Comprehensive Guide to U.S. Healthcare Reform:
ACA, Legislation, and Future Policies Exam |
Questions with 100% Correct Answers | Verified |
Latest Update 2026
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Terms in this set (48)
What is the Federal Poverty Level A measure of income level issued annually by the
(FPL)? federal government used to determine eligibility
for certain programs and subsidies.
How do you calculate the income Multiply the base FPL income by the desired
threshold for a specific percentage percentage (e.g., $15,960 x 1.38 = $22,025).
of the FPL?
What is the primary purpose of To extend insurance coverage to low-income
Medicaid expansion under the ACA? adults under 65 with incomes up to 138% of the
FPL.
, How does the federal government By providing an enhanced federal match, covering
incentivize states to expand 90% of the costs compared to the traditional 50-
Medicaid? 77% match.
What are three common political Political branding through viral moments, info
tactics used by members of dumping in hearings, and leveraging public
Congress regarding healthcare? pressure.
What are hospitals required to post Negotiated rates with each insurer, cash prices,
online under price transparency and shoppable services in a consumer-friendly
laws? format.
What are insurers required to Online price comparison tools that show out-of-
provide under price transparency pocket costs for all services before care is
rules established in 2020? received.
What is the out-of-pocket cap for $2,100 per year.
Medicare prescription drugs under
the Inflation Reduction Act?
What is the monthly insulin cap for $35 per month.
Medicare beneficiaries?
What is a Pharmacy Benefit Manager A middleman that sits between drug companies,
(PBM)? insurance plans, and pharmacies.
How did the Consolidated It mandates a flat fee instead of a percentage of
Appropriations Act of 2026 change the drug's price to remove incentives for pushing
PBM compensation in Medicare? expensive drugs.
What must PBMs do with drug They must give 100% of the rebates back to the
rebates under the 2026 legislation? employer or the patient.
ACA, Legislation, and Future Policies Exam |
Questions with 100% Correct Answers | Verified |
Latest Update 2026
Save
Terms in this set (48)
What is the Federal Poverty Level A measure of income level issued annually by the
(FPL)? federal government used to determine eligibility
for certain programs and subsidies.
How do you calculate the income Multiply the base FPL income by the desired
threshold for a specific percentage percentage (e.g., $15,960 x 1.38 = $22,025).
of the FPL?
What is the primary purpose of To extend insurance coverage to low-income
Medicaid expansion under the ACA? adults under 65 with incomes up to 138% of the
FPL.
, How does the federal government By providing an enhanced federal match, covering
incentivize states to expand 90% of the costs compared to the traditional 50-
Medicaid? 77% match.
What are three common political Political branding through viral moments, info
tactics used by members of dumping in hearings, and leveraging public
Congress regarding healthcare? pressure.
What are hospitals required to post Negotiated rates with each insurer, cash prices,
online under price transparency and shoppable services in a consumer-friendly
laws? format.
What are insurers required to Online price comparison tools that show out-of-
provide under price transparency pocket costs for all services before care is
rules established in 2020? received.
What is the out-of-pocket cap for $2,100 per year.
Medicare prescription drugs under
the Inflation Reduction Act?
What is the monthly insulin cap for $35 per month.
Medicare beneficiaries?
What is a Pharmacy Benefit Manager A middleman that sits between drug companies,
(PBM)? insurance plans, and pharmacies.
How did the Consolidated It mandates a flat fee instead of a percentage of
Appropriations Act of 2026 change the drug's price to remove incentives for pushing
PBM compensation in Medicare? expensive drugs.
What must PBMs do with drug They must give 100% of the rebates back to the
rebates under the 2026 legislation? employer or the patient.
