Kwizona zinto ezisisiseko, imeko ekhoyo ngaphambili yimeko yezokwelapha onayo ngaphambi kokuba ufake isicelo se- inshorensi yezempilo . Iimeko eziphambili ezikhoyo zisetyenziselwa ukuba kube ngumqobo wokufumana inqaku kwiimarike zempilo yomshuwalense, kodwa i-ACA yatshintsha loo nto.
Kutheni Iziganeko Ezingaphambi Kwexesha Ezikhoyo Zisetyenziselwa Ukuba Zizenzile
Ngaphambi koMthetho woNonophelo ongenakuncedo , kwezinye iimeko, umgcini-mali unokungafuni ukukuthengisela umgaqo-nkqubo we-inshorensi yempilo ukuba unemeko ekhoyo ngaphambili.
Kwamanye amaxesha, i-inshurensi yayiza kubandakanywa imeko yakho ekhoyo ngaphambili evela kwi-inshorensi yakho yempilo. Oku kwaziwa ngokuba yimeko ekhoyo ngaphambili .
Kwezinye iimeko, umgcini-inshurensi usenokuba uvumile ukufihla imeko yakho esele ikhona, kodwa unokukuhlawulisa iiprayimari eziphezulu kakhulu kuloo mali kunokuba uhlawulwe umrhumo onjalo ngaphandle kwimeko esele ikhona. Le ndlela yafumana inzuzo kubagcini bomshuwalense njengoko ixesha lihamba, ngenxa yokuba kwakulula lula ngaphezu kokungabandakanyi imibandela ekhoyo ngaphambili.
Ukuba nemeko esele ikhona ngaphambili njengengcinezelo ephezulu yegazi engabandakanyekanga kwi-inshorensi yakho yezempilo yinto enkulu kunokuba nje uhlawule iipilisi zegazi eziphezulu. Ukukhutshwa kwemeko esele ikhona ngaphambili kungabandakanyi ngaphezu kwelo xesha elilodwa elide likhona ukusuka kwirejista. Inokuthi ingabandakanyi zonke ezinye iimeko eziphuhlisiwe ngenxa yesimo sakho esasikhona.
Ngokomzekelo, ukuba imeko yakho engekho ngaphambili ikhona ingcinezelo ephezulu yegazi kwaye une-stroke ngenxa yexinzelelo eliphezulu legazi, inkampani ye-inshorensi yezempilo inganqaba ukuhlawula unyango lwakho. Kuya kuthetha ukuba, ngenxa yokuba isifo sakho sisiphumo esisisigxina se-blood pressure yakho engekho ngaphandle, ukukhwabanisa kwakungabandakanywa kwi-coverage.
Imeko esele ikhona ngaphambili ibenzi nzima ukuba abantu babe neemeko ezikhoyo ngaphambili zokufumana i-inshorensi yempilo yeeprayimari ezifanelekileyo. Ngokuqhelekileyo, abazange bakwazi ukufumana ingqalelo kuzo zonke. Ukuba babenako ukufumana ingqalelo, bekubiza kakhulu kwaye / okanye bakabandakanyi imeko yabo ngaphambili.
Ngo-1996, i- HIPAA , uMthetho we-Inshurensi yokuPhathwa kwe-Intshumo nokuXanduva lokuTyala, ibeka imida xa abaqinisekisi bempilo bevunyelwe ukuba bangazibandakanyi izimo zangaphambi kwexesha kunye nokuba ixesha elide lokukhutshwa kwangaphambili lingaba njani kwezinye iimeko. Funda kabanzi malunga nalo . Nangona kunjalo, ukukhuselwa kwe-HIPAA kusetshenziswe ikakhulu kubantu abafuna ukuhanjiswa phantsi kwezicwangciso ezixhaswe ngumqeshi.
Kwimarike yomntu ngamnye (ukuthengwa komsebenzi ngokwakho, kunokuba ufumane ukuvela emsebenzini) izimo ezengaphambili zibe yingxaki enkulu kubafaki-sicelo kwiindawo ezininzi phambi ko-2014. Kwakunzima, kubiza, okanye akunakwenzeka ukufumana i-inshorensi yempilo eya ukumboza imeko ekhoyo ngaphambili kunye nayiphi na imeko enxulumene nayo.
UMthetho woNonophelo olungabonakaliyo kunye neemeko eziPhambi kwexesha
Ngo-2014, ukukhuselwa kwabathengi abangenakunqunyiwe. Ngoku, ngokubonga kuMthetho woNonophelo olungabonakaliyo, ama-inshorensi yezempilo e-United States akakwazi ukuphendula ingxelo yakho yempilo xa ugqiba ukuba ngaba awukuthengisi, yomshuwalense wezempilo.
Akunakukhuphela ngaphandle imeko ekhoyo ngaphambili ukusuka kwirejista, kwaye abanakukuhlawulisa ngakumbi ngenxa yokuba unesimo esasikhona ngaphambili.
Oku kuye kwenza kube lula kubantu abanemibandela engaphambili yokuthenga i-inshurensi yempilo, ukuguqula imisebenzi, ukuthatha umhlalaphantsi ngaphambi kokufaneleka kwi- Medicare , okanye ukuzityhalela njengomrhwebi. Abantu abasayi kuba nexhala lokuba baxilongwa ngaphandle kokungaxhamli.
Intshuwalense yezempilo ezithengiswa kwi-inshurensi yempilo eyenziwe ngu-Care Affordable Act inokuqinisekiswa , oku kuthetha ukuba inkampani ye-inshorensi yezempilo ayinakukugatya ukuthengiswa kwe-inshorensi yempilo nje kuphela xa ufaka isicelo sokubhengezwa ngexesha lokubhalisa .
Oku kufanayo nakwiinkcukacha ezinkulu zonyango ezithengiswa ngaphandle kokutshintshiselana , nto leyo kufuneka kwakhona ibe yi-ACA.
Ubani Ubhaliso oluvulekileyo kwiiNtshumo zeNtshuwalense yezeMpilo?
Ukuba i-ACA iyaphiliswa, ngaba iimeko eziPhambi kwazo ziya kuba yingxaki kwakhona?
NgoMeyi 4, 2017, amaRiphabhulikhi kwiNdlu yabameli be-US adlulisele uMthetho we-American Health Care Act (AHCA) kwaye uyithumela kwi-Senate. Kodwa nangona uqalise iintlobo ezahlukeneyo zebhilikhi, iiRephabhlikhi zaseRephabliki zazingenakukwazi ukugcina inkxaso eyaneleyo ukuba idlulise nayiphi na yazo.
Ingqungquthela yokuqala ye-AHCA yayiza kugcina ukukhuselwa kwangaphambili kweemeko, kodwa iMacArthur Uhlengahlengiso yatshintshile ibhali-mthetho ukuba ivumele amazwe ukuba akhuphe ezinye i-ACA zokukhusela abathengi. Ngokuqinisekileyo, i-state iya kuba ivumelekile ukuba i-insurers ihlawulise iiprayimari eziphezulu kumakethi athile xa umfaki-sicelo enesimo esasikhona ngaphambili kwaye akazange aqhubeke nokugcinwa kwenyanga ezi-12 ngaphambi kokuba abhalise kwisicwangciso esitsha.
Ukuchitshiyelwa kweMacArthur kwi-AHCA kuya kuvumela ukuba amazwe atshintshe inkcazelo yeenzuzo ezibalulekileyo zezempilo , ngoko ke izicwangciso zezemidlalo zingathengiswa. Oku bekuya kubachaphazela ngokungathanga ngqo abantu abaneemeko zangaphambili, njengoko izicwangciso ezibandakanya ukuxhaswa kweemeko zazo zingenakufumaneka okanye zingabizi ngokuthe ngqo.
Izinguqulelo zeSenate zomthetho ezazisungulwa ngo-2017 zathatha iindlela ezahlukileyo kumba weemeko zangaphambili. Ngokuqhelekileyo, ngelixa ixesha lokuthetha laliqhelekileyo ukuba abantu abaneemeko zangaphambili babeya kukhuselwa, into eyona nto yayiyiyo yokuba abayi kuba. Umxholo oqhelekileyo wawunombono wokwenza amazwe aguquke ngakumbi ukuguqula inkcazelo yeenzuzo ezibalulekileyo zezempilo, okanye ukuvimba ukunika inkxaso ye-ACA kwilizwe kwaye ubavumele ukuba bahlakulele zabo izisombululo.
Ixesha liye laphuma ekuhlaliseni uhlahlo lwabiwo-mali ngo-2017 ngoSeptemba 30, kunye nalo, ithuba lokuphelisa i-ACA ngobuninzi obulula kwi-Senate. Kodwa abameli beRiphabhlikhi bafunge isifungo sokuzama kwakhona ngo-2018 ukuphelisa i-ACA, kwaye akucaci ukuba baya kuphumelela.
Ukuqeda ukukhuselwa kwimeko esele ikhona kubangelwa ngabantu abaninzi, njengoko olo khuselo luya kuba linye yezona zibonelelo ezidumileyo ze-ACA. Kodwa yinto ebangela ukuba iipresimesi zandise kwiimarike zodwa, kwaye abanye abenzi bomthetho bangathanda ukubona ukukhuselwa okuncinci kancinci kubantu abanemeko esele ikhona, kwintengiso yeeprayimari eziphantsi.
Uninzi luya kubonakala malunga nekamva le-ACA, kwaye umba weemeko ezisele zikhona ziza kuphinda zibuye ngokuzayo. Kodwa ngeli xesha, zonke izikhuselo zabathengi be-ACA zihlala zigcwele ngokupheleleyo. Ubhaliso oluvulekileyo lwe-2018 luqala ngoNovemba 1, 2017 nakwiindawo ezininzi, kuya kupheliswa ngoDisemba 15, 2017. Leli thuba lakho lokuthenga ukuthengwa kwemakethe nganye, kwaye imbali yakho yezobugqirha ayiyi kuba yinto ebalulekileyo ekufanelekile okanye kwi-premium yakho.
> Imithombo:
> Isebe Lempilo Neenkonzo Zoluntu, Amalungelo Akho Nge-HIPAA.
> Healthcare.gov. Funda uMthetho woNonophelo ongenakunceda.
> IKomiti yeNdlu yamandla kunye noRhwebi, iMilArthur isilungiso kwi-HR 1628, iCandelo leSahluko seSishwankathelo .
> I-Kaiser Family Foundation, iiNtsholongwane zeeNtsholongwane zeeNtsholongwane: I-Issu eqinisekisiwe . Juni 2012.
> I-Kaiser Family Foundation, Isishwankathelo se-American Health Care Act, ngoMeyi 2017.