美国健康保险交易机构改革评估

Evaluation on Health Insurance Marketplace Reform in United States

目的：对美国医疗保险交易机构改革进行评估。方法：利用2014和2015年医疗保险改革公开数据,构建评价指标体系,进行量化评估。结果：目前4种医疗保险交易所中,27个州是联邦推动建立的交易所,参保登记人数、获得保费援助人数及申请比例有所增加,基本2/3的投保者选择银级医疗保险计划,半数以上投保登记人年龄集中在18-34岁和55-64岁。结论：到2015年6月,患者保护与平价医疗法案（PPACA）已经明显改变了美国医疗保险状况,但其最主要的功能,如医疗保险交易所尚未完全实现。

Objective：To evaluate the health insurance marketplace reform in USA.Method：The evaluation index system was constructed and the quantitative evaluation was carried out according the public data of the medical insurance reform in 2014 and 2015.Result：Twenty-seven states were the federal exchange of the four medical insurance exchanges,the number of insured persons,insurance premiums and the proportion of applicants had increased,two-thirds of the insured＇s choice of silver grade medical insurance plan basically,more than half of the insured registered persons aged from 18 to 34 years old and from 55 to 64 years old.Conclusion：By June 2015,the Patient Protection and Affordable Care Act has substantially changed health coverage in USA but health insurance exchanges remain works in progress.