Masu jefa kuri'a na Colorado za su yanke shawara a fadin duniya a watan Nuwamba
A watan Nuwamba 2016, masu jefa kuri'a na Colorado za su yi tasiri tare da yanke shawarar makomar tsarin kula da asibiti na jihar . Ba abin mamaki ba, akwai tambayoyi masu yawa game da abin da ake samarwa a karkashin ColoradoCare - duka a cikin Colorado kuma daga mutane a wasu jihohin da ke kallon muhawarar.
Wannan matsayi daga likitoci don tsarin lafiyar lafiyar jiki (PNHP) wani abu mai ban sha'awa ne game da samfurori da kamfanoni na ColoradoCare.
PNHP ya lura cewa ColoradoCare ba za ta zama hanya ɗaya ba, saboda wasu mazaunan Colorado za su ci gaba da rufe su da tsarin kiwon lafiya na tarayya (Medicare, VA, Tricare, da Indiana Health Services). Hakan zai zama batun a ko'ina sai dai idan an aiwatar da tsarin tsarin biya ɗaya a matakin kasa, tun da babu wata hanyar da jihohi za su yi amfani da shi don samun kudaden da za a yi amfani da shi don waɗannan shirye-shiryen (akwai hanya zuwa can ne don Medicaid, alal misali, ta amfani da 1115 waiver).
An Kama Gudun Vermont na Kayan Ba da Daidai
Vermont ya kasance a kan hanya don amfani da watsi na 1332 don aiwatar da lafiyar ma'aikatan lafiya guda daya farawa a 2017, amma ya cire toshe a watan Disamba 2014). Colorado Jihar Sanata Irene Aguilar ne ke jagorancin shirin na ColoradoCare. A cewar Sanata Aguilar, ColoradoCare yana da wasu abũbuwan amfãni cewa, shirin simintin gyare-gyare na Vermont bai samu ba:
- Vermont ta riga ta sami tsarin kula da lafiyar jiki, ciki har da tallafin kudi ga dukan mazauna da samun kudin shiga har zuwa 150% na talauci - kafin ACA ta zo. Ƙasar da ba a kula ba a Vermont ta kasance ƙasa da ƙasa, kuma tasirin ACA ba ta da muhimmanci a Vermont kamar yadda yake a wasu jihohin kamar Colorado. ColoradoCare (da kuma Vermont ta hallaka tsarin biya guda daya) ya dogara ne a kan shawo kan 1332 don samar da wasu kudaden da ake bukata domin gudanar da shirin - a game da ColoradoCare, gwamnatin tarayya zata taimaka kusan kashi ɗaya cikin uku na kudin. Wannan kudin ya fito ne daga kudade da gwamnatin tarayya ta yi amfani da shi don tallafawa likita a Colorado ta hanyar Medicaid, tallafin kuɗi, raba kudade, da ƙananan haraji. A cikin lamarin Vermont, yana nuna cewa sun yi nasara a kan yadda za su samu daga gwamnatin tarayya tare da shayarwa ta 1332. Bisa ga mahimmanci, yadda ACA ke da tasiri a kan wani jihohi, yawan kuɗin da ake samu don ɗaukar hoto na 1332.
- Bugu da ƙari ga wannan batu, matakin Colorado na daya biya ne shekaru biyu bayan Vermont (idan an yarda da masu jefa kuri'a, shirin na Colorado ya fara ne a shekara ta 2019, a maimakon tsayayya da 2017). Wannan na nufin Colorado ya iya tattara ainihin bayanai dangane da yawan kuɗin da tarayyar tarayya ke gudana cikin jihar a karkashin ACA a cikin nauyin Medicaid daloli, tallafin kuɗi, tallafin kudade, da ƙananan haraji. Dukkanin wannan kudin za a yi amfani da shi zuwa ColoradoCare a ƙarƙashin shayar ta 1332. Ta hanyar jinkirta aiwatarwa, Colorado na da damar samun bayanai na ainihi dangane da kudade na tarayya. Ana yin lissafin farko na Vermont, tun da sun bayyana shirin su kafin a fara aiwatar da ayyukan ACA.
- Aguilar ya lura cewa masu kirkirar ColoradoCare sun fara tare da kudin kuma sunyi amfani da su don yin la'akari da abin da za a iya yi a gaskiya a Colorado. A Vermont, ƙididdigar farashin da aka samu a ƙarshen shekara ta 2014 (kafin gwamnati ta watsar da shirin su) ya zo da yawa bayan bayanan da aka tsara game da shirin guda daya. Daga qarshe, sai ya bayyana cewa ba za su iya biya kudin da suka tsara ba.
- Aguilar kuma ya nuna cewa Colorado yana da ɗan ƙasa idan aka kwatanta da jihohin kamar Vermont. Colorado yana kewaye da jihohi da mutanen da ba su da yawa. Wanda ke da aiki a cikin gari a wata ƙasa mai kusa ba zai yiwu ya koma Colorado don samun lafiyar kiwon lafiyar kuma ci gaba da tafiya zuwa ga aikinsu ba, domin akwai kawai ba yawancin yawan jama'a ba ne a jihohi makwabta a cikin nesa da dama. Colorado ta iyakoki. Kasancewar zumunci tsakanin mazaunan Colorado yana nufin jihar ba ta da karfin kasuwanci a yayin da ta zo da tsarin kiwon lafiya fiye da karami a cikin arewa maso gabashin da ke kewaye da manyan yawan jama'a kamar New York da Massachusetts.
ColoradoCare da kuma tsofaffi
Kowane mutum a jihar zai rufe shi a ƙarƙashin ColoradoCare, kodayake tsofaffi za su kasance suna da Madica a matsayin ainihin ɗaukar hoto. Ma'aikatan Medicare za su kasance da alhakin biyan kuɗi ga Medicare Sashi na B (mai kulawa da kayan aiki) da Sashe na D (rubutun kalmomi), sai dai idan sun cancanci Medicare da Medicaid (don biyan kuɗi guda biyu, Ana iya bayar da maganin Medicaid a Baya ga Medicare, ko, dangane da samun kudin shiga, Dokar Medicaid za a iya amfani dashi don biya Medicare Sashi na B da D).
Gaskiyar cewa tsofaffi tare da samun kudin shiga mai haraji za su biya ladabi na ColoradoCare a matsayin mai magana game da ColoradoCare, amma wadanda tsofaffi ba za su sake sayen Medigap ɗaukar hoto ba domin ColoradoCare zaiyi aiki a matsayin kariyarsu na Medicare.
Matsakaici na Medigap Premium a Colorado a shekara ta 2015 shine $ 181 / watan, saboda haka cikakkiyar ƙididdigar Medicare a fannin cinikayya don yawan haraji na ColoradoCare ba wani amfani ba ne.
Menene game da tafiye-tafiye na kasa?
ColoradoCare zai zama kamar HMO cikin sharuddan ɗaukar hoto a waje da jihar; Za a rufe kulawar gaggawa a waje da jihar, amma mazaunin Colorado na bukatar samun kulawa ta yau da kullum a cikin Colorado domin su biya shi ta hanyar ColoradoCare.
Sources:
Colorado Care, Ta yaya Zai Yi aiki? An shirya shi ta hanyar ColoradoCareYes. Samun shiga 12/28/2015.