Commonwealth Health Insurance Connector Authority, Boston, Massachusetts, USA.
Health Aff (Millwood). 2010 Jun;29(6):1158-63. doi: 10.1377/hlthaff.2010.0390.
The Patient Protection and Affordable Care Act depends on new, state-based exchanges to make health insurance readily available to certain segments of the population. One such segment is the lower-income uninsured, who can qualify for subsidized coverage only through an exchange. Other segments are unsubsidized individuals and small employers, who may choose to buy coverage inside or outside of an exchange. Although the law provides some guidance in structuring these new exchanges, it leaves many key decisions to the states. Successfully implementing exchanges will require public-private partnerships, expertise in insurance operations and marketing, and a series of strategic decisions. We review the half-dozen most important design issues.
《患者保护与平价医疗法案》依赖新的州级医保交易所，以便向特定人群提供医疗保险。其中一个人群是收入较低的无保险者，他们只有通过交易所才能获得补贴性保险。另一个人群是无补贴的个人和小雇主，他们可以选择在交易所内或外购买保险。尽管该法律在构建这些新的交易所方面提供了一些指导，但许多关键决策仍留给各州。成功实施交易所将需要公私合作伙伴关系、保险运营和营销方面的专业知识，以及一系列战略决策。我们回顾了其中六个最重要的设计问题。
