Michael Milo wa Stanford pa Inflation Reduction and Medicare Act – Legal Complex

The Inflation Reduction Act ya 2022 (IRA) yalandira chidwi kwambiri chifukwa choyang’ana kwambiri zolimbikitsira zopangira mphamvu zamagetsi m’nyumba komanso kuchepetsa mpweya. Koma biluyo idayamikiridwanso ngati malamulo ofunikira kwambiri azaumoyo kuyambira pomwe idaperekedwa ndi Affordable Care Act motsogozedwa ndi Purezidenti Obama. Ndi Michelle Melo, Wasayansi wotsogola pazamalamulo azaumoyoNdipo the Amakambirana za lamulo latsopanoli ndi momwe zimakhudzira chisamaliro chaumoyo cha anthu aku America – kuphatikiza ndalama zolipirira mwezi uliwonse kwa opuma pantchito.

Kodi IRA Act ndi bilu yofunikira pazaumoyo? Ngati yankho ndi inde, ndiye chifukwa chiyani?

Ndilo lamulo lofunikira kwambiri kuyambira ndimeyi ya ACA pankhani yopititsa patsogolo mwayi wopeza chithandizo chamankhwala. (Malamulo ena adadulidwa mosiyana: Mu 2017, Congress idathetsa lamulo lalikulu la Anti-Corruption Act, chilango cha msonkho kwa anthu omwe alephera kugula inshuwalansi ya umoyo. osatetezedwa. chifukwa cha lamuloli.)

IRA ili ndi zinthu zingapo zofunika zomwe zingapangitse kugulidwa kwa mankhwala olembedwa ndi dokotala. Kuthana ndi mtengo wamankhwala kwakhala chimodzi mwazinthu zofunika kwambiri ku America ku Congress. Zimakhala zachilendo kuti anthu asamakhale ndi inshuwaransi yocheperapo pa ndalamazi, chifukwa mapulani ambiri azaumoyo amakhudza kugawana ndalama kwa odwala, ndipo mitengo yamankhwala nthawi zambiri imakhala yokwera kwambiri ndipo yakwera kwambiri.

Biliyo ili ndi zinthu zingapo zomwe zingachepetse mtengo wamankhwala a Medicare poyerekeza $287 biliyoni pazaka 10. Kodi mungalankhule za izi ndipo aku America angapindule bwanji? Ndikumvetsetsa kuti mtengo wamankhwala kwa anthu opuma pantchito ukhoza kukwera kwambiri akasintha kupita ku Medicare kuchokera ku inshuwaransi yachinsinsi.

Pulofesa Michelle Melo ku White House akukondwerera kusaina kwa Inflation Reduction Act

Zoona – Mapulani a mankhwala a Medicare (otchedwa “Part D” mapulani) sakhala ndi vuto logawana mtengo. M’malo mwake, ngakhale kuwerengera ndalama za IRA, mapulaniwa adapangitsa odwala kulipira gawo la mtengo wawo wamankhwala m’njira zosiyanasiyana: Okalamba amalipira ndalama zolipirira pamwezi pamalingaliro awo, kenako amalipira ndalama zochotsedwa, ndiyeno amalipira gawo limodzi mwa magawo atatu a mtengo wawo. malangizo (ngakhale kampaniyo itapereka wopanga mapulani ake kuchotsera pamtengo womata!). Izi zinawonongera anthu okalamba ambiri a ku America ndalama zawozawo, ndipo panalibe malire pa zimene anthu ankayenera kulipira.

IRA imayankha kukwanitsa kwamankhwala kwa opindula ndi Medicare m’njira zingapo. Choyamba, zimachepetsa ndalama zomwe amawononga. Mapulani a Gawo D sangathenso kupempha odwala kuti agawane mtengo wa mankhwala awo pamene mtengo wa mankhwala ufika pamlingo wina. Chofunika koposa, palibe amene amayenera kulipira ndalama zoposa $2,000 pachaka ndi ndalama zazing’ono kuyambira 2025.

Uku ndi kukonza kwa mbiri yakale ku zovuta za Gawo D zomwe ofufuza ndi olimbikitsa zaumoyo akhala akugwira ntchito kwazaka makumi awiri!

Chifukwa chake, mtengo wamankhwala otuluka m’thumba udzakwera $2,000 pachaka. Iyi ndi nkhani yaikulu. Chotsatira Ndi Chiyani?

Zomwe zili mu IRA zimachepetsa mtengo wa insulin kwa opindula ndi Medicare pa $ 35 pamwezi, kuchepetsa ndalama zomwe Gawo D likukonzekera kukweza malipiro kwa okalamba, ndikulola olandira kulipira ndalama zambiri za mankhwala kuchokera m’thumba pakapita nthawi m’malo moyenerera pamene atero. . Yambani kumwa mankhwala.

Gawo lalikulu lachiwiri mu IRA ndikupatsa Centers for Medicare ndi Medicaid Services (kapena CMS, bungwe la federal lomwe limayang’anira Medicare) mphamvu zokambilana za mtengo “woyenera” wa mankhwala omwe amalipidwa ndi Medicare. Ulamulirowu uli ndi chiwerengero chochepa chamankhwala okwera mtengo kuyambira 2026, ndipo malamulo amatanthauzira chomwe chimapanga mtengo wabwino kwambiri. Opanga omwe amakana kukambirana akhoza kupatsidwa chilango chachikulu chomwe chimawerengedwa molingana ndi kuchuluka kwa malonda awo ogulitsa mankhwala komanso nthawi yomwe akhala akulephera kutsatira. Akatswiri ndi ndale kumbali zonse ziwiri za njirayi akhala akupempha CMS kuti apatsidwe ulamulirowu, koma mpaka pano bungweli laletsedwa mwalamulo kuyesa kukambirana za mtengowo.

Pomaliza, lamuloli limaletsa opanga mankhwala kuti apitirize kukweza mitengo chaka ndi chaka. Amanena kuti ngati akweza mtengo wa mankhwalawa kuposa kuchuluka kwa inflation, ayenera kubwezera ku Medicare, kuyambira 2023. kupulumutsa ndalama.

Ndi mwayi wotani womwe ena mwa mapinduwa adzafikira anthu onse aku America? Kodi mitengo yamankhwala imakhudza kwambiri anthu aku America omwe amapeza ndalama zapakati?

Chimodzi mwa zokhumudwitsa za anthu ambiri omwe adagwira nawo ntchitoyi chinali chakuti kuti apeze mavoti kuti adutse, okonzanso adayenera kusiya zomwe opanga mankhwala osokoneza bongo amapereka mtengo wa Medicare womwe unakambitsirana ndi mapulani a zaumoyo. Chifukwa cha lamulo lina, Medicaid ili kale ndi mtengo wabwino kwambiri pamsika, kotero anthu a ku America omwe amapeza ndalama zapakati – omwe amapeza inshuwalansi kuchokera kwa olemba ntchito kapena kugula mapulani a inshuwalansi – tsopano alibe ndalama.

Mayiko akudziwa bwino izi ndipo akuganiza momwe angatetezere gawo lina la miyeso kwa nzika zawo. Ngakhale mayiko ali ndi mphamvu zochepa zowongolera mitundu ina ya mapulani azamalonda, pali zambiri zomwe angachite. Ndagwira ntchito ndi National Academy of State Health Policy kuti ndikhazikitse malamulo achitsanzo omwe mayiko amatha kupanga “Medication Affordability Board” kuti akhazikitse malire apamwamba pazomwe olipira mankhwala a boma azilipira mankhwala. Maboma ochepa akhazikitsa kale mapanelo ogulira mankhwala. Tagwiritsanso ntchito lamulo lachitsanzo kuti mayiko achepetse kukwera kwamitengo.

IRA inatenga miyezi ndipo zokambirana zina zotsutsana zidutse. Mukuganiza bwanji za kupambana kwamalamulo kumeneku potengera momwe zinthu zilili pandale?

Chimodzi mwa zifukwa zomwe IRA yapezera chipambano chachikulu chotere ndi nkhani yododometsa ya malamulo okhudzana ndi kugulidwa kwa mankhwala. Maphwando awiriwa adachita kampeni mwamphamvu pankhaniyi mu 2016, ndipo Purezidenti Trump adapereka njira yoganizira bwino kuti athane ndi vutoli pambuyo pa chisankho chake, chomwe chimaphatikizapo kukambirana mitengo ya Medicare. Koma zinthu zidasokonekera, pomwe olamulira a Trump adataya mtima poyang’anizana ndi kutsika kwamakampani opanga mankhwala osokoneza bongo.

Ngakhale anthu ambiri aku America onse aku Republican ndi ma Democrats adawona kuti ndikofunikira kuti Congress ipereke ndalama zogulira mankhwala ku IRA, palibe wa Republican m’modzi yemwe anali wokonzeka kuvotera biluyo, ndipo mavoti aliwonse a demokalase mu Akuluakulu a Nyumba akuyenera kudutsa. izo. Iye, Iye. Ndi chizindikiro cha nthawi yathu yosiyana kuti zafika pamenepa – chozizwitsa chaching’ono chomwe lamuloli ladutsamo.

Michele Melo (BA ’93) ndi wofufuza wotsogola pazamalamulo azaumoyo omwe kafukufuku wake amayang’ana kumvetsetsa zotsatira za malamulo ndi malamulo pakupereka chithandizo chamankhwala komanso zotsatira zaumoyo wa anthu. Amagwira ntchito limodzi ku Stanford University School of Medicine mu dipatimenti ya zamankhwala. Ndi membala wa National Academy of Sciences, Engineering, and Medicine’s Expert Committee on Affordability of Prescription Drugs, ndipo ndi wolemba nawo lipotili, Kupangitsa kuti mankhwala apezeke: ndizofunikira dziko lonse.

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