Ingenwe ngummongameli nguMongameli uBarack Obama ngo-2010, uMthetho woKhuseleko weMonde kunye noNonophelo loNonophelo olungabonakaliyo unoxanduva lokuguqulwa kweenkqubo ezininzi zezempilo kwi-United States ukususela kwi-1965 ye- Medicare neMedicaid .
Imvelaphi
Ukutshatshaza ngokukhawuleza kunye nemigca yeqela, amaRiphabliki aphikisana noMthetho wokuNakekelwa ongenakunqwenelekayo, ngokugqithiseleyo usebenzisa igama elithi Obamacare ukuchaza uMthetho.
Ngonyaka ka-2012, uMongameli Obama wayefumene igama elithi Obamacare, kwaye ngoku lisetyenziswa ngokubanzi ngabaxhasayo kunye nabachasene nomthetho. Kodwa ukuphikisana malunga ne-ACA iqhubekile emva kokuhamba kwayo, kunye nemingeni emininzi enkundleni yomthetho; umthetho uhlala ungqubuzana phantsi kolawulo lweTrump.
Ziziphi iiNguqulelo?
Olunye lweenguqulelo oluphunyezwe nguMthetho woNonophelo olungabonakaliyo lubandakanya ukuseka iiNtengiso ze-inshurensi zeMpilo , okanye iimarike, apho abantu, iintsapho kunye namashishini amancinci angathengisa umbandela oqinisekileyo wempilo ye-inshurensi ngeemali-mali ezifikelelekayo. Ezi zicwangciso ziyanelisa isigunyaziso somntu ngamnye we-ACA esifuna ukuba abo abangenayo inshuwalense yezempilo bathenge umgaqo-nkqubo we-inshorensi yempilo.
I-ACA inikezela abathengi abaphantsi kunye nabangaphakathi- mali ngenjongo yokuthenga i-inshurensi yempilo enokuthengwa kakhulu (abhalisi abafanelekileyo abanako ukufumana ingeniso ngaphezu kwama-400 ekhulwini lobuhlwempu, okanye i-$ 98,400 kwiintsapho ezine), kunye neenkxaso zokunciphisa ngaphandle kwe-pocket Iindleko zokubhalisa ezifanelekileyo (ingeniso ayinakugqithisa ama-250 ekhulwini kwintlupheko okanye i-61,500 zamawaka kwintsapho yezine ngo-2018).
Ngelo xesha, umthetho ubeka isohlwayo serhafu kulabo abahlala bengakhuselekanga; isohlwayo sagqitywa ngo-2014, kwaye ngokuthe ngcembe kwanyuka kwinqanaba eliphezulu ngo-2016. Kuya kulungiswa ukunyuka kwamaxabiso okuya phambili, kodwa ngo-2017 no-2018, ukulungiswa kwexabiso lokunyuka kwamaxabiso kwakuyi-$ 0, ngoko ke isigwebo siye sahlala singatshintshwa ukususela ngo-2016. kwi-Senate ngo-Disemba 2017 eya kuphelisa isigwebo somntu ngamnye, kodwa ukungafani ne-House version kwakufuneka kuxolelaniswe, ngoko ke ixesha, akukho nto ishintshile malunga nesigwebo senkundla).
I-ACA ivimbela abaqinisekisi ukuba bangafuni ukufihla abantu abaneemeko zangaphambili , okanye ukubabahlawule iiprayimamu eziphakamileyo ngenxa yesimo esele sikhona. Oku kuyinyaniso kunye nokucima ukutshintshisana kwaye kubonisa utshintsho olubalulekileyo ukusuka kwindlela intengiso nganye eyenziwa ngayo ngaphambi ko-2014 phantse kuwo wonke urhulumente.
I-ACA ikhiphe iifowuni zonyaka kunye nezobomi malunga nokuba inkampani ye-inshorensi iya kuhlawula njani ukunakekelwa kwempilo ekhutshiweyo yomshuwalense, kwaye iyanciphisa ama-maximum-pocket maximums .
I-ACA idinga iinjongo ze-inshorensi yempilo kwiimarike zeqela kunye namancinci ukuba zibonelele ngeenzuzo eziyimfuneko zezempilo ezilishumi . Enye yeentlobo zeemfuno zezempilo eziyimfuneko kukunyamekela, kwaye uluhlu olubanzi lweenkonzo zokunakekela ukhuseleko kufuneka lukhutshwe ngaphandle kokwabelana ngeendleko .
I-ACA idinga abaqeshi abakhulu-abo abanabasebenzi abalinganayo bexesha eli-50 okanye abangaphezu kwexesha elipheleleyo-ukubonelela ngexabiso elifanelekileyo, ubuncinci be-inshurensi yezempilo kuzo zonke iixesha ezizeleyo (ii-30 + iiyure ngeveki) abasebenzi, okanye umngcipheko wesihlwayo phantsi komqeshi wabelane ngokubonelela uxanduva . Abaqeshi kufuneka baqinisekise ukuba i-coverage ithathwa njengexabiso elifanelekileyo kumqeshwa, kodwa akukho vavanyo lokukwazi ukufikelela kwiindleko zokugubungela amalungu entsapho phantsi kwesi cwangciso. Ngenxa yokuba le nto isebenza njani nendlela ukufumana inkxaso-mali kunikwa ngayo ukutshintshiselana, abanye abantu abakwazi ukufumana ukuhlawuleka okuthengelekayo ngenxa yento ekuthethwa ngayo ngokuthi " intsapho yokuhlawula ."
[Amanyathelo angentla apha angasetyenziswa kwizicwangciso ezikhulu kunye nezikhulu.
Ezinye iiNxalenye zoNonophelo loNonophelo ongenakunqunyiwe ziye zachithwa okanye zachithwa
Ezinye iindawo ze-ACA azisoze zaphunyezwa: INkundla Ephakamileyo yavumene negalelo eliya kuhoxisa inkxaso-mali ye-Medicaid ye-federal ukuchaza ukuba ayizange inikeze iMedicaid kubantu abaninzi. Oku kuye kwaphumela ekungeneni kwe-gap , apho abantu abayizigidi ezingama-2.4 abaneminyaka engama-18 bathi basenakho ukufikelela ngokukhawuleza kokufikelela.
Ukongezelela, iCongress yachithwa ukunyamekelwa kwexesha elide le-ACA, eyaziwa ngokuba yi- CLASS Act , ngoJanuwari 2013 emva kokuba iSebe lezeMpilo kunye neenkonzo zoLuntu lizimisele ukuba lingenakulungeleka.
Iimpawu ezininzi ze-ACA zilibazisekile, kubandakanywa nomqeshi wabelwe uxanduva lokubonelela (lwaqala ukusebenza ngo-2015, kunoko-2014, kwaye aluzange luqeshwe ngokupheleleyo ngo-2016), i-Cadillac Tax (ngoku isetyenziswe ukusetyenziswa ngo-2020), kwaye ukupheliswa kwezicwangciso ezingahambisani ne-ACA-ezizimeleyo eziye zakhishwa ngaphambi ko-2014 (ezi zicwangciso zenguqu, okanye "zikhulu," kwaye ziyavunyelwa ukuba ziqhubeke zisetyenziswa kuze kube sekupheleni kuka-2018, ekuqaliseni kwamazwe kunye nabanomshuwalense wezempilo).
> Imithombo:
> Isebe Lempilo Neenkonzo Zoluntu, Ukuhlanganiswa koKhuselo lweMonde kunye noMthetho woNonophelo ojongene noThathaka .
> I-Kaiser Family Foundation, Isikhokelo seNkundla ePhakamileyo kwi-ACA's Medicaid Extension , ngo-Agasti 2012.
> Kaiser Family Foundation. I-Gap yesiGaba: Abantu abadala abaNcinci abakwiiNdawo ezingenakwandisa iMedicaid. Novemba 1, 2017.
> Lemieux, Jeff; kunye noMoutray, Chad, malunga neTyala leCadillac, iMicimbi yezezeMpilo, ngo-Ephreli 25, 2016.