ACA

Question 1

What did the ACA end up doing?

Answer 1

Made significant reforms to the health insurance industry and health care system

Question 2

How long is the ACA?

Answer 2

2400 pages long

Question 3

What agencies were affected by the ACA?

Answer 3

1) Center for consumer Information and Insurance Oversight
2) Centers for Medicare and Medicaid
3) Health and Services Resources Administration
4) Centers for Disease Control and Prevention

Question 4

Quality, Affordable Health Care for All Americans

Answer 4

1) Insurance industry reforms
2) Employer and individual mandates
3) Insurance subsidies for low income persons through Exchanges

Question 5

Role of Public Programs

Answer 5

1) Medicaid
2) Indian Health Service
3) Community Health Centers

Question 6

Improving Quality and Efficiency of Health Care

Answer 6

1) Moves health care financing away from fee for service to value based payments based on quality and efficiency

Question 7

Prevention of Chronic Disease and Improving Health

Answer 7

National prevention plan, community grants

Question 8

Health Care Workforce

Answer 8

Increasing primary care providers and emergency prepardness

Question 9

Transparency and Program Integrity

Answer 9

Fraud and abuse

Question 10

Improving Access to Innovative Therapy

Answer 10

Focus is on access to generic drugs for seniors

Question 11

Community Living Assistance and Supports

Answer 11

Major provision for subsidizing long term care insurance program which has been quashed

Question 12

Revenue Provisions

Answer 12

How to pay for everything

Question 13

Strengthening Quality Affordable Health Care for All Americans

Answer 13

bucket list of other provisions

Question 14

What did the ACA do to the workforce?

Answer 14

1) Increased funding for primary care residencies and for primary care practitioners
2) Address nursing shortage by increasing capacity for education programs, supporting training programs
3) Funding for training that employs primary care medical home and disease
4) Funding for dental professions

Question 15

What did the ACA do for Community Health Centers?

Answer 15

1) $11 billion additional funding over 5 years

2) School based health centers, nurse clinics

Question 16

Most of the features of the ACA are designed to:

Answer 16

End insurance company efforts to avoid adverse selection

Question 17

What are some effects of the Health Insurance Industry Reforms

Answer 17

1) Guaranteed issue: Cannot exclude people with pre-existing conditions
2) No rescission- cannot kick sick people off of their plans
3) No annual or lifetime caps
4) Can cover dependents up to 26 years old
5) Effective clinical preventive services must be offered at no charge to patients

Question 18

Essential Health Benefits Package

Answer 18

1) Minimum required set of services to be covered
2) Includes: Outpatient care, hospitalization, emergency services, maternity and newborn care, pediatric care; mental health and addiction treatment, prescription drugs; rehab services and devices; laboratory services; clinical preventive services

Question 19

What is the limit on Annual Out of Pocket Spending?

Answer 19

1) Individual: $6600

2) Family $13200

Question 20

What does the ACA allow the federal government to do?

Answer 20

Regulate insurance company rate increases and unfair practices

Question 21

Health insurance companies must spend what percentage of premiums on health care?

Answer 21

80-85%

Question 22

What do employer health insurance regulations require?

Answer 22

Penalizes companies with over 50 workers that don’t provide insurance (2000 per worker). Don’t have to pay for first 30 workers

Question 23

How does the employer health insurance help small employers?

Answer 23

Provides tax credits for small employers (<25 worker, average wage

Question 24

What is the concern with the employer health insurance:

Answer 24

small employers reduce hours

Question 25

Cadillac Tax starts in:

Answer 25

2020

Question 26

What will the Cadillac tax do?

Answer 26

excise tax of 40% be levied on a high cost health plans over 10200 per individual and 27500 for a family

Question 27

What is the goal of the tax?

Answer 27

To 1) Dis-incentivize firms from offering expensive health plans 2) Allow firms to pass savings on to employees in higher wages

Question 28

What percentage of employers will the tax effect?

Answer 28

60%

Question 29

In general, what is the ACA aiming to do?

Answer 29

1) Individual mandate- you must buy health 2) Government assistance in affording health insurance through expanded public programs and also a new marketplace for purchasing publicly subsidized private insurance

Question 30

When did ideas for the ACA first start?

Answer 30

Mitt Romney introduced reform that implemented health insurance mandate with employer mandate, etc

Question 31

In 2014, what was the penalty?

Answer 31

$95 or 1% of income

Question 32

In 2015, was the penalty?

Answer 32

$325 or 2% of income

Question 33

In 2016 what was the penalty?

Answer 33

2.5% or $695

Question 34

What were the exceptions for the penalty of not purchasing insurance?

Answer 34

Financial hardship, those who don't pay social security, Indian tribes, unauthorized immigrants, uninsured for a period of less than 3 months

Question 35

Who will medicaid cover?

Answer 35

1) Everyone under 133% of the FPL, including childless adults 2) Cover 100% of costs for newly eligible and then 95% and 90% of costs until after 2020 3) Reauthorized CHIP

Question 36

In King vs Sebelius, what did the Supreme Court rule?

Answer 36

That the federal government couldn't penalize states that failed to expand Medicaid

Question 37

What are key achievements to note about the ACA?

Answer 37

1) Uninsured population dropped by 43%(16% in 2010 to 9.1% in 2015) 2) Improvements in access to care 3) Improvements in affordability of care 4) Slowed growth in health care costs 5) Improvements in quality of care