Momwe chiyembekezo chingathe kutseka kusiyana kwa Medicaid

Anthu opitilira 2 miliyoni omwe amapeza ndalama zochepa – theka la iwo ku Florida ndi Texas – alibe inshuwaransi chifukwa atsekeredwa mumpata wopeza: Amapeza ndalama zambiri kuti ayenerere Medicaid, koma chifukwa cha ACA skew amapeza zochepa kwambiri kuti athe kuyenerera. ACA-subsidized market plan.

Vutoli limakhudza anthu m’maiko 11 omwe sanawonjezere Medicaid.

Komabe, ena mwa ogulawa alandila thandizo lazachuma kuti agule dongosolo laumoyo wamsika. Zomwe akuyenera kuchita ndikuyerekeza ndi chikhulupiriro chabwino kuti mu 2023 apeza umphawi wa federal, kapena $13,590 pamunthu. Izi ndi ndalama zochepa zomwe zimafunikira kuti muyenerere zopindula zomwe zimathandiza kulipira malipiro a mapulani a msika.

Ngati ndalama zomwe amapeza mu 2023 zipezeka kuti ndizocheperapo poyerekeza ndi zomwe adayerekeza, sangakumane ndi chilango chandalama kapena kubweza ndalamazo kuboma bola ngati palibe “mwadala kapena mosasamala mosasamala” zomwe zidanenedweratu, adatero Eric Smith. , wolankhulira IRS.

Palibe m’modzi mwa omwe adafunsidwa a KHN omwe amalangiza anthu omwe ali mu “mpata wobisa” kuti agone pamapulogalamu awo amsika (umene ndi mlandu). Koma kudziwa ngati kuyerekeza kwa ndalama zomwe amapeza ndi kwabwino kapena kwachinyengo ndikosavuta. Kuneneratu za ndalama nthawi zambiri kumakhala kosatheka, makamaka kwa anthu omwe amagwira ntchito ganyu kapena kuchita mabizinesi ang’onoang’ono.

“Anthu ayenera kukhala oona mtima powonetsera ndalama zomwe amapeza chaka chamawa, koma kumatanthauza chiyani kukhala oona mtima pamene simukudziwa kuti ndalama zanu ndi chiyani?” adatero mkulu wina ku Urban Institute, Jason Levitis, yemwe adagwira ntchito ku Treasury Department mpaka 2017 ndipo adathandizira kukhazikitsa lamulo la zaumoyo.

Kulembetsa kotsegulidwa ku Federal Market kudayamba mwezi uno ndikupitilira Januware 15.

Othandizira inshuwaransi ndi oyendetsa ndege a ACA, omwe amathandiza ogula kulembetsa mapulani a msika, adanena kuti anthu ambiri sazindikira kuti mwayi wawo wopeza chithandizo chamsika umachokera pa zomwe amapeza chaka chamawa, osati ndalama zamakono kapena zapita. Mosiyana ndi zimenezi, kuyenerera kwa Medicaid ndi mapulogalamu ena ambiri a boma kumachokera ku ndalama zomwe zilipo panopa, ndipo mayiko ena amakana kulembetsa akuluakulu aliwonse opanda ana ngakhale ndalama zomwe amapeza ndizochepa kwambiri.

Oyendetsa ndege angapo a ACA ndi othandizira inshuwaransi omwe adafunsidwa ndi KHN adakhulupirira molakwika kuti makasitomala abweza ndalama kuboma ngati akuganiza kuti ndalama zomwe amapeza zipitilira umphawi koma sizinatero. Amakhulupiriranso kuti boma likufuna kuti ofunsira azikhala ndi zikalata zotsimikizira ndalama zomwe amapeza ngati zomwe akuyerekeza sizikugwirizana ndi zina zaboma.

Koma maganizo amenewanso ndi olakwika.

adatero Elaine Muntz, wachiwiri kwa director ndi director wa Center for Consumer Information and Insurance Oversight ku Centers for Medicare and Medicaid Services.

M’mbuyomu, zolembedwa zimafunikira pomwe olembetsa amayembekezera kuti ndalama zawo zizikhala pamwamba pa umphawi ndipo zomwe boma lidapeza likuwonetsa zomwe zapeza pansipa. Koma mu Marichi 2021, khothi linasintha chigamulochi. Kutsika pansi pa umphawi sikukhudza kuyenerera kwa munthu kuti adzalembetse zopindula m’zaka zamtsogolo, adatero Muntz.

The Affordable Care Act imafuna kuti mayiko agwiritse ntchito mabiliyoni m’madola a feduro kuti awonjezere kuyenerera kwa Medicaid, pulogalamu yaumoyo ya boma ya anthu omwe amalandila ndalama zochepa, kwa aliyense amene amalandira ndalama zokwana 138% ya umphawi, pakali pano $18,755 pa munthu aliyense. Koma mu 2012, Khothi Lalikulu linagamula kuti kukulitsa kuyenera kwa mayiko.

Masiku ano, mayiko 11 ali ndi kusiyana kwakukulu chifukwa sanafutukule Medicaid. Kuphatikiza ku Florida ndi Texas, mayiko amenewo ndi: Alabama, Georgia, Kansas, Mississippi, North Carolina, South Carolina, South Dakota, Tennessee, ndi Wyoming. Oponya voti ku South Dakota mwezi uno adavomereza kusintha kwa malamulo kuti awonjezere kuyenerera kuyambira mu July 2023. Wisconsin sanawonjezere Medicaid, koma imakhudza akuluakulu omwe amafika pa 100% ya umphawi.

Sarah Christian, wogwirizira panyanja wa Primary Health Care Association of South Carolina, adati samadziwa kuti palibe chilango kwa anthu omwe amalandira ndalama zochepa komanso omwe amangoyerekeza ndalama zomwe amapeza kuti apindule. Anati bungwe lake lidalangiza ogula potengera chikhulupiriro chakuti “boma lidzakhazikitsa” zoyembekeza kupitilira ndalama zomwe zilipo komanso umboni wofunikira.

Allison Holmes, wazaka 58, wa ku Longwood, Fla., Adaganiza kuti akakhalabe pachiwopsezo cha Medicaid kwa zaka 10 motsatizana mu 2023 chifukwa ndalama za banja lake chaka chino zinali $ 16,000 – zocheperapo $27,750 zomwe banja la ana anayi liyenera. mumapeza kuti muchipeze. thandizo la msika. Koma, atapatsidwa ntchito yaganyu monga wolemba ndalama zothandizira ndalama, akukhulupirira kuti zomwe amapeza mu 2023 zidzakankhira ndalama za banjali pamwamba pa umphawi. Zotsatira zake, mukukonzekera kulemba kuti mulandire chithandizo.

Kwa nthawi yoyamba m’zaka khumi, a Holmes adati, anali ndi chiyembekezo kuti inshuwaransi yazaumoyo ikhoza kukhala yotsika mtengo kwa iye. “Ngakhale zitakhala kwa chaka, kuti ndithe kuyesa mayeso onse, ndi kulemera kotani pamapewa anga,” adatero.

Ana a Holmes amaphunzitsidwa ndi Medicaid, ndipo mwamuna wake amathandizidwa ndi Dipatimenti ya Veterans Affairs.

Holmes adati ngakhale adakumana ndi oyendetsa ndege a ACA, samadziwa kuti IRS siyingamufunse kuti abweze ndalamazo ngati ndalama za banja lake zidatsika ndi umphawi. Popanda chithandizo chamankhwala, akuwopa kuti sangathe kukhala wathanzi kuti asamalire mwana wake wolumala.

Kelly Fristow, pulezidenti wa National Association of Health Insurance Agents ndi wothandizira inshuwalansi ku Wichita Falls, Texas, adanena kuti akufunsa makasitomala omwe sali oyenerera Medicaid koma omwe ndalama zawo zili pansi pa umphawi kuti aganizire njira zomwe angapangire ndalama zambiri. “Ndikamva anthu akunena kuti amapeza $10,000 kapena $12,000 pachaka, ndimati, ‘Bwerani munthu, kodi pali china chilichonse chimene mungachite kuti mupange ndalama, monga kutchera udzu kapena kuyeretsa garaja, kungopeza ndalama zokwana madola 13,500. chizindikiro? “Ndipo ngati mutero, mutha kupeza inshuwaransi yaumoyo kwaulere.”

Zili choncho chifukwa anthu omwe amapeza ndalama zochepa kwambiri amalandila mapindu apamwamba kwambiri, zomwe zimawalola kusankha njira yaumoyo yopanda ndalama zolipirira pamwezi komanso ndalama zochepa kapena zosatuluka m’thumba. Fristoe adati zimathandiza kusaina anthu omwe amawakhulupirira kuti adzalandira ndalama zokwanira kuti awaike pamwamba pa umphawi wa federal. Koma “ena amati, ‘Ayi, palibe njira yochitira zimenezo,’ ndipo ndiyenera kunena kuti, ‘Palibe njira imene ndingakuthandizireni,’ iye anatero.

Cynthia Cox, wachiwiri kwa purezidenti wa KFF, adanena kuti ogula msika nthawi zambiri amayembekezera kupanga ndalama zambiri mchaka chotsatira ndipo amatha kukhala ndi chiyembekezo.

Ananenanso kuti ndalama za anthu opeza ndalama zochepa nthawi zambiri zimasinthasintha, mwa zina chifukwa cha maola omwe amagwira ntchito komanso malipiro awo amatha kusintha m’chaka. Makasitomala angafunike kupereka chiwongola dzanja chapamwamba cha chaka chamawa kuposa chomwe adapeza mchakachi.

“Kodi mumasiyanitsa bwanji chinyengo ndi chiyembekezo?” Iye anatero.

Ngakhale kuti anthu omwe amapeza ndalama zochepa pa umphawi sakuyenera kulipira chilichonse kuti awononge ndalama zomwe amapeza chaka chotsatira ndi kulandira phindu la msika wa ACA, anthu omwe ali ndi ndalama zambiri amayenera kubwezera boma ngati anyalanyaza malipiro awo ndi kulandira ndalama zambiri. Sabuside kuposa omwe ali oyenera – mpaka ndalama zina. Mwachitsanzo, munthu wosakwatiwa yemwe ndalama zake zili pakati pa 100% ndi 200% ya umphawi adzabweza ndalama zokwana madola 350 ngati ndalama zomwe munthu amapeza mu 2023 ndizoposa zomwe amayembekezera, malinga ndi IRS.

Pafupifupi gawo limodzi mwa magawo atatu a anthu omwe amabwera kudzathandizidwa ali ndi ndalama zochepa paumphawi ndipo ali pachiwopsezo, atero a Jose Ibarra, omwe amayang’anira oyendetsa ma ACA ku CentroMed, chipatala cha anthu ku San Antonio.

“Ndizomvetsa chisoni kwambiri tikakumana ndi anthu pakamwa pake,” adatero. “Timaphunzitsa anthu kuti azifunsa anthu amene adzalembetse ntchito ngati akuganiza kuti angayembekezere kupeza maola owonjezera a ntchito chifukwa chakuti atsala pang’ono kumaliza ntchitoyo. mawu awo.”

Dongosolo lakale lotsimikizira ndalama zomwe boma lidapeza kwa anthu omwe ali ndi ndalama zosachepera umphawi zidalepheretsa anthu kusaina, adatero Islara Souto, woyang’anira pulogalamu ya Navigation wa Epilepsy Alliance Florida, ogula ambiri adasiya kupempha thandizo ndipo apanyanja adasiya kuyesa kuwatsimikizira kuti alembetse.

Iye anati: “Tili ndi chizoloŵezi chotere, chifukwa ndife dziko losakulitsa luso la Medicaid.” Iye anati: “Mumapeza ndalama zochepa, ndipo simupindula nazo.”

Koma ataphunzira kuchokera kwa mtolankhani wa KHN zakuchepetsa zofunikira, Soto adati agwira ntchito ndi apanyanja kuti afikire ogula omwe adakanidwa m’mbuyomu. “Tibwerera m’mbuyo zaka zingapo ndikupeza ogula omwe tikudziwa kuti adakumanapo ndi vutoli ndikuwachezeranso ndipo mwina kuwafikira ndikunena kuti, ‘Tiyeni tiyese izi,” adatero.

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