesilivere zifihla malunga nama-70 ekhulwini, iiplani zegolide zifihla malunga nama-80 ekhulwini, kwaye iiplatinum zicwangcisa malunga neepesenti ezingama-90 (nge-+/- 2 yepesenti kwinqanaba ngalinye, ngoko ke isicwangciso sesilivere sinakho xabiso nantoni na kwiindawo ezingama-68 ukuya kuma-72 ekhulwini).
Ngaphantsi kwe-AHCA, imfuno yokuba iqela elincinci (kunye nezicwangciso) ezihambelana nezinga lezakhiwo zentsimbi ziza kupheliswa emva kokuphela konyaka we-2019. Oko kuya kuthetha ukuhlukahluka kwezicwangciso, kwaye bekuza kwenza kube nzima ukuthelekisa ii-apula kwiipulo xa ukhangela izicwangciso ezininzi.
Ngaphantsi kwe-BCRA, ixabiso lexabiso lexabiso le-actuarial value alishintshintshi kwinqanaba le-federal, kodwa liza kuba nenkululeko yokukhupha okanye ukutshintsha iimfuno ngokusebenzisa i-1332 yaivers, eya kuhanjiswa ngeemfuneko ezingqongqo phantsi kwe-BCRA (i-1332 waivers inxalenye ye-ACA, kodwa i-ACA inesikhokelo esiqinileyo malunga nendlela kwaye ingafumaneka ngayo, i-BCRA iya kuphelisa uninzi lweemfuno).
I-Cadillac Tax: ixhaswe kude kube ngu-2026
I-ACA ye- Cadillac irhafu sele ibambezelekile kude kube ngu-2020, kodwa eyenziwa ngabaqeshi abathile xa bejonga iminyaka embalwa phantsi kwendlela. Intlawulo yeCadillac i-40 yepesenti yentlawulo yerhafu kwi-premium yama-premiums ngaphezulu kwinqanaba elisengaphambili. Kujoliswe ekujoliseni kuphela izicwangciso zeendleko eziphezulu, kodwa abagxeki banenkxalabo yokuba ngokuhamba kwexesha, kuya kusebenza kwinani elikhulayo lezicwangciso, ngenxa yokunakekelwa kweendleko zempilo ukukhula kwexabiso lokunyuka kwamaxabiso. Kwaye kwiindawo zelizwe apho i-inshurensi yezempilo ibiza kakhulu (njenge-Alaska, umzekelo), iya kusebenza ngaphezu kweenkqubo eziphezulu.
I-AHCA kunye ne-BCRA iya kugxotha irhafu yeCadillac ukususela ngo-2020 ukuya ku-2025, kungekho ntlawulo yerhafu esetyenziswayo ngeli xesha. Zomibini iinguqulelo zomthetho ziza kulungisa irhafu ukuba isebenze ngo-2026, kodwa kunokwenzeka ukuba umthetho ongezelelweyo ungasetyenziselwa phakathi ngoku kunye nokuphelisa irhafu ngokupheleleyo, njengoko kungathandeki kumacala omabini e-politike.
Ubume beFlexibility: Izibonelelo zezeMpilo ezibalulekileyo
Ngomzamo wokufumana amalungu e-House Freedom Caucus ukuba axhasane ne-AHCA, abenzi bezomthetho baquka iMilArthur Amendment ukuvumela amazwe ukuba aphucule imigangatho esetyenziswa kwimpilo ebalulekileyo kunye nokulinganisa uluntu.
Ngaphantsi kwe-ACA, izicwangciso zeqela elincinci (kunye nezicwangciso zorhwebo) kufuneka zifake iinkonzo zezempilo ze - ACA ezibalulekileyo , kwaye amaqela amancinci akakwazi ukuhlawulwa iiprayimari eziphezulu ezisekelwe kwimbali yezonyango zabasebenzi.
I-MacArthur Amendment ivumela amazwe anqume ukuba ayenze ukunyanzelisa loo mithetho, ngenzame yokuhlawula iiprayimari kubabhalisi bezempilo. I-trade-off, eqinisweni, kukuba abantu abaneemeko zangaphambili ezikhoyo ukukhetha ukuphumeza iimfuno ze-lax banokufumanisa ukuba iqela elincinci elungiselelwe ukuba lifumaneke alikho njengezicwangciso ezikhoyo ngoku.
Ukuba amazwe afuna ukuyeka ukuvumela iiprayimari eziphezulu kubantu abaneemeko zangaphambili ezikhoyo, eziza kusebenza kwimakethi nganye, kunokuba kuthengiswe imarike yeqela.
I-BCRA ithatha indlela eyahlukileyo, ngokunika ilungelo lokusebenzisa ama-1332 ukukhangela ukwenza utshintsho olungabandakanya ukuhlengahlengisa inzuzo yezempilo ebalulekileyo. Njengoko kuphawuliwe ngasentla, i-BCRA inenkqubo encinci yokumisela ukuvumela amazwe ukuba afumane ama-1332 aivers (xa kuthelekiswa ne-ACA). Iiprojekthi ze-CBO eziphantse malunga nesigamu sabemi belizwe zihlala kwiindawo eziza kufuna ama-1332 aiver ukwenzela ukunciphisa ububanzi bezinto ezibalwa njengezinto ezibalulekileyo zezempilo ukuba i-BCRA iya kuzaliswa. Oku kuya kuba nefuthe kwiiplani zeqela kunye namancinci phakathi kwala mazwe, ngokukhawuleza kungabi namandla kwixesha.
Ukukhuselwa kuNcitshiswa kwiiNkcazo zoBomi kunye noNyaka oMawulo kunye neNgaphandle kwePocket
Ngaphantsi kwe-ACA, zonke izicwangciso ezingabonakaliyo-ngabanye, izicwangciso zeqela eliqinisekisiwe ngokupheleleyo, kunye nezicwangciso ezizimeleyo-kufuneka ziphelise iifowuni zemivuzo yonyaka kunye neyokuphila (oko kukuthi, isicwangciso asikwazi ukufumana iintlawulo ezipheleleyo kwi-1 million yezigidi okanye i-$ 5 yezigidi ngaphezulu , njengoko kwakusoloko kuthethwa yi-ACA ngaphambili).
Zonke izicwangciso ezingenakulinganiswa nazo kufuneka zinciphise iindleko zokuphuma ngaphandle kwee-pocket zingabi ngaphezu kwexabiso elimiselwe ngaphambili (ngo-2017, i-$ 7,150 enye umntu).
Kodwa zombini ezo zinto zisebenza kuphela kwiimfuno zezempilo ezibalulekileyo . Ukuba urhulumente ufuna ukuxhaswa kunye nokunciphisa ububanzi beemfuno zezempilo ze-ACA ezibalulekileyo, imimiselo malunga nokuphila / ama-maximum yonyaka kunye nokukhawulelwa kwe-out-of-pocket kuya kukhululeka. Izinto ezingasayi kubonwa njengezibonelelo zezempilo eziyimfuneko aziyi kubakho nokhuseleko.
Yintoni engatshintshiyo
Olunye ukhuseleko lwabathengi iinkalo ze-ACA zixhaphake kakhulu, kwaye azicetywanga ukutshintsha phantsi kwe-AHCA okanye i-BCRA. Nantsi into enokuthi ihlale ifanayo kwiiplani ezixhaswe ngumqeshi:
- Abantu abadala abakhulileyo banokuhlala kwisicwangciso sezempilo somzali de kube ngama-26 ubudala.
- Iingxowa-mali zonyaka kunye nezobomi ziyakwenqatshelwa (kwindlela abafaka ngayo kwiimfuno zezempilo ezibalulekileyo;
- Izikhathi zokulinda ukufumana ingxelo xa abasebenzi basanda kulungelelanisa ukufikelela kwiinkcukacha ezingenakugqithisa iintsuku ezingama-90 (oku kungatshintshwa phantsi kwe-Amendment ye-Cruz ye-BCRA-okanye mhlawumbi ingayi kuba yinguqu ekugqibeleni ye-bill-kodwa kuya kuba kulungelelaniso lwesizwe ngasinye).
- Iindleko ezingaphandle kweefowuni zithathwe (umyinge we-2017 u-$ 7,150 ngamnye kunye ne-14,300 zamawaka kwintsapho; ngo-2018, umda ube ngu-$ 7,350 umntu ngamnye kunye ne-14,700 zamawaka kwintsapho). Nangona kunjalo, njengoko kuchaziwe ngasentla, imida ephuma ngaphandle isebenza kuphela kwizibonelelo zempilo ezibalulekileyo.
> Imithombo:
> Congress.gov, HR1628, UMthetho wezeMpilo waseMelika we-2017. Ukwaziswa kwiNdlu njengento yonke ngoMatshi 20, 2017.
> House.gov Iimithetho zeNdlu yoLungiso (iprogram engabonakali yengozi) kwi-HR1628 (uMthetho we-American Health Care Act) , ngo-Ephreli 6, 2017.
> I-House.gov Ulungiso loMlawuli kuMthetho wezeMpilo waseMelika, iiNguqulelo zoMgaqo-nkqubo , ngoMatshi 20, 2017.
> I-House.gov Isilungiso soMlungiselo woMphathi ku-HR1628 , ngoMatshi 24, 2017.
> I-Kaiser Family Foundation, Isishwankathelo se-American Health Care Act, ngo-Apreli 2017.