The Affordable Care Act includes provisions that Select one: a. set limits on me

Question

The Affordable Care Act includes provisions that

Select one:

a. set limits on medical loss ratios (80% or 85%) for health insurance plans.

b. allow health insurance premium rates to vary only by individual or family coverage, geographic rating area, age, or tobacco use.

c. mandate that U.S. citizens have health insurance coverage with only a few exceptions.

d. All of the above

Adverse selection may be a problem in the Affordable Care Act if

Select one:

a. health insurance premiums reflect only the quality of the health plan.

b. risk adjustment is used to redistribute premium dollars across health plans in an exchange.

c. healthy and unhealthy individuals are equally likely to enroll in health plans in a state health insurance exchange.

d. consumers enroll in a health plan only when they need health care.

In the article “Big Med”, Atul Gawande argues that

Select one:

a. generally, health care providers across the U.S. currently provide customized care.

b. health care providers operate very much like the Cheesecake Factory in terms of standardization.

c. health care providers will never be able to standardize care to become more efficient.

d. generally, health care providers across the U.S. currently provide standardized care.

Explanation / Answer

1) Solution: all of the above

Explanation: The Affordable Care Act requires that insurance companies at least spend 80% or 85% of premium dollars on medical care where premium rates vary.

2) Solution: consumers enroll in a health plan only when they need health care

Explanation: Adverse selection predicts that people with lower health status would be more likely enroll for health insurance

3) Solution: health care providers operate very much like the Cheesecake Factory in terms of standardization.

Explanation: Accordng to the article "Big Med" by Atul Gawande

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