Sekunjalo malunga ne-29 yezigidi ezingenayo i-inshurensi yempilo ngo-2016
Ngo-2013, ngokwe-data ye-US Census, kwakukho izigidi ezingama-41.8 zabantu abangaphantsi kobudala abangaxhaswanga kwi-United States. Ngo-2016, elo nani liqikelelwe libe yizigidi ezingama-29. Oku kuyancipha kakhulu, kodwa kunengqiqo ukubuza ukuba kutheni abantu baninzi bengenayo inshuwalense yezempilo.
UMthetho woNonophelo ojongene noNyaka ongenakunqunyanyiswa wenziwa ngo-2010, kwaye ubuninzi beemigaqo zalo zaphunyezwa phakathi ko-2014 no-2016.
Ukuze uphephe isigwebo, abaqeshi abaninzi ngoku bafuneka ukuba banikeze i-coverage efikelelekayo kwixesha labo elipheleleyo (ii-30 + iiyure ngeveki) abasebenzi. Abantu ngabanye kufuneka bahlale banjengo-inshorensi yempilo okanye bajongane nezigwebo kwiirhafu zabo zerhafu. Ukuxhaswa kweeNkulumbuso kunye neenkxaso-mali zokwabelana ngeendleko kwiintlobo zengxoxo zenze i-coverage kunye nokunyamekela okuthengekayo kubantu abangenayo kwimali ephakathi. Kwaye ukwandiswa kweMedicaid kwenza i-free-or-almost coverage-coverage etholakalayo kwiintsapho ezinomvuzo ophantsi.
Ngoko kutheni kubakho abantu abangama-29 ezigidi abangenayo inshorensi yempilo e-United States? Lelo nani lihambelana nokuhlalutya olwenziwa yi-ACA Signups ngoMatshi 2016. Kwaye nangona kuncinci kunabantu abayizigidi ezingama-33 abangakhange baxhaswe ngo-2014 ngokwe-data ye-US Census, kuhambelana nokuqulunqwa kwee-Congressional Budget Office (CBO) ka-2012 ukuba bekuya kuba nezigidi ezingama-30 ezingezangezikhulile zase-US ngaphandle kwe-inshorensi yempilo ngo-2022 ( Idata ephathelele kwinani labantu abangenayo i-inshorensi yempilo ngokubhekiselele kubemi abangaphantsi, njengoko i- Medicare ihlanganisa abantu abaninzi xa befikelela kwiminyaka yobudala engama-65).
Ngaphambi kokuba iNkundla ePhakamileyo igwebe ngo-2012 ukuba i-ACA's Medicaid yokwandisa yayiza kuba yinto ekhethekileyo kwilizwe, i-CBO yayifake ukuba kwakuza kuba nezigidi ezingama-27 ezingezangezikhulile ezingabincedisi baseMelika ngo-2022. Abamemezeli nabalawuli bazi ukuba kwasekuqaleni ukuba I-ACA yayiza kwenza i-dent enkulu kwinani labantu abangaxhaswanga base-US (kwaye likhona), bekuya kuba nezigidi zabantu abangenayo inshorensi yempilo emininzi kwiminyaka emva kokuphunyezwa ngokupheleleyo komthetho.
Nazi ezinye zezizathu zokuba i-ACA ayizange ibangele i-inshurensi yempilo yonyango e-US:
Abafuduki abangabathunywa
I-ACA ayinikezeli naluphi na uhlobo lwe-inshorensi yezempilo yabangaphandle abangabhalwanga. Akunakwenzeka nje kuphela ukuba bafumane inkxaso-mali, banqatshelwe ukubhalisa kwisicwangciso sokutshintshiselana kuwo onke, nokuba ngaba banakho ukuhlawula ixabiso elipheleleyo le-coverage (iCalifornia yadlulisela ibhilida ngo-2016 eya kuvumela abafuduki abangabhalwa phantsi ukuba bathenge i-full- ixabiso lokuthengwa kwe-California, kodwa urhulumente kufuneka afumane ukukhishwa kwirejista kwi-federal government ukuze kuphunyezwe elo mbandela). Abafuduki abangabikho mthethweni nabo banqatshelwe ukufumana iMedicaid.
I-Kaiser Family Foundation iqikelele ngo-2013 ukuba bekukho izigidi ezi-4.8 ezingabangabikho kwamanye amazwe phakathi kwabantu abangaqinisekanga, ababalelwa kuma-15 ekhulwini kwabemi abangaxhaswanga.
Ukukhutshwa kweNkundla kunye nokuNqongophala
Nangona i-ACA eyabelwe uxanduva lokubambisana (i-aka, "igunya lomntu ngamnye") lifuna ukuba bonke abemi baseUnited States babe nokugcinwa kwe-inshorensi yempilo okanye bajongane nesohlwayo, kukho uluhlu olude lokuxolelwa kwesohlwayo, kwaye i-IRS incinci endleleni ukunyanzelisa isigwebo xa sisebenza.
Ngasekuqaleni kuka-2016, i- IRS yabika ukuba iifayile zerhafu ezizi-7.9 zixhomekeke kwisigwebo sokwabelana ngabanye ngenxa yokungaqinisekisiwe ngo-2014, kodwa ezinye izihlomelo zerhafu ezi-12,4 zikhutshwe kwihlwayo, nangona zingenakunikwa inkxaso ngo-2014.
Isihlwayo sifanele sibe "intonga," ngelixa ii-ACA zenkxaso "yi-kroti." Kodwa njengoko kuphawuliwe ngasentla, inani labantu abangaqinisekanga liyakwazi ukufumana ilungelo lokuxolelwa ngaphandle kokuthotyelwa kwesihlwayo. Kwaye nangona xa isohlwayo sisebenza (okt, i-taxer fayile ayifaneleki naziphi na izizathu zokuxolelwa ), i-IRS ayikwazi ukusebenzisa amanyathelo amiselweyo okuthotyelwa ukuqokelela isohlwayo.
Banokuyinqanda kwimbuyekezo ebolekiweyo yerhafu yefayile (okanye ukubuyiselwa kwemali ehlawulwa kunyaka ozayo), kodwa abanako ukusebenzisa izibambiso, iirhafu, okanye ukutshutshiswa kwecala, ngendlela abanokuyenza ngayo kunye nezinye iintlobo zetyala lingahlawulwanga. Ngenxa yoko, isohlwayo sokungabikho kubhengezwa kubonwa ngabanye njengento yokuzikhethela, becinga ukuba bahlawula irhafu yabo ukuze bangahlawulwanga imali.
Ewe, ukungaqiniseki kwaye ukufumana uncedo lwezononophelo olunzulu luyinkxalabo enkulu, kodwa inani elingeyona nto ingabalulekanga yamaMelika aphelelwe ngumsebenzi afuna ukuwela i bhuloho ukuba kwaye xa ifika apho, kuba iiprayimari kuya kufuneka zihlawule i-inshurensi yezempilo yingaphaya koko bacinga ukuba ixabiso elinakho.
Gap Coverage
I-ACA icela ukuba wonke urhulumente akwandise ukufaneleka kwemali ye-Medicaid ukuya kuma-138 ekhulwini kwinqanaba lehlwempu (ama-133 ekhulwini, kunye ne-5 ekhulwini yokungahoywa imali). Amazwe aya kuqhubeka nokuhlulwa kwemali ekhoyo kwi-Medicaid yoluntu eyayisele ifanelekile phambi kokunyusa, kodwa ukususela ngowama-2014, urhulumente wephondo uza kuhlawula iindleko ezipheleleyo zokufihla abantu abasandul 'ukufumana. Ngomnyaka we-2020, owehla ukuya kuma-90 ekhulwini, kodwa urhulumente wesigqeba uya kuqhubeka nokuhlawula iipesenti ezingama-90 kwiminyaka ezayo, ngelixa i-state ayihlawuli ngaphaya kwe-10 ekhulwini yeendleko zokugubungela abantu abasandul 'ukufumana.
INkundla ePhakamileyo yagweba ngo-2012 ukuba urhulumente wesigqeba akasenakufuna amazwe ukuba awandise iMedicaid ukuze aqhubeke nokufumana inkxaso-mali ye-Medicaid. Ngenxa yoko, ama-19 athi awanakwandanga iMedicaid. Kwi-18 yalawo mazwe, i-gap yokukhawulela ibangelwa ukuba abantu abangaba zigidi ezintathu abanakho ukufikelela kwiinkxaso-mali kwi-OR or Medicaid (i- Wisconsin ayizange ikhulise iMedicaid, kodwa isebenzisa iimali zelizwe ukubonelela ngeMedicaid kubantu abanomvuzo ongaphantsi kwinqanaba lehlwempu , ngoko akukho sikhala sobhengezo).
Ukungabikho kokuqonda malunga neenketho ezikhoyo
Nangona abanye be-uninsured abasalayo bejonge iinqunto zabo baza bagqiba ukuba baxabisa kakhulu kwaye / okanye abafuni ukubhalisa kwi-coverage, baninzi nabantu abanokuqiniseka ngezinto ezikhoyo okanye ukuba zinokukunceda njani kubo.
Kubantu abengenakunikwa inkxaso ngo-2015, phantse isiqingatha bafanelekile kwi-Medicaid, iNkqubo ye-Intshuwalense yezeMpilo yeNtwana (CHIP), okanye inkxaso-mali ye-premium ekutshintshiseni (esinye isiqingatha sasiyi-gap coverage, abafudumiweyo abangabhalwanga phantsi, okanye abangavumelekanga ngokutshintshiselwa ngenxa yemali engenayo okanye umnikelo womqeshi wokufikelela ngokukhawuleza). Abanye balaba bantu bayazi ukuba uncedo lwezemali olutholakalayo kubo kwaye banqwenela ukuyibeka phambili. Kwaye abanye banamathengiswa yimimiselo enobungqina njengokwenkcenkcesha yentsapho , eyenza ukuba ingenakulungiswa. Kodwa abaninzi abaqapheli ukuba banokufumana inkululeko okanye iindleko eziphantsi kakhulu ngeMedicaid okanye i-CHIP, okanye inkxaso-mali yeprayimenti ukwenzela ukuba kubekho ukufihlakeleka kwangasese kunokuba kunokwenzeka.
Ukuba uphakathi kwezigidi ezingama-29 zaseUnited States ezingagqithwanga, unomdla wakho ukujonga kwizinto ozikhethayo. Ukuba ufanelekile kwiMedicaid okanye i-CHIP, ungabhalisa naliphi na ixesha. Ukuba unelungelo lokufumana inkxaso-mali ekutshintshisweni, ukubhaliswa okuvulekileyo ku-2017 kuphezu kwekona-kuqala ngoNovemba 1, 2016.
> Imithombo:
> I-Ofisi yeBhajethi ye-Congressional, i- Estimates for the Assurance Couptions Act of the Affordable Care Act, ihlaziywe kwisigqibo seNkundla ePhakamileyo seJaji, kuJulayi 2012 .
> I-Cornell Univerity Law School, i-Legal Information Institute, iNational Federation of Business Independent v. Sebelius, echazwe ngoMatshi 26, 27, 28, 2012-Inqunywe ngoJuni 28, 2012.
> I-Kaiser Family Foundation, iNew Estimates of Eligibility for ACA Umlinganiselo Phakathi kwe-Uninsured, uJanuwari 22, 2016.
> I-United States Bureau of Census, Ubume Bomshuwalense Wezempilo E-United States: 2014.