Chapter 26 – Health Care Reform: The Patient Protection and Affordable Care Act
Chapter 26 Health Care Reform: The Patient Protection and Affordable
Care Act
Multiple Choice
1. Prior to the passage of the Patient Protection and Affordable Care Act which of the following
was illegal
A) an insurance company cutting off children at 18.
B) charging more to insure a person with a previous history of cancer.
C) charging more for women than men.
D) stopping payment on a bill once a person gets sick.
2. Prior to the passage of the Patient Protection and Affordable Care Act which of the following
was illegal
A) an insurance company cutting off children at 18.
B) setting of annual limits on coverage.
C) setting of lifetime limits on coverage.
D) stopping payment on a bill once a person gets sick.
3. After the passage of the Patient Protection and Affordable Care Act which of the following
was illegal
A) setting of annual limits on coverage.
B) setting of lifetime limits on coverage.
C) charging more for women than men.
D) all of the options are correct.
4. After the passage of the Patient Protection and Affordable Care Act which of the following
was illegal
A) an insurance company cutting off children at 18.
B) charging more to insure a person with a previous history of cancer.
C) charging more for women than men.
D) all of the options are correct.
Chapter 26 – Health Care Reform: The Patient Protection and Affordable Care Act
5. Before the passage of the Patient Protection and Affordable Care Act the age at which a
person could no longer be guaranteed health insurance coverage on a dependent child was
A) 16.
B) 18.
C) 23.
D) 26.
6. After the passage of the Patient Protection and Affordable Care Act the age at which a person
could no longer be guaranteed health insurance coverage on a dependent child was
A) 16.
B) 18.
C) 23.
D) 26.
7. After the passage of the Patient Protection and Affordable Care Act a woman
A) had to be charged more for insurance than a man.
B) could be charged more for insurance than a man.
C) had to be charged the same for insurance as a man.
D) could be charged less for insurance than a man.
8. Before the passage of the Patient Protection and Affordable Care Act a woman
A) had to be charged more for insurance than a man.
B) could be charged more for insurance than a man.
C) had to be charged the same for insurance as a man.
D) had to be charged less for insurance than a man.
9. Before the passage of the Patient Protection and Affordable Care Act a sick person
A) Had to be charged more for insurance than a healthy person
B) Could be charged more for insurance than a healthy person
C) Had to be charged the same for insurance as a healthy person.
D) Had to be charged less for insurance than a healthy person.
Chapter 26 – Health Care Reform: The Patient Protection and Affordable Care Act
10. After the passage of the Patient Protection and Affordable Care Act a sick person
A) had to be charged more for insurance than a healthy person.
B) could be charged more for insurance than a healthy person.
C) had to be charged the same for insurance as a healthy person.
D) had to be charged less for insurance than a healthy person.
11. Before the passage of the Patient Protection and Affordable Care Act a cancer survivor
A) had to be charged more for insurance than anyone else.
B) could be charged more for insurance than anyone else.
C) had to be charged the same for insurance as anyone else.
D) had to be charged less for insurance than anyone else.
12. After the passage of the Patient Protection and Affordable Care Act a cancer survivor
A) had to be charged more for insurance than anyone else.
B) could be charged more for insurance than anyone else.
C) had to be charged the same for insurance as anyone else.
D) had to be charged less for insurance than anyone else.
13. Before the passage of the Patient Protection and Affordable Care Act
A) annual limits on how much the insurance company would pay were illegal.
B) annual limits on how much the insurance company would pay were required.
C) annual limits on how much the insurance company would pay were legal but not
required.
D) no insurance company even considered imposing annual limits.
14. After the passage of the Patient Protection and Affordable Care Act
A) annual limits on how much the insurance company would pay were illegal.
B) annual limits on how much the insurance company would pay were required.
C) annual limits on how much the insurance company would pay were legal but not
required.
D) no insurance company even considered imposing annual limits.
Chapter 26 – Health Care Reform: The Patient Protection and Affordable Care Act
15. Before the passage of the Patient Protection and Affordable Care Act
A) lifetime limits on how much the insurance company would pay were illegal.
B) lifetime limits on how much the insurance company would pay were required.
C) lifetime limits on how much the insurance company would pay were legal but not
required.
D) no insurance company even considered imposing lifetime limits.
16. After the passage of the Patient Protection and Affordable Care Act
A) lifetime limits on how much the insurance company would pay were illegal.
B) lifetime limits on how much the insurance company would pay were required.
C) lifetime limits on how much the insurance company would pay were legal but not
required.
D) no insurance company even considered imposing lifetime limits.
17. Before the passage of the Patient Protection and Affordable Care Act
A) premiums were limited by the Department of Health and Human Services.
B) premium increases were limited by the Department of Health and Human Services.
C) premiums were set by the Department of Health and Human Services.
D) there were no limits on health insurance premiums.
18. After the passage of the Patient Protection and Affordable Care Act
A) premiums were limited by the Department of Health and Human Services.
B) premium increases were limited by the Department of Health and Human Services.
C) premiums were set by the Department of Health and Human Services.
D) there were no limits on health insurance premiums.
19. Before the passage of the Patient Protection and Affordable Care Act
A) the proportion of premiums going to profit and administrative costs were limited by the
Department of Health and Human Services.
B) increases in the proportion of premiums going to profit and administrative costs were
limited by the Department of Health and Human Services.
C) the proportion of premiums going to profit and administrative costs were set by the
Department of Health and Human Services.
D) there were no limits the proportion of premiums going to profit and administrative costs.
Chapter 26 – Health Care Reform: The Patient Protection and Affordable Care Act
20. After the passage of the Patient Protection and Affordable Care Act
A) the proportion of premiums going to profit and administrative costs were limited by the
Department of Health and Human Services.
B) increases in the proportion of premiums going to profit and administrative costs were
limited by the Department of Health and Human Services.
C) the proportion of premiums going to profit and administrative costs were set by the
Department of Health and Human Services.
D) there were no limits the proportion of premiums going to profit and administrative costs.
21. The passage of the Patient Protection and Affordable Care Act resulted in many changes to
the way in which insurance companies could charge customers. These changes
A) made everyone pay less than they would have.
B) made everyone pay more than they would have.
C) simply shifted the costs from one group to another.
D) dramatically lowered insurance company profits leading to many to declare bankruptcy.
22. If a health economist is worried that a system of health insurance will break down because,
when combined with policies outlawing the use of an individual’s health information in
setting coverage and rates, the sickest will be the only one who will want insurance and the
healthiest will go without insurance, that economist is focused on the problem of
A) moral hazard.
B) adverse selection.
C) mandation.
D) lack of universal coverage.
23. If a health economist is worried that a system of health insurance will break down because of
the problem of adverse selection, that economist may focus on ____ as a solution to that
problem.
A) moral hazard.
B) eliminating pre-existing condition clauses.
C) mandation.
D) lowering insurance premiums.
Chapter 26 – Health Care Reform: The Patient Protection and Affordable Care Act
24. The Patient Protection and Affordable Care Act requires that after 2014
A) employers provide health insurance.
B) employers and employees share in the cost of health insurance.
C) individuals maintain health insurance.
D) government provide Medicare for everyone.
25. The Patient Protection and Affordable Care Act includes an employer mandate
A) True
B) False
26. The Patient Protection and Affordable Care Act includes an individual mandate
A) True
B) False
27. After the passage of the Patient Protection and Affordable Care Act insurance companies can
A) charge higher premiums for mental health care than for other forms of care.
B) charge older individuals more than younger ones.
C) deny coverage to certain religious groups.
D) charge higher premiums to individuals based on their drug arrests.
28. After the passage of the Patient Protection and Affordable Care Act insurance companies can
A) charge higher premiums for mental health care than for other forms of care.
B) charge tobacco users up to 50% higher premiums than non-tobacco users.
C) deny coverage to certain religious groups.
D) charge higher premiums to individuals based on their drug arrests.
29. After the passage of the Patient Protection and Affordable Care Act insurance companies can
A) charge higher premiums for mental health care than for other forms of care.
B) charge higher premiums to larger families more than smaller ones.
C) deny coverage to certain religious groups.
D) charge higher premiums to individuals based on their drug arrests.
Chapter 26 – Health Care Reform: The Patient Protection and Affordable Care Act
30. After the passage of the Patient Protection and Affordable Care Act insurance companies can
A) charge higher premiums for mental health care than for other forms of care.
B) charge higher premiums to people living in Florida than people living in Oregon.
C) deny coverage to certain religious groups.
D) charge higher premiums to individuals based on their drug arrests.
31. After the passage of the Patient Protection and Affordable Care Act, which of the following
insurance premium schemes would be illegal?
A) Charging tobacco users $1,000 per month and non-tobacco users $700 per month.
B) Charging residents of Oregon $1,000 per month and residents of Florida $700 per month.
C) Charging a family of five $1,000 per month and a family of three $900 per month.
D) Charging 60 year olds $2,500 per month and 20 year olds $700 per month.
32. After the passage of the Patient Protection and Affordable Care Act, which of the following
insurance premium schemes would be illegal?
A) Charging tobacco users $2,000 per month and non-tobacco users $700 per month.
B) Charging residents of Oregon $1,000 per month and residents of Florida $700 per month.
C) Charging a family of five $1,000 per month and a family of three $900 per month.
D) Charging 60 year olds $2,500 per month and 20 year olds $1,000 per month.
33. After the passage of the Patient Protection and Affordable Care Act, which of the following
insurance types was made illegal (except by waiver)?
A) HMOs
B) PPOs
C) Mini-meds
D) Fee for service plans
34. After the passage of the Patient Protection and Affordable Care Act, Medicaid will cover
A) everyone in any household.
B) anyone in any household earning less than 133% of the poverty line.
C) only children in households earning less than 133% of the poverty line.
D) only children in households earning less than 200% of the poverty line.
Chapter 26 – Health Care Reform: The Patient Protection and Affordable Care Act
35. After the passage of the Patient Protection and Affordable Care Act, which of the following
changed?
A) Qualifications for Medicaid
B) Medicare Advantage
C) Laws regarding private insurance
D) All of the options are correct
36. After the passage of the Patient Protection and Affordable Care Act, how did Medicaid
change?
A) It became less costly to the government.
B) It became more costly to the government.
C) It became easier for hospitals to deny coverage to Medicaid patients.
D) Insurance companies became free from most regulation.
37. After the passage of the Patient Protection and Affordable Care Act, which of the following
occurred with regard to Medicare?
A) The part D donut hole increased.
B) The part D donut hole was eliminated.
C) The effect of the part D donut hole was mitigated by rebate checks.
D) A donut hole in part D was created.
38. After the passage of the Patient Protection and Affordable Care Act, which of the following
occurred with regard to Medicare?
A) Medicare Advantage was enhanced.
B) Medicare Advantage was restricted and will likely be eventually eliminated.
C) Medicare Advantage was created.
D) Medicare Advantage was immediately eliminated.
39. After the passage of the Patient Protection and Affordable Care Act, which of the following
occurred with regard to Medicare part D?
A) Prescription Drug prices (on all drugs) paid by part D to manufacturers was increased.
B) Prescription Drug prices (on branded drugs) paid by part D to manufacturers was
increased.
C) Prescription Drug prices (on all drugs) paid by part D to manufacturers was decreased.
D) Prescription Drug prices (on branded drugs) paid by part D to manufacturers was
decreased.
Chapter 26 – Health Care Reform: The Patient Protection and Affordable Care Act
40. After the passage of the Patient Protection and Affordable Care Act, which of the following
occurred with regard to Medicare?
A) Physicians were encouraged to form groups to build new hospitals to serve Medicare
patients.
B) Physicians were forbidden from forming new groups to build new hospitals to serve
Medicare patients.
C) Physician owned hospitals were forbidden from billing Medicare.
D) Physician owned hospitals were required to sell their assets to the government.
41. After the passage of the Patient Protection and Affordable Care Act, which of the following
occurred with regard to Medicare?
A) Physicians were encouraged to counsel patients near the end of their life on their
alternatives.
B) Physicians were discouraged to counsel patients near the end of their life on their
alternatives.
C) Physicians were banned from counseling patients near the end of their life on their
alternatives.
D) Government employees were hired to pressure patients near the end of their life to
terminate their care.
42. The Patient Protection and Affordable Care Act, for purposes of determining whether an
employer was “large” the rule was if the employer had which of the following occurred with
regard to Medicare?
A) 25 employees
B) 50 employees
C) 50 full time employees
D) 100 full time employees
43. Under the Patient Protection and Affordable Care Act, if a large employer does not provide
health insurance to their employees they
A) are subject to fines.
B) are subject to jail time.
C) face no consequences.
D) have tax credits removed for other portions of their operations.
Chapter 26 – Health Care Reform: The Patient Protection and Affordable Care Act
44. Under the Patient Protection and Affordable Care Act, a large employer that provides health
insurance may compel their employees to pay
A) $400.
B) no more than 40% of the total cost of their care and not more than the maximum allowed
under health savings accounts.
C) the entire cost of the insurance.
D) for no part of the insurance.
45. Under the Patient Protection and Affordable Care Act, a large employer that fails to provide
health insurance owes a fine equal to
A) $2000 per employee or $3000 per employee who gets insurance through a subsidized
state exchange, whichever is lower.
B) $2000 per employee or $3000 per employee who gets insurance through a subsidized
state exchange, whichever is higher.
C) $2000 per employee.
D) $3000 per employee who gets insurance through a subsidized state exchange.
46. Under the Patient Protection and Affordable Care Act, if you are an employer that has fewer
than the number that defines being a large employer it is clearly
A) in your best interest to hire enough employees to become a large employer because you
get a subsidy to provide health insurance.
B) in your best interest to hire enough employees to become a large employer because you
are then required to provide health insurance.
C) not in your best interest to hire enough employees to become a large employer because
you would then be required to provide health insurance.
D) not in your best interest to hire enough employees to become a large employer because
you would then be required to provide health insurance or pay a fine.
47. Under the Patient Protection and Affordable Care Act, if you are an individual seeking
insurance because your employer does not offer it you can buy it through
A) Medicare.
B) Medicaid.
C) a federally created exchange.
D) a state-run exchange.
Chapter 26 – Health Care Reform: The Patient Protection and Affordable Care Act
48. Under the Patient Protection and Affordable Care Act, the exchanges created to allow the
uninsured to buy insurance at an affordable price
A) included non-profit options.
B) included a public option (buying into Medicaid for instance).
C) were created using state money.
D) were operated by the federal government.
49. Under the Patient Protection and Affordable Care Act, the exchanges created to allow the
uninsured to buy insurance at an affordable price
A) were created using federal money.
B) included a public option (buying into Medicaid for instance).
C) were created using state money.
D) were operated by the federal government.
50. Under the Patient Protection and Affordable Care Act, the exchanges created to allow the
uninsured to buy insurance at an affordable price
A) were operated by state governments.
B) included a public option (buying into Medicaid for instance).
C) were created using state money.
D) were operated by the federal government.
51. Under the Patient Protection and Affordable Care Act, an individual without health
insurance
A) could be jailed unless they purchased it.
B) were provided it through a public option.
C) could be fined twice the cost of the insurance.
D) were fined up to $695 or 2.5% of their income, whichever is smaller.
52. Which of the following taxes were included under the Patient Protection and Affordable Care
Act,
A) a 10% tax on indoor tanning.
B) an across the board sales tax.
C) an across the board payroll tax.
D) a one-percentage point increase in all taxes.
Chapter 26 – Health Care Reform: The Patient Protection and Affordable Care Act
53. Which of the following taxes were included under the Patient Protection and Affordable
Care Act,
A) a tax on drug companies.
B) an across the board sales tax.
C) an across the board payroll tax.
D) a one-percentage point increase in all taxes.
54. Which of the following taxes were included under the Patient Protection and Affordable Care
Act,
A) a tax on medical device companies.
B) an across the board sales tax.
C) an across the board payroll tax.
D) a one-percentage point increase in all taxes.
55. Which of the following taxes were included under the Patient Protection and Affordable Care
Act,
A) a surtax on high incomes.
B) an across the board sales tax.
C) an across the board payroll tax.
D) a one-percentage point increase in all taxes.
56. Which of the following taxes were included under the Patient Protection and Affordable Care
Act,
A) a tax on unearned income above $200,000.
B) an across the board sales tax.
C) an across the board payroll tax.
D) a one-percentage point increase in all taxes.
57. Which of the following taxes were included under the Patient Protection and Affordable Care
Act,
A) A limit on the deductibility on salaries paid to insurance company executives.
B) an across the board sales tax.
C) an across the board payroll tax.
D) a one-percentage point increase in all taxes.
58. Under the Patient Protection and Affordable Care Act, the medical device tax is legally
imposed on medical device companies,
A) but the economic incidence falls on consumers.
B) and the economic incidence falls on those medical device companies.
Chapter 26 – Health Care Reform: The Patient Protection and Affordable Care Act
C) but the economic incidence will likely be shared equally between consumers and medical
device companies.
D) but the economic incidence will likely be borne mostly by Medicare itself since it would
fall on consumers but they have most of their bills paid by Medicare.
59. Under the Patient Protection and Affordable Care Act, health savings accounts are
A) eliminated.
B) greatly expanded.
C) can no longer be used for over-the-counter drugs without a prescription.
D) were left unaffected.
60. Under the Patient Protection and Affordable Care Act, health savings accounts are
A) eliminated.
B) greatly expanded.
C) limited to half their previous size.
D) were left unaffected.
61. Under the Patient Protection and Affordable Care Act, tax deductions to employers for post-
retirement drug benefits were
A) eliminated.
B) greatly expanded.
C) limited to half their previous size.
D) were left unaffected.
62. Under the Patient Protection and Affordable Care Act, which tax form will be altered to
include an employer report of health insurance
A) the W-2.
B) the W-4.
C) the 1099.
D) schedule B.
63. Under the Patient Protection and Affordable Care Act, large employers will be required to
assume that employees
A) want the health insurance that is being offered.
B) do not want the health insurance that is being offered.
C) are unhealthy, until they prove they are, in fact healthy.
D) want to pay their portion of premiums pre-tax.