Ingabe i-AHCA noma i-BCRA Change Insurance izohlinzeka ngabakwa-Employers?
Nakuba ingxabano mayelana nokuguqulwa kwezempilo kuhlale igxile emakethe yemshwalense (okusho ukuthi abantu abangatholi ukuvela kumqashi) kanye neMedicaid, umthetho ocatshangelwayo uzoholela ekushintsheni okubalulekile kumshwalense abaqashi abakunikela ngawo abasebenzi babo.
Umthetho Wokunakekelwa Okunenzuzo (ACA) usekuqaleni kusukela ngo-2010, futhi abameli beRiphabhulikhi bebelokhu bezama ukuwuqeda kusukela kusungulwa.
I-veto ipeni likaMongameli Obama lagcina umthetho uhambelana kuze kube ngu-2017, kodwa uma uMongameli Trump eqala ukusebenza, kwakukhona indlela yamaRiphabliki okuqhubeka phambili nemizamo yabo yokuchitha.
NgoMeyi 4, abameli beNdlu baphakamise umthethosivivinywa wabo wokunakekelwa kwezempilo, i-American Health Care Act (AHCA), 217 kuya ku-213, futhi bayithumela eSenate. Umthetho wawudinga amavoti angama-216, ngakho-ke ukunqoba kwakuwumkhawulo omncane kakhulu.
Ihhovisi le-Congressional Budget lalingakaze lizuze umthethosivivinywa wokugcina ngaphambi kokuba iNdlu ivote; Izichibiyelo ezintathu zanezelwa kusukela i-CBO ngaphambilini isithole umthethosivivinywa ngo-Mashi, ngakho umphumela ogcwele we-AHCA wawungacacile, ngisho nangemva kokuba umtsetfosivivinywa usuvele uphume endlini. Isaphulelo se-CBO ekugcineni kwaleso sikweletu sanyatheliswa ngoMeyi 24-cishe amasonto amathathu emva kokuba iNdlu idlulise umthetho.
I-AHCA: Thatha eyodwa
Umgwaqo wokuqeda usuke unamahloni, ohlukanisayo obala phakathi kweNdlu yamaRephablikhi ngokuqondene nokuthi yiziphi izingxenye ze-ACA okufanele zishintshwe noma zitshiswe.
I-AHCA yasungulwa ngo-Mashi 2017, kodwa yadonswa imizuzu ngaphambi kokuvota okuhleliwe eNdlu ngoMashi 24, ngemuva kwamahora amaningi ephikisanayo, ngenxa yokungabi nesekelo.
Indlu yePhalamende uParry Ryan (R, Wisconsin) ekuqaleni wathi amaRiphabhulikhi azoqhubeka nezinye izinto kwi-ajenda yabo, kodwa ngesonto elilandelayo, i-AHCA ibuyele etafuleni.
Le mpikiswano kusukela ngaleso sikhathi yayizungezile izama ukuthola indawo ephakathi yokuhlanganisa amaRephabliki aphikisana ne-AHCA. Lokho kwakuyinselele, njengoba labo abenzi bomthetho bekhona kokubili okulinganiselwe futhi okungezona okumele kube khona komgomo we-GOP.
Kwakukhona okungenani abameleli abangu-33 baseRepublican abaphikisana ne-AHCA ngoMashi, kanti nakuba amaRiphabhuliki eningi eNdlu, angadlula umthetho kuphela uma amaRiphablikhi angabonisi ama-22 (wonke amaDemokhrasi ahlanganisiwe ngokumelene ne-ACA kusukela ekuqaleni) .
I-AHCA ne-MacArthur Amendment no-Upton Ukuchitshiyelwa: May 4th Vote = Pass
Izingxoxo ngo-Ephreli nasekuqaleni kukaMeyi zazihlanganisa izichibiyelo ezintathu ezengeziwe: uhlelo lokungabonakali kolwazi lokukwabiwa kwezinhlekelele , i-MacArthur Amendment kanye ne-Upton Amendment.
Ukulungiswa kokungabonakali kohlelo lokukwabelana ngeengozi kwanezelwa ekuqaleni kuka-Ephreli, futhi kubiza amaRandi ayizigidi eziyizigidi eziyizinkulungwane ezingu-15 ($ 15 billion) ngemali engaphansi kweminyaka engaphezu kwengu-9 ukusiza ukuzinzisa izimakethe zempilo yomshwalense.
I-MacArthur Amendment, eyethulwa ngo-Ephreli ngo-Ephreli ngu-Rep. Tom MacArthur (R, New Jersey), ivumela izizwe ukuba zivikele ezinye zokuvikela izimboni ze-ACA, kuhlanganise nezidingo zezempilo ezidingekayo , imithetho yokulinganisa iminyaka, nokulinganisa umphakathi.
Uma nje kusho ukuthi kuthatha izinyathelo eziyisisekelo kakhulu zokusekela izimakethe zabo zomshuwalense, bazovunyelwa ukunciphisa ububanzi bezinzuzo ezibalulekile okumelwe zihlanganiswe izinhlelo zeqembu ngalinye namancane.
Bazokwazi futhi ukuvumela izinkampani zomshuwalense ukuba zikhokhise amaphrimiyamu aphezulu kubantu abanezimo ezandulele ezingabamba ukugcinwa okuqhubekayo. Umuntu onesiphakamiso sokungenani okungenani izinsuku ezingu-63 ezinyangeni ezingu-12 ezedlule uzokhokhwa imali yokukhokha ngokusekelwe emlandweni wezokwelapha (okungukuthi, amaphrimiyamu aphakeme uma enezimo zempilo) ezinyangeni ezingu-12 zokuqala ngemuva kokubhalisa kumgomo wezimakethe ngamunye (ngokunye , imithetho ejwayelekile ye-AHCA ingasebenza kumazwe athi angafuni ukuxoshwa; abafakizicelo abanesiphakamiso sokufaka imali bazokhokhwa amaphesenti angama-30 aphezulu ngonyaka owodwa, kungakhathaliseki umlando wezokwelapha).
I-MacArthur Amendment yazuza ukwesekwa kwe-House Freedom Caucus, kodwa yenza amaRiphabhulikhi ajwayelekile ahambe kude ne-AHCA, phakathi kokukhathazeka ukuthi abantu abanezimo ezikhona ngaphambili bazolahlekelwa yizivikelo abazitholile ngaphansi kwe-ACA.
I-Upton Amendment, eyethulwa ngoMeyi ngo-Meyi ngo-Meyi u-Fred Upton (R, Michigan), inikeza amaRandi ayizigidi eziyi-8 ngaphezulu kweminyaka emihlanu ngenxa yokuthi zivumela ukuvikeleka kwemibandela ekhona ngaphambili, ukuze kusize lezi zizwe zihlehlise amanye amaphrimiyamu engeziwe -Izimo ezikhona zizokhokha. Nakuba kunezinkathazo ukuthi leyo $ 8 billion ngaphezulu kweminyaka emihlanu ngeke ibe ngokwanele, futhi ukuthi ukuchitshiyelwa empeleni kugijima ngezinhloso ezihamba phambili nemfuneko yokuqhubeka yokukhishwa kwe-ACHA, i-Upton Amendment yahambisa ezinye izilinganiso ukuze zisekele i-AHCA, futhi umthethosivivinywa uphumelele eNdlu ntambama kaMeyi 4.
Umthethosivivinywa weSénate
Ngo-June, iSenate Republicans yaqala uhlelo lwaso lwe-bill, okuthiwa yi-Better Care Reconciliation Act (BCRA). Bethule ukuhluka okuncane kwe-BCRA; nansi incazelo yokungafani phakathi kwe-AHCA ne-BCRA .
I-Senate iphinde yafaka isilinganiso sokuthi "ukuphinda nokulibaziseka", okuyisisekelo esiphezulu somthethosivivinywa ukuthi iCongress idluliselwe ngo-2015 (HR3762), kodwa yikuphi uMongameli Obama owavotela. Intsha entsha ye-Senate yamaRiphabhulikhi ka-HR3762 ibizwa ngokuthi uMthetho Wokubuyisana Wokubuyisana Wokuqokwa Kwe-Obamacare ka-2017 (ORRA). Ungafunda isifingqo somthethosivivinywa , kanye nokuhlaziywa kwe-Bill ye-CBO. Akungabazeki ukuthi i-ORRA izothola ukusekelwa okwanele phakathi kweSenate Republicans ukuba idlule, njengoba abaningi babo beveze ukubhuka ngomqondo wokuphinda i-ACA ngaphandle kokulungiswa ukuhamba.
Umthelela kumsebenzi okhokhelwa ngumqashi
I-AHCA isivele idlulile iNdlu, kodwa inguqulo yeSénate (i-BCRA) ihlukile ngezindlela ezimbalwa. Uma inguqulo yeSénate idlula, iNdlu kumele ivumelane nezinguquko ngaphambi kokuba ithunyelwe kuMongameli.
Kodwa uma umthetho wezinguquko wawuzokwenziwa njengo-, ngabe wawuzoba nomthelela kanjani kubantu abathola umshuwalense wabo wezempilo kumqashi? Iningi lokugxila e-AHCA nase-BCRA bekulokhu ukuthi ukuguqulwa kuzoshintsha kanjani abantu abazithenga umshwalense wabo wemakethe noma ukuthola iMedicaid. Kodwa kuthiwani ngezinhlelo ezixhaswe ngumqashi?
I- ACA ilethe izinguquko eziningi kumshuwalense wezempilo oxhaswe ngumqashi . Ake sibuke umthelela u-AHCA no-BCRA abazoba nayo emshwalense wezempilo abantu abawuthola kubaqashi babo.
Amaqembu amakhulu: Ukuqedwa Kwemisebenzi Yomqashi
Abaqashi abanabasebenzi abangu-50 noma ngaphezulu ngeke besadingeka ukuba banikeze umshuwalense wezempilo. Ngaphansi kwe-ACA, abaqashi abanabasebenzi abangu-50 + kufanele banikeze abasebenzi babo besikhathi esigcwele umshuwalense wezempilo ongenakuthola okuhlinzeka okungenani inani eliphansi (okungukuthi, lihlanganisa okungenani amaphesenti angama-60 wezindleko zokwelapha ezivamile). Uma behluleka ukwenza kanjalo, bangaphansi kwesigwebo sentela. I-AHCA izoqeda leyo nhlawulo, ibuyele emuva ekuqaleni kuka-2016. Ngakho-ke ukubusa kuka-ACA okudinga ukuthi abaqashi abakhulu babezobe bekhona ezincwadini, kodwa ngeke kube nemiphumela yabaqashi abangayilandelanga.
Ukuze kucaciswe, iningi labaqashi abakhulu bebevele belinika izinzuzo zezempilo ngaphambi kokuba i-ACA yenze imfuneko. Kodwa akuzange bonke banikezele ukuthengwa okubekwe okungabizi (okuchazwe yi-ACA ngo-2017 njengesivumelwano esisebenzayo kuphela esingabizi ngaphezu kwamaphesenti angama-9.69 emali engenayo yasendlini) futhi ephelele. Abanye abaqashi bafuna abasebenzi ukuba bakhokhe izinkokhelo ezingazange zihambisane nencazelo ye-ACA engabizi, nabanye abaqashi-ikakhulukazi embonini yesevisi nemisebenzi ene-"mini-meds" enikezwe inzuzo ephezulu ehlanganisa imali encane yokunakekelwa kwezokwelapha ngephansi kakhulu uzuze umkhawulo (isibonelo, uhlelo oluvame ukuvakashelwa odokotela njalo kodwa lunciphisa izinzuzo eziphelele kuma $ 5,000 noma $ 10,000 ngonyaka wonke, ongahambi kude uma isisebenzi singene esibhedlela).
Ukuhlaziywa kwezindaba zezeMpilo ngokusekelwe kwedatha yangaphambi kwe-ACA (2009), kutholakale ukuthi amaphesenti angu-38 abaqashi abakhulu bebengabhekana nezinhlawulo ngaphansi kwe-ACA uma izinzuzo zabo zingakaze zishintshwe lapho igunya lomqashi liqala ukusebenza.
Uma umqashi enquma ukuthi isigwebo siqedwa, omunye umqashi omkhulu angase abuyele ekunikezeni amathambo, futhi abanye bangase baqale bafune ukuthi abasebenzi bakhokhe imali enkulu yamaphrimiyamu. Lokhu angeke kuthandwe nabasebenzi, ngakho-ke cishe kungenzeka ukuthi ngeke kubuyele ngokugcwele ekubukeni kwangaphambi kwe-ACA. Kodwa kuyinto yokubukela, ikakhulukazi uma umqashi wakho ekhulisa izinzuzo zakho eminyakeni embalwa edlule ngenxa ye-ACA.
Abaqashi abancane-abachazwe njengabasebenzi abangaphansi kuka-50-abazange badingeke ukuba banikezele, ngakho ukuchitha igunya lomqashi ka-ACA ngeke kubathinteke. Kodwa-ke, i-AHCA ne-BCRA izoqeda, kusukela ngo-2020, izikweletu zentela ukuthi abahola kancane, abaqashi abancane manje bangasebenzisa ukukhokha izindleko ze-premium kuze kube seminyaka emibili yokufaka. Yize lokhu kungewona ukuhlinzekwa kabanzi kwe-ACA, ukuqedwa kwayo kungenza kube nzima kwamanye amabhizinisi amancane ukuthi akwazi ukukhokhelwa.
Ihhovisi le- Congressional Budget lilinganisela ukuthi ngo-2018, inani labantu abahlanganiswe nomshuwalense oxhaswe ngumqashi lizolahlekelwa yizigidi ezingu-2 ngaphansi kwe-AHCA, futhi ngo-2026, inani labantu abayizigidi ezi-3 lizobe likhona ngaphansi kwezinhlelo ezixhaswe ngumqashi. Ngaphansi kwe-BCRA, i- CBO inqume ukuthi abantu abayizigidi ezingu-4 abambalwa babeyoba nomshuwalense wempilo oxhaswe ngumqashi ngo-2018, kodwa ngo-2026, abantu abayizigidi ezimbili kuphela abazoba nomshuwalense wezempilo oxhaswe ngumqashi (uma kuqhathaniswa nokuthi kuzoba kanjani ngo-2026 uma I-ACA kwakufanele ihlale ingalungile).
Abanye kulabo bangabantu abazovele bavele baphume ohlelweni lwabaqashi uma nje isigwebo somuntu ngamunye siqedwa ngaphansi kwe-AHCA noma i-BCRA. Kodwa abanye abantu abaqashi babo bekayeka ukuhlinzekwa uma ngabe umqashi enquma ukuthi isigwebo siqedwe yi-AHCA.
Kuyaphawuleka ukuthi ukuhlaziywa kwe-CBO yangaphambilini ( okushicilelwe ngasekupheleni kuka-Mashi ) we-AHCA kuye kwafakazela ukuthi inani labantu abanezinhlelo ezixhaswe ngumqashi lizokwehla ngamamiliyoni angu-7 ngo-2026. Ekuhlaziyweni okulandelayo, i-CBO ibone ukuthi isizathu esincane ukwehla kwenani labantu elihlanganiswe nezinhlelo ezixhaswe ngumqashi (izigidi ezingu-3 esikhundleni sezigidi ezingu-7) kungenxa yokuthi izinketho zokuthengwa kwamakethe zizobe ziwuhlobo olubi kakhulu futhi zingafinyeleleki kalula emazweni afuna ukuxoshwa ngaphansi kwe-MacArthur Amendment.
I-CBO icacisa ukuthi abaqashi abambalwa bayakucabangela imakethe ngayinye indlela engcono yokuhlinzekwa kweqembu kubasebenzi babo, futhi ngaleyo ndlela bayoqhubeka nokuhlinzeka ngeqembu, nakuba bengase bangenzi kanjalo uma ngabe ukuchitshiyelwa kweMacArthur kwakungeke kwengezwe AHCA. Nakuba i-CBO ingakaze izuze i-BCRA ne-Cruz Amendment, cishe abaqashi bayoba nokubhuka okufanayo mayelana nokuthumela abasebenzi babo emakethe ngayinye ukuze bathenge ukuthengwa kwabo uma ngabe lokho kulungiswa kwakuzosetshenziswa njengengxenye ye-BCRA (i-Cruz Amendment vumela abakwa-insurer ukuba banikeze izinhlelo ezingekho ezihambisanayo zezempilo uma nje behlinzeka izinhlelo ezimbalwa eziyisisekelo ze-ACA-ezihambisanayo).
Imikhawulo yokunikezwa kwe-FSA: Isusiwe ngemva kuka-2017
I-ACA ibeka umnikelo kwi- akhawunti ye-Flexible Spending Accounts (i-FSAs) ku-$ 2,600 ngo-2017, ikhokhelwe imali ye-inflation. I-AHCA ne-BCRA izosusa lo mkhawulo ngemuva kokuphela kuka-2017, iphinde ibuyele ohlelweni lapho umqashi ebeka khona inani eliphakeme elinganikelwa yi-FSAs yabasebenzi.
Imikhawulo yokunikezwa kwe-HSA: Yanda kusukela ngo-2018
Kubantu abanempilo ephakeme ye-HSA-abafanelekayo, uhlelo lokugcina imali lwe-akhawunti yokulondoloza impilo (ama-HSAs) luyizigidi ezingu-6,750 emndenini, kanti u-$ 3,400 umuntu oyedwa. Iminikelo ingaphambi kwentela, futhi ingenziwa ngumqashi noma isisebenzi, noma ukuhlanganiswa kokubili.
Ngaphansi kwe-AHCA ne-BCRA, umkhawulo wokunikela uzokwenyuka ukuze ulingane nezindleko eziphezulu ezingaphandle kwezimpahla ezivunyelwe ezinhlelweni zezempilo. Ngo-2017, lokho kungu-$ 7,150 kumuntu oyedwa, no-$ 13,400 ngomndeni. Ngonyaka we-2018, kuhloswe ukwandisa kube ngu-$ 7,350 umuntu ngamunye, futhi u-$ 14,700 umndeni.
Uma abasebenzi bengakwazi ukufaka imali eyengeziwe kuma-HSA abo, bazophelelwa imali engenayo ekhokhwa intela, futhi bakhokhe intela encane.
Amaqembu Amancane: Izinkokhelo Eziphakeme Kwabasebenzi Abadala
I-ACA ayidingi abaqashi abancane ukuba banikeze ukufakwa, kodwa uma beyenzayo, ukufakwa ngokwayo kulawulwa yi-ACA. Izinhlelo ezingamakhulu ezincane zeqembu (kanye nezinhlelo zamakethe ezithengiswa ngabanye) ziba nemingcele ngokwemali engaphezulu yezindleko eziphezulu ezingabhaliswa ngokudala nakubhalisile abancane.
Ngaphansi kwe-ACA, inani liyi-3: 1 . Lokhu kusho ukuthi ukubhalisa abaneminyaka engu-64 ngeke bakwazi ukukhokhiswa okungaphezu kwesithathu ngokulingana no-21 ubudala ubudala.
Ngaphansi kwe-AHCA ne-BCRA, noma kunjalo, lokho kuzoguqulwa kuya ku-5: 1 (noma ngaphezulu, uma uhulumeni esebenzisa ukukhishwa), ngaphandle uma izwe likhetha ukugcina isilinganiso se-ACA sika-age band endaweni (ekuhlaziyweni kwabo kwe-BCRA, Amaphrojekthi we-CBO amaningi athi angakhetha ukuvumela isilinganiso esingu-5: 1). Ngokulinganisa okungu-5: 1, ukubhaliswa kwabantu abadala bangakhokhiswa kasikhombisa kubhalisile abancane (lokho kubiza izindleko zenkampani yomshuwalense, okukhokhwa ngabasebenzi kanye nabeqashi ngabasebenzi; inani abaqashi abadingayo abasebenzi lokukhokha lingashintsha ubudala, kodwa kunemithetho yokubandlululwa kweminyaka yobudala ehambisana nonyaka).
I-MacArthur Amendment ku-AHCA ivumela izifunda ukuthi zisebenzise isilinganiso sobudala obukhulu kunama-5: 1, okusho ukuthi abasebenzi abancane abangaphezu kweminyaka engu-50 bangase bakhokhiswe izikhathi ezingaphezu kuka-5 nabasebenzi abaneminyaka engu-21 ubudala.
Amaqembu Amancane: Ukuqedwa Kwezidingo Zezinga Lezinsimbi Kungenzeka
I-ACA idinga izinhlelo zeqembu elincinci ezingekho ezincane zokuzivumelanisa nezinkomba zezinga lezinsimbi ze-ACA: ithusi, isiliva, igolide, noma i-platinum. Lesi yisilinganiso sokubaluleka kwamanje (iphesenti yezindleko zempilo ukuthi uhlelo kulindeleke ukuba lumboze kulo lonke inani eligcwele labantu ababhalisile; iphesenti langempela lokubambisana lomuntu othile lizoxhomeka ekunakekeleni kwezempilo). Izinhlelo ze-bronze zihlanganisa cishe amaphesenti angu-60, izindleko zesiliva zimboza cishe amaphesenti angu-70, izinhlelo zegolide zimboza cishe amaphesenti angu-80, futhi amapulani e-platinum ahlanganisa cishe amaphesenti angu-90 (nge-+/- 2 amaphesenti wezinga ngalinye ezingeni ngalinye, ukubaluleka kwe-actuarial noma yikuphi phakathi kwamaphesenti angu-68 kuya kwamaphesenti angu-72).
Ngaphansi kwe-AHCA, isidingo sokuthi amaqembu amancane (kanye nabanye) amaphuzu ahambisana nezinga lezinsimbi ze-value actuarial value zizoqedwa ngemuva kokuphela kuka-2019. Lokhu kungasho ukuhlukahluka kwamapulani, futhi kungenza kube nzima ukuqhathanisa ama-apula nama-apula lapho ubheka izinhlelo eziningi.
Ngaphansi kwe-BCRA, izidingo ze-value actuarial value ayiguquki ezingeni likahulumeni, kodwa uthi kuzoba nokukhululeka ukushintsha noma ukuguqula izidingo besebenzisa ama-1332 waivers, anganikezwa ngezidingo ezincane kakhulu ngaphansi kwemithetho ye-BCRA (1332 waivers ingxenye ye-ACA, kodwa i-ACA ineziqondiso eziqinile ngokuqondene nokuthi zinganikezwa nini futhi nini; i-BCRA izoqeda iningi lalezo zidingo).
Intela ye-Cadillac: isenqatshelwe kuze kube ngu-2026
Imali ye- Cadillac ye-ACA iselahlekile kuze kube ngu-2020, kodwa yenza abaqashi abathile besabe njengoba bebukeka iminyaka embalwa emgwaqweni. Intela ye-Cadillac ingumholo wamanani wamanani angu-40 engxenyeni yemaliyamuyamu engqikithi ngaphezu kwezinga elinqunyiwe ngaphambili. Kuhloswe ukukhomba kuphela izinhlelo ezibiza kakhulu, kepha abagxekayo bakhathazeka ngokuthi ngokuhamba kwesikhathi, kuzosebenza kwinani elikhulayo lamapulani, ngenxa yezindleko zokunakekelwa kwempilo ekukhuleni ukukhuphuka kwamanani emali. Futhi nasezindaweni zezwe lapho umshuwalense wezempilo ubiza kakhulu (njenge-Alaska, isibonelo), uzosebenza okungaphezulu nje kwezinhlelo eziphezulu.
I-AHCA ne-BCRA beyomisa intela yeCadillac kusukela ngo-2020 kuya ku-2025, kungekho ntela yentengo esetshenziswa ngaleso sikhathi. Zombili izinguqulo zomthetho zizohlela ukuthi intela izosebenza ngo-2026, kodwa kungenzeka ukuthi umthetho owengeziwe ungasetshenziswa phakathi naleso sikhathi kuze kube yilapho kuqeda intela ngokuphelele, njengoba engathandeki ezinhlangothini zombili zesiteji sezombusazwe.
Ukuziphendulela koMbuso: Izinzuzo zezempilo ezibalulekile
Emzamweni wokuthola amalungu e-House Freedom Caucus ukusekela i-AHCA, abenzi bezomthetho bahlanganisa i-MacArthur Amendment ukuvumela amazwe ukuba aphumule izindinganiso ezisebenzayo ezinzuzo zezempilo kanye nokulinganisa umphakathi.
Ngaphansi kwe-ACA, amacebo amancane amaqembu amancane (kanye namasu omakethe ngamunye) kumele ahlanganise izinzuzo zezempilo ze - ACA , futhi amaqembu amancane angeke akhokhiswe amaphrimiyamu amaningi aphezulu ngokusekelwe emlandweni wezokwelapha zabasebenzi.
I-MacArthur Amendment ivumela amazwe ukuba anqume ukuthi azokwenza yini leyo mithetho, ukuze azame ukukhokhela izinkokhelo zababhalisile abanempilo. I-trade-off, yebo, ukuthi abantu abanemibandela ekhona ngaphambili ukuthi bakhetha ukusebenzisa izidingo ze-lax bangase bathole ukuthi iqembu elincane lihlela ukuthi litholakale kubo akulona njengezinhlelo ezikhona njengamanje.
Uma izifunda zifuna ukuyeka ukuvumela amaphrimiyamu aphezulu kubantu abanezimo ezikhona ngaphambili abahlangabezana negebe ekubambeni, lokho kuzosebenza emakethe ngayinye, kunokuba imakethe yeqembu.
I-BCRA ithatha indlela ehlukile, ngokunikeza ukuthi ilungelo lokusebenzisa ama-1332 waivers ukwenza izinguquko ezingabandakanya ukuhlenga kabusha izinzuzo ezibalulekile zezempilo. Njengoba kuphawuliwe ngenhla, i-BCRA inenqubo encane kakhulu yokuvimbela amazwe ukuthola ama-1332 waivers (kuqhathaniswa ne-ACA). Imiklamo ye-CBO cishe cishe ingxenye yesigamu sezwe ihlala emazweni angafuna ama-1332 waivers ukunciphisa ububanzi bezinto ezibalwe njengezinzuzo zezempilo ezibalulekile uma i-BCRA izokwenziwa. Lokhu kuzoba nomthelela kokubili amapulani eqembu ngalinye namancane phakathi kwalezi zindawo, ngokubhekwa kokungapheli isikhathi eside.
Ukuvikelwa Kuncishisiwe Ukulinganiselwa Kwesikhathi Sokuphila Kwangempela Nesikhathi Sokuphila Kwangempela
Ngaphansi kwe-ACA, zonke izinhlelo ezingekho-grandfathered-ngabanye, izinhlelo zeqembu eliqinisekisiwe ngokugcwele, kanye nezinhlelo ezizimele-kufanele ziqede izinkampani zokuhlomula zonyaka nonyaka (ie, uhlelo alukwazi ukufaka izinzuzo eziphelele ku-$ 1 million noma $ 5 million , njengoba kwakunjalo njalo ngaphambi kwe-ACA).
Wonke amapulani angewona amancane nawo kumele akhokhe izindleko eziphuma ngaphandle kwe-pocket ezingaphezu kwesilinganiso esinqunyiwe ngaphambili (ngo-2017, kungu- $ 7,150 kumuntu oyedwa).
Kodwa kokubili kulawo mithetho kusebenza kuphela ezintweni ezibalulekile zezempilo . Uma ngabe izwe lifuna ukuyeka futhi linciphisa ububanzi bezinzuzo zezempilo ze-ACA, imithetho ephathelene nokuphila kwamaphesenti / ama-maximums waminyaka yonke kanye nokulinganiselwa ngaphandle kwe-pocket kuzokhululeka. Izinto ezingasabhekwa njengezinzuzo ezibalulekile zezempilo ngeke zisakwazi ukuzivikela.
Yini engashintshi
Okunye ukuvikelwa komthengi izici ze-ACA zithandwa kakhulu, futhi azihlelwe ukushintsha ngaphansi kwe-AHCA noma i-BCRA. Nakhu okungenzeka ukuthi uhlale okufanayo kumacebo axhaswe ngumqashi:
- Abantu abadala bangahlala ohlelweni lwezempilo lomzali kuze kube yiminyaka engu-26.
- Ama-caps enzuzo yonyaka kanye nesikhathi sokuphila ayavunyelwe (ngokwezinga abasebenzisa kuzo izinzuzo zezempilo ezibalulekile; njengoba kuchazwe ngenhla, izidingo ezivame uketshezi zezinzuzo zezempilo ezibalulekile ziyokwenqabela ukuvinjelwa kwamaphakheji enzuzo ngonyaka)
- Izinkathi zokulinda zokuqashwa lapho abasebenzi abasanda kufaneleka ukukhishwa ngeke bakwazi ukudlula izinsuku ezingu-90 (lokhu kungashintshwa ngaphansi kwe-BCRA's Cruz Amendment-okungenzeka noma kungeke kube yinguqulo yokugcina yesibambiso-kodwa kuzobe sekuqondakala kombuso ngamunye).
- Izindleko ezingaphandle kwe-pocket zithathwe (umkhawulo we-2017 u-$ 7,150 umuntu ngamunye no-$ 14,300 umndeni; ngo-2018, umkhawulo u-$ 7,350 umuntu ngamunye no-$ 14,700 umndeni). Kodwa-ke, njengoba kuchazwe ngenhla, imingcele engaphandle kwe-pocket isebenza kuphela ezinsizeni ezibalulekile zezempilo.
> Imithombo:
> Congress.gov, HR1628, I-American Health Care Act ka-2017. Kuthunyelwe eNdlini njengento yonke ngoMashi 20, 2017.
> House.gov Imithetho yeNdlu Ukuchitshiyelwa komididi (uhlelo olungabonakali lokukwabelana ngezingozi) ku-HR1628 (i-American Health Care Act) , ngo-Ephreli 6, 2017.
> Ukuchitshiyelwa kweMenenja ye-House.gov kuMthetho wezeMpilo waseMelika, Izinguquko Zenqubomgomo , Mashi 20, 2017.
> House.gov Ukuchitshiyelwa kokuchitshiyelwa kweMenenja ku-HR1628 , kuMashi 24, 2017.
> Kaiser Family Foundation, Isifinyezo Somthetho Wezempilo waseMelika, ngo-Ephreli 2017.