Like it or not, these days you can’t avoid talk of health care reform. That’s because on Tuesday, the states roll out their new health insurance exchanges, a key piece of the Affordable Care Act. So whether you’ve been meticulously tracking the details of Obamacare, or have passively allowed the news stories and TV, radio and online ads wash over you, take our quiz and see how you rate! (Answers are at the end of the quiz.)
1. How long is the open enrollment for the new insurance exchanges?
a. 3 months, Oct. 1 to Jan. 1, 2014.
b. 6 months, Oct. 1 to Mar. 31, 2014.
c. 1 year, beginning Oct. 1.
d. It never closes.
2. Who will be penalized if they are uninsured and don’t buy insurance?
a. Medicare recipients.
b. Native Americans.
c. Prison inmates.
d. College students.
e. All of the above.
3. The Affordable Care Act requires insurance plans do all of the following except:
a. Allow you to go to any doctor and hospital that you want.
b. Cannot deny coverage based on pre-existing conditions.
c. Pays for preventive care including mammograms, colonscopies and flu shots, with no cost sharing.
d. Cannot impose annual or lifetime coverage limits.
e. Must limit out-of-pocket costs.
4. Who is eligible for financial help paying for health insurance?
a. A family of four earning up to $120,200.
b. Undocumented immigrants.
c. Individuals earning up to $45,950.
d. Those under age 30 buying a “catastrophic” plan.
5. Which businesses must buy insurance for their employees beginning in 2014?
a. Those with 50 or more full-time equivalent employees.
b. Those with a gross income of $500,000 or more.
c. Those unwilling to pay a per-employee fine.
d. None of the above.
6. True or false: If lawmakers don’t pass funding legislation and the federal government shuts down, the insurance exchanges will not open Tuesday and the Affordable Care Act will be defeated.
7. True or false: You must buy your insurance from within the state’s exchange if you want to take advantage of any subsidies.
8. True or false: All insurance plans must pay for maternity care, including devices called breast pumps that help nursing mothers.
9. True or false: The Affordable Care Act requires all hospital gowns to reach mid thigh and include at least three ties for sufficient closure, or the institution faces a per-gown fine.
10. True or false: “Obamacare” is a term of endearment originally bestowed by ACA supporters who believe President Obama wants everyone to be healthy.
1. b. The exchange is open extra long during this first enrollment period. It reopens again in later 2014 from Oct. 15 to Dec. 7, and during these same dates in years following.
2. d. College students do need insurance, which they often can get through school, and the law now allows parents to include their kids on their insurance plans until they’re 26. Other folks exempt from purchasing insurance include Medicaid recipients, those covered by military and veteran plans, people opposed to insurance and health care for religious reasons, undocumented immigrants, and certain low-income residents.
3. a. If you have a doctor, clinic or hospital that you really love, check to make sure they’re part of the plan you want to purchase because they will limit the docs and places they’ll cover.
4. c. A family of four can earn up to $94,200 and likely still qualify for subsidies.
5. d. The “employer mandate” was delayed until 2015, when companies with 50 or more full time workers will need to provide insurance coverage or pay a fine.
6. False. Much of the money needed to launch the insurance exchanges has already been spent, and most of the programs are paid for with “mandatory funding” not tied to the current spending debate.
7. True. Insurance coverage will be available “outside” of the exchange, but it won’t qualify for benefits that reduce premiums.
8. True. There’s a long list of benefits that insurance now must cover — remember that the official title of the new law is the “Patient Protection and Affordable Care Act” so these provisions fall under the Patient Protection idea of the reform. Plans inside and out of the exchange must cover: ambulatory patient services, emergency services, hospitalization, maternity and newborn care, mental health and treatment of substance abuse disorders, including behavioral health treatment, prescription drugs, rehabilitative services and devices, laboratory services, preventive and wellness services and chronic disease management, pediatric services, including oral and vision care.
9. False. Maybe this will show up in future reforms, but it ain’t likely.
How many did you get right?
10, a perfect score: Grab your lollipop from the receptionist, and congrats.
7 to 9 correct: ‘Tis only a flesh wound. You’ll survive, and now you know better how the ACA works.
4 to 6 correct: Carefully read the Times’ handy user’s guide and call me in the morning.
2 to 3 correct: Update your will and inform your next of kin — your prognosis is not good.
0-1 correct answer: You really missed the hospital gown and/or the Obamacare question? You are declared DOA!