Ukuzivocavoca Okuvinjelwe Umthetho Wokunakekelwa Okunganakusiza I-No-Rescissions Clause
Ezweni lezomthetho, ukususwa kusho ukuthi inkontileka phakathi kwamaqembu amabili avulekile, ukuthatha izinhlangothi ezimbili zenkontileka emuva lapho zikhona ngaphambi kokuba zenze isivumelwano noma ukuthengiselana.
Ukuqeda igama elisetshenziswe lapho inqubomgomo yomshuwalense wezempilo ikhanselwa ngokuphindaphindiwe yinkampani yomshuwalense. Bangakwazi ukwenza lokhu ngokusemthethweni ngaphansi koMthetho Wokunakekelwa Ongabizi kahle uma isiguli senze ubuqili noma uma isiguli siqamba ngamabomu mayelana nezinto ezibonakalayo ngendlela evinjelwe ngokwemigomo yophiko lomshuwalense wezempilo.
Kwamanye amacala, akukho emthethweni ukuthi inkampani yomshuwalense ikhiphe imvume.
Ekuqashelweni, ukukhishwa kususwe kusukela ekuqaleni kwenqubomgomo, kusale ukuthi isiguli sinesibopho sezindleko zabo ezenziwe. Ngokuvamile, babuyiselwa imali yamaphrimiyamu abo.
I-No-Rescission of Coverage Ukuhlinzekwa kwe-ACA
Ukuchazwa akuvunyelwe (ngaphandle kokukhwabanisa nokwaziswa okungalungile kwamaqiniso) ngaphansi koMthetho Wokunakekelwa Onganakekelwa Ngomthetho Wezinyunyana 45 CFR 147.128: Imithetho Ngokuphathelene Neziphakamiso. Kwathatha ukusebenza ngokuhlela iminyaka kusukela ngo-September 23, 2010.
Ngokwenza njalo, isidingo sokuhlinzekwa ngokubambisana naphezu kwezimo zangaphambili ezikhona ngaphansi koMthetho Wokunakekelwa Onganakekelwayo kuphelile iningi lezinkampani ezinomshuwalense ukwenza izinqubomgomo zokuthola iziguli ezibiza kakhulu. Nakuba ngaphambi kokuba imigomo yabo yokusebenza ingadinga ukudalulwa kwesimo sokuxoshwa ngaphambi kokuba sihlanganiswe futhi sinekhono lokuphika ukukhishwa noma ukukhokhisa imali ephakeme kakhulu, abakwazi ukwenza lokhu.
Ngaphambilini, iziguli zinezizathu zokuqamba amanga futhi zingabonakali izimo zezokwelapha, futhi izinkampani zomshuwalense zinezizathu zokubheka ngokucophelela ukungazidalwanga nokuzibiza ngokuthi ukukhwabanisa.
Izinkampani zomshuwalense zingasenza izinkinga ngokunye okungaqondile ngamabomu, njengokuhluleka ukudalula isehlukaniso futhi oshade naye oqhubeka naye ukuthola izinzuzo ngaphansi kohlelo.
Umshuwalense kumele akhombise ukuthi ufuna ukukhohlisa.
Ukuhlukunyezwa Kwezingqinamba Ngaphambi kwe-ACA
Iziphakamiso zazivame ukuxoxwa ekuthuthukiseni izinguquko zokunakekelwa kwempilo, nemikhuba eminingi ebonakalayo. Izinkampani zomshuwalense wezempilo, ngomzamo wokuqukatha izindleko, zinganquma ukunqanda ukuhlinzekwa kwesiguli esiphephile ukuthi ukunakekelwa kubiza kakhulu kunalokho abafuna ukukhokha.
Uma isiguli sigula, umshwalense uzobukeza ngokucophelela isicelo sakhe sokuqala sokuthola ulwazi, thola (lokho okubheka ukuthi kukhona) ukungafani, bese ethi umguli oqinisekisiwe uqambe amanga ngesicelo sakhe. Lokho kwanikeza umshuwalense imvume yomthetho ukulahla isimangalo. Ezinye izinkampani zomshuwalense zathuthukisa isofthiwe yocwaningo lokukhwabanisa olwenziwe ngezigulane ezathola ukuxilongwa ngesimo esingaba yizindleko eziphezulu.
Izinkinga zenzelwe iziguli ezingazange zikhohlise ngamabomu izicelo zabo, futhi lowo umshuwalense othole ukungafani okungahambisani nawo. Ngokwesibonelo, esimweni saseTexas, ukutholakala komama kwahlelwa ngemuva kokuba aqale umdlavuza webele . Umshuwalense usuqede ukumbozwa kwakhe ngokusho ukuthi wehluleka ukudalula ukuvakashela kudematistist nge-acne, okungaqondakali kahle.
Izinkinga ezengeziwe zenzelwe iziguli ezazikhokhela ama- premium okwesikhashana kodwa emva kokugula kwazo zawela ngemuva kokugula.
Umshuwalense akazange akhathazeke ngokubukeza inqubomgomo kuze kube yilapho umuntu ekhokha ohlelweni. Baqoqa imali, kodwa bebengenakuhlinzeka ngamasevisi abo athembisiwe. Lokhu "ukwehla uma uguga" manje sekuhambisana nesigatshana sokungabikho-soMthetho we-Care Affordable Act.
Isikhathi sizokutshela ukuthi ukuhlukunyezwa okunjalo kuzoqhubeka nokuthi ngabe kukhona imithetho eminye edingekayo ukuqeda umkhuba.