Inguqulo ye-Senate Kungenzeka ukuthi ihlukile ngokuhlukile
NgoMeyi 4, 2017, iNdlu yabaMamele yadlulisa uMthetho wezeMpilo waseMelika (AHCA) futhi wayithumela eSenate. Ngokushesha nje lapho lesi silinganiso sidlulile, izindlu zeRepublic Republican zajoyina uMongameli Trump, u-Vice President Pence, noNobhala weHHS uTom Price emkhosini eWhite House. Kodwa i-AHCA isenayo ikusasa eliqinisekile kakhulu.
Ivoti leNdlu yafika emva kwamasonto ambalwa okuvunyelwayo kanye nokuchibiyela oklanyelwe ukunqoba ukwesekwa kwababameli beRiphabhuliki abaphikisana ne-AHCA ngoMashi.
Ngamaviki ayisithupha nje ngaphambi kokuthi umtsetfosivivinywa udluliselwe eNdlu, ubuholi beRiphabhuliki bewuthathe ngaphambi kokuvota okuhleliwe ngo-Mashi, lapho kwacaca ukuthi kwakungekho ukwesekwa okwanele okukudlula.
Amademokhrasi aphikisana nomthetho wonke jikelele, kanti nakuba amaRiphabhulikhi aneningi eNdlu, uma abameli bamaRepublican abangaphezu kwezingu-22 bephikisana nalo mthethosivivinywa, bekungeke kudlule. Ngo-Mashi, kwakukhona okungenani ama-Republican angu-33 aphikisana ne-ACHA. Kodwa lapho ivoti lifika ekuqaleni kukaMeyi, amaRephabliki angu-20 kuphela avotela umthethosivivinywa, futhi wadlula ngevoti elilodwa ekugcineni (217-213; kwakudingeka 216 kudlule).
Akucaci ukuthi i-Senate izodlula yini isilinganiso sokuphinda kwe-ACA, futhi uma yenza, kungakhathaliseki ukuthi amakamelo amabili azokwazi ukuvumelanisa ngokungqubuzana okugcina okungenani ezinye izingxenye ze-AHCA.
Umthelela weMithethosivivinywa Yamanje
I-AHCA yasungulwa ngokusemthethweni eNdlu ngo-Mashi 20, futhi yadlula ngaphansi kwamasonto ayisi-7 kamuva.
Phakathi naleso sikhathi senze izinguquko ezimbalwa eziphawulekayo ngezichibiyelo. Esinye sezici eziphikisanayo zokuvota kweNdlu kwakuwukuthi ngaphambi kokuba i-Nonpartisan Office Budget Office (CBO) ingabi nesikhathi sokuhlola ibhilidi ebuyekeziwe futhi iphinde ibe nomthelela wayo.
I-CBO yenza amanxephezelo emthethweni phakathi kuka-Mashi, futhi futhi ngemva kwezinsuku ezimbalwa ngemuva kokuba abameli bengeze ukuchitshiyelwa komthetho kumthetho.
Ukubheka kuzo zombili izimo kwakuwukuthi i-AHCA izoholela kubantu abayizigidi ezingu-24 abangenasibindi e-US ngo-2024 . Kodwa lo mthethosivivinywa ochitshiyelwe uhlolwe ukunciphisa ukulahlekelwa kwezimali ngo-$ 150 billion kuphela kule minyaka eyishumi ezayo, uma kuqhathaniswa nokuncishiswa kweR $ 337 billion okwenzelwe inguqulo yokuqala ye-AHCA.
Ngemuva kwesiqephu sesibili se-CBO, i-House Republican yanezela izichibiyelo ezintathu ezibalulekile ku-AHCA:
- Isichibiyelo sokwakha "uhlelo lokungabonakali lwengozi olungabonakali" oluzohlinzeka ngemali eyizigidi eziyizigidi eziyizinkulungwane ezingu-15 ezikhwameni zikahulumeni ukuqinisekisa ukukhokhela izindleko zemali emikhulu emakethe yomshuwalense wezempilo.
- I-MacArthur Amendment, evumela amazwe ukuba aphume kwezinye izivimbela zabathengi be-ACA. Amazwe angakhetha ukuvumela abakwa-inshurensi ukuba baphakamise izinga lokulinganisa iminyaka yobudala be-premium ngenhla kwekhasi le-5: 1 elibekwa i-AHCA, bahlenge izinzuzo zezempilo ze -ACA, futhi basebenzise umlando wezokwelapha ukucacisa amaphrimiyamu kwabafakizicelo abaye bahlangabezana negebe ekubanjeni esikhathini esedlule ngonyaka.
- I- Upton Amendment , eyethula usuku ngaphambi kokuba iNdlu ivotelwe ukudlulisa i-AHCA, yayihloswe ukuvusa ukukhathazeka okulinganisiwe kwamaRephabhuliki mayelana nomthelela we-MacArthur Amendment. I-Upton Amendment inikeza amaRandi ayizigidi eziyizinkulungwane eziyisishiyagalolunye ($ 8 billion) ngemali eyisibonelelo sikahulumeni (ngo-2018 kuya ku-2023) ezosetshenziselwa ukwehlisa amanye amaphrimiyamu aphakeme abantu abanemibandela ekhona ngaphambi kokuba bafunde emazweni abakhetha ukuvumela abakwa-insurer ukuba basekele amaphrimiyamu emlandweni wezokwelapha lapho abafakizicelo igebe ekukhunjweni.
I-MacArthur Amendment inqobile i-House Freedom Caucus, futhi u-Upton Amendment wathola ukwesekwa okwanele kusuka kumaRephabhulikhi ajwayelekile ukuthi lo mthethosivivinywa wakwazi ukuphumelela eNtabeni.
Kodwa lapho abameli beNdlu beyidlulisela lo mthethosivivinywa, bebengakazi ukuthi umthelela wabo ongenamthelela kangakanani ngesilinganiso esingavunyelwe, noma ekusetshenzisweni kwemali. Babevotele kulo mthethosivivinywa ngemva kwamahora ngemva kokuletha ukuchitshiyelwa kokugcina, futhi kuthatha i-CBO cishe amasonto amathathu ukuqeda amagoli abo kulo mthethosivivinywa obuyekeziwe.
I-Updated Score: Izigidi ezingu-23 Ezikhokhelwa Ama-insuredi; US $ 119 Billion ekunciphiseni kokulahlekelwa
Ngo-Meyi 24, i-CBO yashicilele ukuhlaziywa okubuyekeziwe kwe-AHCA, ukubalwa kwezichibiyelo ezintathu ezintsha.
Baphetha ngokuthi inguqulo eguquliwe ye-AHCA (eyadlulisela iNdlu cishe amasonto amathathu ngaphambili) yayiyoholela kubantu abayizigidi ezingu-51 abangatholakali ngo-2026, kusuka ku-28 million ngaphansi kwe-ACA. Lokho kukhula kwezigidi ezingama-23 ezingaqinisekisiwe kwakuncane kunokwanda kwangaphambili kwezigidi ezingama-24 ezingezona eziqinisekisiwe ezingakabanjwanga, kepha kuseyizindlela eziphazamisayo ngokwezinga elingavunyelwe.
Amaprojekti amasha okuthuthukisa i-CBO ukuthi ukulahlekelwa kwezimali kuzokwehliswa yi-$ 119 billion ngaphansi kwe-AHCA (imali encane kune-$ 337 billion kanye no-$ 150 billion ngaphambili eyalinganiselwa ukuthi i-CBO yayilinganiselwa ngo-Mashi).
I-AHCA eSenate: Ingabe izodlula i-Byrd Test?
AmaRephabhulikhi aneningi eSenate, kepha umkhawulo wabo uncane kakhulu kulowo gumbi. Kukhona amaRiphabhulikhi angu-52 eSenate, kanye nama-Democrats angu-46 kanye nama-Independents amabili, omabili ama-caucus namaDemocrats. Njengoba i-AHCA iyinkokhelo yokubuyisana, ingadlulela ngobuningi eSenate, kunokudinga amavoti angama-60.
Kodwa lokho kusho ukuthi uma abangaphezu kwama-Republican Senators abangaphezu kuka-2 benqabela ukulinganisa, ngeke kudlule (i-Vice President Pence ingakwazi ukufaka ivoti-breaker vote uma isibalo sokugcina singama-50-50). Kusho futhi ukuthi amaDemokhrasi akakwazi ukulawula umphumela wesikweletu; wonke ama-Democrat eSenate angavotela, kanye neRiphabhuliki eyodwa noma amabili, futhi izoqhubeka idlula.
Iqiniso lokuthi i-AHCA iyisilwayo sokubuyisana sisho ukuthi sinemithetho eqondile okufanele ihambisane nayo. Izikweletu zokubuyisana zingaxazulula kuphela izinkinga ezithinta ngqo ukusetshenziswa kwemali. I-Byrd Rule ivimbela iSenate ekucabangeni "indaba engaphandle" (okungukuthi, izinto ezingathinti ngokuqondile ukusetshenziswa kwemali) njengengxenye yesikweletu sokubuyisana.
Kube khona ingxabano enkulu mayelana nokuthi ngabe ukuchitshiyelwa kweMacArthur kuzodlula yini ukuhlolwa koMthetho we-Byrd; kungase kuphele ukuxoshwa yiSenate ngoba nje ayihlangabezani nokuhlolwa kwalokho okungabandakanywa esayilweni sokubuyisana. Ngamanye amazwi, iPhalamende leSenate, u-Elizabeth MacDonough, lingasho ukuthi ulimi eMicArthur Amendment luzodinga amavoti angama-60, kunama-51; Ngakho-ke bekufanele kususwe kumthethosivivinywa, njengoba iSenate Republican ngeke ikwazi ukuthola amavoti angama-60 ukuqeda i-ACA.
Ukuze isebenzise inqubo yokubuyisana, iSenate nayo izodinga amaphuzu avela ku-CBO ngenguqulo abayiphakamisayo; ukuvotela ngaphandle kwemiphumela, njengoba iNdlu yenze, akuyona inketho yebhilidi yokubuyisana, ngoba umthelela wesabelomali wesifundazwe kumele ube yindawo eyaziwayo.
Senate Ukubhala Umthethosivivinywa Wabo. Zizogcina Ziningi Kangakanani I-House House?
Ngosuku olufanayo i-AHCA yadlulela iNdlu, izitolo zezindaba zaqala ukubika ukuthi iSenate yayilungiselela ukubhala ibhilidi labo esikhundleni sokushintsha inguqulo yeNdlu. Ngokushesha ngemva kwalokho, iSenate Republican yamemezela iqembu elisebenza ngamalungu ayishumi nambili elizoba ngumthethosivivinywa weSénate, futhi kucacise ukuthi umthetho ungabhalwa ngasese, kunokuba kuqhutshwe imibiko yomphakathi kanye nekomidi lokuhamba.
Kodwa ingakanani izinga leNdlu elizogcinwa yiSenate? Futhi ingabe iNdlu iyavumelana nokungafani okugcina phakathi kweNdlu nezindleko zeSenate?
Emasontweni emva kokuba i-MacArthur Amendment yengezwe endlini ukuze inqobe amaRiphabhulikhi ase-ultra-conservative kulelo kamelo, kwakukhona ingxabano enkulu mayelana nokuvikela abantu ngezimo ezandulele. Lokhu kwaba yindawo yokukhulumisana noJimmy Kimmel, owasebenzisa indaba yenhliziyo yakhe yokuhlinzwa kwenhliziyo yokuzalwa kwenhliziyo ukuze abonise ukubaluleka kokumboza izimo ezikhona ngaphambili ngaphandle kokunye.
Ngenxa yokuthi ulimi lwe-MacArthur Amendment angeke luhambisane noMthetho We-Byrd, ukwehlisa ukuvikela kwabantu abanezimo ezandulele kungase kungenzi kunguqulo yeSénate yomthetho. USenator Susan Collins (R, Maine) uthe esidlangalaleni ukuthi ngeke asisekele inguqulo yeNdlu ye-AHCA, noma yiyiphi enye imali ekhokhwayo eyenza abantu abangaphezu kwezigidi ezingu-23 abangabanjwanga, noma amaphesenti angama-850 ekhulwini labantu abadala asebekhulile (i-CBO) Umbiko we-House we-AHCA ubonisa ukuthi uma umuntu oneminyaka engu-64 ubudala ehola i-$ 26,500 / ngonyaka, ama-premium emva kokusizwa azokhula kusuka ku-$ 1,700 / ngonyaka ngaphansi kwe-ACA eya ku-$ 16,100 / ngonyaka ngaphansi kwe-AHCA ekuthiwa kugcina ukuvikela kwe-ACA abathengi, futhi u-$ 13,600 kuthiwa uvumela ukuvikeleka kwabathengi be-ACA; noma iyiphi indlela, ukwanda okungenakuqhubeka).
Kodwa kunenkinga enkulu kakhulu engozini-eyodwa engakutholi ngempela ukunakwa njengoba iqinisekisa ngenkathi i-AHCA isendlini. I-AHCA izoxosha ama-Medicaid e-Federal federal ngamaRandi ayizigidi eziyizinkulungwane ezingu-834 eminyakeni eyishumi ezayo, ngokusho kokuhlaziywa kwe-CBO.
Ukulondolozwa kunama-angles amabili ahlukene: Ukwehlisa ukwandiswa kwe - ACA's Medicaid (akukho okushiwo okungu-19 okungazange kwandiswe i-Medicaid kungakhetha ukukwenza kanjalo, futhi uthi ukuthi kwandiswe ukufakwa kokuxhumana ngeke ukwazi ukubhalisa abahlomuli abasha ezingeni lokukhulisa yezimali ezikhokhelwa ngumasipala ngemuva kokuphela kuka-2019), futhi sishintshe imali yonke yezimali yaseMedicaid evela ohlelweni lokufananisa oluvulekile lokuvimbela izibonelelo noma ama-capitenti ngayinye. Noma yikuphi ukhetho oluzophela lapho kunezifunda ezinezimali ezingaphansi kweMedicaid esikhathini eside.
Inkinga ye-Medicaid kungenzeka ibe yisisithiyo esikhulu eSenate. Kunabantu abaningi baseRepublican senators-kubandakanya ezinye ezivela emazweni ezandise iMedicaid-eziveza ukukhathazeka mayelana nokuhlelwa kwezimali ze-AHCA ekuxhasweni kwemali yaseMedicaid kanye nomthelela ozoba nawo kubantwini babo abathembele ku-Medicaid, okufaka kokubili ukwandisa iMedicaid kanye neMedicaid yendabuko.
Kwenzekani Uma iSenate Idlula Incwadi Yayo Yakho?
Ngenxa yokuthi iSenate Republican kumele iqoqe cishe wonke amalungu awo-ilahlekelwe okungaphezu kwamabili-ukuze idlule inguqulo yabo ye-AHCA, ivesi alinakuqiniseka. Kodwa kwenzekani ngokulandelayo uma umtsetfosivivinywa weSenate ubeka ama-garners okungenani amavoti angu-51 (kufaka phakathi ukuvotela okungenzeka ukuthi u-Vice President)?
Ngenxa yokuthi iSenate ibhala umthetho wayo, futhi ngenxa yokukhathazeka ukuthi i-MacArthur Amendment angeke ihambisane noMthetho We-Byrd, futhi ngenxa yokuthi abaningana baseRepublican Senators baye babonisa ukukhathazeka mayelana nomthelela wesikweletu seNdlu ku-Medicaid, kuqinisekisiwe ukuthi iNdlu neSenate izikweletu ziyoba nokungafani okukhulu.
Uma lokho kwenzeka, ikomidi lesigungu lizokwakhiwa, elinamalungu avela kokubili eNdlu naseSenate. Umsebenzi wabo uzoba ukuvumelanisa umehluko phakathi kwezikweletu ezimbili bese udala umbiko wenkomfa. Ukusuka lapho, boMbili iNdlu neSenate kufanele idlulise umbiko wenkomfa, ongaphikisana nabomthetho kodwa angaguquki .
Uma bobabili iNdlu neSenate zidlulisela umbiko wenkomfa, ithunyelwa kumongameli ngesignesha. UMongameli Trump kungenzeka asayine noma yiliphi ibhilikhithi elinikezwe kuye elichitha noma lokushintsha okungenani izingxenye ezithile ze-ACA. Akuqiniseki-ke ukuthi noma yikuphi amakamelo eCongress azokwazi ukuvumelana ngesilinganiso sokuthumela kumengameli.
Kungenzeka ukuthi abameli abanesifiso esikhulu sokususa okungenani ezinye ze-ACA-umkhankaso wesikhankaso sabaningi babo-kuzobangela ukuba bavotele umthethosivivinywa abangawusekeli ngokugcwele.
Ngakolunye uhlangothi, i-House Freedom Caucus yabeka ukusekela kwabo i-AHCA ngoMashi, futhi ayivumelanga ukuvota kulo mthethosivivinywa kuze kube yilapho i-MacArthur Amendment ihlanganisiwe, okuvumela ukuthi izikhulu ziphumule imithetho ephathelene nezinzuzo ezibalulekile zezempilo kanye nokwaziswa kokuqala -izimo ezikhona. Ingabe i-Freedom Caucus izovuma ukuvumelana nombiko ongasungulwa wenkomfa ohlukanisa lokho kuguquguquka? Mhlawumbe, kodwa asikwazi ukusho ngokuqinisekile.
Izwi elivela
Nakuba ubuholi beNdlu kanye noHulumeni lweTrump bagubha ukuhamba kwe-AHCA eNdlu, umthetho usenendlela ende yokuhamba. Uma i-Senate idlula inguqulo yayo, kungenzeka ukuthi ihluke kakhulu eNkulumweni yeNdlu, futhi ayikho isiqinisekiso sokuthi zombili amakamelo azovuma ukuyekethisa okuzodingeka ukuvumelanisa lezi zikhwama ezimbili.
Ngesikhathi esifanele, i-ACA ihlala ingumthetho wezwe. Umshuwalense wezeMpilo emakethe ngayinye usaqinisekisiwe kuwo wonke amazwe, kungakhathaliseki ukuthi umlando wezokwelapha ( izenzakalo ezifanelekayo ziyadingeka ukuze ubhalise ngaphandle kokubhalisa okuvulekile). Izinsizakalo ze-Premium , ezisekelwe emalini engenayo kanye nezindleko zokwaziswa endaweni ngayinye, zisatholakala ekushintshaneni kombuso ngamunye, futhi ukwandiswa kweMedicaid akushintshiwe emazweni angu-31 naseDkt lapho kunwetshiwe khona. Imfuneko ye-ACA yokugcina ukukhokhelwa noma ukubhekana nesigwebo sentela nayo isebenza, futhi kuyoba yilapho umthetho uhlelwa ukuwuqeda.
> Imithombo:
> Congress.gov. I-HR1628, uMthetho wezeMpilo waseMelika ka-2017. Kuthulwe ngoMashi 20, 2017.
> Ihhovisi le-Congressional Budget, uMthetho wezeMpilo waseMelika . Ngo-Mashi 13, 2017.
> Ihhovisi le-Congressional Budget, uMthetho Wezempilo waseMelika , Mashi 23, 2017.
> Ihhovisi le-Congressional Budget Office, i- HR1628, uMthetho wezeMpilo waseMelika , kuMeyi 24, 2017.
> Hall M; kanye no-Bagley N, Ukwenza Sense "Ngokwabelana Ngeengozi Engabonakali" kwezeMpilo, ngo-Ephreli 12, 2017.
> I-US House of Representatives, iKomidi Lemithetho, Isifinyezo Somthetho We-Byrd.