Healthcare Debate Vocab 2026-2027

Yay!

Deductible

Amount you pay out of pocket before insurance starts covering costs

Premium

The regular fee, monthly fee you pay to have insurance

Subsidy

Government financial aid to lower your premium or other costs, usually based on income

Medicare

Federal insurance for people 65+ or with certain disabilities

Medicaid

State/federal insurance for low-income individuals

Administrative Costs

Money spent on billing, paperwork, and running the insurance/healthcare system rather than actual patient care

Copayment (Copay)

A fixed fee you pay per visit or service (e.g., $25 per doctor visit)

Healthcare Provider

Any person or place giving you medical care (doctor, hospital, clinic, etc.)

Out-of-Pocket Costs

All the money you personally pay for care (deductibles + copays + coinsurance, etc.)

Primary Care

Your regular, general care for everyday health needs

Preventative Care

Care aimed at stopping illness before it starts (screenings, vaccines, checkups)

Doctor’s Reimbursement Rate

How much a doctor actually gets paid by insurance for providing a service for someone

Penalty

A fine for not having insurance or breaking plan rules (less common now, but still applies in some cases/states)

Exchange/Health Insurance Marketplace

An online service in every state that helps people shop for and enroll in health insurance

Fee-For-Service

A health care payment model where providers are paid for the number of services delivered - it incentivizes service volume rather than quality of care or outcomes

Global Budgeting

A healthcare payment model where a hospital, health system, or entire region is given a fixed amount of $ to cover all services for a year. That single, lump-sum budget makes it hard to raise costs!

Public Option

A proposal to offer an insurance plan by the government alongside private insurance, typically through the exchange

High Deductible Healthcare Plans

Health insurance plans with higher deductibles and lower premiums than traditional plans - when they need it, people pay more out of pocket before insurance steps in

Private Healthcare

Care run by independent, usually for-profit companies funded by private insurance or out-of-pocket payments

Public Healthcare

Care funded and managed by the government using tax dollars

Out-Of-Pocket Maximum

The absolute most you will have to pay in deductibles, co-payments, and coinsurance in a single year before your plan covers the rest! - a safety net depending on your plan