The postelection efforts to repeal, replace, or modify the Affordable Care Act (ACA) suggest that the debate over healthcare coverage will remain contentious, particularly because of the high and rising cost of health care. Feasible, potentially bipartisan approaches to improving access to coverage should emphasize reforming health care to achieve higher quality at a lower cost. In the individual market, where many enrollees face limited options and rising premiums, a combination of high-risk pools, reinsurance, and risk adjustment could improve coverage options while encouraging innovations in care for the highest-risk patients. State Medicaid programs, which are increasingly important sources of coverage but are crowding out other important budget priorities that affect population health, could achieve better results through federal reforms that provide more flexibility for states alongside greater emphasis on achieving better outcomes. Accelerating payment reforms and other policy changes to encourage more innovative and efficient care delivery models, along with developing better evidence on successful models, can also improve the prospects for coverage reform.

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《平价医疗法案》：下一步是什么？

选举后废除，取代或修改《负担得起的医疗法案》（ACA）的努力表明，关于医疗保险的争论将继续引起争议，特别是由于医疗保健成本高昂且不断上升。可行的，可能两党合作的改善覆盖范围的方法应强调改革医疗保健，以较低的成本获得更高的质量。在个别市场中，许多入学者面临的选择权有限且保费上涨，高风险池，再保险和风险调整的组合可以改善承保范围，同时鼓励对高风险患者的护理创新。州医疗补助计划，这些计划越来越重要，但是却排挤了影响人口健康的其他重要预算优先事项，可以通过联邦改革取得更好的结果，该改革为各州提供了更大的灵活性，同时更加强调了取得更好的结果。加快支付改革和其他政策变化，以鼓励采用更具创新性和效率的医疗服务模式，并为成功的模式提供更好的证据，这也可以改善保险改革的前景。