کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
6239566 1279002 2014 7 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Balancing adequacy and affordability?: Essential Health Benefits under the Affordable Care Act
ترجمه فارسی عنوان
تعادل مناسب و مقرون به صرفه بودن: مزایای بهداشت ضروری تحت قانون مراقبت مقرون به صرفه
کلمات کلیدی
قانون مراقبت مقرون به صرفه، اصلاحات بهداشتی، مزایای بهداشت ضروری، بسته های بیمه،
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی سیاست های بهداشت و سلامت عمومی
چکیده انگلیسی

The Essential Health Benefits provisions under the Affordable Care Act require that eligible plans provide coverage for certain broadly defined service categories, limit consumer cost-sharing, and meet certain actuarial value requirements. Although the Department of Health and Human Services (HHS) was tasked with the regulatory development of these EHB under the ACA, the department quickly devolved this task to the states. Not surprisingly, states fully exploited the leeway provided by HHS, and state decision processes and outcomes differed widely. However, none of the states took advantage of the opportunity to restructure fundamentally their health insurance markets, and only a very limited number of states actually included sophisticated policy expertise in their decisionmaking processes. As a result, and despite a major expansion of coverage, the status quo ex ante in state insurance markets was largely perpetuated. Decisionmaking for the 2016 revisions should be transparent, included a wide variety of stakeholders and policy experts, and focus on balancing adequacy and affordability. However, the 2016 revisions provide an opportunity to address these previous shortcomings.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Health Policy - Volume 118, Issue 3, December 2014, Pages 285-291
نویسندگان
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