Unansi pakati pa malamulo a boma ndi malamulo a boma umaimira kutsutsana kwakukulu kwa boma la America, makamaka m'nkhani za zaumoyo. Malamulo a Federal amakhazikitsa zolinga zazikulu za dziko ndi miyezo yocheperapo, pamene maboma ali ndi ulamuliro waukulu wa kugwiritsira ntchito, wowonjezera, kapena, nthaŵi zina, kutsutsa malangizowo. Zimenezi zimapanga malamulo a zaumoyo amene amasiyanasiyana m’mayiko, kukhudza chilichonse kuchokera ku inshuwalansi ndi kulipira ndalama zothandizira ku ku kukonzekera kwamwadzidzidzi ndiponso kubisa chinsinsi cha anthu oleza mtima. Kuzindikira mmene malamulo a boma amalinganizidwira ndi [1] ndi zosankha zapamwamba nkofunika pomvetsa dongosolo la zamakono ndi la za zaumoyo. Nkhaniyi imapenda njira za malamulo a boma a za zaumoyo, malamulo ogaŵana, ndi kutsutsana koyenera pakati pa ulamuliro wa Washington.

Kumvetsetsa Uchigaŵenga pa Zaumoyo

Federalism mu United States imagaŵira mphamvu pakati pa boma la dziko ndi maboma 50. Malamulo amapatsa Nyumba ya Malamulo kuŵerengedwa, monga ulamuliro wa kuyang'anira malonda a boma ndi msonkho ndi kuwonongera ubwino wa onse. Maulamuliro ameneŵa amapereka maziko alamulo a boma la zaumoyo monga Medicare, Medicaid, ndi Affordal Care Act (AA). Panthaŵi imodzimodziyo, Tenth Amendramendment ku maulamuliro onse osaperekedwa mwalamulo ku boma, kuphatikizapo mphamvu ya polisi yamwambo kutetezera thanzi, chisungiko, ndi ubwino wa nzika zawo. Uchifumu umenewu umatanthauza kuti malamulo awo a inshuwalansi ya zaumoyo, zaumoyo, za anthu, zodzitetezera, ndi zaumoyo, ndi zaumoyo wa anthu.

Dongosolo la zaumoyo ndi chitsanzo cha bungwe la boma logwirizana, limene milingo yonse iŵiri ya boma imagawana mathayo, kaŵirikaŵiri mwa kupereka ndalama ndi kugwirizana kwa boma. Mwachitsanzo, Medicaid ndi programu ya ndalama zonse zimene boma limakhazikitsa kuchuluka ndi kupindula ndi malamulo a boma koma boma limayang'anira pulogalamu ndi kukhala ololera kupanga madongosolo awo opereka zinthu. Momwemonso, makampani a inshuwalansi a AA adapanga masinthidwe a boma ocheperapo kuti apereke, komabe maboma akupitirizabe kuyang'anira malonda awo, kusungitsa chitetezo, ndi kuyendetsa mainshuwalansi awo a za umoyo. Kusintha kumeneku kungatsogolera kukonza madongosolo awo, monga momwe maboma amachitira ndi maluso atsopano kapena kuwonjezera, koma kungatulutsenso kugaŵa, monga momwe kusiyanasiyana kwa Mididistiki m'dziko lonse ndi kufalikira kwa maiko ambiri.

Zochitika za m'mbiri zatsimikizira mobwerezabwereza kuikidwa kwa boma m'zosamalira zaumoyo. Mwachitsanzo, kukhazikitsidwa kwa Medicare ndi Medicaid mu 1965 kunafutukula kwambiri ntchito ya boma, koma kuyang'anira Medicaid kunasiyidwa dala ku boma. Posachedwapa, lamulo la ACA linachirikizidwa monga lamulo lalamulo logwiritsira ntchito mphamvu ya Congress yoson'azetsa msonkho mu [FLD:0] National Federation of Independent Business v. Sebelius , koma Khoti inalamulanso kuti boma la United States silingapereke chilango chakuti lamulo la ACCA lakuwonjezera mphamvu ya ku ACICA mwa kuchotsa ndalama zonse zimene zilipo m'makedia. Chigamu choweruza chokhudza ufulu chokhudza ufulu chomasinthasintha chiwonjezedwa cha boma chomakulakula cha boma cha boma la boma la boma la ACide .

Policies, Malamulo Aakulu Okhudza Umoyo wa Boma

Malamulo akuluakulu angapo asintha kwambiri njira yosamalira zaumoyo wa boma. malamulo ameneŵa amakhazikitsa chipinda chosungiramo, otetezera ogula, ndi osungira katundu, pamene kuli kwakuti amayambitsanso njira zothandizira boma kulolera kapena kukana.

Njira Yosamalira Anthu Odwala Mosavuta (ACA)

Atavomerezedwa mu 2010, ACA imaimira kusintha kwakukulu kwa boma kwa zaumoyo kuyambira ku Medicare ndi Medicaid . Malamulo ake aakulu amaphatikizapo: (1) lamulo la munthu aliyense (lotha kuchotsedwa ndi Tsitsi la TCs ndi Jobs Act ya 2017), (2) kukhazikitsidwa kwa inshuwalansi ya zaumoyo, (3) ndalama zothandizira anthu otsika ndi opeza ndalama zapakati, (4) kusintha konga kotsimikiziridwa ndi kupima kwa chitaganya, ndi (5) kuwonjezereka kwa Medicadidificid mpaka 138% ya mlingo wa umphaŵi wa dzikolo. AAid amafunikira kusinthitsana ndalama zawo kapena kulephera kusinthitsa ndalama za boma. Monga momwe za 2025, 18 ndi zigawo za chigawo cha chigawo chotsalacho, pamene maiko owonjezera, MCAdiced propedition (kuwonjezera ndi "NUmwini wopangidwa ndi: N.[10]) kaŵirikaŵiri zovomerezedwa ndi zowonjezereka ndi zowonjezereka ndi maiko za anthu opangidwa ndi maiko ena.

Médicaid ndi CIP

Mdicaid, yomwe inapangidwa mu 1965, ndi programu ya boma yogwirizana ya zaumoyo imene imapatsa anthu olandira ndalama zochepa, mabanja okhala ndi ana, akazi oyembekezera, achikulire, ndi anthu olumala. Maboma ayenera kumamatira ku miyezo ya boma ya kuchuluka ndi kukwaniritsa mapindu ena apadera (m’jere, mautumiki achipatala, machipatala osamalira okalamba, koma ali ndi ufulu waukulu wosamalira anthu ndi mautumiki, ndi kukhazikitsa ndalama zolipirira. Ana a Health Inishuwarensis program (CHIP), adapangidwa mu 1997, mofananamo akupatsa ndalama zothandizira ana m’mabanja okhala ndi malipiro ambiri ochulukirapo chifukwa cha Mdid koma pansi pa lamulo. Polonse paŵiriwo ali ndi nkhani ya kukonzanso ndi kusintha kwa ndandanda ya boma (MP), zimene zigamu za kayenderedwe kayendere ka ka ka kayendetsedwe ka zinthu ka boma, ndi kayendetseke kamodzi.

Act ya Inshuwalansi ya Zaumoyo ndi Kuŵerengera Umboni (HIPAA)

HIPAA, yomwe inakhazikitsidwa mu 1996, imaphatikizapo makonzedwe amene amayambukira mwachindunji kayendetsedwe ka boma. Lamulo lachinsinsi limakhazikitsa miyezo ya dziko kaamba ka kutetezeredwa kwa chidziŵitso chaumoyo aliyense wodziŵika, kukhazikitsa malamulo a boma ofooka koma kulola maboma kusungitsa kapena kukhazikitsa malamulo okhwima. Maboma agwiritsira ntchito kulolera kumeneku kukhazikitsa malamulo ofunikira kuwonjezera kulolera koleza mtima kwa zolembedwa zina zokhudza mtima (m'm'njira yakuti munthu akhale ndi HIV). Malamulo a HiPAAAAD Simpliation amalamuliranso kuyendetsa malamulo a zamagetsi ogwirizana ndi madongosolo awo a za zaumoyo. Maboma a kusungidwa kwa anthu osakhala omvera malamulo a za kuŵerengera zinthu zina (m.

Medicare

Monga programu ya boma yokwanira ya anthu a zaka 65+ ndi anthu ena achichepere okhala ndi kulumala, Medicare samaloŵetsamo mwachindunji kuyang'anira boma. Komabe, imakhudza kwambiri malamulo a zaumoyo. Mwachitsanzo, ndalama za Medicare , za kuchipatala ndi za dokotala , monga mapepala a anthu achinsinsi ndi opatsirana. Maboma amadaliranso pa Medicare kubisa anthu aŵiri oyenerera (oyenerera Medicare ndi Medicaid), kuchepetsa kugwiritsa ntchito kwa boma pa kusamalira kwanthaŵi yaitali ndi mankhwala osokoneza anthu. Kuwonjezera apo, Mediaravers ndi kuonetsa maprojekiti (zotero monga kusamalira) zingagwirizanitsidwe ndi ntchito za m'dziko la Medicad progation , kuchirikiza ntchito zosamalira.

Malamulo Ena Okhudzana ndi Magulu Ankhondo

Malamulo owonjezereka a boma a kayendetsedwe ka zaumoyo. Kupereka chithandizo cha mankhwala otetezereka kwa boma. [FLT:] Act [EMTALA] kumafuna zipatala zimene zimatenga mbali m'Medica kuti zipereke chisamaliro chamwadzidzidzi mosasamala kanthu za malo kapena kukhoza kwa wodwalayo kulipira, kuika mtolo pa zipatala zotetezedwa ndi boma. [FLT:] . [FLT:] SITCH Act [[FLT:] ya 2009] kupititsa patsogolo kuperekedwa kwa mafaisensi a za za za za zamagetsi (EHR) kupyolera pa zisonkhetso za ndalama, ndipo maiko awonjezera kusintha chidziŵitso chako cha za umoyo. [FF] Kachitidwe kabwino kabwino ka ka ka kachitidwe ka ka ka ka ka ka kachitidwe ka za za za zamankhwala, akuphatikizaponso ntchito yothandiza kuyendetsa ntchito yothandiza kukonza zaunika, ndipo kuwonjezera kukonza kwa zaumoyo. [F3] Operationtiontions. [3]

Kugaŵana kwa Madesitid: Kupenda Nkhani m’Chikhalidwe Chadziko Chadziko

Mdicaid yomwe ikupita patsogolo pansi pa ACA ndi chitsanzo cha boma cha chisonkhezero pa lamulo la boma. Kufutukukako kwawonjezera kuchepa kwakukulu kwa achikulire onse okhala ndi ndalama pa 138% ya mlingo wa umphaŵi wa boma (FPL), ndi boma loyamba kukwaniritsa 100% za mtengo wa olembetsa atsopano, pang’onopang’ono kukwera kufika ku 90% pofika 2020. Maboma amene aona kutsika kwakukulu kwa ziŵerengero zosafunika, kuwongolera kwa kuchepetsa kusamala, ndi kuchepetsa mtengo wa chisamaliro cha chipatala. Mwachitsanzo, kufufuza ndi Chithandizo cha Commovercoverful Fund kunapeza kuti kukula kwa anthu achikulire kwapeza kuti 30% mwa kutsika kwa anthu osaŵerengeka kwa magawo otsika. Mayiŵa awonjezeka pakati pa zaka za 2013, anawonjezerapo kuwonjezereka, ndipo anawonjezera kuwonjezereka kwa matenda.

Mosiyana ndi zimenezi, 10 amanena kuti sanachuluke kwambiri ku South ndi Midwest . Malinga ndi Kaiser Family Foundation, pafupifupi 1.9 miliyoni auchikulire m'mayiko osafuna kuwonjezera, akulephera kuyenerera ndalama za ACAIA , chisamaliro cha mankhwala chochepekera, ndi kusungidwa kwa zipatala. M’madera ameneŵa, machipatala amasunga ndalama zambiri kuposa ndalama za boma (kaŵirikaŵiri FPL yochepera pa 50% ya anthu achikulire opanda ana). Anthu ameneŵa kaŵirikaŵiri alibe njira zopitira kumbuyo, ndipo amalephera kulipira ndalama zambiri.

Chigamulo cha kufutukuka ndicho cha ndale zadziko ndi zachuma. Maboma ena, monga Idaho ndi Nebraska, anafutukula ndi njira zaudindo mosasamala kanthu za chitsutso cha boma. Ena, monga Texas ndi Florida, adakana mwamphamvu kuwonjezera ndalama zotsala zodetsa nkhaŵa . Ngakhale kuti boma likufuna kuwonjezera ndi 90% ya ndalama zimene amalingalira kuti ndi andale. Maboma angapo atsatira njira zina: Arkansas analandira ndalama zogulira Medicaid kugula inshuwalansi yachinsinsi pa kusinthana; kuwonjezeka kwa Indiana kumaphatikizapo ndalama zosungira zaumoyo ndi ndalama zosungidwa; ndi kuwonjezeka kwaumoyo kwa Utah kuphatikizapo kupyola pa 100% FPL. Mabomawawawa, operekedwa pansi pa Desertmental Act , akusonyeza muluwa wina wa bungwe la za bungwe la Amedics (Madics) ndi mautumiki a ku Miedicedia) monga momwe ayenera kuyenera kugwirira ntchito kwa mabwalo ambiri.

Chiyambukiro cha Malamulo Oyenderana pa Ntchito za Umoyo wa Boma

Kupyola pa malamulo aakulu, malamulo ambiri a boma amasintha mwachindunji ntchito zaumoyo wa boma. Malamulo ameneŵa kaŵirikaŵiri amakhazikitsa miyezo yochepera ya mkhalidwe, chisungiko, ndi malo achinsinsi zimene maboma ayenera kutsata, pamene akulola maboma kukhazikitsa zofunika zowonjezereka. Mwachitsanzo, mikhalidwe ya CMS ya kugawana ndi Medicaid imapereka malamulo a zipatala, nyumba zosamalira zaumoyo, mabungwe a zaumoyo, ndi opereka chithandizo. Maboma ali ndi thayo la kuchititsa kufufuza ndi kugonjera; kulephera kukwaniritsa miyezo ya boma kungatulukapo m’kuchotsa ndalama. Zimenezi zimapereka boma lamphamvu kuti lisungitse mabenchi apamwamba a boma, koma limaikanso ndalama zoyendetsera ntchito pa mabungwe ofufuza boma, amene angayendetsedwe pansi pa kuyendera boma.

Mbali ina yofunika kwambiri ndi inshuwalansi ya zaumoyo. ACA a insurensi amafunikira kukwaniritsa mapindu ofunika a thanzi (EHB) m'misika yaing'ono ndi imodzi, koma maboma ali ndi ufulu wofotokoza mapindu enieni amene akuphatikizidwa. Monga chotulukapo, mapindu ofunika kwambiri a thanzi amasiyana ndi boma; mwachitsanzo, maboma ena amalamulira kuti apereke chithandizo cha kusabereka, kutaya thupi, kapena kuchepetsa kulemera, pamene kuli kwakuti ena satsatira. Mofananamo, malamulo a boma onena za kutayikitsa kwa mankhwala (MLR) amafuna kuti anthu opereka chithandizo cha maading’onoa (individ / gulu lochepa) kapena 85% (kakulu) ya ndalama zothandizira ndi zowongoletsera, koma madipatimenti a inshuwalansiti ndi oyang'anira madandaulo ameneŵa.

CHRIPT Act ya HTTP Act yafunikiritsa mapangano otsekeredwa kudziŵikitsa anthu. HOPAA’S Lay Relations imakhazikitsa malo a dziko, koma maboma akhazikitsanso chitetezo china cha chidziŵitso cha majini (GINA), zolembedwa za thanzi, ndi za HIV / AIDS. Panthaŵi ino, lamulo la HUTECH Act lakudziŵitsa lakubisa limafuna zinthu zimene zimatsekedwa kuti anthu, HHS, ndipo nthaŵi zina manyuzipepala a makompyuta a data opatuka. Mayiko ambiri ali ndi malamulo awo odziŵitsa zinthu amene amakhazikitsa nthaŵi yokhwima kapena kutchula zofunika, kuchititsa kuti avomereze malamulo ambiri a boma akwanire. Kuwonjezerapo, 21st Cex Creacts Acts Reviceptions Relationstionsss Resocialstions oletsa machitidwe osinthana chidziŵitso, kukakamiza makampani a Mdictime kukhazikitsa njira zawo zoyendera kuyendera malamulo awo.

Nkhani Yopitiriza: Kulimbana ndi Ufulu Wachibadwidwe wa United States

Kulimbana pakati pa ufulu wa boma ndi uyang'aniro wa boma kuli nkhani yachikhalire m'ndale za America zosamalira zaumoyo. Ochirikiza ulamuliro wa boma amanena kuti maboma a m'dziko ali ndi malo abwino ochitirapo kanthu pa mikhalidwe yapadera ya anthu, zachuma, ndi chikhalidwe cha anthu awo. Amatchula za kuyesa kopambana kwa boma monga mabungwe a Oregon (CCOS) ogwirizana (Cicaid) a Medicaid, amene amasamalira thupi, ndi kusamala mano ndipo apeza ndalama zosungidwa ndi kuwongolera. Maboma angagwirenso ntchito monga makompyuta a democracy, kuyesa malamulo amene pambuyo pake angatengedwe m'dzikolo, mwachitsanzo, Massachusetts atha 2006 adatumikira monga chitsanzo cha ACCA. Kuwonjezerapo, kukonza kwa boma kusamala maupandu a bungwe la dziko la anthu audindo a m'amphaka amene angagwire ntchito m’matauni kapena m’madera osiyanasiyana.

Mosiyana ndi zimenezi, ochirikiza auyang'anira boma amanena kuti kusiya chisamaliro cha zaumoyo ku mayiko akupitirizabe ndi ngakhale kuchepetsa kugaŵanika. Zotsatira za umoyo ku United States zimasiyana kwambiri ndi boma: moyo umayambira zaka 75 ku Missississippi mpaka 80 ku Hawaii ndi California; ziŵerengero za ana akufa ndi matenda osatha zimasonyezanso kugaŵikana kwakukulu. Ndi mbali yamphamvu ya boma yokha imene ingatsimikizire chitetezo chosatha chakusoŵa thandizo, monga momwe kukhalira kotsimikizirika kwa kutha kusamala, kuletsa tsankho malinga ndi mikhalidwe yapasadakhaleko, ndi miyezo yabwino ya nyumba za odwazika. Uyang'anira wa mautumiki wadziko ndi wothandiza kwambiri pa zochitika zaumoyo, monga momwe kunasonyezedwa ndi mliri wa COVID, pamene boma likusinthasinthasintha njira zopimira, kugaŵira mankhwala, kufalitsa, ndi kuyendetsa ndalama.

Nkhondo zalamulo pa zaumoyo ndizobwerezabwereza. Makhoti ayesapo pa nkhani zoyambira pa kuletsa kutaya mimba (kugwirizana kwa Hyde Amendment ndi bajeti ya boma) kufikira ku kulamulidwa kwa munthu aliyense ndi Medicaid. Chigamulo cha Supreme Court cha 2012 chotsimikizira kuti kufutukuka kwa ACA’s Medicaid sikungasungidwe kukhala koyenera kusungidwa ndi boma lapadera, koma zigamulo zotsatira, kuphatikizapo King v. Burwell . [FLT:] (20) (20) Kuchirikiza chibalo cha ngongole m'dziko lonse, kaŵirikaŵiri atsimikiziranso mphamvu ya boma ya kulinganiza ndi kuyendetsa zachuma za zaumoyo. Maweruzi aweruzawawo amapangitsa kusatsimikizirika kaamba ka kufunafuna makonzedwe a mtsogolo.

Kufufuza Milandu: Kulabadira Malamulo a Boma

Kupenda mmene maboma achitira ndi malamulo a zaumoyo a boma kumasonyeza kugwirizana kocholoŵana kwa ndale zadziko, chuma, ndi zosoŵa za kumaloko.

California: Kufika kwa Ofutukula

California wapitirizabe kulimbikitsa malamulo a boma a zaumoyo. Iko kunakulitsa Medicaid (Medi- Cal) mofulumira ndi mwaukali, kuphatikizapo kufalitsa achinyamata osalembedwa (kupyola zaka 26) kuyambira 2020 ndi ku kulowa pansi kulikonse osalembedwa ndi akulu mu 2024 . California imayendetsanso inshuwalansi yakeyake ya zaumoyo (Medi California), yomwe yakhala chitsanzo cha dziko lonse cha kupambana ndi kulembetsa. Malamulo a boma mu 2023 adakhazikitsa mapulani a anthu onse (Oyang'anira Bizinesi Zaing’ono) ndi kuika zoirira zochepetsera mankhwala osokoneza mankhwala kudzera m'malo a mankhwala osokoneza bongo. California imaphatikizaponso malamulo otetezera ndi odabwitsa a boma.

Texas: Chitsanzo Chotsutsa

Mosiyana kwambiri ndi Texas, pali mlingo wina wapamwamba kwambiri wosatsutsika m'dziko (pafupifupi 18% monga 2023), makamaka chifukwa chakuti boma lakana kufutukula Medicaid pansi pa ACA . Mosasamala kanthu za kuyesayesa kwa boma mobwerezabwereza ndi bipartisan yochirikizana ndi atsogoleri ena a kumaloko, kufutukuka kumakhala kosatheka. Texas imadaliranso pa kusinthana kosavuta, mmalo mwa kulenga kwake. Boma lakhala likuyang'anira njira zina: kulimbikitsa madamu apamwamba a anthu okhala ndi mikhalidwe yapasadakhalepo (asanafike AA), kusungika m'malo a zaumoyo, ndi kugwiritsa ntchito ndalama zoperekedwa ndi boma kuwonjezera ntchito ndalama zochepetsedwa m'makonzedwe ake opereŵeruka. Komabe, kusoŵa kwa kuchuluka kwa machipatala akumidzikulu, ndi kusoŵa kwabwino kwa anthu ambiri, kuphatikizapo kuyendetsa ntchito kwa ulamuliro waudindo kwa boma kuyendera ngakhale pa kuthanga kwa ufulu wa boma.

New York: Maforamest ofutukulidwa

New York ikusonyeza njira ina: kugwiritsira ntchito mapeto a boma ndi kuyambitsidwa kwa boma kufutukula kuposa zimene lamulo la boma likufuna. Mwachitsanzo, programu ya Medicaid ya New York iri imodzi ya maluso aakulu koposa m'dzikolo, kuphatikizapo kukwaniritsa mautumiki anthaŵi yaitali ndi kuchirikiza, chisamaliro chaumwini, ndi thanzi. Boma limachita kusintha kwalo (Mzinda wa Thungwe la Zaumoyo) ndipo lakhala mtsogoleri m'kugwiritsira ntchito ACA’S Encyal Health Benence Benement, kuwonjezera zifuno zonga kulera ndi zothandizira kumva. New York imagwiritsiranso ntchito njira za ku Restory Sy Sy Indice Incentive Preciocreation (DRIP) kukonzanso njira zina zothandizira ndi kuwonjezera ntchito za boma popanga zinthu zothandizira anthu.

Florida: Kulera Ana Opatula ndi Awaivers

Florida sanafutukule pulogalamu yake ya ku Medicaid , koma aphatikizapo njira zina za boma zosamalira zaumoyo. Bomalo limalinganiza za Medicare Convetion (kudzera mwa mabungwe oyang'anira) ndipo lapeza opatulira kuti akonzere ntchito yake ya Medicaid kukhala njira yoyendetsera bwino. Florida imayendetsanso njira yothandiza yochepetsera zinthu zaumoyo koma yakhala yochepetsera ndalama. Boma lakhala logwira ntchito zolimba m'zochitika 1115, kufuna chilolezo cha ntchito ndi maprogramu a chithandizo, ngakhale kuti zoyesayesa zambiri zantchito zatsekedwa m'khoti. Njira za Florida zimasonyeza kukhumba mabizinesi oikidwa ndi kuwonjezera ndalama za mwambo, pamene likuyang'anirabe ndalama za bungwe la osamalira ndi osamalira.

Maphunziro a Chovid-19 Pandemic

COVID-19, kuphatikizapo kulembetsa kwa boma ndi dziko lomwe linayesedwapo. Boma linapempha bungwe la Public Health Service Act kuti lipereke chilengezo chakuti maprogramu a Zaumoyo wa Public Health Emergency (PHE) ayambitsa kuchuluka kwa anthu ku Medicare, Médicaid, ndi inshuwalansi ya munthu payekha, kuphatikizapo kulembetsa kopitirizabe mu Medicaid (“kupinga kwa nthaŵi zonse”) ndi kuwonjezera chiŵerengero cha boma cha boma kaamba ka kuyankha kwa Medicaid (maperesenti 6.2 owonjezereka mu FMAP). Mayiko analimbana ndi kutenga zinthu zimenezi pamene akutsatira malamulo awo pa kuyesa, kuteteza, kuteteza, ndi kuletsa makampani, ndi kuyendetsa malonda. Zotsatira zake zinali kuyankha kochititsa kuti boma, pamene boma linawonjezera kusokonezedwa ndi kuyendetsa ntchito ya zamalonda.

Kuvuta kwa Malamulo a Boma M’tsogolo

Malamulo a boma ndi boma osamalira zaumoyo adzapitirizabe kusintha chifukwa cha kusintha kwa ndale, mavuto azachuma, ndi mavuto ena a zaumoyo.

Kusintha Kothekera m’Kachitidwe ka Federal

Chiyambukiro cha masankho a dziko chimakhudza kwambiri zosankha za boma. Kuyang'anira zamtsogolo kukafuna kukwaniritsa zinthu zonse kupyolera mwa njira ya onse kapena ngakhale Medicare ya onse, yomwe idzapanikiza kwambiri ufulu wa boma. Komanso, maulamuliro osinthasintha kwambiri angapereke maulamuliro kusinthika kwambiri mwa kupatsa ndalama zothandizira Medicaid kapena ziwiya zimene zimalola maboma kukhazikitsa zofunika za ntchito, kugwiritsa ntchito ndalama zoyendetsera ntchito, kapena kupanga maadireshoni ena a inshuwalansi. Kukambirana kopitirizabe pa ngongole za boma ndi kupereŵetsa ndalama kungachepetse ndalama za boma za Medicaid kapena kuchepetsa ndalama zoyendetsera ndalama, kukakamiza maboma kutengera ndalama zowonongedwa kapena kuchepetsa ndalama.

Mavuto a Zaumoyo

Vuto lotsatira la thanzi la anthu (kaya matenda opatsirana, mliri wopatsirana, ziyambukiro za nyengo, kapena kuwonjezereka kwa thanzi lamaganizo) lidzayesanso kugwira bwino ntchito kwa boma. Maphunziro a CVOVID-19 angatsogolere kupempha dongosolo la zaumoyo la anthu lapakati, kuphatikizapo miyezo ya boma ya kusonkhanitsa ndi kuyang'anira, kapena kaamba ka kulimba kwa boma ndi chichirikizo cha boma. Mtolo wa matenda aakulu ndi Midid, idzasonkhezera kukambitsirana kowonjezereka kwa zisonkhetso zaumoyo pa maprogramu a programu, monga kuphatikiza Medicare ndi Médicaid kaamba ka kuyang'anirana kwa zigawo ziŵiri za ndalama ndi zoyendera kuchirikiza bungwe la Unitedernal Health Careal Health Center Office (FSSA).

Boma Linasintha Zinthu

Mayiko adzapitiriza kuyesa njira zatsopano: Kuyesayesa kwa California kupanga dongosolo la wopereka ndalama mmodzi pamlingo wa boma (SB 770 kaamba ka dongosolo la zaumoyo logwirizana) kuli ndi zopinga zazikulu, koma maboma ena angalondole njira zapoyera kapena zoperekera. Malamulo amtengo wapatali, monga ngati mabungwe osamalira ndi ndalama zoikizira, zikupititsidwa kale ndi onse a boma ndi opanga malamulo a boma. Maboma angapikisane ndi opinga kuti ayese mapimelo atsopano, monga ngati Oregon’s Medicaid apange chisonyezero cha kulinganiza nyumba ndi chakudya ndi thanzi, kapena kufutukuka kwa Massachusetts kuti aphatikize osamukirako alendo. Kufufuzaku kudzakhala umboni umene boma lingadziŵitse lamulo la dziko lonse.

Kuzenga Malamulo ndi Malamulo

Kutsutsa pa ACA kupitirizabe; mwachitsanzo, kutsutsana ndi lamulo lalamulo la munthu mmodzi ndi mmodzi mu California v. Texas (2021] anachotsedwa pa maziko oimirira, koma milandu ina yolimbana ndi mautumiki otetezera, lamulo la kuletsa, ndi malamulo a inshuwalansi akugwira ntchito m’makhoti aang'ono. Mofananamo, malamulo a boma, makamaka pambuyo pa Dobs v. Jackson’s Health Organization ya Akazi [202]), yawonjezera mikangano ya boma pa za ndalama za kubereka (momestry) ndi mbali ya boma kutetezera kudziko lonse.

Kumaliza

Chiyambukiro cha malamulo a boma pa malamulo a zaumoyo nchakuya, nchochuluka, ndipo chimasintha nthaŵi zonse. Kuyambira kukwera kwa makampani ndi kusintha kwa inshuwalansi ndi kuwongolera njira za zaumoyo ndi njira za anthu, kuyenderana pakati pa ulamuliro ndi boma kumayambitsa mipata ndi maupandu a kusalunjika. Kumvetsetsa ubale umenewu nkofunika kwa aphunzitsi, ophunzira, opanga malamulo, ndi nzika zimene zimafuna kuyendetsa njira za za zaumoyo wa America. Pamene dziko likupitirizabe kusintha / kudalirana ndi ndale, zamakono, ndi mavuto osayembekezereka pakati pa boma ndi oseŵera a boma, kudzakhalabe patsogolo kutsimikizira kuti kusamala thanzi n’ko, kotheka, ndiponso kosakwanira. Vuto lalikululo likulephera kusankha kuyang'anira pakati pa kuyang'anira kapena kuyang'anira dongosolo la boma, koma kukonza njira iliyonse yoyendera mphamvu za boma.