ACA and Public Health

Question 1

health care system challenges

Answer 1

• high costs and poor outcomes
• # of Americans ages 65+ will be nearly 100 million by 2060
• growth of government funded programs is not sustained
• larger number of Americans are uninsured
• there is a shortage of primary care physicians
• health and health care disparities

Question 2

Purpose of ACA

Answer 2

ACA was meant to insurance coverage and access to care- designed to expand insurance access

Question 3

Pre-ACA the following groups faced barriers to insurance coverage

Answer 3

• young adults- (people 19 would be off insurance (22 students))
• childless adults (could not get on medicaid no matter what salary is)
• very sick individuals (limits on annual of lifetime coverage)
• people w/ pre-existing condition (denied insurance if they had a health condition prior to the start of a new insurance plan)

Question 4

Who’s plan was the ACA built on?

Answer 4

Mitt Romney insurance expansion plan

Question 5

Most Controversial ACA provisions

Answer 5

1. Quality, Affordable healthcare for all Americans
2. The role of Public Programs

Question 6

The ACA mandate reforms for EMPLOYERS

Answer 6

• dependents can be on their parents health insurance until 26
• penalties for companies with 50+ employees that do not have insurance
• tax credits for companies with <50 employees who provide insurance

Question 7

The ACA mandate for health insurance INDUSTRY- attempts to stop insurance companies adverse selection

Answer 7

• guaranteed issue: cannot exclude people with pre-existing conditions
• No recession: cannot kick sick people off of their pans
• no annual or lifetime caps to care

Question 8

ACA Mandate on individuals with health insurance

Answer 8

• everyone must have health insurance or pay a penalty
• government assistance with new “marketplace” for purchasing publicly sub-sized private insurance a expansion of public programs

Question 9

Market places are for people to purchase insurance

Answer 9

individuals and small employee groups can purchase private insurance exchanges

Question 10

3 Types of Marketplaces/exchanges

Answer 10

state, federal, state/federal poverty level subsides and tax credits available to offset costs

Question 11

Medicaid

Answer 11

pre-ACA: childless adults
post-ACA: Medicaid will cover everyone under 133% of FPL

Question 12

Additional Major Features of ACA

Answer 12

essential health, benefits package limit on annual out-of-pocket spending

Question 13

ACA address public health

Answer 13

insurance plan must cover evidence-based preventive service, creation of prevention of Public Health Fund and created National Prevention, Health Promotion and Public Health Promotion

Question 14

Challenges of ACA

Answer 14

• did not want to call it a mandate- a law in 2012
• but medicaid expansion provision was unconstitutional - allow state choose

Question 15

Where is ACA today?

Answer 15

was successful in reducing # of uninsured Americans (30 mil. insured)

Question 16

the uninsured individuals include:

Answer 16

• low income in medicaid, those unable to afford market place coverage, undocumented immigrants, low income immigrants

Question 17

Trump weakened ACA

Answer 17

eliminated the individual mandate, supported work requirements for medicaid beneficiaries, ended subsidies to insurance participating in exchanges