Imbali, Iimpembelelo zayo, kunye nendlela ekwazi ukuBumba ngayo iNguqulelo yezeMpilo kwixesha elizayo
I-Hyde Amendment ngokufanelekileyo ikhusela inkxaso-mali ye-federal ekubeni isetyenziswe ukuhlawula ukukhipha isisu-ngaphandle kwemida encinane-ngokusebenzisa nayiphi na inkqubo elawulwa yiSebe lezeMpilo kunye neNkonzo zoLuntu (HHS).
Isilungiso, esenziwe ngu-Rep. Henry Hyde (R, Illinois), senziwa ngo-1976, kwaye nangona singakaze sibe ngumthetho osisigxina, iCongress iye yavuselela ngonyaka iminyaka emashumi amane adlulileyo, iyifake njengomgibeli kwii-bH .
Okukuphela kwezinto phantsi kwe-Hyde Amendment ziimeko ezibandakanya ukudlwengula okanye ukutshata, okanye xa ubomi bomama busemngciphekweni.
Ubani Ubungakanani Ochaphazelekayo?
Isihlomelo sithintela kakhulu kubasetyhini abagqitywa yiMedicaid , kodwa kwandisa kwiNkqubo ye-Intshumo yeMpilo yabantwana , iiNkonzo zeeMpilo ze- Indiya kunye ne- Medicare (malunga nabantwana abafazi abaneminyaka eyi-1 ubudala abanokuzala abantwana abaphantsi koMntwana, njengokuba inkqubo ihlanganisa abo abakhubazekileyo ukongezelela kwabalupheleyo).
Kwaye kwenziwe amalungiselelo afanayo kunyaka osebenza kwiinkcazo ezinikezelwa kwabasetyhini emkhosini (TRICARE), abasebenzi baseburhulumenteni abafumana inkxaso yabo ngeProgram ye-Federal Employee Benefits Programme, kunye nabasetyhini abakhonza kwi-Peace Corps.
Ukuvinjelwa kokukhupha isisu kuVolon Corps amavolontiya kunye nabasetyhini abakhonza emkhosini ngokwenene bahamba ngaphaya kweemfuno ze-Hyde Amendment, ukususela ngo-1979 ukuya ku-2014 kubaVolontiya be-Peace Corps, ukusuka ngo-1981 ukuya ku-2013 kubafazi abasemkhosini.
Umthetho-mali we-1979 woxolo we-Peace Corps wawuquka ukuvinjelwa ngokupheleleyo ukukhutshwa kwesisu kwala mavolontiya, kungakhathaliseki ukudlwengulwa, ukutshata, okanye ingozi kwimpilo yowesifazane. Ukuvinjelwa kwaqhubeka kwaze kwaba ngo-2014, xa isaziso semali eselwayo esandula ukukhupha isisu kuVolontiya be-Peace Corps kwiimeko zokudlwengula okanye ukuxhatshazwa, okanye xa ubomi bowesifazane buya kuba segazini ngokuthwala ukukhulelwa kwisithuba.
Ukususela ngoko, iivolontiya ze-Peace Corps ziye zakhupha isisu esifana nesisombululo se-Hyde Amendment. Oko kukuthi, akukho phantse, kodwa kwiimeko zokudlwengula, ukuxhatshazwa, okanye ingozi ebomini bomi, kunjalo.
Ukuqala ngowe-1981, kubafazi abakhonza emkhosini, ukukhupha isisu kwafunyanwa kuphela ukuba ubomi bowesifazane busemngciphekweni wokuqhubeka nokukhulelwa. Kodwa ngowama-2013, ukukhutshwa kwezempi kwandiswa ukuba kubandakanywe ukukhutshwa kwezisu kwiimeko zokudlwengula okanye ukuxhatshazwa komzimba, ukuyihambisa ngokuhambelana ne-Hyde Amendment.
Ukuxhaswa kweMithi yoMkhamo
Ngenxa ye-Hyde Amendment, imali ye-Medicaid yezimali (ehamba ngeHHS) ayinakusetyenziswa ukuhlawula ukukhupha izisu ngaphandle kweemeko zokudlwengula, inzala okanye inengozi ebomini bomama.
Ndiyabulela inxalenye yoNyuselo lweMpilo yoNcedo olungenakunqwenelekayo (okwangoku kusemngciphekweni emva kokhetho lukaDonald Trump), amabini kuwo onke amabhinqa ase-America ebudaleni bokuzala ahlanganiswa nguMedicaid.
Kwaye ukukhipha isisu kufumaniswe ngokungafani nabasetyhini abanomvuzo ophantsi. Phantse isiqingatha sokukhupha isisu esenziwa ngo-2014 kwakukho kwabasetyhini abanomvuzo ngenqanaba lentlupheko. Ngaphantsi koMthetho woNonophelo olungabonakaliyo (ACA), wonke umntu onomvuzo phantsi kwezinga lehlwempu uya kufumana iMedicaid, kodwa kusekho ama-19 athi ayenqaba ukwandisa iMedicaid, kwaye ngo-18 kubo, kukho i- gap-coverage .
Ngoko abanye abafazi abanomvuzo ongaphantsi kwinqanaba lehlupheko abanakho ukhetho olufanelekileyo lwe-inshurensi yezempilo. Uninzi lwabanye lube neMedicaid, nangona i-Hyde Amendment ikhusela i-Medicaid inkxaso ye-Medicaid yokukhupha isisu kwiimeko ezininzi.
Kodwa i-Medicaid ixhaswa ngemali kunye noorhulumente baseburhulumenteni. Kwaye i-15 ithi isebenzise imali ye-Medicaid yemali yokukhupha isisu kwiimeko ezingekho nje ukudlwengulwa, ukutshata, okanye ingozi ebomini bomi:
- Alaska
- California
- Connecticut
- EHawaii
- Maryland
- EMassachusetts
- Minnesota
- Montana
- Enew Jersey
- ENew Mexico
- Inew york
- Oregon
- Vermont
- EWashington
- West Virginia
Uninzi lwale mazwe lwenza oko ngenxa yesigqibo senkundla.
I-Arizona kunye ne-Illinois nazo ziyaxhomekeka kumyalelo wenkundla efanayo kodwa ziyaqhubeka-ngokuphulwa kwemiyalelo yenkundla-ukunika inkxaso ngeMedicaid ukukhupha izisu kwiimeko zokudlwengula, ukuxhatshazwa, okanye ingozi kwimpilo kamama.
Kuthiwani NgezoNtsingiselo ze-Intshumo yezeMpilo?
UDonald Trump wanqoba ukhetho lukaMongameli ngo-2016 kwaye uthembisa ukuphinda aze atshintshe i-ACA. Ngoko ikamva lomthetho liphezulu emoyeni. Kodwa ngeli xesha, i-Hyde Amendment idlala indima ekunikeni igalelo kunye nokuxhaswa ngemali kwi-inshurensi yezempilo.
I-ACA isungulwe utshintsho lwempilo yoshishino lomshuwalense kwimeko nganye, apho ininzi ilawulwa nguRhulumente wezeMpilo nge-HealthCare.gov. Zonke izicwangciso zeemarike zithengiswa ukususela ngo-2014-kubandakanya ezo zithengiswa kwii-exchange-kufuneka zibandakanye ukuhanjiswa kweenzuzo ezi- 10 ezibalulekileyo ezichazwe yi-ACA. Nangona ukunyamekela kwamakhwenkwe amancinci, izithintelo zokukhulelwa, kunye nokukhulelwa komama zonke ziyimfuneko, ukukhipha isisu akunjalo. Kodwa ngexesha elifanayo, izicwangciso zezempilo ze-ACA azivumelwanga ekugqibeleni izisu.
Amazwe angakwazi ukuphumeza imigaqo yawo ngokubhekiselele ekubeni ngaba izicwangciso zezempilo ezithengiswayo ekutshintshiseni zinga kunika inkxaso yokukhupha izisu. Ukususela ngo-2016, kwakukho amazwe angama-25 aye aphumeze imimiselo yawo yokukhawulela ukufikelela kwiinkonzo zokukhipha isisu kwiiplani ezithengiswa ngotshintshiselwano. Uninzi lwazo luhlinzekela ngaphandle kokuhambelana ne-Hyde Amendment (oko kukuthi, amatyala okudlwengula, ukutshata, okanye ingozi ebomini bomi).
Ukutshintshiselwa yindawo ephela apho inkxaso-mali ye-premium ikhona, kwaye ukuxhasa amalungelo okuzala kuye kwaphawula ukuba kulawo ma-25 athi (kunye namanye amazwe angama-6 apho i-inshorensi ivumelekile ukuba ifake i-coverage yokukhipha isisu kwisicwangciso sawo shintsho kodwa sele ukhethe ukwenza njalo ), akukho ukufikelela kwi-inshurensi yempilo enokuthengwa ngokukhipha isisu.
Kodwa ngaphesheya kwempikiswano, abavakalisi bayaphawula ukuba kumazwe apho ukukhutshwa kwesisu ekuthengiseni kuvunyelwe khona, kunokuba nzima kubafundi ababhalise ubomi ukuba baqaphele ukuba zeziphi izicwangciso ezikhupha izisu kwaye ezingenayo. Ukususela ngo-2016, kwakukho iindawo ezimbini-iHawaii neVermont-apho zonke iiplani zokufumana utshintsho ezikhoyo ziquka ukukhutshwa kwesisu, ukudala iingxaki zokuziphatha ngokubambisana nokuchaswa kwefilosofi ukukhipha isisu.
Izicwangciso ze-inshorensi zempilo ezithengiswa ngezoshishino ziyaxhaswa ngemali nge-ACAs premium subsidies. Ngoko ukuthotyelwa kwe-Hyde Amendment kufuna i-insurers yempilo kwiingxoxo ezinikezela ukukhutshwa kwesisu-ngaphaya kwemida emincinci kwi-Hyde Amendment-ukuqokelela iintlawulo ezimbini ze-premium kunye nokuzigcina kwiingxelo ezihlukeneyo. Yiloo ndlela abaqinisekisa ngayo ukuba inkxaso-mali iyasetyenziselwa ukukhupha iindleko zokukhawulwa kweenkonzo ezingahambelani nokukhipha isisu. Kodwa kumbono womthengi, akuyinto enzima, njengoko umthetho uvumela i-bill ye-premium ibhawulwe ngenkokhelo enye, kwaye umphathisi-mali unokuhlukanisa imali emva kokufumana intlawulo.
Isithintelo kuMyinge wezeMpilo oMntu omnye
Nangona yahlulwa ngokugqithiseleyo ngabavoti baseColorado kunyaka-2016, abatshali-ntliziyo abakhokhwa ngabanye bazama ukuzisa iColorCare , inkqubo yokufumana inkxaso-mali ye-single-payer ifumaneke ukusebenza ngo-2019. Kodwa kwaye kwaxhatywa ngamanye amaqela aqhubela phambili, ngokuqhelekileyo ukuba ayenomdla wesiphakamiso sokunakekelwa kwempilo esisodwa. Enye yeengxaki zabaqhubi abaqhubela phambili kwakufuneka kwenziwe ngokuxhaswa kwemali.
I-NARAL Pro-Choice Colorado iphikisana neColoradoCare ngezizathu zokuthi iza kuphelisa ukukhutshwa kwezisu kwilizwe. Ukuxhalaba kwabo kukuba i-Colorado Constitution, ukususela ngo-1984, yathintela ukusetyenziswa kweemali zelizwe ukuhlawula isisu "ngaphandle kokuba kuyimfuneko ukukhusela ukufa komfazi okanye umntwana ongakazalwa apho kukho konke umzamo owenziwe ukugcina ubomi bomntu ngamnye."
I-ColoradoCare yayiya kuxhaswa ngemali ngokuhlanganiswa kwemali karhulumente kunye neseburhulumenteni phantsi koMthetho wokuNakekelwa ongenakunqunyiwe 1332. Nangona ulwazi lweColorCare olubekwe phambi kokukhetho aluzange luchaze ukukhipha isisu kuwo onke, abameli be-pro-choice babecinga ukuba ayikho indlela eya kukwazi ukuxhasa ukukhupha isisu, kwaye banenkxalabo yokuba abafazi baseColorado okwangoku Ukukhupha isisu nge-inshurensi yabucala kuya kulahlekelwa ukufikelela kumsebenzi wokukhupha isisu phantsi kweColoradoCare.
Ukuxhalabisa okufanayo kwaye kwaphawulwa xa uSenin Bernie Sanders (D, Vermont) ecetyiswa ukuba angayikhokheli enye ye-Medicare for All ". Ukususela kwinqanaba likaSanders liza kususa iiplani ezizimeleyo (apho ukukhulelwa kwesisu kutholakala khona) kwaye kufakwe endaweni ye-inshurensi yezempilo ejongene ne-HHS (kwaye ngoko kuxhomekeke kwi-Hyde Amendment) izigidi zamabhinqa ziza kulahlekelwa ngumshuwalense wezempilo ukuze ukhuphe isisu .
Kodwa ukhathalelo lwempilo lwabazali abangabodwa lusekho itafile kwixesha elizayo elizayo, emva kokuphumelela kweTump in ukhetho loongameli kunye neninzi yeRiphablikhi eNtendlwini naseSenate.
Ngaba Ulungelelwaniso lwe-Hyde luya kuQiniswa kuMthetho?
UMongameli okhethiweyo uDonald Trump wathetha ngokuphindaphindiweyo ngeli phulo lokuba wayechasene nokukhupha isisu. Kwaye nangona i-website yakhe yephulo ayizange ifake inkcazo yokukhupha isisu kwindawo yakhe yokunakekelwa kwempilo, i-website yayo yenguqu isishwankathelo esincinci sokulungisa impilo.
Nangona iiDemokhrasi kunye noHillary Clinton babiza ukuba basuse i-Hyde Amendment ngokupheleleyo, iSiphathamandla sePublic Republic Party sabiza ukuba siyiququzelele emthethweni . INdlu yabameli ibonise umthetho ngo-2011 oya kwenza i-Hyde Amendment ngumthetho osisigxina, kodwa ayizange idlule iSeneti.
NgoSeptemba 2016, uTrump wabhala ileta apho aphindaphindiweyo phantsi kokuchasana nokukhupha isisu, kuquka nezicwangciso zakhe zokumisela izithintelo zokukhupha isisu kwiNkundla ePhakamileyo, kwaye umnqweno wakhe wokwenza i-Hyde Amendment ngumthetho osisigxina.
Kuhlala kubonakala ukuba i-Hyde Amendment iya kuba yigxina. Okwangoku, sinokucinga ukuba ngexesha elincinci, liya kuqhubeka longezwa kwiimali zeebhilikhwe zekamva elibonakalayo.
> Imithombo:
> I-ACLU Inkcazelo ye-Peace Corps Ukukhupha isisu, ngo-2014
> Bernie 2016, i-Medicare kubo bonke.
> I-Kaiser Family Foundation, Ukukhusela Iinkonzo Zokukhipha Isisu kwi-Medicaid, Izicwangciso zeMakethe, kunye neziCwangciso zangasese. NgoJanuwari 20, 2016.
> I-Kaiser Family Foundation, i-Hyde Amendment kunye neNgcaciso yeeNkonzo zoKhupha, ngo-Septemba 30, 2016.
> NARAL Pro-Choice Colorado. I-NARAL Pro-Choice Colorado ichaza ukuchasiswa kohlengahlengiso 69. NgoJuni 22, 2016.