1. Which of the following is the primary purpose of the Affordable
Care Act (ACA) in relation to health insurance in the U.S.
A) To reduce the overall cost of health insurance premiums for all
individuals
B) To make health insurance more affordable and accessible for
individuals
C) To eliminate private health insurance companies
D) To provide free healthcare services to all U.S. citizens
Answer: B) To make health insurance more affordable and accessible
for individuals
Rationale: The ACA aimed to make health insurance more affordable
and accessible for individuals, particularly by expanding Medicaid,
creating health insurance marketplaces, and providing subsidies for low-
income individuals. It did not aim to eliminate private insurance or
provide free services for all citizens.
2. Which of the following is considered a "Marketplace" plan under
the Affordable Care Act (ACA)?
A) Medicaid
B) Medicare
C) Health insurance purchased through a state-based or federal
exchange
D) Employer-sponsored health insurance
Answer: C) Health insurance purchased through a state-based or
federal exchange
Rationale: A "Marketplace" plan refers to health insurance purchased
through the ACA exchanges, which are either state-based or the federal
,HealthCare.gov. These plans are designed for individuals who do not
have access to employer-sponsored insurance and meet certain
eligibility criteria for subsidies.
3. What is the primary function of the risk adjustment program under
the ACA?
A) To prevent insurance companies from overcharging high-risk
individuals
B) To ensure health insurance companies are not profiting from high-
risk individuals
C) To balance the risk pool by redistributing funds among insurers based
on the health status of their enrollees
D) To provide direct subsidies to insurance companies
Answer: C) To balance the risk pool by redistributing funds among
insurers based on the health status of their enrollees
Rationale: The risk adjustment program is designed to ensure that
health insurance companies that enroll a higher proportion of high-risk
individuals (i.e., people with greater health care needs) receive
compensation to prevent them from facing financial difficulties. This
aims to create a more balanced and stable insurance market.
4. Under the ACA, what is the "individual mandate"?
A) A requirement for individuals to purchase health insurance or pay a
penalty
B) A requirement for employers to provide health insurance to their
employees
,C) A program that gives subsidies to all individuals regardless of income
D) A regulation that limits the amount of healthcare one can use
Answer: A) A requirement for individuals to purchase health insurance
or pay a penalty
Rationale: The individual mandate, which was a key feature of the ACA,
required most Americans to have health insurance or face a penalty
(although the penalty was effectively eliminated by the Tax Cuts and
Jobs Act in 2017 for most states). The goal was to encourage a broad,
healthy risk pool in the insurance market.
5. Which of the following is a feature of the Medicare Advantage (Part
C) program?
A) It provides coverage for hospital care only
B) It is provided directly through the federal government without third-
party involvement
C) It is a private insurance plan that replaces Original Medicare
D) It covers prescription drugs only
Answer: C) It is a private insurance plan that replaces Original
Medicare
Rationale: Medicare Advantage (Part C) is a private health insurance
plan approved by Medicare that replaces Original Medicare (Part A and
Part B). It typically offers additional benefits like dental, vision, and
prescription drug coverage. It is an alternative to the traditional
government-managed Medicare plan.
6. Which of the following is the maximum annual out-of-pocket limit
for Essential Health Benefits under the ACA for an individual in 2024?
, A) $1,500
B) $4,200
C) $8,550
D) $10,000
Answer: C) $8,550
Rationale: Under the ACA, the maximum annual out-of-pocket limit for
individual coverage for Essential Health Benefits in 2024 is $8,550. This
limit is meant to cap the amount an individual has to pay out of pocket
for covered services in a given year, excluding premiums.
7. What is the purpose of a Health Savings Account (HSA)?
A) To help individuals save money for medical expenses with tax
advantages
B) To reduce the cost of health insurance premiums
C) To reimburse employers for employee medical costs
D) To provide a one-time payment for emergency medical procedures
Answer: A) To help individuals save money for medical expenses with
tax advantages
Rationale: A Health Savings Account (HSA) allows individuals with high-
deductible health plans to save money for qualified medical expenses.
Contributions to an HSA are tax-deductible, and withdrawals for eligible
expenses are tax-free, providing a financial benefit for those saving for
healthcare costs.
8. Which of the following is true about Medicaid eligibility under the
ACA?
Care Act (ACA) in relation to health insurance in the U.S.
A) To reduce the overall cost of health insurance premiums for all
individuals
B) To make health insurance more affordable and accessible for
individuals
C) To eliminate private health insurance companies
D) To provide free healthcare services to all U.S. citizens
Answer: B) To make health insurance more affordable and accessible
for individuals
Rationale: The ACA aimed to make health insurance more affordable
and accessible for individuals, particularly by expanding Medicaid,
creating health insurance marketplaces, and providing subsidies for low-
income individuals. It did not aim to eliminate private insurance or
provide free services for all citizens.
2. Which of the following is considered a "Marketplace" plan under
the Affordable Care Act (ACA)?
A) Medicaid
B) Medicare
C) Health insurance purchased through a state-based or federal
exchange
D) Employer-sponsored health insurance
Answer: C) Health insurance purchased through a state-based or
federal exchange
Rationale: A "Marketplace" plan refers to health insurance purchased
through the ACA exchanges, which are either state-based or the federal
,HealthCare.gov. These plans are designed for individuals who do not
have access to employer-sponsored insurance and meet certain
eligibility criteria for subsidies.
3. What is the primary function of the risk adjustment program under
the ACA?
A) To prevent insurance companies from overcharging high-risk
individuals
B) To ensure health insurance companies are not profiting from high-
risk individuals
C) To balance the risk pool by redistributing funds among insurers based
on the health status of their enrollees
D) To provide direct subsidies to insurance companies
Answer: C) To balance the risk pool by redistributing funds among
insurers based on the health status of their enrollees
Rationale: The risk adjustment program is designed to ensure that
health insurance companies that enroll a higher proportion of high-risk
individuals (i.e., people with greater health care needs) receive
compensation to prevent them from facing financial difficulties. This
aims to create a more balanced and stable insurance market.
4. Under the ACA, what is the "individual mandate"?
A) A requirement for individuals to purchase health insurance or pay a
penalty
B) A requirement for employers to provide health insurance to their
employees
,C) A program that gives subsidies to all individuals regardless of income
D) A regulation that limits the amount of healthcare one can use
Answer: A) A requirement for individuals to purchase health insurance
or pay a penalty
Rationale: The individual mandate, which was a key feature of the ACA,
required most Americans to have health insurance or face a penalty
(although the penalty was effectively eliminated by the Tax Cuts and
Jobs Act in 2017 for most states). The goal was to encourage a broad,
healthy risk pool in the insurance market.
5. Which of the following is a feature of the Medicare Advantage (Part
C) program?
A) It provides coverage for hospital care only
B) It is provided directly through the federal government without third-
party involvement
C) It is a private insurance plan that replaces Original Medicare
D) It covers prescription drugs only
Answer: C) It is a private insurance plan that replaces Original
Medicare
Rationale: Medicare Advantage (Part C) is a private health insurance
plan approved by Medicare that replaces Original Medicare (Part A and
Part B). It typically offers additional benefits like dental, vision, and
prescription drug coverage. It is an alternative to the traditional
government-managed Medicare plan.
6. Which of the following is the maximum annual out-of-pocket limit
for Essential Health Benefits under the ACA for an individual in 2024?
, A) $1,500
B) $4,200
C) $8,550
D) $10,000
Answer: C) $8,550
Rationale: Under the ACA, the maximum annual out-of-pocket limit for
individual coverage for Essential Health Benefits in 2024 is $8,550. This
limit is meant to cap the amount an individual has to pay out of pocket
for covered services in a given year, excluding premiums.
7. What is the purpose of a Health Savings Account (HSA)?
A) To help individuals save money for medical expenses with tax
advantages
B) To reduce the cost of health insurance premiums
C) To reimburse employers for employee medical costs
D) To provide a one-time payment for emergency medical procedures
Answer: A) To help individuals save money for medical expenses with
tax advantages
Rationale: A Health Savings Account (HSA) allows individuals with high-
deductible health plans to save money for qualified medical expenses.
Contributions to an HSA are tax-deductible, and withdrawals for eligible
expenses are tax-free, providing a financial benefit for those saving for
healthcare costs.
8. Which of the following is true about Medicaid eligibility under the
ACA?
