Patient Protection and Affordable Care Act Overview

These flashcards cover key topics and issues related to the Patient Protection and Affordable Care Act (ACA), including risk management strategies, the importance of universal coverage, and challenges faced by the ACA.

What does the Patient Protection and Affordable Care Act focus on regarding health insurance?

It aims to ensure universal coverage and prevent issues related to experience rating.

What are the two strategies for balancing risks in health insurance?

1. Hike rates for high-risk cases or eliminate them from the pool. 2. Increase low-risk individuals in the risk pool.

What are the components of experience rating as a risk balancing strategy?

Higher rates for high-risk individuals and the elimination of the highest risk cases.

What is universal coverage under the ACA designed to avoid?

Denial of insurance for pre-existing conditions, cancellation of insurance due to chronic illness, lifetime limits, and increased costs based on risk.

What was one significant trouble faced by the ACA in December 2014?

Defunding of risk corridors.

What impact did the repeal of the individual mandate in December 2017 have on insurance coverage?

An estimated 13 million less insured by 2027 and a 10% increase in ACA compliant premiums.

What did the February 2018 proposed regulation aim to change regarding short-term insurance policies?

It aimed to extend the duration of short-term limited-duration policies from a maximum of 3 months to 1 year.

What was the result of the Texas v United States case filed by 20 state Attorneys General?

It sought to either rule the ACA unconstitutional or at least strike down guaranteed issuance and community rating.

What percentage of the US population aged 18-64 has some pre-existing condition according to the KFF study 2015?

27% of the US populace aged 18-64 has some pre-existing condition.

What was the situation regarding pre-existing conditions before the ACA in 2010?

42% of adults aged 50-64 seeking insurance were either denied, faced higher premiums, or had conditions exempted from coverage.