Shin za a iya hana ƙwaƙwalwa da ƙwaƙwalwar ƙetare don cutar da Medicaid?
Harkokin kiwon lafiyar sun kasance mayar da hankali ga muhawarar siyasa. Shin GOP za ta soke Dokar Kulawa tagari, ta Obamacare, ko kuma 'yan Jamhuriyar Republican za su gano wasu hanyoyin da za su janye manufofinta? Bayan Dokar Kula da Lafiya ta Amurka (ACHA), aka tsayar da kuri'a a cikin House a watan Maris na 2017, yana da wuya a san abin da zai sa ran a karkashin gwamnatin ta yanzu.
Yakin ya yi nisa. Shugaban Majalisar Dattawa Bulus Ryan yana neman daukar mataki kan kiwon lafiyar, kodayake bai yi iyakacin lokaci ba. Da fatan, za a gabatar da shirin kula da kiwon lafiya mafi mahimmanci kuma madaidaici a madadin jama'ar Amurka. Menene wannan shirin zai hada da Medicaid, shirin kiwon lafiya wanda ke kula da talakawa da marasa lafiya?
Yadda Gwamnatin Tarayya ta Yi Magungunan Medicaid
Medicaid ne shirin gudanar da gwamnatocin tarayya da jiha. Gwamnatin tarayya ta kafa dokoki ga wanda kuma abin da dole ne a rufe, kuma kowace jiha ta yanke shawarar ko za ta ƙara ƙarin ayyuka a shirin. Ba za su iya bayar da ƙasa ba. Game da kudade, gwamnatocin tarayya da jihohi suna ba da gudummawa ga shirin su na Medicaid.
Don fahimtar canje-canjen da canje-canjen da muke zuwa, muna bukatar mu fahimci yadda gwamnatin tarayya ta tallafa wa Medicaid a farkon ƙararrawa.
Duk jihohi suna karɓar kudade na tarayya ta hanyoyi uku.
- Abun Gurasar Ƙara Ma'aikata (DSH): Tare da reimbursements na Medicaid sananne kadan, asibitoci da ke kula da yawan marasa lafiya a Medicare ko wadanda ba su da hannu ba zasu iya gwagwarmayar kudi. An biya biyan kuɗi DSH ga jihohi don rarraba zuwa asibitoci da ake bukata.
- Asusun tallafi na likita na tarayya (FMAP): Gwamnatin tarayya ta dace da bayar da kuɗin kuɗin a kan dolar Dollar Dollar ta dollar kuma tana ba da kudade mafi girma a jihohin da ke da kuɗi a cikin kuɗi.
- Ƙarin ingantaccen daidaitattun: Gwamnatin tarayya ta biya sama da ƙananan hanyoyin FMAP don wasu ayyuka ciki har da amma ba'a iyakance ga kulawa da ciwon daji da ƙwayar mahaifa ba , tsarin iyali, sabis na kiwon lafiya na gida, da kuma kariya ga mazan .
Tambayar ita ce ko wadannan hanyoyin tallafi na tarayya za su ci gaba a ƙarƙashin Shugaba Trump ko kuma idan za a maye gurbin su tare da wata hanya ta sauran kuɗi.
Tarayyar Tarayya don Faɗakarwa na Medicaid
Rahoton Medicare ya karu a shekarar 2014 kuma ya kasance babban bangare na Dokar Kulawa mai Kulawa. Ya canza iyakokin kudin shiga wanda zai cancanci mutane don Medicaid kuma ya bari mutane marasa aure ba tare da yara su cancanci idan sun sadu da iyakacin kudin shiga ba.
Matsayi na talauci na tarayya (FPL), wanda aka tsara a kowace shekara, ya dogara ne akan ko kai mutum ko cikin iyali, kuma a kan girman iyalinka. Jihohi sun kafa izinin Medicaid bisa la'akari da kashi na FPL. Obama yana ƙarfafa ka'idojin samun kudin shiga na Medicaid zuwa kashi 133 na FPL ga jihohin da suka zaɓa don shiga, yayin da jihohin da aka dakatar da ƙwarewar Medicaid zai iya ci gaba da daidaitattun ka'idodi a baya, kashi 44 na FPL.
Ƙasashe marasa zaman kansu na iya ci gaba da warewa maras yara daga ɗaukar hoto.
A hakika, wannan kudade na tarayya ya shafi shirin. Kasashen da ke da ƙwayoyi na Medicaid sun karbi karin dala na tarayya don taimaka musu, har zuwa kashi 100 na farashin fadada ta 2016 kuma kashi 90 cikin 100 na wadannan farashin ta hanyar 2022.
Ana samar da canjin kudi ga Medicaid
Dokar Dokar Kula da Lafiya na Amirka ta ha] a da wa] ansu tsare-tsaren da suka sanya ku] a] e ga Medicaid Kodayake shirin da aka kaddamar da ƙwarewar Medicaid, ya bayyana cewa zai samar da ƙarin kudade ga jihohin da aka yi alkawarinta ta hanyar 2022.
Bisa ga bayanin lafiyar lafiyar kasa, yawancin maganin magani ya wuce dala biliyan 545 a shekara ta 2015, yana da kashi 17 cikin 100 na dukiyar kula da lafiya.
Tare da wannan lambar a kan Yunƙurin, 'yan Republican suna neman hanyar da za a yanke wa wannan kudade. Mahimman shawarwari guda biyu na gyaran maganin Medicaid sune canji ga iyakacin iyakoki ko tallafawa tallafi.
Ƙididdigar iyakar kuɗin kuɗin kuɗi ne wanda za a biya a jihar kowace shekara. Darajar ta dogara ne akan yawan mutane da ke cikin shirin Medicaid. Wannan zai bada izinin kudin Tarayyar Tarayya don ƙarawa a cikin shekaru masu zuwa idan karin mutane sun cancanci kuma sun shiga cikin shirin. An ba da iyakokin iyakokin Ma'aikata a kan Medicaid tare da rubutun farko na Dokar Kula da Lafiya ta Amirka.
Yawancin 'yan Jamhuriyyar Republican, musamman ma' Yancin 'Yancin Gudanar da' Yanci, sun yi imanin cewa, iyakokin da ba su da iyaka, ba su wuce ba, don rage yawan ku] a] en tarayya a kan Medicaid. Dokar Dokar Kula da Lafiya ta Amurka ta canja daga miƙa iyakoki a kowace iyaka don yin amfani da tallafin asusun don Medicaid. Ba kamar iyakokin kuɗi ba, asusun tallafi ba la'akari da yawan mutane a kan Medicaid. Ana rarraba kudaden Tarayya a cikin adadin kuɗi wanda zai kara yawanci a kowace shekara don asusun ajiyar kuɗi. Matsalar ita ce karuwar farashi zai iya tashi da hankali fiye da farashin kulawa.
Wani bincike da Avalre, wani kamfani mai kula da harkokin kiwon lafiya ya yi, ya kiyasta cewa, fiye da shekaru biyar, gwamnatin tarayya za ta iya adana kusan dala biliyan 110 idan sun yi amfani da iyakacin kuɗi ko dala miliyan 150 idan sun yi amfani da tallafi na likita don Medicaid.
Ta Yaya Shirye-shiryen Medicaid zai Sauya?
Tambayar ta kasance idan an yi la'akari da wannan daga cikin wadannan shawarwari a matsayin ɓangare na aikin kiwon lafiyar Ryan na gaba. Idan an kafa iyakoki a kan iyakokin kuɗi ko kuma tallafawa tallafi, jihohi zasu rasa kudaden kudade. Don magance wadannan asarar, suna iya buƙatar yin canje-canje da suka sa shirye-shirye na Medicaid ya fi dacewa.
Ƙasar na iya ɗaukar yawancin maganin maganin Medicaid, yanke ayyukan da Medicaid ya rufe, ko sanya iyaka akan yawan mutane da za su iya rajista, ko da idan waɗannan sun sadu da ka'idojin cancanta. Ƙididdigar ƙididdigar za ta kasance da iyakancewa ga jihohi domin suna hana dukkan biyan kuɗi da yin rajista.
> Sources:
> HR1628 - Dokar Kula da Lafiya ta Amirka na 2017. Yanar Gizo Congress.gov. https://www.congress.gov/bill/115th-congress/house-bill/1628. Updated Maris 24, 2017.
> Lambar Bayanin Gaskiya na Lafiya na kasa. Cibiyoyin Cibiyar Magunguna da Magungunan Medicaid. https://www.cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/nationalhealthexpenddata/nhe-fact-sheet.html. Updated Disamba 2, 2016.
> Pearson CF. Kashe kuɗi a Medicaid zai iya rage muhimmancin rage yawan kudin Tarayya. Avalere.com. http://avalere.com/expertise/managed-care/insights/capped-funding-in-medicaid-could-significantly-reduce-federal-spending. An buga Fabrairu 6, 2017.
> Rosenbaum S, Schmucker S, Rothenberg S, Gunsalus R. Menene Baya Gida ko Ƙididdiga a kan Per Capita Kudin Ma'anar Medicaid? Takaitacciyar Batu (Asusun Kasuwanci). 2016 Nov; 39: 1-10. https://www.ncbi.nlm.nih.gov/pubmed/27959479.
> Sharuɗɗa na Talauci na Tarayyar Amurka da aka Yi amfani da su don ƙayyade ƙimar kuɗi don wasu shirye-shirye na tarayya. Ofishin Mataimakin Sakataren Harkokin Kasuwanci da Bincike, Ma'aikatar Lafiya ta Ma'aikatar Harkokin Kiwon Lafiya ta Amurka. https://aspe.hhs.gov/poverty-guidelines. Updated Janairu 31, 2017.