Izindaba ezinkulu zingase zingathinteli ababhalisile abaningi
NgoNovemba 2015, njengoba kubhalisiwe ukuvota kwa-2016, i-UnitedHealthcare yamemezela ukuthi ibhekene nokulahlekelwa okukhulu kunalokho okulindelekile ekuthenganeni kwe-Obamacare futhi yaxwayisa ukuthi ingase iqhubeke ihlinzeka ngokubambisana ekupheleni kwe-2016. Ngo-Ephreli 2016, baqinisekisile ukuthi bazophuma kakhulu ekuhwebeni ekupheleni konyaka.
Umthelela wokuphuma kwe-United
Ngonyaka we-2014, i-UnitedHealthcare yanikeza izinhlelo zokwenza izingxoxo ezikhulwini ezinhlanu. Lokho kwakhula kwaba ngu-23 ngonyaka ka-2015, kanti ku-34 kuthiwa ngo-2016. Eziningi zalawo mazwe, i-UnitedHealthcare ngeke ihlinzekele izinhlelo ekushintsheni ngo-2017, nakuba ziqinisekisile ukuthi zizoqhubeka zihlanganyele "ezincane" zokuhwebelana, kuhlanganise ne-Nevada ne-New York.
I-UnitedHealthcare yi-insurer enkulu kakhulu yesizwe, futhi leli qiniso liye laphindaphindiwe ezinhlokweni eziningi ezimemezela ukuhamba komthwali wezinkampani eziningi. Kodwa lokho akutsheli lonke indaba.
Kuyiqiniso ukuthi bangumshwalense omkhulu kunabo bonke, kodwa ukugxila kwabo kuyiMediare market ( Medicare Advantage kanye neMedigap yokuthengiswa kwemali ) kanye nemakethe yomshuwalense oxhaswe ngumqashi , ngokungafani nemakethe yomshuwalense wezempilo (iningi labantu abaye ukubhalisa ngokusebenzisa ukuhwebelana kusezinhlelo zomakethe ngamunye).
I-UnitedHealthcare ingaba yinkampani enkulu kunazo zonke emhlabeni wonke, kodwa iqinisekisa abantu abangu-795,000 kuphela ekuthengiseni - amaphesenti angaba ngu-6 abantu ababhalisile kumacebo ngokusebenzisa ukuhwebelana ezweni lonke. Futhi i-United ilindele ubulungu bayo bezoshintshanisa ukuthi behlele ku-650 000 ngasekupheleni kuka-2016.
Ngakho iningi labantu ababhalisile ezinhlelweni ngokusebenzisa ukuhwebelana ngeke kuthinte ngqo ngokuphuma kuka-United ekupheleni kuka-2016.
Izinkokhelo kanye nokukhethwa kwabathengi
Ngenxa yokuthi i-UnitedHealthcare ayizange ibe umdlali onobudlova ekuthenganeni, izinhlelo zabo azijwayele ukuba phakathi kwezinkampani ezincintisana kakhulu. I-Kaiser Family Foundation yenza ukuhlaziywa kwamanani okuhlelwa kwe-United mayelana namanye amacebo ngo-2016, futhi bathola ukuthi i-United inikeza izinhlelo eziyisiliva eziphansi kunazo zonke noma ezisezingeni eliphansi kunazo zonke (okukhethwa kakhulu kunazo zonke) ngamaphesenti angu-35 kuphela ezifunda lapho othintekayo unikeza izinhlelo zokushintshanisa.
Ezingxenyeni, abathengi ngokuvamile banomthelela kakhulu, futhi abathwali bavame ukuthola isabelo esikhulu semakethe lapho izinhlelo zabo zithengiswa kakhulu kunabancintisana. Isikhundla se-United kuzimakethe eziningi akuyona emithwalini ephansi kunazo zonke, futhi lokho kubonakalisa ukwabelana ngemakethe yezohwebo, okuncane kakhulu emazweni amaningi.
Umphumela walokhu ukuthi ukuhlaziywa kwaKaiser Family Foundation kuthole ukuthi uhlelo olubanzi olunamanani lokulinganisa uhlelo (i-second-low-cost-cost plan plan yesiliva) lalizobe liyingxenye eyodwa kuphela ephakeme ngo-2016 uma u-United engakahlanganyeli ekuhwebeni kulo nyaka .
Kodwa lokho kuyisilinganiso sikazwelonke. Kunamanye amazwe lapho umthelela we-premium premium uzoba ophawuleka kakhulu uma u-United engakanikeli izinhlelo ngo-2016 (kusheshe ukutshela ukuthi lokhu kuzodlala kanjani ngo-2017, ngoba amanani awazange avunyelwe ngo-2017 okwamanje) . Kunezigaba ezine lapho izinkokhelo zezinkokhelo zizoba okungenani ama-$ 25 / ngenyanga ngaphezulu okungenani amaphesenti angama-40 emiphakathini kahulumeni uma u-United engakahlanganyeli ekuthengiseni ngo-2016: i-Alabama, i-Iowa, i-Nebraska ne-North Carolina.
Futhi ukukhethwa kwabathengi nakho kuyisici esibalulekile sezokuhwebelana. Ngokusho kokuhlaziywa kwe-Kaiser Family Foundation, kunezifunda ezingu-1121 e-US lapho okwamanje kunomunye oyedwa noma ababili abanomshwalense abanikeza izinhlelo ku-exchange.
Uma i-United kufanele ihoxise kuzo zonke izingxoxo (lokho kungabonakali, njengoba ezinye izizwe ziqinisekisile ukuthi i-United isala ekushintshaneni kwabo), ukuhlaziywa kwe-Kaiser Family Foundation kwathola ukuthi amanye amanani angu-532 angase awele esigabeni sokuba khona okukodwa noma ezimbili ezithintekayo zokuthutha izinkampani (futhi ngaphezu kwalokho, izifunda ezingu-536 ezinezinkampani ezimbili okwamanje zingaphonsa kuphela). Umphumela wukuthi amaphesenti angu-53 e-US angenayo eyodwa kuphela noma ababili ababambisene nabashuwalense ekushintsheni.
Ngakho-ke naphezu kokuthi i-UnitedHealthcare ayiyona enye yezinketho eziphansi kunawo wonke kulezi zifunda lapho zisebenza manje, ziletha ukhetho olwandayo lokubhalisa kubantu abathengisayo, futhi lokho ngokuqinisekile ngeke kunciphise ngo-2017.
Ngesikhathi esifanayo, kubalulekile ukukhumbula ukuthi abanye abathwali ngeke nakanjani bangene ezimakethe zokushintshanisa kwezinye izindawo lapho u-United ephuma khona. Isibonelo, eVirginia, i-UnitedHealthcare izoqhubeka nokuhlinzeka ngamalungiselelo ngo-2017, kodwa hhayi emazweni amaningi njengoba inikela ngamalungiselelo ngo-2016 (okungukuthi, ivele iphuma ezindaweni ezithile zombuso). Kodwa uCigna ujoyina ukushintshaniswa kweVirginia okokuqala ngo-2017.
Kunezimboni ezimbili - i-Oklahoma ne-Kansas - lapho i-UnitedHealthcare njengamanje yilabo abathwali ababili abahlinzeka izinhlelo ekushintsheni (ngokusemthethweni, i-Kansas inabathwali abaningi, kodwa ngaphandle kwe-UnitedHealthcare, bonke bangabelungu beBlue Cross Blue Shield). U-United uphuma kokubili kulabo abasebenzisana nombuso ekupheleni kuka-2016. Ngaphandle kokuba omunye umshwalense ajoyine, i-Oklahoma neKansas zizoshiywa ngumshuwalense oyedwa ngo-2017 (i-Wyoming isesimweni esifanayo ngo-2016, futhi iWest Virginia yayine-carrier eyodwa kuphela 2014 no-2015).
Kungani Ukubhikisana Okubambene?
Isinqumo seMelika sokuphuma kakhulu kwezingxoxo sisekelwe ekulahlekelweni kwezimali abaye bazitholela - futhi balindele ukungena emakethe. Phakathi kokulahlekelwa kokushintshaniswa kwabo ngo-2015 nokuthi yini abayilindele ukulahlekelwa ekuthengiseni ngawo ngo-2016, ukulahlekelwa okuphelele kwaleso sigaba semakethe cishe kuzofinyelela ku-$ 1 billion.
Ukuze kucace, i-UnitedHealthcare iseyinkampani enenzuzo. Kodwa banqume ukuthi abakwazi ukuvumela izingxenye zemakethe zabo ezizuzayo zixhase ingxenye yabo yemakethe yokushintshanisa okungenzi inzuzo ngokuhamba kwesikhathi. Abantu ababhalise izinhlelo zokushintshanisa ze-United baye babulala kunabo ababhalisile kwezinye izingxenye zamakethe, okwenza kube nezindleko eziphakeme zomshuwalense (le nkinga ayifani neze ne-United; abathwali abaningi baye bathola ukuthi ukushintshanisa kwabo kusetshenziswa ukunakekelwa kwempilo kunokuba kulindeleke).
Ngasekupheleni kuka-2015, i-UnitedHealthcare yamemezela ukuthi ngeke ikhokhise ama-commissions ama-plan for izinhlelo ezithengiswa emakethe ngayinye ngemuva kokuphela kuka-2015. Lokhu kwakuwumzamo wokunciphisa ukubhaliswa ngo-2016, njengoba bebevele bebona ukuthi ingxenye yabo yemakethe yokushintshanisa yayingenanga ukuze kube nenzuzo.
Yini Engidinga Yenza?
Uma ubhaliswe ohlelweni lokushintshanisa ngo-UnitedHealthcare ngo-2016, uzokwazi ukugcina ekupheleni konyaka uma nje uqhubeka ukhokhela ama-premium akho. Uzothola isaziso kusuka kokubili u-United nokushintshaniswa kamuva ngonyaka ukunika ulwazi ngezinyathelo ozodinga ukuthatha ngesikhathi sokubhalisa okuvulekile ( into efanayo eyenziwe ngabantu abaningi kwi-CO-OP izinhlelo ngasekupheleni kuka-2015 ).
Ungakwazi ukugcina inguqulo yokushintshana kwe-UnitedHealthcare plan, kodwa kubalulekile ukwazi ukuthi izinsizakalo ze-premium nezinsizakalo zokwabelana ngezindleko azitholakali kunoma yiziphi izinhlelo zokushintshanisa. Iningi labantu abhalise ezinhlelweni ngokusebenzisa ukuhwebelana bathola izinsizakalo ze-premium.
Ngesikhathi sokubhalisa okuvulekile, uzoba nethuba lokukhetha uhlelo lokushintshanisa oluvela kusithwali esithintekayo ukuze ususe uhlelo lwakho lwe-UnitedHealthcare. Ukuze wenze le nqubo ibe lula kakhulu, inkambo engcono kakhulu yokusebenza kuyoba ukujoyina ohlelweni olusha ngo-Disemba 15, ukuze kuqinisekiswe ukuguquka okungenasici kanye nosuku olusebenzayo lukaJanuwari 1 lwepulani lakho elisha (Massachusetts, Rhode Island, futhi Izwe laseWashington livumela ukubhaliswa ukuthi kugcwaliswe ngasekupheleni kukaDis. 23 ngeJan. 1 izinsuku eziphumelelayo, kanti u-United uphuma ukuhwebelana kuwo wonke amathathu kulawo mazwe).
Ungase ufanelekele isikhathi sokubhalisa esikhethekile esabangelwa ukulahlekelwa kwesinye isabelo, ngakho-ke uvumelekile ukubhalisa kuze kube sekupheleni kuka-Dec. 31 ngomhla ka-Jan. 1 osebenzayo. Kodwa lokhu kuyinkimbinkimbi kakhulu , futhi inqubo izoba lula uma ukhetha uhlelo lwakho olusha ngo-Dec. 15.