Ukugcina i-American Children Healthy
Uhlelo lomabili lwe-Medicaid kanye ne-Children's Health Insurance Program (CHIP) lunikeza ukuhlinzeka ngempilo kwezingane ezincane ezingenayo imali. Zombili izinhlelo zixhaswe ngokuhlanganyelwe nguhulumeni wezombusazwe nezombuso. Bobabili baphathwa yizizwe.
Kukhona ukungezwani okwehlukile phakathi kwezinhlelo ezimbili okudingeka uziqonde uma unesana esidinga ukunakekelwa kwezempilo. Kalula nje, kuncike ukuthi uhlala kuphi.
Ukufaneleka Kwemithi Yezingane
Izingane ezikhuliswe emindenini ehola amaphesenti angu-133 noma ngaphansi kobuphofu baseFrance ( ngonyaka ka- 2005) zifanelekile ukuthola i-Medicaid. I-FPL ibalwa nguMnyango wezeMpilo waseMelika kanye nezinsizakalo zabasebenzi njalo ngonyaka futhi isekelwe kwinani labantu emndenini ngokucatshangelwa futhi kunikwe indawo. Phela, ezinye izifunda zibiza kakhulu ukuhlala kunezinye, isibonelo, i-Alaska ne-Hawaii.
Ngaphambi koMthetho Wokunakekelwa Okunganakekelwa (ACA) wadluliselwa ngo-2010, izingane zafaneleka ukuthola iMedicaid esekelwe kokubili ubudala nemindeni yomndeni. Ngokuvamile, ingane ekhulile ifike, cishe kungenzeka ukuthi ikwazi ukuthola ukuxilongwa nge-Medicaid ngenzuzo efanayo yomndeni. Kusobala ukuthi lokhu kwakusho ukuthi ezinye izingane ezingaphansi komndeni ofanayo zingase zihlanganiswe kunoma yimuphi unyaka onikeziwe. Umthetho omusha wenza izinga lokufaneleka lokuthola imali elifanayo nezingane ezineminyaka engu-0 kuya kwengu-19 ubudala.
Ezinye izifunda zinezidingo ezihlukile zokufaneleka eziqenjini ezihlukene, kodwa inani elijwayelekile manje selihlelwe okungenani ngamaphesenti angu-133 eFPL kubo bonke abantwana. Ngaphambi kwe-ACA, isibopho sokufaneleka sabekwa ngamaphesenti angu-100 kuphela ezinganeni eziphakathi kweminyaka engu-6 no-19 ubudala.
Ukufaneleka kwe-CHIP
I-medicaid ihloselwe ukuhlinzeka ngezingane ezihluphekayo kakhulu.
Uhlelo lwe-CHIP lwasungulwa ngo-1997 njengendlela yokwandisa ukuhanjiswa kwabantwana abanemali encane yomndeni kepha abawela ngaphandle kweWedicaid iwindi yokufaneleka.
Amazwe ekugcineni anqume izikhwama zokufaneleka ze-CHIP, kodwa iningi lamazwe (angu-46 kuthiwa nesifunda sase-Columbia) labeka lelo bundu ngo-200% we-FPL noma ngaphezulu.
Uxhaso lukahulumeni lweMedicaid
Uma kuziwa ku-Medicaid, uhulumeni wesifundazwe ufanisa nokusetshenziswa kwezwe "dollar ye dollar," okungenani ngomqondo. Isebenzisa lokho okubizwa ngokuthi i- Federal Medical Assistance Percentages (FMAP) ukucacisa ukuthi kuzokhokha malini. Ama-FMAPs acabangela inzuzo ejwayelekile yombuso ehlobene nesilinganiso sikazwelonke.
Umbuso ngamunye unikezwa i-FMAP okungenani amaphesenti angu-50, okusho ukuthi uhulumeni wesifundazwe ukhokha ama-50% wezindleko ze-Medicaid. Zonke ezinye izifunda zithola iphesenti ephakeme yezimali ze-Medicaid ngokusekelwe ku-FMAP yazo ebalwa. Ngenani elingenayo eliphansi kakhulu lokuthola imali, iMisissippi ine-2017 FMAP yamaphesenti angaba ngu-74.63 ukuze uhulumeni wesifundazwe anikeze u-$ 2.94 imali yonke i-$ 1 idolobha elichitha.
Ukuze uthole imali ye-Medicaid, izifunda ziyavumelana neminye imibandela. Umbuso awuvunyelwe ukubeka abantu ezinhlwini zokulinda, angeke ube nekhwalithi yokubhalisa, futhi angeke akhokhise ama-premium noma amakhophi we-copayments kunoma ubani ohola ngaphansi kwama-150% we-FPL.
Imali ye-Federal ye-CHIP
Imali ye-Federal ye-CHIP, ngakolunye uhlangothi, inemingcele engaphambi kokusetha. Umbuso ngamunye unikezwa isabelo minyaka yonke njengesibonelelo se-block. Inani le dollar lihleliwe kungakhathaliseki ukuthi inani labantu lihlanganiswe yini nalolu hlelo.
I-50 ithi nesifunda sase-Columbia sinokuzikhethela ukusebenzisa izibonelelo zabo zezinhlamvu ngezindlela ezintathu:
- Njengenhlanganisela yohlelo lwe-Medicaid-CHIP (izinhlelo ezingu-29 zombuso)
- Njengengxenye yokwandiswa kweMedicaid (state 9 programs)
- Njengenhlelo ehlukile ye-CHIP (izinhlelo ezingu-13 zesimo)
Ukukhuthaza uhulumeni ukuba ahlanganyele ku-CHIP, uhulumeni wesifundazwe unikeza izinga elilinganayo eliphakeme kunalokhu elikuMedicaid.
Isilinganiso sikazwelonke seMedicaid singamaphesenti angu 57 kodwa kuyi-70% ye-CHIP. Futhi, kusho izidingo zezomnotho eziphakeme ezikhokhelwa ngezinga eliphakeme.
Labo basebenzisa izinhlelo zokuhlanganiswa noma ukwandiswa kweMedicaid banesidingo esifanayo sohlelo njengeMediicaid yendabuko. Amazwe anezinhlelo ezihlukile ze-CHIP, noma kunjalo, unegumbi eliyinkimbinkimbi. Uma kunesidingo, bangafaka izingane ezinhlu zokulinda noma basungule ama-caps wokubhalisa ukuze bavuselele izindleko ze-CHIP. Iningi lalawo mazwe lizokhokhisa ama-premium kanye ne-copayments kulabo abazuzayo.
Umehluko ku-Coverage for Medicaid ne-CHIP
Imithethonqubo ye-Federal Federal Medicaid inikeza izinsizakalo ezithile ezinganeni zayo ezimboziwe. Lokhu kufaka ukuhlolwa kokuqala nokuhlaziywa, ukuxilongwa nokuphathwa (EPSDT), izinsizakalo eziphelele ezigxila ekunakekeleni nokuvikela kahle. Kufaka okulandelayo:
- Ukubuyekezwa komlando okuphelele
- Ukunakekelwa kwamazinyo
- Ukuzwa ukuhlolwa, kufaka phakathi ama-cochlear transplants kanye nezinsiza zokuzwa
- Ukugonywa kanye nemigomo
- Ukuhlola ukuhola
- Ukuhlolwa kwempilo yengqondo nokweluleka
- Ukuhlola ngokomzimba
- Ukuhlola okubonwayo, kufaka phakathi izibuko
Izinsizakalo ezibuye zihlanganiswe ne-Medicaid zibandakanya ukunakekelwa okuhlinzekwa emaZiko WezeMpilo Ezifanelekile (Federally Qualified Health Centers) (FQHCs) kanye nezinsizakalo zokuvuselela.
Izinhlelo ze-CHIP, kodwa, akudingeki zihlangabezane nezinga elihlelwe yi-EPSDT, nakuba kufanele linikeze ukunakekelwa kwebhekmark ehlanganisa ukunakekelwa esibhedlela, izifundo zebholabhu, ama-ray, kanye nokuhlolwa kwezingane ezincane, kuhlanganise nokugoma. Ukunakekelwa kwamazinyo kungase kungabi kakhulu njengoba kuhlinzekwe ngaphansi kwe-EPSDT kodwa kufanele kube yingxenye yephakheji ehlanganisiwe. Kuze kube sekugcineni, umbuso ngamunye ungakhetha inzuzo yabo yamazinyo ngokusekelwe ohlelweni lomsebenzi wamazinyo wesifundazwe esithandwa kakhulu, uhlelo oludume kakhulu lomsebenzi wamazinyo lwabantu abathintekayo, noma ukufakwa kohlelo lomshwalense ovelele kakhulu kwezohwebo embusweni.
Ikusasa le-Medicaid ne-CHIP
Ezombusazwe, i-Medicaid yinkinga ekhokhiswayo. Ukuphathwa kwamanje kuzama ukuchitha uMthetho Wokunakekelwa Ongenakusiza, okuzobe usuqede ukukhuliswa kweMedicaid. Inhloso ukunciphisa nokuxhasa ngemali e-Federal Medicaid.
Uhlelo lwezempilo lwe-GOP lwakamuva lufuna ukuthatha indawo ehambisana ne-federal ye-Medicaid nge-flat-rate block block kuhulumeni ngamunye. Nakuba ukuxhaswa kwezibonelelo bekuzuzisa uhlelo lwe-CHIP, uhlelo lwe-CHIP lube lukhulu kakhulu kunalolu hlelo lwe-Medicaid. Futhi, ukuvimba izibonelelo kunqunyelwe ukuthi zingaki izingane ezingase zihlanganise ngaphansi kwe-CHIP. Amazwe anezibonelelo ze-block abeka izingane ezinhlu zokulinda.
Bangaki abantwana abazolahlekelwa ukutholakala kwezempilo uma ukuguqulwa kwezempilo kwe-GOP kudlula?
Izwi elivela
Izingane ezikhuliswa emindenini engenamali ephansi zifanelwe ukunakekelwa kwezempilo okufanayo njengabangane babo abahola imali ephakeme. I-Medicaid inikeza ukunakekelwa emindenini empofu kakhulu ngenkathi i-CHIP idlulisela ukusabalala kwinani elikhudlwana lezingane. Ukunakekela ngokusebenzisa uhlelo lweMedicaid kungase kube kakhulu, kodwa uhlelo lwe-CHIP lunikeza nokujula okubanzi kokubika. Qonda umehluko phakathi kwalezi zinhlelo ezimbili futhi usebenzise kakhulu ukunakekelwa kwempilo yengane yakho.
> Imithombo:
Uhlelo lwe-Insurance Health yezingane (CHIP). Iwebhusayithi yakwaMedicaid.gov. https://www.medicaid.gov/chip/chip-program-information.html.
> Thola Izinhlelo kuHulumeni Wakho. InsureKidsNow.gov iwebhusayithi. https://www.insurekidsnow.gov/state/index.html.
> Idatha yokubhalisa ye-Medicaid ne-CHIP. Iwebhusayithi yakwaMedicaid.gov. https://www.medicaid.gov/medicaid/program-information/medicaid-and-chip-enrollment-data/index.html
> Patrick SW, Choi H, Davis MM. Ukwandisa kumdlalo wesifundazwe ohambisana nokuzuza okuphawulekayo ekusakazeni izingane ngokusebenzisa i-Medicaid ne-CHIP. Ezempilo Aff . 2012 Aug; 31 (8): 1796-802. i-doi: 10.1377 / hlthaff.2011.0988.
> I-Racine AD, i-Long TF, i-Helm Helm, ne-al. Uhlelo lwe-Assurance Health yezingane (CHIP): okufeziwe, izinselelo, kanye nezincomo zenqubomgomo. Izingane zokwelapha. 2014 Mar; 133 (3): e784-93. doi: 10.1542 / peds.2013-4059.