Uma uthenga umshuwalense wakho wezempilo emakethe ngayinye, cishe uke wabona izihloko eziphathelene nokwanda kwezinga elizofika ngo-2018. Imakethe yeqembu elincanyana, elawulwa ngaphansi kweMithetho Yokunakekelwa Okunenzuzo Efanayo (ACA) njengemakethe ngayinye , izophinde ibone izinga lokukhuphuka, nakuba ukukhuphuka jikelele ngeke kube okuphawulekayo.
Kodwa lezi zihloko zivame ukugxila ekukhuleni kwesilinganiso esiphakathi, noma ngaphezulu kombuso wonke, noma ngaphesheya kwendawo yonke yabashuwalense.
Kubantu abanokungena kwiqembu elincane noma emakethe yomshuwalense ngamunye, ukwanda kwamanani okwenyathelo ngalinye kanye nelungu kungashintsha kakhulu kusuka kumaphakathi kuhulumeni noma umshwalense.
Yilokho kunjalo njalo, kodwa kukhona ushintsho olusha ngo-2018 ngokuthi amazinga abalwa kanjani kubantwana-ikakhulukazi kwentsha-futhi kungaholela ekukhuphukeni kwenani lemindeni. Ngakho ake sibheke ukuthi kwenzekani ngezinga lezingane, nokuthi yini ongayilindela ngonyaka omusha.
Izingane Zizoba Nezibalo Zamazinga
I-ACA ibeke imithetho emisha kumaphrimiyamu wezinhlelo zomshuwalense wezempilo weqembu ngalinye nezincane (izinhlelo ezimele ngabanye abantu abazithengela zona; izinhlelo zamacembu amancane ngokuvamile anikezwa abaqashi abanabasebenzi abangaba ngu-50, kodwa kunezimbalwa lapho amaqembu abasebenzi abangaba ngu-100 abhekwa njengamaqembu amancane ).
Ngaphansi komthetho, i-premium yabantu abadala asebekhulile ayikwazi ukuphindaphinda kathathu i-premium yeminyaka engu-21 ubudala.
Izingane zinikezwa izinga eliphansi, okwamanje lihlelwe ngamaphesenti angu 63.5 wezinga lomuntu oneminyaka engu-21 ubudala. Lokhu kusetshenziswe kuzo zonke izingane, kusukela esanda kuzalwa kuya eminyakeni engu-20, kusukela ngo-2014.
Ngaphambi kuka-2014 (okungukuthi, ngaphambi kokuba imithetho yokulinganisa ye-ACA isetshenziswe), ama-premium ajwayelekile asetshenziswa kumaqembu ahlukene ahlukene ngokusekelwe kwezicelo ezilindelekile zeqembu ngalinye leminyaka.
Izingane zivame ukuba nezicelo eziphakeme uma zisencane nezinsana, izimangalo ezingezansi uma sezifunda esikoleni esiphansi futhi esiphakathi, bese kuthiwa zivame ukukhuphuka njengoba izingane zingena eminyakeni yabo esemncane. Ngaphambi kuka-2014, abanikazi bomshuwalense bangafaka lokho ku-rate-setting-abanye babe nezinkokhelo eziphakeme kakhulu ezinsana, isibonelo.
Kodwa ngaphansi kwe-ACA imithetho kusukela ngo-2014 kuya ku-2017, bonke abantwana abaneminyaka engaba ngu-20 bakhokhiswa ngamaphesenti angu-63.5 we-premium esetshenziswe kumuntu oneminyaka engu-21 ubudala. Lokho kuguquka ngo-2018, ngenxa yemithetho emisha eyaqedwa ngu-HHS ngoDisemba 2016 (indlela ethile yokulinganisa ichazwe kabanzi ku- Isithasiselo 1 salesi simemo se-HHS ):
- Izinga lomuntu oneminyaka engu-21 lizoqhubeka liba yisilinganiso sokuqala lapho amanye amanani asethwa khona.
- Izingane ezineminyaka engama-0 kuya kwengu-14 zizokhokhiswa ngamaphesenti angu-76.5 wezinga lesisekelo.
- Izingane ezineminyaka engu-15 zizokhokhiswa ngamaphesenti angu-83.3 wezinga lesisekelo.
- Abantwana abaneminyaka engu-16 bazokhokhiswa ngamaphesenti angama-85.9 wezinga lesisekelo.
- Izingane ezineminyaka engu-17 zizokhokhiswa ngamaphesenti angu-88.5 wezinga lesisekelo.
- Izingane ezineminyaka engu-18 zizokhokhiswa ngamaphesenti angama-91.3 wezinga lesisekelo.
- Izingane ezineminyaka engu-19 zizokhokhiswa ngamaphesenti angama-94.1 wezinga lesisekelo.
- Abantwana abaneminyaka engama-20 bazokhokhiswa ngamaphesenti angu-97 wezinga lesisekelo.
- Abantu abadala bazoqhubeka bekhokhiswa amanani asekelwe eminyakeni yabo, ngesilinganiso esiphezulu (kubantu abaneminyaka engu-64 nangaphezulu) izikhathi ezintathu eziyisisekelo se-premium.
I-HHS iphawula ukuthi nakuba izindleko zithi izindleko zivame ukuphakama ezinganeni ezingaphansi kweminyaka engama-4 futhi zinciphise izingane ezineminyaka engu-4 kuya ku-14 ubudala, isilinganiso esisodwa sebhodi yezingane kusukela ekuzalweni kuya eminyakeni eyi-14 sihloselwe ukusakaza izindleko kubantu abaningi, futhi sinciphise ukukhuphuka kwenyuka okungazelelwe okuzosebenza emndenini osanda kuzalwa uma amanani asethwe ngokusekelwe ngokuphelele ekumangeleni okulindelekile kweqembu ngalinye leminyaka.
Lolu shintsho endleleni yokusetshenziswa kwamazinga ayifaki ukukhula okujwayelekile okusebenza ngonyaka ngamunye ngenxa yezindleko ezikhulayo zokunakekelwa kwezokwelapha nezinye izici ezenza izinga lonke likhuphuke.
Lezo zinguquko ziyokwandisa izinga lesisekelo, ngakho-ke ukulinganisa okusha kwezingane kuzobe sekusebenzisa amaphesenti amakhulu kakhulu esilinganiso sezinga eliphansi, okuqhubeka nokukhuphula izinga lokuhamba okuzosebenza ekubhekaneni nezingane.
Isifunda saseColombia nase-Alabama, eMassachusetts, eMinnesota, eMisissippi, eNew Jersey, e-Oregon nase-Utah- sebenzisa indlela yabo-ukubeka indlela, ngakho-ke izinombolo ezintsha ze-premium zezingane azisebenzi kulawo mazwe. Ngaphezu kwalokho, iNew York neVermont akuvumeli ukulinganiswa okusekelwe eminyakeni, ngakho-ke akukho ukushintsha kwama-premium asekelwe eminyakeni yobudala kulawo mazwe amabili.
Amaqembu amakhulu asebenzisa ukulinganisa okuhlukile
Qaphela ukuthi ama-premiums amaqembu amaningi asekelwe ngokulinganisa amanani ahlanganisiwe, futhi ahlukahluka kuphela ngokuthi isisebenzi sibhalisa njenge-self-kuphela, isisebenzi kanye nomlingani, isisebenzi kanye nezingane, noma umsebenzi kanye nomlingani kanye nezingane. Iminyaka yezingane-futhi ngisho nenani labantwana-ayithinti kakhulu amaphrimiyamu akhokhiswayo. Imithetho emisha echazwe ngenhla ngokubeka ama-premiums kubantwana iqondene ngqo nemakethe yeqembu ngalinye namancane.
Linganisa Ukuguquka Ngeke Kube Sekugqamile Uma Abantu Bengu-21
Amanani wezingane azobe ephakeme ngo-2018 kunokuba ayeke esikhathini esidlule, ukwanda okuphawulekayo okusetshenziselwa izintsha ezindala. Kodwa uma lezo zinsuku zigcina ziba ngu-21, ngeke zithole ukwanda kwezinga elibukhali elivame ukusetshenziswa. Ngaphambi kuka-2018, umuntu oneminyaka engu-21 uzohamba ekukhokheleni amaphesenti angu-63.5 wezinga eliyisisekelo sokukhokha isilinganiso sesisekelo, konke ukuqhuma okulodwa; ukugxuma kuzobe kushintshwe kusukela eminyakeni engu-15 ukuya ku-21.
Amanani azobe esezansi kubantu abadala kunokuba bebengaba khona
Kubalulekile futhi ukukhumbula ukuthi amaqembu okulinganisa iminyaka ahloswe njengendlela yokusakaza izindleko eziphelele kulo lonke inani eligcwele le-insureds. Konke inani lamaphrimiyamu adingekayo ukumboza izindleko zokunakekela ubulungu obulonke bomhlaba, iphesenti yaleso samba manje izosebenza kancane kubantwana, okusho ukuthi kuzosebenza kancane kancane kubantu abadala. Inani eliphelele okufanele liqoqwe alithinteki ngendlela entsha yokulinganisa.
Yiqiniso, lokho kusebenza kulo lonke ilunga lomhlangano; umthelela emndenini ngamunye uzohluka, futhi indlu egcwele intsha izothola amaphrimiyamu angaphambilini okusizayo ngo-2018 kunokuba bebengabhekana namabandla omnyaka omusha, ngisho nangemva kokubalwa kwama-premiums omzali. Kodwa ngokugcwele, amaqembu amasha ama-age for kids ashintshe inani eliphelele lemali abaqashi abazoqoqa kuwo wonke amalungu awo ahlangene (ekhumbula ukuthi inani eliphelele elizodinga ukuqoqwa lizoba ngaphezulu ngo-2018 kunalokho 2017, ngenxa yezici evamile ezishintsha izinga lezinga lokushayela).
Ukuxhaswa kwe-Premium kuzoshintsha ukuhamba ngezindleko ezintsha
Kubantu abathengisa ukuthengiswa kwemakethe ngayinye ekushintsheni ( futhi kuphela ekushintshaneni ) kuhulumeni ngamunye, izinsizakalo ze- premium (izikweletu zentela zama-premium) zenzelwe ukugcina izindleko zokubheka ezingeni elingabizi. Inani le-subsidy linqunywa ngokubetha izindleko zepulani yesibili-ephansi kunazo zonke zesiliva ohlelweni oluthile lwemali engenayo yomndeni, ngamaphesenti aphansi kwababhalisile abangenayo imali encane, futhi ephakeme kumarejistres aphezulu azuza.
Njengoba izindleko zokuhlinzekwa komndeni onikeziwe ziyanda, kanjalo nenani le-subsidy yabo. Ngeshwa, izinsizakalo azitholakali kumakhaya athola izikhathi ezingaphezu kwesine ububha, ngakho-ke umndeni wabahlanu ungawufaneleki ngemali ekhokhelwa yi-premium uma imali engenayo ingaphezu kuka-115,120 ngo-2018. Kodwa ngemindeni enenzuzo engadluli izikhathi ezine zobumpofu, izinsizakalo zikhula ukuhambisana nezindleko zokubambisana, kanti isibonelelo sisho ngqo izindleko zangempela zomkhaya zokubambisana (inothi ukuthi izinsizakalo azitholakali uma ungaphakathi kwegebe lokubheka i - Medicaid noma uma i- glitch yomndeni isebenza esimweni sakho) .
Kubalulekile futhi ukuqonda ukuthi izindleko ze-ACA izindleko ezinganeni ezingaphansi kweminyaka engu-21 ezingaphezu kwemithathu emndenini ngamunye, kokubili emakethe yeqembu ngalinye namancane. Ngakho-ke umndeni onabantwana abayisithupha abangaphansi kweminyaka engu-21 uzokhokhwa imali eyodwa kuphela uma uqala ukukhokhela izingane zabo ezinganeni ezingamashumi amabili nambili, kungakhathaliseki ukuthi abanye abaningi abancike kuloluhlelo).
Ukuthatha okukhona lapha ukuthi ngenkathi amanani azokhula ngaphezu kokujwayelekile emindenini enezinsizwa, izinsizakalo ze-premium zizokhula futhi kulawo mindeni uma zifaneleka ukuthola izinsizakalo. Kule mizi enikezwa yi-subsidy-efanelekile, izinsizakalo zizogcina i-premium yenamba yesibili yezindleko zesiliva eziphansi kakhulu ezingeni eliphezulu. Uma imali engenayo yomndeni ingaguquki kusukela ngo-2017, izindleko zenetha lentengo yesibili-ephansi kunazo zonke zesiliva empeleni ziyobe ziphansi kancane ngo-2018 kunokuba zikhona ngo-2017, naphezu kokunyuka kwamazinga ka-2018 kanye namaqembu omnyaka wezingane.
> Imithombo:
> Amasevisi e-Medicare naseMedicaid Services. Isikhungo Sokwaziswa Komthengi kanye Nokuqapha Umshuwalense. Isilinganiso seMakethe Shintsha, sibuyekezwe ngoJuni 2, 2017.
> UMnyango wezeMpilo kanye nezinsizakalo zabasebenzi. Ama-Insurance Standards Bulletin Series-Ulwazi . NgoDisemba 16, 2016.
> UMnyango wezeMpilo kanye nezinsizakalo zabasebenzi. Ukuvikelwa kwesineke kanye noMthetho Wokunakekelwa Kwezinkinga; Isaziso se-HHS Isaziso seNzuzo kanye neMigomo yokukhokha ka-2018; Ukuchitshiyelwa kwezikhathi ezikhethekile zokubhalisa kanye nohlelo lwabathengi olusetshenzisiwe futhi oluhlelekile . NgoDisemba 16, 2016.
> Ibhulogi lezempilo zeJost T. I-CMS iqedela uMthetho Wokukhokha WaseMakethe Omusha, Ngempumelelo ngoJanuwari 17, 2017. Ngo-Disemba 17, 2016.