J Health Polit Policy Law. 2013 Jun;38(3):599-610. doi: 10.1215/03616878-2079532.
A primary goal of the Patient Protection and Affordable Care Act (PPACA) is to reduce the number of uninsured by making health insurance more affordable for small businesses and individuals. Toward that end, the PPACA encourages the creation of nonprofit, member-owned health insurance cooperatives to operate inside each state exchange. Co-ops face significant challenges in entering mature insurance markets, but they also possess unique characteristics that may help them survive and thrive. Using Common Ground Healthcare Cooperative in Wisconsin as a case study, this article traces the origins of co-ops in health care reform at national and state levels and analyzes the political and technical challenges and opportunities facing these organizations.
《平价医疗法案》（PPACA）的主要目标之一是通过使小企业和个人更能负担得起医疗保险来减少无保险人数。为此，PPACA 鼓励在每个州的交易所内创建非营利性、会员所有的医疗保险合作社。合作社在进入成熟的保险市场时面临重大挑战，但它们也具有独特的特点，可能有助于它们生存和发展。本文以威斯康星州的 Common Ground Healthcare Cooperative 为例，追溯了合作社在国家和州一级医疗改革中的起源，并分析了这些组织面临的政治和技术挑战与机遇。
