Ukunyamekela okukhuselekileyo-enye yeenzuzo zezempilo ze-ACA-ziphakathi kwamalungiselelo athandwa kakhulu kuMthetho woNonophelo onoxanduva. Ama-Insureds kuzo zonke izicwangciso ze-ACA ezihambelanayo akumele zihlawule nantoni na uluhlu olude lweenkonzo zokukhusela ezisebenza kubasetyhini, abantwana kunye nabo bonke abantu abadala.
Ukunyamekelwa kokukhusela okukhuselekileyo kusetyenziswa kwizicwangciso ezininzi zezempilo e-US ngoku, kwaye kwamiselwa phambi kobuninzi beemfuno ze-ACA ngo-2014.
Ubonelelo lusebenza kwizicwangciso ngamnye kunye nezicwangciso zeqela elincinci nelincinci. Izicwangciso zezempilo ezininzi zikhululekile kwiimfuno zokukhawulela ukunakekelwa kokukhusela ngaphandle kokunikwa iindleko (izicwangciso ezinjengezinto eziye zaqala ukusebenza ngo-Matshi 23, 2010 wenkundla ye-ACA isayinwe kumthetho). Ngo-2014, malunga nekota yesigxina sabasebenzi abanezicwangciso ezixhaswe ngumqeshi babenomsebenzi wokuvalela. Kodwa ukukhula kwezicwangciso ezininzi bekuye kwahla kwehla ngo-2010.
Ulwaphulo - Yintoni ekhutshwe ngekhululekile?
I-HHS yenze uluhlu lwabafazi abathile lonyango olwenziwe ngokusesikweni oluye lwaqala ukusebenza kuzo zonke izicwangciso ezintsha kunye nokuvuselela izicwangciso ezingabonakaliyo ngo-Agasti 2012. Kubandakanya ukukhutshwa komzimba ngaphandle kokwabelana ngeendleko. Kodwa oko akuthethi ukuba zonke iinketho ezikhoyo zokulawulwa kokuzalwa ziya kunikwa ngumphathi we-inshurensi yempilo ngaphandle kweendleko.
I-HHS icacise ukuba izicwangciso zezempilo kufuneka zinikezele ubuncinane olunye uhlobo lweendlela zonke ezivunyiweyo ze-FDA zokukhulelwa kwezesetyhini, ngaphandle kwezilwanyana ezingabonakaliyo (izicwangciso zezempilo azinyanzelwanga ukugubungela ukukhulelwa kwezilwanyana kumadoda, kuquka i-vasectomies).
Xa iinguqu eziqhelekileyo zoluhlobo oluthile lokukhulelwa komzimba lukhona, isicwangciso sezempilo sinokunikezela ngesizukulwana ngaphandle kokwabelana ngeendleko kodwa ukubeka i-copay ukuba i-insured ikhetha uhlobo lwegama lomenzi (kukho imfuneko yokuba i-copay ikhutshwe xa ugqirha inquma ukuba enye enye into enikezelwa ngokungahlawulwanga kwisicwangciso sezempilo kuya kuba yinto engafanelekanga isigulane).
Kukho iindidi ezingama-18 ezahlukeneyo zokukhulelwa kwezilwanyana ezivunyiweyo yi-FDA:
• Utyando olutsha
• Ukufakelwa kwenkqubo yokuzalisa inzalo
• Intonga enokutsha
• Isixhobo se-Copper intrauterine (IUD)
• IUD nge progestin
• Umtshini / umjovo (Depo-Provera)
• Ukukhulelwa komlomo (ipilisi), kunye ne-estrogen kunye neprogesin
• Ukukhulelwa komlomo kunye neprogesin kuphela ("ipilisi ye-mini")
• Ukukhulelwa komlomo kunye nokusetyenziswa okuninzi okulibaziseka ukuya kwinyanga (eyaziwayo njengepilisi yokunciphisa iinyanga)
• I-patch
• Iindandatho zokukhusela izondo
• Isilathisi
• Isipongo
• Ikhefu lomlomo wesibeleko
• Iikhondom yabasetyhini
• I-Spermicide
• Ukukhulelwa kwangxamisekileyo (Isicwangciso B / emva kwepilisi)
• Ukukhulelwa kwangxamisekileyo (Ella / Ulipristate acetate)
I-inshorensi yakho yezempilo inokukunika ubuncinane ukhetho olulodwa kwiintlobo ezili-18, ngaphandle kweendleko zokuphuma ngaphandle. Kwezinye iintlobo zokukhulelwa kwezilwanyana, kukho iindlela ezininzi ezikhoyo, kunye ne-inshurensi yakho yezempilo inokumisela i-copay ininzi yabo, ngokungakhathaliseki ukuba ubuncinane banikelwa yona ngaphandle kwento.
I-LARC - ifikeleleke phantsi kwe-ACA
Imfuno yokuba uhlobo ngalunye lwe-contraceptive lufumaneke ngaphandle kokubelana ngeendleko kubaluleke ngokukhethekileyo kwi-contraceptive ephendulela ixesha elide (iUDs kunye neentonga ezifakekayo).
Ezi zikhetho zazihlala zibiza ngokwexabiso ngokubhekiselele kwiindleko zangaphambili phambi kwegunya le-ACA lokukhulelwa (nakuba nangona ubomi bomkhiqizo, bahlala bebiza kakhulu kunezo zokukhulelwa komlomo). Kodwa baphumelele kakhulu kwaye uphando lubone ukuba abafazi bathanda ezinye iindlela zokukhusela xa iindleko zingasona mqobo. Ukusetyenziswa kwexesha elide lokubuyisela ukukhulelwa kwangoko kwakuye kwanda ngo-2012, kunye neprojekthi yeengcali ukuba ukusetyenziswa kwazo kuya kwanda ngakumbi ngenxa ye-ACA.
imingeni yokugunyazwa kokukhulelwa
I-ACA ingabandakanyi iicawa kunye neenkolo ezingenanto inikwe igunya lokukhusela, kodwa ezinye iimbutho ziye zahlambalaza igunya kwaye ezinye ziye zanqoba enkundleni.
Ngo-2014, uLobby lobby yaxela ilungelo lokukhuphela iintlobo ezine zokukhulelwa komzimba (zombini ii-IUD, kunye neCwangciso B kunye no-Ella) kwisicwangciso sezempilo sabasebenzi. INkundla ePhakamileyo inamathele kwi-Hobby Lobby, ilawula ukuba urhulumente kufuneka athole indlela yokuqinisekisa ukuba "iinkampani ezibanjelwe ngokubambisana" (njengeHobby Lobby) kunye nenkcaso kwezinye iindlela okanye zonke iindlela zokulawula ukuzalwa ziyakwazi ukuphepha ukuzihlawulela njengenxalenye sabo sicwangciso sezempilo.
NgoJulayi 2015, ngokuphendula kwi-Burwell v. Isibambiso seLobby sokuHlola, i-HHS iphelile isigqibo esivumela indawo yokuhlala "inhlangano ebanjelwe inzuzo engenakho inzuzo enokwenkolo yokubonelela ngeenkonzo ezithile okanye zonke iinkonzo zokukhusela," ngelixa Ukuqinisekisa ukuba abafazi banokufikelela kwiinkalo ezipheleleyo ze-FDA ezivunyiweyo. Ngaphantsi kwendawo yokuhlala, i-insurer yezempilo (okanye umlawuli wesithathu kwimeko yezicwangciso ezizimeleyo) ithatha iindleko zokumboza ezinye okanye zonke izicwangciso zokukhulelwa, ngaphandle kweendleko kumfazi okanye kumqeshi. Iindawo zokubambisana ngokubambisene neenjongo zentengiso zifana nendawo yokuhlala iHHS eyayikubonelela ngaphambili ngonqulo olungenalo inzuzo.