Rosenbaum Sara, Lopez Nancy, Burke Taylor, Dorley Mark
School of Public Health and Health Services, The George Washington University, USA.
Issue Brief (Commonw Fund). 2012 Jul;19:1-18.
Health insurance exchanges are the centerpiece of the private health insurance reforms included in the Patient Protection and Affordable Care Act. As of May 2012, 13 states, together with the District of Columbia, had taken legal action to establish exchanges, through legislation or executive order. State implementing laws are essential to the translation of broad federal policies into specific state and market practices. Overall, the laws in the 14 jurisdictions vary, but they tend to show a common approach of according exchanges much flexibility in how they will operate and what standards they will apply to the insurance products sold. In all states, these "threshold policies" will be followed by policy decisions, expressed through regulations, guidelines, and health plan contracting and performance standards.
医保交易所是《患者保护与平价医疗法案》中私人医疗保险改革的核心内容。截至2012年5月，13个州以及哥伦比亚特区已通过立法或行政命令采取法律行动来建立医保交易所。州实施法律对于将宽泛的联邦政策转化为具体的州和市场实践至关重要。总体而言，这14个司法管辖区的法律各不相同，但它们往往呈现出一种共同的方式，即在医保交易所的运营方式以及它们将适用于所售保险产品的标准方面给予其很大的灵活性。在所有州，这些“门槛政策”之后将是通过法规、指南以及健康计划签约和绩效标准所表达的政策决策。
