Giôø choùt Obama nhöôïng boä
caùc noã löïc phoø söï soáng
Giôø choùt: Obama nhöôïng boä caùc noã löïc phoø söï soáng.
Hoa Kyø (VietCatholic News 21/03/2010) - Trong nhöõng giôø cuoái cuûa cuoäc tranh luaän quoác gia veà Caûi Toå Y Teá, vì thieáu tuùc soá ñeå thoâng qua döï luaät Caûi Toå Y Teá, Obama ñaõ phaûi nhöôïng boä nhoùm daân bieåu phoø söï soáng caàm ñaàu bôûi Daân Bieåu Stupak baèng caùch ñoàng yù seõ kyù moät saéc leänh ngaên caám duøng tieàn Lieân Bang cho chi phí phaù thai vaø duy trì nhöõng ñieàu khoûan baûo veä quyeàn löông taâm. Vôùi söï nhöôïng boä naøy, ít ra laø 2 quan ngaïi saâu saéc cuûa caùc Giaùm Muïc Coâng Giaùo Hoa Kyø ñaõ ñöôïc giaûi quyeát.
Noäi dung cuûa saéc leänh seõ ñöôïc kyù vaøo ngaøy thöù Hai 22/03/2010 nhö sau:
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Do quyeàn löïc ñöôïc trao phoù cho toâi laø Toång Thoáng, phaùt xuaát töø Hieán phaùp vaø phaùp luaät cuûa Hoa Kyø, bao goàm ñaïo luaät "Baûo veä Beänh nhaân vaø Cung caáp dòch vuï Y teá vôùi giaù phaûi chaêng" (pheâ duyeät ngaøy. . . thaùng. . . , 2010), toâi ra leänh nhö sau:
Phaàn 1. Chính saùch.
Sau khi ñaïo luaät "Baûo veä Beänh nhaân vaø Cung caáp dòch vuï Y teá vôùi giaù phaûi chaêng" ("Ñaïo luaät") vöøa ñöôïc thoâng qua, laø caàn thieát ñeå thaønh laäp moät cô cheá thi haønh ñeå ñaûm baûo raèng quyõ lieân bang khoâng ñöôïc söû duïng cho caùc dòch vuï phaù thai (ngoaïi tröø trong tröôøng hôïp bò haõm hieáp hay loaïn luaân, hoaëc khi cuoäc soáng cuûa ngöôøi phuï nöõ bò laâm nguy), phuø hôïp vôùi nhöõng giôùi haïn theo luaät lieân bang ñaõ coù töø laâu ñôøi thöôøng ñöôïc goïi laø Tu chính aùn Hyde. Muïc ñích cuûa saéc leänh naøy laø thaønh laäp moät caùch toaøn dieän, cho toøan quoác nhöõng chính saùch vaø thuû tuïc ñeå ñaït ñöôïc muïc tieâu naøy vaø ñeå chaéc chaén raèng taát caû caùc quan chöùc Lieân bang, vieân chöùc Tieåu Bang (keå caû nhöõng nhaân vieân kieåm soùat baûo hieåm) vaø caùc cô quan cung caáp chaêm soùc y teá, nhaän thöùc ñöôïc traùch nhieäm cuûa mình, môùi cuõng nhö cuõ.
Ñaïo luaät duy trì nhöõng haïn cheá phaù thai hieän taïi cuûa Tu Chaùnh AÙn Hyde vaø môû roäng caùc haïn cheá naøy tôùi thò tröôøng baûo hieåm y teá môùi ñöôïc thaønh laäp. Theo luaät, nhöõng luaät lieân bang coù töø laâu ñôøi baûo veä quyeàn löông taâm (nhö Tu chính aùn Church, 42 USC § 300A-7, vaø Tu chính aùn Weldon, Pub L. Soá 111-8, § 508 (d) (1) (2009) ) vaãn ñöôïc duy trì vaø nhöõng baûo veä môùi naøy caám phaân bieät ñoái xöû ñoái vôùi caùc cô sôû chaêm soùc y teá vaø caùc nhaø cung caáp chaêm soùc y teá khoâng muoán cung caáp, traû tieàn, baûo hieåm, hoaëc cho tham khaûo veà phaù thai.
Nhieàu cô quan haønh phaùp seõ ñoùng moät vai troø trong vieäc ñaûm baûo raèng nhöõng haïn cheá naøy ñöôïc thi haønh, trong ñoù coù Boä Y Teá vaø Nhaân Söï (HHS), Vaên phoøng Quaûn lyù vaø Ngaân saùch (OMB), vaø Vaên phoøng Quaûn lyù nhaân söï (OPM).
Phaàn 2. Tuaân thuû nghieâm ngaët caùc ñieàu caám taøi trôï phaù phai trong thò tröôøng baûo hieåm y teá. Ñaïo luaät ñaëc bieät nghieâm caám vieäc söû duïng caùc khoaûn tín duïng thueá (mieãn thueá) vaø giaûm thueá ñeå chia seû caùc khoaûn thanh toaùn cho caùc dòch vuï phaù thai (ngoaïi tröø trong tröôøng hôïp bò haõm hieáp hay loaïn luaân, hoaëc khi cuoäc soáng cuûa ngöôøi phuï nöõ bò laâm nguy) trong thò tröôøng baûo hieåm y teá seõ ñöôïc hoaït ñoäng vaøo naêm 2014. Ñaïo luaät naøy cuõng aùp ñaët thanh toaùn nghieâm ngaët vaø caùc yeâu caàu keá toaùn ñeå ñaûm baûo raèng quyõ lieân bang khoâng ñöôïc söû duïng cho caùc dòch vuï phaù thai trong caùc keá hoaïch treân thò tröôøng (ngoaïi tröø trong tröôøng hôïp bò haõm hieáp hay loaïn luaân, hoaëc khi cuoäc soáng cuûa ngöôøi phuï nöõ bò laâm nguy) vaø yeâu caàu caùc uûy vieân baûo hieåm y teá caáp Tieåu Bang (state health insurance commissioners) baûo ñaûm raèng caùc coâng ty baûo hieåm taùch bieät caùc khoûan chi phí theo nguyeân taéc keá toaùn chung, theo caùc thoâng tö cuûa OMB, vaø theo nhöõng höôùng daãn töø Vaên phoøng Keá Toùan cuûa Chính phuû.
Toâi ra leänh Giaùm ñoác OMB vaø Toãng thö kyù HHS ñeå thaønh laäp, trong voøng 180 ngaøy keå töø ngaøy kyù saéc leänh naøy, moät moâ hình taäp hôïp caùc nguyeân taéc taùch bieät cho caùc uûy vieân baûo hieåm y teá cuûa Tieåu Bang ñeå söû duïng khi xaùc ñònh caùc keá hoaïch baûo hieåm coù tuaân thuû theo yeâu caàu cuûa Ñaïo luaät, theo nhö Muïc 1303 cuûa Ñaïo Luaät, aùp duïng cho nhöõng ngöôøi ghi danh nhaän söï hoã trôï taøi chính lieân bang. Caùc höôùng daãn cuõng cung caáp thoâng tin kyõ thuaät maø caùc tieåu bang phaûi tuaân theo ñeå tieán haønh kieåm toaùn ñoäc laäp, thöôøng xuyeân tôùi caùc coâng ty baûo hieåm tham gia thò tröôøng baûo hieåm y teá. Trong moâ hình phaùt trieån caùc nguyeân taéc naøy, Giaùm ñoác OMB vaø Toång thö kyù HHS phaûi tham khaûo yù kieán vôùi caùc cô quan haønh phaùp vaø caùc vaên phoøng coù chuyeân moân lieân quan trong nguyeân taéc keá toaùn, bao goàm, nhöng khoâng giôùi haïn, Boä Ngaân khoá, vaø Accountability Office. Sau khi hoaøn thaønh nhöõng nguyeân taéc cuûa moâ hình, Toång thö kyù HHS neân khôûi ñaàu kòp thôøi moät qui taéc ñeå ban haønh caùc quy ñònh coù hieäu löïc cuûa phaùp luaät, ñeå giaûi thích caùc yeâu caàu phaân bieät cuûa Ñaïo luaät, vaø seõ cung caáp höôùng daãn cho caùc uûy vieân baûo hieåm y teá Tieåu Bang veà caùch thöïc hieän theo caùc moâ hình höôùng daãn.
Phaàn 3. Chöông trình Trung taâm y teá coäng ñoàng.
Ñaïo luaät thieát laäp moät coäng ñoàng Trung taâm y teá môùi (CHC) do HHS taøi trôï, ñeå cung caáp theâm quyõ lieân bang cho chöông trình trung taâm y teá coäng ñoàng. Phaùp luaät Hieän haønh ngaên caám caùc trung taâm söû duïng quyõ lieân bang ñeå cung caáp dòch vuï phaù thai (ngoaïi tröø trong tröôøng hôïp bò haõm hieáp hay loaïn luaân, hoaëc khi cuoäc soáng cuûa ngöôøi phuï nöõ bò laâm nguy), ñoù laø keát quaû cuûa caû hai Tu chính aùn Hyde vaø caùc quy ñònh laâu ñôøi coù chöùa ñöïng ngoân ngöõ Hyde. Theo luaät, ngoân ngöõ Hyde aùp duïng ñoái vôùi caùc khoûan boài hoøan vaø döï chi cho Trung taâm y teá coäng ñoàng theo qui ñònh soá 10503 vaø taát caû caùc quy ñònh lieân quan khaùc. Toâi ra leänh Boä tröôûng HHS phaûi ñaûm baûo raèng caùc quaûn trò vieân chöông trình vaø ngöôøi nhaän cuûa caùc quyõ lieân bang ñöôïc bieát vaø tuaân thuû caùc haïn cheá veà caùc dòch vuï phaù thai aùp ñaët treân CHCs cuûa phaùp luaät hieän haønh. Nhöõng haønh ñoäng nhö vaäy bao goàm, nhöng khoâng giôùi haïn, caäp nhaät caùc taøi trôï Grant lieân quan ñeán quó cuûa CHC vaø ban haønh nhöõng quy ñònh môùi.
Muïc 4. Nhöõng quy ñònh chung.
(a) Saéc leänh naøy seõ khoâng aûnh höôûng ñeán: (i) thaåm quyeàn phaùp ñònh hoaëc ban bôûi toång thoáng cho moät cô quan, hoaëc ngöôøi ñöùng ñaàu cô quan ñoù; hoaëc (ii) chöùc naêng cuûa Giaùm ñoác Vaên phoøng Quaûn lyù vaøNgaân saùch lieân quan ñeán caùc ñeà xuaát ngaân saùch, haønh chính, hoaëc laäp phaùp.
(b) Saéc leänh naøy ñöôïc thöïc hieän phuø hôïp vôùi luaät phaùp hieän haønh vaø tuøy thuoäc vaøo söï saün coù cuûa ngaân khoûan döï chi.
(c) Saéc leänh naøy khoâng coù yù ñònh, vaø khoâng taïo ra baát kyø quyeàn hoaëc lôïi, thöïc chaát hay thuû tuïc, coù theå thöïc hieän ngöôïc vôùi quyeàn lôïi cuûa Hoa Kyø, cuûa caùc ngaønh, caùc cô quan, caùc thöïc theå, caùn boä, nhaân vieân hoaëc ñaïi dieän, hoaëc baát kyø ngöôøi naøo khaùc cuûa HK.
Executive Order
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By the authority vested in me as President by the Constitution and the laws of the United States of America, including the "Patient Protection and Affordable Care Act" (approved March . . . , 2010), I hereby order as follows:
Section 1. Policy.
Following the recent passage of the Patient Protection and Affordable Care Act ("the Act"), it is necessary to establish an adequate enforcement mechanism to ensure that Federal funds are not used for abortion services (except in cases of rape or incest, or when the life of the woman would be endangered), consistent with a longstanding Federal statutory restriction that is commonly known as the Hyde Amendment. The purpose of this Executive Order is to establish a comprehensive, government-wide set of policies and procedures to achieve this goal and to make certain that all relevant actors-Federal officials, state officials (including insurance regulators) and health care providers-are aware of their responsibilities, new and old.
The Act maintains current Hyde Amendment restrictions governing abortion policy and extends those restrictions to the newly-created health insurance exchanges. Under the Act, longstanding Federal laws to protect conscience (such as the Church Amendment, 42 U.S.C. §300a-7, and the Weldon Amendment, Pub. L. No. 111-8, §508(d)(1) (2009)) remain intact and new protections prohibit discrimination against health care facilities and health care providers because of an unwillingness to provide, pay for, provide coverage of, or refer for abortions.
Numerous executive agencies have a role in ensuring that these restrictions are enforced, including the Department of Health and Human Services (HHS), the Office of Management and Budget (OMB), and the Office of Personnel Management (OPM).
Section 2. Strict Compliance with Prohibitions on Abortion Funding in Health Insurance Exchanges. The Act specifically prohibits the use of tax credits and cost-sharing reduction payments to pay for abortion services (except in cases of rape or incest, or when the life of the woman would be endangered) in the health insurance exchanges that will be operational in 2014. The Act also imposes strict payment and accounting requirements to ensure that Federal funds are not used for abortion services in exchange plans (except in cases of rape or incest, or when the life of the woman would be endangered) and requires state health insurance commissioners to ensure that exchange plan funds are segregated by insurance companies in accordance with generally accepted accounting principles, OMB funds management circulars, and accounting guidance provided by the Government Accountability Office.
I hereby direct the Director of OMB and the Secretary of HHS to develop, within 180 days of the date of this Executive Order, a model set of segregation guidelines for state health insurance commissioners to use when determining whether exchange plans are complying with the Act's segregation requirements, established in Section 1303 of the Act, for enrollees receiving Federal financial assistance. The guidelines shall also offer technical information that states should follow to conduct independent regular audits of insurance companies that participate in the health insurance exchanges. In developing these model guidelines, the Director of OMB and the Secretary of HHS shall consult with executive agencies and offices that have relevant expertise in accounting principles, including, but not limited to, the Department of the Treasury, and with the Government Accountability Office. Upon completion of those model guidelines, the Secretary of HHS should promptly initiate a rulemaking to issue regulations, which will have the force of law, to interpret the Act's segregation requirements, and shall provide guidance to state health insurance commissioners on how to comply with the model guidelines.
Section 3. Community Health Center Program.
The Act establishes a new Community Health Center (CHC) Fund within HHS, which provides additional Federal funds for the community health center program. Existing law prohibits these centers from using federal funds to provide abortion services (except in cases of rape or incest, or when the life of the woman would be endangered), as a result of both the Hyde Amendment and longstanding regulations containing the Hyde language. Under the Act, the Hyde language shall apply to the authorization and appropriations of funds for Community Health Centers under section 10503 and all other relevant provisions. I hereby direct the Secretary of HHS to ensure that program administrators and recipients of Federal funds are aware of and comply with the limitations on abortion services imposed on CHCs by existing law. Such actions should include, but are not limited to, updating Grant Policy Statements that accompany CHC grants and issuing new interpretive rules.
Section 4. General Provisions.
(a) Nothing in this Executive Order shall be construed to impair or otherwise affect: (i) authority granted by law or presidential directive to an agency, or the head thereof; or (ii) functions of the Director of the Office of Management and Budget relating to budgetary, administrative, or legislative proposals.
(b) This Executive Order shall be implemented consistent with applicable law and subject to the availability of appropriations.
(c) This Executive Order is not intended to, and does not, create any right or benefit, substantive or procedural, enforceable at law or in equity against the United States, its departments, agencies, entities, officers, employees or agents, or any other person.
Traàn Maïnh Traùc
(VietCatholic News)