Ngesisekelo sayo esisisekelo, isimo esivele sisekhona yisimo sezokwelapha onawo ngaphambi kokufaka isicelo sokuthola umshuwalense wezempilo . Isimo esandulele esasetshenziselwa ukuba yisithintelo sokuthola ukukhangisa emakethe yomshuwalense wezempilo, kodwa i-ACA ishintshe lokho.
Kungani Izimo Ezikhona Zenzeka Ngaphambi Kokusebenza Okukhulu
Ngaphambi koMthetho Wokunakekelwa Ongenakusiza , kwezinye izimo, umshwalense anganqaba ukukuthengisa inqubomgomo yomshuwalense wezempilo uma unesimo esandulele.
Kwezinye izimo, umshwalense uzokhipha isimo sakho esivele sisekhona kusukela ekubhaliseni umshuwalense wezempilo. Lokhu kwaziwa ngokuthi ukukhishwa kwesimo esandulele .
Kwezinye izimo, umshuwalense kungenzeka ukuthi uvumelane ukumboza isimo sakho esandulele, kodwa ngabe ngabe ukukhokhise amaphrimiyamu amaningi aphezulu kulokho kutholakala kunalokho obekukhokhwa ngakho ukukhokhelwa okufanayo ngaphandle kwesimo esandulele. Le ndlela yakuthola umusa kubashuwalense njengoba isikhathi sasihamba, ngoba nje kwakungelula ukubeka ngaphandle kwezimo ezikhona ngaphambili.
Ukuba nesimo esandulele esinjengokuphakama kwengcindezi ephakeme yegazi engekho emithwalweni yakho yomshuwalense wezempilo kwakuwumsebenzi omkhulu kunokuba nje ukhokhele amaphilisi akho ephakeme wegazi. Ukukhishwa kwesimo esivele sikhona kungahle kungabandakanyi okungaphezulu kwalesi simo esisodwa esivele sisekhona kusukela ekubukeni. Kungabandakanyeka zonke ezinye izimo ezakhiwe ngenxa yesimo sakho esandulele.
Isibonelo, uma isimo sakho esingekho esikhishwe ngaphambili sasiyi-high blood pressure futhi une-stroke ngenxa yomshwalense wegazi ophezulu, inkampani yomshuwalense wezempilo ingase inqabe ukukhokha ukwelashwa kwakho kwesifo. Kungathi, njengoba isifo sakho siphumelele ngokuqondile komfutho wegazi ophezulu ongabanjwanga, ukushaywa komzimba kwakungabandakanywa nokuqashwa.
Isimo esandulele esivele sikhona senze kube nzima kubantu abanemibandela elula ekhona ngaphambi kokuthola umshuwalense wezempilo ama-premium afanelekile. Ngokuvamile, bebengakwazi ukuthola ukuthunyelwa nhlobo. Uma bekwazi ukuthola ukukhishwa, kwakubiza kakhulu futhi / noma kungabandakanyi isimo sabo esandulele.
Ngonyaka we-1996, i- HIPAA , uMthetho Wokubheka Umshuwalense WezeMpilo nokuPhatha, ibeka ukulinganiselwa lapho abahlinzeki bezempilo bevunyelwe ukukhipha izimo zangaphambi kwesikhathi nokuthi kungakanani isikhathi sokubanjelwa esikhona ngaphambili. Funda kabanzi ngalokhu . Noma kunjalo, ukuvikela kwe-HIPAA kusetshenziswe ikakhulu kubantu abafuna ukuhlinzekwa ngaphansi kwezinhlelo ezixhaswe ngumqashi.
Emakethe ngayinye (ukuthengwa kwakho ngokwakho, kunokuba uthole emisebenzini) izimo ezikhona ngaphambili kwakuyinkinga enkulu kubafakizicelo emazweni amaningi ngaphambi kuka-2014. Kwakunzima, kubiza, noma akunakwenzeka ukuthola umshuwalense wezempilo owawuzoba ukumboza isimo esivele sikhona kanye nanoma yiziphi ezinye izimo ezihlobene nazo.
Umthetho Wokunakekelwa Onganakekelwayo kanye Nemibandela Elandelanayo
Ngonyaka ka-2014, ukuvikelwa komthengi okungenakusiza okungenakunakekelwa kungena ngemvume. Manje, ngenxa ye-Care Affordable Act, abanikezeli bezempilo e-United States abakwazi ukuthatha umlando wakho wezempilo uma benquma ukuthi bangakudayisi yini noma bangayithengi, inqubomgomo yomshuwalense wezempilo.
Awukwazi ukubeka eceleni isimo esivele sikhona kusukela ekubhaliseni, futhi angeke akhokhe ngaphezulu ngoba unesimo esandulele.
Lokhu kwenze kube lula kubantu abanemibandela ekhona ngaphambi kokuthenga umshuwalense wezempilo ngamunye, ukushintsha imisebenzi, ukuyeka umhlalaphansi ngaphambi kokuba ufanelekile ku- Medicare , noma ukuzishaya ngokwakho njengomuntu osomabhizinisi. Abantu akusadingeki bakhathazeke ngokuthi baxilongwa ngaphandle kokungacabangi.
Umshuwalense wezeMpilo othengiswe ngemali yomshuwalense wezempilo owenziwe yi-Care Affordable Act iyinkinga eqinisekisiwe , okusho ukuthi inkampani yomshuwalense wezempilo ngeke inqabe ukukuthengisa ukuhlinzekwa komshuwalense wezempilo uma nje usebenzisa isicelo sokuthola isikhathi sokubhalisa ngonyaka ovulekile .
Okufanayo nakwezinye izimboni ezinkulu zezokwelapha ezithengiswa ngaphandle kwe-exchange , okumele kube yi-ACA-ehambisanayo.
Ngabe Ukubhaliswa Okuvulekile Kuphikisana Ne-Insurance Insurance?
Uma i-ACA iVuliwe, Ingabe Izimo Ezingakabikho Ziyobe Inkinga Futhi?
NgoMeyi 4, 2017, amaRiphabhuliki eNdlu Yezindwendwe zaseMelika adlulisela uMthetho wezeMpilo waseMelika (AHCA) futhi awuthumela eSenate. Kodwa naphezu kokwethula ukuhlukahluka okungafani kwalowo mthethosivivinywa, iSenate Republican ayikwazanga ukufaka ukusekelwa okwanele ukudlula noma yimuphi wabo.
Inguqulo yokuqala ye-AHCA yayiyobe isigcine izivikelo zangaphambili ezikhona, kodwa iMacArthur Amendment yashintsha umthethosivivinywa ukuze kuvunyelwe ukuthi amazwe akwazi ukuvikela ukuvikeleka kwabathengi be-ACA. Ngokuphawulekayo, kusho ukuthi bekuyokwazi ukuvumela abakwa-inshurensi ukuba bakhokhe imali ephezulu emakethe lapho umfakisicelo enesimo esandulele futhi engakaze aqhubeke nokukhokhela izinyanga ezingu-12 ngaphambi kokubhalisa kuhlelo olusha.
Ukuchitshiyelwa kweMacArthur ku-AHCA nakho kuzovumela izifunda ukuthi zishintshe incazelo yezinzuzo ezibalulekile zezempilo , ngakho-ke amapulani aphezulu angathengiswa. Lokho kungathinta ngokungaqondile abantu abanezimo ezikhona ngaphambili, njengoba izinhlelo ezibandakanya ukufakwa kwemibandela yazo kungenzeka zingatholakali noma ziyabiza ngokweqile.
Izinguqulo ze-Senate zomthetho ezazisungulwa ngo-2017 zithatha izinyathelo ezihlukahlukene ekubhekisweni kwezimo zangaphambili. Ngokuvamile, ngenkathi iphuzu lokukhuluma ngokuvamile ukuthi abantu abanezimo ezikhona ngaphambili babezovikelwa, iqiniso liwukuthi kungenzeka ukuthi bangabi khona. Isihloko esivamile kwakuwumqondo wokunikeza izimo eziguquguqukayo ukushintsha incazelo yezinzuzo ezibalulekile zezempilo, noma ukuvimbela ukunikeza imali ye-ACA emazweni futhi ubavumele ukuba bathuthukise izixazululo zabo.
Iwashi iphelelwe yisikhathi sokubuyisana kwesabelomali ngo-2017 ngo-Septhemba 30, futhi, kanye nalo, kungenzeka ukuthi uphule i-ACA ngobuningi obulula eSenate. Kodwa abameli beRiphabhulikhi bafungile ukuzama futhi ngo-2018 ukuze baqede i-ACA, futhi akucaci ukuthi bazophumelela yini.
Ukuqeda ukuvikeleka kwesimo esivele sikhona kubantu abaningi, njengoba lokho kuvikelwa kubonakala kube yinto evelele kakhulu ye-ACA. Kodwa futhi yisici esibangele ukuba amaphrimiyamu akhule emakethe ngayinye, futhi abanye abomthetho bangathanda ukubona ukuvikeleka okungapheli kwabantu abanezimo ezikhona ngaphambili, ekuhwebeni kwama-premium aphansi.
Kuningi okumele kubonwe mayelana nekusasa le-ACA, futhi inkinga yezimo ezandulele kungenzeka ukuthi ibuye futhi esikhathini esizayo esiseduze. Kodwa okwamanje, zonke izivikelo zomthengi ze-ACA zihlala zigcwele ngokugcwele. Ukuvulwa kokubhalisa ngo-2018 kuqale ngoNovemba 1, 2017 nasemazweni amaningi, kuzophela ngo-Disemba 15, 2017. Lena yithuba lakho lokuthenga ukuthengwa komakethe ngamunye, futhi umlando wakho wezokwelapha ngeke ube yinto ebalulekile ekufanelekeleni kwakho noma nge-premium yakho.
> Imithombo:
> UMnyango WezeMpilo Nemisebenzi Yabantu, Amalungelo Akho Ngaphansi kwe-HIPAA.
> Healthcare.gov. Funda uMthetho Wokunakekelwa Onganakekelwayo.
> Ikomidi leNdlu Yezamandla Nezohwebo, i- MacArthur Ukuchitshiyelwa ku-HR 1628, Isigaba Isifinyezo SeSigaba .
> Kaiser Family Foundation, Ukuvuselelwa Kwempilo Yomshwalense WezeMpilo: I-Issu eqinisekisiwe . Juni 2012.
> Kaiser Family Foundation, Summary of the American Health Care Act, May 2017.