Delivering public health insurance through private plan choice in the United States

摘要

The United States has been experiencing a radical transformation in the delivery of public health insurance that has largely flown under the radar. Policy discussions often treat public health insurance programs as a sort of government monopsony, whereas in fact the majority of enrollees in public insurance programs financed by the federal government are in private insurance plans funded by the government. The pace of this shift from public to private provision has been notable in recent years. In particular, the delivery of expanded health insurance through the use of state private insurance exchanges through the Patient Protection and Affordable Care Act of 2010 has added to the roles of publicly financed, privately provided insurance.