An sanya hannu a doka ta Shugaba Barack Obama a shekara ta 2010, Dokar Tsaron Kariya da Kulawa ta Hankali shine ke da alhakin sauye-gyaren tsarin kiwon lafiyar Amurka tun lokacin da ya wuce 1965 na Medicare da Medicaid .
Bayani
Yayinda aka yi jita-jita tare da wa] ansu jam'iyyun, Jamhuriyar Republican sun yi tsayayya da Dokar Kula da Kulawa, ta amfani da kalmar Obamacare, don bayyana Dokar.
A 2012, Shugaba Obama ya karbi kalmar Obamacare, kuma yanzu magoya bayan magoya bayan shari'a sun yi amfani dashi. Amma jayayya game da ACA ya ci gaba da bayan da ya wuce, tare da kalubalen kotu a kotu; Dokar ta ci gaba da kawo rigima a karkashin Gidan Kwala.
Menene Sake Gyara?
Wasu daga cikin gyare-gyaren da Dokar Kulawa ta Kwaskwarima ta aiwatar sun haɗa da Ƙarƙashin Biyar Kuɗi , ko kasuwa, inda mutane, iyalansu, da kananan ƙananan kasuwancin zasu iya sayen lamarin da aka ba da tabbacin ƙwararrun asibiti na kiwon lafiya da kudaden kuɗi . Wadannan tsare-tsaren sun yarda da dokar ta ACA ta buƙatar waɗanda ba su da asibiti na kiwon lafiya saya tsarin inshora na kiwon lafiya.
Aikin ACA na bayar da bashi da masu saye mai karfin kudi tare da tallafin kuɗi don sayen inshora na lafiya ya fi araha (adadin da ba zai iya samun kudin shiga fiye da kashi 400 na talauci, ko $ 98,400 ga iyali na hudu), da tallafin rage ragewa Kwanan kuɗi ga masu karfin kuɗi (kudin shiga ba zai iya wuce kashi 250 cikin talauci ko $ 61,500 ga iyali na hudu a 2018) ba.
Bugu da} ari, doka ta tanada harajin haraji ga wa] anda ba a san su ba; an yanke hukunci a shekarar 2014, kuma a hankali ya ci gaba har zuwa matsakaicin matakin ta 2016. Za a daidaita shi don karuwar farashi, amma 2017 da 2018, daidaitawar farashi ta $ 0, don haka azabar ba ta canza ba tun shekarar 2016 (doka ta wuce Majalisar dattijai a watan Disamba na shekara ta 2017 wanda zai hana mutum ya yanke hukunci, amma bambance-bambance da House ya buƙaci sulhu, don haka a yanzu, babu abin da ya canza game da hukuncin kisa).
Ƙungiyar ta ACA ta hana masu sayarwa daga kaucewa rufe mutane da yanayin da suka rigaya suka kasance , ko kuma daga cajin su da karfin haraji saboda yanayin da ya riga ya kasance. Wannan gaskiya ne a kan kuma musayar musanya kuma yana wakiltar wani canji mai mahimmanci daga yadda kasuwar mutum ke aiki kafin 2014 a kusan kowace jiha.
Ƙungiyar ta ACA ta kawar da shekara-shekara da kullun rayuwa a kan yadda kamfanin inshora zai biya bashin kula da lafiyar mai insured, da kuma iyakar iyakokin da ake ciki .
Aikin na ACA na buƙatar tsarin tsabtace lafiya na kiwon lafiya a cikin mutum da ƙananan kasuwanni don rufe alamun kiwon lafiya goma . Ɗaya daga cikin muhimman nau'o'in kariya daga kiwon lafiya shine kulawa na tsaro, kuma ana buƙatar adadin ayyukan kulawa da kariya ta hanyar raba farashi .
Aikin na ACA na bukatar manyan ma'aikata - waɗanda ke da ma'aikata 50 ko fiye da suka dace daidai-don bayar da haɗin kuɗi, ƙimar asibiti mai mahimmanci ga dukan ma'aikata na tsawon lokaci (30+ hours a mako), ko kuma suna fuskantar azabtarwa ƙarƙashin aikin haɗin gwiwar haɗin kai . Masu daukan ma'aikata dole ne su tabbatar da cewa ɗaukar hoto an dauke shi mai araha ga ma'aikaci, amma babu wani gwaji na iyawa don kudin da za a rufe iyalin ƙarƙashin shirin. Saboda yadda wannan yake aiki da kuma yadda ake samun tallafin tallafi a cikin musayar, wasu mutane ba su iya samun adadi mai mahimmanci saboda abin da ake kira " dangin iyali ."
[Mafi yawa daga cikin abubuwan da aka ambata a sama ba su dace da shirye-shirye masu girma da kuma grandfathered ba.]
Wasu Yanki na Dokar Kulawa Mai Kulawa An Kashe ko Kashe
Wasu sassa na ACA ba za a taba aiwatar da su ba: Kotun Koli ta haramta wani tanadi wanda zai janye kudade na Medicaid na tarayya zuwa jihohin da ba su ba da magani ga mutane da yawa ba. Wannan ya haifar da raguwa , inda mutane miliyan 2.4 da ke cikin jihohin 18 ba su da damar yin amfani da su.
Bugu da ƙari, Majalisa ta soke dokar ta ACA, wadda aka fi sani da Dokar CLASS , a watan Janairu 2013 bayan Sashen Ma'aikatar Lafiya da Ayyukan Harkokin Kiyaye ta ƙaddara shi ba zai yiwu ba.
Abubuwa masu yawa na ACA sun jinkirta, ciki har da aikin haɗin gwiwar haɗin gwiwar (an aiwatar da ita a shekarar 2015, maimakon 2014, kuma ba a aiwatar dashi ba har zuwa 2016), harajin Cadillac (yanzu an kafa shi a cikin 2020), kuma ƙaddamar da wadanda ba su da girma, wadanda basu da tsarin ACA waɗanda aka ba kafin shekarar 2014 (wadannan shirye-shiryen su ne tsaka-tsakin, ko kuma "grandmothered," kuma an yarda su ci gaba da yin aiki har zuwa karshen 2018, a hankali da jihohi da masu sayen lafiya).
> Sources:
> Ma'aikatar Kiwon Lafiya da Ayyukan Harkokin Kiyaye na Mutum, Tattalin Kariyar Kariya da Abubuwan Kulawa .
> Babbar Gida ta Kaiser, Jagora ga Kotun Koli ta Kan Shawara ta ACA , Agusta 2012.
> Kayan Gida na Kaiser. Ƙungiyar Gudanar da Ƙarƙashin Ƙasa: Ba a Yarda Kasuwanci Matalauta a Amirka ba Wannan Bada Ƙara Magunguna. Nuwamba 1, 2017.
> Lemieux, Jeff; da Moutray, Chadi, Game da Dabbar Cadillac, Lafiya, Afrilu 25, 2016.