Ukunciphisa Ukwabelana Ngezindleko Kuzobe Kutholakala Ngo-2018, Naphezu kokudinga
Ngo-Okthoba 12, 2017, i-Trump Administration yamemezela ukuthi imali yokunciphisa ukwabelana ngezindleko (CSR, ngezinye izikhathi ebizwa ngokuthi izinsizakalo zokwabelana ngezindleko) izophela ngokushesha. Abantu abathengisa umshuwalense wezempilo emakethe ngayinye ngokuzwakalayo bakhathazeke ngesimemezelo, bezibuza ukuthi ngabe ukufakwa kwabo kanye / noma izinsizakalo bazobe zitholakala ngo-2018.
Ngakho ake sibheke ukuthi kwenzekani nokuthi yiziphi imiphumela ezoba khona. Okokuqala futhi okubaluleke kakhulu, konke lokhu kwenzeka emkhatsini wemakethe yomshuwalense, lapho abantu baseMelika abangaba yizigidi ezingu-17.6 bathola umshuwalense wabo wezempilo. Uma uthola ukwaziswa kwakho kumqashi wakho, noma kusuka ku-Medicare noma i-Medicaid, inkinga yezimali ye-CSR ayithinti umshuwalense wakho wezempilo.
Kodwa kulabo abanomshwalense wezempilo ngamunye, ake sibheke ukuthi yini okufanele silindelwe:
Ukunciphisa Ukwabelana Ngezindleko Kuzobe Kutholakala Ngo-2018
Into ebaluleke kakhulu ukuyiqonda ukuthi i-CSR izobe isatholakala ngo-2018 . Kusukela ngoFebruwari 2017, kwakukhona abantu abayizigidi ezingu-10,3 ababhalise izinhlelo zomshuwalense wezempilo zangasese ngokusebenzisa ukuhwebelana e-United States, kanti amaphesenti angu-57 awo azuza ku-CSR, enezindleko ezingaphansi kwe-pocket kunokuba bangenakho ngaphandle kwe-CSR. Lezo zinzuzo zizoqhubeka ngo-2018.
Amaphesenti angama-84 abhalisa ama-exchange abhaliswayo athola izinsizakalo ze-premium , ezingeyona into efanayo ne-CSR.
Izinsizakalo ze-Premium zinciphisa inani okufanele ukhokhe ngenyanga ngayinye ukuze uthole ukufakwa kwakho, kuyilapho i-CSR inciphisa inani okufanele ukhokhe uma udinga ukusebenzisa umshwalense wakho wezempilo ukukhokhela ukunakekelwa kwezempilo. Abantu abaningi bathola izinsizakalo ze-premium kune-CSR ngoba umkhawulo weholo wokukhokhelwa kwe-premium uphakeme, futhi ngoba i-CSR itholakale kuphela ezinhlelweni zesiliva , ngenkathi izinsizakalo ze-premium zingasetshenziselwa izinhlelo zethusi, isiliva, igolide noma iplatinum .
Naphezu kwazo zonke izinhloko ngo-2017, futhi naphezu kokuthi i-Trump Administration ichithe imali ye-CSR, akukho lutho olushintshile mayelana nokufaneleka kwe-CSR noma izinsizakalo ze-premium. Zombili zizoqhubeka zitholakala kubo bonke ababhalisile abafanelekayo ngo-2018.
Indlela kuphela yokuxhaswa okuzophela ukutholakala kuyoba yilapho bonke ababambisene nabo bezokushintshanisa indawo endaweni ethile bephuma emakethe, futhi ukufakwa ngokwazo bekungeke kube khona. Lokhu akuphelelwe umbuzo, kodwa akukenzeki nanoma yiziphi izindawo zezwe. Ama-insurer kufanele asebenze ekushintshaneni kwe-federally-run (i-HealthCare.gov, esetshenziselwa amazwe amaningi) ngo-Septhemba 27, kodwa inkontileka yabo inesigatshana sokuphuma esivumela ukuba basuse ekushintsheni uma imali ye-CSR iyanqunywa.
Ukukhishwa kwezimali kukhishwe ngo-Okthoba 12, kodwa izinkampani zomshuwalense emazweni amaningi zase zivele zisekela amaphrimiyamu awo angu-2018 ekucatshangweni ukuthi imali izokwehliswa. Futhi izinkampani zomshuwalense kwezinye izifunda zanikezwa iwindi elifushane lapho zikwazi ukubuyisela khona amazinga ngezindleko ze-CSR ezingeziwe kuma-premium. Lokhu kusiza ukuvimbela abatshengisi ukuthi bangaphumi emakethe, ngoba bangakwazi ukukhokha ukungabikho kwemali ekhokhelwa yi-federal nama-premium aphezulu, amaningi ayo ahlanganiswa kuphela nezinsizakalo ezinkulu ze-premium.
Ngakho Kwenzekani Amaphromoshini ka-2018?
Isilinganiso samaphrimiyamu omakethe ngamunye azoba ngaphezulu ngo-2018 kunokuba ngabe ngabe ngabe imali ye-CSR yenziwe nguhulumeni wesifundazwe ekuqaleni kuka-2017. Ukuntuleka kwezimali ze-CSR kubheka sengathi kuzoba yingxenye yesigamu sesilinganiso sokulinganisa isilinganiso sonyaka ka-2018, nakuba umthelela oqondile uzoba ikakhulukazi ezinhlelweni zesiliva, futhi ikakhulukazi uzohlanganiswa uhulumeni wesifundazwe ngendlela yokuxhaswa ngezimali eziphezulu.
Ukunqunywa kwezimali ze-CSR kumenyezelwe ngo-Okthoba, kodwa ukungaqiniseki ngokuthi ngabe lokho kuzokwenzeka kwenzeke yini kulo lonke unyaka.
Ama-insurers aqala ukufaka amazinga ngonyaka we-2018 wokusabalalisa emuva entwasahlobo ka-2017, futhi abalawuli bezwe basebenzisa i-summer review them. Ezimweni eziningi, izinkampani zomshuwalense zanikeza amazinga avuselelwe kamuva ehlobo, kanti enye yezinguquko ezivame ukufaka izindleko ze-CSR kuma-premium, ngoba kwakungakaze kube khona ukuzibophezela kuhulumeni wesifundazwe ukuyikhokhela.
Ungabona ukufakwa kwezinga, kufaka phakathi i-memori ye-actuari ejwayelekile ngokuchaza izizathu zokushintsha kwesilinganiso, ku-ratereview.healthcare.gov (khetha "imikhiqizo ehambisana ne-ACA," bese ukhetha isimo sakho bese ubeka uJanuwari 1, 2018 kokubili emabhokisini okuqala nokuphela for the date range effective, ngoba wonke amanani ka 2018 asebenza ngoJanuwari 1). Ukubheka ukulinganisa izinga kuzokunika umqondo omuhle wezinto eziqhuba ukukhokhela izinkokhelo ze-2018. Ukungaqiniseki ngezimali ze-CSR yingxenye enkulu yesithombe. Futhi ngokuyinhloko ngamazinga ahlaziywe asetshenziswe kamuva ehlobo, ababheki bomshuwalense babelokhu bekhetha ukucabanga ukuthi imali ye-CSR ayifuni ukuqhubeka, futhi yayibiza ngentengo izinhlelo zayo ngokufanele.
Akuwona wonke amazwe avumele lokhu, kodwa-ke, ngakho-ke abanye bathi kanye nabashuwalense baye bahlaziya ukulungisa amanani ngomzuzu wokugcina. Kodwa ukuxhaswa kwezimali akuzange kuvele kuluhlaza okwesibhakabhaka, futhi abaningi abanomshwalense babelungiselele kakade ngamanani abawafakile ngo-2018.
Lapho ama-Premium ekhula, lokho kusho ukuthini ukuxhaswa kwe-premium?
Ezimweni eziningi, abanikazi bomshuwalense bangeze izindleko ze-CSR kuma-premium ngezinhlelo zesiliva, ngoba izinhlelo zesiliva yizo kuphela ezifaka i-CSR. Leli qhinga livikela abathengi abaningi emthethweni kahulumeni wesifundazwe ekunqumeni ukuxhaswa kwezimali ze-CSR, ngoba ekugcineni kungumphumela wenkxaso enkulu ye-premium (uxhasomali lwe-premium lusekelwe ezindlekweni zesigidi sesiliva esincane kunazo zonke endaweni ngayinye, njengesiliva hlela amaphrimiyamu akhuphuke, ngakho-ke yenza izinsizakalo).
Ngakho-ke nakuba i-Trump Administration inqume ukuxhaswa kwe-CSR, uhulumeni wesifundazwe uzosebenzisa okuningi ekukhuleni kwezimali ezikhokhelwa yi-premium ngaphezu kokusindisa kwi-CSR.
Ngokusho kokuhlaziywa kweHhovisi likaHulumeni lwe-Congressional Budget lika- Agasti 2017 , umonakalo we-federal uzokwanda ngamaRandi ayizigidi ezingu-194 eminyakeni eyishumi eyalandela, ngenxa yenkxaso enkulu ye-premium kanye nenani elikhudlwana labantu abazokwazi ukuthola usizo lwe-premium (njengoba isamba se-silver plan sanda, abantu abaningi badinga usizo ukuze bathole imali ekhokhelwa imali elandelayo emva kwepesenti yemali yabo engenayo ebhekwa njengengozi).
Yini Engidinga Ukuyenza Ngesikhathi Sokubhalisa Okuvulekile?
Ukuphathwa kweTrump kunqume ukuxhaswa kwe-CSR, futhi umphumela uzoba imali ephakeme kakhulu yokusetshenziswa kwemali kuma-premium. Kodwa abathengi ngabathengi ngabanye kuzodingeka balalele ngokucophelela izinhlelo ezitholakalayo ngo-2018, kokubili nokushintshaniswa.
Amaprimiyamu aphakeme ngenxa ye-CSR defunding izosebenza kakhulu kumazinga ezinhlelo zesiliva, kodwa hhayi ngaso sonke isikhathi. E-Indiana naseColorado, izindleko ezengeziwe ziyasakazeka kuwo wonke amazinga ezensimbi, kunokuba nje izinhlelo zesiliva; kunamanye amazwe lapho umshuwalense ngamunye ethatha khona indlela ehlukile, okusho ukuthi omunye umshwalense angase asakaze izindleko kuzo zonke izinhlelo, kanti omunye umshuwalense wakhetha ukuwusebenzisa kuphela izinhlelo zesiliva.
Kubantu abathola izinsizakalo ze-premium , ukuxhaswa kuzokwenqabela konke noma ukwanda kwenani le-premium. Izinsizakalo ze-Premium zihlanganisa amaphesenti angaba ngu-400 obukhulu bobuphofu, okungama-$ 48,240 kumuntu oyedwa ngo-2018, no-$ 98,400 emndenini wezine.
Kodwa kuzobe kubalulekile ukuqhathanisa isitolo ngesikhathi sokubhalisa okuvulekile. I-CSR itholakale kuphela uma ukhetha uhlelo lwesiliva, kodwa i-CSR itholakale kuphela kubantu abanenzuzo engenayo kuze kube ngamaphesenti angu-250 ebumpofu ($ 30,150 kumuntu oyedwa, no-$ 61,500 kumndeni wesine ngo-2018). Uma ufanelekile kwi-CSR, ikakhulukazi uma imali yakho ingaphansi kwamaphesenti angama-200 ezingeni lobuphofu, cishe uzofuna ukukhetha uhlelo lwesiliva ukuze uthole izinzuzo ze-CSR.
Kodwa-ke, uma ungafanelekile kwi-CSR kodwa ufanelekile ukuthola izinsizakalo ze-premium (okungukuthi, imali yakho engenayo iphakathi kwamaphesenti angu-250 namaphesenti angama-400 ezingeni lobuphofu), ungathola ukuthi uhlelo lwebhusi noma legolide luzoletha inzuzo engcono kakhulu 2018.
Lokhu kungenxa yokuthi izinsizakalo ze-premium zizosekelwa ezindleleni zecebo lesiliva, elizokwenyuka ngamaphesenti amakhulu ezimweni eziningi kunamalungiselelo e-bronze negolide atholakala endaweni efanayo. Kodwa lezo zinsizakalo ze-premium zingasetshenziswa ukuthenga izinhlelo kunanoma iyiphi insimbi yensimbi-hhayi nje izinhlelo zegolide. Lokhu kwenza izinhlelo zethusi negolide (kanye nezinhlelo ze-platinum, ezindaweni lapho zitholakala khona) inani elingcono kakhulu emva kokusetshenziswa kwesibonelelo se-premium.
Kwezinye izimo, izinhlelo zesiliva empeleni zizobiza kakhulu kunezinhlelo zegolide, okuzobenza zibe yizinga elihle kangcono kubantu abangatholi i-CSR, ngoba izinzuzo zezinhlelo zegolide ziqinile kakhulu kunezinzuzo ze-non-CSR zesiliva izinhlelo .
Kubantu abangatholi izinsizakalo ze-premium , kuyobaluleka ukubona ukuthi izinhlelo ezingeni ngalinye lensimbi ziqhathaniswa nomunye nomunye. Uma izinhlelo zesiliva ziphela zibiza kakhulu kunezinhlelo zegolide endaweni enikeziwe, kuyoba nengqondo ukukhetha uhlelo lwegolide esikhundleni secebo lesiliva (noma uhlelo lwebhusi, olungabiza kakhulu).
Futhi abantu abane-ACA-ehambisanayo yokuhweba emakethe ngaphandle kwe-exchange (okungukuthi, bathenga ngqo kusuka kunkampani yomshuwalense, kunokuba badlulisele ukushintshaniswa) kuyodingeka futhi banakekele le nkinga. Amacebo esiliva okungaxhunyiwe okungaxhunyiwe ezindaweni eziningi (kanye nezinhlelo zokushintshanisa ngaphandle kuzo zonke izinsimbi zensimbi ezinjenge-Indiana naseColorado) zizobe zinezindleko ze-CSR ezinqunyiwe zabo. Lokhu kuzoba ngamaphuzu okushintshaniswa okungaxhunywanga ngawo futhi athengiswa ngokushintshaniswa, ngoba intengo kufanele ifane necebo elifanayo, kungakhathaliseki ukuthi lidayiswa ngokushintshaniswa noma ngqo kubathengi.
Izwi elivela
Izihloko eziphathelene nokuguqulwa kwezempilo ziye zaqhubeka njalo phakathi kuka-2017, futhi isimemezelo sokuthi imali ye-CSR izophela masinyane iye yabangela ukukhathazeka okuqondakalayo kubantu abathengisa umshwalense wabo wezempilo.
Kodwa ngenkathi imali ye- CSR inqanyuliwe, ukutholakala kwe-CSR ngokwayo akushintshe. Izinsizakalo ze-Premium zizoqhubeka zitholakala ngo-2018, futhi ziyoba ezinkulu kakhulu kunalokho ngabe ngabe ngabe imali ye-CSR yenziwe ekuqaleni kuka-2017.
Ngenxa yenkxaso enkulu ye-premium, abathengi abaningi bazovikelwa kusukela ekukhuleni kwesilinganiso okudingekayo ukumboza izindleko ze-CSR. Kodwa kuyobaluleka kakhulu kunanini ngaphambili ngabathengi ngabanye bemakethe-kokubili nokushintshaniswa-ukuqhathanisa ngokucophelela izinketho ezitholakalayo ngesikhathi sokubhalisa okuvulekile, ugcine engqondweni ukuthi ukubhaliswa okuvulekile kuzoba mfushane kakhulu kunalokho okwakuneminyaka engaphambili .
Uma udinga usizo ekuhloleni ukuthi yikuphi uhlelo lokukhetha, finyelela kumgibeli noma umdayisi emphakathini wakho, noma ushayele ukushintshanisa kuhulumeni wakho (qala ku-HealthCare.gov, futhi uma isimo sakho sine-exchange, uzoqondiswa lapho lapho ukhetha isimo sakho).
> Imithombo:
> Amasevisi e-Medicare naseMedicaid Services. 2017 Isitoreji sokubhalisa esenziwe kahle . Ngo-Juni 12, 2017.
> Ihhovisi le-Budget ye-Congressional. Imiphumela Yokuqeda Izinkokhelo Zokunciphisa Ukunikezwa Kwezindleko . Agasti 1, 2017.
> Mark Farrah Associates. Ukubheka Ngokubheka Umshwalense Wempilo Yomshwalense Womuntu Omusha. NgoJulayi 19, 2017.