Umthetho uvule ukufinyelela kubantu abaphika isikhathi eside ukukhishwa
Umthetho Wokunakekelwa Okunenzuzo (ACA), owaziwa ngokuthi u-Obamacare, usayinwe ngomthetho ngo-Mashi 23, 2010 ukuqinisekisa umshuwalense wezempilo ophephile, ozinzile futhi ongenakuthola kubo bonke abaseMelika. I-ACA ayihlinzeki kuphela ngemali yomshuwalense wezempilo lapho abantu kanye namabhizinisi amancane angakwazi ukuqhathanisa futhi athenge ukukhokhelwa komshuwalense, unikezela ngemali yezimali ezingamamemali aseMelika aphakathi nendawo ukuze athenge nge-exchange exchange ngayinye.
Ngaphezu kwalokho, i-ACA yakwandisa ukufaneleka kukaMedicaid kulabo baseMelika abanomvuzo ophansi abenza ngaphansi kwamaphesenti angu-133 emkhakheni wezompofu osemthethweni, izinzuzo zazo ezazitholakale zikhona kubantu abakhubazekile ngenxa ye-HIV.
Naphezu kwemizamo yabanye ukuphikisa noma ukuphonswa komthetho, ukusekelwa komphakathi kwe-ACA kuye kwaba ukuphakama kancane kancane, nemibono yombono ekhombisa ukwesekwa okuqhubekayo komthetho kusukela kokuvotela iDemocratic and Republican kusukela ekuvusweni kweTrint.
Ngokusho kocwaningo oluvela eWashington, e-DC-based Kaiser Family Foundation, abantu abancane, abanomholo ophansi (ngaphansi kuka-$ 40,000 ngonyaka), futhi abazibiza ngokuthi iDemocrat babevame ukusekela umthetho.
Ngenkathi umthelela we-ACA ohlelweni lwezokunakekelwa kwezempilo wase-US ungenakuphikwa, kungathiwa yizigidi ezingu-1.2 zabantu baseMelika abaphila negciwane lesandulela ngculaza kungenzeka bazizwe bebaningi. Ngaphambi kokumiswa komthetho, amaphesenti angu-17 kuphela abantu abane-HIV babe nomshuwalense wezempilo wangasese uma kuqhathaniswa namaphesenti angu-54 abantu abaningi.
Ngaphezu kwalokho, kabili kuningi okwakungenakho ukutholakala kwezokwelapha kwanoma yiluphi uhlobo (amaphesenti angu-29) uma kuqhathaniswa namaMelika ngaphandle kwe-HIV (amaphesenti angu-14).
Umthelela Wokufinyelela Okungeziweko
Kusukela ngo-2010, ukufinyelela okukhulisiwe ekunakekelweni kwezempilo kuye kwamukelwa kahle abantu abane-HIV, ngezifundo eziningi ezikhomba imiphumela ephuthumayo yemitholampilo ngenxa ye-ACA yokuqaliswa.
E-Virginia, isibonelo, amaphesenti angu-47 alabo ababesebenze ukwelashwa ngaphambili ngohlelo lukahulumeni lwe-AIDS Drug Assistance Program (ADAP) babhalise izinhlelo ze-inshuwalense ze-ACA ngo-2014. Njengoba balungiselelwe ukuhlinzekwa okusha, ukukhathalela okuqondene ne-HIV, iziguli umshuwalense bekwazi ukufeza kangcono futhi balondoloze imithwalo engavumeleki yegciwane kuneziguli ezine-ADAP.
Ngaphezu kwalokho, inyanga ngayinye eyengeziwe yokubhalisa kuhlelo lomshuwalense yayihlotshaniswa namaphesenti ayisithupha amathuba okunciphisa amagciwane, kanti abantu ababhalisele unyaka ophelele bangaphezu kwamaphesenti angama-60 amathuba okugcina imithwalo yemigomo egciniwe ngokugcwele.
Amaphethini afanayo abonakala nakwezinye izindawo, neCalifornia, isimo se-ADAP esikhulu kunazo zonke, kubika amaphesenti angama-27 ahlaselwe ukubhaliswa kusukela ngo-2012. Namuhla, abangaphansi kuka-28,000 baseCalifornia bafinyelela ku-ADAP kuqhathaniswa nabangaphezu kuka-38 000 abenze lokhu ngo-2012-okuphansi kakhulu inombolo ebonwe kusukela ngo-2006.
Lokhu akusho ukuthi akuzange kube yizinselele eziyinhloko zokuqalisa ukusebenza. Ngo-l2015, izinkampani eziningi ze-ACA zitshengiswa ukuthi zibandlulula ngokubandlulula abantu abane-HIV ngokuzibandakanya emiphakathini eyingozi , umkhuba lapho iziguli zivinjelwe khona ngokukhetha uhlelo lomshuwalense ngokubeka izindleko zokukhokha zokuthengisa izidakamizwa ezingenakufaneleka.
Kwezinye izimo, izindleko zezidakamizwa ezingaphandle kwezingculaza zabantu abanesandulela ngculaza zaziyizigidi ezingu-3,000 eziphakeme ngonyaka uma kuqhathaniswa nabashuwalense abangazange bahlanganyele emiphakathini emibi.
Ngo-Mashi 2015, ngemuva kokukhukhumeza kwamaqembu okukhuthaza i-HIV ngokufanayo, i-Aetna Insurance ivuselele izinqubomgomo zayo zangaphakathi, isuse imishanguzo yegciwane lesandulela ngculazi kusukela emkhakheni omkhulu kunawo wonke lapho inkokhelo yokukhokha ingakwazi ukuhamba khona ukusuka ku-$ 5 kuya ku-100% ngemuva kokudonswa kwezidakamizwa.
Ngaphezu kwalokho, imizamo eqhubekayo yokuvimba ukukhuliswa kwe-Medicaid efana neVirginia, eLouisana, eTexas naseFlorida bashiya ezinye izakhamuzi ezihluphekile kakhulu kuleli zwe-ngokuvamile ezibeka engozini enkulu yokutheleleka nge-HIV-nganoma yikuphi, ukufinyelela kokuthola usizo lwezokwelapha.
Njengamanje, amazwe angu-19 ase-US anqatshiwe ukunwetshwa kwe-Medicaid .
Isikhathi Nendlela Yokubhalisa
Ukubhalisa yisikhathi sonyaka lapho ungafaka isicelo sosizo lwezindleko, ushintshe amapulani, noma ubhalise ohlelweni oluyinhloko lwezokwelapha olubheka njengento yokubambisana ebalulekile edingekayo ngumthetho.
Umjikelezo wokubhalisa ovulekile uqala ngoNovemba 1, 2017 ngosuku olusebenzayo lokuqala kusukela ngoJanuwari 1, 2018. Nokho, sicela uqaphele ukuthi umphathi weTrump uye wanquma ukunciphisa ifasitela lokubhalisa kusukela ngoJanuwari 31 wonyaka odlule kuya kuDisemba 15, 2018 . Lokhu kunikeza abantu amasonto ayisithupha kuphela ukuze bavikele ukubhaliswa.
Phakathi naleso sikhathi, izifunda eziyisishiyagalombili ezisebenza ngokuzimela ezizimele zizimisele ukunweba usuku lokubhalisa, noma yikuphi kusuka ngoJanuwari 22 kuya ku-31, ngo-2018.
Ngaphansi kwe-ACA, ukubhaliswa kungaphakathi phakathi kwe-Health Insurance Marketplace. Indawo ngayinye yeMakethe isebenza noma nguhulumeni noma uhulumeni wesifundazwe futhi ikunikeza ukuphazamiseka kwezinketho zokufaka ezitholakala ngaphakathi kwendawo yakho, noma ngabe ufuna
- Umshwalense wezempilo wangasese
- Izinkambiso zentela zokuqeda izindleko ze-premium
- Ukubhaliswa kwe- Medicaid
- Uhlelo lwe-Insurance Health yezingane (CHIP)
- Uhlelo lwezinketho zezempilo ezincane (SHOP)
- Umshuwalense oxhaswe ngumqashi
Umnyango WezeMpilo WezeMpilo wase-United States usungulwe i-Health Insurance Marketplace portal e-Healthcare.gov ukusiza ukunquma ukufaneleka kwakho siqu futhi ikuqondise ehhovisi elithile noma emnyangweni oyidingayo. (Isiqondisi solimi lwesiSpanishi sitholakala eCuidadodesalud.gov).
Uma usuqumile ekukhoneni, ungafaka isicelo se-intanethi, ngomuntu, noma ngeposi. Izinqubo zingashintsha kusuka kumbuso ukuya kumbuso, kodwa amafomu okufaka isicelo alula alula futhi alula ukuwaqonda, adinga kuphela inombolo yokuphepha yomphakathi (noma inombolo yombhalo uma ungumfiki wezomthetho) kanye nemibhalo yomqashi / ingeniso (isb., Ama-stubs akhokhelwayo, Ama-W-2, izitatimende zentela).
Uma usuhanjisiwe, isikhathi sokulandelela sikhona phakathi kwamasonto amabili kuya kwamabili, ngokwesilinganiso.
Izinombolo zocingo ezibalulekile
Umshwalense wezeMpilo Marketplace Hotline (etholakalayo amahora angu-24 ngosuku):
- 1-800-318-2596
- I-TTY: 1-855-889-4325
I-Hotline Resources Hotline (ngoMsombuluko kuya kuLwesihlanu, 9:00 ekuseni kuya ku-5: 00 ntambama EST):
- 1-800-706-7893
- I-TTY: 1-800-706-7915
Ukuze uthole ukwaziswa okwengeziwe mayelana nokwandiswa kweMedicaid esifundazweni sakho, umbiko wokuvuselelwa kwesimo se-State Action State utholakala ku-Kaiser Family Foundation engenzi-inzuzo.
>> Imithombo:
> Kaiser Family Foundation (KFF). "I-Kaiser Health Tracking Poll: I-Public View View ku-ACA." Washington, DC; ifinyelelwe ngoNovemba 3, 2015.
> McManus, K .; Rhodes, A .; I-Yerkes, L .; et al. "2014 Ukwelashwa Okunenzuzo Okunakekelwa Kwemisebenzi Yogciwane Lwezifo Ezingculazi kanye Nemiphumela Ye-HIV Ehlanganisiwe." Iviki le-ID 2015. Okthoba 9, 2015; I-San Diego, eCalifornia; > isethulo somlomo; abstract 728.
> Jacobs, D. no-Sommers, B. "Ukusebenzisa izidakamizwa ukukhetha - Ukukhethwa Okubi Emkhakheni Wemakethe Yomshuwalense." I-New England Journal of Medicine. NgoJanuwari 29, 2015; 372: 379-402.
> I-Advisory Board Company. "Lapho i-state ithi ukunyuka kwe-Medicaid." Washington, DC; ifinyelelwe ngoNovemba 3, 2015.