Indlela Ukuguqulwa Kwezempilo Okuthinta Ngayo
Ngo-Mashi 23, 2010, uMongameli Obama wasayinela umthetho umthetho we-federal reform reform owaziwa ngokuthi uMthetho Wokunakekelwa Kwezezimali. Inhloso yomthetho ukuqinisekisa ukuthi cishe bonke abaseMelika banokuthola umshwalense wezempilo ongabizi .
Ukuguqulwa okubalulekile kuMthetho Wokunakekelwa Onganakekelwayo kwaklanyelwe ukunciphisa kakhulu izithiyo zokuthola ukuhlinzeka ngezempilo kanye nokufinyelela izinsizakalo zokunakekelwa kwezempilo ezidingekayo.
Kodwa umthetho ubelokhu uphikisana kusukela ekuqaleni, futhi ukuhlukana okuhlukumezayo kokuhlukana kokunakekelwa kwezempilo kuye kwaholela ekusetshenzisweni okuncane kwezinguquko zokunakekelwa kwezempilo.
Amalungiselelo amaningi e-ACA aqala ukusebenza ngo-2014, kuhlanganise nemfuneko yokuthi cishe wonke amaMelika ahlinzeke umshuwalense wezempilo-noma ngomqashi wabo, ngokusebenzisa uhlelo lomphakathi njengeMedicaid noma i- Medicare , noma ngokuthenga ukuthenga emakethe ngayinye, noma nge -exchange noma ukushintshaniswa okungekho . Kukhona inhlawulo ehlolwe yi-IRS uma abantu bengagcinanga umshuwalense wezempilo, kodwa leyo nhlawulo izosuswa ngemuva kokuphela kuka-2018, ngaphansi kwemigomo ye-Tax Cuts and Jobs Act, eyenziwe ngoDisemba 2017. kusalokhu kuyisijeziso sokungaqinisekisiwe ngo-2018 , kodwa ngeke kube nesijeziso kubantu abangaqinisekisiwe ngo-2019, ngaphandle uma baseMassachusetts, noma kwezinye izifundazwe ezingase zenze izigwegwe zabo.
Amaphuzu avelele eMnyangweni Wokunakekelwa Onganakekelwayo
Bhaka izinhlelo zezempilo zomuntu ngamunye nezincane kusuka ku:
- Ukwenqaba ukuvota ngenxa yezimo zezokwelapha ezikhona ngaphambili .
- Ukuqeda ukufakwa ngaphandle uma kwenzeka ukukhwabanisa noma ukuphikisa okungalungile.
- Ukushaja amaphrimiyamu aphakeme ngenxa yezindaba zezempilo.
- Ukukhokhisa ama-enrolle asebekhulile izikhathi ezingaphezu kwesithathu kubhalisile abancane.
- Ukuhlinzeka izinhlelo ezingahlanganisi izinzuzo zezempilo ezibalulekile, ngaphandle uma uhlelo luzala noma lukhulu.
Kudinga zonke izinhlelo zezempilo ezingenasipiliyoni:
- Vala ukunakekelwa kokuvimbela ngaphandle kokwabelana ngezindleko.
- Hamba izindleko ze-pocket ngaphandle kwe-inthanethi ezibalulekile izinzuzo zezempilo. I-HHS ibeka umkhawulo ongaphezulu wezindleko ezingaphandle kwe-pocket ngonyaka ngamunye. Ngo-2018, ayikwazi ukudlula u-$ 7,350 kumuntu ngamunye, noma i-$ 13,700 emndenini.
- Vumela abantu abasebasha ukuba bahlale ohlelweni lwezempilo lomzali kuze kube ngu-26 ubudala .
Kudinga abaqashi abakhulu ukuba:
- Nikeza umshuwalense wezempilo ongenakuthola kubasebenzi bazo besikhathi esigcwele, noma kuncike ezinhlakeni ezingahle zibe khona.
Kudinga abantu:
- Thola umshuwalense wezempilo noma ukhokhele inhlawulo , ngaphandle uma befaneleka ukuthola izizathu ezithile . Le mfuneko izohlala isebenza ngokusemthethweni, kodwa inkokhelo izokwehliselwa ku-$ 0 kubantu abangaqinisekisiwe ngo-2019 nangaphambilini ( kusekhona inhlawulo yokungaqinisekiswa ngo-2018 )
Yenza ukuhlanganisa nokukhathalela okungabizi nge:
- Izikweletu zentela ze-Premium
- Ukunciphisa ukwabelana ngezindleko
- Ukwandiswa kwezidakamizwa ( izibalo ezingu-19 azikaze zamukele izimali zikahulumeni zokwandisa iMedicaid kusukela ekuqaleni kuka-2018, nakuba iMaine ihlelelwe ukwandisa iMedicaid phakathi no-2018, ngaphansi kwemigomo yesinqumo abavoti abadlula ngo-2017).
Izinguquko zabaseMelika abangenawo Umshwalense Wezempilo
Kuye ngemali engenayo, usayizi womndeni, nesimo sokuhlala, ungase ube nezinketho eziningi zokuhlanganisa, kufaka phakathi usizo lwezezimali (izinsizakalo) uma ungeke ukwazi ukuthenga umshuwalense wezempilo. Okulandelayo yizibonelo zokukhethwa kokufakaza - amazinga okuthola imali asebenza ku-2018.
Ukuze kutholakale ukufaneleka kweMedicaid, izinombolo zezinga lika-2018 zaseNtshonalanga yeNhlupheko zisetshenzisiwe ngo-2018, kanti lapho kutholakala khona ukufaneleka koxhaso lwama-premium, izinombolo ze-2017 FPL zisetshenziselwa ukuhlinzekwa ngo-2018 (lokhu kungenxa yokuthi ukubhaliswa okuvulekile kokubheka izinhlelo ezizimele kwenzeka ngaphambi kokuqala unyaka, nangaphambi kokuba izinombolo zeFPL zibuyekezwe ngonyaka omusha).
Isibonelo soku-1: Ilungele ukuxilongwa ku- Medicaid esimweni esandise iMedicaid
Imali engenayo yonyaka:
- kufika ku-$ 16,753 umuntu ngamunye
- kuze kufike ku-$ 34,638 emndenini wezine
Amazwana:
- Abantu baseMelika abangenayo imali abayisakhamuzi sase-US, kanye nabahambeli abaningi bezomthetho, bangabhalisa ohlelweni lukahulumeni lwe-Medicaid.
- Isimo sakho singase sibeke izinga elincane elingaphansi kwezindleko zokuphuma ngaphandle , njengokukhokhwa kwe-$ 1 kuya ku-$ 5 ukuvakasha kukadokotela noma amasevisi akhethiwe. Abanye bathi futhi baphakamise amaphrimiyamu akhethiwe okuthiwa i-Medicaid abhalise ngenzuzo engaphezu kwezinga lobuphofu (i-ACA ivumela ukuba i-Medicaid ikhulise kuze kube ngu-138% wezinga lobuphofu).
- Ezizweni ezingazange zandise i-Medicaid, abakhulile, abangenabantwana abangenabantwana ngokuvamile abavumelekile ku-Medicaid kungakhathaliseki ukuthi imali ephansi kangakanani, futhi ukufaneleka kwabazali bezingane ezincane kuvame ukulinganiselwa kulabo abanemali ephansi kakhulu-ngaphansi kwezinga lobuphofu .
Isibonelo sesi-2: Kuvumelekile ukuthenga uhlelo lwezempilo oluxhaswe ngemali yomshuwalense wezempilo osekelwe emphakathini (owaqala ngo-2014)
Imali engenayo yonyaka:
- kuze kube ngu-$ 48,240 umuntu ngamunye
- kufika ku-$ 98,400 emndenini wezine
Amazwana:
- Izinhlelo zezempilo ezibandakanya ukushintshaniswa kumele zinikeze iphakheji lezinzuzo zezempilo ezibalulekile futhi zimboze okungenani izindleko zokunakekelwa kwempilo ezingama-60% ( izinhlelo eziyingozi zingafaka amaphesenti aphansi wezindleko ezijwayelekile, kodwa izinsizakalo zingasetshenziselwa ukuthenga izinhlelo eziyingozi).
- Uma uthenga umshuwalense wakho wezempilo ngokushintshanisa futhi ufanelekele ukusizwa ngezimali ze-premium, isabelo sakho se-premium (sokuhlelwa kwesiliva esincane kunawo wonke endaweni yakho) ngeke sidlulele amaphesenti athile eholo lakho-kusuka ku-2.01% ukuya Amaphesenti angu-9.56 ngo-2018-kuye ngokuthi uhola kangakanani. Awudingi ukuthenga uhlelo lwesiliva-oluphansi kakhulu olubiza imali. Ungakhetha ukuthenga uhlelo olubi kakhulu noma oluphansi, futhi usebenzise isibonelelo kulolu hlelo esikhundleni salokho. Uma uthenga uhlelo olubizayo, uzokhokha iphesenti elingaphansi lemali yakho engenayo kuma-premium ezayo ngemuva kwalokho, futhi uma uthengisa uhlelo olubizayo, uzokhokha iphesenti ephakeme yemali engenayo emalini akhokhelo.
Isibonelo sesi-3: Kudingeka ukuthenga ukuthunyelwa kwangasese kodwa ngaphandle kosizo lwezezimali
Imali engenayo yonyaka:
- $ 48,241 nangaphezulu ngenhloso yomuntu ngamunye
- $ 98,401 nangaphezulu ngenani lomndeni wezine
Amazwana:
- Awunelungelo lomxhaso, noma usizo lwezezimali kulezinga leholo.
- Uma uhlala ungenakho umshuwalense wezempilo , kufanele ukhokhe inhlawulo elingana namaphesenti angu-2.5 wemali engenayo noma u-$ 695 umuntu omdala ongaqinisekisiwe ngaphandle kokuthi ufanelekele ukukhululwa okuthile. Le nhlawulo izobekwa ku-$ 0 kubantu abangabanjwanga ukuqinisekiswa ngo-2019 noma ngaphezulu.
- Uma imali yakho engenayo ingaphezulu nje kwemibandela yokufaneleka, ungayinciphisa ngokufaka i-IRA yendabuko noma i-HSA (uma unempilo ye-HSA-efanele).
Izinguquko zabaseMelika abanomshwalense wezempilo
Ngokuya ngohlobo lomshuwalense wezempilo osuvele unalo, kungenzeka noma ungazange ushintshe izinguquko ngenxa ye-ACA. .
Uma umthombo wakho wokuhlinzeka ngezempilo usuvele usuhlelo lomqashi, lezi ezinye zezinketho zakho:
Hlala ohlelweni lwakho lomqashi: Uma umqashi wakho eqhubeka nokunikeza umshuwalense wezempilo, ungayigcina.
Thenga uhlelo lwezempilo ngokusebenzisa ukushintshaniswa komshuwalense wezempilo esifundazweni sakho: Uma ungumnikazi webhizinisi elincane , noma umqashi wakho unikeza izinzuzo ezincane kuphela, noma kufanele ukhokhe okungaphezu kuka-9.56% wemali engenayo yakho kuma-premium (ngo-2018), ungabheka ukuze uthole izinketho ezingcono ekushintsheni.
Uma umthombo wakho womshuwalense wezempilo ngumgomo ngamunye owathengile wena kanye / noma umndeni wakho ngaphambi kuka-2014 lezi yizinketho zakho:
Gcina uhlelo lwakho lwamanje: Uma uhlelo lwakho lwezempilo luqhubeka lunikeza ukufana okufanayo, ungakwazi ukuyivuselela. Kodwa-ke, izinqubomgomo zomshuwalense wezempilo kumele zihambisane nezindinganiso ezisezingeni eliphansi zokufunda; Izinhlelo zempilo ezindala ezingahlangabezani nalezi zindinganiso azikwazi ukubhalisa amakhasimende amasha. Amalungiselelo amakhulu (asebenza ngo-Mashi 23, 2010) angakwazi ukuhlala kuze kube phakade, uma nje umshuwalense eqhubeka evuselela- okungadingeki ukuba benze . Amapulani amakhulu (izinsuku eziphumelelayo emva kuka-Mashi 23, 2010, kodwa ngaphambi kokuphela kuka-2013) avunyelwe ukuqhubeka nokusebenza ekupheleni kuka-2018.
Thenga ukukhokhelwa ngokushintshaniswa komshuwalense esifundazweni sakho: Uma imali yakho engenayo ingadluli amaphesenti angu-400 ebunini lobuphofu ($ 48,240 kumuntu oyedwa ngo-2018), ungase ufanelekele izikweletu zemali yentela ukuze usize ukwehlisa izindleko ze-premium yakho. Qaphela ukuthi ungathenga kuphela ukukhishwa okukhulu kwezokwelapha (ukuvala noma ukuvala ukushintshaniswa) ngesikhathi sokubhalisa ngonyaka ovulekile , noma ngesikhathi sokubhalisa esikhethekile okubangelwa umcimbi ofanelekayo .
Uma useMidare, izinketho zakho kungenzeka ukuthi azishintshi kakhulu, kodwa izindleko zakho ezihlobene nezidakamizwa ziyehlile uma udinga imithi eyanele ukuthi ufinyelele emgodini we-donut , futhi ukufinyelela kwakho kumasevisi kungase kuthuthuke:
Izinzuzo zakho eziyisisekelo (noma eziqinisekisiwe) nokufaneleka akushintshe: I-ACA ayizange ishintshe imithetho yokufaneleka ye-Medicare.
I-Medicare Advantage : Izinsizakalo ze-Federal for Medicare Advantage izinhlelo zancishisiwe, okwakuqala ekucabangeni ukuthi izinhlelo zaziyobe zizinzile futhi zilahlekelwe ukubhalisa. Kodwa ukubhaliswa kwe-Medicare Advantage kuye kwaqhubeka kwanda eminyakeni kusukela i-ACA isayinwe emthethweni, futhi izinhlelo ziyaziwa kakhulu kunanini ngaphambili, kanti owesithathu wabo bonke abahlomulayo ababhalise eMigungwini ye-Medicare Advantage ngo-2017.
Ukufinyelela kumasevisi: I- Medicare manje ihlanganisa ukuvakashelwa kokuhamba kahle ngonyaka, ngenxa yezinhlinzeko zokunakekelwa kokunakekelwa kokuphepha kwe-ACA.
Ukufakwa kwezidakamizwa ezidakamizwa: I- gap yokudoba izidakamizwa zemithi (Medicare Part D donut hole) iyaqedwa kancane kancane, futhi izoqedwa ngo-2020.
> Imithombo:
> I-Federal Register. 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 22, 2016.
> HealthCare.gov Funda uMthetho Wokunakekelwa Onganakekelwayo.
> Insizakalo yangaphakathi yeNgeniso, Inqubo Yokuthola Imali Yenzuzo 2017-36 .
> Kaiser Family Foundation, Imingcele Yokuthola Imali Yokuthola Imali Kubantu Abadala Njengamaphesenti Esikhundleni Sobumpofu Base-Federal. NgoJanuwari 2017.
> Kaiser Family Foundation. Medicare Advantage. Ngo-Meyi 11, 2016.