Namanje Ngama-29 Million Ngaphandle Kwempilo Umshuwalense ngo-2016
Ngo-2013, ngokusho kwedatha ye-US Census, kwakukhona izakhamizi ezingama-41.8 ezingezona asebekhulile ezingaqinisekisiwe e-United States. Ngo-2016, lelo nani linqunywa ukuthi liyizigidi ezingu-29. Lokhu kunciphisa okukhulu, kodwa kunengqondo ukubuza ukuthi kungani kusenabantu abaningi kangaka ngaphandle komshuwalense wezempilo.
Umthetho Wokunakekelwa Okunakekelwayo ongenakunqunywa wenziwa ngonyaka ka-2010, kanti iningi lamalungiselelo alo asetshenziswa phakathi kuka-2014 no-2016.
Ukuze ugweme inhlawulo, abaqashi abakhulu manje kudingeka ukuba banikeze ukukhokhelwa okungabizi ngesikhathi sabo esigcwele (abasebenzi base-30 + amahora ngeviki). Abantu kudingeka badondoloze umshuwalense wezempilo noma babhekane nezinhlawulo ekukhokheni intela yabo. Izinsizakalo ze-Premium kanye nokwabelana ngezindleko ekuthengisaneni kwenza ukuhlinzeka nokukhathalela okungabizi kakhulu kubantu abahola imali ephakathi. Futhi ukunwetshwa kwe-Medicaid kwenza i-free-or almost-cover-coverage etholakalayo emindeni ephansi engenayo.
Ngakho-ke kungani kubalwa abantu abayizigidi ezingu-29 bengenawo umshuwalense wezempilo e-United States? Leyo nombolo kulandela ukuhlaziywa okwenziwa yi-ACA Signups ngo-March 2016. Futhi nakuba liphansi kunabantu abayizigidi ezingu-33 abangazange baqinisekiswe ngo-2014 ngokwemininingwane ye-US Census, kuhambisana nalokho okushiwo yi-Congressional Budget Office sika (CBO) ka-2012 ukuthi kuzoba khona izigidi ezingama-30 ezingezona asebekhulile zase-US ngaphandle komshuwalense wezempilo ngo-2022 ( idatha ephathelene nenani labantu ngaphandle komshuwalense wezempilo ngokuvamile libhekisela kubantu abangewona asebekhulile, njengoba iMedare ihlanganisa abantu abaningi uma befinyelela eminyakeni yobudala engama-65).
Ngisho nangaphambi kokuba iNkantolo Ephakeme inqume ngo-2012 ukuthi ukunyuswa kwe-ACA sikaMedicaid kuzoba yindlela yokuzikhethela, kusho i-CBO ukuthi kuzoba nezakhamuzi ezingu-27 ezingezona asebekhulile ezingagulile e-US ngo-2022. Abenzi bomthetho nabaqondisi bebazi kusukela ekuqaleni ukuthi ngenkathi i-ACA ingenza i-dent ephawulekayo enani labantu abangahlali base-US abangaqinisekisiwe (futhi linalo), bekuzoba namamiliyoni abantu abangenayo imali yomshwalense wezempilo eminyakeni eminingana emva kokusebenzisa ngokugcwele umthetho.
Nazi ezinye zezizathu ukuthi i-ACA ayizange ibangele ukutholakala kwemishwalense yempilo e-US jikelele:
Abafuduki abangabhalisiwe
I-ACA ayihlinzeki nganoma yiluphi uhlobo lokuhlinzekwa komshuwalense wezempilo kwabangaphandle abangabhalisiwe. Akugcini kuphela ukuthi bangatholi izinsizakalo, banqatshelwe ukubhalisela uhlelo lokushintshanisa nhlobo, noma ngabe bayakwazi ukukhokha inani eligcwele le-coverage (i-California idlulisele umthethosivivinywa ngo-2016 ozovumela abokufika abangabhalisiwe ukuba bathenge ngokugcwele- ukuthengwa kwezindleko ku-California exchange, kodwa uhulumeni kumele athole ukukhishwa kwezimali kuhulumeni wesifundazwe ukuze enze lokho kuhlinzekwa). Abafuduki abangabhalwanga nabo bavinjelwe ekutholeni iMedicaid.
I-Kaiser Family Foundation inqunywe ngo-2013 ukuthi kwakunabantu abangaba ngu-4.8 million abahambeli abangabhalisiwe phakathi kwabantu abangaqinisekisiwe, ababalwa ngamaphesenti angaba ngu-15 abahlali abangaqinisekisiwe.
Ukuhlawulwa Kwesigwebo Nokuntuleka Kokuphoqelela
Nakuba ukuhlinzekwa komsebenzi we-ACA okwabelwana ngawo (aka, "igunya lomuntu ngamunye") kudinga cishe zonke izakhamizi zase-US ukugcina umshuwalense wezempilo noma ukubhekana nesigwebo, kukhona uhlu olude lokukhululwa kwezigwegwe, kanti i-IRS incane endleleni yamathuluzi ukuphoqelela inhlawulo uma isebenza.
Ekuqaleni kuka-2016, i- IRS ibike ukuthi izihlungi ezingu-7.9 zezigidi zentela zitholakala ngaphansi kwesigwebo somuntu ngamunye owabelwana ngaso ngenxa yokuthi abazange baqinisekiswe ngo-2014, kodwa abanye abafake amacala entela abayizigidi ezingu-12,4 baxoshwa kuhlawulo, naphezu kokungaqinisekiswa ngo-2014.
Isijeziso kufanele sibe "induku," kuyilapho izinsizakalo ze-ACA ziyi "isanqante." Kodwa njengoba kuphawuliwe ngenhla, inani labantu abangaqinisekisiwe lingase likwazi ukuthola ukukhululwa kunokuba lithathwe ngaphansi kwesigwebo. Ngisho nalapho isigwebo sisebenza (okungukuthi, umfakisi wentela akafanelekeli noma yikuphi ukukhululwa ), i-IRS ayikwazi ukusebenzisa izinyathelo zayo ezijwayelekile zokuqoqa inhlawulo.
Bangayigcina imali ebuyiselwe imali ekhokhiswa intela (noma ukubuyiselwa kwemali ekhokhwa ngonyaka ozayo), kodwa abakwazi ukusebenzisa izixhumanisi, izintela, noma ukushushiswa kobugebengu, ngendlela abangayenza ngayo nezinye izinhlobo zesikweletu sentela esingakhokhiwe. Ngenxa yalokho, isijeziso sokungabi nalutho sibonakala ngabanye njengokuzikhethela, becabanga ukuthi bahlela izintela zabo ukuze bangakhokhiswa imali.
Yiqiniso, ukungaqiniseki futhi ukuthola ukuthi udinga ukwelashwa okuphawulekayo kuyinkinga enkulu, kodwa inani elingelona elincane labantu baseMelika abangaqinisekisiwe bayakhetha ukuwela lelo bhuloho uma befika lapho, ngoba amaphrimiyamu ayodingeka akhokhele umshuwalense wezempilo ungaphezu kwalokho abakucabanga ukuthi bangabizi.
I-Gap Yokuhlanganisa
I-ACA imemezela ukuthi wonke umbuso ukwandisa ukufaneleka kwemali ye-Medicaid kuya kumaphesenti ayisishiyagalombili wezinga lobuphofu (amaphesenti angu-133, kanye nokungahoxiswa kwemali engenayo ye-5%). Izizwe zizoqhubeka nokuhlukaniswa kwemali kahulumeni ekhona kubantu baseMedicaid ababevele befanelekile ngaphambi kokukhuliswa, kodwa kusukela ngo-2014, uhulumeni wesifundazwe uzokhokha izindleko ezigcwele zokumboza umphakathi osanda kutholakala. Ngo-2020, lokho kunciphisa kancane amaphesenti angama-90, kodwa uhulumeni wesifundazwe uzoqhubeka nokukhokhela amaphesenti angu-90 eminyakeni ezayo, kuyilapho amazwe engakhokheli amaphesenti angama-10 ezindleko zokumboza abantu abasanda kutholakele.
INkantolo Ephakeme inqume ngo-2012 ukuthi uhulumeni wesifundazwe akakwazanga ukufuna izimboni zokwandisa i-Medicaid ukuze aqhubeke nokuthola imali ekhona yaseMedicaid. Ngenxa yalokho, izifunda ezingu-19 namanje azange zandise iMedicaid. Ezingu-18 kulawo mazwe, igebe elibhekele ukuhlanganisa lichaza ukuthi cishe abantu abayizigidi ezintathu abangenayo imali yokuthola insizakalo ekushintsheni noma i-Medicaid (i- Wisconsin ayizange ikhulise iMedicaid, kodwa isebenzisa izimali zikahulumeni ukuhlinzeka ngeMedicaid kubantu abanenzuzo engaphansi kwezinga lobuphofu , ngakho ayikho igebe lokubika).
Ukuntula Ukuqonda Ngezinketho Ezikhona
Nakuba ezinye ze-uninsured ezisele zibuke izinketho zabo futhi zanquma ukuthi zibiza kakhulu futhi / noma azifuni ukubhalisa ekubhaleni, kunabantu abaningi abanokuqiniseka ngalokho okutholakalayo noma ukuthi bangakusiza kanjani kubo.
Kubantu abangazange baqinisekiswe ngo-2015, cishe isigamu babelungele uhlelo lwe-Medicaid, i- Child Health Insurance Program (CHIP), noma izinsizakalo ze-premium ekushintsheni (esinye isigamu sasisekhasini lokubambisana, abafuduki abangabhalisiwe, noma abavunyelwe ukusizwa ekushintsheni ngenxa yokuthola imali noma umnikelo womqashi wokukhishwa okungabizi). Abanye balaba bantu bayazi ukuthi usizo lwezezimali olutholakalayo futhi banqume ukuyibeka phambili. Futhi abanye baphonswe yizintambo ezibucayi ezifana ne- glitch yomndeni , okwenza ukubhekwa kungenakulungiswa. Kodwa abaningi abaqapheli ukuthi bangathola ukukhokhelwa okukhululekile noma okuphansi kakhulu nge-Medicaid noma i-CHIP, noma izinsizakalo ze-premium ukwenza ukuphepha okuyimfihlo okungabizi kakhulu kunalokho okungenzeka kube khona.
Uma ungomunye wabantu abayizigidi ezingama-29 base-United States abangakabanjwanga ukuqinisekiswa, kungcono kakhulu ukuhlola izinketho ezitholakalayo kuwe. Uma ufanelekile ku-Medicaid noma ku-CHIP, ungabhalisa noma kunini. Uma ufanelekile ukuthola izinsizakalo ekushintsheni, ukubhaliswa okuvulekile ngo-2017 kuvele kukhoneni-kuqala ngoNovemba 1, 2016.
> Imithombo:
> Ihhovisi le-Budget ye-Congressional, Izilinganiso zokuhlinzekwa koMshuwalense we-Care Affordable Act, i-Updated to the Decent Court Court Decision, ngoJulayi 2012 .
> Cornell Univerity Law School, Legal Information Institute, National Federation of Business Independent v. Sebelius, ophikisana noMashi 26, 27, 28, 2012-Wanquma uJuni 28, 2012.
> Kaiser Family Foundation, Izindleko Ezintsha Zokufaneleka Emkhakheni we-ACA Phakathi kwe-Uninsured, uJanuwari 22, 2016.
> United States Census Bureau, Health Insurance Coverage e-United States: 2014.