ACA Exam with all Correct & 100% Verified Answers |
Latest Version |Already Graded A+
What is it actually called and when was it passed? ✔Correct Answer-• Patient Protection and
Affordable Care Act, signed March 23, 2010
What is the main government website about the ACA and HC? ✔Correct Answer-healthcare.gov
What were some of the factors that lead to its passage and what threatened its passage? ✔Correct
Answer-The large amount of uninsured, the rising cost of HC
Threatened by political opposition, stigma of socialized healthcare
What main problem was it trying to solve? ✔Correct Answer-• Uninsurance - how to get access to
affordable insurance for the uninsured
Which of uninsured did it target? ✔Correct Answer-• The sick, low-wage/under-employed/part-
time workers, small business owners and employees, self-employed, young adults, retirees <65
What is the individual mandate and how do you get exempt? ✔Correct Answer-• US citizens and
legal aliens required to have insurance
• Exemptions: financial hardship, religious, those for whom the lowest cost option exceeds 8% of an
individual's income, undocumented
How is the mandate enforced and what is the penalty for not having insurance? ✔Correct Answer-
• Those without coverage pay tax penalty of $695-$2,085 up to 2.5% of taxable income
How does the ACA expand access to insurance for the uninsured? ✔Correct Answer-• People can
be entitled to insurance subsidies - can be eligible for Medicaid, can get premium tax credits to shop
with, and some people get cost sharing subsidies
• Limits out-of-pocket costs for everyone up to 400% of FPL to $5,950
How does the Medicaid expansion work? Who qualifies? ✔Correct Answer-• Individuals up to
133% of FPL (only if state accepts expansion)
What's an Exchange? How do they work? ✔Correct Answer-• An exchange is a health insurance
marketplace set up to facilitate the purchase of health insurance
• The insurance companies that are allowed to participate are predetermined and regulated -
promotes transparency and accountability, facilitates enrollment and delivery of subsidies
What are the two mechanisms the ACA supports to help people afford insurance purchased through
the Exchanges? How do people qualify for these? ✔Correct Answer-• People between 144% and
400% of FPL get premium tax credits to shop with
• Individuals up to 250% of FPL get cost-sharing subsidies
• Qualified through income eligibility
Roughly what is the limit on out of pocket costs for those qualifying for premiums in the exchange?
✔Correct Answer-• $5,950 for everyone up to 400% of FPL
, What is King v. Burwell about? What impact will the ruling have? ✔Correct Answer-• King v.
Burwell challenges the subsidies in the federal exchange since the language of the ACA only spoke to
premium subsidies in state exchanges
• Could also undermine insurance mandates in federal-exchange states
• 13.4 million people could lose subsidies and by a product, insurance
How does the ACA encourage employers to offer affordable insurance to their employees?
✔Correct Answer-• Employers have to pay a penalty if they don't offer it or it is not affordable
What is the obligation of employers with fewer than 50 employees to provide insurance (and for
those with 100 or more this year, 50 or more next year)? ✔Correct Answer-• >50 employees: no
mandate
• +50 employees: offer coverage to 70% (95% in 2016) of full-time employees and dependent
children
• for 50+, need to provide affordable insurance or pay penalty
How does the ACA help small employers? ✔Correct Answer-• Employers with 25 or fewer
employees get up to 35% subsidies if they pay 50% of total premium
What are the employer rules around part-time or seasonal employees and insurance? ✔Correct
Answer-• No obligation to provide insurance
How does the employer mandate work? Enforcement? Penalties? What triggers a penalty?
✔Correct Answer-• Penalties are triggered if they have at least one full-time employee using
premium tax credits to buy insurance through an exchange
What is a grandfathered plan? ✔Correct Answer-• Employer and individual plans in existence at
time of ACA
What's the ACA's rule on young people? ✔Correct Answer-• Can stay on parents' insurance plan
until age 26
How does the ACA restrict how insurance companies choose who they cover? ✔Correct Answer-•
Ban on denying insurance to children with pre-existing conditions
• Ban on rescission and lifetime caps
How does the ACA restrict what insurance companies cover? ✔Correct Answer-• Must cover 10
essential benefits
• Provide minimum actuarial value and maximum out-of-pocket costs
What information about insurance applicants can insurance companies use in setting premium
prices? ✔Correct Answer-• Geography, family size, age, tobacco use
• CANNOT set prices based on gender or health status
How does the ACA restrict how much insurance companies take for profit and administration?
✔Correct Answer-• Set MLR at 80/20, meaning that 80% must be used for insurance, 20% can be
used elsewhere
What is "rescission" and what does the ACA say about it? ✔Correct Answer-• Rescission is kicking
people off/dropping the sick from an insurance plan. The ACA bans it.
Latest Version |Already Graded A+
What is it actually called and when was it passed? ✔Correct Answer-• Patient Protection and
Affordable Care Act, signed March 23, 2010
What is the main government website about the ACA and HC? ✔Correct Answer-healthcare.gov
What were some of the factors that lead to its passage and what threatened its passage? ✔Correct
Answer-The large amount of uninsured, the rising cost of HC
Threatened by political opposition, stigma of socialized healthcare
What main problem was it trying to solve? ✔Correct Answer-• Uninsurance - how to get access to
affordable insurance for the uninsured
Which of uninsured did it target? ✔Correct Answer-• The sick, low-wage/under-employed/part-
time workers, small business owners and employees, self-employed, young adults, retirees <65
What is the individual mandate and how do you get exempt? ✔Correct Answer-• US citizens and
legal aliens required to have insurance
• Exemptions: financial hardship, religious, those for whom the lowest cost option exceeds 8% of an
individual's income, undocumented
How is the mandate enforced and what is the penalty for not having insurance? ✔Correct Answer-
• Those without coverage pay tax penalty of $695-$2,085 up to 2.5% of taxable income
How does the ACA expand access to insurance for the uninsured? ✔Correct Answer-• People can
be entitled to insurance subsidies - can be eligible for Medicaid, can get premium tax credits to shop
with, and some people get cost sharing subsidies
• Limits out-of-pocket costs for everyone up to 400% of FPL to $5,950
How does the Medicaid expansion work? Who qualifies? ✔Correct Answer-• Individuals up to
133% of FPL (only if state accepts expansion)
What's an Exchange? How do they work? ✔Correct Answer-• An exchange is a health insurance
marketplace set up to facilitate the purchase of health insurance
• The insurance companies that are allowed to participate are predetermined and regulated -
promotes transparency and accountability, facilitates enrollment and delivery of subsidies
What are the two mechanisms the ACA supports to help people afford insurance purchased through
the Exchanges? How do people qualify for these? ✔Correct Answer-• People between 144% and
400% of FPL get premium tax credits to shop with
• Individuals up to 250% of FPL get cost-sharing subsidies
• Qualified through income eligibility
Roughly what is the limit on out of pocket costs for those qualifying for premiums in the exchange?
✔Correct Answer-• $5,950 for everyone up to 400% of FPL
, What is King v. Burwell about? What impact will the ruling have? ✔Correct Answer-• King v.
Burwell challenges the subsidies in the federal exchange since the language of the ACA only spoke to
premium subsidies in state exchanges
• Could also undermine insurance mandates in federal-exchange states
• 13.4 million people could lose subsidies and by a product, insurance
How does the ACA encourage employers to offer affordable insurance to their employees?
✔Correct Answer-• Employers have to pay a penalty if they don't offer it or it is not affordable
What is the obligation of employers with fewer than 50 employees to provide insurance (and for
those with 100 or more this year, 50 or more next year)? ✔Correct Answer-• >50 employees: no
mandate
• +50 employees: offer coverage to 70% (95% in 2016) of full-time employees and dependent
children
• for 50+, need to provide affordable insurance or pay penalty
How does the ACA help small employers? ✔Correct Answer-• Employers with 25 or fewer
employees get up to 35% subsidies if they pay 50% of total premium
What are the employer rules around part-time or seasonal employees and insurance? ✔Correct
Answer-• No obligation to provide insurance
How does the employer mandate work? Enforcement? Penalties? What triggers a penalty?
✔Correct Answer-• Penalties are triggered if they have at least one full-time employee using
premium tax credits to buy insurance through an exchange
What is a grandfathered plan? ✔Correct Answer-• Employer and individual plans in existence at
time of ACA
What's the ACA's rule on young people? ✔Correct Answer-• Can stay on parents' insurance plan
until age 26
How does the ACA restrict how insurance companies choose who they cover? ✔Correct Answer-•
Ban on denying insurance to children with pre-existing conditions
• Ban on rescission and lifetime caps
How does the ACA restrict what insurance companies cover? ✔Correct Answer-• Must cover 10
essential benefits
• Provide minimum actuarial value and maximum out-of-pocket costs
What information about insurance applicants can insurance companies use in setting premium
prices? ✔Correct Answer-• Geography, family size, age, tobacco use
• CANNOT set prices based on gender or health status
How does the ACA restrict how much insurance companies take for profit and administration?
✔Correct Answer-• Set MLR at 80/20, meaning that 80% must be used for insurance, 20% can be
used elsewhere
What is "rescission" and what does the ACA say about it? ✔Correct Answer-• Rescission is kicking
people off/dropping the sick from an insurance plan. The ACA bans it.
